男性甲亢性低钾周瘫患者血清甲状腺激素及性激素水平的变化

目的　观察男性甲亢性低钾周瘫（THPP）患者血清甲状腺激素、黄体生成素（LH）、卵泡刺激素（FSH）、催乳素（PRL）、孕酮（P）、总睾酮（T）、雌二醇（E2）的水平变化。方法分析了38例男性甲亢患者血清钾、总三碘甲腺原氨酸（TT3）、游离三碘甲腺原氨酸（FT3）、总甲状腺素（TT4）、游离甲状腺素（FT4）、促性腺激素与性激素的水平,其中THPP患者19例,无THPP的甲亢患者19例。结果（1）甲亢患者中THPP组血清TT3、FT3、TT4及T水平明显高于无THPP组（P均＜0．01）。血清LH、FSH、PRL、P及E2水平两组无显著差异性。（2）血清TT3、TT4、FT3及T与血清钾水平呈负相关关系,血清TT3与T水平呈正相关关系。结论男性甲亢患者血清甲状腺激素水平明显升高者易发生THPP;伴有THPP的男性甲亢患者T水平升高,其原因尚有待进一步研究。     

无精症与少精症患者的内分泌学研究

目的：探讨男科病人内分泌激素与无精症及少精症的关系。方法：采用放射免疫测定法对50例无精子症和35例少精子症患及30例有政党生育史的男性血清促卵泡激素（FSH）、黄体生成素（LH）、睾酮（T）、催乳素（PRL）、雌二醇（E2）进行测定。结果：无精症组与少精症组血清FSH、LH水平明显高于正常组（P＜0．01），而无精症组血清FSH、LH水平又明显高于少精症组（P＜0．05）；随着血清FSH值的升高，无精症组与少精症组血清LH值亦随之升高，但T／LH比值明显减低（P＜0．01）。结论：男科病人内分泌激素中FSH、LH水平及T／LH比值与无精症及少精症关系密切。     

甲苯对雌性大鼠垂体促性腺激素的影响

【目的】探讨亚慢性甲苯染毒对雌性sD大鼠垂体促性腺激素的影响,为阐明甲苯对雌性生殖内分泌系统的不良影响提供实验依据。【方法】60d雌性sD大鼠,随机分为4组,动情周期2周后分别给予0、35、70、330mg／kg甲苯连续灌胃染毒40～45d,每天上午阴道涂片观察动情周期的变化。于动情期处死大鼠分别提取脑垂体做免疫组化,同时测定血清中FSH和LH含量,观察甲苯对垂体促性腺激素的影响。【结果】高剂量组与对照组相比,动情周期持续时间延长、动情周期异常率升高,规则动情周期数降低,差异有统计学意义（P〈0．05）。免疫组化结果：高剂量组、中剂量组与对照组相比,棕色颗粒明显增多,两组平均光密度（MOD）和面数密度（SD）存在显著性差异（P〈0．01）,低剂量组可见少量棕色颗粒,表明LH和FSH有少量表达,与对照组无明显统计学差别（P〉O．05）。血清中FSH和LH浓度结果：高剂量组与对照组相比明显增高（P〈0．05）;中剂量组和对照组相比明显增高（P〈0．05）;低剂量组和对照组相比无统计学差异（P〉0．05）。【结论】甲苯可引起大鼠动情周期的改变：引起大鼠垂体促性腺激素细胞分泌激素增多,同时可引起血清中FSH和LH含量的增高。     

少精及无精不育患者血清性激素水平分析

目的：探讨少精及无精不育患者血清性激素的水平及其临床意义.方法：对57例少精患者（少精组）及21例无精患者（无精组）进行精液分析,并取30名婚前要求进行精液检查的精子数量正常者作为对照组,采用放射免疫法测定3组患者血清睾酮（T）、促卵泡生成素（FSH）、促黄体生成素（LH）、垂体泌乳素（PRL）的水平.结果：无精组与少精组血清中FSH、LH水平均高于对照组（P ＜0.05～P＜0.01）;而无精组FSH、LH水平又均明显高于少精组（P＜0.01）;无精组PRL水平均较对照组及少精组升高（P＜0.01）;而无精组和少精组血清T水平均明显低于对照组（P＜0.01）.结论：对少精症及无精不育患者血清生殖激素的测定有助于指导诊断、治疗以及预后.     

增龄与成年男性垂体性腺激素水平关系

目的：探讨增龄对成年男性垂体性腺激素水平的影响。方法：将80名成年男性分为三个年龄组－青年组、中年组、老年组，用放射免疫分析法（RIA）测定其血液中垂体性腺激素水平。结果：睾酮（T）随年龄增加而明显降低，青年组＞中年组＞老年组（P＜0．01）。FSH随年龄增加明显升高，各组间差异非常显著（P＜0．01）。LH同时随之升高，但差异并不明显（P＞0．05）。各组之LH／FSH为：青年组3．3，中年组2．0，老年组1．1。各组的PRL值均无明显差异（P＞0．05）。结论：随增龄发生功能改变的原发部位在性腺而不在垂体，发生原发性分泌减少的部位为性器官，男性为睾丸。     

晨尿联合盆腔超声及血清基础促性腺激素水平在女童中枢性性早熟初步诊断中的应用

目的：探讨晨尿联合盆腔超声及血清基础促性腺激素（gonadotropin,Gn）水平检测在女童中枢性性早熟（central precocious puberty,CPP）初步诊断中的意义。方法：以就诊于南京医科大学附属淮安第一医院的83例性早熟女童为研究对象,收集年龄、骨龄、盆腔超声、血清基础Gn等资料,对可疑CPP女童行促性腺激素释放激素（gonadotropin-releasing hormone,GnRH）激发试验,根据结果分为CPP组和非CPP组。同期留取所有病例晨尿3 mL,测定Gn水平。采用SPSS 25.0软件对数据进行统计分析,并绘制受试者工作特征（receiver operating characteristic,ROC）曲线。结果：(1)CPP组晨尿黄体生成素（luteinzing hormone,LH）、卵泡刺激素（follicle-stimulating hormone,FSH）显著高于非CPP组,差异有统计学意义（P <0.05）。(2)晨尿LH与血清LH峰值、子宫容积、卵巢容积呈正相关（P均<0.001）;晨尿LH/FSH比值与血清LH/FSH峰...     

男性急性脑卒中患者下丘脑—垂体—性腺轴功能测定及血清催乳激素水平观察

目的 观察男性急性脑卒中时血清垂体促性腺激素、性腺激素和催乳激素 (PRL)水平的变化。 方法 用放射免疫分析法测定94例男性急性脑卒中患者的血清PRL、黄体生成激素 (LH)、卵泡刺激素 (FSH)、睾酮(T)、雌二醇 (E 2)水平。46例男性高血压动脉硬化患者作为对照组。 结果 急性脑卒中患者与对照组相比血清PRL、LH、FSH、T、E 2 水平升高 (P<0.01) ,以脑出血、蛛网膜下腔出血及重型患者升高尤为明显。结论 男性急性脑卒中患者存在下丘脑—垂体—性腺轴功能及催乳素分泌异常     

松花粉对雄性衰老大鼠性腺轴分泌功能的影响

目的：探讨松花粉预防用药对雄性衰老大鼠性腺轴分泌功能的影响。方法：选用8周龄雄性SD大鼠60只,体重180～220g,随机分为正常对照组、模型组、松花粉预防中（Pz）、低（Pd）剂量组,每组15只。除正常组外其余各组大鼠均采用D－半乳糖连续腹腔注射建立亚急性衰老大鼠模型,预防组在腹腔注射D－半乳糖的同时灌胃松花粉,用药50d。检测各组血清胰岛素样生长因子－1（IGF－1）、黄体生成素（LH）、促卵泡激素（FSH）、睾酮（T）及下丘脑促性腺激素释放激素（GnRH）的含量。结果：模型组大鼠血清中LH、FSH及下丘脑中GnRH含量明显升高,IGF－1、睾酮含量明显下降,与正常组比较差异有显著性（P〈0．05）;松花粉中、低剂量组均能不同程度降低大鼠血清LH、FSH及下丘脑中GnRH含量,提高IGF－1、睾酮浓度,与模型组比较,差异显著（P〈0．05）。结论：松花粉可以预防雄性衰老大鼠性腺轴分泌功能紊乱,对雄性衰老大鼠性腺轴有较为明显的保护作用。     

黄体生成素在控制性超排卵中的作用

目的 探讨体外受精与胚胎移植（IVF－ET）程序中注射人绒毛膜促性腺激素（HCG）日血清黄体生成素（LH）对控制性超排卵及其IVF－ET治疗结局的影响。方法 收集分析我院2000年2月至2001年3月因女性输卵管因素不孕行IVF－ET治疗的481个周期的资料。按注射HCG日血清LH水平由低到高分3组，A组LH＜1IU／L，B组：LH≥1－＜5IU／L和C组：LH≥5IU／L。结果 A组与其它两组比较，其注射卵泡刺激素（FSH）剂量增加（P＜0．001），用药天数延长（P＜0．001），而获卵数较多（P＜0．05），但受精率较低（P＜0．05），差异有统计学意义，A，B，C组的注射HCG日的E2水平，卵裂率，平均移植胚胎数，种植率，临床妊娠率及流产率的差异无统计学意义（P＞0．05）。结论 在控制性超排卵治疗中应维持适量的血清LH水平，如LH水平过低，应适当减少促性腺激素释放激素激动剂（GnRH－a）用量或加用LH。     

绝经后女性脑梗死患者血清垂体促性腺激素、催乳素的检测及其意义

目的探讨血清促卵泡刺激素(FSH)、黄体生成素(LH)及催乳素(PRL)在绝经后女性脑梗死患者发病过程中的变化特点及其意义。方法采用放免法动态测定110例绝经后女性脑梗死患者血清FSH、LH及PRL的水平。分析其与病程、病情、梗死范围及梗死部位的关系。结果①绝经后女性脑梗死患者急性期血清FSH、LH值下降,PRL值升高,与恢复期及对照组比较,差异有统计学意义(P<0.01);恢复期血清FSH、LH及PRL值与对照组比较,差异无统计学意义(P>0.05)。②急性期中、重型组血清FSH、PRL值明显高于轻型组(P<0.05),二组间血清LH差异无统计学意义(P>0.05)。③梗死范围≥2cm×2cm×2cm组血清PRL明显高于梗死范围<2cm×2cm×2cm组(P<0.05);二组间血清FSH、LH差异无统计学意义(P>0.05)。④急性期皮质组、皮质下组、混合组比较,血清FSH、LH及PRL值差异无统计学意义(P>0.05)。结论绝经后女性脑梗死患者急性期存在垂体促性腺激素(FSH、LH)及PRL的紊乱,而随着疾病的恢复趋于正常。且这种紊乱不受梗死部位的影响,除PRL外也不受梗死范围影响,而与病情程度密切相关。     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.