解脲支原体感染对不育男子精液质量的影响

目的:研究生殖道支原体(Uu)感染对不育男性精液质量的影响。方法:通过支原体培养法对精液标本进行检测。结果:82例原发不育组、62例继发不育组、43例习惯流产组支原体感染率明显高于41例正常生育组(P<0.05);Uu阳性标本的精子密度、活率、活力、尾部肿胀率显著降低,液化时间、畸形率、白细胞和抗精子抗体明显增高(P<0.05)。结论:Uu感染可影响精液质量导致男性不育。     

泌尿生殖系统感染对精液质量影响的研究

目的 探讨男性生殖系统病原体感染对精液质鞋的影响及其与男性不育的关系.方法 对380例确诊的有泌尿生殖系统感染的男性不育患者和65例正常生育男性(对照组)的精液标本进行检测,分析生殖道病原体感染对精液各参数指标的影响.结果 有泌尿生殖系统感染的男性不育患者组精子的密度、成活率、活动率、活动度(Ⅳ+Ⅲ级)与对照组比较均显著下降(P<0.05),精液液化时间、精子畸形率显著上升(P<0.01),而精液量、pH值比较差异无显著性(P>0.05).结论 泌尿生殖道病原体感染是精液质量下降的重要危险因素,可导致男性不育.     

抗精子抗体和抗心磷脂抗体在不育夫妇血清中的表达及意义

目的 探讨抗精子抗体和抗心磷脂抗体在不育夫妇血清中的表达和意义.方法 应用酶联免疫吸附测定法检测50对不育夫妇(试验组)和40对正常生育夫妇(对照组)血清中抗精子抗体和抗心磷脂抗体的表达情况及精液分析.结果 试验组男性血清抗精子抗体表达较对照组明显增高(P<0.05),抗心磷脂抗体表达差异无统计学意义(P>0.05).试验组女性抗精子抗体和抗心磷脂抗体表达较对照组明显增高差异有统计学意义(P<0.05).男性中抗精子抗体阳性对精液量、pH值、精子密度及b级精子无影响.精子活率、a级精子、直线速度和曲线速度试验组与对照组相比差异有统计学意义(P<0.01).结论 抗精子抗体可降低精液质量;抗精子抗体和抗心磷脂抗体影响精子活率及精子运动,从而导致不孕不育.     

弓形虫感染与男性不育的相关性研究

目的:探讨弓形虫感染情况与男性不育的关系。方法:将383例弓形虫检测的不育男性分为抗弓形虫抗体(AtAb)阳性组(76例)和阴性组(307例),分别进行精液常规、低渗肿胀率、精液白细胞含量、抗精子抗体(AsAb)检测。结果:阳性组精子密度、精子活率(%)、a+b活力(%)、低渗肿胀率明显低于阴性组(P<0.05);而阳性组精子畸形率、白细胞精液症检出率、AsAb阳性率明显高于阴性组(P<0.05,P<0.01);两组精液量、精液pH值无显著性差异(P>0.05)。结论:弓形虫感染可影响精液质量,是男性不育的原因之一。     

抗精子抗体对精子穿越宫颈黏液及精卵结合的影响

目的观察生殖道局部抗精子抗体对精子穿越宫颈黏液及精卵结合的影响。方法酶联免疫法测定宫颈黏液及精液中抗精子抗体,宫颈黏液穿透试验及精子去透明带仓鼠卵穿透试验。结果精子在宫颈黏液抗精子抗体阳性组中游动明显受阻与缓慢(P<0.01),精液抗精子抗体阳性组与精液抗精子抗体阴性组比较,穿卵率及每个卵子中含精子的均数有显著差异(P<0.01)。结论女性宫颈黏液抗精子抗体阳性及男性精液抗精子抗体阳性均可影响生殖过程,对于不孕不育夫妇生殖道局部抗精子抗体检测应引起重视。     

男性生殖道感染与不育症

目的：研究淋球菌、解脲支原体、沙眼衣原体感染与男性不育症之间的关系。方法：将32例生殖道感染并发不育患者尿道分泌物做淋球菌、解脲支原体、沙眼衣原体培养；精液进行计算机系统检查分析；血清做抗精子抗体的测定。结果：生殖道感染并发不育者的精液质量下降；精液中白细胞数量增加；血清中抗精子抗体阳性率升高。结论：淋球菌、角脲支原体、沙眼衣原体感染可能引起精液质量下降，抗精子抗体产生，从而生育力降低。     

精浆抗精子抗体对男性不育者精液参数和精子顶体酶活性的影响

目的:探讨精浆抗精子抗体(AsAb)对男性不育者精液参数和精子顶体酶活性的影响。方法:用间接血凝法检测2367例男性不育患者精浆AsAb,比色法测定精子顶体酶活性。结果:2367例不育者精浆AsAb阳性率为8.9%,精液AsAb阳性组中精液量,精子密度,精子活率,a、b级活力精子率,畸形精子率与AsAb阴性组相比差异有显著性(P<0.001、P<0.05)。随精子密度、精子活率a、,b级活力精子率、精液量的减少,精液粘度的增高和精液液化时间的延长,精浆AsAb阳性率增高,差异有显著性(P<0.001、P<0.05),精浆AsAb阳性组与阴性组顶体酶活性,顶体酶活性正常组与异常组精浆AsAb阳性率差异无显著性(P>0.05)。结论:精浆AsAb对男性不育者精液参数有影响,对精子顶体酶活性没有影响。     

精液黏度对精液质量的影响及相关因素

目的观察精液黏度增高对精液质量的影响及相关因素分析。方法308例男性不育门诊患者,按精液黏度正常与否分为黏度增高组和正常组,进行精液检查。结果精液黏度正常组和增高组患者的精液量、精子密度、a级精子百分比、b级精子百分比、c级精子百分比、正常形态精子百分比、精子运动轨迹各项参数之间差异无统计学意义(P>0.05);黏度增高组精液pH值、液化时间、d级精子百分比分别为7.3±0.2、(22.0±4.3)min和(59.5±15.5)%,分别高于黏度正常组的7.1±0.2、(20.7±5.1)min和(54.5±19.3)%,差异有统计学意义(P<0.05);黏度增高组精子存活率为(65.2±17.0)%,低于黏度正常组的(70.7±15.2)%,差异有统计学意义(P<0.05)。精液黏度增高与精液白细胞数量无关(rs=-0.005,P=0.927),与精浆抗精子抗体存在正相关(rs=0.184,P=0.001)。结论精液黏度增高可以导致精液液化时间延长,pH值增高,降低精子存活率和活动力,与精浆抗精子抗体相关,应当引起临床医生的高度重视。     

海口地区成年男性精子质量与吸烟指数的相关性研究

目的:通过分析海口地区成年男性精液量、精子密度、活率及精子形态与吸烟指数之间的关系,探讨吸烟对男性精液质量的影响。方法:通过分析系统对107例吸烟男性和20例健康男性志愿者的精液量、精子的密度、活率和精子形态学等参数进行检测并分析其与吸烟指数相关性。结果:与对照组相比,吸烟人群精液量、精子密度、活率均显著下降(P<0.05),但A组与B组比较差异无统计学意义(P>0.05),与C组比较差异有统计学意义(P<0.01)。与对照组相比,吸烟人群正常形态精子百分率明显下降;小头、锥形头和无定形头精子百分率均增高(P<0.01,P<0.05,P<0.01),但畸形精子百分率差异无统计学意义(P>0.05)。结论:吸烟可引起男性精子精液量、精子密度、活率等参数及形态异常,大量吸烟可能对男性不育有不良影响。     

解脲脲原体感染降低精子参数、精子膜功能及顶体酶活性

目的 研究解脲脲原体(ureaplasmaurealyticum,Uu)感染对精子主要参数、精子膜功能及精子顶体酶活性的影响.方法 以精子密度、精子活力、精子形态、低渗肿胀及精子顶体酶活性为观察指标,比较38例uu阳性患者和30例Uu阴性患者的精子质量情况,分析uu感染对精子主要参数及精子功能的影响.结果 Uu阳性组与Uu阴性组相比,精子前向运动率[(34.32 4±14.21)%vs(45.32±9.43)%]、精子畸形率[(77.43±20.32)%vs(65.78 4±16.65)%]、低渗肿胀率[(45.35 4±15.46)%vs(59.65±14.32)%]及顶体酶活性[(17.23±6.56)vs(22.23±4.68)]差异有统计学意义(P<0.05,P<0.01),精子密度2组比较无明显差异(P>0.05).结论 Uu感染可以明显降低精子主要参数、精子膜功能及顶体酶活性,可能与Uu感染引起精液炎症介质增加,破坏精子膜结构有关.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.