分泌性激素功能的卵巢肿瘤临床表现分析

目的观察和探讨分泌性激素功能的卵巢肿瘤患者临床表现及特征。方法对20例临床确诊为卵巢肿瘤的女性患者于入院起开始详细记录基本情况、病史病例、临床表现等,并将数据整合分析,分别对不同种类的卵巢肿瘤的性激素异常情况、临床不良症状、治疗、预后等进行分析比较,得出结论。结果雌激素分泌过盛患者9例,雌二醇平均水平值达(377.2)pmol/L,临床表现主要有月经紊乱2例(22.22%)、绝经后仍有出血7例(66.67%),性早熟1例(11.11%);雄激素分泌过盛者11例,雄二醇平均水平值(23.2±12.6)nmol/L。临床表现为多毛者9例(81.82%),阴蒂增大者4例(36.36%),出现喉结者3例(27.27%)。结论分泌性激素功能的异常——尤其是雄性激素引起的多毛、阴蒂增大、出现喉结等以及雌性激素引起的性早熟、闭经后阴道出血等都可能是卵巢肿瘤的临床指征,需要高度重视,并在确诊后及时手术治疗。

131I治疗Graves甲亢对男性患者性激素及性功能的影响研究

目的探讨131I治疗Graves甲亢对男性患者性激素及性功能的影响。方法将自2008年3月—2011年6月之间该院收治的40例Graves甲亢患者为研究对象,患者的年龄在25～45岁之间,患者均无长期服药史,对患者服用131I治疗前与治疗3个月后的甲状腺激素和促性腺激素、性激素进行测定,同时对患者进行勃起功能问卷评分调查(IIEF-5),将患者作为实验组,将同期来该院进行体检的健康男性40例为对照组,两组资料比较无显著差异,P>0.05差异无统计学意义。结果实验组患者治疗前患者的FSH、LH、E2与治疗后的比较,P<0.05有统计学意义,治疗3个月后患者的FSH、LH、E2逐渐趋于正常,与对照组比较意义,p<0.01有统计学意义,实验组患者(IIEF-5)评分明显低于对照组,两组比较差异显著,P<0.05有统计学意义。结论男性Graves甲亢患者进行131I治疗后,FSH、LH、E2均有显著的下降,逐渐恢复正常,亦可以明显的改善患者的性功能。

子宫动脉栓塞术治疗前置胎盘剖宫产产后出血对患者应激反应及性激素的影响

目的:探究子宫动脉栓塞术治疗前置胎盘剖宫产产后出血对患者应激反应及卵巢储备功能的影响。方法:回顾性收集2019年1月-2020年3月本院因前置胎盘剖宫产产后出血患者84例临床资料,根据治疗方法不同分为B-Lynch缝合法治疗的缝合法组40例,子宫动脉栓塞术治疗的动脉栓塞组44例。观察两种方法止血效果,比较两组产前及术后血清应激反应指标丙二醛(MDA)、超氧化物歧化酶(SOD)、过氧化氢酶(CAT),产前和术后3、6个月卵巢储备功能指标血清雌二醇(E2)、卵泡刺激素(FSH)、黄体生成激素(LH)。结果:动脉栓塞组止血有效率(95.4%)与缝合法组(92.5%)无差异(P>0.05)。两组术后血清MDA均低于产前,SOD、CAT水平均高于产前,术后3、6个月FSH、LH水平均高于产前,E2水平均低于产前,术后6个月FSH、LH、E2水平均低于术后3个月(P<0.05)。动脉栓塞组术后MDA水平低于缝合法组,SOD、CAT水平均高于缝合法组,术后3、6个月FSH、LH、E水平均高于缝合法组(均P<0.05)。结论:子宫动脉栓塞术治疗前置胎盘剖宫产产后出血效果确切,且可有效减轻患者应激反应,降低对患者术后卵巢储备功能的影响,助于患者恢复。

New understandings of the genetic basis of isolated diopathic central hypogonadism

Idiopathic hypogonadotropic hypogonadism is a rare disease that is characterized by delayed/absent puberty and/or infertility due to an insufficient stimulation of an otherwise normal pituitary-gonadal axis by gonadotrophin-releasing hormone （GnRH） action. Because reduced or normal luteinizing hormone （LH）/follicle-stimulating hormone （FSH） levels may be observed in the affected patients, the term idiopathic central hypogonadism （ICH） appears to be more appropriate. This disease should be distinguished from central hypogonadism that is combined with other pituitary deficiencies. Isolated ICH has a complex pathogenesis and ~s fivefold more prevalent in males. ICH frequently appears in a sporadic form, but several familial cases have also been reported. This finding, in conjunction with the description of numerous pathogenetic gene variants and the generation of several knockout models, supports the existence of a strong genetic component. ICH may be associated with several morphogenetic abnormalities, which include osmic defects that, with ICH, constitute the cardinal manifestations of Kallmann syndrome （KS）. KS accounts for approximately 40% of the total ICH cases and has been generally considered to be a distinct subgroup. However, the description of several pedigrees, which include relatives who are affected either with isolated osmic defects, KS, or normo-osmic ICH （nlCH）, justifies the emerging idea that ICH is a complex genetic disease that is characterized by variable expressivity and penetrance. In this context, either multiple gene variants or environmental factors and epigenetic modifications may contribute to the variable disease manifestations. We review the genetic mechanisms that are presently known to be involved in ICH pathogenesis and provide a clinical overview of the 227 cases that have been collected by the collaborating centres of the Italian ICH Network.

Osteoporosis in celiac disease and in endocrine and reproductive disorders

As the increase in lifespan brings to light diseases that were previously not clinically detectable,osteoporosis has become an issue of worldwide significance. The disease is marked by a loss of bone mass; the bones become less dense,fragile and more prone to fracturing. Because it is regulated by endocrine and environmental factors,osteoporosis presents a multifactorial etiopathogenesis,with the genetic component accounting for 70% of an individual variation in bone mass density (BMD),the principal determinant,with age,of fracture risk. Pathological conditions such as celiac disease (CD) exacerbate the process of bone loss,so that the occurrence of osteoporosis in celiac subjects is of particular note: indeed,the screening of osteoporosis patients for this disease is advisable,since it may be the only sign of undiagnosed CD. An increase in interleukin IL-1β,of the IL-1 system,in the relatives of celiac patients confirms the genetic predisposition to osteoporosis and its presence is evidence of an association between the two conditions. The direct effect on the bones of CD is secondary to poor absorption of calcium and vitamin D. In women osteoporosis is indirectly associated with early menopause and amenorrhea,and it may follow prolonged breast-feeding and frequent pregnancies,while in men it is associated with hypogonadism and GH deficit. These endocrine and non-endocrine factors exert their effects on bones by modulating the RANK/RANK-L/OPG system. An appropriate lifestyle from adolescence onwards,together with early diagnosis of and treatment for CD and primary and secondary endocrine pathologies are important for the prevention of damage to the bones.

Is kinase activity essential for biological functions of BRI1？

Brassinosteroids （BRs） are a major group of plant hormones that regulate plant growth and development. BRI1, a protein localized to the plasma membrane, functions as a BR receptor and it has been proposed that its kinase activity has an essential role in BR-regulated plant growth and development. Here we report the isolation and molecular characterization of a new allele of bril, bril-301, which shows moderate morphological phenotypes and a reduced response to BRs under normal growth conditions. Sequence analysis identified a two-base alteration from GG to AT, resulting in a conversion of 989G to 9891 in the BRI1 kinase domain. An in vitro assay of kinase activity showed that bril-301 has no detectable autophosphorylation activity or phosphorylation activity towards the BRI1 substrates TTL and BAK1. Furthermore, our results suggest that bril-301, even with extremely impaired kinase activity, still retains partial function in regulating plant growth and development, which raises the question of whether BRI1 kinase activity is essential for BR-mediated growth and development in higher plants.

Gastrointestinal hormone abnormalities and G and D cells in functional dyspepsia patients with gastric dysmotility

AIM: To investigate the relationship between gastric dysmotility,gastrointestinal hormone abnormalities, and neuroendocrine cells in gastrointestinal mucosa in patients with functional dyspepsia (FD).METHODS: Gastric emptying was assessed with solid radiopaque markers in 54 FD patients, and the patients were divided into two groups according to the results, one with delayed gastric emptying and the other with normal gastric emptying. Seventeen healthy volunteers acted as normal controls. Fasting and postprandial plasma levels and gastroduodenal mucosal levels of gastrointestinal hormones gastrin, somatostatin (SS) and neurotensin (NT)were measured by radioimmunoassay in all the subjects.G cells (gastrin-producing cells) and D cells (SS-producing cells) in gastric antral mucosa were immunostained with rabbit anti-gastrin polyclonal antibody and rabbit anti-SS polyclonal antibody, respectively, and analyzed quantitatively by computerized image analysis.RESULTS: The postprandial plasma gastrin levels, the fasting and postprandial plasma levels and the gastric and duodenal mucosal levels of NT were significantly higher in the FD patients with delayed gastric emptying than in those with normal gastric emptying and normal controls. The number and gray value of G and D cells and the G cell/D cell number ratio did not differ significantly between normal controls and the FD patients with or without delayed gastric emptying.CONCLUSION: Our findings suggest that the abnormalities of gastrin and NT may play a role in the pathophysiology of gastric dysmotility in FD patients, and the abnormality of postprandial plasma gastrin levels in FD patients with delayed gastric emptying is not related to the changes both in the number and gray value of G cells and in the G cell/D cell number ratio in gastric antral mucosa.

miR-21 SIRT1在早发性卵巢功能不全中的表达及相关性分析

目的分析微小核糖核酸-21(miR-21)、沉默信息调节因子2相关酶1(SIRT1)在早发性卵巢功能不全中的表达及相关性。方法选取60例2019年8月—2020年9月早发性卵巢功能不全患者于天津医科大学第二医院进行就诊作为研究组,同时期进行健康体检的正常女性60例作为正常组,实时定量PCR检测miR-21表达,SIRT1表达采用蛋白免疫印迹法,化学发光法检测性激素表达,超声检查子宫体积、卵巢体积、内膜厚度变化情况。受试者特征曲线(ROC)分析miR-21、SIRT1在早发性卵巢功能不全中诊断价值。结果研究组miR-21、SIRT1、卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E_(2))、子宫体积、卵巢体积及内膜厚度分别为(0.61±0.17)、(0.59±0.13)、(42.59±9.39)U/L、(32.98±10.03)U/L、(109.59±31.26)pmol/L、(24.98±7.36)cm^(3)、(3.02±1.23)cm^(3)、(4.12±1.36)mm,正常组miR-21、SIRT1、FSH、LH、E_(2)、子宫体积、卵巢体积及内膜厚度分别为(1.03±0.30)、(1.12±0.36)、(7.59±2.81)U/L、(6.14±2.01)U/L、(269.59±80.69)pmol/L、(43.12±12.59)cm^(3)、(7.26±2.36)cm^(3)、(5.83±1.59)mm,研究组miR-21、SIRT1、E_(2)表达以及子宫体积、卵巢体积、内膜厚度低于正常组,FSH、LH表达高于正常组,差异均有统计学意义(P<0.05)。miR-21与FSH、LH呈负相关(r=-0.431,P<0.01;r=-0.421,P<0.01),与E_(2)、子宫体积、卵巢体积、内膜厚度呈正相关(r=0.551,P<0.01;r=0.542,P<0.01;r=0.544,P<0.01;r=0.498,P<0.01)。SIRT1与FSH、LH呈负相关,与E_(2)、子宫体积、卵巢体积、内膜厚度呈正相关(P<0.05)。ROC分析miR-21、SIRT1诊断早发性卵巢功能不全的曲线下面积(AUC)低于两项联合,两项联合检测对早发性卵巢功能不全患者诊断效能较高(P<0.05)。结论miR-21、SIRT1在早发性卵巢功能不全中低表达,二者具有相关性,低表达miR-21、SIRT1是预测早发性卵巢功能不全发病的重要指标。

Clinical observation on herb-partitioned spreading moxibustion at Baliao points plus climen for diminished ovarian reserve

Objective:To observe the clinical efficacy of herb-partitioned spreading moxibustion at Baliao points plus climen for diminished ovarian reserve(DOR).Methods:A total of 60 patients with DOR were randomized into a spreading moxibustion group and a Western medicine group by the random number table method,with 30 cases in each group.The Western medicine group was treated with climen,starting from the 5th day of the menstrual cycle for 21 d.The spreading moxibustion group was treated with herb-partitioned spreading moxibustion at Baliao points on the basis of the medication in the Western medicine group,1 h per time,once a week.The treatment was performed for 1 month as one treatment course in both groups,for 3 courses in total.The serum follicle-stimulating hormone(FSH),luteinizing hormone(LH)and estradiol(E2)in the patients were measured before and after treatment.The peak systolic velocity(PSV)and resistance index(RI)were also detected.The traditional Chinese medicine(TCM)symptom score was evaluated.The clinical efficacy was evaluated after treatment.Results:The total effective rate in the spreading moxibustion group was 93.3%,which was significantly higher than 80.0%in the Western medicine group,and the difference between the groups was statistically significant(P<0.05).After treatment,the TCM symptom scores,the serum FSH levels,FSH/LH ratios and RI in both groups decreased,and the intra-group differences were all statistically significant(all P<0.05).The serum E2 level and PSV increased compared with those in the same group before treatment,and the intra-group differences were statistically significant(all P<0.05).After treatment,the TCM symptom score,the serum FSH level,FSH/LH ratio and RI in the spreading moxibustion group were lower than those in the Western medicine group,while the serum E2 level and PSV were higher than those in the Western medicine group,and the differences between the groups were statistically significant(all P<0.05).Conclusion:Herb-partitioned spreading moxibustion at Baliao points plus climen can produce valid therapeutic efficacy for DOR.It can improve the clinical symptoms,regulate serum hormone levels and increase ovarian blood perfusion,thus improving ovarian reserve function,producing more significant efficacy than climen alone.