目的:分析46,XX睾丸型性腺发育异常患者的遗传和临床资料,为加深对该疾病的认识提供依据。方法:收集2017年1月至2023年1月在南京医科大学第一附属医院生殖中心被诊断为46,XX睾丸型性腺发育异常的患者资料,分析其遗传学和临床资料特征,并...目的:分析46,XX睾丸型性腺发育异常患者的遗传和临床资料,为加深对该疾病的认识提供依据。方法:收集2017年1月至2023年1月在南京医科大学第一附属医院生殖中心被诊断为46,XX睾丸型性腺发育异常的患者资料,分析其遗传学和临床资料特征,并对SRY阳性患者取外周血进行SRY基因染色体定位分析。结果:(1)共26例患者被纳入研究,所有患者染色体核型均为46,XX,且AZFa、b、c区全部缺失。患者身高为(168.3±5.9)cm,体重为(64.0±7.5)kg,BMI为(22.66±2.79)kg/m^(2),左侧睾丸体积(2.53±1.16)ml,右侧睾丸体积:(2.74±1.34)ml。精液量为1.35(0.18~2.78)ml,FSH(36.85±18.01)IU/L,LH(19.71±9.71)IU/L,T(6.08±2.71)nmol/L。3例患者最高学历是大学本科,其余均为本科以下学历。(2)SRY阳性患者20例,SRY阴性患者6例。与SRY阳性患者相比,SRY阴性患者合并有生殖系统发育异常问题概率较高(5/6 vs 3/20,P=0.004),而两组在身高、体重、BMI、生殖激素,睾丸体积等参数差异均无统计学意义。(3)14例SRY基因定位分析显示:13例定位于Xp末端,1例定位于15p末端。结论:46,XX睾丸型性腺发育异常患者在遗传学和临床特征上呈现出一定相似性和异质性,需要寻求更好的方案提高患者的生活质量和生活满意度。展开更多
Objective:To observe the effects of moxibustion at different temperatures(38℃,46℃)on blood lipids,endothelial morphology of the thoracic aorta,serum endothelin-1(ET-1),calcitonin gene-related peptide(CGRP),nitric ox...Objective:To observe the effects of moxibustion at different temperatures(38℃,46℃)on blood lipids,endothelial morphology of the thoracic aorta,serum endothelin-1(ET-1),calcitonin gene-related peptide(CGRP),nitric oxide(NO),and endothelial NO synthase(eNOS)in hyperlipidemic rats.Methods:Using the random number table method,60 Sprague Dawley rats were randomly and evenly divided into blank,model,38℃-moxibustion,and 46℃-moxibustion groups.Rats in the 3 experimental groups were fed a high-fat feed to model hyperlipidemia in rats.Rats in the 38℃-moxibustion and 46℃-moxibustion groups were moxibustion on the Shenque and bilateral Zusanli acupoints for 10 minutes each,once every other day for 4 weeks,at temperatures of 38±1℃ and 46±1℃.After that,rat blood samples were collected to detect blood lipids and ET-1,CGRP,eNOS and NO.Take the endotheal tissue of the thoracic aorta to do HE staining.Results:(1)The serum total cholesterol,triglycerides,and low-density lipoprotein cholesterol of rats in the 46℃-moxibustion group were significantly lower than those in the model and 38℃-moxibustion groups.(2)Revealed by hematoxylin and eosin staining,showed necrosis in the local vascular endothelial cells and mild inflammatory cell infiltration in the tunica adventitia of the hyperlipidemic rats.These endothelial morphologies did not improve significantly after moxibustion at 38℃ but did improve at 46℃.(3)Compared with the blank group,serum ET-1 was significantly higher and serum CGRP,NO,eNOS were significantly lower in the model group.Compared with the model and the 38℃-moxibustion groups,serum ET-1 was significantly lower and serum CGRP,NO,eNOS were significantly higher in 46℃-moxibustion groups.Conclusion:Moxibustion at 46℃ effectively regulated blood lipids,improved the morphology of the vascular endothelium,and protected vascular endothelial function.展开更多
46,XX男性综合征是一类罕见的性发育障碍性疾病,通常染色体为46,XX且Y染色体性别决定区(sex-determining region Y gene,SRY)阳性,有正常的外生殖器和男性表型,多因成年后不育就诊。而SRY阴性的46,XX男性综合征患者多伴发外生殖器发育畸...46,XX男性综合征是一类罕见的性发育障碍性疾病,通常染色体为46,XX且Y染色体性别决定区(sex-determining region Y gene,SRY)阳性,有正常的外生殖器和男性表型,多因成年后不育就诊。而SRY阴性的46,XX男性综合征患者多伴发外生殖器发育畸形,多因年幼时性发育异常就诊。报告1例SRY阴性的46,XX男性综合征患者,该患者外生殖器及第二性征发育均为正常男性型,检查发现患者核型为46,XX、SRY阴性、AZF区域缺失、高促性腺激素性性腺功能减退症且无精子症,其生育建议行供精人工授精。展开更多
对1株富产吲哚喹唑啉类生物碱(IQAs)的海绵共附生真菌Aspergillus giganteus MA 46-5的IQAs类成分进行了研究。根据IQAs的结构特征,在TLC、LC-MS和GNPS(global natural products social molecular networking)技术的共同指导下,从大米...对1株富产吲哚喹唑啉类生物碱(IQAs)的海绵共附生真菌Aspergillus giganteus MA 46-5的IQAs类成分进行了研究。根据IQAs的结构特征,在TLC、LC-MS和GNPS(global natural products social molecular networking)技术的共同指导下,从大米培养基的乙酸乙酯部位分离得到10个IQAs类生物碱。通过NMR、HR-ESI-MS、OR和CD等方法并结合文献比对鉴定其分别为:tryptoquivaline(1)、nortryptoquivaline(2)、deoxytryptoquivaline(3)、deoxynortryptoquivaline(4)、aspertoryadin C(5)、aspertoryadin G(6)、quinadoline A(7)、fiscalin E (8)、quinadoline B(9)和prelapatin B(10)。8和10为首次从Aspergillus属中得到,2、4~7为首次从Aspergillus giganteus中分离得到。展开更多
46,XY性发育异常(disorders of sex development,DSD)是一种遗传学性别、表型性别和性腺性别不一致的先天性疾病,确诊该病的关键是基因检测。回顾分析1例46,XY DSD患者,患者社会性别为女性,因查体发现性腺发育异常就诊。患者46,XY DSD...46,XY性发育异常(disorders of sex development,DSD)是一种遗传学性别、表型性别和性腺性别不一致的先天性疾病,确诊该病的关键是基因检测。回顾分析1例46,XY DSD患者,患者社会性别为女性,因查体发现性腺发育异常就诊。患者46,XY DSD合并肥胖及高胰岛素血症,致病基因为类固醇生成因子-1(steroidogenic factor 1,SF-1,又称NR5A1),突变位点为c.1095_1096insTCGG(p.Q366Sfs*22),对该基因进行遗传学分析,该位点所致的基因突变可能与肥胖及糖尿病相关。行腹腔镜双侧隐睾切除术+外阴整形术+阴蒂切除术,维持患者女性社会性别。从遗传学角度检测病因可为46,XY DSD的临床诊治提供指导及依据。展开更多
文摘目的 分析46,XX睾丸型性发育异常胎儿的基因型与表型,并进行文献复习。方法 1例超声提示胎儿颈后透明层增厚的孕妇来我院产前诊断中心咨询。因其符合产前诊断指征,遂行胎儿染色体核型检测、胎儿染色体基因芯片检测。以“46,XX男性综合征”、“产前诊断”、“46,XX睾丸型性发育异常”、“prenatal diagnosis”、“46,XX male syndrome”、“46,XX testicular disorder of sex development”为检索词,检索中国知网、万方数据库、PubMed数据库(建库至2023年2月底),选取产前诊断为46,XX睾丸型性发育异常胎儿且临床资料完整的文献进行复习并总结胎儿表型。结果 胎儿染色体核型正常(46,XX),基因芯片提示Yp11.31-p11.2区域拷贝数为1,大小为3299 kb,存在SRY基因,胎儿被诊断为46,XX睾丸型性发育异常。文献检索发现仅报道9例产前诊断为46,XX睾丸型发育异常(SRY基因阳性)胎儿,大部分(70%, 7/10)胎儿孕期无明显异常,其中3/10的胎儿存在结构异常或超声提示NT增厚,其中5/10孕妇存在高龄风险。结论 在产前诊断中,发现46,XX睾丸型性发育异常胎儿是极为罕见的。孕期46,XX睾丸型性发育异常胎儿无明显异常;由于CMA检测的局限性,部分46,XX睾丸型DSD胎儿(SRY基因阴性)会被漏诊,这些因素给产前诊断和遗传咨询带来极大的挑战。
文摘目的:分析46,XX睾丸型性腺发育异常患者的遗传和临床资料,为加深对该疾病的认识提供依据。方法:收集2017年1月至2023年1月在南京医科大学第一附属医院生殖中心被诊断为46,XX睾丸型性腺发育异常的患者资料,分析其遗传学和临床资料特征,并对SRY阳性患者取外周血进行SRY基因染色体定位分析。结果:(1)共26例患者被纳入研究,所有患者染色体核型均为46,XX,且AZFa、b、c区全部缺失。患者身高为(168.3±5.9)cm,体重为(64.0±7.5)kg,BMI为(22.66±2.79)kg/m^(2),左侧睾丸体积(2.53±1.16)ml,右侧睾丸体积:(2.74±1.34)ml。精液量为1.35(0.18~2.78)ml,FSH(36.85±18.01)IU/L,LH(19.71±9.71)IU/L,T(6.08±2.71)nmol/L。3例患者最高学历是大学本科,其余均为本科以下学历。(2)SRY阳性患者20例,SRY阴性患者6例。与SRY阳性患者相比,SRY阴性患者合并有生殖系统发育异常问题概率较高(5/6 vs 3/20,P=0.004),而两组在身高、体重、BMI、生殖激素,睾丸体积等参数差异均无统计学意义。(3)14例SRY基因定位分析显示:13例定位于Xp末端,1例定位于15p末端。结论:46,XX睾丸型性腺发育异常患者在遗传学和临床特征上呈现出一定相似性和异质性,需要寻求更好的方案提高患者的生活质量和生活满意度。
基金This work was supported by National Natural Science Foundation of China(NO.81603695).
文摘Objective:To observe the effects of moxibustion at different temperatures(38℃,46℃)on blood lipids,endothelial morphology of the thoracic aorta,serum endothelin-1(ET-1),calcitonin gene-related peptide(CGRP),nitric oxide(NO),and endothelial NO synthase(eNOS)in hyperlipidemic rats.Methods:Using the random number table method,60 Sprague Dawley rats were randomly and evenly divided into blank,model,38℃-moxibustion,and 46℃-moxibustion groups.Rats in the 3 experimental groups were fed a high-fat feed to model hyperlipidemia in rats.Rats in the 38℃-moxibustion and 46℃-moxibustion groups were moxibustion on the Shenque and bilateral Zusanli acupoints for 10 minutes each,once every other day for 4 weeks,at temperatures of 38±1℃ and 46±1℃.After that,rat blood samples were collected to detect blood lipids and ET-1,CGRP,eNOS and NO.Take the endotheal tissue of the thoracic aorta to do HE staining.Results:(1)The serum total cholesterol,triglycerides,and low-density lipoprotein cholesterol of rats in the 46℃-moxibustion group were significantly lower than those in the model and 38℃-moxibustion groups.(2)Revealed by hematoxylin and eosin staining,showed necrosis in the local vascular endothelial cells and mild inflammatory cell infiltration in the tunica adventitia of the hyperlipidemic rats.These endothelial morphologies did not improve significantly after moxibustion at 38℃ but did improve at 46℃.(3)Compared with the blank group,serum ET-1 was significantly higher and serum CGRP,NO,eNOS were significantly lower in the model group.Compared with the model and the 38℃-moxibustion groups,serum ET-1 was significantly lower and serum CGRP,NO,eNOS were significantly higher in 46℃-moxibustion groups.Conclusion:Moxibustion at 46℃ effectively regulated blood lipids,improved the morphology of the vascular endothelium,and protected vascular endothelial function.
文摘46,XX男性综合征是一类罕见的性发育障碍性疾病,通常染色体为46,XX且Y染色体性别决定区(sex-determining region Y gene,SRY)阳性,有正常的外生殖器和男性表型,多因成年后不育就诊。而SRY阴性的46,XX男性综合征患者多伴发外生殖器发育畸形,多因年幼时性发育异常就诊。报告1例SRY阴性的46,XX男性综合征患者,该患者外生殖器及第二性征发育均为正常男性型,检查发现患者核型为46,XX、SRY阴性、AZF区域缺失、高促性腺激素性性腺功能减退症且无精子症,其生育建议行供精人工授精。
文摘46,XY性发育异常(disorders of sex development,DSD)是一种遗传学性别、表型性别和性腺性别不一致的先天性疾病,确诊该病的关键是基因检测。回顾分析1例46,XY DSD患者,患者社会性别为女性,因查体发现性腺发育异常就诊。患者46,XY DSD合并肥胖及高胰岛素血症,致病基因为类固醇生成因子-1(steroidogenic factor 1,SF-1,又称NR5A1),突变位点为c.1095_1096insTCGG(p.Q366Sfs*22),对该基因进行遗传学分析,该位点所致的基因突变可能与肥胖及糖尿病相关。行腹腔镜双侧隐睾切除术+外阴整形术+阴蒂切除术,维持患者女性社会性别。从遗传学角度检测病因可为46,XY DSD的临床诊治提供指导及依据。