雄激素对高盐饮食状态下雄性大鼠血管内皮功能的影响

目的 探讨不同水平雄激素对高盐饮食状态下雄性大鼠血管内皮功能的影响.方法 雄性Wistar大鼠32只随机分为4组,每组各8只:假手术组(Sham),去势组(Cas),去势后补充睾酮组(TC),去势后补充睾酮和氟他胺组(FTC).各组均以8％NaCl高盐颗粒饲料喂养,Sham组施以假手术,Cas、TC及FTC组均施以去势手术.TC及FTC组予以丙酸睾酮(TP) 2mg/(kg·2d)皮下注射,FTC组同时予以氟他胺1mg/(kg·d)灌胃,持续8周.尾动脉脉压法测定各组实验前、实验4周、实验8周后尾动脉血压,8周后酶联免疫吸附测定法(ELISA)测定血清中睾酮(T)、内皮素1(ET-1)的浓度,比色法测定血浆中一氧化氮(NO)水平.结果 (1)与Sham组血压相比,Cas组和FTC组明显下降[Cas组:(124.8±4.4) vs(135.9±3.7) mmHg,P＜0.01;FTC组:(127.7±3.0)vs(135.9±3.7) mmHg,P＜ 0.01];与基础血压相比,Sham组和TC组明显升高(P＜0.01);(2)与Sham组T浓度相比,Cas组的明显下降[(0.26±0.02) vs (3.15±0.54) μg/L,P＜ 0.01],而FTC组明显升高[(5.47±1.29) vs(3.15±0.54) μg/L,P＜0.01];(3)与Sham组血清ET-1浓度相比,Cas组和FTC组明显下降[Cas组:(0.77±0.23) vs(1.08±0.15)μg/L,P＜0.01;FTC组:(0.80±0.21) vs(1.08±0.15) μg/L,P＜0.05]; TC组差异无统计学意义(P＞0.05);(4)与Sham组NO浓度相比,Cas组和FTC组明显升高[Cas组:(42.37±15.74)vs(17.20±7.32) mmol/L,P＜0.01; FTC组:(33.44±8.50) vs(17.20±7.32) mmol/L,P＜0.01];TC组差异无统计学意义(P＞0.05).结论 高盐饮食下,雄激素水平的变化可能影响雄性大鼠血管内皮功能.     

L- carnitine in idiopathic asthenozoospermia: a multicenter study

Summary. The aim of the study described here was to evaluate any possible effect of L-carnitine on spermatozoal motility in a group of patients with unexplained asthenozoospermia in four different infertility centres. One hundred patients received 3 g d⁻¹ of oral L-carnitine for 4 months. Sperm parameters were studied before, during and after this treatment. Motility was also studied by means of a computer-assisted sperm analysis.
The results of the study indicate that L-carnitine is able to increase spermatozoal motility, both in a quantitative and in a qualitative manner (per cent motile spermatozoa increased from 26.9±1.1% to 37.7 ± 1.1% [ P < 0.001]; per cent spermatozoa with rapid linear progression increased from 10.8 ± 0.6% to 18.0 ± 0.9% [ P < 0.001]; mean velocity increased from 28.4 ± 0.6 μm s⁻¹ to 32.5 ± 0.8 μm s⁻¹ [ P < 0.001]; linearity index increased from 3.7 ± 0.1 to 4.1±0.1 [ P < 0.001], especially in the subgroup of patients with poor rapid linear progression of spermatozoa (per cent of motile spermatozoa increased from 19.3± 1.9% to 40.9± 1.4% [ P < 0.001], and per cent of spermatozoa with rapid linear progression increased from 3.1±0.4% to 20.3±1.6% [ P < 0.001]) An increase in spermatozoal output was also observed (total number of ejaculated spermatozoa increased from 142.4 ± 10.3 10⁶ to 163.3 ± 11.0 × 10⁶ [ P < 0.001]). The authors conclude that oral administration of L-carnitine may improve sperm quality at least in patients with idiopathic asthenozoospermia.     

Long-term effects of vasectomy part II: Immunological parameters

A cross-sectional study was undertaken to assess the long-term immunological sequelae of vasectomy with respect to humoral response as well as the cell-mediated immune response (CMI) to spermatozoa. In the humoral response, circulating immune-complexes (CICs) were also estimated and attempts were made to investigate whether the development of antibodies to spermatozoa had any association with the HLA system. Four different techniques, viz. tray agglutination test (TAT), spermatozoa immobilization test (SIT), cellular-radioimmunoassay (CRIA) and the enzyme-linked immunosorbent assay (ELISA) were used to estimate antibodies to spermatozoa. Serum samples were considered positive when at least two of the above mentioned techniques gave a positive response to spermatozoal antigens. The results indicated that 37.5% of the vasectomized men developed antibodies to spermatozoa. CICs were present in 12% of the vasectomized subjects and 4% of the controls. 59.3% of the vasectomized who showed the presence of CICs, were negative to the presence of antibodies to spermatozoa. The HLA antigen frequency in the vasectomized subjects did not differ in individuals with and without spermatozoal antibodies. The CMI response to spermatozoa was negative in vasectomized subjects.     

Measurement of effective elastance of the total respiratory system in ventilated patients by a computed method

We have studied 28 patients mechanically ventilated for acute respiratory failure at different levels of externally applied positive end-expiratory pressure (PEEP_e). We describe and compare a computed method of measuring effective elastance of the total respiratory system (E_rs,eff) with the static values of elastance of the total respiratory system (E_{rs, st}), obtained with the end-inflation occlusion technique. E_{rs, eff} was computed by an original device (Heres, R.P.A., Belgium), also the effective resistance of the total respiratory system was calculated. At zero end-expiratory pressure set by the ventilator (ZEEP). E_{rs, eff} averaged 29.5±13.5 cm H₂O·L^–1 while E_{rs, st} non-corrected for intrinsic PEEP (PEEP_i) averaged 36.4±15.1 cm H₂O·L^–1 and E_{rs, st} corrected for PEEP_i averaged 28.2±13.4 cm H₂O·L^–1. The small difference between_{Ers, eff} and_{Ers, st} corrected for PEEP_i was statistically significant and these two values were highly correlated (r=0.98). This significant difference disappeared rapidly with PEEP_e and probably reflects a frequency-dependance due to pendelluft. We also observed that PEEP_i was present in 21 of 27 patients at ZEEP. Our results also indicate that low levels of PEEP may improve E_rs in hyperinflated COPD patients, without inducing further hyperinflation. In conclusion, values of E_{rs, eff} are very similar to static values corrected for PEEP_i and permit an accurate and rapid approach to the management of ventilated patients.     

多囊卵巢综合征的中西医结合治疗临床观察

从本专科不孕症患者中,选出因多囊卵巢综合症所致不孕症者102例,随机分为两组,治疗组予中西医药物+针刺治疗,调冲促孕汤、黄体汤为本院名老中医赵华英经验方。对照组西医常规治疗。均以1个月经周期为1个疗程,2~6个疗程后进行疗效比较。结果证明中西医结合治疗多囊卵巢综合症所致的不孕症的疗效明显优于西药组。     

腹痛为首发症状的老年男性系统性红斑狼疮1例

1 临床资料 患者男性,81岁,因"上腹部疼痛2周"于2012年3月23日入院.患者于2周前无明显诱因突发上腹部持续性疼痛,伴腹胀,咳嗽时加重,便秘,约3～5d 1次;无恶心、呕吐、腹泻、腹鸣,无发热;精神、食欲及睡眠尚可,小便正常.