Anabolic steroid induced hypogonadism treated with human chorionic gonadotropin.

A case is presented of a young competitive body-builder who abused anabolic steroid drugs and developed profound symptomatic hypogonadotrophic hypogonadism. With the help of prescribed testosterone (Sustanon) he stopped taking anabolic drugs, and later stopped Sustanon also. Hypogonadism returned, but was successfully treated with weekly injections of human chorionic gonadotropin for three months. Testicular function remained normal thereafter on no treatment. The use of human chorionic gonadotropin should be considered in prolonged hypogonadotrophic hypogonadism due to anabolic steroid abuse.     

嗜麦芽假单胞菌HCG结合蛋白（受体）配体印...

A ligand blotting technique was developed to study the HCG-binding protein from Pseudomonas maltophilia after size separation by SDS-polyacrylamide gel electrophoresis under nonreducing conditions. The separated proteins were transferred to a nitrocellulose sheet, which was subsequently incubated with [125I]iodo HCG, and subjected to determination for radioactivity in gamma-counter. A radioactivity peak equivalent to an M(r) 70000 appeared, which was not observed when the hormone incubation was performed in the presence of an excess of unlabeled HCG. The peak also disappeared when the protein samples were treated with reducing agent, which showed that integrity disulfide bonds of the protein was essential for the protein-hormone interaction. In addition, position of the radioactivity peak which was due to the binding of [125I]iodo HCG to western blots of the HCG-binding protein was corresponding to that of the antibodies against the HCG-binding protein recognizing a 70000 protein on the western blots. These results show that the HCG-binding protein from Pseudomonas maltophilia is an M(r) 70000 protein and that the HCG-binding protein contains at least one disulfide bond essential to its binding activity.     

Efficacy and safety of human chorionic gonadotropin combined with human menopausal gonadotropin and a gonadotropin-releasing hormone pump for male adolescents with congenital hypogonadotropic hypogonadism

Background:Compared to adult studies, studies which involve the treatment of pediatric congenital hypogonadotropic hypogonadism (CHH) are limited and no universal treatment regimen is available. The aim of this study was to evaluate the feasibility of human chorionic gonadotropin (hCG)/human menopausal gonadotropin (hMG) therapy for treating male adolescents with CHH.Methods:Male adolescent CHH patients were treated with hCG/hMG (n = 20) or a gonadotropin-releasing hormone (GnRH) pump (n = 21). The treatment was divided into a study phase (0–3 months) and a follow-up phase (3–12 months). The testicular volume (TV), penile length (PL), penis diameter (PD), and sex hormone levels were compared between the two groups. The TV and other indicators between the groups were analyzed using a t-test (equal variance) or a rank sum test (unequal variance).Results:Before treatment, there was no statistical difference between the two groups in terms of the biochemistry, hormones, and other demographic indicators. After 3 months of treatment, the TV of the hCG/hMG and GnRH groups increased to 5.1 ± 2.3 mL and 4.1 ± 1.8 mL, respectively; however, the difference was not statistically significant (P > 0.05, t = 1.394). The PL reached 6.9 ± 1.8 cm and 5.1 ± 1.6 cm (P < 0.05, t = 3.083), the PD reached 2.4 ± 0.5 cm and 2.0 ± 0.6 cm (P < 0.05, t = 2.224), respectively, in the two groups. At the end of 6 months of treatment, biomarkers were in normal range in the two groups. Compared with the GnRH group, the testosterone (T) level and growth of PL and PD were significantly greater in the hCG/hMG group (all P < 0.05). While the TV of both groups increased, the difference was not statistically significant (P > 0.05, t = 0.314). After 9 to 12 months of treatment, the T level was higher in the hCG/hMG group. Other parameters did not exhibit a statistical difference.Conclusions:The hCG/hMG regimen is feasible and effective for treating male adolescents with CHH. The initial 3 months of treatment may be a window to optimally observe the strongest effects of therapy. Furthermore, results from the extended time-period showed positive outcomes at the 1-year mark; however, the long-term effectiveness, strengths, and weaknesses of the hCG/hMG regimen require further research.Trial Registration:ClinicalTrials.gov, NCT02880280; https://clinicaltrials.gov/ct2/show/NCT02880280.     

Hypersensitivity reaction with intravenous GnRH after pulsatile subcutaneous GnRH treatment in male hypogonadotrophic hypogonadism

Chronic pulsatile subcutaneous administration of low doses of gonadotrophin releasing hormone (GnRH) is an effective therapy for men with hypogonadotrophic hypogonadism. Hypersensitivity reactions to GnRH are rare. We wish to report hypersensitivity reactions with intravenous GnRH after low dose subcutaneous pulsatile GnRH treatment in two men with hypogonadotrophic hypogonadism due to suprasellar disease.     

甲氨蝶呤对异位妊娠血清人绒毛膜促性腺激素高值患者的疗效及安全性

目的 探讨甲氨蝶呤在不同血清人绒毛膜促性腺激素（β-hCG）水平的异位妊娠患者中的疗效和安全性。方法 选取2019年1月—2020年10月海南现代妇女儿童医院收治的90例异位妊娠患者为研究对象。根据治疗前24 h的β-hCG水平将患者分为β-hCG高值组55例（β-hCG≥3 000 u/L）和β-hCG低值组35例（β-hCG <3 000 u/L）。所有患者给予甲氨蝶呤50 mg/m2肌内注射。比较两组治疗后的临床疗效、β-hCG水平恢复情况、异位妊娠包块消失情况及不良反应。结果 治疗7 d后β-hCG高值组临床总有效率高于β-hCG低值组（P <0.05）;治疗7 d后β-hCG高值组β-hCG恢复时间短于β-hCG低值组（P <0.05）,β-hCG水平低于β-hCG低值组（P <0.05）,异位妊娠包块消失时间短于β-hCG低值组（P <0.05）,异位妊娠包块直径小于β-hCG低值组（P <0.05）;两组总不良反应发生率比较,差异无统计学意义（P>0.05）。结论 相对于低值β-hCG患者,高值β-hCG异位妊娠患者接受甲氨蝶呤治...     

绒毛膜促性腺激素治疗儿童隐睾症172例临床疗效分析

目的观察绒毛膜促性腺激素治疗儿童隐睾症的临床有效性。方法采用绒毛膜促性腺激素（HCG）治疗172例隐睾症儿童,通过对年龄、隐睾单双侧和隐睾所在部位进行分层分析,临床评价治疗的有效性。结果应用HCG治疗双侧隐睾的疗效比单侧好,有效率分别为83.3%和51.5%,差异有统计学意义（P〈0.05）;生后3-5岁这个年龄段治疗效果是较好的,有效率达69.2%,与另外两个年龄段的治疗有效率相比,差异有统计学意义（P〈0.05）;低位隐睾包括腹股沟管内和外环口以外,有效率分别为58.5%和66.3%,而高位隐睾有效率仅为8%,三者差异有统计学意义（P〈0.05）。结论对于3-5岁之间、双侧和低位隐睾症的患儿选用HCG治疗有效,但对于雄激素受体数量和功能异常的患儿疗效差,应行手术治疗。     

人的正常卵巢及巢癌绒毛膜促性腺激素受体的研究

Human Chorionic Gonadotropin (HCG) is major physiological luteotropic factors for the human corpus luteum. The observations strongly suggest that the human ovary possesses a gonadotropin receptor in the cell membrane. We studied the HCG receptor in normal human ovary and ovarian tumors. Twenty-three human ovarian specimens and 16 ovarian tumor specimens were obtained from women patients having gynecological surgery. Ovaries were homogenized and sonicated. The homogenates were centrifuged at 2000 g for 15 min. After sucrose density gradient ultracentrifugation (78,000 g, 4 h), two fractions were collected from layer of 33% and interface between 33% and 37%. Thirty micrograms of ovarian protein, 8 ng 125I-HCG and unlabeled HCG in a final volume of 0.5 ml of 0.05 mol/L Tris buffer were incubated at 30 degrees C for 2 h. The results were shown in the table.     

HCG及PLF水平与胎儿发育迟缓的相关研究

目的探讨孕妇血浆绒毛膜促性腺激素（HCG）及胎盘异铁蛋白（PLF）水平与胎儿宫内发育迟缓（IUGR）发生、发展的关系。方法对晚孕早期（孕24—34周）最初正常的1802例孕妇，根据随访妊娠结局分为IUGR组（64例），用化学发光法进行血浆绒毛膜促性腺激素和胎盘异铁蛋白的水平测定，并与正常组（50例）对比分析。结果IUGR组p—HCG为（50．63±8．86）μg／L校正常组（18．76±3．69）μg/L明显升高；而PLF（242．76±43．69）mg／L低于正常组（716．95±82．63）mg／L，差异有统计学意义（P〈0．01）；绒毛膜促性腺激素与胎盘异铁蛋白水平呈负相关（r=-0．563，P〈0．01）。结论晚孕早期绒毛膜促性腺激素水平升高和胎盘异铁蛋白水平的降低与胎儿宫内发育迟缓的发生有密切关系。     

人绒毛膜促性腺激素宫腔灌注改善反复着床失败患者冻融胚胎的助孕结局

目的：研究胚胎移植前人绒毛膜促性腺激素(human chorionic gonadotropin,hCG)宫腔灌注是否改善反复着 床失败患者冻融胚胎移植的助孕结局。方法：采用前瞻性随机对照研究,纳入拟行复苏胚胎移植且符合反复着床失 败(repeated implantation failure,RIF)诊断、并排除其他因素(如子宫畸形、宫腔分粘术后、输卵管积液、内分泌疾病、 子宫内膜异位症)的患者140例,并将其通过计算机随机数字表随机分成hCG灌注组和对照组,两组患者的年龄、基础 日雌激素水平、移植胚胎数、优胚数、移植前子宫内膜厚度差异均无统计学意义(均P>0.05)。hCG灌注组和对照组分 别于胚胎移植日配制灌注液(分别为hCG+G2培养基液和G2培养基),分别于胚胎移植3 min前注入宫腔40 μL灌注液。 比较两组临床妊娠率、种植率是否存在差异。结果：hCG 灌注组的种植率和临床妊娠率均高于对照组(均P<0.05)。 结论：胚胎移植前宫腔灌注hCG可改善RIF患者冻融胚胎移植的着床率和临床妊娠率。     

早期自然流产中卵泡休止素的变化及与HCG的相关研究

目的:探讨早期自然流产中卵泡休止素(FS)的变化,比较其与人绒毛膜促性腺激素(HCG)有无相关性以及FS的高低与妊娠结局有无关系.方法:应用酶联免疫法对早期自然流产孕妇、正常早期妊娠孕妇血清FS进行测定,用放射免疫法对上述2组妊娠42～43 d的孕妇进行HCG测定.结果:早期自然流产孕妇组血清FS和HCG水平明显低于正常早期妊娠孕妇组(P＜0.01),保胎失败孕妇组血清FS水平明显低于保胎成功孕妇组(P＜0.01),FS与HCG的变化在早期自然流产及正常早期妊娠中均呈正相关.结论:血清FS水平的变化参与了早期妊娠的维持,FS减少容易引起早期自然流产,FS值的高低决定了早期自然流产的妊娠结局.     

子宫腔灌注人绒毛膜促性腺激素对多囊卵巢综合征患者植入窗期子宫内膜容受性的影响

目的探讨子宫腔灌注人绒毛膜促性腺激素(h CG)对多囊卵巢综合征(PCOS)患者植入窗期子宫内膜容受性的影响。方法选择2016年4月至2018年4月新乡医学院第三附属医院收治的已婚PCOS患者31例为研究对象,对患者的连续2个月经周期进行自身对照试验,第1个月经周期为对照周期,第2个月经周期为灌注周期,其中对照周期28例(3例因无排卵予以排除),灌注周期29例(2例因无排卵予以排除)。患者2个月经周期的第5～9天均给予来曲唑2. 5 mg,口服;从月经周期第10天开始,连续阴道超声卵泡监测直至排卵,分别于第2个月经周期的排卵前2日及排卵日子宫腔灌注h CG 500 IU(0. 5 m L)。于排卵后第6～8天(植入窗期)检测患者血清雌激素(E2)和黄体酮(P)水平,并使用一次性S型子宫腔组织吸引管抽取少许子宫内膜组织,S-3500N扫描电子显微镜下观察子宫内膜胞饮突发育情况。结果对照周期与灌注周期的植入窗期患者血清E2水平比较差异无统计学意义(t=0. 501,P>0. 05);灌注周期的植入窗期患者血清P水平显著高于对照周期(t=3. 193,P <0. 05)。对照周期和灌注周期有子宫内膜成熟胞饮突的患者分别为9例(32. 14%)、17例(58. 62%),灌注周期有成熟胞饮突患者比例显著高于对照周期(χ2=4. 032,P <0. 05)。结论 PCOS患者植入窗期胞饮突发育不良,宫腔灌注h CG可增加成熟胞饮突数量,提高血清P水平,改善子宫内膜容受性。     

阿托西班联合人绒毛膜促性腺激素宫腔灌注对不孕症患者妊娠结局的影响

目的 探讨阿托西班联合人绒毛膜促性腺激素(hCG)宫腔灌注对不孕症患者妊娠结局的影响.方法 选择2015年1月至2017年2月安徽医科大学附属妇幼保健院生殖中心胚胎着床失败2次或2次以上的患者121例,按随机数字表法分成A(39例)、B(40例)、C(42例)3组.其中,A组患者给予hCG宫腔灌注治疗,灌注后行冻融胚胎移植(F-ET)45个周期,B组患者静推阿托西班后,行F-ET44个周期,C组患者给予宫腔灌注联合阿托西班静推,后行F-ET45个周期.比较3组患者临床妊娠率、多胎妊娠率、着床率、流产率、异位妊娠率及活产率情况.结果 3组患者的胚胎着床率、活产率比较,差异有统计学意义(P<0.05).C组患者胚胎着床率(43.53％)高于A组(21.84％)和B组(31.76％),与A组比较,差异有统计学意义(χ2=9.212,P=0.002),与B组比较,差异无统计学意义(χ2=2.506,P=0.113);C组患者活产率(57.78％)高于A组(28.89％)和B组(45.45％),与A组相比,差异有统计学意义(χ2=7.647,P=0.006),与B组相比,差异无统计学意义(χ2=1.353,P=0.245).结论 F-ET前给予阿托西班静推联合hCG宫腔灌注可提高F-ET着床率和活产率.     

紫河车治疗早期先兆流产对人绒毛膜促性腺激素、孕酮含量的影响

目的:观察紫河车最细粉治疗先兆流产的临床疗效及对人绒毛膜促性腺激素(HCG)、孕酮(P)的影响。方法:成都中医药大学附属医院妇科病房先兆流产患者202例,随机分为两组,治疗组122例采用紫河车最细粉联合黄体酮保胎治疗,对照组80例采用注射用绒毛膜促性腺激素联合黄体酮保胎治疗,观察药物对HCG、P水平的影响及疗效。结果:治疗组与对照组在不同孕周血HCG、P水平比较差异无统计学意义,疗效比较差异亦无统计学意义。结论:紫河车治疗先兆流产疗效确切,且无毒副作用,值得推广。     

Bone mineral density in human immunodeficiency virus-1 infected men with hypogonadism prior to highly-active-antiretroviral-therapy (HAART)

Alterations of bone metabolism have been observed in numerous studies of HIV-infected patients. Sex steroids are known to profoundly influence bone mass and bone turnover. Hypogonadism is common in HIV-infection. Therefore, we performed a cross sectional study of 80 male HIV-infected patients without wasting syndrome, and 20 healthy male controls, in whom we analyzed urine and serum samples for both calciotropic hormones and markers of bone metabolism and of endocrine testicular function. Bone mineral density (BMD) was assessed by dual-energy X-ray absorptiometry both in the lumbar spine and Ward''s triangle of the left hip. None of the patients received highly-active-antiretroviral-therapy (HAART). Compared to eugonadal HIV-infected patients, subjects with hypogonadism (n = 32; 40%) showed statistically significant decrease of serum osteocalcin (p < 0.05) and elevated urinary excretion of crosslinks (p < 0.05). However, we found 13 and 15, respectively, patients with osteopenia (t-score -1.0 to -2.5 SD below normal) of the lumbar spine. The dissociation between bone formation and resorption and the reduction of of BMD (p < 0.05) is stronger expressed in patients with hypogonadism. Habitual hypogonadism appears to be of additional relevance for bone metabolism of male HIV-positive patients prior to HAART.     

儿童生长贴联合重组人生长激素治疗特发性矮小症的疗效

目的探讨儿童生长贴联合重组人生长激素对特发性矮小症的治疗效果。方法回顾性分析2016年2月～2017年2月我科因特发性矮小症就诊的患儿45例;按治疗方法分为对照组、观察组1、观察组2各15例,对照组为拒绝一切药物治疗者,观察组1为采用儿童生长贴治疗的患儿;观察组2为采用生长贴联合重组人生长激素治疗的患儿,疗程均为12个月。比较身高增长值、遗传身高、预测成年身高。结果对照组、观察组1和观察组2比较,身高增长值分别为(3.87±1.25)cm、(7.93±1.53)cm、(10.20±1.97)cm,差异有显著性(F=59.48,P0.01);遗传身高分别为(156.80±4.94)cm、(156.07±3.97)cm、(156.13±4.58)cm,差异无显著性(F=0.12,P0.05);成年预测身高分别为(155.73±3.31)cm、(164.80±5.24)cm、(167.87±5.68)cm,差异有显著性(F=25.35,P0.01)。结论儿童生长贴联合重组人生长激素治疗特发性矮小症可显著增加患儿身高增长值,提高其成年身高预测值。     

Clinical significance of pregnancy-specific beta glycoprotein, human placental lactogen and beta-human chorionic gonadotropin in the serum of patients with trophoblastic diseases

Serum levels of pregnancy specific beta 1 glycoprotein (SP1), human placental lactogen (hPL) and beta-human chorionic gonadotropin (beta-hCG) in the normal men, non-pregnant women, normal pregnant women and patients with trophoblastic diseases were determined by radioimmunoassay. Serum SP1, hPL and beta-hCG levels in patients with trophoblastic diseases decreased with advance of the degree of malignancy. The SP1/beta-hCG ratio was less than 1.5 in 4/36(11.1%) of the cases of hydatidiform mole, 13/16 (81.2%) of the cases of invasive mole and choriocarcinoma. The beta-hCG/hPL ratios were below 15 in 30/36 (83.3%) of the cases of hydatidiform mole and 4/16(25.5%) of the cases of malignant trophoblastic disease. After operation and chemotherapy, patients with SP1 and beta-hCG levels decreased gradually achieved favourable prognosis. Thus, this may be used as an index for monitoring and follow-up studies of trophoblastic disease.     

不同孕期女性血清中人绒毛膜促性腺激素与促甲状腺激素水平相关性分析

目的 研究不同孕期女性人绒毛膜促性腺激素(HCG)和促甲状腺激素(TSH)的相关性。方法 本研究随机选取2018年10月至2020年6月杭州市妇产科医院产科门诊就诊的150例妊娠期女性作为研究对象,根据妊娠期不同,分为妊娠早、中、晚期各50例,对比三组孕妇HCG、TSH、游离甲状腺素(FT4)的水平、分析不同孕期HCG、TSH和FT4的相关性、比较不同孕期甲减发生率。结果 妊娠晚期女性TSH水平最高,其次是妊娠中期和早期,妊娠晚期女性HCG和FT4水平最低,其次是妊娠中期和早期,组间比较差异有统计学意义(P0.05)。不同妊娠期甲减发生率为2.0%～6.0%,组间比较,差异无统计学意义(P0.05)。经Pearson相关性分析显示,妊娠晚期孕妇HCG水平均与FT4水平呈正相关(r=0.311,P=0.028),不同妊娠期孕妇HCG水平均与TSH水平呈负相关(r=-0.103,P=0.048;r=-0.111,P=0.044;r=-0.149,P=0.030)。结论 随着妊娠周期的增加,HCG水平逐渐降低,而TSH水平持续升高,FT4分泌减少,可能会增加甲状腺功能发生紊乱的风险。因HCG可对垂体-甲状腺轴产生一定影响,故可根据HCG变化水平定期检查甲状腺功能,从而有效预防或改善不良妊娠结局,以确保孕妇及胎儿健康,对临床合理干预具有较高价值。