性激素水平与痤疮中医分型的关系研究

目的:探讨性激素水平与痤疮中医分型的关系。方法:采用放射免疫双抗法进行血清血清黄体生成素(LH)、卵泡刺激素(FSH)、雌激素(E2)、睾酮(T)、血清泌乳素(PRL)水平的检测。结果:女性肝郁气滞型痤疮患者的血清性激素水平与女性湿热内蕴型痤疮患者血清性激素水平比较,LH差异无显著性(P>0.05),FSH、E2T、PRL、LH/FSH差异均有显著性(P<0.01)。男性肝郁气滞型痤疮患者血清性激素水平与男性湿热内蕴型痤疮患者血清水平进行比较,血清T、PRL差异有显著性(P<0.05)。结论:性激素水平与痤疮中西分型有关,PRL、LH/FSH是肝郁气滞型痤疮患者中西分型的微观物质基础,而T是湿热内蕴型痤疮患者中医分型的微观物质基础。     

绝经后子宫内膜癌患者血清中性激素和促性腺激素的测定

本文测定12例绝经后子宫内膜癌患者手术前后血清雌二醇(E_2)、睾酮(T)、促卵泡成熟激素(FSH)、黄体化激素(LH)和催乳激素(PRL)的水平。对照组为非子宫内膜癌妇科肿瘤组和生殖道非肿瘤性疾病组。结果显示子宫内膜癌组与对照组间5种血清激素水平无显著差别。手术后内膜癌组和对照组血清E_2、FSH和LH水平与术前无差异;两组PRL水平术后均有显著性升高,内膜癌组术后血清睾酮水平下降。本文对此结果进行了讨论。     

武汉地区正常育龄妇女月经周期血清中七种激素的放射免疫测定

选抒12例正常月经周期的武汉地区妇女,研究她们的内分泌图象,采用放射免疫测定法测定每天血清中促黄体生成激素(LH)、促卵泡生成素(FSH)、垂体催乳素(PRL)、雌二醇(E_2)、孕酮(P)、睾丸酮(T)和皮质激素(C)的浓度。其中LH、FSH、E_2和P的周期变化和水平与其他文献报告的结果相同,月经中期LH峰值是50mIU/ml,FSH峰值为12mIU/ml,排卵前E_2峰值为252pg/ml,P值为16ng/ml,在大多数周期中,PRL在月经中期水平是高的,但黄体期PRL平均水平高于滤泡期,月经中期T和C值无明显变化,而滤泡期C水平(91ng/ml)高于黄体期(81ng/ml)。     

中西医结合治疗卵巢储备功能异常

目的:观察中西医结合疗法对卵巢储备功能异常的改善作用。方法:96例卵巢储备功能异常患者按照随机数表法分为观察组和对照组各48例。对照组给予补佳乐和黄体酮序贯治疗,观察组在对照组治疗基础上根据月经周期给予不同中药汤剂。治疗后,比较两组患者西医临床疗效、中医证候疗效,两组患者治疗前后促卵泡激素(follicle-stimulating hormone,FSH)、雌二醇(estradiol,E_2)、促黄体生成素(luteinizing hormone,LH)、抗缪勒管激素(anti-mullerian hormone,AMH)及FSH/LH的变化,记录两组治疗后皮疹、恶心干呕、子宫出血等不良反应的发生情况。结果:治疗后,观察组的西医临床疗效(68.75%)明显高于对照组(47.97%),观察组的中医证候疗效(79.17%)明显高于对照组(60.41%),观察组不良事件发生率(6.25%)明显低于对照组(22.91%),差异均有统计学意义(P0.05);治疗后观察组患者血清中FSH、LH、E_2水平和FSH/LH均低于对照组,AMH水平高于对照组,两组比较,差异均有统计学意义(P0.05)。结论:中西医结合治疗卵巢储备功能异常疗效显著,可降低患者血清中FSH、LH、E_2水平和FSH/LH,提高AMH水平,减少不良事件的发生率。     

中西医结合治疗卵巢储备功能异常

目的:观察中西医结合疗法对卵巢储备功能异常的改善作用。方法:96例卵巢储备功能异常患者按照随机数表法分为观察组和对照组各48例。对照组给予补佳乐和黄体酮序贯治疗,观察组在对照组治疗基础上根据月经周期给予不同中药汤剂。治疗后,比较两组患者西医临床疗效、中医证候疗效,两组患者治疗前后促卵泡激素(follicle-stimulating hormone,FSH)、雌二醇(estradiol,E_2)、促黄体生成素(luteinizing hormone,LH)、抗缪勒管激素(anti-mullerian hormone,AMH)及FSH/LH的变化,记录两组治疗后皮疹、恶心干呕、子宫出血等不良反应的发生情况。结果:治疗后,观察组的西医临床疗效(68.75%)明显高于对照组(47.97%),观察组的中医证候疗效(79.17%)明显高于对照组(60.41%),观察组不良事件发生率(6.25%)明显低于对照组(22.91%),差异均有统计学意义(P<0.05);治疗后观察组患者血清中FSH、LH、E_2水平和FSH/LH均低于对照组,AMH水平高于对照组,两组比较,差异均有统计学意义(P<0.05)。结论:中西医结合治疗卵巢储备功能异常疗效显著,可降低患者血清中FSH、LH、E_2水平和FSH/LH,提高AMH水平,减少不良事件的发生率。     

子宫肌瘤患者及接受UAE治疗后血清性激素水平分析

目的：探讨性激素在子宫肌瘤发病中的意义。方法：采用化学发光技术检测正常对照61例(对照组)、子宫肌瘤患6l例(患组)以及44例子宫肌瘤接受子宫动脉栓塞治疗(UAE)后的患，血清促卯泡成熟激素(FSH)、促黄体生成激素(LH)、雌激素(E2)、垂体泌乳素(PRL)、睾酮(T)水平。结果：子宫肌瘤患组的血清FSH、LH、PRL、T水平均明显高于对照组；血清E2水平与对照组无显差异。其中44例接受UAE治疗的子宫肌瘤患术后血清LH、E2、PRL、T水平均比术前明显降低，FSH与术前无显差异；术后血清FSH、PRL、T水平均明显高于对照组，LH、E2水平明显低于对照组。结论：PRL、T是子宫肌瘤的发病因素。     

自拟乳结散对乳腺增生病患者血清性激素水平的影响

目的探讨舒肝健脾、活血散结类中药乳结散对乳腺增生病患者性激素水平的影响。方法选择乳腺增生病患者80例,用自拟乳结散治疗3个疗程,观察治疗前后血清雌二醇(E_2)、孕酮(P)、睾酮(T)、黄体生成素(LH)、卵泡生成激素(FSH)、催乳激素(PRL)等性激素水平的变化。并与30名健康对照者进行比较。结果自拟乳结散治疗80例乳腺增生病总有效率为88.75%(71/80)。治疗组治疗后与治疗前比较,E_2、PRL水平下降,P水平提高(P<0.05),而LH、T、FSH水平治疗前后差异无统计学意义(P>0.05)。治疗组治疗前血清性激素水平与健康对照组比较,E_2、E_2/P水平升高,P水平下降(P<0.05),LH、T、FSH、PRL水平差异无统计学意义(P>0.05)。结论舒肝健脾、活血散结类中药乳结散可能通过调节性激素水平而抑制乳腺增生。     

150例女性不孕症患者血清性激素水平分析

目的 了解女性不孕症患者血清性激素检测的临床意义.方法 将女性不孕症患者150例分为5组,并以已有健康子女的育龄妇女作对照(正常组),分析促卵泡刺激素(FSH)、促黄体生成激素(LH)、垂体泌乳素(PRL)、雌二醇(E2)、孕酮(P)和睾酮(T)水平.结果 A组和B组的FSH、LH、PRL明显高于正常组(P<0.05),而E2和P则明显低于正常组(P<0.05);C组和D组的LH、PRL、E2、P和T 与正常组比较,差异均有统计学意义;E组与正常组比较,除PRL和E2外,其他均无统计学意义(P>0.05).结论 女性不孕症患者血清激素水平检测具有重要的临床意义,可为不孕症的诊治提供依据.     

卵巢储备功能下降的中医辨证及其临床特点

目的探讨卵巢储备功能下降(DOR)的中医辨证分型及其临床特点。方法纳入450例DOR患者,根据不同临床表现进行中医辨证分型,并辨证论治。比较不同中医辨证分型患者的年龄以及治疗前抗苗缪勒氏管激素(AMH)、促卵泡激素(FSH)、黄体生成素(LH)、雌二醇水平。采用Cochran-Armitage趋势检验分析中医辨证分型发生情况随DOR患者年龄、AMH、FSH、LH、雌二醇的变化趋势。观察不同中医辨证分型患者的疗效。结果 450例DOR患者中,中医辨证分型为肝肾阴虚型246例(54.7%),脾肾阳虚型154例(34.2%),血枯血瘀型50例(11.1%)。与其他两组证型的患者比较,肝肾阴虚型患者的年龄更大,治疗前的AMH及雌二醇水平较低(均P<0.05)。Cochran-Armitage趋势检验结果显示,DOR患者肝肾阴虚型的发生与年龄、治疗前雌二醇及AMH水平之间存在线性变化趋势(均P<0.05)。治疗后,肝肾阴虚型、脾肾阳虚型、血枯血瘀型患者治疗总有效率分别为88.2%(217/246)、80.5%(124/154)、74.0%(37/50)。结论根据患者临床表现,可将DO...     

绝经后妇女垂体性腺轴激素的改变

介绍绝经后78例患者血清中LH、FSH、E_2、P、T、PRL6项垂体性腺轴激素的改变,并设正常健康妇女46例作为对照,检查结果绝经妇女E_2、P、PRL、水平均降低,而T、FSH、LH明显升高。     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

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.