过敏煎加减治疗男性免疫性不育32例

目的:观察过敏煎加减治疗男性免疫性不育患者的临床疗效。方法:将32例男性免疫不育症的患者随机分为2组,治疗组32例,采用过敏煎加减治疗;对照组32例,予以强的松治疗。结果:总有效率治疗组78.26%,对照组65.21%,2组总有效率比较,差异有显著性意义(P<0.05)。结论:过敏煎加减治疗男性免疫性不育症具有较佳的临床疗效。     

脱敏煎治疗男性免疫性不育疗效分析及对外周血T细胞亚型的影响

目的分析脱敏煎治疗男性免疫性不育患者前后AsAb、精液常规参数、外周血T细胞及Th细胞亚型分布的变化情况,探讨脱敏煎对男性免疫性不育患者的精液常规参数及机体免疫状态的影响。方法收集男性免疫性不育患者50例,在脱敏煎治疗前后检测患者AsAb;计算机辅助精子分析仪检测精子浓度及前向运动精子(PR);低盐膨胀实验检测精子存活率,Diff-Quick染色法检测正常精子形态百分率;流式细胞术检测患者外周血T细胞亚型分布;RT-PCR检测IFN-γ、IL-4 mRNA表达情况。结果经脱敏煎治疗后,患者AsAb转阴率达76.00%,精子浓度明显升高(P0.05),精子活率及PR亦明显升高(P均0.01),而正常精子形态百分率无明显变化(P0.05)。患者外周血CD3~+T和CD8~+T细胞数明显降低,CD4~+T细胞数明显升高(P均0.01)。IFN-γmRNA表达量显著下调(P0.05),IL-4 mRNA的表达量显著上调(P0.05)。结论脱敏煎治疗可明显改善男性免疫性不育患者T淋巴细胞功能失调,提高精子浓度/精子存活率和活力,降低AsAb阳性率。     

免疫性不育的中医治疗

免疫性不育是指由男性自身对精子的自身免疫反应所引起的不育症.在我国约8-10对育龄夫妇中就有一对患有不育症,其中50%的原因在于男性.近年来越来越多的证据表明,免疫性不育在其中占有相当的比重,据世界卫生组织人类生殖研究发展和研究培训特别规划署1988年的报告6407例男性不育患者中,有 2.9%的患者病因为免疫因素,在继发性不育中免疫性不育占4.0%.     

生精合剂对不育男性精子参数及精子凋亡的影响

<正>研究~[1-2]表明,以精子DNA损伤为特征的精子染色质结构异常是男性不育、复发性自然流产(recurrent spontaneous abortion,RSA)以及辅助生殖技术治疗失败的重要原因之一,精子DNA损伤亦是近年来生殖医学的研究热点之一。迄今为止,多数男性不育症仍缺乏令人满意的治疗方法。笔者临床应用生精合剂治疗男性不育症疗效满意,本研究借助流式细胞技术观察生精合剂对不育男性精子凋亡的影响,报道如下。     

还精煎治疗免疫性不孕68例

不孕、不育症是一种独特的疾病，其发病率为10％-15％^[1]，在多种致病因素中，抗精子抗体所导致的免疫性不孕占不孕患者的10％-30^[2]．应用中药还精煎辅以小剂量强的松治疗抗精子抗体引起的免疫性不孕，抗体转阴率88％，受孕率70％，疗效显著，且副作用小，是一种安全、有效的治疗方法。     

男性免疫性不育症的现代中医研究进展

免疫性不育症是指由男性自身对抗精子的自身免疫反应所引起的不育症。以往本症多称为“不明原因的男性不育症”,中医学无此病名记载,多归于“不育”、“无子”等范畴。近年来,随着免疫学的发展,逐步发现男性自身的免疫反应与其生育能力密切相关。大约10%的不育男子发现有抗精子抗体,其发病率占所有不育夫妇病因的3%左右[1]。目前,国内外主要应用类固醇免疫抑制法、避孕套隔离法、防凝法及夫妻间血液注射免疫法、精子洗涤后人工授精等方法治疗,但疗效并不理想。现代中医男科学对男性免疫性不育的基础理论、临床诊治研究进行了有益的探索,并取…     

精液洗涤技术治疗男性免疫性不育的研究

免疫性不育是引起男性不育的原因之一 ,临床上治疗方法很多 ,主要采用皮质激素进行周期性治疗 ,减少或消除免疫性不育患者血清中抗体 ,从而达到治疗不育的目的 ,但上述方法用药疗程长 ,疗效不理想 [1 ]。笔者旨在研究一种简便、安全、有效的精液洗涤技术 ,寻求男性免疫性不育治疗的新途径。1　资料与方法1.1　研究对象本组共收治 4 2对因男方免疫性不育而未育的夫妻 ,其中男性年龄在 2 2～ 38岁 ,平均 (2 4 .6± 3.0 )岁 ,平均婚后不育时间为 (3.2± 1.4 )年 ,其中原发不育 31例 ,占 73.8% ,继发不育11例 ,占 2 6 .2 % ,对就诊的男性常规详…     

消抗丸治疗男性免疫性不育58例

引起男性不育的病因很多，临床统计发现，不育患者有10％～15％是免疫因素造成的。由抗精子抗体（ASAb）所导致的男性不育在临床上称为男性免疫性不育。男性免疫性不育以不育为主要表现，多无其他特异性体征。诊断上以不育男性的血清或（和）精浆中发现抗精子抗体为依据，目前尚无令人满意的治疗手段。笔者运用具有补肾活血、解毒祛湿，改善过敏体质为主要功能的中药制剂消抗丸治疗男性免疫性不育58例，并随机与对照组30例比较观察，中药治疗组疗效满意，现报道如下。[第一段]     

男性免疫性不育症中医阶梯性治疗临床研究

观察中医阶梯治疗的方法治疗男性免疫性不育症的疗效。对 160例免疫性不育患者随机分成阶梯性口服抗免1、2、3号方治疗组 80例和口服知柏地黄汤对照组 80例 ,进行 3个疗程 ( 9个月 )的治疗 ,采用ELISA检测。结果 :治疗组和对照组的抗体转阴率分别为 90 %和 80 % (P <0 0 1) ;治愈率分别为 5 2 5 %和 40 0 % (P <0 0 1)。结论 :在男性免疫性不育症治疗中 ,中医阶梯性治疗方法优于传统的分型论治方法。     

中西医治疗男性免疫性不育的临床研究

男性不育症患者中,约17%属于免疫性不育.主要由于男性产生的抗精子抗体,引起精子凝集、制动,引发不育.我们根据中医理论结合临床实践,自拟"消抗"方剂治疗免疫性不育取得满意疗效.现与西医疗法对比治疗.报告如下.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.