男性不育患者精液参数测量的临床研究

目的：探讨精液中参数测定与男性不育的关系。方法：采用北京伟力精液检测系统测定精液参数、UU感染（解脲支原体感染）及药敏和A5-A6（抗精子抗体）进行相关性分析。结果：574例男性不育就诊者中159例精液白细胞〉1×10^6个／ml设为阳性组；415例精液白细胞≤1×10^6个／ml设为阴性组；阳性组精子活率（1％）、密度、低渗肿胀率明显低于阴性组（P〈0．05）；阳性组精子畸型率、枯度增高率、UU感染率和AsAb阳性率明显高于阴性组（P〈0．05，P〈0．01）；两组精液量、精液pH值差异无显著性（P〉0．05）。结论：精液中白细胞含量增高影响精液质量，是男性不育的重要原因之     

精液白细胞与男性不育的关系

目的:探讨精液白细胞与男性不育的关系。方法:检测3867例不育者精液白细胞,观察其与精液常规分析参数、UU感染、AsAb和精浆果糖含量、α-糖苷酶活性、酸性磷酸酶活性的关系。结果:3867例不育者精液白细胞>5个/HP为36.93%。白细胞>5个/HP组精液量、精子密度、精子活动率、a,b级活力精子率、顶体酶活性均明显低于精液白细胞≤5个/HP组(P<0.001,P<0.05)。精液白细胞>5个/HP组畸形精子率、精液粘度增高率和精液UU阳性率明显高于白细胞≤5个/HP组(P<0.001)。两组比较果糖含量和α-糖苷酶活性均没有明显差异,两组酸性磷酸酶活性有差异(P<0.05)。结论:精液白细胞可影响精液质量。     

弓形虫感染与男性不育的相关性研究

目的:探讨弓形虫感染情况与男性不育的关系。方法:将383例弓形虫检测的不育男性分为抗弓形虫抗体(AtAb)阳性组(76例)和阴性组(307例),分别进行精液常规、低渗肿胀率、精液白细胞含量、抗精子抗体(AsAb)检测。结果:阳性组精子密度、精子活率(%)、a+b活力(%)、低渗肿胀率明显低于阴性组(P<0.05);而阳性组精子畸形率、白细胞精液症检出率、AsAb阳性率明显高于阴性组(P<0.05,P<0.01);两组精液量、精液pH值无显著性差异(P>0.05)。结论:弓形虫感染可影响精液质量,是男性不育的原因之一。     

男性不育症精浆抗精子抗体与支原体感染的相关性分析

目的探讨男性不育症精浆抗精子抗体与支原体感染的相关性。方法选取我院收治的男性不育患者306例,在患者禁欲3 d~6 d之后手淫获得精液。用金标免疫斑点法对抗精子抗体进行检测。结果 306例男性不育患者中138例精浆解脲支原体(UU)阴性,168例精浆UU阳性。精浆UU阴性的138例中,抗精子抗体(AsAb)阴性124例(89.8%),AsAb阳性14例(10.1%);168例UU阳性患者中,AsAb阴性119例(70.9%),AsAb阳性49例(29.1%)。UU阴性组的AsAb阳性率明显低于UU阳性患者。结论不育症患者其精液中AsAb阳性率的高低对精子密度、精子活动力、精子活动百分率产生很大的影响,测定AsAb对查找男性不育症患者的病因有很重要的临床价值。     

精浆抗精子抗体对男性不育者精液参数和精子顶体酶活性的影响

目的:探讨精浆抗精子抗体(AsAb)对男性不育者精液参数和精子顶体酶活性的影响。方法:用间接血凝法检测2367例男性不育患者精浆AsAb,比色法测定精子顶体酶活性。结果:2367例不育者精浆AsAb阳性率为8.9%,精液AsAb阳性组中精液量,精子密度,精子活率,a、b级活力精子率,畸形精子率与AsAb阴性组相比差异有显著性(P<0.001、P<0.05)。随精子密度、精子活率a、,b级活力精子率、精液量的减少,精液粘度的增高和精液液化时间的延长,精浆AsAb阳性率增高,差异有显著性(P<0.001、P<0.05),精浆AsAb阳性组与阴性组顶体酶活性,顶体酶活性正常组与异常组精浆AsAb阳性率差异无显著性(P>0.05)。结论:精浆AsAb对男性不育者精液参数有影响,对精子顶体酶活性没有影响。     

解脲支原体感染对男性不育患者精液质量的影响

目的探讨解脲支原体(UU)感染对精液体积、精子活动度、精子活率、精液密度等参数的影响,以及与男性不育的关系。方法用培养法对就诊的291例不育者与100例正常生育者进行UU检查,观察不育者UU阳性与正常生育者UU阴性的精液体积、精子活动度、精子活率、精液密度,并进行对比分析。结果不育者中UU阳性数140例,正常生育者中UU阳性数26例,不育组UU感染者的精液体积、精子活动度、精子活率、精液密度等参数明显低于正常生育组UU阴性者(P<0.05)。结论 UU感染影响精液质量,会导致男性不育。     

精浆抗精子抗体与精液黏度和液化时间关系分析

目的:探讨精浆抗精子抗体与精液黏度和液化时间的关系。方法:间接血凝法测定AsAb。结果:3432例不育者AsAb呈阳性反应者350例,占10.20%。AsAb阳性组与AsAb阴性组比较,精液黏度增高和液化时间异常率均明显增加(P<0.001,P<0.001);AsAb阳性与AsAb阴性组液化时间比较差异有显著性(P<0.001)。精液黏度正常组与增高组液化时间比较差异有显著性(P<0.001)。结论:精浆AsAb对精液黏度和液化时间有影响。     

男性免疫性不育患者抗精子抗体、解脲脲原体感染的关系探讨

目的　探讨男性免疫性不育症中活精子表面抗精子抗体 (antispermantibody ,AsAb)与精浆中解脲脲原体(ureaplasmaurealyticum ,UU)感染的关系。 方法　对 112例男性不育患者采用直接混合抗球蛋白反应试验 (mixedantiglobulinreaction ,MARtest)检测新鲜精液中活精子表面被覆的AsAb ,并采用培养法检测精浆中UU。 结果　112例男性不育症患者AsAb阳性 6 1例 ,UU阳性 5 2例 ;两者都为阳性 34例 ;两者都为阴性 33例 ;AsAb阳性、UU阴性 2 7例 ;AsAb阴性、UU阳性 18例。AsAb阳性组UU阳性检出率为 5 5 .74 % (34/ 6 1) ,明显高于AsAb阴性组中UU检出率为 35 .2 9% (18/ 5 1) ,二者差异具有显著性 (P <0 .0 5 )。结论　AsAb的产生与生殖道感染UU有密切关系。     

不育症男性精浆抗精子抗体与支原体感染的相关性分析

目的:了解男性不育症患者精浆抗精子抗体(AsAb)与解脲支原体(UU)感染的关系。方法:精浆抗精子抗体采用金标免疫斑点法,解脲支原体采用培养法,分别检测306例男性不育症患者精浆中的抗精子抗体和解脲支原体。结果:306例男性不育症患者中,UU阳性有168例,UU阴性有138例;UU阳性组中精浆AsAb阳性49例,阳性率为29.2%;UU阴性组中,精浆AsAb阳性14例,阳性率为10.1%。精浆AsAb阳性率UU阳性组高于UU阴性组,差异有统计学意义(P<0.05)。结论:解脲支原体感染是男性生殖道感染的常见病原体,UU感染能刺激机体产生AsAb,导致男性免疫性不育。     

解脲支原体导致的男性不育及其治疗

目的从精液体积、精子活动率及活动力、精子畸形率和精子密度几个方面来探讨男性精液解脲支原体(UU)感染对不育的影响,以及治疗的效果.方法用培养法对本院不孕不育门诊男性患者进行了支原体检查,并同时进行了精液常规分析.结果在1574例男性不育患者中,UU阳性708例,阳性率45%.对52例正常男性生殖道UU感染检测表明,15例呈阳性,阳性率28.8%.感染UU的男性不育患者,其精子活动率、活动力和密度均明显低于UU阴性组的精子,而且UU阳性组的精子畸形率也明显高于UU阴性组.我院对UU治疗结果显示敏感药物依次为:交沙霉素、美满霉素、克拉霉素和左氧氟沙星.结论UU感染对精液质量具有干扰作用,可以导致男性不育.     

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.