Nonspermatozoal Cells in Human Sperm: A Study of 1243 Subfertile and 253 Fertile Men

The presence of nonspermatozoal cells (NSC) and, more particularly, of immature seminal line elements (ISLE) in the semen of subfertile men seems to result from a dysfunction of spermatogenesis. A positive correlation was found between the number of NSC and the degree of teratozoospermia, as well as between the number of NSC and the percentage of ISLE. The degree of teratozoospermia and the percentage of ISLE were also correlated. There was no correlation between the number of NSC or the percentage of ISLE and the length of sexual abstinence. The number of NSC and the initial sperm motility were negatively correlated, but this correlating seems to be directly related to teratozoospermia.

In the control population a negative correlation was found between the percentage of normal spermatozoa and that of ISLE. The question is raised whether findings such as normozoo-spermia associated with a high percentage of ISLE should not lead to further examination of the results.     

子宫内膜功能亢进性疾病的“异病同治”诊治研究思路＊

笔者根据现代临床子宫内膜的病理演变过程结合中医“异病同治”理念，提出“子宫内膜功能亢进性疾病”概念，涵盖5种常见的子宫内膜疾病：无排卵性异常子宫出血（Abnormal Uterine Bleeding Ovulatory dysfunction，AUB-O），子宫内膜息肉（Endometrial Polyp，EP），子宫内膜异位症（Endometriosis，EMs），子宫腺肌病（Adenomyosis，AM），子宫内膜癌（Endometrial Carcinoma，EC）。基于文献的汇总，分析得到此类疾病的子宫内膜病理演变与中医病因病机的关联性，为寻找关键通路、创新性治疗此类疾病提供了重要的参考方向，对深化中医妇科学常见疾病的共性病因病机提供了理论依据和探索思路。     

糖代谢异常者血脂、hs-CRP的表达水平及其临床意义

目的：分析糖代谢异常者血脂、hs-CRP表达水平及临床意义。方法采用回顾性方法分析,选取该院自2012年10月—2014年10月期间口服糖耐量试验患者172例,将其分为对照组(正常糖耐量)、观察组(葡萄糖调节异常),两组各86例,比较两组的血脂各项指标及hs-CRP表达水平。结果观察组血脂水平及hs-CRP水平与对照组相比差异有统计学意义(P<0.05);且各项血脂指标、hs-CRP检出率高于对照组(<0.05)。结论高TG、高LDL-C 是糖代谢异常者血脂代谢的典型特征,联合CHO、HDL-C、hs-CRP各项指标可以评估糖尿病及其相关疾病患者的心血管受损情况,对于糖尿病合并冠心病患者的早期诊治、预后评价有重要意义。     

一例染色体复杂易位致胎儿多发畸形的遗传学诊断

目的: 对一例染色体复杂易位致多发畸形胎儿进行遗传学分析和诊断。方法: 对一例多发畸形胎儿行G显带染色体核型分析、单核苷酸多态性微阵列（SNP array）及荧光原位杂交（FISH）检测。胎儿父母行外周血染色体核型分析及FISH检测。结果: 胎儿的羊水染色体核型为46,XN,t（12;13）（q22;q32）。SNP array显示胎儿存在1q42.13q44重复（20 192 kb）及15q26.1q26.3缺失（13 293 kb）,核型分析与基因芯片结果不一致。FISH验证了SNP array的结果。母亲外周血FISH结果确认为隐匿性46,XX,t（1;15）（q42.1;q26.1）携带者,而胎儿遗传了其中一条衍生的15号染色体der（15）t（1;15）（q42.1;q26.1）。即胎儿遗传了父亲的t（12;13）（q22;q32）平衡易位及母亲的隐匿性平衡易位形成的衍生15号染色体。结论: 1q42.13q44重复和15q26.1q26.3缺失是导致本例胎儿畸形的遗传学病因,产前诊断时多种遗传学技术联合应用可为临床提供准确的诊断。     

儿童肝功能异常940例临床特征分析

【摘要】 目的 探讨940例肝功能异常患儿临床特征,为临床早期诊断、及时治疗提供参考依据。 方法 回顾性分析2015年1月～2018年9月来自云南地区以不明原因肝功能异常收治入院的940例患儿的临床资料,包括临床表现、病因、肝功能及临床疗效等。 结果 肝功能异常与年龄相关,以0～12个月婴儿为高发年龄群（706例,75.11%）。肝功能异常程度以轻度异常（534例,56.81%）最多见,其中以0～6个月小婴儿轻度肝功能异常最多见(P＜0.05)。肝功能异常病因以感染为主（543例,57.76%,其中病毒感染353例,细菌感染190例）,其次为其他不明原因（290例,30.85%）。经治疗88.40%的患儿治愈或好转。结论 应重视儿童肝功能常规检查,特别是对于12个月以内的小婴儿。肝功能异常病因明确者应及时采取对因治疗;不明原因者需进一步完善遗传、代谢疾病基因筛查甚至行有创操作等检查以明确病因,早期干预,合理治疗。     

增殖瘢痕成纤维细胞接触后增殖及生物合成特性对异常瘢痕形成的机理

目的 为明确不同异常瘢痕成纤维细胞在体外完全接触后其增殖活性及生物全成功能的特性。方法 以瘢痕疙瘩、增生性瘢痕和正常皮肤（各6例）为材料，通过细胞培养、免疫组织化学及分子生物学等方法，对不同成纤维细胞在细胞接触及未接触时通过检测增殖细胞核内抗原、P16、Ⅰ、Ⅲ型胶原蛋白及前胶原基因表达对成纤维细胞的增殖、抑制及生物合成进行了研究。结果 瘢痕疙瘩成纤维细胞接触表现为细胞交叉重叠及较高的增殖活性及旺盛的生物合成功能，提示其失去了接触性抑制及密度抑制。皮肤成纤维细胞接触后则增殖及生物合成功能明显下降。增生性瘢痕成纤维细胞接触后表现为旺盛的生物合成功能，但其增殖活性处于瘢痕疙瘩和正常皮肤成纤维细胞之间。结论 不同瘢痕成纤维细胞接触后增殖及生物合成的特性可能是形成不同瘢痕的机理之一。     

152例肝移植术后肝功能异常的肝活检

目的评价肝活检在明确肝移植术后肝损害病因中的作用，分析组织学诊断存在误差的常见原因，进一步提高肝活检的准确性，以利临床治疗。方法260例肝活检来自于152例肝移植受者，术后出现临床无法解释的肝功能异常，肝功能检测结果高于正常值的2倍以上。回顾组织学改变及最终的临床诊断，评价相符程度。结果大部分的组织学诊断与最终的临床诊断相符，有7例组织学改变为胆管炎后经进一步临床检查证实4例为血管并发症、2例为败血症、1例为保存性损伤。2例组织学诊断为保存性损伤的病例后证实为药物性肝损害。结论移植后肝活检可明确许多肝功能异常的原因；评判病变的严重程度，指导临床治疗；对一些复杂病例应将以往的活检和整个临床病程、其他实验室检查及影像学检查进行综合考虑，可提高诊断的准确性。     

Neocortical hyperexcitability in a genetic model of absence seizures and its reduction by levetiracetam

PURPOSE: To study the effect of the antiepileptic drug levetiracetam (LEV) on the patterns of intrinsic optical signals (IOSs) generated by slices of the somatosensory cortex obtained from 3- and 6-month-old WAG/Rij and age-matched, nonepileptic control (NEC) rats. METHODS: WAG/Rij and NEC animals were anesthetized with enfluorane and decapitated. Brains were quickly removed, and neocortical slices were cut coronally with a vibratome, transferred to a submerged tissue chamber, and superfused with oxygenated artificial cerebrospinal fluid (aCSF). Slices were illuminated with a dark-field condensor and examined with a x2.5 objective; images were processed with a real time digital video image-enhancement system. Images were acquired before (background) and during electrical stimulation with a temporal resolution of 10 images/s and were displayed in pseudocolors. Extracellular stimuli (200 micros; <4 V) were delivered through bipolar stainless steel electrodes placed in the white matter. RESULTS: IOSs recorded in NEC slices bathed in control aCSF became less intense and of reduced size with age (p < 0.05); this trend was not seen in WAG/Rij slices. Age-dependent decreases in IOS intensity and area size were also seen in NEC slices superfused with aCSF containing the convulsant 4-aminopyridine (4-AP, 5 microM); in contrast, significant increases in both parameters occurred with age in 4-AP-treated WAG/Rij slices (p < 0.05). Under any of these conditions, the IOS intensity and area size slices were larger in WAG/Rij than in NEC slices. LEV (50-500 microM) application to WAG/Rij slices caused dose-dependent IOS reductions that were evident both in control and in 4-AP-containing aCSF and were more pronounced in 6-month-old tissue. CONCLUSIONS: These data demonstrate age-dependent IOS modifications in NEC and WAG/Rij rat slices and identify a clear pattern of hyperexcitability that occurs in 6-month-old WAG/Rij neocortical tissue, an age when absence seizures occur in all animals. The ability of LEV to reduce these patterns of network hyperexcitability supports the potential use of this new antiepileptic drug in primary generalized epileptic disorders.