孕酮对缺血/再灌注脑损伤大鼠脑磁共振波谱和ATP-P2X7R信号通路的影响

目的 探讨孕酮（progesterone,PROG）对缺血/再灌注（ischemia-reperfusion,I/R）脑损伤大鼠的神经保护作用及其可能机制。方法 138只大鼠随机等分为假手术（Sham）组、大脑中动脉栓塞（middle cerebral artery occlusion,MCAO）组和PROG+MCAO组,分别采用Longa法和Morris水迷宫试验评估大鼠运动功能和认知功能;脑组织TTC染色法、磁共振波谱（magnetic resonance spectroscopy,MRS）法和Annexin V-FITC/PI双染法评估神经细胞损伤情况;ELISA法检测脑脊液ATP、IL-6、TNF-α和COX-2含量;Western blotting法检测脑组织P2X₇R和NF-κB蛋白表达的变化。结果 与MCAO组相比,PROG+MCAO组大鼠Longa评分（第5~7天）和Morris水迷宫试验潜伏期（第4~7天）下降（P<0.05或P<0.01）,而目标交叉次数增高（P<0.05）;PROG+MCAO组大鼠NAA/Cr和Cho/Cr比值较MCAO组升高,脑梗死体积和细胞凋亡率较MCAO组明显降低（P<0.05）;MCAO组脑脊液ATP、COX-2、TNF-α和IL-6的含量明显高于Sham组,PROG+MCAO组上述指标含量明显低于MCAO组（P<0.05）;MCAO组脑组织P2X₇R和NF-κB蛋白的表达水平高于Sham组,而其在PROG+MCAO组表达水平又明显低于MCAO组（P<0.05）。结论 PROG通过降低神经细胞凋亡率、减轻神经元损伤及髓鞘降解而改善I/R脑损伤大鼠运动和认知功能,这一保护作用与其抑制ATP-P2X₇R信号通路密切相关。     

来曲唑联合地屈孕酮治疗不孕症疗效及对血清孕酮的影响

目的:研究来曲唑片和地屈孕酮片联合治疗不孕症的疗效及其对患者血清孕酮的影响。方法:选取在某院确诊为不孕症并接受治疗的患者100例作为研究对象,按照治疗方法的不同,将其均分为单一组和联合组两个组别。单一组患者在常规治疗基础上通过来曲唑片进行的单一治疗,联合组患者在对照组基础上通过地屈孕酮片进行治疗,对比两组患者治疗的效果及相关指标的变化。结果:联合组患者治疗的总有效率为90%,显著高于单一组患者的72%(P<0.05);联合组患者的排卵率、SP、E2、LH水平均有显著改善,且优于单一组患者(P<0.05)。结论:对于不孕症患者来说,相比于使用来曲唑片进行单一治疗,来曲唑片和地屈孕酮片联合治疗不仅可以有效提高治疗效果及妊娠率,而且可以更有效改善患者的血清孕酮等水平,因此值得推广。     

黄体酮与盐酸利托君联合治疗先兆早产的临床研究

目的:探讨黄体酮与盐酸利托君联合治疗先兆早产的临床效果。方法:选择2017年1月~2018年12月某院收治的96例先兆早产患者作为研究对象,以随机数表法将其分为对照组与研究组各48例。对照组应用盐酸利托君治疗,研究组在此基础上联合黄体酮治疗,评价两组患者保胎成功率、药物起效时间、妊娠延长时间以及药物不良反应。结果:研究组保胎成功率95.83%高于对照组84.78%(P<0.05);研究组药物起效时间与住院时间均低于对照组(P<0.05),妊娠延长时间高于对照组(P<0.05);两组不良反应发生率对比差异无统计学意义(P>0.05)。结论:黄体酮与盐酸利托君联合治疗先兆早产起效快,保胎效果佳。     

血清β-人绒毛膜促性腺激素与孕酮预测早孕不良结局的临床价值

目的探讨血清β-人绒毛膜促性腺激素(β-HCG)及孕酮的动态监测对早孕不良结局的临床价值。方法选取2013年3月至2014年5月于重庆市渝北区妇幼保健院就诊的212例早孕不良结局患者,根据不良结局类型分为先兆流产组(78例)、稽留流产组(65例)、异位妊娠组(69例)。采用化学发光法检测患者初次就诊的血清β-HCG、孕酮水平,并于48h后复查,比较分析各组血清β-HCG水平与倍增时间,以及孕酮水平与分布情况。结果初次及48h后血清β-HCG水平比较,从高到低依次为先兆流产组、稽留流产组、异位妊娠组,其中先兆流产组与稽留流产组和异位妊娠组分别比较差异均有统计学意义(P0.05)。β-HCG倍增时间比较,从低到高依次为先兆流产组、稽留流产组、异位妊娠组,其中异位妊娠组与先兆流产组和稽留流产组分别比较差异均有统计学意义(P0.05)。孕酮水平比较,从高到低依次为先兆流产组、稽留流产组、异位妊娠组,其中异位妊娠组初次孕酮水平与先兆流产组和稽留流产组分别比较差异均有统计学意义(P0.05)。19.23%的先兆流产组患者初次孕酮水平高于79.25nmol/L,无一例低于15.85nmol/L者,而稽留流产组与异位妊娠组初次孕酮水平低于15.85nmol/L者分别占32.31%、44.93%。结论动态监测血清β-HCG与孕酮水平在预测和诊断早孕先兆流产、稽留流产及异位妊娠中具有重要价值。     

Association of the Alu insertion polymorphism in the progesterone receptor gene with breast cancer in a Mexican population

Introduction

The progesterone receptor (PR) gene plays an important role in reproduction-related events. Data on polymorphisms in the PR gene have revealed associations with cancer, particularly for the Alu insertion polymorphism, which has been suggested to affect progesterone receptor function and contribute to tumor promotion in the mammary gland.

Material and methods

We examined the role of the Alu insertion polymorphism in the PR gene by comparing the genotypes of 209 healthy Mexican women with those of 481 Mexican women with breast cancer (BC).

Results

The genotype frequencies observed in the controls and BC patients were 0% and 4% for T2/T2 (Alu insertion), 16% and 21% for T1/T2, and 84% and 75% for T1/T1 (Alu deletion), respectively. The obtained odds ratio (OR) was 1.7, with a 95% confidence interval (95% CI) of 1.1–2.6, p = 0.009, for the T1/T2–T2/T2 genotypes. The association was also evident when the distributions of the T1/T2–T2/T2 genotypes in patients in the following categories were compared: obesity grade II (OR = 1.81, 95% CI: 1.03–3.18, p = 0.039) and the chemotherapy response (OR = 1.91, 95% CI: 1.27–3.067, p = 0.002).

Conclusions

The T1/T2–T2/T2 genotypes of the Alu insertion polymorphism in the PR gene are associated with BC susceptibility in the analyzed Mexican population.     

The different role of sex hormones on female cardiovascular physiology and function: not only oestrogens

Human response to different physiologic stimuli and cardiovascular (CV) adaptation to various pathologies seem to be gender specific. Sex‐steroid hormones have been postulated as the major contributors towards these sex‐related differences. This review will discuss current evidence on gender differences in CV function and remodelling, and will present the different role of the principal sex‐steroid hormones on female heart. Starting from a review of sex hormones synthesis, receptors and CV signalling, we will summarize the current knowledge concerning the role of sex hormones on the regulation of our daily activities throughout the life, via the modulation of autonomic nervous system, excitation–contraction coupling pathway and ion channels activity. Many unresolved questions remain even if oestrogen effects on myocardial remodelling and function have been extensively studied. So this work will focus attention also on the controversial and complex relationship existing between androgens, progesterone and female heart.