多囊卵巢综合征患者内脂素水平变化及分析

目的 探讨内脂素水平变化与多囊卵巢综合征之间的相互关系.方法 选取2010年1月～2011年12月期间在某院检查确诊的128例多囊卵巢综合征患者(PCOS组),其中肥胖组52例及非肥胖组76例,随机选取门诊同期体检妇女120例作为对照组,观察各组体重指数(BMI)、腰臀比(WER)、血清卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)、孕酮(P)、睾酮(T)、泌乳素(PRL)、内脂素、空腹血糖(FPG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)变化情况.结果 PCOS组BMI、WER、LH、T、FINS、HOMA-IR水平高于对照组,PCOS组内脂素水平(32.27±16.62) ng/ml,对照组(18.83±12.21) ng/ml,两组之间比较差异有统计学意义(P＜0.05);肥胖组患者BMI、FINS、HOMA-IR水平明显高于非肥胖组患者,肥胖组内脂素水平(34.86±17.14) ng/ml,非肥胖组(27.76±12.27)ng/ml,两组之间比较差异有统计学意义(P＜0.05).结论 多囊卵巢综合征患者血浆内脂素水平较正常人群明显升高,并且在肥胖患者中升高更为明显.     

北京市婴儿早期维生素D营养状况与体格生长发育的关系

目的 评估北京地区婴儿早期维生素D营养状况,探讨其与体格生长发育的关系.方法 选取2020年4至10月在北京妇产医院门诊进行42天常规体检、年龄在36～48天的1160例健康婴儿作为研究对象,对其进行身长、体重等体格测量和血清25-羟基维生素D[25(OH)D]水平的测定.根据维生素D营养状况将所有婴儿分为缺乏组、不足组和正常组,分析3组婴儿身长、体重和体质量指数(BMI)等的差异.结果 1160例婴儿血清25(OH)D的平均水平为(25.33±6.82)ng/mL,其中男婴为(25.46±6.70)ng/mL,女婴为(25.21±6.94)ng/mL.维生素D缺乏率、不足率和正常率分别为22.24％、55.09％ 和22.67％,维生素D水平和营养状态性别间差异均无统计学意义(P>0.05).缺乏组、不足组和正常组42天体检时的体重、BM I和BMI增量差异均有统计学意义(F值分别为4.397、8.788、4.042,P<0.05);体重增量、身长和身长增量在3组间的差异均无统计学意义(P>0.05).两两比较显示,缺乏组的婴儿42天体检时体重高于正常组,BMI和BMI增量均高于不足组和正常组(P<0.05).分层分析显示,42天体检时男婴中维生素D缺乏组仅BMI高于正常组(P<0.05);女婴中维生素D缺乏组其体重、BMI和BMI增量均高于不足组和正常组(P<0.05).不同BMI的婴儿其25(OH)D水平差异有统计学意义(F=3.979,P<0.05),肥胖婴儿的25(OH)D水平低于BMI正常者(P<0.05),且肥胖婴儿的维生素D缺乏率高于BMI正常者(χ2=8.287,P<0.05).结论 北京地区婴儿早期维生素D缺乏或不足率较高,婴儿早期维生素D缺乏与肥胖有一定相关性.     

多囊卵巢综合征患者血清激素水平变化和月经紊乱的关系

目的对闭经和月经稀发多囊卵巢综合征(Polycystic ovarian syndrome,PCOS)患者的血清激素水平进行测定,探讨PCOS患者血清激素水平变化和月经紊乱的关系。方法选择嘉兴市妇幼保健院妇科2013年1月-2015年12月闭经或月经减少PCOS患者100例进行研究,根据是否闭经分为闭经组44例和月经稀发组56例。测定两组患者的身高、体重、腰围、臀围,计算BMI和腰臀比,电化学发光免疫分析法测定血清睾酮(Testosterone,T)、孕酮(Progesterone,P)、雌二醇(Estradiol,E2)、促黄体生成素(Luteinizing hormone,LH)、促卵泡生成素(Follicle Stimulating Hormone,FSH)水平。结果闭经组患者月经改变时间高于月经稀发组(P0.05),闭经组患者月经规律者所占比例低于月经稀发组(P0.05),两组初潮年龄比较,差异无统计学意义(P0.05)。闭经组和月经稀发组腰臀比和BMI比较,差异无统计学意义(P0.05)。闭经组患者血清T水平为(1.18±0.27)nmol/L,月经稀发组为(0.81±0.23)nmol/L,两组比较,差异有统计学意义(P0.05);闭经组患者血清P水平为(0.72±0.26)ng/ml,月经稀发组为(1.98±1.02)ng/ml,两组比较,差异有统计学意义(P0.05);闭经组和月经稀发组E2、LH、FSH、LH/FSH比较,差异无统计学意义(P0.05)。结论 PCOS患者月经紊乱和血清睾酮和孕酮水平有关,PCOS月经紊乱者血清睾酮水平升高,孕酮水平降低。     

青少年原发性精索静脉曲张手术治疗的临床疗效分析

目的 探讨青少年原发性精索静脉曲张手术治疗的适应证及治疗效果.方法 回顾性分析30例青少年原发性精索静脉曲张患者的临床资料,比较手术前后左侧睾丸容积、睾丸萎缩指数、促卵泡激素、黄体生成素、睾酮、精液量、精子密度、精子活力、精子正常形态率.结果 30例患者术后左侧睾丸容积、精子密度、精子活力、精子正常形态率较术前均明显提高[(8.13±3.03) ml比(6.81 ±3.05) ml、(79.08±28.56)×106/ml比(66.12±32.15)×106/ml、(37.63±10.95)％比(28.35±11.82)％、(73.83±9.98)％比(64.38±12.67)％],术后睾丸萎缩指数、促卵泡激素、黄体生成素均较术前明显降低[(11.88±7.59)％比(15.55±10.63)％、(4.22±2.01) U/L比(5.65±2.19)U/L、(3.60±1.67) U/L比(6.08±1.50) U/L],差异均有统计学意义(P＜0.05).术后睾酮、精液量与术前比较差异无统计学意义(P＞0.05).结论 手术治疗青少年原发性精索静脉曲张,患者的睾丸指标、性激素、精液指标水平均有明显改善.因此,手术是治疗青少年原发性精索静脉曲张的有效方法.     

甲状腺功能亢进症伴周期性麻痹患者血睾酮水平的变化及意义

目的 探讨甲状腺功能亢进症伴周期性麻痹(TPP)患者血睾酮(T)水平的变化及意义.方法 选择男性甲状腺功能亢进症患者50例,按是否伴周期性麻痹分为TPP组和单纯甲状腺功能亢进症组(对照组),每组25例,比较两组治疗前后游离甲状腺素(FT4)、游离三碘甲腺原氨酸(FT3)、高敏促甲状腺素(sTSH)、T、促黄体生成素(LH)、促卵泡生成素(FSH).结果 两组治疗前sTSH、LH、FSH比较差异无统计学意义(P＞0.05).TPP组治疗前FT3、FT4低于对照组[(18.04±7.22)pmol/L比(25.06±14.15) pmol/L,(48.68±19.06) pmol/L比(62.23±27.42) pmol/L],T高于对照组[(12.17±2.09) μg/L比(8.62±2.76) μg/L],差异有统计学意义(P＜0.05).TPP组治疗前FT3、FT4、sTSH、T与治疗后比较差异有统计学意义(P＜0.05),治疗前LH、FSH与治疗后比较差异无统计学意义(P＞0.05).对照组治疗前FT3、FT4、sTSH、T与治疗后比较差异有统计学意义(P＜0.05),治疗前LH、FSH与治疗后比较差异无统计学意义(P＞0.05).两组治疗后FT3、FT4、sTSH、LH、FSH比较差异无统计学意义(P＞0.05).TPP组治疗后T高于对照组[(7.25±1.37) μg/L比(6.17±1.35)μg/L],差异有统计学意义(P＜0.05).结论 TPP患者存在血T水平升高,血T水平升高可能为甲状腺功能亢进症患者发生周期性麻痹的原因之一.     

亚慢性染毒2,3,7,8-四氯二苯并二(口恶)英对雄性大鼠生殖系统的影响

目的 了解2,3,7,8-四氯二苯并二(口恶)英(TCDD)对雄性大鼠生殖系统的影响.方法 清洁级Wistar雄性大鼠32只,体重(100±10)g,随机分成4组,每组8只,连续经口灌胃染毒90d,剂量分别为2.5,25,250 ng/kg,对照组给予二甲基亚砜(DMSO),测定血清中睾酮(T)、促黄体生成素(LH)、促卵泡生成素(FSH)的激素水平以及睾丸、前列腺、精囊腺的脏器质量系数,附睾尾精子畸形率.结果 与对照组比较,各染毒组T水平下降,差异有显著性(P＜0.05);各染毒组FSH和LH水平上升,但差异无显著性(P＞0.05);中、高剂量组的睾丸、精囊腺及所有染毒组的前列腺脏器质量系数均低于对照组(P＜0.05);各染毒组精子畸形率随剂量的增加而上升,中、高剂量组与对照组相比差异显著(P＜0.01).结论 TCDD亚慢性染毒,可影响精子和生殖系统的正常发育,并在一定程度上对生殖激素的稳态造成了干扰.     

孕妇体质指数对分娩方式及新生儿体重影响

目的 研究孕妇体质指数对分娩方式及新生儿出生体重的影响.方法 选取单胎初产妇360人作为研究对象,分别按照孕前和产前体质指数(BMI)分组,孕前肥胖组33人,孕前体重正常组327人;产前肥胖组204人,产前体重正常组156人.对妊娠结局、新生儿出生体重等进行调查并进行组间分析比较.结果 孕前肥胖组分娩方式、新生儿出生体重与孕前正常组比较差异无统计学意义(P＜0.05);产前肥胖组剖宫产增加、新生儿出生体重增加,与产前正常组比较差异有统计学意义(P＜0.05);孕妇产前体重增加值与新生儿出生体重显著相关(P＜0.05).结论 加强围生期保健,控制孕期体重,可减少母婴并发症.     

内肥素与儿童青少年肥胖、非酒精性脂肪肝的关联研究

目的 探讨血清内肥素与儿童青少年肥胖、非酒精性脂肪肝(NAFLD)的关联.方法 采用双抗体夹心ELISA法,测定69名体重正常无NAFLD和106名肥胖儿童青少年(肥胖无NAFLD 49名及合并NAFLD 57名,其中轻度42名、中重度15名)的血清内肥素水平.结果 体重正常组与肥胖组血清内肥素水平分别为( 1.75±0.37)、(1.71±0.37)ng/ml,差异无统计学意义(P=0.455)；肥胖儿童青少年血清内肥素水平随着脂肪肝程度的加重而上升[肥胖无NAFLD组为(1.59±0.36)ng/ml、肥胖合并轻度NAFLD组为(1.74±0.36) ng/ml、肥胖合并中重度NAFLD组为( 1.97±0.36)ng/ml,三者之间差异有统计学意义(P＜0.05)],与年龄(^β=-0.326,P=0.000)、丙氨酸转氨酶活性(^β=0.286,P=0.004)相关,不同程度NAFLD者内肥素水平差异有统计学意义(^β=0.246,P=0.014).结论 肥胖儿童青少年中血清内肥素水平与NAFLD相关.     

学龄前肥胖儿童体质指数与血清瘦素、胰岛素及性激素水平的关系

[目的]研究学龄前肥胖儿童体质指数与血清瘦素、胰岛素及性激素水平的关系. [方法]对122例学龄前肥胖儿童及61例健康正常儿童的瘦素(Leptin)、胰岛素(Ins)、胰岛素样生长因子-Ⅰ(IGF-Ⅰ)、胰岛素样生长因子结合蛋白-3(IGF-BP3)、雌二醇(E2)和睾酮(T)水平进行测定,测量其身高、体重.计算其体质指数(body mass index,BMI),并分析BMI与各激素的相互关系. [结果]①肥胖组儿童BMI及血清Leptin、Ins、IGF-Ⅰ、IGF-BP3和E2水平明显高于正常组,且差异有显著性(P值均<0.001),而两组睾酮水平差异无显著性(P>0.05);相关分析显示肥胖儿童BMI与血清Leptin和Ins水平有明显正相关(r=0.412,r=0.336.P值均<0.001);②正常组儿童BMI与血清Leptin、Ins、IGF-Ⅰ、IGF-BP3、E2和睾酮水平均无相关性(P值均>0.05),③BMI与血清Leptin和Ins水平的相关系数肥胖男童大于肥胖女童,且肥胖女童BMI与血清E2水平有显著正相关(P<0.05),而肥胖男童则无显著相关性(P>0.05);④多元线性回归分析显示肥胖儿童血清Leptin和Ins水平是影响BMI的重要因素(P值均<0.001). [结论]BMI对儿童肥胖的早期诊断、早期干预是非常有意义的.     

个体化健康管理对老年肥胖患者的干预效果

目的 探讨老年肥胖人群的个体化健康管理方案,为肥胖的综合防治提供依据.方法 2014年1-7月选取武汉市一社区肥胖患者62人做为干预组,同时选取另一社区的肥胖居民62人做为对照组,干预组进行6个月的个体化肥胖管理.结果 干预前124名老年肥胖患者体质指数(BMI)均值为(31.29±2.38) kg/m2;男性患者腰围(WC)均值为(94.71±6.70) cm,女性为(92.05±8.53) cm,不同组别患者BMI、WC差异无统计学意义(P＞0.05).个体化健康管理后不同组别患者BMI、WC差异均有统计学意义(均P＜0.01);干预前不同组别患者血脂差异无统计学意义(P＞0.05),干预后不同组别患者血脂差异有统计学意义(P＜0.05).结论 个体化健康管理是老年肥胖患者有效的健康促进途径,应积极探讨综合防治模式,实现控制体重和血脂的目标.     

HIV levels in semen don't match levels in blood

At the World AIDS Conference in Geneva, Phalguni Gupta from the University of Pittsburgh reported that viral load tests on semen are necessary to determine the amount of HIV that can be transmitted during risky sexual contact. Forty-four percent of men involved in a 10-week study had semen viral loads that fluctuated frequently during the study, however, the blood viral loads remained the same. Further studies are needed to determine why semen viral load fluctuates.     

Use of blood levels to infer carcass levels of contaminants

Inferences may be made about the carcass levels of a contaminant based on the contaminant level in blood samples. A method is given for comparing such populations that utilizes bivariate normal distributions and their principal axes, thereby avoiding a dilemma arising from the use of regression techniques. Confidence intervals and power calculations are given. Data from captive barn owls provide partial justification for the use of this method.     

Relation of pregnancy serum ferritin levels to hemoglobin levels throughout pregnancy

Thirty women were studied for the impact of pregnancy iron status on hemoglobin (Hb) and serum ferritin (Ft) during the course of pregnancy. Blood samples were taken 4 weeks before their last menstrual period, at 8, 12, 16, 20, 24, 28, 32 and 36 weeks of pregnancy, during labor and 1 month after delivery. Two groups were formed based on prepregnancy Ft concentration: with high Ft (Ft greater than or equal to 20 micrograms/l) and with low Ft (Ft less than 20 micrograms/l). In women with high Ft, Hb decreased significantly during the first weeks of pregnancy while Ft increased, followed by a gradual fall as pregnancy progressed. In women with low Ft, Hb increased during the first weeks of pregnancy while Ft remained practically unchanged but very close to 0 microgram/l throughout pregnancy. Our findings suggest that besides the hemodilution characteristic of pregnancy, iron deficiency does develop during this period. The fall in Ft in well-nourished women during the first 30 weeks of pregnancy suggests an increased utilization of iron stores, while for those with already low levels of prepregnancy serum Ft, iron stores are not available for this physiological response. Therefore, iron supplementation should be given to women with reduced iron stores before they start a pregnancy so as to insure sufficient iron deposits to cope with the increased iron requirements during this period.     

Endotoxin levels in farming: absence of symptoms despite high exposure levels

The endotoxin concentration in air was measured in farms where 11 farmers had experienced febrile reactions or allergic alveolitis and in a random sample of farms with 17 symptomless farmers. Samples were obtained during normal dairy farming in eight reference farms (background samples) and in all farms during the handling of material which had probably caused symptoms or disease or, in reference farms, maximal spore exposure (worst case samples). In addition, parallel samplers were used in reference farms, one with a cyclone (5 microns cutoff) and one without, to measure the dust and endotoxin concentrations in the respirable fraction and total dust. The endotoxin worst case values varied from less than 0.01 to greater than 50 micrograms/m3 in symptom farms (median 6.4 micrograms/m3, geometric mean 2.2 micrograms/m3) and from less than 0.01 to greater than 50 micrograms/m3 in reference farms (median 42 micrograms/m3, geometric mean 29 micrograms/m3). This difference was not statistically significant. The background values in reference farms were 1.3 (median) and 0.4 (geometric mean) micrograms/m3. The differences between samples with and without cyclone and between background and worst case samples were statistically significant (p less than 0.02). About 75% of the activity was found in the non-respirable fraction. No correlation was found between exposure to endotoxin and symptoms in farmers. There were weak, but statistically significant, correlations between endotoxin concentrations and total spore count or dust concentrations. The surprisingly high endotoxin values in the respirable fraction of air from environments which apparently did not cause symptoms raises the concern that the Limulus amebocyte assay might be sensitive to other components in the dust rather than endotoxin.