Serum Tumor Markers Combined with 18F-FDG PET/CT Volumetric Metabolic Parameters in the Prognosis of Ovarian Cancer

Ovarian cancer (OC) is the most fatal gynecological malignancy, and identifying reliable prognostic indicators can help guide therapeutic treatment. Various tumor marker-guided treatment regimens can considerably improve patient prognosis with a better understanding of the molecular underpinnings of ovarian cancer recurrence and metastasis. Fluorine-18-fluorodeoxyglucose Positron emission tomography/computed tomography (18F-FDG PET/CT) is a molecular imaging tool that provides anatomical and functional information about the tumor, and its volume-based metabolic parameters allow for quantifiable observation of ovarian cancer recurrence, prognosis, and therapeutic efficacy. The combined utilization of serological and radiologic markers has been found to provide increased clinical benefit. This article reviewed the predictive value of serum tumor markers and 18F-FDG PET/CT volumetric metabolic parameters for the prognosis of patients with ovarian cancer.

Evaluation of glucose metabolism in women with multiple ovarian follicles

Objective ：To investigate glucose metabolism in women with multiple ovarian follicles （MOF） and explore the relationship between glucose metabolism, insulin resistance and body weight. Methods：We evaluated 46 women with MFO and 30 normal women as controls. All the subjects were given 75g of glucose orally in order to perform the oral glucose tolerance test （OGTT） and insulin releasing test （IRT）, and they were also evaluated for insulin resistance using the insulin resistance index with homeostatic model assessment （HOMA）. Results：The occurrence of impaired glucose tolerance in women with MOF was 10.87%, which was significantly higher than that in the control group （3.33% ,P 〈 0.05）. The rate of insulin resistance was 30.43% in the study group as compared to 10.00% in the control group. The results showed that there was significant difference between the two groups（P 〈 0.05）. The levels of FSH,LH,PRL,E2,T and P between the two groups had no significant difference （P 〉 0.05）. BMI in women with impaired glucose tolerance was correlated positively to insulin resistance （r = 0.567, P 〈 0.05）. Conclusion：Abnormal glucose metabolism was observed in women with unitary multiple ovarian follicles, and this could be attributed to obesity and insulin resistance. Women with MOF and associated obesity should be subjected to OGTT so that their glucose levels can be monitored as a preventive measure.

Relationship among uterine involution, ovarian activity, blood metabolites and subsequent reproductive performance in Egyptian buffaloes

The aim of the study to monitor post partal uterine involution, ovarian activity and biochemical parameters and it is relation to the subsequent fertility. A total sixty normal calving pluriparous buffaloes were examined between 14th and 75th day post partum (p.p.) rectaly, ultrasonically and blood sampling were collected on weekly sessions. There were differences (P < 0.01) between pregnant (PREG) and non-pregnant (NPREG) groups in Body condition score (BCS) and body weights. There was a difference between previous gravid uterine horn (PGUH) and non-gravid uterine horn (NPGUH) diameter in PREG and NPREG groups at 28th day p.p. The calving to first service interval in the PREG group was shorter (P = 0.03) than that of NPREG one. The number of buffaloes with dominant follicles (DF 3 8 mmdiameter) in ipsilateral and contralateral ovary to the PGUH in PREG group was higher (P < 0.01) than in NPREG. The calving to first service interval in the PREG group having DF in the ovary ipsilateral to the PGUH (n = 16) was shorter (P < 0.01) than those buffaloes having no DF (n = 18). The number of service per conception and days open in the PREG buffaloes which had no DF in the ovary ipsilateral to the PGUH were higher and longer (P < 0.01) than that which had DF group. The values of glucose and triglyceride were higher (P = 0.057) in PREG than NPREG group. In conclusion, postpartum ovarian activity has positive effect on the uterine involution and postpartum profile of some metabolities may be a good predictor of fertility status of buffaloes.

United observation and analysis of the effect of tripterygium wilfordii on sex hormone levels, apoptosis in ovary and bone metabolism in female rats

Objective:To study the effect of tripterygium wilfordii on sex hormone levels, apoptosis in ovary and bone metabolism in female rats.Methods: Adult female SD rats were chosen as experimental animals and divided into model group and control group, model group were made into premature ovarian failure models through intragastric administration of tripterygium wilfordii, and control group were given intragastric administration of same dose of normal saline. Serum was collected 14 d after model making to determine the contents of sex hormones and bone metabolism markers, ovarian tissue was collected to determine the expression of apoptosis genes and tibial tissue was collected to determine the expression of bone metabolism marker genes.Results: FSH, LH,β-CTX and TRACP5b levels in serum of model group were significantly higher than those of control group whereas E2, PINP and N-MID levels were significantly lower than those of control group;Fas, FasL, APAF-1 and Caspase-3 mRNA expression in ovarian tissue of model group were significantly higher than those of control group whereas Bcl-2 and XIAP mRNA expression were significantly lower than those of control group;RUNX2, BAP and OPG mRNA expression in bone tissue of model group were significantly lower than those of control group whereas RANKL and RANK mRNA expression were significantly higher than those of control group.Conclusion:There are sex hormone changes, apoptosis aggravation in ovarian tissue and systemic bone metabolism disorder in rat model with tripterygium wilfordii-induced premature ovarian failure.

Myo-inositol versus metformin effects on clinical features, endocrine and metabolic profiles in infertile women with polycystic ovary syndrome: A randomized controlled trial

Objective:To compare the effectiveness of inositol and metformin on the clinical characteristics,and endocrine and metabolic profiles of infertile polycystic ovarian syndrome(PCOS)women from Vietnam.Methods:From June 2018 to August 2022,a randomized trial was undertaken at the Hue Center for Endocrinology and Reproduction on infertile women aged 18 to 40 years with polycystic ovarian syndrome.The clinical,endocrine,and metabolic features of these individuals were assessed before and after 3 months of treatment with 2 g of inositol or 1700 mg of metformin per day.Natural pregnancy rates,adverse effects,and tolerance of inositol were recorded.Results:The study included 171 infertile PCOS women who were eligible to participate and took part in the baseline assessment,of whom 132 women participated in data analysis after 3 months.After metformin treatment,42.1%of women with oligomenorrhea experienced regular menstruation.Metformin significantly lowered body mass index(BMI),waist circumference and testosterone levels,but had no effect on other clinical characteristics,endocrine profiles,or metabolic profiles.29.2%Of women reported experiencing side effects.21%Of them attained pregnancy,which resulted in 17.1%of live births.In the inositol group,the rate of regular cycle increased by 18.2%and the total testosterone concentration significantly decreased.In overweight/obese women with PCOS,inositol significantly decreased weight,BMI,waist and hip circumferences(P<0.05).100%Of women tolerated inositol and continued treatment.18.9%Of them became pregnant,leading to 17%of live births.Conclusions:Metformin and inositol can improve weight and waist circumference in overweight/obese infertile women with PCOS.Metformin is associated with a higher rate of regular menstruation,whereas inositol is associated with a lower rate of adverse effects.The spontaneous conception,clinical pregnancy,and live birth rates between two groups are comparable.

Vitamin E modulates androgen receptor gene expression to attenuate ovarian dysfunctions in a rat model of dehydroepiandrosterone-induced polycystic ovary

Objective:To investigate the protective effect of vitamin E in dehydroepiandrosterone(DHEA)-induced polycystic ovary in rats.Methods:Premature female Wistar rats were randomly allocated into four groups,with 7 rats in each group.Group栺received corn oil(vehicle)and served as the control group;group栻received 0.2 mL of 0.06 mg/g DHEA in corn oil;group栿received 200 mg/kg vitamin E;group桇received DHEA plus vitamin E.All treatments lasted for 15 days,with DHEA administered subcutaneously,while vitamin E and corn oil were administered orally.After the experiment,serum samples and ovaries were harvested for biochemical,immunohistochemical,hormonal,and histological analysis.The ovarian mRNA expression of androgen receptor was analyzed by reverse transcriptase quantitative polymerase chain reaction(qPCR).Results:The antioxidant and metabolic enzyme activity significantly decreased in the DHEA-treated rats compared to the control rats(P<0.05).Administration of vitamin E to DHEAtreated rats significantly decreased cytokines and malondialdehyde compared to the DHEA-treated rats.The histological analysis showed reduced atretic and cystic ovaries,increased E-cadherin and Bcl-2 expression,and reduced expression of Bax in the DHEAtreated rats co-treated with vitamin E.The mRNA expression of androgen receptor was upregulated in the DHEA-treated rats compared to the control rats.Conclusions:Vitamin E ameliorates the hyperandrogenic effect of DHEA-induced polycystic ovaries via metabolic,antioxidant,and anti-apoptotic pathways.

卵巢储备功能减退的年轻不孕症女性代谢综合征发生情况分析

目的探究代谢综合征(MS)在卵巢储备功能减退(DOR)的年轻不孕症女性中的发生情况并分析其影响因素。方法共纳入141名合并DOR的年轻不孕症女性(年龄<35岁),设为DOR组,另外选取141名与DOR组年龄配对且卵巢储备功能正常(NOR)的不孕症女性作为对照组(NOR组)。比较两组患者MS的发生情况并分析DOR组MS发生的影响因素。结果DOR组MS发病率明显高于NOR组,差异有统计学意义(χ^(2)=8.25,P<0.05)。logistic多因素分析发现,高FSH/LH比值为年轻不孕症女性合并DOR发生MS的独立危险因素(OR=1.26,P<0.05),而高AMH、高bLH和高bE2水平为DOR年轻不孕症女性发生MS的保护因素(OR分别=0.28、0.58、0.86,P均<0.05)。结论年轻不孕症女性中,合并DOR者MS的发病率明显升高,FSH/LH、AMH、bLH、bE2为发生MS的影响因素。

饲料中虾青素对凡纳滨对虾雌虾肝胰腺脂代谢和卵巢发育的影响

研究旨在探讨不同虾青素水平对凡纳滨对虾(Litopenaeus vannamei)雌虾肝胰腺脂代谢和卵巢发育的影响。实验设计了4种不同虾青素含量(0、40、80和120 mg/kg)的等氮等能饲料,并进行了30d的投喂试验。结果显示,与对照组相比,80 mg/kg组显著提高雌虾增重率、性腺指数和平均产卵量(P<0.05),而在120 mg/kg组中无显著影响(P>0.05),并伴有肝胰腺萎缩现象。添加80 mg/kg虾青素能显著增加T-AOC活性和T-SOD含量(P<0.05),提高雌虾抗氧化能力。添加80 mg/kg虾青素还能显著降低肝胰腺中SFA的含量(P<0.05),显著提高MUFA、EPA和ARA的含量(P<0.05),降低雌虾肝胰腺中fas和srebp1的表达(P<0.05),并提高fabp1和fatp的表达(P<0.05)。通过对卵巢组织进行转录组分析发现,差异表达基因主要涉及“类固醇激素合成”“甘油磷脂代谢”“谷胱甘肽代谢”等途径。此外,与对照组相比,80 mg/kg组在gls、pla2和mfe等氨基酸代谢和类固醇激素合成相关基因表达量显著上调(P<0.05),而在120 mg/kg组显著下调(P<0.05)。综上所述,研究表明,在凡纳滨对虾雌虾饲料中添加80 mg/kg虾青素,能减少脂肪酸合成和沉积,促进脂肪酸的吸收转运;更能够促进雌虾性腺发育及相关基因表达,提高雌虾繁殖性能。

晒田环境胁迫对克氏原螯虾卵巢组织、卵黄蛋白原及营养物质代谢的影响

【目的】研究克氏原螯虾在晒田环境胁迫条件下卵巢组织学特点、卵黄蛋白原浓度及营养物质代谢水平的变化,探索其性成熟过程中体内营养物质变化相关机制,为晒田环境胁迫促进克氏原螯虾卵巢成熟这一生产操作的改良和标准化提供参考依据。【方法】试验对象分为晒田组与对照组克氏原螯虾,在晒田胁迫0、3、7、10 d时分别采集30只雌性克氏原螯虾,取卵巢进行石蜡切片和HE染色,并采集试验组的卵巢、肝胰腺和血清,检测卵黄蛋白原mRNA表达水平和浓度及营养物质代谢水平。【结果】雌性克氏原螯虾在晒田胁迫期间共鉴定出4个卵巢发育阶段,包括卵黄发生前阶段(Ⅰ期,卵巢为黄色,卵母细胞直径150~250μm)、初级卵黄发生阶段(Ⅱ期,卵巢为橙色,卵母细胞直径250~600μm)、次级卵黄发生阶段(Ⅲ期,卵巢为棕色,卵母细胞直径高于600μm)、成熟阶段(Ⅳ期,卵巢为黑褐色,卵母细胞直径高于1000μm)。晒田胁迫0 d时,晒田组与对照组雌性克氏原螯虾卵巢成熟率相似;晒田胁迫10 d时,晒田组雌性克氏原螯虾卵巢成熟率升至96.67%,而对照组仅升至60.00%。随着胁迫时间增加,晒田组和对照组雌性克氏原螯虾的卵巢与肝胰腺的卵黄蛋白原mRNA相对表达量均呈上升趋势,且卵黄蛋白原mRNA在肝胰腺的相对表达量大于卵巢;试验期间,晒田组和对照组雌性克氏原螯虾卵黄蛋白原在肝胰腺的表达总量均大于在卵巢的表达总量,且卵黄蛋白原在肝胰腺的贡献率均大于在卵巢的贡献率。晒田组与对照组雌性克氏原螯虾卵巢、肝胰腺和血液中的卵黄蛋白原浓度均随时间增加呈上升趋势;晒田组浓度上升幅度大于对照组,肝胰腺卵黄蛋白原浓度与卵巢卵黄蛋白原浓度、肝胰腺卵黄蛋白原浓度与血清卵黄蛋白原浓度、卵巢卵黄蛋白原浓度与血清卵黄蛋白原浓度呈极显著正相关(P<0.01)。随着晒田胁迫时间增加,晒田组和对照组雌性克氏原螯虾血蓝蛋白(Hem)、总蛋白(TP)、乳酸(LA)和葡萄糖(Glu)含量均呈下降趋势,晒田组的下降幅度大于对照组;晒田组和对照组雌性克氏原螯虾甘油三酯(TG)和胆固醇(TC)含量呈上升趋势,晒田组的上升幅度大于对照组。【结论】晒田环境胁迫期间共鉴定出4个克氏原螯虾卵巢发育阶段。随胁迫时间增加,克氏原螯虾不同组织卵黄蛋白原mRNA相对表达量和浓度均呈上升趋势,卵黄蛋白原的肝胰腺贡献率大于卵巢贡献率。克氏原螯虾体内Hem、TP、LA和Glu含量降低,TG和TC含量升高,表明晒田环境胁迫对卵巢发育具有积极作用。

医源性早发性卵巢功能不全性激素水平的变化及对糖代谢的影响

目的研究医源性早发性卵巢功能不全(premature ovarian insufficiency,POI)性激素水平的变化及对糖代谢的影响。方法募集2022年1月到2024年4月就诊于首都医科大学附属北京妇产医院内分泌科的20~40岁的60例因造血干细胞移植(hematopoietic stem cell transplantation,HSCT)导致的医源性POI患者和60例特发性POI患者,一般资料包括身高、体质量、年龄,并计算体质量指数(body mass index,BMI),实验检测指标包括卵泡刺激素(follicle stimulating hormone,FSH)、黄体生成素(luteinizing hormone,LH)、雌二醇(estradiol,E 2)、皮质醇(cortisol,F)、总睾酮(total testosterone,TT)、游离睾酮(free testosterone,FT)、空腹血糖(fasting plasma glucose,FPG)及空腹胰岛素(fasting insulin,FINS)。结果医源性POI患者体质量、BMI、E 2、TT、FT低于特发性POI患者,差异有统计学意义(P均<0.05)。医源性POI患者的FSH、LH、FINS、FPG高于特发性POI患者,差异有统计学意义(P均<0.05)。医源性POI患者与特发性POI患者的年龄、身高和皮质醇相比,差异无统计学意义(P均>0.05)。医源性POI患者高胰岛素血症的比例明显高于特发性POI患者(P=0.025)。结论医源性POI患者性激素水平的降低和糖代谢异常均比特发性POI患者更加严重,可能原因是疾病治疗对卵巢功能的损伤更大。但医源性POI是可以预防的。卵巢组织冻存(ovarian tissue cryopreservation,OTC)可以同时保护生育力和卵巢内分泌功能,使医源性POI的防治从不可能变为可能,因此在接受放射治疗和化学药物治疗之前进行OTC十分有必要。

二甲双胍联合奥利司他治疗肥胖型多囊卵巢综合征伴胰岛素抵抗的临床效果

目的:研究肥胖型多囊卵巢综合征(polycystic ovary syndrome,PCOS)伴胰岛素抵抗患者采用二甲双胍联合奥利司他治疗的临床效果。方法:选择150例肥胖型PCOS伴胰岛素抵抗患者,随机分为对照组与研究组,每组各75例;对照组给予二甲双胍、炔雌醇环丙孕酮等基础治疗,研究组采用基础治疗联合奥利司他治疗;治疗3个月,比较两组人体测量学指标、糖脂代谢指标及性激素水平差异。结果:治疗3个月后,与对照组比较,研究组体重、体重指数、腰臀比、体脂率、空腹血糖、餐后2 h血糖、空腹胰岛素、糖化血红蛋白、稳态模型评估-IR(HOMA-IR)均明显降低(P<0.05);三酰甘油、总胆固醇、低密度脂蛋白胆固醇均明显降低(P<0.05),高密度脂蛋白胆固醇明显升高(P<0.05);黄体生成素(LH)、雌二醇、睾酮、泌乳素和LH/卵泡刺激素(FSH)明显降低(P<0.05),FSH比较差异无统计学意义(P>0.05)。结论:肥胖型PCOS伴胰岛素抵抗患者采用二甲双胍联合奥利司他治疗可更好地改善糖脂代谢,减轻体重及胰岛素抵抗,改善性激素紊乱。

卵巢癌脂质代谢相关基因预后模型的构建及免疫浸润分析

目的构建卵巢癌(ovarian carcer,OC)脂质代谢相关预后模型,探讨脂质代谢相关生物标志物及免疫细胞浸润程度在OC预后预测中的作用。方法下载TCGA数据库中OC样本转录组数据和临床数据,MSigDB数据库获取脂质代谢相关基因(LMRGs),caret包将样本按1:1随机分为训练集与验证集,单因素Cox分析得到与OC预后显著相关的LMRGs,LASSO-Cox分析筛选模型基因以构建预后模型,Kaplan-Meier曲线及受试者工作特征(ROC)曲线评估预后模型效能,并进行TCGA内部验证。最后构建列线图并采用CIBERSORT算法进行免疫浸润分析。结果构建了1个8基因的OC预后模型,生存分析显示高风险组与低风险组预后差异有统计学意义(P<0.05)。AUC提示该模型具有中等程度预测效能;多因素Cox分析显示LMrisk是OC患者的独立预后因素(P<0.001);免疫浸润分析显示LMrisk与OC免疫相关。结论OC患者预后模型可作为1种新的独立预后评估手段,LMrisk可作为稳健的预后生物标志物,可能具有进一步临床应用的价值。

代谢综合征基于PI3K/AKT信号通路对卵巢癌发生发展影响的研究进展

代谢综合征以胰岛素抵抗、腹部肥胖、血压升高等一系列代谢异常为特征,近年来发病率高。卵巢癌是女性生殖系统常见的癌症之一,有研究证据表明代谢综合征会促进卵巢癌的发生发展。PI3K/AKT信号通路为卵巢癌中经常改变的信号通路,通过对中英文多个数据库进行检索,我们发现PI3K/AKT信号通路与糖尿病、肥胖和高血压等代谢性疾病相关。然而,医学界尚未对代谢综合征与PI3K/AKT信号通路在卵巢癌发病机制中的作用进行深入阐述,基于此,该文通过对PI3K/AKT信号通路进一步探讨代谢综合征异常表现对卵巢癌发生发展的影响,旨在深入了解卵巢癌相关代谢综合征的分子机制,从而为卵巢癌防控及治疗提供新的思路。

PCOS不孕症患者糖脂代谢变化及其与子宫内膜容受性的关系

目的探讨多囊卵巢综合征(PCOS)不孕症患者糖脂代谢变化及其与子宫内膜容受性的关系。方法选取2021年3月至2022年10月商丘市妇幼保健院接收的136例PCOS不孕症患者作为疾病组,同时选取在商丘市妇幼保健院体检并明确因男性因素不孕的健康女性136例作为健康组。检测两组糖脂代谢指标[空腹血糖(FBG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)]和子宫螺旋动脉搏动指数(PI)、阻力指数(RI)及子宫内膜厚度(Em)并比较。采用Pearson法分析PCOS不孕症患者糖脂代谢变化与子宫螺旋动脉PI、RI、Em的相关性。另根据疾病组患者子宫内膜容受性将其分为子宫内膜容受性良好组和不良组,比较两组患者糖脂代谢变化,并采用多因素logistic回归分析PCOS不孕症患者糖脂代谢变化对子宫内膜容受性的影响。结果疾病组FBG、FINS、TC、TG、LDL-C、HOMA-IR和子宫螺旋动脉PI、RI均高于健康组(P<0.05),HDL-C水平和Em均低于健康组(P<0.05);Pearson分析结果显示,PCOS不孕症患者FBG、FINS、TC、TG、LDL-C、HOMA-IR与PI、RI均呈正相关(P<0.05),与Em呈负相关(P<0.05);HDL-C水平与PI、RI均呈负相关(P<0.05),与Em呈正相关(P<0.05);子宫内膜容受性不良组FBG、FINS、TC、TG、LDL-C、HOMA-IR和子宫螺旋动脉PI、RI均高于良好组(P<0.05),HDL-C水平和Em均低于良好组(P<0.05);多因素logistic回归分析结果显示FBG、FINS、HOMA-IR、TC、TG、LDL-C、HDL-C均是PCOS不孕症患者子宫内膜容受性不良的影响因素(P<0.05)。结论PCOS不孕症患者FBG、FINS、TC、TG、LDL-C水平和HOMA-IR均升高,HDL-C水平降低,且均与子宫螺旋动脉PI、RI、Em相关联,糖脂代谢紊乱是PCOS不孕症患者子宫内膜容受性不良的影响因素。

脐周八穴埋线对肥胖型多囊卵巢综合征不孕症患者IVF-ET治疗结局的影响

目的:探讨脐周八穴埋线治疗对肥胖型多囊卵巢综合征(PCOS)不孕症患者体外受精-胚胎移植(IVF-ET)结局的影响。方法:将90例肥胖型PCOS不孕症患者按随机数字表法分为观察组和对照组各45例。对照组患者接受IVF-ET治疗,观察组患者以脐周八穴埋线联合IVF-ET治疗,检测治疗前、后患者抑制素B(INHB)、黄体生成素(LH)、睾酮(T)、卵泡刺激素(FSH)、视黄醇结合蛋白4(RBP-4)、白脂素(Asprosin)、瘦素(LEP)、脂联素(APN)、白细胞介素-17(IL-17)、胆固醇(TC)、甘油三酯(TG)水平,以及卵巢基质血流动力学指标舒张末期流速(EDV)、收缩期最大流速(PSV)、阻力指数(RI),记录患者促性腺激素(Gn)使用剂量、获取卵泡个数、MⅡ卵率、受精率、优质胚胎率、临床妊娠率、流产率。结果:治疗后,两组患者INHB、T、LH、TC、TG、Asprosin、RBP-4、LEP、IL-17水平较治疗前降低,FSH、APN水平较治疗前升高(P<0.05),且观察组INHB、T、LH、TC、TG、Asprosin、RBP-4、LEP、IL-17水平较对照组低,FSH、APN水平较对照组高(P<0.05);治疗后,两组EDV、RI水平均降低,PSV水平升高(P<0.05),且观察组EDV、RI水平较对照组低,PSV水平较对照组高(P<0.05);观察组Gn使用剂量少于对照组(P<0.05),获取卵泡个数多于对照组(P<0.05),受精率、MⅡ卵率、临床妊娠率高于对照组(P<0.05)。结论:脐周八穴埋线治疗肥胖型PCOS不孕症行IVF-ET患者,可改善患者性激素指标,调节卵巢储备功能与基质血流动力学,改善糖脂代谢与胰岛素敏感性,抑制机体炎症,有利于获取卵泡,改善妊娠结局。

二甲双胍联合屈螺酮炔雌醇对多囊卵巢综合征患者性激素和血糖代谢指标的影响

目的探讨二甲双胍联合屈螺酮炔雌醇治疗多囊卵巢综合征(PCOS)的临床效果。方法选取2021年全年在郑州市第二人民医院接受治疗的100例PCOS患者作为研究对象,根据随机数字表法将其分为对照组和观察组,各50例。对照组给予屈螺酮炔雌醇治疗,观察组给予二甲双胍联合屈螺酮炔雌醇治疗。比较两组的临床症状、性激素指标、糖代谢指标及不良反应发生情况。结果治疗后,观察组的改良Ferriman-Gallwey(mF-G)、痤疮综合分级系统(GAGS)评分低于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组的黄体生成素(LH)、卵泡刺激素(FSH)和抗苗勒管激素(AMH)水平低于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组的空腹血糖(FPG)、空腹胰岛素(FINS)水平和胰岛素抵抗指数低于对照组,差异具有统计学意义(P<0.05)。两组的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论二甲双胍联合屈螺酮炔雌醇治疗PCOS效果较优,可改善临床症状、性激素和血糖代谢指标,且该联合用药方案较为安全,值得临床进一步推广和应用。

静吸复合麻醉对卵巢癌根治术患者手术相关指标的影响

目的探讨卵巢癌根治术采用静吸复合麻醉(IIA)对患者术中体征、脑氧代谢率及免疫功能的影响。方法选取2021年2月至2022年5月在监利市人民医院进行卵巢癌根治术(ROOC)治疗的76例患者作为研究对象,根据麻醉方式分别纳入TIA组和IIA组,各38例。TIA组进行全凭静脉麻醉(TIA),IIA组进行IIA。比较两组患者准备麻醉前(T_(0))、气管插管后(T_(1))、气管插管后10 min(T_(2))和手术结束(T_(3))时的心率(HR)、平均动脉压(MAP)、脑氧代谢指标[脑血流量/脑氧耗(CBF/CMRO_(2))、脑氧耗/脑糖耗(CMRO2/CMRGlu)和乳酸生成量(ADVL)]及麻醉期的各项指标,比较两组患者T_(0)、T_(3)、术后12 h和术后24 h的T淋巴细胞亚群指标。结果IIA组患者麻醉苏醒时间、恢复自主呼吸时间均显著短于TIA组(P<0.05)。术中两组患者HR和MAP均处于正常波动范围,且无显著差异(P>0.05)。T_(1)、T_(2)、T_(3)时与T_(0)时比较,IIA组患者CBF/CMRO_(2)、CMRO_(2)/CMRGlu、ADVL均显著升高(P<0.05),TIA组患者CBF/CMRO2、ADVL显著升高(P<0.05);IIA组患者CBF/CMRO2、ADVL升高幅度显著小于TIA组(P<0.05),CMRO_(2)/CMRGlu升高幅度显著大于TIA组(P<0.05)。T_(3)、术后12 h和术后24 h,与TIA组相比,IIA组患者CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)水平较高(P<0.05);T_(3)和术后12 h,与T_(0)相比,IIA组患者CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)水平显著降低(P<0.05);T_(3)、术后12 h和术后24 h,与麻醉前相比,TIA组患者CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)水平均显著降低(P<0.05)。结论进行IIA的ROOC患者苏醒和恢复自主呼吸用时较短,对脑氧代谢平衡和免疫相关T淋巴细胞亚群影响较小,安全性较高。

中医辨证结合中西医治疗PCOS疗效及对患者性激素、脂代谢和卵巢的影响

目的:探讨中医辨证结合中西医治疗多囊卵巢综合征(PCOS)疗效及对性激素、脂代谢和卵巢的影响。方法:选择本院2022年5月-2023年5月收治的PCOS患者90例,随机数字表法分为两组各45例,西医组常规西药治疗,中西医组在西医组治疗基础上采用基于中医辨证的中药治疗,对比两组临床疗效、性激素水平、脂代谢指标、卵巢情况。结果:中西医组临床治疗总有效率(88.9%)高于西医组(68.9%);治疗后两组促卵泡激素(FSH)、睾酮(T)、黄体生成素(LH)、卵泡数目、卵巢体积、总胆固醇(TC)、甘油三酯(TG)、空腹胰岛素(FINS)水平均降低,且中西医组FSH(4.79±0.68 mU/ml)、T(2.46±1.14 ng/ml)、LH(11.29±1.47 ng/ml)水平低于西医组(5.22±1.09 mU/ml、3.24±1.23 ng/ml、13.44±2.36 ng/ml),卵泡数目(7.21±1.25个)、卵巢体积(8.54±1.35 cm^(3))低于西医组(9.46±1.49个、10.21±1.62 cm^(3)),TC、TG、FINS水平低于西医组(均P<0.05)。结论:中医辨证结合中西医治疗PCOS可提升临床疗效,进一步改善患者性激素、脂代谢水平和卵巢功能。

健脾温肾化痰祛湿法对PCOS伴胰岛素抵抗临床疗效及对双侧卵巢体积变化、性激素水平和糖脂代谢的影响

目的:探究多囊卵巢综合征(PCOS)伴胰岛素抵抗(IR)患者采用健脾温肾化痰祛湿法治疗的效果及对卵巢体积、性激素和糖脂代谢的影响。方法:选取2020年6月~2022年7月本院收治的PCOS伴IR患者,共136例,采取随机数表法分为两组。对照组(n=68)给予常规西医治疗,观察组(n=68)予以健脾温肾化痰祛湿法联合常规西医治疗,比较两组患者疗效、中医证候积分、双侧卵巢体积大小、性激素水平以及糖脂代谢指标变化情况。结果:观察组总有效为94.12%,高于对照组88.24%(χ^(2)=1.462,P=0.227);治疗后两组月经周期、腰膝痠软等中医证候积分、双侧卵巢体积均降低,且观察组低于对照组(P<0.05);治疗后黄体生成激素(LH)、LH/卵泡刺激素(FSH)、睾酮(T)水平逐渐降低,且观察组低于对照组,而FSH、性激素结合球蛋白(SHBG)水平逐渐升高,且观察组高于对照组(P<0.05);治疗后空腹胰岛素(FINS)、空腹血糖(FPG)、HOMA-IR水平均降低,且观察组低于对照组,而脂联素(APN)水平升高,且观察组高于对照组(P<0.05)。结论:健脾温肾化痰祛湿法治疗PCOS伴胰岛素抵抗效果显著,该方可有效改善患者中医证候积分、调节患者性激素水平和糖脂代谢指标。

屈螺酮炔雌醇联合二甲双胍治疗多囊卵巢综合征伴糖脂代谢紊乱患者对血脂、血糖及卵巢功能的影响

目的探讨屈螺酮炔雌醇联合二甲双胍治疗多囊卵巢综合征(PCOS)伴糖脂代谢紊乱患者对血脂、血糖及卵巢功能的影响。方法选取84例PCOS伴糖脂代谢紊乱患者,按照随机数字表法分成研究组与对照组,各42例。对照组采取单纯屈螺酮炔雌醇治疗,研究组在对照组基础上联合二甲双胍治疗。对比两组血脂、血糖与卵巢功能指标。结果经3个疗程治疗后,研究组血糖、血脂及卵巢功能指标均优于对照组(P<0.05)。结论屈螺酮炔雌醇联合二甲双胍治疗PCOS伴糖脂代谢紊乱患者,可有效调节血脂、血糖水平,还能改善卵巢功能,值得临床推广与应用。