青春期及儿童卵巢肿瘤46例临床分析

目的：探讨儿童及青春期女性卵巢肿瘤的临床特点。方法：对我院46例青春期及儿童卵巢肿瘤患者的临床资料进行回顾性分析,所有病例均经手术及病理支持。结果：46例中良性肿瘤42例,恶性肿瘤4例;从组织学类型上看,包括生殖细胞肿瘤29例,上皮性肿瘤16例,性索间质肿瘤1例;月经初潮前生殖细胞肿瘤发生率较高,为51．72％,月经初潮后上皮性肿瘤的发生率较高,为93．75％;实性及混合性B超回声的卵巢肿瘤共19例,其中恶性肿瘤4例,囊性回声的卵巢肿瘤27例,其中恶性肿瘤0例。结论：肿瘤组织学类型与月经初潮与否有关,超声检查对卵巢肿瘤性质初步诊断有重要意义。     

Interaction effects between estrogen receptor α and vitamin D receptor genes on age at menarche in Chinese women

AIM: To evaluate whether estrogen receptor alpha (ER-alpha) and vitamin D receptor (VDR) genes are associated with the age at menarche in Chinese women. METHODS: A total of 390 pre-menopausal Chinese women were genotyped at the ER-alpha PvuII, XbaI, and VDR ApaI loci using polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP). RESULTS: Neither the ER-alpha gene nor the VDR gene individually had significant effects on the age at menarche in our subjects (P>0.10). However, evidence of interaction effects between the two genes were observed: with the aa genotype at the VDR ApaI locus, subjects with haplotype PX at the ER-alpha gene had, on average, 6 months later onset of menarche than the non-carriers (P=0.01). CONCLUSION: We found that neither the ER-alpha gene or the VDR gene had a significant association with the age at menarche individually. However, potential interaction effects between the two genes were observed in Chinese women.     

河南汉族女大学生月经初潮年龄相关因素分析

目的调查分析河南汉族女大学生月经初潮年龄及其与成年期体型、运动及饮食习惯的关系。方法对2007级、2008级、2009级的542名新乡医学院河南籍汉族女大学生进行健康调查,对月经初潮年龄、运动情况、饮食习惯进行回顾并测定成年期体型,用SPSS 13.0软件进行统计学分析。结果河南汉族女大学生平均月经初潮年龄为(13.19±1.44)岁,与成年期体质量指数具有相关性(r=-0.425,P<0.01);运动组与非运动组之间月经初潮年龄比较差别有统计学意义(t=3.01,P=0.003);调查中未发现饮食习惯和月经初潮年龄之间的相关性。结论河南汉族女大学生平均月经初潮年龄存在提前趋势,运动可使月经初潮年龄在正常范围内适当推迟,而月经初潮年龄对成年期体型则有明显影响。     

血清瘦素对青春期女生月经初潮的影响

【目的】　探讨血清瘦素在女生青春期发育中的作用。　【方法】　健康女生 13 2名 ,调查月经初潮时间 ,测定血清瘦素、雌二醇、促卵泡成熟激素、黄体生成激素、胰岛素水平 ,采用多元Logistic回归模型分析女生青春期发育的影响因素 ;同时连续两年观察 ,分析血清瘦素对女生月经初潮的影响。　【结果】　末次研究已初潮组血清瘦素( 180 5 .6± 13 2 .1)pmol/L、促卵泡成熟激素 ( 5 .9± 0 .3 )lU/L、黄体生成激素水平 ( 8.9± 0 .4)IU/L、胰岛素 ( 6.8± 0 .5 )mIU /L均明显高于未来潮组 ( 12 11.1± 88.1) pmol/L、( 3 .5± 0 .3 )IU /L、( 6.4± 0 .3 )IU/L (P <0 .0 1)、( 3 .5± 0 .4)mIU /L(P <0 .0 5 ) ,雌二醇 ( 13 .7± 0 .8) pmol/L则无明显变化 ( 12 .6± 0 .7)pmol/L(P >0 .0 5 )。多因素分析显示血清瘦素 (OR =1.193 ,P <0 .0 5 )、黄体生成激素 (OR =1.2 5 3 ,P <0 .0 1)、胰岛素 (OR =1.3 18,P <0 .0 1)、体重 (OR =1.2 81,P <0 .0 1)为女生青春期发育的独立影响因素。初次资料分析 ,初潮前组血清瘦素 ( 10 3 4.9± 13 2 .1) pmol/L、黄体生成激素水平 ( 2 .9± 0 .5 )IU/L、体重 ( 2 6.8± 0 .8)kg明显高于未来潮组 ( 70 4.5± 66.0 ) pmol/L、( 1.6± 0 .3 )IU /L、( 2 3 .5± 0 .5 )kg (P     

女青少儿腰围与性发育关系研究

【目的】分析不同腰围女青少儿体脂肪和性发育的关系。【方法】选择6 157名6~18岁女孩,依据中国汉族学龄儿童青少年腰围正常值的第75和第95百分位数(P75、P95),划分为适宜腰围、偏大腰围和较大腰围组,分析各组身高、体重、体脂率、第二性征分期,现状法分析来潮状况,回顾法分析初潮年龄。【结果】偏大腰围、较大腰围检出率分别为29.35%和16.86%,其性发育明显超前于同龄适宜腰围者。来潮率表现为:较大腰围组偏大腰围组适宜腰围组,初潮年龄表现为:较大腰围组偏大腰围组适宜腰围组。【结论】腰围与性发育(尤其初潮年龄)早晚密切相关。通过监测腰围变化控制中心性肥胖发生,对青春期少女健康至关重要。     

Menstrual psychosis

This paper reviews some of the literature on menstrual psychosis, and proposes a new classification, adapting that of v. Krafft-Ebing (1902) and Jolly (1914). The world literature consists almost entirely of case reports; they include a few with statistical evidence of an association between the onset of psychosis and menstruation, and many other claims with less solid evidence. The complete cases include those with premenstrual, catamenial, paramenstrual and mid-cycle onsets, and continuous phasic illnesses with switches in rhythm with the menstrual cycle. In affected women, psychosis complicates only a small number of cycles, which seem to be concentrated around the menarche and after childbirth. The clinical picture resembles puerperal psychosis, with which it has often been associated. Nosologically menstrual psychosis seems to fall under the manic depressive rubric. Menstruation is one of a family of triggers linked to female reproduction. The evidence for an association with anovulatory cycles suggests that a relative excess of oestrogen may be implicated in the pathogenesis.     

Childhood femoral fracture can lead to premature knee-joint arthritis: 21-year follow-up results: a retrospective study

Background and purpose

During the past decades, treatment of pediatric femoral fractures in Finland has changed from mostly non-operative to more operative. In this retrospective study, we analyzed the long-term results of treatment.

Patients and methods

74 patients (mean age 7 (0–14) years) with a femoral fracture were treated in Aurora City Hospital in Helsinki during the period 1980–89. 52 of 74 patients participated in this clinical study with a mean follow-up of 21 (16–28) years. Fracture location, treatment mode, time of hospitalization, and fracture alignment at union were assessed. Subjective assessment and range of motion of the hip and knee were evaluated. Leg-length discrepancy and alignment of the lower extremities were measured both clinically and radiographically.

Results

Of the 52 children, 28 had sustained a shaft fracture, 13 a proximal fracture, and 11 a distal fracture. 44 children were treated with traction, 5 by internal fixation, and 3 with cast-immobilization. Length of the hospital treatment averaged 58 (3–156) days and the median traction time was 39 (3–77) days. 21 of the 52 patients had angular malalignment of more than 10 degrees at union. 20 patients experienced back pain. Limping was seen in 10 patients and leg-length discrepancy of more than 15 mm was in 8 of the 52 patients. There was a positive correlation between angular deformity and knee-joint arthritis in radiographs at follow-up in 6 of 15 patients who were over 10 years of age at the time of injury.

Interpretation

Angular malalignment after treatment of femoral fracture may lead to premature knee-joint arthritis. Tibial traction is not an acceptable treatment method for femoral fractures in children over 10 years of age.Femoral fractures account for approximately 2% of all childhood fractures. In most cases, the child must be hospitalized. Traditionally, these fractures have been treated with traction and/or casting (Aronson et al. 1987). The long hospital stay and rising healthcare costs popularized surgical treatment from the beginning of the 1990s (Reeves et al. 1990, Hughes et al. 1995, Hedin 2004, Hedin et al. 2004).Although there have been numerous studies describing different operative treatment methods, there is still no consensus as to which method should be used (Sanders et al. 2001, Flynn and Schwend 2004, Hedin 2004, Anglen et al. 2005, Cummings 2005, Wright et al. 2005, Poolman et al. 2006).Femoral fracture treatment may lead to various complications such as malunion, non-union, leg-length discrepancy, skin lesions, and nerve injuries (Yandow et al. 1999, Flynn and Schwend 2004, Anglen and Choi 2005). Persistent angular deformity of the lower limb may lead to premature arthritis (Eckhoff et al. 1994). There are guidelines on the magnitude of angular deformity that can correct spontaneously during further growth which change depending on the child’s age (Flynn and Skaggs 2010).In this retrospective study, we evaluated the childhood femoral fractures in patients treated in Aurora Hospital, Helsinki, during the years 1980–89. This hospital was the primary treatment institution for pediatric trauma patients in Helsinki during the study period, although patients with multiple trauma were treated elsewhere. We assessed the long-term results after non-operative treatment of femoral fractures. This may serve as a baseline to which future long-term results of operative treatment methods can be compared.     

广州市越秀区应元学校女生月经失调的调查分析

目的探讨影响女中学生月经失调的因素。方法从我校420名女生中抽查156例月经失调者进行调查分析研究。结果影响月经失调的因素主要为心理因素,痛经程度与初潮年龄有关（P〈0.01）,初潮年龄越小或年龄越大痛经人数越多。且大多数痛经患者无器质性病变。结论加强健康心理引导,创造良好氛围,进行合理三级预防,可有效减少月经失调的发病率。