微电脑前列腺脉冲式水囊按摩药渗仪的研制及应用

目的介绍微电脑前列腺脉冲式水囊按摩药渗仪的研制及临床应用.方法根据慢性细菌性前列腺炎的病理特点,在临床实验的基础上,结合生物医学工程技术和现代中医药理论,研制出微电脑前列腺脉冲式水囊按摩药渗仪.试用于治疗慢性细菌性前列腺炎病人600例.结果临床治愈459例(76.5%),显效101例(16.8%),好转40例(6.7%).无任何副作用.结论微电脑前列腺脉冲式水囊按摩药渗仪对慢性细菌性前列腺炎是一种良效、安全、舒适而科学的治疗新途径.     

微电脑药物透入水囊按摩仪治疗慢性前列腺炎的初探

我们在临床实践的基础上，根据现代中医药理论，结合电子学技术，采用内病外治、电磁效应、热灸、中药透入及脉冲式水囊按摩等原理研制出微前列腺药物透入囊按摩仪，临床治疗１００例生前列腺炎患者，取得了满意疗效．     

BAEP对新生儿及婴儿听力检测的价值

目的：探讨脑干听觉诱发电位(BAEP)对新生儿及婴儿听力检测的价值。方法：利用BAEP对50例在出生后用耳声发射仪做听力筛查“未通过”(其中双侧37例、右耳6例、左耳7例)的新生儿及婴儿进行听力测定及BAEP检测。结果：作BAEP时听阈测定耳聋38例(占76％)(双耳耳聋的为27例，单侧耳聋的为11例)。其中轻至中度耳聋27例(占54％)，中至重度以上耳聋11例(占22％)，不同程度耳聋伴BAEP异常的为37例(占54％)，轻度耳聋伴BAEP正常1例，BAEP及听力均正常2例．另有10例为单纯的BAEP异常。结论：BAEP能鉴别新生儿及婴儿“听力筛查未通过”是因耳蜗感音性听力障碍还是脑干听觉通路异常引起，以及判断耳聋的程度，为临床的诊断和评估疗效提供可靠的依据。     

Klinefelter综合征患者141例分析

本文对1982－1997年15年来至我院就诊的141例Kinefelter综合征患者进行分析，其中标准型患者132例，占93．6％，嵌合型4例，占2．8％，合并易位型1例，占0．7％，伴小Y型3例，占2．1％，其它变型1例，占0．7％，这些患者大多表现为结婚多年不育或第二性征发育异常，提示克氏征是男性不育的重要病因之一。     

阴道镜检查在妇科的应用价值

目的：探讨阴道镜检查在妇科疾病诊断中的应用价值。方法：随机抽取268例患者的阴道镜检查资料并结合细胞学检查进行回顾性分析。结果：268例阴道镜检查结合病理学检查中，阳性结果240例(占89．56％)，其中慢性宫颈炎191例(79．58％)，宫颈尖锐湿疣32例(13．33％)，宫颈不典型增生6例(2．50％)，宫颈原位癌6例(2．50％)，宫颈浸润癌4例(1．67％)，宫颈结核1例(0．42％)。结论：阴道镜检查结合细胞学检查为早期宫颈癌和宫颈尖锐湿疣早期阶段的诊断提供了可靠依据，对慢性宫颈炎的鉴别诊断有一定临床价值，可作为妇科疾病常规检查和宫颈癌普查项目之一。     

腮腺炎性脑膜炎脑电图分析

目的：探讨腮腺炎性脑膜炎病人的临床特征及脑电图变化。方法：对60例腮腺炎性脑膜炎病人的脑电图检查结果进行分析。结果：60例中广泛弥漫性异常46例(76．6％)，边缘状态8例(13．3％)，正常范围6例(10％)，3例伴抽搐，1例见痫样放电。结论：腮腺炎性脑膜炎病人的临床症状与脑电图变化大致呈平行关系。     

江门市桑拿按摩女性从业人员性传播疾病／艾滋病感染情况分析

目的了解江门市桑拿按摩女性从业人员性传播疾病／艾滋病的流行情况。方法对213位桑拿按摩女性从业人员进行性病病原体检测。结果在213名桑拿按摩女性从业人员中发现性病84例，性病感染率为39．44％，其中HIV抗体阳性1例（0．47％），细菌性阴道病16例（7．51％），淋病7例（3．29％），衣原体性宫颈炎38例（17．84％），尖锐湿疣1例（0．47％），梅毒14例（6．57％），念珠菌性阴道病7例（3．29％）。结论桑拿按摩女性从业人员是性病的高危人群，应主动定期对该人群进行监测，并加强行为干预和治疗。     

29例伴del(20q)骨髓增生异常综合征的细胞遗传学和临床特征

目的 分析伴del(20q)的骨髓增生异常综合征(myelodysplastic syndrome，MDS)患者的细胞遗传学和临床特征。方法 对29例伴del(20q)MDS的细胞遗传学改变、临床表现、实验室检查特点及病程转归进行总结分析。结果 (1)29例del(20q)的MDS中，11例(37．9％)混合正常核型，难治性贫血(refractory anemia，RA)／伴环形铁粒幼细胞增多的难治性贫血(RA with ringed sideroblasts，RAS)组有9例，而原始细胞增多的RA(RA with excess blasts，RAEB)／转变中的RAEB(RAEB in transformation，RAEB-T)组2例；RA／RAS组中缺失以del(20q)(q11)多见(63．2%)，而RAEB／RAEB-T组中以del(20q)(q12)多见(70．0％)；RA／RAS组的附加核型改变和复杂核型改变发生率为26．3％、5．3％，均低于RAEB／RAEB-T组的50．0％和30．0％；(2)伴del(20q)的MDS多表现为两系或3系血细胞减少，几乎全部患者有红系和粒系病态造血，而58．6%的患者有巨核细胞病态造血，13例(44．8％)患者为两系病态造血，14例(48．3％)患者为3系病态造血，另2例为单纯红系病态造血；62．5％患者的有核红细胞糖原染色阳性和中性粒细胞碱性磷酸酶积分减低；81．8％患者有淋巴细胞的免疫学标记表达；(3)2例患者转化为急性非淋巴细胞性白血病(acute nonlymphocytic leukemia，ANLL)M2a型。结论 del(20q)可能是血液肿瘤中一种早期和初步的细胞遗传学异常，伴del(20q)的MDS以两系和3系血细胞减少及病态造血常见，可表达淋巴细胞标记，随病情进展正常核型减少而附加和复杂核型增加。     

反复体外受精方法失败者卵胞浆内单精于注射预后分析

目的 探讨反复常规体外受精—胚胎移植(IVF—ET)方法失败伴受精不良者行卵胞浆内单精子注射(ICSI)预后。方法 收集1999年10月到2002年8月在我院生殖中心接受常规IVF技术治疗至少1个周期以上失败伴受精率低于50％的23例(31个周期)女性不育患者为研究对象，在以后的治疗周期采用ICSI治疗方法。同时选择2001年10月到2002年8月因男性因素不育而行ICSI的30例(32个周期)患者为对照组，对比两组的临床结果。采用常规超排卵治疗长方案治疗，成熟的卵母细胞行单精子显微注射。结果 两组平均获卵数和受精率、四、六细胞卵裂率无显著差异。但八细胞卵裂率、种植率、临床妊娠率，IVF失败组分别为：26．6％、7．5％、21．4％，男性因素不孕组分别为：35.8％、18％、47.2％。两组有显著性差异。同时比较失败组自身前后两种不同受精方法的实验室情况。IVF的受精率，四、六细胞卵裂率无显著差异。但八细胞卵裂率、种植率、临床妊娠率，IVF失败组分别为：26．6％、7．5％、2l、4％，男性因素不孕组分别为：35．8％、18％、47.2％。两组有显著性差异。同时比较失败组自身前后两种不同受精方法的实验情况。IVF的受精率，四、六、八细胞卵裂率分别为48．1％、35.4％、29．9％、26.8％。ICSI的分别为68.9％、53．7％、29．9％、26.6％。其受精率及四细胞卵裂率有显著差异，六、八细胞卵裂率无差异。结论 ICSI可提高反复IVF-ET失败件受精不良患者受精率，并使部分患者妊娠，但其优质胚胎率、种植率及临床妊娠率相对单纯男性因素行ICSI者较低。提示反复IVF-ET失败伴受精不良者可能存在某种配子异常，显然ICSI可使卵子受精，但配子的异常使胚胎的发育受到损害，降低了种植率和临床妊娠率。     

494例次移植肝穿刺活检病理组织学分析

目的 通过对354例(494例次)移植肝穿刺活检组织进行病理分析，观察移植肝的组织学变化，探讨其出现肝功能不全的原因。方法 移植肝穿刺活检组织经10％中性福尔马林固定，快速石蜡连续切片，常规HE染色。部分病例做VG、Masson、PAS、网状纤维组织化学和免疫组织化学染色，抗体为HBsAg、HBcAg、HcVAg、CMV、CD8、CD4、CK19。对排斥反应病例，依照国际统一的BANFF标准进行急性排斥反应分级，应用排斥活动指数(RAI)进行排斥反应程度评分。结果 急性细胞性排斥反应最常见，180例(50．85％)，慢性排斥反应11例(3．11％)，再灌注缺血损伤20例(5．65％)，胆汁淤滞及急慢性小胆管炎64例(18．08％)，药物性肝损害18例(5．08％)，移植肝无功1例(0．28％)，CMV感染24例(6．78％)，乙肝病毒再感染及乙肝复发27例(7．63％)，丙型肝炎复发2例(0．56％)，原发性硬化性胆管炎复发1例(0．28％)，难以诊断6例(1．69％)。结论 移植肝穿刺活检对移植术后并发症的诊断及选择治疗方案具有重要价值。     

Is abnormal expression of semenogelin I involved with seminal vesiculitis?

Seminal vesiculitis is the common disease of male urogenital system. However, the pathogenesis of seminal vesiculitis remains unclear. Semenogelin I (Sg I) is mainly synthesized and secreted by seminal vesicle and has antibacterial activity. We thus postulate that Sg I plays an important role during the occurrence and development of seminal vesiculitis. In the present study, we analyzed the expression of Sg I in normal seminal vesicle tissues and seminal vesiculitis tissues through immunohistochemistry. The results showed down-regulated expression of clusterin at protein level in seminal vesiculitis tissues compared with normal seminal vesicle tissues. Our preliminary data suggest that the abnormal expression of clusterin is closely related to seminal vesiculitis. Downregulation of Sg I expression may weaken the antibacterial activity of the seminal vesicle and then induce the occurrence of disease. This is the first study to focus on the relationship between Sg I and human seminal vesiculitis.     

Karman's cannula and vacuum aspirator in gynecological practice.

The charts of 340 patients who underwent an endometrial suction procedure using Karman''s cannula and syringe were reviewed. The therapeutic uses of this instrument were for the treatment of chronic endometritis (18.6%), the evacuation of incomplete or missed abortion (14.6%) and hydatidiform mole (0.8%), and the retrieval of the missing tail of an intrauterine contraceptive device (1.2%). Its diagnostic indications include: the investigation of infertility (55.3%), dysfunctional uterine bleeding (8.7%), and postcoital bleeding (0.8%). The diagnostic yield of the instrument was 96.6%. Transient postoperative abdominal pain occurred in 65.9% of the cases while cervical dilatation preceded aspiration in 12.9% of the cases with cervical stenosis. The advantages of the instrument are discussed and its usefulness in everyday gynecological practice highlighted.     

慢性丙型肝炎患者外周血淋巴细胞亚群与病毒载量的相关性分析

目的:分析慢性丙型肝炎患者外周血淋巴细胞亚群的变化以及与HCV病毒载量的相关性,探讨慢性HCV感染慢性化的免疫机理.方法:应用直接免疫荧光-流式细胞术检测47例慢性丙型肝炎患者外周血T淋巴细胞亚群及NK细胞的相对数量,与35例正常健康人做比较;应用实时荧光定量RT-PCR对其外周血HCV病毒载量进行检测,将慢性HCV感染者分为两组进行比较分析.结果:外周血CD4 T淋巴细胞比例和CD4/CD8比值慢性丙型肝炎患者组低于正常人组(P＜0.05),HCV RNA阳性组与HCV RNA阴性组之间的差异无统计学意义(P＞0.05);NK细胞比例慢性丙型肝炎患者组高于正常人组(P＜0.05),HCV RNA阴性组高于HCV RNA阳性组(P＜0.05).结论:慢性HCV感染者存在细胞免疫功能低下,NK细胞介导非特异性免疫的持续上调,在有效地清除了部分HCV病毒的同时,可能促进了持续性免疫性肝损伤.     

子宫内膜微创术及宫腔内人工授精治疗不明原因不孕的疗效观察

目的观察子宫内膜微创术及宫腔内人工授精治疗不明原因不孕患者的疗效。方法选择2008年3月至2009年9月因不明原因不孕在不孕不育门诊就诊的患者108例。所有患者均进行过3次及以上正规宫腔内人工授精未孕。以上患者随机分为研究组47例,对照组61例。研究组于月经周期第8-10天行子宫内膜微创术,用5号刮匙酌情轻微搔刮子宫内膜壁,当周期于卵泡成熟破裂前后行IUI。对照组仅行IUI。结果研究组47例共进行82周期治疗,对照组61例共进行125周期治疗,研究组临床妊娠率20.73%,累积妊娠率36.17%。对照组妊娠率12%,累积妊娠率24.59%。结论子宫内膜微创术联合IUI治疗,可明显提高不明原因不孕患者的妊娠率,无毒副作用,易于操作,值得基层推广应用。     

Molecular analysis of microdeletions of the Y chromosome in Venezuelan males with idiopathic infertility

Today infertility is a major health problem affecting about 10-20% of couples. A male factor is assumed to be responsible in about 50% of the infertile couples. The origin of reduced testicular sperm function is unknown in about 60-70% of cases. There are several causes of male infertility such as varicocele, spermatic duct obstruction, and endocrine disorders. Micro-deletions in the Yq are known to represent the pathogenic mechanisms for infertile males. Three different non-overlapping regions designated as AZFa, AZFb, and AZFc are located in interval 5-6 of Yq, and are associated with impaired spermatogenesis in humans. To determine the prevalence of Y chromosomal microdeletions in Venezuelan males with idiopathic infertility, chromosomal, seminal, histological and molecular analyses were carried out in 29 Venezuelan males with idiopathic azoospermia or oligoospermia. Y-microdeletions analyses were performed using a multiplex polymerase chain reaction (PCR)-based technique with 22 sequences-tagged-sites (STSs). One of 29 patients (3.4%) had Yq microdeletions on AZFc. The frequency of AZF microdeletions in Venezuelan patients was similar to other populations with different ethnical or geographical origin.     

乳酸脱氢酶同工酶X与男性不育关系的初步研究

目的测定男性不育患者精液和精浆中乳酸脱氢酶同工酶X（LDH-X）的含量,以探讨其与男性不育的相关性,进而丰富男性不育的实验室诊断方法。方法选择60例不育患者作为研究对象,随机分成两组：A组精液异常不育组,B组少精症不育组。对照组30例为生殖能力正常的男性。精液乳酸脱氢酶X测定采用定量检测试剂盒,用两点法测定。结果对照组的精子密度、活率、A＋B级均极显著高于A组和B组;不育患者精子LDH-X较对照组均有明显下降,与对照组相比,差异极显著（P〈0.01）,不育患者精浆/精子LDH-X比值较对照组有显著性差异（P〈0.05）。结论不育患者精子LDH-X含量下降,能反映精子的活力,是男性不育临床诊断的较好指标。精浆/精子LDH-X比值对于男性不育的临床诊断也有一定参考价值。     

Dexamethasone therapy of infertile men with sperm autoantibodies: immunological and sperm follow-up.

A group of 14 infertile men with significant titres of anti-sperm antibodies in their sera and seminal plasma were treated with dexamethasone acetate at 2 of 3 mg/day for s13 or 9 weeks respectively. Response to the treatment was evaluated by the evolution of seminal and circulating anti-sperm antibodies and semen characteristics. An overall decline in the anti-sperm antibodies was observed. Serum spermotoxicity and seminal agglutinins decreased below detectable levels in 67 and 58% of the men respectively. The decrease in both kinds of antibodies was closely correlated. Serum sperm agglutination titres fell slightly (2 to 3 log2 dilutions) in most cases. The disappearance of antibodies from the semen was accompanied by decreased autoagglutination and increased percentages of progressively motile spermatozoa. In two oligozoospermic men a striking increase in the sperm count was observed. Pregnancies occurred in three couples at times when serum spermotoxic and seminal agglutinating antibodies were undetectable and semen characteristics were normal.     

Immunological disorders, as the cause of ivf failure in patients with adenomyosis

Adenomyosis is a disorder which is still of unknown nature despite a lot of research. Recent studies have not confirmed uniformly, whether the immunological disorders can be the cause of infertility. We have retrospectively evaluated the immunogramms of 71 patients aged 25–39 years old (31 ± 5,4) with adenomyosis and infertility, that underwent IVF treatment cycle, in which more than 2 embryos of good quality were transferred.
RESULTS:  There were five types of immunogramms: 1 type-normal, was in 18 patients (25.3%), 2 type-reduced number of all cell types of lymphocytes and/or reduced T-helpers cells – 22 cases (31%), 3 type-reduced quantity of T-supressors cells or/and increased T-helpers – 17 patients (24%), 4 type-increased quantity of NK 4 patients, 5 type-other abnormalities – 10 (14.1%).
The results of the IVF cycle were as following: in the 1 type group 10 pregnancies (55.5%), in the 2 type patients – no pregnancies, in the 3 type – four pregnancies (23.5%) in the 4 group – no pregnancies, and in 5 type group – four pregnancies (40%).
The difference among the groups is statistically significant.
CONCLUSIONS:  The results showed that the problems in systemic immunity can be one of the causes IVF failure and infertility in patients with adenomyosis.     

Functionally inactive protein C inhibitor in seminal plasma may be associated with infertility.

Protein C inhibitor (PCI) has been found in seminal plasma and is considered to protect intact surrounding cells and seminal plasma proteins from possible proteolytic damage. In the present study, we showed that although the antigenic levels of PCI in two seminal plasma samples from patients with infertility were normal or slightly elevated, their inhibitory activities toward urokinase plasminogen activator (uPA) and tissue-type plasminogen activator (tPA) were absent. In contrast, uPA and tPA proteolytic activities in these two samples were 20-60-fold higher than that from normal volunteers. A time-course analysis of PCI-uPA complex formation showed that >80% of the complex had been formed within 15 min in normal seminal plasma in the presence of heparin, compared with the total complex formed after 150 min incubation, whereas no response to heparin stimulation was observed in the assays with the two patient samples. Similarly, >90% of PCI-tPA complex was formed after 30 min of heparin stimulation in normal seminal plasma but no response was observed in the two patient samples. Kinetic assays of PCI inhibitory function in the presence of activated protein C (APC) showed that PCI inhibitory activity in the two patient samples was absent and not stimulated by heparin. Western blotting also showed that most of the intact PCI molecules, in normal samples, formed complexes with either uPA or tPA but there was no complex formed in one of the two patient samples and very little complex was observed in the other, suggesting that PCI in the two patient samples is inactive. These results suggest that the presence of functionally inactive PCI in seminal plasma may be associated with infertility.