BMI对早卵泡期超长方案多囊卵巢综合征患者辅助生殖结局的影响

目的 探讨不同BMI对采用早卵泡期超长方案的多囊卵巢综合征(PCOS)患者行体外受精-胚胎移植(IVF-ET临床结局的影响。方法 选取2016年9月至2020年9月温州医科大学附属第二医院生殖医学中心收治的行IVF-ET的942例(976个周期)PCOS患者为研究对象,并以同期本院收治的1 258例(1 298个周期)男方或输卵管因素导致不孕的非PCOS患者为对照。根据BMI将PCOS患者与非PCOS患者分为低体重组(BMI<18.5 kg/m²组)、正常体重组(18.5 kg/m²≤BMI<24 kg/m²)、超重组(24 kg/m²≤BMI<28 kg/m²)和肥胖组(BMI≥28 kg/m²)4个亚组。分析比较PCOS患者4个亚组及相同BMI下PCOS患者与非PCOS患者一般情况、实验室及临床结局的差异。结果 随着BMI上升,PCOS患者实验室结局出现明显恶化,临床结局中超重儿出生率上升。PCOS与非PCOS各亚组实验室结局比较,P...     

来曲唑对不同体质指数PCOS患者促排卵治疗效果的影响

目的 分析来曲唑对不同体质指数(BMI)多囊卵巢综合征(PCOS)患者促排卵治疗效果的影响。方法 选取2019年1月至2021年1月就诊于山西白求恩医院妇产科门诊的160例PCOS不孕患者为研究对象,按照BMI不同分为低BMI组(BMI<18.5 kg/m²,25例)、正常BMI组(18.5 kg/m²≤BMI<23 kg/m²,45例)、超重组(23 kg/m²≤BMI<25 kg/m²,55例)、肥胖组(BMI≥25 kg/m²,35例)。检测所有患者月经来潮第2～3天的基础性激素(睾酮、促黄体生成素、卵泡刺激素)以及空腹胰岛素、空腹血糖、促甲状腺素水平,评估患者基础状态。于月经周期第3天开始口服来曲唑(5 mg/d,连续5 d)促排卵治疗,比较4组患者卵泡成熟时间、人绒毛膜促性腺激素注射日子宫内膜的厚度、成熟卵泡(≥18 mm)个数、排卵率和临床妊娠率。结果 160例不孕患者接受了366个来曲唑促排卵治疗周期。4组患者早期流产率、异...     

女性体重指数对IVF/ICSI周期结局的影响

目的:探讨体外受精/卵胞浆内单精子注射(in vitro fertilization/intracytoplasmic sperm injection,IVF/ICSI)助孕的女性体重指数(body mass index,BMI)对鲜胚移植周期临床结局的影响。方法:回顾性分析2016年6月—2018年6月在本中心首次IVF/ICSI治疗并行单个鲜胚移植的1 784例患者临床资料,按照BMI值(中国标准)分为偏瘦组(150例,BMI <18.5 kg/m²)、正常组(1 098例,18.5 kg/m²≤BMI <24.0 kg/m²)、超重组(437例,24.0 kg/m²≤BMI <28.0 kg/m²)、肥胖组(99例,BMI≥28.0 kg/m²),并以不同受精方式分为IVF亚组和ICSI亚组。比较新鲜周期的获卵数、临床妊娠率、种植率、活产率、流产率的区别,以及各亚组间受精率和优质胚胎率的差异。结果:偏瘦组获卵数显著高于其余3组,肥胖...     

体质量指数对长方案控制性超促排卵患者新鲜和冻融胚胎移植周期妊娠结局的影响

目的：探讨不同体质量指数(BMI)患者采用长方案超促排卵(COH)后新鲜胚胎移植周期和冻融胚胎移植(FET)周期的妊娠结局,分析BMI与辅助生殖技术(ART)治疗后妊娠结局的相关性。方法：将采用COH的患者分为新鲜胚胎移植周期组(n=1 957)和FET周期组(n=2 328),根据BMI情况将2组患者分为偏瘦组(BMI <18.5 kg·m^-2)、正常组(18.5 kg·m^-2≤BMI<24.0 kg·m^-2)、超重组(24.0 kg·m^-2≤BMI<28.0 kg·m^-2)和肥胖组(BMI≥28.0 kg·m^-2)。收集并分析各组患者的一般资料、COH情况、胚胎情况和临床妊娠结局。结果：新鲜胚胎移植周期组共1 957例患者,1 957个周期,其中偏瘦组103个周期、正常组1 254个周期、超重组476个周期和肥胖组124个周期。与正常组比较,偏瘦组患者基础卵泡刺激素(bFSH)、基础雌二醇(bE2)和基础促黄体生成素(bLH)水平均明...     

双胎妊娠孕妇的孕期增重分析及适宜值探讨

目的 通过研究双胎妊娠孕妇的孕期增重与母婴结局的关系,探讨我国双胎妊娠孕妇的孕期体重总增长的适宜范围,为进一步指导双胎妊娠孕期体重管理及营养摄入提供依据。方法 选取我院分娩的符合纳入标准的研究对象585例。按照孕前BMI分为4个组：低体重组(BMI<18.5kg/m²)、正常体重组(18.5≤BMI<24kg/m²)、超重组(24≤BMI<28kg/m²)和肥胖组(≥28kg/m²)。记录孕期增重数值,将总增重的P25～P75区间定为适宜增重范围,并据此将研究对象分为3个组：孕期增重过少组(孕期增重小于适宜范围下限)、孕期增重适宜组、孕期增重过多组(孕期增重大于适宜范围上限)。结果 本研究表明双胎妊娠孕妇孕期总增重的适宜范围为12～18kg。低体重组、正常体重组、超重组及肥胖组的双胎孕妇的适宜增重范围分别为14～17kg、13～19kg、12～18kg、11～17kg。双胎妊娠孕妇孕期增重与其产次呈正相关,孕期体重增重不足的孕妇胎膜早破、妊娠期肝内胆汁淤积症、妊娠合并贫血的发生率高...     

肥胖程度对急性ST段抬高型心肌梗死患者预后的影响

目的 探讨肥胖程度对于急性ST段抬高型心肌梗死(ST-segment elevation myocardial infarction, STEMI)患者预后的影响。方法 连续入选2013-2018年因首次发作STEMI收入首都医科大学宣武医院治疗的患者,按照体质量指数(body mass index, BMI)(kg/m²)将患者分为4组:低体质量组(A组):BMI<18.5 kg/m²;正常体质量组(B组):18.5 kg/m²≤BMI<24 kg/m²;超重组(C组):24.0 kg/m²≤BMI<28.0 kg/m²;肥胖组(D组):BMI≥28.0 kg/m²。比较4组患者住院和随访期间的全因死亡和主要不良心脑血管事件(major adverse cardiovascular and cerebrovascular events,MACCE)发生率。结果 低体质量组和其他3组相比男性患者所占比例更高,年龄更大。患者住院接受再灌注治疗的比例随BMI的增加整体呈现上升趋势。住院期间低体质量、正常体质量、超重和肥胖组的住院全因病死率分别为14.71%、3.97%、2.89%和3.09%,差异有统计学意义(P=0.003),低体质量组的全因病死率显著高于超重组和肥胖组。Kaplan-Meier生存曲线显示,低体质量、正常体质量、超重和肥胖组患者的5年预期全因病死率分别为37.0%、19.5%、13.8%、13.0%,差异有统计学意义(P=0.040),低体质量组的5年预期全因病死率显著高于其他3组。用限制性立方样条(restricted cubic spline,RCS)拟合Cox回归模型显示,BMI与随访全因死亡和发生MACCE的风险之间均呈U型关系。在用Cox回归分析校正了混杂因素后,BMI不是STEMI患者远期死亡或MACCE的独立预测因素。结论 肥胖程度对STEMI患者的远期预后没有直接影响。     

体重指数对胶质母细胞瘤患者临床预后的预测价值分析

目的 探讨体重指数(body mass index,BMI)对胶质母细胞瘤患者生存预后的预测价值。方法 回顾性分析2019年1月至2020年8月首都医科大学附属北京天坛医院收治的72例胶质母细胞瘤患者的临床资料。分析患者的临床特征以及预后不良的影响因素。根据BMI不同将患者分为正常组(18.5kg/m²≤BMI<24.0kg/m²,38例)、超重组(24.0kg/m²≤BMI<30.0kg/m²,26例)和肥胖组(BMI≥30.0kg/m²,8例)，比较分析不同BMI组患者的总生存期。结果 本研究中男女比例为1:1.4，异柠檬酸脱氢酶(isocitrate dehydrogenase,IDH)突变率为19.4%,6-氧-甲基鸟嘌呤-DNA甲基转移酶(6-methyiguanine-DNA methyltransferase,MGMT)启动子甲基化比例为59.7%,36.1%的患者超重，11.1%的患者肥胖，70.8%(51/72)的患者死亡。单因素分析结果显示，年龄...     

低体质指数不利于不明原因原发不孕患者人工授精诱导排卵周期妊娠结局

【目的】探索女方体质指数(BMI)对不明原因原发不孕女性人工授精诱导排卵周期(OI-IUI)妊娠结局的影响。【方法】回顾性分析2016年1月至2022年12月于中山大学孙逸仙纪念医院生殖中心行OI-IUI助孕的不明原因原发不孕夫妻共764个周期的临床资料。按照女方患者BMI分为3组,低BMI组(消瘦,BMI<18.5 kg/m²)、正常BMI组(正常体质量,18.5 kg/m²≤BMI<23.0 kg/m²)、高BMI组(超重、肥胖,BMI≥23.0 kg/m²),比较各组间一般资料以及妊娠结局。采用单因素分析和Logistic回归分析矫正混杂因素,探讨BMI与OI-IUI活产率的相关性。【结果】三组HCG阳性率(7.08%、9.74%、13.19%)、宫内妊娠率(5.51%、7.91%、13.19%)和活产率(4.72%、6.90%、12.50%)由低BMI组到高BMI组依次递增,早期流产率(14.28%、10.26%、5.26%)则是由低BMI组至高BMI组依次递减,其中高BMI组活...     

妊娠期肝内胆汁淤积症与子痫前期的相关性研究

目的 探讨妊娠期肝内胆汁淤积症(ICP)与子痫前期(PE)的相关性。方法 选择2013年2月-2021年2月在我院产科分娩的PE 864例(PE组)和同期分娩的非PE 33909例(非PE组)作为研究对象,分析两组中ICP的比例,并进行多因素分析和分层分析探讨ICP与PE的相关性。结果 (1)PE组中年龄、BMI及辅助生育受孕、ICP、妊娠期糖尿病、双胎妊娠、抗磷脂综合征和系统性红斑狼疮的比例均显著大于非PE组(P<0.05);(2)多因素分析提示年龄、BMI、辅助生育受孕、ICP、双胎妊娠、系统性红斑狼疮和抗磷脂综合征与PE显著相关(P<0.05),其中ICP对PE的OR值为2.159(95%CI:1.434-3.251,P<0.01);(3)分层分析提示在孕妇年龄<35岁、体重不足(BMI<18.5kg/m²)、正常BMI(18.5kg/m²≤BMI<24.0kg/m²)、单胎妊娠和初产妇中,ICP与PE显著相关(P<0.05),其OR值分别为2.871(95%CI:1.86...     

广东地区下焦湿热型石淋患者体质量指数与胱抑素C的相关性分析

【目的】分析广东地区下焦湿热型石淋(泌尿系结石)患者体质量指数(BMI)与血清胱抑素C之间的相关性，探讨BMI升高对下焦湿热型石淋患者胱抑素C的影响。【方法】选取2020年9月至2022年9月在广州中医药大学第一附属医院门诊及住院部就诊的下焦湿热型石淋患者，共纳入200例。通过医院病历系统收集符合纳入标准的200例患者的一般资料及临床资料，通过医院检验系统收集患者就诊时(术前)血清胱抑素C、β2微球蛋白、尿素氮、肌酐、尿酸、肾小球滤过率及血压等数据，按照BMI数值分为正常组(18.5 kg/m²≤BMI<24 kg/m²)60例、超重组(24 kg/m²≤BMI<27 kg/m²)80例、肥胖组(BMI≥27 kg/m²)60例，比较各组间血压及血液生化指标之间的差异，分析广东地区下焦湿热型石淋患者BMI与血清胱抑素C及血尿酸的相关性。【结果】(1)在广东地区男性下焦湿热型石淋患者中，其收缩压、舒张压、胱抑素C、尿素氮、尿酸数值均为肥胖组>超重组>正常组...     

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.