针灸在多囊卵巢综合征患者宫腔内人工授精助孕术中的应用

目的:通过对近10年相关文献的研究,总结针灸在多囊卵巢综合征患者宫腔内人工授精助孕术中的影响以及在此方面的应用。方法:检索中国期刊全文数据库1996-01/2006-06与针灸对多囊卵巢综合征患者的影响有关的文章,检索词为"针灸,多囊卵巢综合征,人工授精助孕术",限定文章语言种类为中文。同时检索Elsevier-SDOL数据库1996-01/2006-06的相关文章,检索词为"acupuncture,polycystic ovary syndrome,intrauterine insemination",限定文章语言种类为英文。结果:选取文章应该是在下列范围内:针灸对多囊卵巢综合征患者的影响、针灸在宫腔内人工授精助孕术中的应用、多囊卵巢综合征患者在行宫腔内人工授精助孕术时的影响因素以及有关针灸在此方面的研究。共收集到200篇关于"针灸对多囊卵巢综合征患者的影响"的文章,300篇关于"多囊卵巢综合征患者在行宫腔内人工授精助孕术时的影响因素"的文章,30篇关于"针灸在宫腔内人工授精助孕术中的应用"的文章,16篇符合本文标准。既往大多数研究是集中在关于针灸治疗多囊卵巢综合征以及针灸促排卵的临床研究上,认为针灸可以有效治疗多囊卵巢综合征,还可以通过对卵巢的刺激作用而达到促进排卵的作用,并一致认为针灸促排卵不但无副作用而且疗效好,作用稳定、持久。另外曾有德国学者发现将针灸疗法应用于辅助体外授精或精子卵浆内注射技术中,其怀孕成功机率提高近50%。然而,关于针灸在多囊卵巢综合征患者宫腔内人工授精助孕技术中的应用国内外却均未见报道。结论:宫腔内人工授精助孕术已经广泛应用于不孕症的治疗中,而针灸又有很好的促排卵作用。因此可以尝试在多囊卵巢综合征患者行宫腔内人工授精术前后加用针灸疗法,从而研究针灸辅助卵巢诱导排卵在多囊卵巢综合征患者行宫腔内人工授精中的应用,观察针灸是否可以提高多囊卵巢综合征患者的宫腔内人工授精助孕术的成功率。     

青蒿琥酯在奶牛体内的药代动力学与代谢

青蒿琥酯(artesunate,AS)是抗疟新药青蒿素的一个活性衍生物。近年来我国兽医工作者将其用于治疗牛羊泰勒氏焦虫病及双芽、巴贝斯焦虫病、鸡球虫病和耕牛血吸虫病,也收到了满意的效果。AS在大白鼠、兔、狗及人体内的药代动力学研究已见报道。本     

Avascular necrosis of the femoral head in HIV positive patients-an assessment of risk factors and early response to surgical treatment

26 consecutive patients (37 hips) with avascular necrosis (AVN) of the femoral head treated surgically at our institution from 1999 to 2008 were reviewed. The aims of the study were to evaluate the risk factors associated with AVN in HIV positive and HIV negative individuals, and assess early response to total hip replacement (THR) surgery in HIV positive and negative patients. There were 15 male and 11 female patients in total. The mean age for all patients was 47.1± 8.0 years (range, 33 to 66 years). 12 patients were HIV positive, 11 patients were HIV negative and 3 patients had unknown HIV status. Excessive alcohol intake was the most common risk factor for developing AVN .15 patients (58%) had more than one risk factor for AVN and only 2/12 (17%) HIV positive patients had no other risk factor apart from HIV infection. There were no early postoperative complications in 34 arthroplasties in both HIV positive and negative patients. The aetiology of AVN seems often to be multifactorial, even in the presence of HIV infection. Early response to arthroplasty surgery in AVN of the femoral head is equally good irrespective of the HIV serostatus of the patients.     

The Dissociative Subtype of Posttraumatic Stress Disorder: Unique Resting-State Functional Connectivity of Basolateral and Centromedial Amygdala Complexes

Previous studies point towards differential connectivity patterns among basolateral (BLA) and centromedial (CMA) amygdala regions in patients with posttraumatic stress disorder (PTSD) as compared with controls. Here we describe the first study to compare directly connectivity patterns of the BLA and CMA complexes between PTSD patients with and without the dissociative subtype (PTSD+DS and PTSD−DS, respectively). Amygdala connectivity to regulatory prefrontal regions and parietal regions involved in consciousness and proprioception were expected to differ between these two groups based on differential limbic regulation and behavioral symptoms. PTSD patients (n=49) with (n=13) and without (n=36) the dissociative subtype and age-matched healthy controls (n=40) underwent resting-state fMRI. Bilateral BLA and CMA connectivity patterns were compared using a seed-based approach via SPM Anatomy Toolbox. Among patients with PTSD, the PTSD+DS group exhibited greater amygdala functional connectivity to prefrontal regions involved in emotion regulation (bilateral BLA and left CMA to the middle frontal gyrus and bilateral CMA to the medial frontal gyrus) as compared with the PTSD−DS group. In addition, the PTSD+DS group showed greater amygdala connectivity to regions involved in consciousness, awareness, and proprioception—implicated in depersonalization and derealization (left BLA to superior parietal lobe and cerebellar culmen; left CMA to dorsal posterior cingulate and precuneus). Differences in amygdala complex connectivity to specific brain regions parallel the unique symptom profiles of the PTSD subgroups and point towards unique biological markers of the dissociative subtype of PTSD.     

Variable hearing impairment in a DFNB2 family with a novel MYO7A missense mutation

Hildebrand MS, Thorne NP, Bromhead CJ, Kahrizi K, Webster JA, Fattahi Z, Bataejad M, Kimberling WJ, Stephan D, Najmabadi H, Bahlo M, Smith RJH. Variable hearing impairment in a DFNB2 family with a novel MYO7A missense mutation. Myosin VIIA mutations have been associated with non‐syndromic hearing loss (DFNB2; DFNA11) and Usher syndrome type 1B (USH1B). We report clinical and genetic analyses of a consanguineous Iranian family segregating autosomal recessive non‐syndromic hearing loss (ARNSHL). The hearing impairment was mapped to the DFNB2 locus using Affymetrix 50K GeneChips; direct sequencing of the MYO7A gene was completed. The Iranian family (L‐1419) was shown to segregate a novel homozygous missense mutation (c.1184G>A) that results in a p.R395H amino acid substitution in the motor domain of the myosin VIIA protein. As one affected family member had significantly less severe hearing loss, we used a candidate approach to search for a genetic modifier. This novel MYO7A mutation is the first reported to cause DFNB2 in the Iranian population and this DFNB2 family is the first to be associated with a potential modifier. The absence of vestibular and retinal defects, and less severe low frequency hearing loss, is consistent with the phenotype of a recently reported Pakistani DFNB2 family. Thus, we conclude this family has non‐syndromic hearing loss (DFNB2) rather than USH1B, providing further evidence that these two diseases represent discrete disorders.     

Identification of three mutations and associated haplotypes in the protoporphyrinogen oxidase gene in South African families with variegate porphyria

Mutation analysis of genomic DNA samples obtained from 17 unrelated South African patients with variegate porphyria (VP) revealed three novel missense mutations in the protoporphyrinogen oxidase (PPOX) gene. A common C to T transition at nucleotide position 452 (R59W) was identified in 15 of the patients analysed, while base changes at positions 336 (H20P) and 779 (R168C) were identified in the remaining two patients. Using protein analysis software we were able to predict that all three mutations have a similar biophysical effect on the protein, being the disturbance of amphiphatic regions within the protein, which might result in misfolding of the protein. Mutation R59W, identified in the majority of South African VP families, was shown to create a Styl restriction site, while mutation R168C would abolish a Dsal restriction site in genomic DNA of affected individuals. As 100% of the index patients analysed were molecularly characterized, the combined use of restriction enzyme and single-strand conformation polymorphism (SSCP) analysis now allows a rapid and accurate diagnosis of VP in South Africa. Mutation R59W was furthermore shown to be in association with one of four potential haplotypes defined by two newly described polymorphisms in exon 1 of the PPOX gene. Our molecular data thus strongly support the founder hypothesis for VP in South Africa.      

大连市7～18岁学生1995～2005年肥胖流行情况分析:以皮褶厚度计算体脂含量

目的:采用皮褶厚度计算体脂含量的方法,了解大连学生超重和肥胖流行现状和流行趋势,为青少年生长发育研究、改善学生营养状况和制定学生肥胖防治措施提供依据。方法:①2005-05/06采用简单随机抽样原则,抽取大连市区的出生并生长的7～18岁汉族学生2474名,其中男生1244名,女生1230名。采用国际通用的人体测量学方法测量纳入学生的肱三头肌和肩胛下角部的皮褶厚度,并通过皮褶厚度推算体密度,计算全身体脂含量,再利用体脂含量判断肥胖并计算发生率。并将上述结果与1995年大连市内7～17岁汉族学生1190名和2000年大连市内7～18岁汉族学生1275名肥胖调查结果进行对比分析。②性别差异比较使用大样本的u检验。结果:2005年参与调查的2474名学生均进入结果分析。①学生体脂含量女生随年龄的增长而增加,男生则在11岁时达高峰后呈逐渐下降趋势,生长曲线男女无交叉现象。而且相同年龄段的体脂含量均是女生高于男生,并且除10～13岁年龄组外,其他年龄组差异均有显著性意义(u>1.96,2.58,P<0.05～0.01)。②与1995年调查结果比较,学生体脂含量10年来有较大程度增长,10年平均增长男女生分别为6.31%和4.47%。③学生2000年超重、轻度肥胖和中重度肥胖的发生率男生分别为14.3%,11.1%和7.9%,女生分别为11.0%,7.2%和2.8%。2005年超重、轻度肥胖和中重度肥胖的发生率男生分别为18.0%、11.6%和19.9%,女生分别为15.0%,10.2%和11.7%。结论:①2005年青春期后学生体脂含量有性别差异。②大连学生10年来体脂含量有较大程度的增长,并有继续增加的趋势。③大连学生5年间超重、轻度肥胖和中重度肥胖的发生率增加明显。     

犬自体肺组织瓣修补食管壁部分缺损的可行性

目的:分析犬自体肺组织瓣修补食管壁部分缺损的可行性。方法:实验于2003-01/2004-11在中国医科大学附属第二医院动物实验室完成。选用健康成年杂种犬20只,按随机数字表法分为2组,即支架组和无支架组,每组10只。20只实验犬经右胸第5肋间进胸,于胸内中段食管处胸内食管侧壁制成长4cm,环1/2~2/3周径全层缺损。于相应部位选择适当的肺组织,制成带蒂类舌状肺组织瓣。两组均将肺组织瓣覆盖并缝合固定于食管缺损处,支架组于食管缺损内衬自扩性记忆合金支架(管腔直径2.0cm、长6.0cm)并固定。术后抗炎及营养支持治疗。观察实验犬术后情况,并于术后2,4,6,8,10和12周定期处死实验犬行组织学观察。结果:无支架组实验犬存活7只,其中1只犬存活>24个月;支架组存活6只。①实验犬术后一般情况:存活犬于术后均能正常经口进食,早期有进食后呕吐,再吃下呕吐食物的现象,以支架组明显。②组织学观察结果:术后2周,无支架组均可见替代物表面有胶原及炎性渗出物,边缘见1~2层鳞状上皮细胞;支架组除有无支架组基本表现外,可见支架固定良好,光镜下见网架压迫处有较多中性粒细胞浸润。4~6周,两组均可见替代物表面有新生的3~5层复层鳞状上皮细胞;支架组见支架已基本陷入黏膜层内。8~10周,两组均可见管腔表面有6~8层新生复层鳞状上皮细胞;支架组网架边缘瘢痕组织增生,支架完全被包裹,炎症较重的局部有细胞爬行中断现象或新生细胞层数较薄,多为一两层。结论:应用自体肺组织瓣修补食管壁部分缺损是可行的,但支架组支架对食管修补处组织刺激大,炎性反应重,瘢痕重,因此如何选择合适的支撑物是今后替代节段性食管缺损面临的重要问题。     

Unbound immunoglobulins are a major source of error in the quantitation of platelet surface-bound immunoglobulin levels

Analysis of assays for the determination of platelet-associated immunoglobulins (PAIgs) has led to disagreement over the amount of surface-bound Igs in both normal controls and patients with elevated platelet Ig levels. By the use of radiolabeled platelets and platelet counts, it was demonstrated that more than 10(8) platelets are disrupted after each centrifugation during platelet isolation procedures, releasing intraplatelet contents into the fluid phase of resuspended platelets in buffer. It was shown that suspensions of whole washed platelets contain a significant, but generally overlooked, amount of unbound Igs that have been liberated from platelets disrupted during processing. When platelet suspensions are evaluated for Igs with assays that fail to incorporate a final separation of whole platelets from the suspension fluid, unbound Igs as well as those bound to the platelet surface are measured, which yields a logarithmic overestimation of surface-bound Igs. It has been further demonstrated that patients infected with human immunodeficiency virus type 1 can have elevations of PAIgG, PAIgA, and PAIgM in both the thrombocytopenic and nonthrombocytopenic states. These elevations are due to increased internal platelet pools of Igs and not to increased surface-bound Igs.     

自体骨髓单个核细胞移植治疗下肢缺血性疾病中细胞因子的作用

目的:评估自体骨髓单个核细胞移植治疗下肢动脉缺血性疾病中几种细胞因子的作用。方法:实验于2006-09/12在河北医科大学唐山临床学院中心实验室完成。实验材料:日本大耳白兔40只,清洁级,5月龄,体质量2.5～3.0kg,由华北煤炭医学院动物中心提供(合格证为SCXK-2005-0002),采用完全随机设计方法将日本大耳白兔分为4组:对照组、缺血组、磷酸盐缓冲液组、骨髓单个核细胞治疗组,10只/组。实验方法:对照组不作任何干预措施,其他3组建立日本大耳白兔右下肢缺血模型。取右下肢缺血模型制备2周后的兔,分离获取骨髓单个核细胞。缺血组制备右下肢缺血模型后不作其他干预措施。磷酸盐缓冲液组模型制备2周后,用1mL注射器将0.01mol/L磷酸盐缓冲液分15点注射于右下肢股骨中点股内收肌群内。骨髓单个核细胞治疗组模型制备2周后,用1mL注射器将1×109L-1骨髓单个核细胞悬液分15点注射于右下肢股内收肌群内。实验评估:造模后3d切取内收肌组织标本,测量其组织匀浆中血管内皮生长因子、碱性成纤维细胞生长因子、白细胞介素1β的含量;4周后行数字减影血管造影术,术后取右下肢内收肌标本,采用CD34免疫组织化学法检测毛细血管密度,观察下肢血管再生情况。结果:40只日本大耳白兔均进入结果分析。①移植后4周腹主动脉造影检测:骨髓单个核细胞治疗组结扎股动脉处的远端毛细血管生成较明显,血管成网状。缺血组及磷酸盐缓冲液组结扎处远端毛细血管生成不明显。②CD34免疫组织化学方法检测毛细血管密度:对照组平均为16个/×400高倍镜,缺血组和磷酸盐缓冲液组平均为5个/×400高倍镜,治疗组毛平均为20.5个/×400高倍镜。骨髓单个核细胞治疗组肌肉标本毛细血管密度明显高于缺血组和磷酸盐缓冲液组(P<0.05)。③造模后3d检测细胞因子含量:缺血组、磷酸盐缓冲液组、骨髓单个核细胞治疗组的碱性成纤维细胞生长因子含量明显高于对照组[(1.83±0.90),(3.22±2.10),(3.20±1.56),(3.75±1.07)ng/g,P<0.05]。骨髓单个核细胞治疗组白细胞介素1β含量明显高于对照组、缺血组、磷酸盐缓冲液组[(10.87±6.42),(10.74±6.32),(11.80±4.50),(16.73±4.21)ng/g,P<0.05],各组血管内皮生长因子水平差异不明显(P>0.05)。结论:自体骨髓单个核细胞移植治疗缺血性疾病过程中,白细胞介素1β对毛细血管的生成起主要作用。