性早熟女童病因分析及临床研究

目的:探讨分析性早熟女童病因分析及临床研究。方法:选取我院2015年6月至2017年6月收治的103例性早熟女童,对其一般资料,发病原因实施回顾性分析。结果:性早熟患者最常见的是特发性GnRH依赖型,小于3岁组患者表现为单纯性乳房早发育,外周性性早熟和GnRH依赖;在3-5岁患者中表现为继发性GnRH依赖型、单纯性乳房发育;在6-8岁组患者中表现为特发性GnRH依赖型和单纯性乳房早发育。单纯性乳房早发明显出现骨龄提前症状。结论:导致女童出现性早熟的原因来源于多方面,在婴幼儿时期常见为单纯性乳房早发,学龄前儿童为继发性GnRH依赖型,临床诊断时可以将骨龄和生长速度作为单纯性乳房早发和GnRH依赖型的鉴别指标。     

血清25羟维生素D3、糖类抗原125、睾酮在子宫内膜癌中的表达及其联合检测的临床价值

目的 探讨女性血清25羟维生素D3[25(OH)D3]、糖类抗原125(CA125)、睾酮在子宫内膜癌中的表达水平及其三项同时检测对子宫内膜癌诊断的临床价值研究。方法 选择2020年10月至2021年4月蚌埠医学院第一附属医院住院并手术的子宫内膜癌50例（均由该院病理科诊断为子宫内膜癌）、子宫良性病变40例和同期在该院体检各方面均正常的健康人30例。各组血清25(OH)D3、CA125、睾酮的表达水平检测方法均为电化学发光法。结果 血清25(OH)D3在子宫内膜癌组中的表达水平为（16.83±5.49）μg/L,在子宫良性病变组中的表达水平为（18.52±5.92）μg/L,差异无统计学意义（P>0.05）,但血清25(OH)D3在子宫内膜癌组中的表达水平（16.83±5.49）μg/L和子宫良性病变组中的表达水平（18.52±5.92）μg/L均低于健康组（25.21±5.02）μg/L(P<0.05)。血清CA125、睾酮在子宫内膜癌组中的表达水平均明显升高,且数值明显高于子宫良性病变组及健康组（P<0.05）。血清25(OH)D3、CA125、睾酮表达水平与子宫...     

性激素、超声及骨龄指数联合监测对女童性早熟的早期诊断价值

目的：探讨性激素、超声及骨龄指数(BAI)联合监测对女童性早熟的诊断价值。方法：选取2020年7月—2022年12月某院收治的性早熟女童100例，根据促性腺素释放激素(Gnrh)激发试验分为中枢性性早熟(CPP)组和外周性性早熟(PPP)组，各50例。2组女童均接受性激素、超声及BAI监测，分析性激素、超声及BAI联合监测诊断女童性早熟的价值。结果：CPP组FSH[(9.43±2.62)mIU/L]、LH[(3.13±0.85)mIU/L]、E2[(64.35±10.16)mIU/L]、子宫容积[(4.35±0.92)mL]、卵巢容积[(3.63±0.82)mL]、BAI(0.27±0.10)均高于PPP组[(3.43±1.06)mIU/L、(1.65±0.67)mIU/L、(24.63±4.73)mIU/L、(3.53±0.85)mL、(2.37±0.69)mL、(0.18±0.07)],差异均有统计学意义(P<0.05)。ROC曲线结果显示，FSH、LH、E2、子宫容积、卵巢容积、BAI及联合监测诊断女童性早熟的AUC分别为0.818、0.761、0.839、0.755、0....     

曲普瑞林治疗特发性中枢性性早熟女童的临床效果分析

目的探讨曲普瑞林治疗特发性中枢性性早熟女童的临床效果。方法选择我院2006年8月至2010年8月特发性中枢性性早熟女童共28例,本组患儿均给予曲普瑞林治疗,起初剂量为80～100μg/kg,肌肉注射,每隔30d注射一次,在治疗过程中根据患儿性腺抑制情况及身高增加情况调整剂量。在性腺抑制的前提下逐渐减量,维持生长速度>4cm/年。本组患儿连续治疗2年。观察本组患儿治疗前后骨龄指数、身高年龄对骨龄的追赶(HtSDSBA)、体质量指数、预测成年身高。结果本组患儿治疗后骨龄指数、身高年龄对骨龄的追赶(HtSDSBA)、体质量指数、预测成年身高分别与治疗前比较,差异有统计学意义(P<0.05)。结论曲普瑞林能够抑制特发性中枢性性早熟女童性腺轴及第二性征发育,有助于延缓骨龄成熟,疗效显著。     

注射用醋酸亮丙瑞林对特发性中枢性性早熟的疗效观察

目的：观察注射用醋酸亮丙瑞林（GnRHa）对特发性中枢性性早熟（ ICPP ）女童的临床疗效。方法对45例ICPP女童给予注射用醋酸亮丙瑞林治疗,每4周注射1次,治疗12个月。观察分析治疗前后患儿第二性征、子宫、卵巢、雌二醇（E2）、黄体生成素（LH）、促卵泡激素（FSH）、骨龄（BA）,预测成人身高的变化及药物不良反应。结果45例患儿治疗后乳房、子宫、卵巢体积均有缩小, E2、LH、FSH较治疗前显著降低,骨龄成熟减缓,骨龄/年龄（BA /CA）值下降,预测成人身高增加（4.5±0.4）cm,与治疗前相比,差异具有统计学意义（P﹤0.05）。结论注射用醋酸亮丙瑞林能显著有效抑制特发性中枢性性早熟女童性腺轴及第二性征发育,延缓骨龄成熟,达到改善性早熟患儿成年终身高的目的。     

中成药治疗儿童单纯性乳房早发育疗效分析

目的分析中成药乳癖消、逍遥丸、知柏地黄丸合大补阴丸、桂枝茯苓软胶囊治疗单纯性乳房早发育的近期与远期疗效。方法纵向回顾分析在南通市中医院、南通大学附属医院及南通瑞慈医院2001—2006年确诊为单纯性乳房早发育的359例患儿临床及实验诊断资料,并以乳癖消(63例)、逍遥丸(79例)、知柏地黄丸合大补阴丸(53例)、桂枝茯苓软胶囊(164例)治疗,随访至9岁,观察乳房消退及单纯性乳房早发育转化为中枢性性早熟情况。结果乳房消退情况:乳房完全消退243例,占67.69%;乳房退缩后再增大70例,占19.50%;乳房持续不消退46例,占12.81%。单纯性乳房早发育转化为中枢性性早熟:乳癖消组4例,占6.67%;逍遥丸组6例,占7.59%;知柏地黄丸合大补阴丸组7例,占13.20%;桂枝茯苓软胶囊组22例,占13.41%。总转化率为10.86%。结论中成药能有效治疗单纯性乳房早发育,并延缓中枢性性早熟的到来。单用乳癖消与逍遥丸疗效优于单用桂枝茯苓软胶囊及知柏地黄丸合大补阴丸。     

重组人生长激素联合亮丙瑞林治疗特发性中枢性性早熟女童的疗效

目的：探讨重组人生长激素联合亮丙瑞林对特发性中枢性性早熟女童的治疗效果及对雌二醇（E2）、促卵泡成熟激素（FSH）及黄体生成激素（LH）水平的影响。方法：选取2016-2018我院收治的56例特发性中枢性性早熟女童，按随机数表法分为治疗组和对照组各28例，对照组单用亮丙瑞林治疗，治疗组在对照组治疗基础上加用重组人生长激素，观察两组治疗后的骨龄（BA）、体质量指数（BMI）、预测成年身高（PAH-BA）、骨龄别身高标准差分值（HtSDS-BA）和年化平均生长速度（△GV）。结果：两组患儿乳房发育年龄、治疗时年龄、身高、BA、PAH-BA、HtSDS-BA、遗传靶身高、BMI、左卵巢容积、右卵巢容积、子宫容积和△G比较差异均无统计学意义（P>0.05）。治疗后两组患儿性激素水平（E2、LH、FSH）均显著下降，且治疗组低于对照组（P<0.05）。治疗后两组患儿BA、HtSDS-BA及BMI比较差异无统计学意义（P>0.05）；治疗组PAH-BA、△GV高于对照组（P<0.05）。两组不良反应总发生率比较差异无统计学意义（P>0.05）。结论：重组人生长激素联合亮丙瑞林可明显改善中枢性性早熟患儿的成年预测身高和体内E2、FSH、LH水平     

维生素D联合布拉氏酵母菌对单纯性肥胖儿童的干预效果研究

目的 分析维生素D联合布拉氏酵母菌治疗单纯性肥胖儿童的临床效果。方法 选取2018年2月—2021年2月漯河市第三人民医院儿童体检筛查出体质量指数(BMI)异常的单纯性肥胖儿童80例,按随机数字表法分为观察组(n=40)和对照组(n=40),两组均采取运动与饮食干预,对照组口服维生素D,观察组在对照组的基础上联合布拉氏酵母菌治疗。对比两组体质量指数(BMI)、血清25-羟维生素D3[25-(OH)D3]水平、血脂指标[甘油三酯(TG)、总胆固醇(TC)]水平及不良反应发生率。结果 治疗前两组BMI指数与25-(OH)D3水平差异无统计学意义(P>0.05),治疗6个月后,观察组BMI指数(18.57±2.68)较对照组(25.61±2.36)低,25-(OH)D3水平(26.55±6.54)较对照组(18.42±6.45)高,对比有统计学意义(P<0.05);治疗前两组TG、TC水平差异无统计学意义(P>0.05),治疗6个月后,观察组TG水平(1.19±0.11)及TC水平(2.18±0.29)较对照组[(2.23±0.15)、(5.17±1.36)]低,对比有统计...     

曲普瑞林治疗中枢性性早熟女童骨密度的变化

目的探讨醋酸曲普瑞林治疗中枢性性早熟女童过程中对骨密度的影响。方法对55例中枢性性早熟女童用醋酸曲普瑞林治疗2年后进行治疗前后自身对照,观察治疗前后乳房、子宫、卵巢容积、骨龄、身高增长速率、骨密度的变化。结果治疗后乳房、子宫、卵巢均缩小,骨成熟缓慢,骨龄（BA）／生活年龄（CA）值下将,身高增长速率减缓;骨密度下降：治疗6个月时Z值由治疗前的（1．1±0．5）降至（-0．7±0．6）,与治疗前对比有明显差异;百分位数由治疗前的（69±18）降至（20±16）,与治疗前对比有明显差异;给予补钙治疗可恢复正常。结论醋酸曲普瑞林在有效抑制中枢性性早熟患儿的性腺功能的同时,可导致患儿骨密度下降,有导致骨质疏松风险,但适当给予补钙治疗可纠正。     

不同剂量知柏地黄方药穴位贴剂对TannerⅡ Ⅲ期性早熟女童的疗效比较

<正>随着社会环境因素和生活的改善,以及体质性因素的影响,性早熟(precocious puberty,PP)目前已成为儿科内分泌门诊最常见的病种之一。性早熟定义,是指女童8岁前、男童9岁前呈现第二性征的改变,10岁前月经出现亦为性早熟范畴[1]。性早熟分为真性性早熟和假性性早熟两种,真性性早熟为中枢性性早熟(central precocious puberty,CPP),假性性早熟又称为外周性性早熟,单纯性乳房早发育     

A cytochemical study of the livers of rats treated with diethylnitrosamine/phenobarbital, with benzidine/phenobarbital, with phenobarbital, or with clofibrate

Male Sprague-Dawley rats were treated with clofibrate (CLOF) in the diet for 2 years or with 4 i.p. injections of either diethylnitrosamine (DEN) or benzidine (BZ) followed by phenobarbital (PB) in the diet for 67 weeks, or just with PB for 41 weeks. Animals were killed at frequent intervals, some while still on treatment and others after 3 or 6 months withdrawal of treatment. The livers were subjected to cytochemical measurements of the parenchyma, foci, nodules and carcinomas. The parenchyma of the CLOF groups showed, in general, increases in glucose-6-phosphate dehydrogenase (G-6PD), alpha-glycerophosphate dehydrogenase (alpha-GPD), 5'-nucleotidase (5'-Nu), acid phosphatase (AP) and catalase and decreases in uricase and glutathione (GSH). CLOF induced a low incidence of GSH positive foci; nodules showed universally lower levels of catalase and GSH. In the DEN/PB and BZ/PB groups the parenchyma showed increases (even before PB treatment started) in G-6PD and in gamma-glutamyl transpeptidase (gamma-GT) and decreases in GSH. DEN raised and BZ lowered 5'-Nu. Neither initiator affected alpha-GPD. Both initiators caused a high incidence of foci positive for G-6PD and for gamma-GT; nodules induced by DEN/PB were mainly positive for gamma-GT and showed an erratic response to the other parameters. Carcinomas, found only after DEN/PB, were all positive for G-6PD and, with one exception, all were negative for alpha-GPD, 5'-Nu, AP and GSH. All changes regressed within 3 months of withdrawal of CLOF but not after withdrawal of PB from DEN-initiated animals. In conclusion G-6PD, alpha-GPD and 5'-Nu may be useful histocytochemical parameters for studying the precarcinogenic hepatic changes and nodules induced by peroxisome proliferators and by genotoxic hepatocarcinogens.     

Pharmacokinetics of Pyrazinamide under Fasting Conditions,with Food,and with Antacids

Study Objectives . To determine intrasubject and intersubject variability in, and the effects of food and antacids on, the pharmacokinetics of pyrazinamide (PZA). Design . Randomized, four-period, crossover phase I study. Subjects . Fourteen healthy men and women volunteers. Interventions . Subjects ingested single doses of PZA 30 mg/kg under fasting conditions twice, without a high-fat meal and with an aluminum-magnesium antacid. They also received standard dosages of isoniazid, rifampin, and ethambutol. Measurements and Main Results . Serum was collected for 48 hours and assayed by gas chromatography with mass selective detector. Data were analyzed by noncompartmental methods and a compartmental analysis using nonparametric expectation maximization. Both fasting conditions produced similar results: mean PZA C_max 53.4 ± 10.4 μg/ml, T_max 1.43 ± 1.06 hours, and AUC_0-∞, 673 ± 79.7 μg·hr/ml. Fasting results are similar to those in previous reports. In the presence of antacids, subjects had a mean C_max of 55.6 ± 9.0 μg/ml, T_max of 1.43 ± 1.23 hours, and AUC_0-∞ of 628 ± 88.4 μg·hr/ml. In the presence of the high-fat meal, mean C_max was 45.6 ± 9.44 μg/ml, T_max 3.09 ± 1.74 hours, and AUC_0-∞ 687 ± 116 μg·hr/ml. Conclusions . These small changes in C_max. T_max, and AUC_0-∞. can be avoided by giving PZA on an empty stomach whenever possible. Conclusion : Serum concentrations in this study were consistent with those described previously. In addition, PZA's kinetic behavior was consistent between fasting treatments. Antacids and food had minimal effects on the agent's absorption. Samples drawn between 0.5 and 3 hours after dosing approached C_max for most subjects, with 1 hour being closest. Samples drawn as early as day 2 of daily PZA therapy will produce serum concentrations that approach steady-state values.     

Etomidate-anaesthesia, with and without fentanyl, compared with urethane-anaesthesia in the rat

In spontaneously breathing rats, continuous infusion of etomidate with and without fentanyl caused a slight decrease in blood pressure and heart rate. Coadministration of fentanyl and etomidate in order to obtain full anaesthesia and analgesia resulted in respiratory depression. In artificially ventilated rats both etomidate as well as the anaesthetic combination caused a strong reduction in aortic flow and an increase in total peripheral resistance. A single infusion of etomidate did not change blood pressure. Etomidate combined with fentanyl reduced blood pressure. Under adjusted ventilation blood pressure, aortic flow, max(dF/dt) and heart rate were progressively reduced during a 4 h period. In contrast, urethane anaesthesia reduced aortic flow to a minor extent. Total peripheral resistance and max(dF/dt) were hardly affected. The slightly reduced blood pressure and blood gas variables remained stable during the experiment. From pharmacokinetic studies it was established that effective etomidate plasma levels were maintained constant during the experimental period. Pharmacokinetic interaction between etomidate and fentanyl did not occur. It is concluded that for anaesthesia of longer duration during cardiovascular experiments in rats, urethane is preferable to etomidate/fentanyl because it does not cause serious changes in basal haemodynamic variables.     

Ecotoxicology, ecophysiology, and mechanistic studies with rotifers

Invertebrates play an increasing role in assessing the impacts of environmental contaminants in aquatic ecosystems. Substantial efforts were made to identify suitable and environmentally relevant models for toxicity testing. Rotifers have a number of promising characteristics which make them candidates worth considering in such efforts. They are small, simple in their organization, genetically homozygous, easy to cultivate. Rotifers are further widely distributed and ecologically important in freshwaters, in estuaries and coast, and also play an important role in the transportation of aquatic pollutants across the food web. In the last decades there has been a substantial increase of contributions on rotifers, particularly in areas of their ecology, geophylogeny, genomics and their behavioral, physiological, biochemical and molecular responses, following exposure to environmental chemicals and other stressors. Gene expression analysis enables ecotoxicologists to study molecular mechanisms of toxicity. Rotifers also appear as useful tools in the risk assessment of pharmaceuticals and their metabolites that find their way into aquatic ecosystems because their sensitivity to some of these substances is higher than that of cladocerans and algae. In respect to endocrine disruptors, rotifers seem to be particularly sensitive to androgenic and anti-androgenic substances, whereas copepods and cladocerans are typically more affected by estrogens and juvenile hormone-like compounds. Generally, a combination of whole-animal bioassays and gene expression studies allow an understanding of toxicological mechanisms. The purpose of this review is to demarcate the potential of using rotifers as important invertebrate aquatic model organisms for ecophysiology, ecotoxicology and environmental genomics. This review does not claim to find reasons for a superior use of rotifers in these fields. But the different phylogenetic allocation of rotifers in the Platyzoa (formerly Nemathelminthes) justifies its consideration since there are evolutionary differences in biochemical and genetic performances that need to be considered. Problems, controversials and needs for further studies are discussed. We are providing a literature survey here for the last 15 years that shows a steady increase of ecotoxicological research on rotifers.     

Interactions of alkylureas with l-valine,l-valyl-l-valine,l-leucine,and l-leucyl-l-leucine

The solubilities of l -valine, l -leucine, l -valyl-l -valine, and l -leucyl-l -leucine have been determined in methyl-, N,N′-dimethyl-, and ethylurea solutions. Gibbs free energies of transfer of both amino acids and dipeptides as well as the peptide unit from water to alkylurea solutions have been ascertained. Enthalpies of transfer for the same compounds and the peptide unit have been determined from calorimetric measurements. The additivity principle for the contribution of the peptide unit and the side chains is obeyed neither for Gibbs free energy nor for the enthalpy of transfer. The most characteristic feature of Gibbs free energy data are the negative values for the transfer of the peptide unit to urea solutions and the positive values for the transfer to alkylurea solutions. Moreover, Gibbs free energy of transfer of the l -valyl and l -leucyl side chains is negative in alkylurea and urea solutions. The enthalpy of transfer values for urea solutions are generally negative, whereas the values for alkylurea solutions are positive. The enthalpy values for the l -valyl and l -leucyl side chains are positive as well. However, the enthalpy values for the peptide unit are all negative.     

Dechlorination with sodium thiosulfate affects the toxicity of wastewater contaminated with copper, cadmium, nickel, or zinc

Sodium thiosulfate is recommended by U.S. Environmental Protection Agency for dechlorination of the effluent samples containing residual chlorines before the toxicity testing. For samples contaminated with residual chlorine and metals, e.g., Cd(II), Cu(II) and Ni(II); however, metal toxicity as measured with Daphnia magna was reduced even at approximately half the recommended amount of sodium thiosulfate. Formation of metal-thiosulfate complexes that are less bioavailable may explain the apparent reduction of metal toxicity. In contrast, for samples spiked with Zn(II), dechlorination with sodium thiosulfate increased toxicity. The use of sodium thiosulfate for dechlorination should be cautioned when the sample under the bioassay is potentially contaminated with metals.     

Characteristics of patients with bulimia only, bulimia with affective disorder, and bulimia with substance abuse problems

Characteristics of patients with a diagnosis of bulimia only (N = 46), bulimia with a history of affective disorder (N = 34), and bulimia with a history of substance abuse (N = 34) were compared. Results showed that compared to patients with bulimia only or with bulimia and affective disorders, patients with bulimia and substance abuse experienced a higher rate of diuretic use to control weight, financial and work problems, stealing before and after the onset of the eating disorder, previous psychiatric inpatient treatment, and greater amount of alcohol use after the onset of the eating disorder. Both the substance abuse group and affective disorder group showed a higher incidence of attempted suicide, more social problems, and greater overall treatment rate than the bulimia only group. There were no significant differences among groups in their family histories.