宫腔镜在辅助生殖技术中的应用

目的：探讨宫腔镜检查术在辅助生殖技术中应用的重要性。方法：对150例拟行辅助生殖技术的不育妇女行常规宫腔镜检查。结果：宫腔镜150例中47例（31％）有镜下异常，其中：子宫内膜息肉或息肉样增生18例（12％），子宫内膜单纯性增生17例（11％），子宫畸形7例（5％），宫腔粘连狭窄3例（2％），子宫内膜结核1例（0．7％），子宫黏膜下肌瘤或腺肌瘤1例（0．7％）。以宫腔镜诊断为标准，阴道超声诊断敏感性、特异性、阳性预测值、阴性预测值、准确率分别为66％（31／47）、98％（101／103）、94％（31／33）、86％（101／117）、88％（132／150），子宫造影分别为26％（12／47）、100％（95／95）、100％（12／12）、73％（95／130）、75％（107／142）。结论：宫腔镜检查术具有良好的可接受性和准确性，应作为辅助生殖技术前的常规检查。     

Reproductive Function in Epilepsy

Summary: : The hypothalamic-pituitary-gonadal axis is a complex system within which both positive and negative feedback occur among its elements and higher brain systems. The occurrence of seizures and changes in the secretion of pituitary hormones can affect the feedback loop. Both seizures and antiepileptic drugs can affect the hypothalamic-pituitary-gonadal axis of males and females and cause changes in hormones and sexuality. Reproductive dysfunction has a social impact because of reduced fertility. Once conception occurs, live birth rates are not diminished. Prospective studies of men and women with epilepsy are needed.     

育龄妇女、孕妇及乳母碘营养状况调查

目的 了解缺碘地区食用合格碘盐的育龄妇女和孕妇及乳母碘营养状况。方法 对病区育龄妇女和孕妇及乳母进行观察。采用酸消化砷铈接触法及全定量直接滴定法分别检测尿碘，乳碘和盐碘含量。结果 育龄妇女和孕妇及乳母尿碘含量分别为219.37μg/L，203.98μg/L，178.55μg/L，尿碘值小于100μg/L占24.14%，三组人群尿碘水平依次降低，但差异未显示统计学意义；乳碘值为122.72μg/L，小于100μg/L达33.93%，提示应关注特需人群的碘营养问题。结论 应开展对育龄妇女和孕妇及乳母的尿碘监测。以指导合理补碘，防止胎儿和婴幼儿碘营养不良的发生。     

备孕期高血压的规范管理

近年来由于生活压力的增加,我国越来越多的育龄期男女罹患高血压,因此如何规范管理备孕期高血压已成为当前的焦点。本文从备孕期间血压的监测与评估和降压药的使用两方面分别对育龄期男性和女性备孕期间的血压规范管理进行阐述,强调女性备孕期间的高血压管理应同时考虑母体和胎儿的安全性,选择相对安全的降压药,如甲基多巴、拉贝洛尔、硝苯地平等;男性备孕期间的高血压管理应同时考虑降压药的疗效及其对性功能和精子的影响,推荐奈必洛尔、血管紧张素转换酶抑制剂（ACEI）/血管紧张素Ⅱ受体拮抗剂（ARB）和钙离子通道阻滞剂（CCB）类药物,旨在为临床备孕期高血压的管理提供指导并为未来研究提供参考方向。     

Localization of tyrosine hydroxylase-immunoreactivity in the brain of the Senegalese sole, Solea senegalensis

The localization of catecholamines in the brain of the Senegalese sole was determined by immunohistochemical techniques using antibodies against tyrosine hydroxylase. Although the general pattern of distribution of catecholamines is consistent with that reported in other teleosts, some remarkable differences are observed. The most rostral tyrosine hydroxylase immunoreactive (TH-ir) cells were identified in the olfactory bulbs, in which a clear asymmetry in the number and location of TH-ir perikarya and fibers was observed. The number of TH-ir cells is manifestly higher in the right olfactory bulb, especially in the internal cell layer. TH-ir fibers are also much more abundant in the right bulb, principally in the glomerular and internal cell layers. Other TH-ir cell masses were identified in the ventral telencephalon, preoptic area, caudoventral hypothalamus, posterior tuberculum, synencephalon, isthmic region and rhombencephalon. Surprisingly, no ir cell bodies were identified in the ventromedial thalamic nucleus, which exhibits a large number of TH-ir cells in other teleosts. The presence of TH-ir fibers in the brain of sole is particularly evident within and around the nuclei in which immunoreactive cells are found. However, other zones such as the dorsal telencephalon, posterior commissure, optic tectum, torus semicircularis, reticular formation or inferior olive also displayed TH-ir fibers. TH-ir axons also enter the infundibulum, reaching the proximal pars distalis of the adenohypophysis. The distribution of TH-ir cells and fibers is compared with that observed in other teleosts and is discussed in a comparative context.     

Calcium taste preference and sensitivity in humans. I. Gender comparisons

Calcium is an essential nutrient, particularly during growth and during reproduction, and the latter is probably why the avidity for calcium may be greater in females of some species. However, in humans, despite widespread belief in calcium appetite, it has not been studied experimentally. Here we compared the hedonic responses of 17 men and 24 women to test whether women show a greater avidity for calcium in line with its greater biological significance for them. We find no gender difference in the hedonic response to calcium, and no change with the menstrual cycle.     

Reproduction and thermoregulation in Peromyscus: Effects of chronic short days

Seven groups of laboratory reared Connecticut P. leucopus were exposed to a 9L:15D photoperiod for either 6, 9, 12, 20, 25, 32, or 36 weeks. An eighth group was maintained on 16L:8D. During the final 6 weeks all mice were cold exposed (13°C). Substantial reproductive regression occurred in females following 6 weeks exposure to 9L:15D relative to 16L:8D animals. In males, a slight decrease in testicular weight occurred following 6 weeks on 9L:15D; this effect was pronounced by 9 weeks, along with a decrease in seminal vesicle weight. Reproductive recrudescence occurred in females by week 32 and in males by week 36. Between 10 and 12 weeks on 9L:15D mice exhibited increases in nesting, incidence of daily torpor, and presence of the winter molt. These increases persisted through 36 weeks on 9L:15D. An increase in the interscapular brown fat pad occurred between 12 and 25 weeks. Reproductive and thermoregulatory characters respond differently to prolonged exposure to a short day photoperiod in this species.     

Critical evaluation of medical, statistical, and occupational data sources in the Kola Peninsula of Russia pertinent to reproductive health studies

Background: The feasibility study described herein was prompted by a report in 1992 of possible reproductive and developmental health concerns among female workers in a Russian nickel refinery. Objective: The primary goal was to ascertain whether medical, statistical, and occupational data bases could be accessed for information about the pregnancy histories, occupational histories, and life-style factors of the women affected. Methods: The project was facilitated by construction of a registry of all births in three towns with a nickel refinery and verification of its contents against patients' records obtained from hospital delivery and gynecology departments and community polyclinics. Municipal Registration Board, Regional Health Statistics Board, and nickel company records were also reviewed. Results: Reproductive/developmental outcome information and workplace histories were acceptable. Sample-size calculations indicated that a cohort or cross-sectional study would be amenable and suitable for the detection of an excess risk for spontaneous abortion with adequate statistical significance and power. Such investigations would need to be supplemented by workplace environmental/biological monitoring assessments for evaluation of exposure to occupational hazardous factors and a worker's questionnaire to obtain information about life-style factors. A case-control design is recommended for the study of congenital defects. Conclusions: A well-designed, comprehensive epidemiology study is technically feasible because of the availability of a favorable pool of study subjects, reproductive/developmental outcome data, information to control for major confounders, and suitable occupational records. Received: 13 July 1998 / Accepted: 7 February 1999     

Investigation of clusters of adverse reproductive outcomes, an overview

Clusters of adverse reproductive outcomes are reported with increasing frequency to public health services, but it is likely that only a minority of clusters are caused by a common environmental teratogen or mutagen. Many guidelines and protocols have been developed for the investigation and the management of chronic disease clusters and can be applied to the study of adverse reproductive outcomes. Cluster investigation normally follows four successive phases: (i) the generation of one or more etiologic hypotheses, (ii) the confirmation of the hypotheses, (iii) an intervention aimed at reducing any dangerous exposure, and (iv) the evaluation of the effect of the intervention. However, each situation is unique and there is no standard recipe for conducting the epidemiologic investigation at each successive phase, for choosing the appropriate statistical technique and for communicating with interested parties. In order to minimize both the risk of pursuing a worthless investigation and the risk of ignoring a real excess of cases caused by an adverse environmental factor, it is imperative to rely on a team of specialists with expertise in epidemiology, statistics, toxicology, embryology, and communication.