多囊卵巢综合征不孕症患者血清氧化应激和IGF-I检测的临床意义

目的探讨血清氧化应激和IGF-I水平在多囊卵巢综合征不孕症患者中检测的临床价值。方法选取112例多囊卵巢综合征不孕症患者为病例组,选取因男方少弱精子症需要进行夫精宫腔内人工授精的妇女50例为对照组,对比分析两组研究对象的氧化应激及IGF-I等指标水平是否存在差异,以及相关指标与多囊卵巢综合征患者促排卵及妊娠结局等的相关性。结果病例组患者SOD水平低于对照组(68.64±12.22vs113.62±23.60μU/ml),血清MDA、 LPO、GSH-Px和IGF-1水平高对照组(13.25±4.67VS6.7 3±2.75 U/L、8.34±1.27 VS 3.48±0.68μU/ml、211.86±32.27 VS 161.48±21.68 U/L、262.83±29.94 VS 149.38±12.50μg/L),差异具有统计学意义(P0.01);病例组中排卵率以及妊娠率均明显低于对照组(78.57 VS 94.00%、15.18 VS36.00%),差异具有统计学意义(P0.05);而流产率及多胎率高于对照组(4.46 VS 2.00%、3.57VS 0.00%),但差异无统计学意义(P0.05));血清氧化应激MDA、 LPO、GSH-Px和IGF-1水平与多囊卵巢综合征不孕症患者排卵率、妊娠率呈负相关相关(r值分别为-0.731,-0.562,-0.689,-7.786;-0.685,-0.680,-0.776,-0.742),差异具有统计学意义(P0.05);与流产率以及早产率呈正相关(r值分别为0.687, 0.664, 0.685, 6.038; 0.587, 0.634, 0.564, 0.656),差异具有统计学意义(P0.05);血清SOD与多囊卵巢综合征不孕症患者排卵率、妊娠率呈正相关(r=7.834),差异具有统计学意义(P0.05);与流产率以及早产率呈正相关(r=-0.834),差异具有统计学意义(P0.05);临床妊娠组血清MDA,LPO,GSH-Px和IGF-1水平高于未妊娠组,而血清SOD水平明显高于未妊娠组,差异具有统计学意义(P0.01)。结论多囊卵巢综合征患者血清氧化应激和IGF-I与促排卵疗效和妊娠结局具有一定的相关性,上述指标可能在临床多囊卵巢综合征不孕症患者的治疗中具有一定的参考价值。     

腔镜手术对卵巢子宫内膜异位囊肿合并不孕的疗效分析

目的:卵巢子宫内膜异位囊肿合并不孕症患者经腔镜手术后的疗效分析.方法:卵巢子宫内膜异位囊肿合并不孕症患者86例,腹腔镜下囊肿剥出术46例,剖腹囊肿剥出术40例,对照分析.结果:术中出血量、术后用药日、术后住院日、术后妊娠率两组比较有统计学意义(P＜0.05).右侧卵巢子宫内膜异位囊肿治疗后的妊娠率高于左侧和双侧.结论:腹腔镜手术治疗卵巢子宫内膜异位囊肿合并不孕症与经腹手术组具有相似的治疗效果,且疗效更优于经腹手术组.     

控制性卵巢刺激过程中卵巢慢反应1例分析

目前体外受精-胚胎移植(IVF-ET)技术为越来越多的不孕症患者所接受,是治疗不孕症的重要方法。控制性卵巢剌激(controlled ovarian stimulation,COS)方案能否获得数量适中且质优的卵母细胞及胚胎是影响IVF-ET成功率的关键因素。COS过程中如若出现卵巢慢反应,一旦处理不当,就会转变为卵巢低反应,导致获卵数少、临床妊娠率低,因此必须积极干预。本文通过对COS过程中出现卵巢慢反应的1例患者进行分析,探讨卵巢慢反应的临床特征、发生原因、治疗措施、转归及预防。     

浅谈多囊卵巢综合征所致不孕症的治疗

多囊卵巢综合征(PCOS)是育龄期妇女最常见的内分泌疾病,目前其发病率正呈上升趋势,其所致不孕症的发生,不仅影响婚姻、家庭亦能影响社会的和谐发展,所以PCOS所致不孕症的治疗尤为重要,本文旨在综述各种治疗方法。     

基于“心-肾-胞宫”学说理论下的养心清肝育麟方对卵巢储备功能低下性不孕症患者促排卵效果及性激素水平的影响

目的 探讨基于“心-肾-胞宫”学说理论下的养心清肝育麟方在卵巢储备功能低下性不孕症患者中的临床应用效果及对性激素水平的影响。方法 选取2018年1月至2019年10月南京中医药大学南通附属医院收治的96例卵巢储备功能低下性不孕症患者作为研究对象。根据系统抽样法随机将其分为对照组和观察组,各48例。对照组予以常规西医药物治疗,观察组在予以常规西医药物治疗的基础上联合基于“心-肾-胞宫”学说理论下的养心清肝育麟方治疗。比较两组治疗后的卵巢储备功能改善情况、性激素水平,以及治疗后1年的妊娠率。结果 治疗后观察组的卵巢面积、卵巢平均直径明显大于对照组,窦卵泡数显著多于对照组,差异具有统计学意义(P<0.05);治疗后,观察组的血清黄体生成素(LH)、卵泡刺激素(FSH)水平明显低于对照组,血清雌二醇(E₂)、抗苗勒管激素(AMH)水平显著高于对照组,差异具有统计学意义(P<0.05);治疗后1年,观察组的妊娠率(93.75%)明显高于对照组(75.00%),差异具有统计学意义(P<0.05)。结论 卵巢储备功能低下性不孕症患者采用基于“心-肾-胞宫”学说...     

中西医结合治疗多囊卵巢综合征不孕症86例临床观察

目的:观察补肾、活血、调肝中药联合氯米芬治疗多囊卵巢综合征(PCOS)不孕症临床疗效,探讨其可能的疗效机制.方法:将86例中医辨证为肝肾阴虚兼郁型PCOS不孕症患者随机分为两组,补肾、活血、调肝中药联合氯米芬治疗组46例,氯米芬对照组40例进行比较研究,分别观察治疗前后血清T、LH/FSH的变化及治疗周期排卵率及受孕率.结果:中西药治疗组总有效率89.13%,氯米芬对照组总有效率50%;治疗组排卵率为82.83%,受孕率为52.17%;对照组排卵率为40%,受孕率为22.5%.治疗组治疗后血清T、LH/FSH比治疗前有显著下降(P＜0.05),对照组的各项指标治疗前后无显著性差异.结论:中药补肾、活血、调肝联合氯米芬治疗有协同作用,能明显改善PCOS不孕症临床症状,提高受孕率,特别是对耐氯米芬的PCOS患者有良好的治疗效果,即治疗组疗效优于对照组.其作用机制可能与调节下丘脑-垂体-卵巢轴的功能,降低胰岛抵抗有关.卵巢激素水平改善,抑制卵巢T的合成释放,降低雄激素水平而恢复排卵,最终达到月经来潮及妊娠目的.     

疏肝益肾方结合来曲唑治疗肾虚肝郁型多囊卵巢综合征伴不孕症患者对其孕激素及受孕率的影响

目的探讨疏肝益肾方结合来曲唑肾虚肝郁型多囊卵巢综合征(PCOS)伴不孕症患者对其孕激素及受孕率的影响。方法选取2018年5月至2019年12月宁德师范学院附属宁德市医院诊治的92例肾虚肝郁型PCOS伴不孕症患者作为研究对象。根据随机数表法分为对照组和研究组,各46例。对照组采用来曲唑治疗,研究组在对照组基础上结合疏肝益肾方治疗。比较两组受孕情况、性激素、卵巢储备功能及不良反应。结果研究组排卵率、妊娠率均比对照组高,差异具有统计学意义(P0.05)。治疗后,研究组血清总睾酮(T)、促黄体素(LH)、卵泡刺激素(FSH)水平均比对照组低,孕酮(P)水平比对照组高,差异具有统计学意义(P0.05)。治疗后,研究组卵巢动脉收缩期峰值流速(PSV)比对照组高,阻力指数(RI)比对照组低,差异具有统计学意义(P0.05)。两组自然流产率、不良反应总发生率比较,差异无统计学意义(P0.05)。结论疏肝益肾方结合来曲唑治疗肾虚肝郁型PCOS伴不孕症患者,可有效改善患者的性激素水平和卵巢血流循环,促进排卵及妊娠。     

姜黄素抑制小鼠生殖器官氧化产物生成的研究

目的:探讨姜黄素对氧化应激小鼠子宫、卵巢组织脂质过氧化水平的影响。方法:昆明种雌性成年小鼠40只,随机分成正常对照组,0 mg/kg Cur组,100 mg/kg Cur组,200 mg/kg Cur组,连续用药21天,实验结束后测定小鼠子宫、卵巢组织以及血清中丙二醛(MDA)、活性氧(ROS)的含量。结果:100 mg/kg Cur组,200 mg/kg Cur组血清、子宫以及卵巢氧化应激产物ROS、MDA与砷暴露组相比均有降低,具有明显统计学差异(P0.05)。结论 :姜黄素可降低小鼠子宫、卵巢组织以及血清中氧化产物MDA、ROS的含量,对小鼠卵巢氧化应激引起的生殖器官损伤有保护作用。     

AMH联合E_2、FSH/LH检测对不孕症患者卵巢储备功能及反应性的评估作用

目的探讨抗苗勒管激素(AMH)联合雌二醇(E_2)、促卵泡激素(FSH)/黄体生成素(LH)检测对不孕症患者卵巢储备功能及反应性的评估作用。方法选取2016年3月至2018年12月湖北省襄阳市第一人民医院诊治的193例不孕症患者作为研究对象。均于月经期第2d～第3d检测血清AMH、E_2和FSH/LH水平,另记录获取卵子数目。根据获卵数将患者分为卵巢反应正常组(n=149)、卵巢低反应组(n=25)、卵巢高反应组(n=19),比较三组患者血清AMH、基础E_2和FSH/LH水平,并绘制基于血清AMH、基础E_2和FSH/LH水平单项及联合预测卵巢储备功能及反应性的工作曲线(ROC),分析其灵敏度、特异度及曲线下面积(AUC)。结果 193例不孕症患者血清AMH为(1.82±0.41)ng/mL,基础E_2水平为(30.45±2.37)pg/mL,基础FSH/LH为(1.64±0.35);193例不孕症患者中卵巢低反应25例(12.95%),卵巢正常反应149例(77.20%),卵巢高反应19例(9.84%);卵巢反应正常组、卵巢高反应组的血清AMH水平均明显高于卵巢低反应组,差异具有统计学意义(P0.05),卵巢高反应组的AMH水平高于卵巢反应正常组,差异具有统计学意义(P0.05);卵巢反应正常组、卵巢高反应组的基础E_2、FSH/LH水平均明显低于卵巢低反应组,差异具有统计学意义P0.05),卵巢高反应组的基础E_2、FSH/LH水平均明显低于卵巢反应正常组,差异具有统计学意义(P0.05);血清AMH、基础E_2、FSH/LH及联合预测不孕症患者卵巢低反应的AUC分别为0.824、0.652、0.765、0.911,灵敏度分别为72.00%、60.00%、64.00%、84.00%,特异度分别为82.55%、83.22%、79.87%、88.59%;血清AMH、基础E_2、FSH/LH及联合预测不孕症患者卵巢高反应的AUC分别为0.714、0.791、0.691、0.936,灵敏度分别为73.68%、68.42%、73.68%、84.21%,特异度分别为82.55%、83.89%、74.50%、88.59%。结论不孕症患者血清AMH水平在卵巢高反应性、卵巢正常反应性、卵巢低反应性中呈逐渐降低趋势,而基础E_2、FSH/LH则逐渐升高,血清AMH、基础E_2、基础FSH/LH均对卵巢反应性具有一定的预测价值,但此3项指标联合预测的价值优于各指标单独预测。     

经阴道超声在年轻不孕症患者卵巢储备功能评估及排卵预测中的应用价值分析

目的 探究经阴道超声在年轻不孕症患者卵巢储备功能评估及排卵预测中的应用价值。方法 以2020年3月至2021年12月温州医科大学附属台州妇女儿童医院88例年轻不孕症患者为研究对象,均采用经阴道超声检查。根据患者卵巢储备功能将其分为正常组(n=47)及异常组(n=41),分析超声指标对卵巢储备功能的诊断价值,并比较正常组不同月经周期的阴道超声指标。结果 异常组卵巢体积及卵巢间质动脉收缩期最大血流速度(PSV)、舒张期最低血流速度(EDV)小于正常组(P<0.05);超声指标联合检测诊断不孕症患者卵巢储备功能的曲线下面积(AUC)大于各指标单独检测(P<0.05);卵巢体积<4.27 cm³、PSV<10.62 cm/s、EDV<5.56 cm/s是影响不孕症患者卵巢储备功能的危险因素(P<0.05);不同月经周期患者的PSV、EDV、血流搏动指数(PI)及阻力指数(RI)比较,差异具有统计学意义(P<0.05);排卵期、黄体期的PSV、EDV大于黄体萎缩期及卵泡前期,RI、PI小于黄体萎缩期及卵泡前期(P<0.05);...     

氧化应激机制在盆腔器官脱垂中的研究进展

氧化应激是机体内活性氧(ROS)和抗氧化剂失衡引起的一种应激反应,近年研究发现氧化应激与盆腔器官脱垂(POP)的发病密切相关。POP是由于盆底肌肉、韧带及筋膜组织损伤所致的一种妇科常见病,是影响女性生活质量的五大慢性病之一,还是导致女性性功能障碍(FSD)的主要器质性疾病。研究发现POP的多种危险因素均可导致氧化应激损伤,并且POP患者的盆底主要支持组织中表现出显著的氧化应激特征,说明过量的ROS可能通过氧化损伤、影响胶原代谢和促细胞凋亡等机制及相关信号通路不同程度的影响盆底组织结构功能。研究氧化应激在POP中的作用,不仅有助于揭示POP的发病机制,也将为POP的防治提供一种新思路。     

Proceedings of the 3rd Annual Meeting of the Japanese Photoaging Research Society, Kobe, Japan, 23 August 2002

The nematode Caenorhabditis elegans has proven a robust genetic model for studies of aging and the roles of stress. In this review we focus on the genetics of select long‐lived and short‐lived mutants of C. elegans that have proven useful in revealing the relationships that exist between oxidative stress and life span. The former are known to be controlled by an insulin/insulin‐like signaling pathway, while the latter are affected by mitochondrial functions.     

Reproduction,skin aging,and sleep in middle-aged women

There is a growing trend for women to delay having children, with a significant number of women postponing motherhood until the third or fourth decade of life. At the same time, these middle-aged women may be more concerned about skin aging and use dermatologic procedures to delay or repair the effects of aging, environmental factors, and oxidative stress on the skin. It has been suggested that the use of skin cosmetics and procedures may play a role in the reproductive system, although their possible effects have not yet been clearly elucidated. Another crucial factor that needs to be raised in this context is poor sleep, which seems to have an important relationship with both reduced fertility and accelerated skin aging, especially when it is associated with greater oxidative stress and hormonal imbalance. This review discusses the important triad of sleep, dermatology, and reproduction, a subject that has received relatively little attention; and, given its potentially wide-ranging implications, one that deserves more frequent and detailed consideration in future studies. Understanding this complex web of interactions could help to provide outcomes that include healthier skin, safety, improved self-esteem, and successful fertility treatments, all of which can directly affect quality of life.     

氧化应激与皮肤病相关性的研究进展

皮肤微环境中氧化应激和抗氧化的平衡失调是皮肤疾病发生、发展的重要基础。紫外线已成为引起皮肤氧化应激损伤的越来越主要的原因。本文综述了氧化应激尤其是紫外线产生的氧化应激损伤与临床上常见皮肤疾病发生、发展的相关性。     

UVB诱导人皮肤成纤维细胞的氧化应激损伤研究

目的 观察人皮肤成纤维细胞被UVB照射后的光损伤、凋亡、周期阻滞和氧化应激损伤状态,并检测氧化应激的相关信号蛋白p66Shc的表达情况。方法 用小剂量UVB多次照射培养的人皮肤成纤维细胞,以细胞衰老β-半乳糖苷酶（SA-β-Gal）化学染色法观察细胞衰老状态,流式细胞仪检测细胞凋亡和细胞周期,ELISA法检测细胞内超氧化物歧化酶活性和丙二醛的含量,并以Western印迹法检测p66Shc蛋白的表达。结果 SA-β-Gal染色显示,培养的人皮肤成纤维细胞在UVB照射后呈强阳性染色;细胞凋亡率在未照射的对照组为0.96％,UVB照射组为37％;而细胞周期检测显示,经UVB照射的人皮肤成纤维细胞大部分阻滞于G0/G1期（80.07%）。细胞内超氧化物歧化酶水平对照组为（52.35 ± 4.97） ng/g蛋白,UVB照射组为（7.81 ± 0.68） ng/g蛋白（两组比较,P < 0.01）;而丙二醛水平两组分别为（3.52 ± 0.34） ng/g蛋白和（33.91 ± 3.20） ng/g蛋白（两组比较,P < 0.05）。人皮肤成纤维细胞经UVB照射诱导后24 h,p66Shc呈弱阳性表达,48 h后表达进一步增强。结论 培养的人皮肤成纤维细胞经UVB照射后进入氧化应激增强状态。p66Shc蛋白在此过程中表达逐渐增强。     

Pseudoxanthoma elasticum: oxidative stress and antioxidant diet in a mouse model (Abcc6-/-)

Pseudoxanthoma elasticum (PXE), a multisystem disorder characterized by ectopic mineralization of soft connective tissues, is caused by mutations in the ABCC6 gene. The pathomechanistic details of the mineralization process are largely unknown, but oxidative stress has been suggested to play a role. In this study, we tested Abcc6(-/-) mice, which serve as a model of PXE, for markers of the oxidative stress in the liver and serum. The total antioxidant capacity as well as markers of protein oxidation and lipid peroxidation suggested the presence of chronic oxidative stress. Feeding these mice for 5 months with a diet supplemented with antioxidants (vitamins C and E, selenium, and N-acetylcysteine) countered the oxidative stress but did not modify the ectopic mineralization process. These results suggest that the Abcc6(-/-) mice suffer from chronic oxidative stress but this does not contribute to connective tissue mineralization, the hallmark of PXE.     

宿主氧化损伤及致病真菌抗氧化损伤机制的究进展

病原体入侵机体后,诱导机体进入一种氧化应激状态,吞噬细胞释放大量活性氧介质,当活性氧介质的产生和清除存在不平衡时,会造成细胞氧化损伤.而病原体本身在遇到氧化应激时也表达一些抗氧化物质,来启动抗氧化机制,以降低氧化损伤对其杀伤和破坏.阐述宿主释放的活性氧介质如过氧化氢、超氧阴离子、羟自由基等对致病真菌的氧化损伤,以及致病真菌表达抗氧化物质如过氧化氢酶、超氧化物歧化酶等抗氧化损伤的机制.     

A chemiluminescence study of UVA-induced oxidative stress in human skin in vivo

Oxidative stress is defined as an imbalance between pro-oxidants and antioxidants in favor of pro-oxidants. Photon emission (also called chemiluminescence) has been widely used to study oxidative stress in biological systems in vitro. In vivo chemiluminescence has been proposed as a non-invasive method to assess oxidative stress in the skin. UVA (320-400 nm part of the ultraviolet radiation) exposure is generally accepted as a source of oxidative stress in the skin. In this study, UVA-induced oxidative stress was studied by using an in vivo chemiluminescence detection method. First, the dose response and the fluence rate response of the UVA-induced oxidative stress in human skin were investigated by examining the decay kinetics of the chemiluminescence signal following UVA exposure. A kinetic model was proposed to help differentiate these two responses. We found that the initial burst of the chemiluminescence signal depended on the UVA fluence rate, whereas the decay of the signal following exposure can be related to the UVA dose involved. Second, a significant reduction of UVA-induced chemiluminescence signal was observed after tape-stripping, indicating that stratum corneum is a major source of UVA-induced oxidative stress in the skin. Furthermore, the oxygen dependence of UVA-induced chemiluminescence signal was also confirmed by application of a pressure cuff, implying that some of the oxidative stress occurs in the deeper layers of the skin. Finally, topical application of vitamin C before exposure significantly reduced the UVA-induced chemiluminescence signal. We thus conclude that chemiluminescence is an effective method to assess the oxidative stress induced by UVA in human skin in vivo.     

Idebenone: a new antioxidant - Part I. Relative assessment of oxidative stress protection capacity compared to commonly known antioxidants

Topical applications of skin care products containing antioxidants have become increasingly popular. Numerous studies have elucidated the biological effects of these substances. General antiaging effects, anti-inflammatory properties, photoprotective properties, and prevention of ultraviolet (UV) immunosuppression have been documented. However, a standardized method to characterize and compare the properties and oxidative stress protection capacity of antioxidants was lacking. A multistep in vitro process utilizing a variety of biochemical and cell biological methods combined with in vivo studies was designed to compare the oxidative stress protective capacity of commonly used antioxidants. Data were presented for L-ascorbic acid, dl-alpha-tocopherol, kinetin, dl-alpha lipoic acid, ubiquinone, and idebenone. Methods included using UV-induced radical trapping/scavenging capacity measured by photochemiluminescence, pro-oxidative systems (LDL-CuSO(4), microsome-NADPH/ADP/Fe(3+)) with measurement of primary and secondary oxidation products, UVB irradiation of human keratinocytes, and in vivo evaluation, using the human sunburn cell (SBC) assay. Correlation and trends between in vitro and in vivo results were established, and the standardized test protocol was used to quantify oxidative stress protection capacity of antioxidants. Summarizing and totaling the data equally weighted for each oxidative stress study, the overall oxidative protection capacity scores of 95, 80, 68, 55, 52, and 41 were obtained for idebenone, dl-alpha tocopherol, kinetin, ubiquinone, L-ascorbic acid, and dl-alpha lipoic acid, respectively. The higher the score, the more effective the overall oxidative stress protection capacity of the antioxidant became. This multistep protocol may serve as a standard in investigating and comparing new putative antioxidants for topical use as well as a valuable tool to assess the anti-inflammatory properties, photoprotective properties, and prevention of UV immunosuppression of topical antioxidants.