高原低氧环境下男性激素变化分析

目的了解在高原低氧环境下男性的睾酮（T）、雌二醇（E2）的变化,探讨性激素与高原低氧的关系。方法采用放射免疫竞争法分析低海拔地区和移居高原地区50例健康男性血清中T、B的浓度。结果移居高原地区短时间后可导致男性的T、B水平下降,与低海拔地区人群的T、E2浓度之间的差异有统计学意义（P〈0．01）。结论高原低氧可能是导致T、B水平产生变化的主要原因,男性性激素水平的差异是一种适应性和代偿性的改变。     

壮阳生精片联合万艾可治疗男性勃起功能障碍的疗效观察

为探讨壮阳生精片联合万艾可治疗男性阴茎勃起功能障碍 (ED)的疗效 ,我院对 75 8例男性阴茎勃起功能障碍的病人口服壮阳生精片 ,tid ,每次 10片 ,连续服用 3个月。期间每次性生活时加服万艾可 5 0mg。结果总有效率为 95 .9%。壮阳生精片联合万艾可对ED患者有良好的疗效。     

精索静脉曲张对睾丸生精功能影响的研究进展

精索静脉曲张（varicocele, VC）是男性泌尿生殖系统的常见疾病之一,其发病率以青壮年较高,其中80%～98%好发于左侧精索静脉。研究发现,VC能够影响睾丸局部微环境的温度、参与生精环境局部的氧化应激进程、影响精子线粒体功能、调节男性内分泌系统过程、诱导睾丸及附睾细胞凋亡等。因此,VC会对男性睾丸生精功能造成重要影响,进而引发男性不育。但VC影响男性生精功能的具体分子机制尚未完全研究清楚。因此该文将对VC对睾丸生精功能影响的作用及机制研究作一综述。     

生精细胞形态学

澳大利亚男科学专家Deviretser和Baker共同提出了一种新的逻辑性男性不育症分类法.这方法全面而新颖,即考虑到传统经验,又避免了仅以精液分析参数为依据的分类法过于笼统的缺点,同时包括了最新进展,值得我们借鉴.该分类法已为我国学者采纳与接受.其主要是将男性不育症分睾丸前、睾丸后和睾丸等因素.而精液生精细胞检查可以判断睾丸生殖功能,有利于将精液生精细胞分析结果与临床结合.     

血清抑制素B检测在评价男性睾丸生精功能中的应用价值

目的 研究血清抑制素B与睾丸生精功能的关系,探讨血清抑制素B检测在评价男性睾丸生精功能中的应用价值.方法 按WHO人类精液检查与处理实验室手册(第五版)方法对精液进行常规分析,根据精子密度将研究对象分为无精子症组、精子密度≤5×106/ml组、精子密度(6～14)×106/ml组、精子密度(15～20)× 106/ml组及精子密度＞20×106/ml组.根据睾丸穿刺活检病理结果将无精子症组分为梗阻性无精子症组及非梗阻性无精子症组.采用ELISA法分别对上述各组进行血清抑制素B的检测.利用方差分析对组间均值进行统计学分析.结果 精子密度≤5×106/ml组、精子密度(6～14)×106/ml组、精子密度(15～20)×106/ml组及精子密度＞20×106/ml组、梗阻性无精子症组及非梗阻性无精子症组血清抑制素B浓度分别为:62.28±21.64pg/ml、70.52±23.24pg/ml、114.39±35.46 pg/ml、132.42±40.98 pg/ml、102.64±32.79 pg/ml及22.34±10.58pg/ml.统计学分析结果表明,精子密度(15～20)× 106/ml组、精子密度>20×106/ml组及梗阻性无精子症组间血清抑制素B浓度无显著性差异,但均显著高于精子密度≤5×106/ml组、精子密度(6～14)× 106/ml组及非梗阻性无精子症组,差异具有统计学意义.精子密度≤5×106/ml组及精子密度(6～14)×106/ml组血清抑制素B浓度无显著性差异,但均高于非梗阻性无精子症组,差异具有显著性.结论 血清抑制素B检测不仅可作为评价睾丸生精功能的一项指标进行应用,也可用于对无精子症睾丸活检结果进行预测,从而避免不必要的损伤.     

生精煎治疗男性不育症78例

生精煎治疗男性不育症７８例广东开平市第二人民医院刘新蔼１９９０年１月～１９９６年５月间自拟生精煎加减治疗７８例男性不育症患者。其中２５～３０岁４２例，３１～４０岁３０例，４１岁以上６例。婚龄时间２～１２年，婚后均未采取任何避孕措施，女方妇检正常。排除...     

高原低氧对大鼠心肺组织超微结构的影响

背景：研究表明快速进入高原地区时,机体不可避免地会受到不同程度的损伤,以心肺损伤较显著。目的：观察低氧习服对高原低氧大鼠心肺组织的超微结构影响。方法：将SD大鼠分别为进行高原低氧干预1,3和30d,并设置对照组。3个高原低氧组由海拔5m的西安途中耗时1d带到海拔2700m的青海格尔木地区、途中耗时3,30d分别带到海拔4500m的西藏那曲地区,观察各时间点心肺标本的组织学变化。结果与结论：急性高原低氧1,3d组肺组织显微和超微结构出现明显的间质性肺水肿和肺泡性肺水肿,其心脏组织光镜下大鼠各室壁心肌细胞均可见不同程度的浊肿、空泡变性、溶解坏死及间质水肿等,电镜下可见心肌细胞线粒体肿胀,肌浆网扩张,肌原纤维溶解,细胞内外水肿等,急性高原低氧3d上述改变右室壁较左室壁明显,而低氧习服后高原低氧30d组间质性水肿和则肺水肿明显减轻。结果证实,高原急性缺氧可造成大鼠间质性肺水肿和肺泡型肺水肿,并引起以右心室为主的全心性损伤,经过高原低氧习服后心肺组织病变明显减轻。     

高原低氧对大鼠心肺组织超微结构的影响

背景:研究表明快速进入高原地区时,机体不可避免地会受到不同程度的损伤,以心肺损伤较显著。目的:观察低氧习服对高原低氧大鼠心肺组织的超微结构影响。方法:将SD大鼠分别为进行高原低氧干预1,3和30d,并设置对照组。3个高原低氧组由海拔5m的西安途中耗时1d带到海拔2700m的青海格尔木地区、途中耗时3,30d分别带到海拔4500m的西藏那曲地区,观察各时间点心肺标本的组织学变化。结果与结论:急性高原低氧1,3d组肺组织显微和超微结构出现明显的间质性肺水肿和肺泡性肺水肿,其心脏组织光镜下大鼠各室壁心肌细胞均可见不同程度的浊肿、空泡变性、溶解坏死及间质水肿等,电镜下可见心肌细胞线粒体肿胀,肌浆网扩张,肌原纤维溶解,细胞内外水肿等,急性高原低氧3d上述改变右室壁较左室壁明显,而低氧习服后高原低氧30d组间质性水肿和则肺水肿明显减轻。结果证实,高原急性缺氧可造成大鼠间质性肺水肿和肺泡型肺水肿,并引起以右心室为主的全心性损伤,经过高原低氧习服后心肺组织病变明显减轻。     

高原低氧快速适应人群筛选及其低氧适应相关基因的表达研究

目的以世居平原汉族、急进高原汉族(3、7天)、高原低氧习服训练(30、90天)、久居高原汉族人群(10年)以及世居高原藏族的人群为研究对象,筛选高原低氧快速适应人群及其低氧适应相关基因。方法采用全自动血细胞分析仪和血氧饱和度检测仪测定不同分组人群血常规及血氧饱和度S_pO_2数据,qRT-PCR技术检测不同分组人群低氧诱导因子相关基因mRNA表达水平的差异,蛋白电泳方法检测不同分组人群高氧亲和力血红蛋白F(HbF)的差异。结果进入高原后血红蛋白水平增高(平原汉族为146.12±15.5 g/L,入高原3天为173.05±11.7 g/L、7天为173.57±11.2 g/L、30天为175.86±10.4 g/L、90天为181.98±16.6 g/L及久居高原汉族为195.46±22.4 g/L,P0.05),S_pO_2显著降低(平原汉族97.28±1.46%、入高原3天87.6±3.1%、30天90.4±2.6%,P0.05);世居高原藏族血红蛋白水平略高于平原,S_pO_2略降低(P0.05);进入高原7天、90天、久居高原汉族及藏族EPAS1基因mRNA表达水平显著高于平原(P0.05);平原汉族急进高原3天EPAS1基因表达未升高人员进入高原后RBC、Hb及Hct变化高于基因表达升高人员(P0.05);世居高原藏族HbF电泳阳性率(54.5%)明显高于久居高原汉族(27.3%)及平原汉族(14.3%)。结论平原汉族可筛选进入高原3天EPAS1基因mRNA高表达及高携氧能力HbF人群,为高原低氧快速适应人群的筛选提供理论依据。     

正常成年男性乳腺的CT表现

男性乳腺属于退化性器官,疾病的发生率远低于女性乳腺,常见病变为男性乳腺发育症、男性乳癌和转移性肿瘤等犤1-4犦,有关的影像学表现已有文献描述犤5-6犦。本文通过对110例正常成年男性乳腺CT表现的研究,旨在提高对男性乳腺正常表现及相关疾病的诊断水平。1材料和方法1.1临床资料110例经临床及CT检查,无肺部炎症,无肺结核、肺癌、肝脏病变、内分泌疾病及乳腺区疾病的症状和体征,均为成年男性,年龄24～84岁,平均53.3岁。1.2研究方法1.2.1扫描技术使用美国PICKER公司产PQ-5000型螺旋CT机,常规轴位胸部螺旋扫描,层厚8㎜,层距8㎜,螺距1.5,…     

利舒康与黄芪水提取物对模拟高原缺氧大鼠的作用及相关机制研究

目的 分析利舒康与黄芪水提取物对模拟高原缺氧大鼠的作用及相关机制.方法 将60只Wister大鼠按随机数字表法分为常氧对照组(NC组,0.9％氯化钠溶液灌胃)、缺氧模型组(HM组,0.9％氯化钠溶液灌胃)、利舒康组(LS组,利舒康胶囊0.56 g/kg灌胃)、黄芪水提取物组(AE组,黄芪水提取物0.35 g/kg灌胃)...     

促甲状腺素释放激素与多巴胺伍用抗高原创伤低血容量性休克大鼠的作用

目的：观察促甲状腺素释放激素（ＴＲＨ）与多巴胺（ＤＡ）伍用对高原创伤低血容量性休克大鼠的治疗作用。方法：初进高原大鼠２８只，分生理盐水对照组（８只），ＴＲＨ组（７只），ＤＡ组（６只）和ＴＲＨ与ＤＡ合用组（７只）。大鼠右侧股骨粉碎性骨折加放血（血压６．０ｋＰａ维持１小时）复制创伤低血容量性休克模型，观察ＴＲＨ（５ｍｇ／ｋｇ）、ＤＡ（１ｍｇ／ｋｇ）和ＴＲＨ与ＤＡ半量合用对创伤低血容量性休克大鼠血流动力学指标和大鼠存活时间的影响。结果：ＴＲＨ单用或与ＤＡ合用能显著提高休克大鼠的血压，改善心肌收缩向量环面积（Ｌｏ），两药单用或合用均能改善休克大鼠左心室收缩压（ＬＶＳＰ）、左心室收缩压最大变化速率（±ｄｐ／ｄｔｍａｘ）、心肌最大收缩速度（Ｖｐｍ）；ＴＲＨ单用及与ＤＡ合用可明显延长休克大鼠的存活时间，合用效果优于ＴＲＨ或ＤＡ单用效果，并显示出一定的协同作用。结论：ＴＲＨ与ＤＡ合用抗高原创伤低血容量性休克有一定的协同作用。     

高原环境对移居大鼠子代主要脏器指数及心脏形态学的影响

目的探讨移居高原大鼠子代在高原环境中主要脏器发育状况,观察移居高原大鼠子代心脏组织形态学改变。方法将24只(18只雌鼠,6只雄鼠)8周龄wistar大鼠平均分为高原组和平原组,每组12只(9只雌鼠,3只雄鼠)按3:1雌雄比例合笼受孕,所有孕鼠均自然分娩。比较高原组和平原组子代大鼠出生后的第1天、第30天、第60天心、肝、脾、肺、肾、脑的脏器指数,取心脏组织做HE染色检测病理学变化。结果高原组子代大鼠出生第1天体重低于平原组,分别为6.20±0.77g,6.60±0.90g(P<0.05)。第60天高原组子代大鼠心脏指数高于平原组,分别为0.76±0.11,0.61±0.01(P<0.05)。高原组子代大鼠心肌组织HE染色可见心肌间质内有炎性细胞浸润,心肌细胞结构破坏,胞核消失,胞质溶解,均质红染,部分心肌纤维呈不规则断裂,出现大小不等的空泡,心肌间隙扩大,小动脉玻璃样变。结论高原环境对移居孕鼠子代心脏的发育有影响,心肌组织病理改变明显,可能与高原低压、低氧有关。     

Systemic treatment for severe concentrated sulfuric acid burns in an adult male at high altitude: A case report

BACKGROUND The aim of this study was to report a case of a patient who suffered from severe concentrated sulfuric acid burns while working at high altitude.This patient recovered after systemic treatment.We also provide a literature review for a better understanding of the disease.CASE SUMMARY A 30-year-old male,who was working in a local chemical plant in Xining at an altitude of 2261 m,suffered from 85%burns(Ⅲ°70%,deep Ⅱ°15%)after a tank containing 80%concentration of sulfuric acid exploded.The patient immediately received a series of first aid treatments,as well as rigorous wound managements after admission,which included protection for the whole body and organs,prevention and treatment of eye burns,and the appropriate oxygen therapy.After 65 d of treatment,the burn wounds had completely healed,and the patient was transferred to another specialized hospital for further eye treatment.The first aid before admission and the emergency treatment of wounds following admission were appropriate.No severe complications of sepsis,severe renal insufficiency,septic costal chondritis,corneal perforation or other burns occurred during the treatment.CONCLUSION The main causes of concentrated sulfuric acid burns consisted of accidental burns at work,accidents in the outside,factitious injuries and improper laboratory operations.The clinical manifestations were mostly deep Ⅱ°and Ⅲ°burns,with a formation of brown-black,leather-like eschar on the wound surface and locally embolized dendrite-like vessels.The clear cause of the injury and typical clinical manifestations in this case made it easy to diagnosis.However,adult cases with severe concentrated sulfuric acid burns in high altitude areas are rare,so the successful treatment of this case is of great significance.     

Capillary filtration coefficient and urinary albumin leak at altitude

Rapid ascent to altitude risks the development of acute mountain sickness. This study demonstrates changes in peripheral capillary filtration coefficient and renal protein loss in subjects suffering from various degrees of mountain sickness after passive ascent to 4559 m. Capillary filtration coefficient of the calf capillary bed, measured by computer-based multistep strain gauge plethysmography, increased significantly after 23.5 h at altitude when symptoms were most severe: 4.45 (2.76–6.03) to 6.31 (3.86–11.07) ml min^–1 per 100 g of tissue mmHg^–1, median (range) (P <0.02). Urinary albumin excretion was increased after one night at altitude from 1.1 (0.6–1.5) to 2.45 (1.0–6.8) mg of albumin per mmol of creatinine (P <0.05). These results demonstrate simultaneous leakage of a peripheral capillary bed to fluid measured by strain gauge plethysmography, and renal albumin leak, and suggest a systemic process of increased capillary leakage for different-sized molecules caused by rapid exposure to hypobaric hypoxia.     

Capillary filtration coefficient and urinary albumin leak at altitude

Rapid ascent to altitude risks the development of acute mountain sickness. This study demonstrates changes in peripheral capillary filtration coefficient and renal protein loss in subjects suffering from various degrees of mountain sickness after passive ascent to 4559 m. Capillary filtration coefficient of the calf capillary bed, measured by computer-based multistep strain gauge plethysmography, increased significantly after 23.5 h at altitude when symptoms were most severe: 4.45 (2.76–6.03) to 6.31 (3.86–11.07) ml min^–1 per 100 g of tissue mmHg^–1, median (range) ( P  <0.02). Urinary albumin excretion was increased after one night at altitude from 1.1 (0.6–1.5) to 2.45 (1.0–6.8) mg of albumin per mmol of creatinine ( P  <0.05). These results demonstrate simultaneous leakage of a peripheral capillary bed to fluid measured by strain gauge plethysmography, and renal albumin leak, and suggest a systemic process of increased capillary leakage for different-sized molecules caused by rapid exposure to hypobaric hypoxia.     

A comparison of two methods of heart rate variability assessment at high altitude

Heart rate variability (HRV) is a useful index of autonomic function and has been linked to the development of high altitude (HA) related illness. However, its assessment at HA has been undermined by the relative expense and limited portability of traditional HRV devices which have mandated at least a minute heart rate recording. In this study, the portable ithlete^? HRV system, which uses a 55 s recording, was compared with a reference method of HRV which utilizes a 5 min electrocardiograph recording (CheckMyHeart^?). The root mean squares of successive R‐R intervals (RMSSD) for each device was converted to a validated HRV score (lnRMSSD × 20) for comparison. Twelve healthy volunteers were assessed for HRV using the two devices across seven time points at HA over 10 days. There was no significant change in the HRV values with either the ithlete (P = 0·3) or the CheckMyHeart^? (P = 0·19) device over the seven altitudes. There was also a strong overall correlation between the ithlete^? and CheckMyHeart^? device (r = 0·86; 95% confidence interval: 0·79–0·91). The HRV was consistently, though non‐significantly higher with ithlete^? than with the CheckMyHeart^? device [mean difference (bias) 1·8 l; 95% CI ?12·3 to 8·5]. In summary, the ithlete^? and CheckMyHeart^? system provide relatively similar results with good overall agreement at HA.     

高海拔地震灾区患者围手术期的护理

目的探讨高海拔地震灾区患者围手术期的护理体会。方法回顾性分析和总结18例高海拔地震灾区患者围手术期的护理经验。结果 18例无1例出现切口感染、挤压伤等相关并发症,16例功能恢复良好,1例患侧肢体运动尚处于恢复期,1例因腰1椎体爆裂性骨折伴神经损伤仍在康复期。结论严密观察病情变化,心理护理和功能锻炼对提高海拔地震灾区患者救治成功率具有积极的意义。     

去铁胺对大鼠肺组织低氧诱导因子-1表达及对模拟高原低氧大鼠肺组织结构的影响

目的:观察去铁胺对大鼠肺组织低氧诱导因子-1(HIF-1α)表达及对模拟高原低氧环境下肺结构的影响。方法:实验分成两部分,(1)25只Wistar大鼠随机分成5组,腹腔注射去铁胺(DFX)200mg/kg后,分别用RT-PCR和免疫组化方法在各个时相点(0、2、4、8、24h)检测肺组织HIF-1α mRNA和蛋白质的表达。(2)40只Wistar大鼠随机分成5组,每组8只。常氧对照组(N),急性低氧对照组(H0),急性低氧组(H1),DFX处理组(DFX0),DFX处理+急性低氧组(DFX1)。各组动物经相应处理后,测定N、H0、DFX0组肺组织HIF-1α mRNA,观察N、H1、DFX1组肺显微及超微结构变化并检测肺组织一氧化氮浓度及Na+-K+-ATP酶活性。结果:(1)大鼠腹腔注射DFX后肺组织未表达HIF-1α蛋白质,对照组(0h)大鼠肺组织少量表达HIF-1α mRNA,2h后开始升高,4h达峰值(P<0.01),以后逐渐下降,24h后基本恢复到正常对照组水平。(2)大鼠腹腔注射DFX200mg/kg,1次/d,5d后,DFX0组HIF-1α mRNA表达水平显著高于H0和N组(P<0.01)。(3)经模拟海拔6000m急性低氧24h后,H1组肺组织NO浓度和Na+-K+-ATP酶活性低于N组(P<0.01),而DFX1较H1组明显升高(P<0.01)。(4)经模拟海拔6000m急性低氧24h后,H1组肺出现明显的间质性水肿,而DFX1组则水肿明显减轻。结论:DFX可以促进大鼠肺组织表达HIF-1α mRNA;间断腹腔注射DFX可以减轻大鼠低氧性肺间质水肿并提升肺组织NO浓度和Na+-K+-ATP酶活性。     

Cardiac baroreflex control in humans during and immediately after brief exposure to simulated high altitude

To examine the baroreflex response in humans during and immediately after acute hypoxia exposure, the cardiac baroreflex sensitivity (BRS) was studied using adaptation of RR intervals in response to spontaneous systolic blood pressure fluctuations (sequences methodology) in 11 unacclimatized subjects. All measurements were made under fixed breathing rate, and realized consecutively at baseline level (20 min), at an inspired oxygen concentration of 11% (15 min) and again under normoxic conditions (20 min; recovery period). The spontaneous baroreflex response decreases progressively during hypoxic exposure, causing a tachycardic response at this FiO2 without any significant alteration of the systolic or diastolic blood pressure. The magnitude of decrease for this variable at the end of exposure averaged 42.9 +/- 15.6%. The simultaneous spectral analysis of heart rate (HR) variability in hypoxic condition confirmed an alteration in the parasympathetic activity (HFnu: -17.8 +/- 30.9% versus basal conditions, P < 0.01) counterbalanced by an exaggerated sympathetic activity (LFnu: +33 +/- 42.4%, P < 0.05) at the sinus node. Interestingly, we could observe an enhanced cardiac baroreflex response during the period following the inhalation of the hypoxic mixture (+130.6 +/- 15.6% of basal conditions, P < 0.001). There is a relationship with a significant and abrupt increase in the parasympathetic control of HR (mean HR reached 111 +/- 8.1% of the mean basal HR, P < 0.01). These results suggest that brief exposure to hypoxia under rate-controlled ventilation is associated with a significant alteration in the spontaneous cardiac baroreflex. This important cardiac autonomic imbalance is followed by a significant increase in the cardiac parasympathetic drive even after the disappearance of the hypoxic stimulus.