Effects of passive smoking on lung function tests in preschool children born late-preterm: a preventable health priority

Objective: Late-preterm delivery is known to be associated with potential adverse effects on lung development. Passive smoking may result in alterations of pulmonary function in infants born late-preterm. Impulse oscillometry (IOS) is a noninvasive, rapid, and practicable technique that can assess lung function. This study aimed to evaluate the effect of passive smoking on lung function tests in preschool children born late-preterm using IOS.

Methods: The study population consisted of a total of 139 children between 3 and 7 years of age born late-preterm who were being followed-up at our outpatient unit at the time of study period. Late-preterms were subcategorized according to presence or absence of exposure to passive smoking (PS). Those with and without exposure to passive smoking were referred to as PS group (56.1%, n?=?78) and non-PS group (43.9%, n?=?61), respectively. Resistance (R5–R20), reactance (X5–X20), and resonant frequency were measured by impulse oscillometry (IOS) at 5–20?Hz.

Results: Median R5-R20 and Z5 were significantly higher and median X10 was significantly lower in PS group compared to non-PS group (p?Conclusions: This study demonstrated that passive smoking significantly increases peripheral airway resistance and seems to adversely affect lung function in children born late-preterm.     

环氧司坦的诱变性研究

本文应用中国仓鼠肺细胞(CHL)和小鼠骨髓细胞的染色体畸变,研究了环氧司坦的诱变作用。离体CHL细胞培养分代谢活化和非代谢活化二个系列,环氧司坦剂量分别为0μg/ml、20μg/ml、40μg/ml和80μg/ml。小鼠在体试验剂量为0mg/kg、240mg/kg、480mg/kg和960mg/kg,均一次性灌胃给药,并设阳性对照组。结果表明,离体CHL细胞代谢活化与非代谢活化组和小鼠骨髓细胞各剂量组的染色体畸变率小于5%,而阳性对照分别为76%、51%和42%。各处理组与阴性对照组间经统计学分析,无显著性差异,提示了环氧司坦无细胞学诱变作用。     

Ultrasound tissue characterization with the gray level histogram width of the B-mode

Objectives. We investigated fetal lung immaturity, fetal brain periventricular echodensity (PVE) and other problems related to changes in fetal tissue by non-invasive ultrasound tissue characterization, using a commonly available real-time B-mode ultrasound machine.

Methods. Histograms of a region of interest (ROI) were displayed on a B-mode screen. The base length of a histogram divided by the full gray-scale length gave the gray level histogram width (GLHW); this value is insensitive to changes in B-mode model, device gain or image depth. Any variation in the magnitude of GLHW in high-contrast images was easily corrected. Fetal lung immaturity was suspected when the fetal lung GLHW was less than that of normal fetal lung and fetal liver after 30 weeks of pregnancy. The GLHW values of fetal brain PVE were also compared to those of normal fetal brain.

Results. GLHW values were compared between the “mature fetal lung” and the “immature fetal lung” groups, as determined by the stable microbubble test: the former had 5 or more microbubbles per 1 mm² of aspirated and shaken amniotic fluid on microscopic observation, while the latter had less than 5. The sensitivity and specificity of the GLHW criterion in predicting lung immaturity were 89% and 79%, respectively, when the GLHW was less than 31%, and less than that for fetal liver. The GLHW of fetal brain PVE was significantly higher than that of normal fetal brain. The GLHW was also high in various obstetrical abnormalities and in the case of malignant gynecological masses.

Conclusion. The GLHW of B-mode images from simple real-time ultrasound imaging machines is useful for the characterization of fetal tissue.     

Associations between toxic metals in follicular fluid and in vitro fertilization (IVF) outcomes

Purpose

We previously reported associations between trace concentrations of Hg, Cd and Pb in blood and urine and reproductive outcomes for women undergoing in-vitro fertilization (IVF). Here we assess measurements in single follicular fluid (FF) specimens from 46 women as a presumably more relevant marker of dose for reproductive toxicity.

Methods

FF specimens were analyzed for Hg, Cd and Pb using sector field-inductively coupled plasma-mass spectrometry (SF-ICP-MS). Variability sources were assessed by nested ANOVA. Multivariable regression was used to evaluate associations for square root transformed metals with IVF outcomes, adjusting for confounders.

Results

An inverse association is detected for FF Pb and fertilization (relative risk (RR) = 0.68, P = 0.026), although positive for Cd (RR = 9.05, P = 0.025). While no other statistically significant associations are detected, odds ratios (OR) are increased for embryo cleavage with Hg (OR = 3.83, P = 0.264) and Cd (OR = 3.18, P = 0.644), and for embryo fragmentation with Cd (OR = 4.08, P = 0.586) and Pb (OR = 2.22, P = 0.220). Positive estimates are observed for Cd with biochemical (RR = 19.02, P = 0.286) and clinical pregnancies (RR = 38.80, P = 0.212), yet with very low precision.

Conclusions

We have identified associations between trace amounts of Pb and Cd in FF from a single follicle, and oocyte fertilization. Yet, the likelihood of biological variation in trace element concentrations within and between follicles, coupled with levels that are near the limits of detection suggest that future work should examine multiple follicles using a ‘one follicle-one oocyte/embryo’ approach. A larger study is merited to assess more definitively the role that these environmental factors could play with respect to egg quality in IVF programs.     

长效孕激素炔诺酮庚酸酯及复方18甲基炔诺酮对血清性激素结合球蛋白的影响

24例妇女肌注炔诺酮庚酸酯200 mg,肌注前血清性激素结合球蛋白(SHBG)为53.32±23.23 nmol╱L。注射后5天为41.99±17.06nmol/L(P<0.05),21天降至最低值14.72±10.01 nmol/L,以后逐渐回升,直至注射后84天仍未回复到原来水平(34.46±20.39 nmol/L)。10例妇女单次口服18甲基炔诺酮6 mg+炔雌醚3 mg,服药前血清SHBG水平为42.76±13.89 n mol/L,服药后7天为62.53±10.90 nmol/L(P<0.01),14天达峰值为71.33±5.77 nmol/L,以后持续此高水平,直至服药后56天;8例连续3次口服18甲+炔雌醚,每次间隔23天,服药前血清SHBG水平为44.94±15.36 nmol/L,第1次服药后9天为83.46±10.08 nmol/L(P<0.01),16天达峰值为91.74±2.28nmol/L,以后持续高水平直至第3次服药后30天,第2、3次重复给药对业已升高的SHBG水平无影明显响。第2、3次服药后LNG峰值明显高于首次服药后峰值6倍。     

甲状腺功能减退症与勃起功能障碍关系的初步探讨

甲状腺功能减退(HT)即甲状腺激素分泌不足的状态下,脂质代谢紊乱产生的高脂血症、血管内皮细胞功能障碍、血管平滑肌细胞舒张性下降等均可影响阴茎勃起功能。NO、CO、H2S及内皮素等在HT中起着重要作用。通过对高脂血症、高血糖、心血管病变的治疗及补充睾酮等,可明显改善阴茎勃起功能,因而积极治疗HT,对改善HT所致阴茎勃起功能障碍(ED)具有重要意义。内皮功能障碍被认为是ED的主要发病机制,因此治疗HT时同时改善内皮功能,也会对ED发挥治疗作用。同时HT引起的神经损伤也参与了ED。通过对这些物质、神经及其功能的深入研究,可为今后临床上治疗ED提供理论依据。     

高雄激素血症与多囊卵巢综合征中非酒精性脂肪性肝病的关系

目的:探讨高雄激素血症(HT)与多囊卵巢综合征(PCOS)患者非酒精性脂肪性肝病(NAFLD)发病的关系。方法:对306例PCOS患者进行基础内分泌、口服糖耐量试验及胰岛素释放试验、肝功能、血脂等检查,B超诊断脂肪肝。结果:306例PCOS患者中诊断出NAFLD94例,发病率为30.7%;其中NAFLD轻度56例(59.6%),中度34例(36.2%),重度4例(4.2%)。PCOS患者NAFLD的发病率与HA无明显相关性,与稳态模型评估胰岛素抵抗指数(HOMA-IR)、甘油三酯(TG)呈正相关。PCOS合并NAFLD组胰岛素抵抗(IR)发生率明显高于PCOS不合并NAFLD组,P<0.05;PCOS高雄激素血症(PCOS-HA)组IR发生率与PCOS非高雄激素血症(PCOS-NHA)组无明显差异,P>0.05。结论:PCOS患者NAFLD发病率较高,PCOS患者NAFLD的发生与IR、代谢异常密切相关,与HA无明显相关。     

Polycystic ovary syndrome and the single nucleotide polymorphisms of methylenetetrahydrofolate reductase: a pilot observational study

Polycystic ovary syndrome (PCOS), insulin resistance and overall mortality due to diabetes and coronary artery disease are higher in South Asians than in Caucasians. Aims: We compared the prevalence of the C677T and A1298C single nucleotide polymorphisms in the methylenetetrahydrofolate reductase gene in South Asian and Caucasian women, its association with folate and homocysteine (Hcy) metabolism, and its relevance to future atherogenic events. Methods and results: 71 women were recruited for the study: South Asian PCOS (21) plus controls (9) and Caucasian PCOS (25) plus controls (16). Anthropometric and laboratory parameters were compared. South Asian PCOS women were significantly hyperandrogenic and exhibited a greater degree of insulin resistance. Caucasian PCOS women had higher plasma Hcy concentrations with a 1.9 times higher frequency of the T allele than the South Asian PCOS group. In the presence of this variant allele, plasma Hcy levels appear to be higher in both PCOS groups. The South Asians had a 1.8 times higher frequency of the C allele than the Caucasians; however, the overall frequency was comparable in the two PCOS groups. The frequency of homozygosity, i.e. TT677 and CC1298, was 7.2% and 4.9% in the Caucasians and 0% and 16.6% in the South Asian recruits, respectively.

Dietary inadequacies in the South Asian women can influence their plasma folate and B12 concentrations resulting in hyperhomocysteinemia which, in combination with dyslipidaemia and insulin resistance, can lead to long-term atherogenic consequences. Conclusions: Current data suggests that the mechanisms of atherothrombosis have separate pathways in the two ethnic groups. Larger studies exploring the current theme need to be carried out in the PCOS groups to obtain adequate insight.     

脂质蓄积指数较腰围更好反映多囊卵巢综合征患者的胰岛素抵抗

目的:比较多囊卵巢综合征(PCOS)人群脂质蓄积指数(LAP)和腰围(WC)与胰岛素抵抗(IR)的相关性。方法:纳入121例PCOS患者和115例正常对照,测量人体参数及血液代谢指标,行75 g口服葡萄糖耐量试验,对其中20例对照及90例PCOS患者行高胰岛素-正葡萄糖钳夹术,并计算HOMA2-IR及LAP。结果:PCOS组LAP、WC等较对照组明显增高(P<0.05),胰岛素敏感性明显降低(P<0.05);匹配WC和年龄后,PCOS组LAP仍明显高于对照组(P<0.01),胰岛素敏感性明显低于对照组(P<0.05);与WC相比,LAP与M值(r=-0.66 vs r=-0.68,P<0.01)及HOMA2-IR(r=0.49 vs r=0.55,P<0.01)间关系更密切,校正WC后,LAP仍与M值(r=-0.37,P<0.01)及HOMA2-IR(r=0.26,P<0.01)相关;二项Logistic回归显示,高LAP患者发生IR的风险是正常LAP患者的6.05倍(OR=6.05,95%CI:1.67,21.90,P<0.05)。结论:在PCOS人群中,LAP与胰岛素敏感性相关,较WC更好地反映IR。     

新型左炔诺孕酮/炔雌醇复方避孕贴剂的家兔药代动力学研究

目的:探讨新型左炔诺孕酮(levonorgestrel,LNG)和炔雌醇(ethynylestradiol,EE)在家兔体内的药物动力学特征,评价多次给药后是否出现药物蓄积情况。方法:家兔在单次和多次给药及停止给药后不同时间点耳缘静脉采血,选择放射免疫分析(radioimmunoassay,RIA)法测定各时间点各组家兔雌/孕激素的血药浓度,使用药物动力学软件计算各药物动力学参数并对其进行统计分析。结果:单次给药后受试贴剂低(10cm2)、中(20 cm2)和高剂量(40 cm2)组血清LNG峰浓度(Cmax)分别为1.04±0.12 ng/ml、2.42±0.60 ng/ml和4.90±1.39 ng/ml,3组间有显著差异(P<0.05)。血药浓度-时间曲线下面积(AUC)分别为49.93±9.79h.ng/ml、115.14±34.25 h.ng/ml和251.22±80.55 h.ng/ml,3组间有显著差异(P<0.01);血清EE峰浓度(Cmax)分别为112.00±45.50 pg/ml、139.23±28.23 pg/ml和290.26±66.62 pg/ml,中、高剂量组间有显著差异(P<0.05),而中、低剂量组间无统计学差异(P>0.05)。EE血药浓度-时间曲线下面积(AUC)分别为4.70±1.34 h.ng/ml、6.59±1.23h.ng/ml和16.59±2.33 h.ng/ml,中、高剂量组之间有显著差异(P<0.01)。Evra参比避孕贴剂组血清LNG浓度的Cmax为3.16±1.00 ng/ml,AUC为155.29±46.14 h.ng/ml,与LNG/EE避孕贴剂中剂量组(拟采用的临床试验剂量)相比,两者无显著差异(P>0.05)。中剂量组血清EE浓度与Evra避孕贴剂的相比显著降低(P<0.05)。多次给药后LNG/EE避孕贴剂10 cm2组和20 cm2组在重复给药10次的过程中未出现LNG和EE血药浓度蓄积现象,Evra贴剂组在重复给药4次的过程中未出现LNG和EE血药浓度蓄积现象。结论:中剂量的LNG/EE避孕贴剂具有良好的避孕效果,同时其副作用可能小于Evra。     

鸟氨酸脱羧酶对人滋养细胞分泌绒毛膜促性腺激素的调控作用

本实验应用无血清短周期培养方法，研究了人滋养层细胞（ＣＴＣ）分泌ｈＣＧ的调节机制。实验发现：ＣＴＣ经８ｈ培养具有良好的ｈＣＧ分泌功能。这些细胞的匀浆液具有鸟氨酸脱羧酶（ＯＤＣ）的活性，而且对二丁酰ｃＡＭＰ、多胺、放线菌素Ｄ和二氟甲基鸟氨酸（ＤＦ－ＭＯ）呈现不同的应答效应。ＯＤＣ的活性与ＣＴＣ的数量及各试剂的剂量都有密切的相关性。ＯＤＣ活性的改变又与细胞分泌ｈＣＧ功能有关。它们在ＣＴＣ分泌的调控中可能是一个重要的因素．     

取卵日血清脑源性神经营养因子与辅助生育结局的相关性

目的:探讨取卵日血中脑源性神经营养因子(BDNF)能否预测卵母细胞质量和其后的卵胞质内单精子注射(ICSI)的妊娠结局。方法:总共纳入57例进行ICSI患者,在取卵日清晨抽取空腹静脉血,测量BDNF,E2和P的浓度。比较妊娠组与非妊娠组的相关数据,并分析取卵日BDNF水平与E2、P、年龄和IVF相关数据之间的相关性。结果:妊娠组与非妊娠组的BNDF浓度无明显差异;取卵日BDNF浓度与E2和P呈明显正相关。BDNF与获卵数和成熟卵母细胞数成正相关。结论:尚不能用取卵日BDNF来预测ICSI的妊娠结局,但BDNF可能在卵母细胞发育成熟过程中发挥着重要作用。     

Maternal infibulation and obstetrical outcome in Djibouti

Objective: The objective of the present study was to assess the relation between female genital mutilation and obstetric outcome in an East African urban clinic with a standardized care, taking into account medical and socioeconomic status.

Methods: This was a cohort study conducted in Djibouti between October 1, 2012 and April 30, 2014. Overall 643 mothers were interviewed and clinically assessed for the presence of female genital mutilation. The prevalence of obstetric complications by infibulation status was included in a multivariate stepwise regression model.

Results: Overall, 29 of 643 women did not have any form of mutilation (4.5%), as opposed to 238 of 643 women with infibulation (37.0%), 369 with type 2 (57.4%), and 7 with type 1 mutilation (1.1%).Women with a severe type of mutilation were more likely to have socio-economic and medical risk factors. After adjustment, the only outcome that was significantly related with infibulation was the presence of meconium-stained amniotic fluid with an odds ratio of 1.58 (1.10–2.27), p value=0.014.

Conclusions: Infibulation was not related with excess perinatal morbidity in this setting with a very high prevalence of female genital mutilation, but future research should concentrate on the relation between infibulation and meconium.     

Dehydroepiandrosterone sulfate/free androgen index ratio predicts a favorable metabolic profile in patients with polycystic ovary syndrome

Potential effect of hyperandrogenemia on metabolic disturbances in polycystic ovary syndrome (PCOS) has always been a matter of interest. We analyzed the records of 125 patients with PCOS and 54 age-matched healthy women. All participants underwent biochemical and hormonal assessment and a 75?g oral glucose tolerance test was performed. PCOS and control groups were comparable in terms of age. Dehydroepiandrosterone sulfate/free androgen index (DHEAS/FAI) ratio was negatively correlated with body mass index (BMI) (p?<?.001), fasting glucose (p?=?.02), area under the curve (AUC) of glucose (p?=?.03), AUC of insulin (p?=?.001), homeostasis model assessment-estimated insulin resistance (HOMA-IR) (p?<?.001), and triglycerides (TG) (p?=?.009), and positively correlated with insulin sensitivity index (ISI) (p?<?.001) and high-density lipoprotein cholesterol (HDL-C) (p?<?.001) among PCOS patients. In logistic regression analysis, higher DHEAS/FAI ratio levels were associated with lower risk of low HDL-C [RR(95%CI); 0.97(0.95–0.98); p?<?.001] as well as atherogenic dyslipidemia (TG/HDL-C) [RR(95%CI); 0.97(0.94–0.99); p?=?.035] even after adjustment for BMI in the PCOS group. Androgens, DHEAS and FAI act differently on metabolic parameters. Our results demonstrate that high DHEA-S/FAI ratio levels are associated with a more favorable metabolic profile.     

hMG对分泌晚期子宫内膜雌、孕激素受体基因表达的影响

目的:研究人绝经期促性腺激素(hMG)促排卵治疗对分泌晚期子宫内膜雌激素受体(ER)、孕激素受体(PR)基因表达的影响。方法:采用原位杂交技术,对9例hMG促排卵周期(实验组)分泌晚期子宫内膜ER、PRmRNA进行测定,并与11例自然周期(对照组)进行对照研究。结果:实验组分泌晚期子宫内膜腺体细胞内ER、PRmRNA水平明显低于对照组(P<0.05和P<0.005)。结论:hMG在转录水平降低分泌晚期子宫内膜腺体细胞ER、PRmRNA的表达。     

非编码RNA在卵泡发育和卵巢疾病中的研究进展

非编码RNA(non-coding RNA,nc RNA)是目前生物医学领域的研究热点,如长链非编码RNA(long non-coding RNA,lnc RNA)和小非编码RNA:微小RNA(mirco RNA,mi RNA)、内源性小干扰RNA(endogenous small interfering RNA,endo-si RNA)、PIWI相互作用RNA(PIWI interacting RNA,pi RNA)等,它们作为细胞内基因调控网络的重要成员影响细胞的各种生命活动。近年来研究表明这些非编码RNA在卵巢也发挥重要作用,参与了颗粒细胞增殖、分化、凋亡以及激素合成的调控,在卵母细胞存活和发育中发挥重要作用,非编码RNA的表达异常与多囊卵巢等疾病密切相关,本文就非编码RNA与卵巢卵泡发育以及卵巢相关疾病的研究作一简述。