EFFECT OF ROSIGLITAZONE AND METFORMIN ON CLOMIPHENE CITRATE RESISTANCE IN WOMEN WITH POLYCYSTIC OVARY SYNDROME

Objective To evaluate the impacts of rosiglitazone and metformin on ovarian response, hirsutism and insulin action in women with polycystic ovary syndrome (PCOS). Methods Ninety women resistant to clomiphene citrate with PCOS were randomized, 40 cases to rosiglitazone group, 50 cases to meformin group. Rosiglitazone and metformon were administered for 6 months in combination with clomiphene citrate on cycle day 5th to 9th, respectively. The clinical evaluations were performed monthly. Reproductive hormone, serum glucose and insulin levels were observed before and after treatment. The data were analyzed using repeated analysis of variance (ANOVA). Results There were significant changes in reducing hirsutism score, serum testosterone level, LH/FSH ratio, and restoration of ovarian ovulation after metformin or rosiglitazone administration respectively (P<0.05). Insulin sensitivity was more significantly improved in the rosiglitazone group than in metformin group (P<0.05) After treatment. Homa IR and Homa β were decreased from 1.54±0.34 to 0.83±0.38 and from 5.83±0.55 to 4.95±0.54 (P<0.05) in the rosiglitazone group. The body mass index(BMI) was decreased from 25.30±3.64 to 23.83±2.32 in the metformon group (P<0.05). There were no significant changes in ovulation rate and pregnancy rate between groups (P>0.05). Conclusion Rosiglitazone can increase insulin sensitivity. Metformon may reduce BMI. They all restore regular menstrual cycles, increase pregnancy rate, and reduce testosterone and LH concentration in women with polycystic ovary syndrome.     

胃食管反流病的内镜、食管动力学检查与中医证型的关系

通过对64不同中医证型的胃食管反流病（GERD）患者进行内镜、食管动力学检查，探讨胃食管反流病的内镜、食管动力学与中医证型之间的关系。结果显示：GERD患者脾胃虚寒型比肝胃不和型和肝郁化热型的食管粘膜炎症分级增高（P＜0.05）；食管动力学检查显示：脾胃虚寒型投肝胃不和型和肝部化热型的LESP、GEBP、APP降低（P＜0．01或P＜0．05），技肝胃不和型的LESRT延长（P＜0．01），PCS减任（P＜0．05）。提示：GERD康证型较实证型的食管粘膜炎症损害程度重且食管运动功能差。     

助孕胶囊对多囊卵巢大鼠卵巢细胞凋亡的影响

目的观察助孕胶囊对多囊卵巢(PCO)大鼠血性激素水平及卵巢细胞凋亡的影响,探讨其对PCO模型大鼠的治疗作用并分析其可能的作用机制。方法采用孕激素联合人绒毛膜促性腺激素(HCG)造模法制备PCO模型大鼠。随机分为对照组、PCO模型组、中药组(助孕胶囊)、西药组(克罗米酚),运用放免法测定血性激素水平的变化;采用TUNEL法检测卵巢组织凋亡细胞及免疫组化染色检测卵巢组织颗粒细胞Bcl-2、Bax的表达水平。结果助孕胶囊可明显降低PCO大鼠血清睾酮T、促黄体生成素LH水平,显著降低卵巢颗粒细胞凋亡率并下调卵巢组织颗粒细胞Bax蛋白的表达。结论助孕胶囊能够通过调整内分泌及抑制卵巢局部细胞凋亡,在中枢及卵巢局部协调发挥作用,从而调整PCO性腺功能,促进卵泡的发育成熟及排卵。     

GnRH和TRH刺激试验在诊断与鉴别多囊卵巢综合征中的应用

由临床表现、基础生殖激素测定及阴道超声，虽可对大多数多囊卵巢综合征（Polycysticovariansyndrome，PCOS）患者做出正确诊断，但部分病例仍有困难。为解决这一问题，对7例泌乳素（prolactin，PRL）水平升高的PCOS患者（HP－PCOS），12例PRL水平正常的PCOS患者（NPRL－PCOS），7例单纯PRL水平升高患者（HP）及10例正常妇女进行GnRH和TRH刺激试验。结果：刺激试验前，4组基础LH／FSH比值无显著性差异；刺激试验后，两组PCOS妇女峰值时LH／FSH比值显著高于HP及对照组，而HP－PCOS与HP组的PRL反应无差别。提示：GnRH和TRH刺激试验有助于PCOS的确诊及鉴别。     

多囊卵巢综合征患者肾素血管紧张素与雄激素及胰岛素抵抗的相关性

目的探讨多囊卵巢综合征(PCOS)患者肾素血管紧张素与雄激素及胰岛素抵抗的相关性。方法选择PCOS患者和正常对照组妇女各40例,检测血浆肾素活性(PRA)、血管紧张素Ⅱ(AngⅡ)、胰岛素、血糖和性激素水平。结果①F-G评分、LH/FSH比值、T、PRA和AngⅡ浓度,空腹胰岛素(FINS)、胰岛素抵抗指数(Homa IR)、胰岛素分泌指数(Homaβ)显示,PCOS组>对照组(P<0.05);②PCOS组PRA与月经周期、AngⅡ、LH/FSH、T、FINS、Homa IR、Homaβ、β细胞功能评定指数(MBCI)呈正相关性(分别为r=0.40,0.44,0.37,0.35,0.50,0.42,0.48,0.38,P<0.05);AngⅡ与月经周期、LH/FSH比值、T呈正相关(分别r=0.34,0.32,0.42,P<0.05);AngⅡ与FSH呈负相关(r=-0.36,P<0.05)。结论①多囊卵巢综合征存在肾素-血管紧张素-雄激素级联亢进;②RAS亢进可能参与PCOS胰岛素抵抗和生育障碍的发生。     

人细小病毒B_(19)感染与川崎病关系的初步研究

研究人细小病毒 B19( HPVB19)感染与川崎病 ( KD)的关系。方法　采用巢式聚合酶链反应技术 ,对 30例急性 KD患儿和 2 5例健康儿童的血清进行检测。结果　 30例急性 KD患儿血清中 HPVB19- DNA阳性 7例 ,阳性率为 2 3.3% ,其中 6例合并冠状动脉扩张 ;对照组 2 5例血清中 HPVB19- DNA均阴性。结论　HPVB19可能是 KD的重要病原菌之一 ,且可能参与了 KD患儿冠状动脉并发病的形成     

Effects of pioglitazone on serum leptin and adiponectin in polycystic ovary syndrome patients with insulin resistance

Objective To investigate the effects of pioglitazone on serum leptin and adiponectin in polycystic ovary syndrome (PCOS) patients with insulin resistance (IR). Methods Thirty-five PCOS patients with IR were treated with pioglitazone 15mg/d for 12 weeks. The results of ovulation induction were observed. The changes of fasting plasma glucose (FPG), fasting serum insulin (FINS), serum levels of leptin, adiponectin, follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T) and blood fat were examined at the baseline and after the therapy by enzyme-linked immunosorbent assay (ELISA) and radioimmunoassay (RIA). Results After the treatment, the rate of ovulation per cycle was improved in 31 (88.5%) out of the 35 patients. After treatment, the level of serum leptin was decreased (P<0.05) while the level of serum adiponectin was increased (P<0.05). After 12 weeks'treatment, waist-to-hip ratio and F-G score were significantly decreased (P<0.05), BMI declined but without significant difference (P>0.05). The levels of LH, T, FINS, Homa-IR, total cholesterol, triglyceride and low density lipoprotein-cholesterol were significantly decreased (P<0.01, P<0.05), whereas the level of high density lipoprotein-cholesterol was significantly increased (P<0.01). No significant difference was seen in FSH and FPG following treatment (P>0.05). Conclusion Pioglitazone treatment can effectively improve PCOS with IR patients'clinical syndromes, insulin sensitivity, glucose and lipid metabolism at least partly through improving the profiles of leptin and adiponectin.     

从SARS疫情启示看新冠肺炎疫情对交通运输行业的影响

为了研究新冠肺炎疫情对交通运输行业造成的影响,首先分析了SARS疫情对交通运输行业的影响,然后结合我国当前经济发展特征,就新冠肺炎疫情对交通运输行业的影响进行了分析。研究认为,新冠肺炎疫情对交通运输行业的影响是短期的,不会造成长期趋势性改变;新冠肺炎疫情对交通运输行业的影响远超过SARS疫情;交通运输各个领域恢复期将表现出明显差异。最后,有针对性地提出一些应对新冠肺炎疫情影响的措施建议,供各级交通运输管理部门决策参考,具体包括切实做好新冠肺炎疫情影响程度更深的应对准备;提供安全可靠的客运服务;不断提升交通运输行业应急处置能力;建立交通运输行业重大危机救助基金。     

肾综合征出血热患者白细胞介素-6的动态变化及意义

用双抗体夹心ELISA法检测36例肾综合征出血热102份系列血清中IL－6含量，发现患者血清IL－6含量在6病日前及发热低血压期均高于正常；6病日达高峰，7病日开始下降；发热期明显升高，少尿期达峰值；IL－6含量在轻、中、重及危重型患者之间有明显差异；IL－6与尿蛋白在含量间明显正相关。提示IL－6含量变化与病程进展一致，是引起肾病综合征出血热病理损伤的重要因素之一；且与病情轻重密切相关，可一定程度判定患者预后和转归，反映肾损伤程度。     

直接ELISA法早期诊断肾综合征出血热

联合应用硫酸鱼精蛋白沉淀和蔗糖垫层超速离心,从感染鼠脑中纯化HFRSV抗原,纯化抗原用HRP标记,成功地建立了采用酶标记HFRSV抗原的IgM抗体捕捉ELISA法,即直接ELISA法,检测HFRS患者血清特异IgM抗体。与已报道的采用酶标记HFRSV IgG的IgM抗体捕捉ELISA法相比。二法敏感度相似,但直接ELISA法可减少一步免疫反应,并能完全避免类风湿因子的干扰。应用直接ELISA法检测临床诊断的HFRS患者血清87份,其中早期患者(1～5病日)血清37份,特异IgM抗体阳性检出率分别为96.5%和91.8%。我们认为酶标记抗原直接ELISA法为HFRS的早期诊断提供了更为特异、简便快速的新方法。