不同剂量硒对染铅孕鼠仔代生长发育影响

目的 探讨不同剂量硒对染铅孕鼠仔代性别分化、生长发育和青春期启动的影响.方法 SD大鼠随机分为5组,自受孕1～20d,中毒组孕鼠自由饮用含2mg/ml醋酸铅的双蒸水,硒拮抗组在此基础上分别自由饮用含2,4,8μg/ml亚硒酸钠的双蒸水,对照组自由饮用双蒸水.自然分娩后各组母鼠均饮用双蒸水并哺乳,观察仔鼠性别比例、出生后4,22d生存率、肛殖距离(AGD)和青春期启动的情况.结果 4μg/ml硒拮抗组仔鼠的生长发育和青春期启动与对照组比较差异无统计学意义(P>0.05),各组仔鼠的性别比例和肛殖距离差异无统计学意义(P>0.05).结论 4μg/ml亚硒酸钠可明显拮抗2mg/ml醋酸铅对仔鼠生长发育和青春期启动的毒性,孕期适宜的硒营养补充量可明显改善有铅暴露史孕鼠仔代的生长发育和青春期启动.     

特发性性早熟女童LHR基因Asp~(578)Gly突变研究

目的:研究黄体生成素受体(LHR)基因Asp578Gly突变与女童特发性性早熟的关系。方法:从16例特发性性早熟女童的口腔拭子中提取DNA,5’-CAC TGC TGG CTT TTT CAC TGT ATT-3’和5’-TGA AGG CAG CTG AGA TGG CAAAAA-3’作引物,经常规PCR扩增后采用限制性内切酶MspI消化,检测LHR基因是否存在A1733G的单碱基突变。结果:16例性早熟女童的LHR基因均未检测到Asp578Gly突变。结论:Asp578Gly突变不是女童特发性性早熟的主要病因。     

A Survey of Treatment of Acne by Acupuncture

Acne usually affects the face, chest and back in puberty. Here, the author would like to present a survey of acupunture treatment of acne according to the clinical reports in resent years.     

雌孕激素复合口服避孕药治疗青春期功能失调性子宫出血的临床观察

目的探讨简单、方便、经济、顺从性好的治疗青春期功能失调性子宫出血的止血方法。方法将青春期功能失调性子宫出血患者200例，随机分为治疗组和对照组，治疗组口服雌孕激素复合口服避孕药敏定偶（复方孕二烯酮）或者妈富隆（复方去氧孕烯），3、4片／d；对照组口服结合型雌激素2．5mg／d或者戊酸雌二醇4mg／d：比较两组病例的止血时间。结果采用雌孕激素复合口服避孕药止血法患者的止血时间与采用雌激素修复内膜止血法患者的止血时间有明显统计学差异（P〈0．05）。结论用雌孕激素复合口服避孕药治疗青春期功能失调性子宫出血，方法简单经济方便有效。     

Transient true precocious puberty. A report of five cases

Five girls with idiopathic true precocious puberty are reported who underwent spontaneous regression of sexual development. In all patients the signs of sexual maturation were of moderate degree. Considering the possible spontaneous regression of precocious puberty, in similar cases it seems advisable to defer suppressive central therapy for about 6–12 months.Abbreviations FSH follicle stimulating hormone - Gn-RH gonadotrophin releasing hormone - LH-RH luteinizing hormone releasing hormone     

Juvenile Granulosa Cell Tumor

A 2-year-old girl presented with isosexual precocity, and a juvenile granulosa cell tumor of the left ovary was removed. The tumor was unusual in that striated muscle differentiation of the tumor cells was demonstrated. This suggests that the mesenchymal cells retain the potential for divergent differentiation.     

A physiological mode of puberty induction in hypogonadal girls by low dose transdermal 17β-oestradiol

Transdermal 17-oestradiol administration (17-E₂), used mainly in menopausal women, allows a continuous 17-E₂ delivery through the skin into the systemic circulation, avoiding intestinal and hepatic passage. In order to explore whether transdermal 17-E₂ could be used for the induction of puberty, 17-E₂ patches with low dose delivery were administered in nine prepubertal girls with Turner syndrome (bone age >10.5 years) for a mean period of 2.2 years. Treatment schedule: 5 g/day for 6–9 months, 10 g/day for 6–9 months, 25 g/day for long-term substitution; addition of cyclic gestagen p.o. after 18–24 months. Breast development started within 3 months of therapy and menstruation occurred after 2 years. Growth rate increased from 3.2 to 5.0 cm/year during the 1st year of therapy, height prediction did not change. Serum oestradiol (E₂) and urinary E₂ conjugates increased proportionally with 17-E₂ doses, serum oestrone (E₁) rose much less. The possibility to imitate time course, clinical events and hormonal changes of normal puberty, the absence of adverse drug reactions and the excellent acceptance and easy mode of application suggest that transdermal 17-E₂ is optimally suited for hormonal substitution in girls with hypogonadism.Presented in part at the Annual Meeting of the European Society for Paediatric Endocrinology and the LWSPE, Jerusalem November 1989     

Growth and endocrine disorders in optic glioma

Hypothalamo-pituitary function in children with optic glioma may be impaired by the tumour itself and by the high cranial radiation doses used in treatment. This study evaluates the effect of optic glioma and its treatment on patient growth and pubertal development. Twenty-one patients (13 boys, 8 girls), treated for optic glioma by cranial irradiation (45–55 Grays) at a mean age of 5.4 years, were evaluated before (n=10) and/or after (n=21) irradiation. Growth hormone (GH) deficiency was present in only 1 patient tested before irradiation and in all patients after irradiation. Precocious puberty occurred in 7/21 cases, before irradiation in 5 patients and after irradiation in 2 patients. The cumulative height loss during the 2 years after irradiation was 0.2±0.2 SD (m±SEM) in 7 patients with precocious puberty and 1.1±0.2 SD in 14 prepubertal patients (P<0.01). The corresponding bone age advance over chronological age, evaluated 1–3 years after irradiation, was 1.1±0.5 and –0.7±0.3 year in the two groups (P<0.01). The mean height loss between time of irradiation and the final height was 2.3±0.6 SD (n=6). Primary amenorrhoea, associated with low oestradiol levels, occurred in two of the three girls of pubertal age. These data indicate that the high dose of cranial radiation used to treat optic glioma invariably results in GH deficiency within 2 years and that hGH therapy is required when GH deficiency is documented. Precocious puberty, resulting in apparently normal growth velocity in spite of GH deficiency, should be treated with luteinizing hormone-releasing hormone analogues because of the risk of accelerated bone maturation and reduced final height.     

Growth and Development of Children with Chronic Renal Failure

ABSTRACT. Preliminary results from an ongoing multicentre study on pubertal growth and sexual maturation in chronic renal failure are presented. Puberty was delayed by approximately 2.5 years in both sexes in children with chronic renal failure. There was also an irreversible decline in height SDS during puberty. The pulsatile secretion of growth hormone (GH) and luteinizing hormone (LH) were disrupted in patients on conservative treatment or dialysis compared with those in patients with renal transplants; the mean nocturnal GH level and the mean GH peak amplitude were increased, while the number of pulses and peak amplitude of LH were decreased. The biopotency of LH, expressed as the ratio of bioactive to immunoreactive LH, was suppressed in patients with renal transplants.     

Pelvic ultrasound findings in different forms of sexual precocity

Recently produced reference curves for various ultrasound dimensions were used to retrospectively assess 67 pelvic ultrasound scans carried out at the initial presentation in girls with sexual precocity. At presentation the group with precocious puberty had significantly increased uterine lengths and ovarian volumes compared with the normal population, and a significantly increased fundal–cervical ratio. Ovarian volume was also significantly increased in thelarche and thelarche variant. The fundal–cervical ratio was significantly increased in thelarche variant. There was considerable overlap between individuals with sexual precocity and normal subjects. The ultrasound findings that best discriminated early or precocious puberty from other forms of sexual precocity were the presence of a midline endometrial echo, and a uterine length above the 97th centile for age. An entirely normal pelvic ultrasound at presentation did not rule out the possibility of precocious puberty.