170例女性不孕患者血清AMH、FSH、LH及E2水平分析

目的 探讨女性不孕患者检测血清中抗缪勒管激素(AMH)、卵泡刺激素(FSH)、黄体生成素(LH)及雌二醇(E2)水平变化的临床价值.方法 选择2015年10月至2017年1月来本院生殖中心就诊的170例女性不孕患者为研究对象,对照组为同期在本院进行体检的150例已生育健康正常女性.采用化学发光法对以上两组受试者进行血清AMH、FSH、LH及E2检测.结果 不孕组患者血清中AMH、FSH及LH水平分别为(5.16± 1.45) ng/ml、(9.81±8.26) mIU/ml和(8.57±6.32)mIU/ml,均明显高于对照组(2.20±1.07) ng/ml、(5.53±1.49) mIU/ml和(3.98±1.64) mIU/ml;不孕组患者血清中E2水平为(29.43±12.96) pg/ml,明显低于对照组(40.25±18.10)pg/ml,差异有统计学意义(P＜0.05).结论 AMH、FSH、LH及E2联合检测在女性不孕症的诊断中具有重要价值,可为临床诊断和治疗提供依据.     

多囊卵巢综合征患者性激素和胰岛素水平与中医证型的相关性研究

目的研究PCOS(多囊卵巢综合征)患者性激素和胰岛素水平与中医证型的相关性。方法随机选取我院在2008年3月至2014年2月间收治的80例多囊卵巢综合征患者为研究对象,回顾性患者临床资料,采用中医四诊分类,对患者治疗前后的性激素与胰岛素水平进行观察,检测其PRL(泌乳素)、LH(血清促黄体生成素)、P(孕酮)、T(睾酮)、E2(雌二醇)、FSH(促卵泡生成素)血清胰岛素(FFINS)水平指标。结果在80例患者中,有35例(43.8%)患者表现为脾虚痰湿证,21例(26.3%)患者表现为肾虚肝郁证、15例(18.8%)患者表现为肾虚血瘀证、9例(11.3%)患者表现为痰瘀互结证。患者在LH/FSH、P、E2、LH、FSH水平方面无统计学意义(P>0.05)。从PRL水平上看,肾虚肝郁证患者明显升高,与其他三组差异显著,具有统计学意义(P<0.05)。结论多囊卵巢综合征肾虚肝郁证患者与PRL水平升高具有明显相关性,多囊卵巢综合征胰岛素抵抗与痰湿阻滞存在相关性。     

肺炎支原体肺炎病儿血清长链非编码 RNA MALAT1、微小 RNA-125b的表达及临床意义

目的探讨肺炎支原体肺炎( MPP)病儿血清长链非编码 RNA MALAT1(LncRNA MALAT1)、微小 RNA-125b(miR125b)的表达水平及其临床意义。方法选择 2016年 4月至 2018年 6月许昌市人民医院 40例 MMP病儿( MPP组),选择同期该院体检的健康儿童 40例(对照组),采用实时荧光定量逆转录聚合酶链反应( qRT-PCR)检测血清 LncRAN MALAT1、miR125b的表达水平,酶联免疫吸附测定(ELISA)检测血清白细胞介素 -6(IL-6)、肿瘤坏死因子 α(TNF-α)水平,比浊法检测血浆 C反应蛋白( CRP)水平,比较 MPP组同对照组 LncRAN MALAT1、miR-125b、CRP、IL-6、TNF-α水平差异,并观察 MPP病儿不同病程 LncRAN MALAT1、miR-125b、CRP、IL-6、TNF-α水平差异,分析 MPP病儿 LncRAN MALAT1、miR-125b的表达量与 CRP、IL-6、 TNF-α的相关性。结果 MPP组 LncRAN MALAT1的表达水平( 2.13±0.16)高于对照组( 1.00±0.10)(P<0.05)miR-125b的表达水平( 0.52±0.11)低于对照组( 1.01±0.13)(P<0.05)CRP、IL-6、TNF-α水平高于对照组( P<0.05);重症 MPP病儿,血清 LncRAN MALAT1的表达水平高于轻症病儿( P<0.05)miR-12,5b的表达水平低于轻症病儿( P<0.05)Pearson相关分析显示, MPP病儿 LncRAN MALAT1表达量与 CRP、IL-6、TNF-α呈,正相关( P<0.05),miR-125b的表达量与 CRP、I,L-6、TNF-α呈负相关( P<0.05)。     

AMH、IFN-γ、IL-2检测在卵巢早衰诊断和病情评估中的应用价值

目的 分析抗苗勒管激素(AMH)、干扰素-γ(IFN-γ)、白细胞介素-2(IL-2)检测在卵巢早衰(POF)诊断以及病情评估中的应用价值。方法 选取2015年2月—2020年3月收治的POF 109例为POF组,另选取同期行健康体检月经周期正常女性100例为对照组。对比2组AMH、IFN-γ、IL-2、卵泡刺激素(FSH)、雌二醇(E₂)、黄体生成素(LH)水平以及窦状卵泡(AFC)数目;采用Pearson检验分析AMH、IFN-γ、IL-2与性激素及AFC的相关性,绘制受试者工作特征曲线分析AMH、IFN-γ、IL-2检测对POF的诊断价值。结果 POF组IFN-γ、LH、FSH水平高于对照组,AMH、IL-2、E₂水平低于对照组,AFC数目少于对照组(P<0.01)。POF患者AMH、IL-2与LH、FSH呈负相关,与E₂、AFC呈正相关(P<0.05,P<0.01);IFN-γ与LH、FSH呈正相关,与E₂、AFC呈负相关(P<0.05,P<0.01)。AMH、...     

加味补中益气汤联合戊酸雌二醇/雌二醇环丙孕酮片治疗女性肾阴虚肝郁型更年期综合征的临床疗效观察

目的 观察加味补中益气汤联合戊酸雌二醇/雌二醇环丙孕酮片治疗女性肾阴虚肝郁型更年期综合征的临床疗效及对病人血清促卵泡激素(FSH)、黄体生成激素(LH)表达的影响。方法 按随机数字表法将2019年4月至2021年1月唐山市人民医院收治的198例女性肾阴虚肝郁型更年期综合征病人分入观察组与对照组(各99例)。对照组给予戊酸雌二醇/雌二醇环丙孕酮片治疗,观察组在对照组治疗基础上联合加味补中益气汤治疗。比较两组病人临床疗效、中医证候评分,应用女性绝经期自测表(Kupperman改良评分)评估病人治疗前后临床症状改善情况,检测血清FSH、LH水平及不良反应情况。结果 治疗后,与对照组(70.70%)相比,观察组总有效率(90.90%)更高(P<0.05)。治疗后两组月经紊乱、潮热汗出、急躁易怒、阴道干涩、腰膝酸软、舌质暗红苔薄等各项中医证候评分均降低,且观察组低于对照组(P<0.05)。治疗后两组Kupperman积分均降低,且观察组低于对照组(P<0.05);治疗后两组血清FSH、LH水平降低,雌二醇(E₂)水平升高,且观察组血清FSH、LH水平低于对...     

老年重症肺炎病人血清微小 RNA-146a、微小 RNA-223、微小 RNA-21、微小 RNA-124水平及其与预后的关系

目的探究老年重症肺炎病人血清微小 RNA(miR)-146a、miR-223、miR-21、miR-124表达水平及其与预后的关系。方法选取 2018年 2月至 2020年 3月郑州大学第二附属医院诊治的 128例老年重症肺炎病人、 130例普通肺炎病人分别为重症肺炎组、普通肺炎组,并纳入同期 128例体检健康者为健康组。比较三组血清 miR-146a、miR-223、miR-21、miR-124表达水平及肿瘤坏死因子 -α(TNF-α)水平;分析老年重症肺炎病人血清 miR-146a、miR-223、miR-21、miR-124表达水平与 TNF-α的相关性;比较不同预后老年重症肺炎病人临床资料和血清 miR-146a、miR-223、miR-21、miR-124水平;分析老年重症肺炎病人死亡的影响因素;分析血清 miR-146a、miR-223、miR-21、miR-124、TNF-α对老年重症肺炎病人预后的预测价值。结果普通肺炎组病人血清 miR-146a、miR-223、miR-21表达水平及 TNF-α水平分别为 1.67±0.56、1.64±0.55、1.71±0.57、(12.78±4.30)ng/L,重症肺炎组病人血清 miR-146a、miR-223、miR-21表达水平及 TNF-α水平分别为 2.32±0.78、2.27±0.76、2.39±0.80、(23.64±7.92)ng/L,高于健康组的 1.03±0.35、1.01±0.34、0.99±0.33、(5.43±1.84)ng/L、(P<0.05)普通肺炎组、重症肺炎组血清 miR-124表达水平分别为 0.71±0.24、0.37±0.13,低于健康组的 1.07±0.37(P<0.05);重症肺炎人血清 miR-146a、miR-223、miR-21表达水平及 TNF-α水组病,平高于普通肺炎组( P<0.05)血清 miR-124表达水平低于普通肺炎组( P<0.05);老年重症肺炎病人血清 miR-146a、miR-223、 miR-21表达水平与 TNF-α呈正,相关( P<0.05)血清 miR-124表达水平与 TNF-α呈负相关( P<0.05);死亡组老年重症肺炎病人血清 miR-146a、miR-223、miR-21、TNF-α水平及有,呼吸系统疾病史、吸烟史、机械通气占比高于生存组( P<0.05),血清 miR-124表达水平、氧分压水平低于生存组( P<0.05); miR-146a、miR-223、miR-21、TNF-α、机械通气是老年重症肺炎病人死亡的危险因素( P<0.05);血清 miR-146a、miR-223、miR-21、miR-124、TNF-α预测老年重症肺炎病人预后的曲线下面积( AUC)分别为 0.84、0.88、0.82、0.66、0.68,其灵敏度分别为 72.5%、80.4%、82.4%、60.8%、60.8%,特异度分别为 85.7%、81.8%、79.2%、67.5%、72.4%。结论老年重症肺炎病人血清 miR-146a、miR-223、miR-21表达水平较高,与 TNF-α水平呈正相关; miR-124表达水平较低,与 TNF-α水平呈负相关。且测定血清 miR-146a、miR-223、miR-21表达水平有助于临床预测老年重症肺炎病人的预后情况。     

自拟补肾调经汤配合耳穴贴压治疗70例肾虚肝郁型卵巢早衰的临床观察

目的探讨自拟补肾调经汤配合耳穴贴压综合治疗肾虚肝郁型卵巢早衰临床疗效及对血清卵泡刺激素（FSH）、黄体生成激素（LH）、雌二醇（E2）的影响及其可能的作用机制。方法选70例肾虚肝郁型卵巢早衰患者随机分为治疗组、对照组各35例。对照组予妈富隆口服,治疗组予补肾调经汤配合耳穴贴压治疗,均治疗3个月,于治疗前后检测血清FSH、LH、E2的值,停药3个月后统计疗效。观察患者临床症状改善情况及治疗前后患者血清FSH、LH、E2值的变化情况。结果治疗组、对照组分别脱落2例、1例。治疗组总有效率84.85%,对照组总有效率52.94%,差异显著（P〈0.05）。治疗3个月后治疗组血清FSH值较治疗前明显降低,差异有极显著性（P〈0.01）,与对照组相比有统计学意义（P〈0.05）;两组治疗3个月后血清LH值明显降低,与治疗前相比差异有统计学意义（P〈0.05）,但组间比较无统计学意义（P〉0.05）;治疗组治疗3个月后血清E2值较治疗前明显升高（P〈0.01）,且与对照组比较差异有显著性（P〈0.05）。结论补肾调经汤配合耳穴贴压的中医综合疗法对肾虚肝郁型卵巢早衰有较好的临床疗效。     

血清抗缪勒氏管激素(AMH)诊断多囊卵巢综合征的价值观察

目的探究血清抗缪勒氏管激素(AMH)用于诊断多囊卵巢综合征的临床价值。方法回顾性分析2016年1月～2018年1月就诊的58例多囊卵巢综合征患者(观察组)和同期进行体检的经期正常的女性38例(对照组)。分别测定两组人员的生殖内分泌指标[AMH、促卵泡激素(FSH)、促黄体生成激素(LH)]水平,并对比AMH与LH/FSH诊断多囊卵巢综合征的敏感度和特异度。结果两组FSH水平差异无统计学意义(P 0.05),观察组血清AMH、LH水平均明显高于对照组,差异有统计学意义(P 0.05)。两组受试者血清AMH与LH/FSH检测结果显示:血清AMH诊断多囊卵巢综合征的敏感度、特异度、准确率均高于LH/FSH。结论血清AMH水平可作为多囊卵巢综合征的参考指导标志物,具有较高的敏感性和特异性,在多囊卵巢综合征的临床诊断中具有重要的应用价值。     

坤宁丸联合激素治疗卵巢早衰的效果观察

目的:研究分析坤宁丸联合激素替代法治疗卵巢早衰的临床疗效,并观察安全性.方法:采用前瞻性病例对照研究,选取卵巢早衰患者50例为对照组,均给予性激素替代疗法:戊酸雌二醇片,1mg,1次/d;2周后加服黄体酮,100mg,2次/d,服用1周.同期收治的卵巢早衰患者50例为试验组,均加用坤宁丸,3g,3次/d,连用8周.8周后评估临床疗效,电化学发光法检测血清黄体生成素(LH)、雌二醇(E2)和卵泡生成素(FSH)水平,彩色多普勒超声检测卵巢血流状态.结果:试验组有效率为96.0%(48/50),显著高于对照组[80.0%(40/50)](P<0.05).治疗前两组LH、FSH及E2水平无显著差异(P>0.05),治疗后两组E2均显著升高(P<0.05),而LH、FSH均显著下降(P<0.05);但试验组LH和FSH水平低于对照组(P<0.05),但E2水平高于对照组(P<0.05).治疗后试验组卵巢血流参数均优于对照组(P<0.05).治疗期间两组不良反应发生率无显著差异(P>0.05).结论:坤宁丸联合激素替代法治疗卵巢早衰可获得良好疗效,安全性较好.     

重症肺炎 64例外周血微 RNA-34a、沉默信息调节因子 1的表达

目的研究重症肺炎病人外周血微 RNA-34a(miR-34a)、沉默信息调节因子 1(Sirt1)的表达变化及临床意义。方法选取 2017年 10月至 2020年 4月武警重庆总队医院收治的 64例重症肺炎病人为重症肺炎组,同期收治的 80例普通肺炎病人为普通肺炎组,进行健康体检的 70例健康志愿者为对照组。采用实时荧光定量 PCR法( qRT-PCR)检测外周血 miR-34a表达水平,采用酶联免疫吸附法检测血清 Sirt1、炎症细胞因子表达水平; Kaplan-Meier生存分析研究 miR-34a与 Sirt1表达水平与重症肺炎组病人预后的关系; Cox回归分析影响重症肺炎病人预后的因素。结果重症肺炎组 miR-34a的表达水平高于普通肺炎组和对照组( 1.65±0.28比 1.32±0.33、1.00±0.25)Sirt1表达水平低于普通肺炎组和对照组［( 6.83±1.59)μg/L比( 8.94±1.62)μg/L、(12.11±1.77)μg/L］(P<0.05); miR-34a表达与 Sirt1表达水平存在明显负相关( P<0.05)。高危、中危病人 miR-34a表达水平高于低危病人, Sirt1表达水平低于低危病人( P<0.05),高危病人 miR-34a表达水平高于中危病人, Sirt1表达水平低于中危病人(P<0.05)。 miR-34a高表达病人血清肿瘤坏死因子 -α(TNF-α)、细胞间黏附分子 -1(ICAM-1)、白细胞介素( IL)-6和高迁移率族蛋白 B-1(HMGB1)水平高于 miR-34a低表达病人, 30 d累积生存率低于 miR-34a低表达病人( P<0.05); Sirt1高表达病人血清 TNF-α、ICAM-1、IL-6、HMGB1水平低于 Sirt1低表达病人, 30 d累积生存率高于 Sirt1低表达病人( P<0.05)。ICAM-1、miR-34a及 Sirt1均是影响重症肺炎病人预后的独立危险因素( P<0.05)。结论重症肺炎病人外周血中 miR-34a表达增加与血清 Sirt1表达降低具有相关性,且 miR-34a、Sirt1的变化与病情加重、炎症反应激活、预后不良有关。     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

---

Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Pharmacological treatment of COVID-19: an opinion paper

The precocity and efficacy of the vaccines developed so far against COVID-19 has been the most significant and saving advance against the pandemic. The development of vaccines has not prevented, during the whole period of the pandemic, the constant search for therapeutic medicines, both among existing drugs with different indications and in the development of new drugs. The Scientific Committee of the COVID-19 of the Illustrious College of Physicians of Madrid wanted to offer an early, simplified and critical approach to these new drugs, to new developments in immunotherapy and to what has been learned from the immune response modulators already known and which have proven effective against the virus, in order to help understand the current situation.     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.     

Alzheimer’s disease – current trends in basic and clinical research. Highlights from the 16th ECNP

Advances in the molecular biological knowledge of neuronal nicotinic acetylcholine receptors (nAChRs) have led to a growing interest by the pharmaceutical industry in the development of novel compounds that selectively modulate nAChR function. The ability of (-)-nicotine, an activator of nAChRs, to enhance attentional aspects of cognition in animals and humans, to exert neuroprotective and anxiolytic-like effects, and presumably to mediate the negative correlation between smoking and Alzheimer's (and Parkinson's) Disease, has focused interest on the potential therapeutic utility of modulators of nAChR function for treatment of some of the deficits associated with these progressive, neurodegenerative conditions. Numerous compounds are known which activate nAChRs and which might serve as lead compounds toward the development of such agents. The pharmacologic diversity of neuronal nAChR subtypes suggests the possibility of developing selective compounds which would have more favourable side-effect profiles than existing agents. This broader class of agents, collectively called cholinergic channel modulators (ChCMs), is anticipated to encompass compounds which would have more favourable side-effect profiles than existing agents, which generally exhibit low selectivity. This selectivity may be achieved by preferentially activating some subtypes of nAChRs (i.e., Cholinergic Channel Activators, ChCAs) or inhibiting the function of other subtypes (Cholinergic Channel Inhibitors, ChCIs). An overview of the biology of nAChRs and the rationale for the use of ChCMs for the treatment of dementia related to neurodegenerative diseases are presented, followed by a discussion of lead compounds and compounds under consideration for clinical evaluation.