体外受精-胚胎移植患者卵巢颗粒细胞卵泡刺激素受体启动子突变与卵巢反应不良的关系

Objective To sequence follicle stimulating hormone receptro (FSHR) promoter of the ovarian granulocyte and initially research the molecular mechanism of the poor ovarian response. Methods To study the relationship between FSHR promoter mutation of ovarian granulocyte and ovarian respone. The 263 bp DNA fragments before FSHR 5'initiation site in 70 cases of patients with poor ovarian respone and 88 cases of patients with ovarian normal respone who were in the cycle of IVF-ET were sequenced, Results There were 63 cases which occurred 29th site G → A point mutation in 158 women and the mutation rate was 40. 0%. Mutation rate [ 60. 0% ( 42/70 ) ] of 29th site G → A in group of poor ovarian respone was significantly higher(χ2 = 21. 450,P < 0. 01 ) than normal response group [ 23.9% ( 21/88 ) ]. There was no obviously variability ( t = 0. 457, P 0. 05 ) of basic FSH values between two groups [ G/G group was (7.2 ± 2. 3) U/L, G/A & A/A group was (7. 1±2. 0) U/L];there was obviously variability (t = 35. 81 ,P < 0. 05 ) in the number of follicles sinus between two groups ( G/G group was 14. 2±1.3, G/A & A/A group was 4. 5±0. 8 ) ;there was obviously variability ( t = 40. 35, P < 0. 05 ) in the number of ovum pick-up between two groups ( G/G group was 14. 0±1.2, G/A & A/A group was 4. 5±1.1 ) ;there was obviously variability (t =25. 80,P <0.05) of FE2-peak value between two groups [G/G group was (2 865±557) pmol/L, G/A & A/A group was (880±211 ) pmol/L] ;there was obviously variability (t =40. 22 ,P <0. 05) in the number of mature eggs ( G/G group was 13.6±1.2, G/A&A/Agroupwas4.3±0. 9).Conclusion The 29th site of FSHR promoter significantly affect the activity of FSHR promoter. Mutation of G→A can weaken promoter activity, so that ovarian granulocyte poor respone to FSH.     

散发性帕金森病患者γ-synuclein基因的研究

目的 探讨γ-synuclein基因C243G和A377T多态在散发性帕金森病(Parkinson’s disease，PD)的疾病易感性中的意义。方法 采用聚合酶链反应-限制性片段长度多态法，对上海汉族人中145例PD患者和184名正常人进行γ-synuclein基因C243G和A377T多态分型，并作与PD的遗传关联研究。结果 PD患者与正常对照间γ-synuclein基因C243G和A377T多态分布的差异无显著性，两种多态与PD亦无关联(P值均大于0．05)。结论 上海地区汉族人群中γ-synuclein基因C243G和A377T多态与散发性PD无关。     

Hydrocelectomy under local anaesthesia in a Nigerian adult population

Background

Hydrocele is abnormal collection of serous fluid in the tunica vaginalis or a patent processus vaginalis. It is commonly encountered in our practice and often requires surgical treatment. However in our setting and in many underdeveloped countries, availability of general anaesthetic service is poor due to lack of trained personnel and equipment.

Objectives

To ascertain the practicability and acceptability of hydrocelectomy under sedation and local anaesthesia in Nigerian adults with hydrocele

Patients and Methods

A prospective study was carried out over a two year period on patients that had hydrocelectomy at the surgery unit of the Obafemi Awolowo University Teaching Hospitals Complex, Wesley Guild Hospital, Ilesa. Consecutive patients with diagnosis of hydrocele who consented had hydrocelectomy using intramuscular diazepam sedation and spermatic-cord block with 0.5% plane xylocaine and the scrotum infiltrated with same along the line of incision.

Results

Fifty adult patients were studied: age range 15–94 years. Eighty percent of the patients had unilateral hydrocele and the commonest type was vaginal hydrocele (94%). All patients had hydrocelectomy, 96% were under local anaesthesia while 4% were converted to general anaesthesia. All patients except one prefer to have future surgery under such local anaesthesia and sedation.

Conclusion

Hydrocelectomy under local anaesthesia and sedation is practicable and was tolerated and accepted by the adults patients studied.     

中学生焦虑、抑郁与生活事件和应对方式研究

中学生处于心理发育的重要时期 ,也是各种心理问题的高发阶段[1- 2 ] 。初三毕业生面临升学的压力 ,这部分同学的心理状况更应引起关注。在各种心理问题中 ,焦虑、抑郁是常见的症状 ,本文拟调查初三毕业生的焦虑、抑郁状况 ,并通过生活事件和应对方式调查 ,以便发现焦虑、抑郁的影响因素 ,这对初三毕业生心理问题的预防和干预将有重要意义。1　对象和方法1.1　对象选取一所普通中学 ,以所有初三毕业生为调查对象 ,发放 35 2份调查表 ,共收集 331名资料完整者 ,资料回收率 94 .0 3%。 331名学生中 ,男生 171名 ,女生 16 0名 ,平均年龄 15 .4 …     

晚期糖基化终末产物通过氧化应激诱导大鼠软骨细胞损伤

目的:探讨晚期糖基化终末产物(advanced glycation end products,AGEs)能否通过氧化应激引起大鼠软骨细胞损伤。方法:原代培养SD大鼠软骨细胞,对细胞表型进行鉴定;应用CCK-8法检测软骨细胞生存率;DCFH-DA染色荧光显微镜下检测胞内活性氧簇(reactive oxygen species,ROS)的水平;Hoechst 33342核染色法及Annexin V-FITC/PI流式细胞法测定软骨细胞的凋亡率;RT-PCR法检测软骨细胞中Bax、Bcl-2、caspase-3、MMP3、MMP13和COL2的mRNA水平;Western blotting法检测软骨细胞中cleaved caspase-3、MMP3、MMP13和COL2的蛋白水平。结果:与对照组相比,AGEs可显著上调胞内ROS水平(P0.05),但经抗氧化剂N-乙酰半胱氨酸(NAC)抑制后ROS的生成明显减少(P0.05);另外,NAC可抑制AGEs引起的软骨细胞凋亡相关分子Bax/Bcl-2和caspase-3水平的上调,并减少MMP3和MMP13表达及COL2的丢失(P0.05)。结论:AGEs可通过氧化应激诱导大鼠软骨细胞损伤。     

胸腹水组织因子及组织因子途径抑制物的检测及其意义

目的研究三组疾病胸腹水组织因子(Tissue factor,TF)及组织因子途径抑制物(Tissue factor pathway inhibitor,TFPI)的表达及其鉴别诊断意义。方法TF和TFPI采用ELISA法测定抗原表达。结果胸腹水TF水平和TFPI水平,恶性肿瘤组(570.04±627.53)ng/L,(28.60±15.57)μg/L和结核病组(283.82±143.16)ng/L,(31.16±12.26)μg/L明显高于肝硬化组(60.83±66.87)ng/L,(7.84±5.45)μg/L,P<0.01。TF/TFPI比值则为恶性肿瘤组(32.17±44.19)明显高于结核病组(13.55±13.15)和肝硬化组(11.22±9.05,P<0.05)。在恶性肿瘤组中,胸腹水癌细胞阳性组的TF表达(1106.92±1244.28)ng/L高于阴性组(331.08±295.84)ng/L,P<0.05。而阳性组的TFPI水平(27.35±17.75)μg/L与阴性组(30.34±13.20)μg/L无明显差异(P>0.05)。TF/TFPI比值则为阳性组(59.59±65.10)明显高于阴性组(11.54±8.37,P<0.01)。结论检测胸腹水TF和TFPI并分析TF/TFPI比值可以作为临床实验室有鉴别诊断意义的辅助指标,同时还可了解疾病的某些病理机制,尤其是肿瘤的某些生物学行为。     

低氧诱导因子1α诱导卵巢癌细胞周期阻滞的研究

目的：探讨低氧诱导因子1α（HIF-1α）对卵巢癌细胞周期的阻滞作用。方法: 采用化学性低氧诱导剂氯化钴（CoCl2）和物理性低氧培养箱两种方法对体外培养的卵巢癌SW626细胞诱导低氧，用诱骗法（decoy）阻断HIF-1α功能，Western blotting、RT-PCR和流式细胞术分别检测HIF-1α蛋白、mRNA的表达水平和细胞周期比率。结果： B1组(3.75±1.31)和C1组(3.48±1.01) HIF-1α蛋白表达水平明显高于A1组(0.97±0.31)（P<0.05), decoy法对HIF-1α蛋白表达没有明显影响(P>0.05)；A1组（0.65±0.32）和B1组（0.64±0.34）HIF-1α mRNA表达水平明显低于C1组（1.28±0.62）（P<0.05），decoy法对HIF-1α mRNA 表达没有明显影响（P>0.05）；流式细胞术检测发现B1组（81.78±24.33）和C1组（77.62±22.76）G0/G1期细胞比率显著高于A1组（49.49±18.54）（P<0.05）；B2组（61.54±20.84）明显低于B1组（P<0.05），C2组明显低于C1组（56.03±21.42），而A1组和A2组之间无明显差异（P>0.05）。结论：CoCl2或物理性低氧均能明显诱导卵巢癌细胞SW626 G0/G1期细胞周期阻滞和HIF-1α的表达，HIF-1α在低氧引起的卵巢癌细胞SW626的细胞周期阻滞中起重要作用。     

胸椎多节段爆裂性骨折伴完全性脱位1例

胸椎多节段爆裂性骨折伴完全性脱位是最严重的脊柱创伤之一,通常由高能量创伤引起,会导致复杂的脊柱脊髓损伤,大多同时伴有严重的合并伤,易危及患者生命,往往给治疗带来巨大挑战。虽然目前对这类损伤的手术时机、入路、复位方式及固定节段长度尚无明确共识,但为了重建脊柱序列和稳定性、减少骨折相关并发症、改善患者生活质量,都需要及时进行手术复位、椎管减压、植骨融合内固定。     

磁共振T2-Mapping成像对呼吸衰竭患者心肌损害的临床应用价值

目的　探讨磁共振T2-Mapping成像对呼吸衰竭患者心肌损害的临床应用价值。 方法　选择2016年8月到2018年12月本院内科诊治的呼吸衰竭患者122例作为研究组,同期无呼吸衰竭病史的78例内科患者作为对照组。所有患者给予超声心动图与磁共振T2-Mapping成像,记录成像参数并进行相关性分析。 结果　衰竭组的DT值高于对照组（P<0.05）;两组E/A与Pulmonary S/D ratio值对比无统计学差异（P>0.05）;两组心磁共振图像质量Ⅲ级与Ⅳ级分别占比80.3%、9.8%和76.9%和12.8%,对比均无统计学差异（P>0.05）;衰竭组短轴位与长轴位的左心室前壁、后壁T2值均大于对照组（P<0.05）;衰竭组患者中,Pearson相关性分析显示短轴位、长轴位的左室前壁、后壁T2值与DT值均呈正相关性（P<0.05）。 结论　磁共振T2-Mapping成像能反映呼吸衰竭患者心肌损害情况,通过定量评估心肌T2值可有效评估左心室心肌功能,对指导临床治疗方案的抉择和预后判断具有重要作用。     

膝关节前交叉韧带后外束股骨止点位置的解剖

目的 通过对膝关节前交叉韧带后外束股骨止点的解剖测量,找到确定前交叉韧带后外束股骨止点的简单可行的方法,为双束重建前交叉韧带手术中的骨道定位提供理论依据。方法 解剖20例新鲜膝关节标本（25~45岁）。在屈膝90°位,测量前交叉韧带后外束股骨止点中心点距股骨髁间窝外侧壁前方、后方和下方软骨缘的距离,再对测量数据进行评估和对比。结果前交叉韧带后外束股骨止点中心点距离股骨前方软骨缘(8.74±1.39)mm,距离后方软骨缘(8.69±1.57)mm（P =0.926）。后外束止点中心点距离股骨下方软骨缘(5.06±0.77)mm。结论膝关节屈膝90°位时,前交叉韧带后外束的股骨止点中心点位于股骨髁间窝外侧壁,距离下方软骨缘5mm,距离前方和后方软骨缘的距离相等。在前交叉韧带双束重建的手术中,应用本研究的结果能够简单、快捷地确定前交叉韧带后外束股骨骨道位置。