不同年龄卵巢储备功能下降患者体外受精-胚胎移植临床结局比较

目的:探讨卵巢储备功能下降(DOR)患者体外受精-胚胎移植(in vitro fertilization and embryo transfer,IVF-ET)的临床妊娠率与年龄的关系。方法:回顾性分析DOR患者行IVF-ET微刺激治疗方案的患者资料,按照患者年龄分为3组:A组(35岁,n=105),B组(35~38岁,n=114),C组(38岁,n=173),比较分析不同年龄组患者一般情况及妊娠结局。结果:各组患者的基础FSH、基础LH、基础E_2、基础窦卵泡数(AFC)、平均每日促性腺激素(Gn)用量、平均Gn使用天数、平均Gn使用总量均无统计学差异(P0.05),促排卵后获卵数、正常受精数、可用胚胎数、优质胚胎数、扳机日LH水平、扳机日E_2水平、未获可移植胚胎率、可移植周期平均移植次数均无统计学差异(P0.05),但生化妊娠率、临床妊娠率、种植率均随着年龄的增加呈下降趋势,A、B组的生化妊娠率、临床妊娠率、种植率与C组相比有着显著的统计学差异(P0.05,P0.01)。结论:DOR患者的生化妊娠率、临床妊娠率、种植率随年龄的增加而下降,年轻的DOR不孕患者临床妊娠结局相对较好。     

脱氢表雄酮对卵巢储备功能下降患者卵巢反应性和IVF-ET结局的影响

目的探讨脱氢表雄酮(DHEA)对卵巢储备功能下降(DOR)患者卵巢反应性和IVF-ET结局的影响。方法收集2014年10月至2016年8月接受IVF和ICSI治疗DOR患者58例,第一周期采用拮抗剂方案,未服用DHEA(对照组);予服用DHEA至少2个月后,第二周期再次采用拮抗剂(治疗组),周期间隔不超过一年。以外源性促性腺激素用量、天数,周期取消率、FSH、窦卵泡计数(AFC)和卵泡数、获卵母细胞数、获卵率、MII数、正常受精率、优胚数、优质胚胎率、妊娠率为变量,利用配对t检验和卡方检验分析。结果对照组和治疗组的Gn总量分别为(36.6±1.9)和(31.4±1.4)支,两组差异有统计学意义(P0.05)。治疗组比对照组有更高的获卵率(83.7%vs.74.1%,P0.01)。对照组和治疗组的妊娠例数分别是3例(5.7%)和20例(37.7%),两组具有统计学差异(P0.01)。结论 DHEA可改善DOR患者卵巢功能,提高获卵率,改善胚胎质量从而提高IVF妊娠率。另外,DHEA可减少IVF中Gn的用量,为患者降低经济成本。     

调经促孕丸结合雌孕激素人工周期治疗DOR不孕症的疗效

目的 探讨调经促孕丸结合雌孕激素人工周期序贯治疗卵巢储备功能减退(DOR)不孕症的临床疗效.方法 选取2014年12月至2015年12月福建省龙岩市中医院妇产科收治的DOR不孕症患者83例为研究对象,分为观察组41例与对照组42例,对照组患者给予雌孕激素人工周期序贯治疗,观察组患者给予调经促孕丸联合雌孕激素人工周期序贯治疗,比较两组患者治疗前后性激素指标、抗苗勒管激素(AMH)水平变化、患者的窦卵泡数(AFC)、卵巢直径(OVD)及卵巢基质血流阻力指数(RI),在治疗结束后对两组患者的妊娠情况进行随访比较.结果 观察组治疗后血清FSH、LH较治疗前显著下降(t值分别为3.078、3.112,均P<0.05),血清E2、AMH较治疗前显著上升(t值分别为2.908、3.024,均P<0.05),而对照组治疗前后上述指标均无显著性差异(t值分别为1.436、1.011、0.978、1.443,均P>0.05).观察组治疗后AFC较治疗前显著上升(t=2.899,P<0.05),卵巢基质RI较治疗前显著下降(t=2.325,P<0.05),而对照组治疗前后上述指标均无显著性差异(t值分别为1.548、0.472,均P>0.05),两组患者治疗前后OVD均无显著性差异(t值分别为1.021、0.890,均P>0.05).观察组治疗后1年内成功妊娠19例,妊娠率为46.34%(19/41),对照组治疗后1年内成功妊娠10例,妊娠率为23.81%(10/42),观察组患者的妊娠率显著高于对照组(χ2=4.634,P<0.05).结论 调经促孕丸联合雌孕激素人工周期序贯治疗DOR不孕症可有效提高卵巢功能及妊娠率,值得临床推广.     

Sorting of neuropeptides and neuropeptide receptors into secretory pathways

There are two major secretory pathways in neurons, the regulated pathway and the constitutive pathway. Neuropeptides and other regulated secretory proteins are known to be sorted into large dense-core vesicles of the regulated pathway in the trans-Golgi network and are secreted upon stimulus-induced increases in intracellular Ca²⁺. The newly synthesized cell surface receptors are usually sorted into microvesicles of the constitutive pathway and inserted into the plasma membrane by spontaneous exocytosis. Small-diameter sensory neurons in dorsal root ganglia and pheochromocytoma cells express neuropeptides (e.g., substance P) and several neuropeptide receptors including opioid receptors. The μ-opioid receptors are delivered to the cell surface through the constitutive pathway, whereas another type of opioid receptor, the δ-opioid receptor, is often found in the membrane of large dense-core vesicles and can be inserted into the plasma membrane when exocytosis occurs. Recent studies show that sequences with opposite electrical polarity within the prohormones of substance P are essential for their sorting into large dense-core vesicles. Moreover, the δ-opioid receptor is sorted into large dense-core vesicles by its interaction with protachykinin, a prohormone of substance P. These findings provide insight into the molecular mechanisms that determine the sorting and trafficking of neuropeptides and neuropeptide receptors in neurons.     

RS3、DeltaV集成系统中的DOR应用技巧

介绍了DOR（DeltaV Operator for RS3）操作站的概念和特点,重点介绍了在实际应用中通过编写DOR标准组件的内部脚本以完善通用操作模板功能的方法,以及为实现RS3和DeltaV系统人机界面的一致性,同步切换工具栏、报警栏的技巧。     

从“治未病”角度探讨防治卵巢储备功能下降和卵巢早衰

卵巢储备功能下降（DOR）和卵巢早衰（POF）在临床上并不少见,我们采用填精补肾,养血疏肝法治疗DOR和POF。对DOR的治疗有明显的降促卵泡激素（FSH）作用,防止其向POF转变,还有部分不孕者受孕;对POF亦能降低FSH,提高雌二醇（E2）水平,明显改善症状,防止骨质疏松、心血管疾病等并发症,部分患者能使月经来潮。体现了中医学＂治未病＂的思想。     

Neuroanatomical characterization of endogenous opioids in the bed nucleus of the stria terminalis

Numerous neuroanatomical data indicate that the bed nucleus of the stria terminalis (BST) provides an interface between cortical and amygdaloid neurons, and effector neurons modulating motor, autonomic and neuroendocrine responses. Distinct divisions of the BST may be involved in stress response, homeostatic regulation, nociception, and motivated behaviors. Endogenous opioid peptides and receptors are expressed in the BST, but their exact distribution is poorly characterized. The present study used in situ hybridization in order to characterize the endogenous opioid system of the BST, focusing on both enkephalin and dynorphin neuropeptides, as well as their respective receptors (mu, delta, and kappa opioid receptors). We report that preprodynorphin mRNA is observed in distinct nuclei of the BST, namely the fusiform, oval and anterior lateral nuclei. In contrast, there is a widespread expression of preproenkephalin mRNA in both anterior and posterior divisions of the BST. Similarly, mu and kappa opioid receptors are broadly expressed in the BST, whereas delta opioid receptor mRNA was observed only in the principal nucleus. For further characterization of enkephalin-expressing neurons of the BST, we performed a double fluorescent in situ hybridization in order to reveal the coexpression of enkephalin peptides and markers of GABAergic and glutamatergic neurons. Although most neurons of the BST are GABAergic, there is also a modest population of glutamatergic cells expressing vesicular glutamate transporter 2 (VGLUT2) in specific nuclei of the BST. Finally, we identified a previously unreported population of enkephalinergic neurons expressing VGLUT2, which is principally located in the posterior BST.     

Accuracy of Clinical Tests in Detecting Disk Herniation and Nerve Root Compression in Subjects With Lumbar Radicular Symptoms

Objectives

To investigate the accuracy of 3 commonly used neurodynamic tests (slump test, straight-leg raise [SLR] test, femoral neurodynamic test) and 2 clinical assessments to determine radiculopathy (radiculopathy I, 1 neurologic sign; radiculopathy II, 2 neurologic signs corresponding to 1 specific nerve root) in detecting magnetic resonance imaging (MRI) findings (extrusion, subarticular nerve root compression, and foraminal nerve root compression).