目的 探讨剪切波弹性成像在精索静脉曲张相关男性不育症诊断中的临床应用价值.方法 选取在我院就诊的精索静脉曲张患者74例(左侧精索静脉单侧曲张Sarteschi分级≥3级),根据精液质量分为精液正常组37例和弱精症组37例,另选74例健康成人为健康对照组,常规超声测量各组睾丸体积,剪切波弹性成像检测睾丸硬度,并对其结果进行比较分析.结果 精液正常组和弱精症组左侧睾丸硬度分别为(5.03±2.68)kPa、(7.23±1.88)kPa,差异有统计学意义(P=0.002);两组与健康对照组左侧睾丸硬度比较差异均有统计学意义(均P<0.001).精液正常组左侧睾丸体积为(15.85±2.6)ml,与健康对照组左侧睾丸体积比较差异无统计学意义(P=0.587);弱精症组左侧睾丸体积为(13.19±2.10)ml,与健康对照组比较差异有统计学意义(P<0.05).精液正常组左侧睾丸体积与右侧比较差异无统计学意义(P=0.813),硬度高于右侧(P<0.001);弱精症组左侧睾丸体积低于右侧,硬度高于右侧,差异均有统计学意义(均P<0.05).结论 剪切波弹性成像是评估精索静脉曲张相关男性不育症的一种有效手段,具有较好的临床应用价值.

目的:探讨年龄相关听力损失(AHL)小鼠在服用中药复聪汤后对耳蜗马达蛋白prestin表达的影响,明确调控马达蛋白prestin表达在AHL方面的预防和治疗作用及机制.方法:采用快速老化DBA/2J小鼠,刚出生和4周龄的小鼠各40只,随机分成中药治疗组和对照组各20只.中药治疗组每天口服中药复聪汤,而对照组给予正常饮水,在治疗前及治疗1、2、3、4个月后测定ABR反应阈值.治疗4个月后,实验动物耳蜗取材,快速固定,耳蜗铺片行毛细胞记数和免疫组化荧光prestin标记染色.在光镜下对全耳蜗毛细胞进行记数,激光共聚焦显微镜进行prestin蛋白表达观察和荧光表达强度测定.结果:刚出生DAB/2J小鼠中药治疗4个月后的ABR反应阈值较对照组低,耳蜗毛细胞顶到中回的存活率高于对照组;4周龄DAB/2J小鼠中药治疗后2～3个月的ABR反应阈值较治疗前的差异不大,但均与对照组有显著差异(P＜0.01),耳蜗毛细胞顶到中回的存活率较对照组明显高,但较刚出生DAB/2J小鼠的毛细胞存活率为低.2批DAB/2J小鼠在中药治疗4个月后的耳蜗毛细胞prestin表达强度上较各自的对照组高.结论:中药复聪汤可以上调耳蜗毛细胞prestin蛋白的表达,促进耳蜗毛细胞存活,阻止毛细胞死亡的进程,从而有效预防和延缓老年性聋的发展进程,早期预防和治疗效果更好.

目的 应用超声观察单纯性腭裂患儿行修补术前使用矫形板对其舌位变化及舌背运动的影响,并探讨其评估患儿语言功能的应用价值.方法 选择拟行腭裂修补术的单纯腭裂患儿36例,于术前按是否早期使用矫形板分为使用矫形板组和未使用矫形板组,各18例;另选同龄健康幼儿18例作为正常对照组;通过超声检测修补术前后两组患儿在发音过程中OA距离和AOB角度,并与正常对照组进行比较;同时对两组患儿手术前后发音清晰度进行评估.结果 术前使用矫形板组、未使用矫形板组OA距离分别为(3.61±0.15)cm、(3.53±0.34)cm,均显著低于正常对照组(4.18±0.16)cm;AOB角度分别为(34°±5°)、(32°±4°),均显著高于正常对照组(20°±1°),差异均有统计学意义(均P<0.05);使用矫形板组和未使用矫形板组术后OA距离均较术前升高,AOB角度均较术前降低,且差异有统计学意义(均P<0.05);使用矫形板组术前获得良好发音的比例(17/18)显著高于未使用过矫形板组(11/18),差异有统计学意义(P<0.05).结论 超声可作为评估单纯性腭裂患儿舌头不规则运动及术后发音功能的一种有效手段;矫形板在腭裂修补术前的使用对患儿术后获得良好发音有着积极有效的应用价值.

Objective:To detect the testicular artery and spermatic vein hemodynamics of patients with testicular microlithiasis (TM) complicated with varicocele (VC) by ultrasonography,and analyze the relationship between VC classification and TM typing.Methods:80 cases patients with TM complicated with varicocele VC and 80 cases of healthy male from August 2014 to Aug.ust 2016 were selected as the research group and the control group.The peak systolic velocity (PSV) and resistance index (RI) oftesticular artery and spermatic maximum velocity (VS-Vmax),reflux time (TR),spermatic vein diameter at rest (DR and diameter at Valsalva maneuver (DV) were detected.The relationship between TM classification and VC typing was analyzed by Spearman rank test.Results:There was no significant difference in the RI of testicular artery between two groups (P ＞0.05),while the PSV of research group was significantly lower than that of the control group (P＜0.05).The DR,DV,VS-Vmax,TR of research group were significantly higher than those of the control group (P＜0.05).TM classification was positively correlated with the VC typing (P＜0.05).Conclusions:The testicular artery and spermatic vein hemodynamics of TM combined with VC patients changed at different degrees,and VC severity was positively correlated with the number oftesticular micro stones.

Objective To investigate the expressions and clinical significance of PPARγ and MMP-9 in the genesis and development of hypertensive disorder-complicating pregnancy(HDCP).Methods The expressions of PPARγ and MMP-9 in placenta of 31 normal pregnant women(control group) and 36 pregnant women with hypertensive disorder-complicating pregnancy(experimental group) were detected by using SP method of immunohistochemistry,and the relationship between PPARγ and MMP-9 expressions and hypertensive disorder-complicating pregnancy was explored.Results ① PPARγ expression in placental tissues was significantly higher in the experimental group than in the control group(P0.05);PPARγ with positive expression rate of exacerbations was significantly increased.② MMP-9 expression in placental tissues showed low expression in the experimental group,which was significantly different from that in the control group(P0.05);MMP-9 with positive expression rate of exacerbations was significantly decreased.③ The Pearman correlation analysis of PPARγ and MMP-9 showed that the expression level of the two had a negative correlation(r=-0.529,P0.01).Conclusion PPARγ has a high expression in the placenta of patients with HDCP while MMP-9 has a low expression,suggesting that they may be involved in the pathogenesis of HDCP by inhibiting the infiltration capacity of nourishing cells.

免疫机制贯穿于妊娠始终,免疫失调在妊娠期高血压疾病的发病中起重要的作用,现对该病的免疫学发病机制及治疗进展作一综述。

目的 了解血脂异常患者血尿酸含量变化和临床意义.方法 选取血脂异常患者335例,其中男162例,女173例,年龄35～55岁,以体检无血脂异常健康人群376名为对照组.结果 血脂异常组有64例(19.1%)和对照组有8例(2.13%)血尿酸(UA)≥420μmol/L,两组患病率差异有统计学显著性意义(P<0.001),其中血脂异常高尿酸患病率男性比例高于女性(0.05<P<0.1),血脂两项以上指标升高者,高尿酸血症明显高于血脂单项指标升高者(P<0.01),LDL升高与血脂异常患者发生高尿酸有相关性,高尿酸组尿素氛、血糖高于正常对照组(P<0.01).结论 血脂异常患者高尿酸血症患病率较正常人群高,应引起临床对此类患者血尿酸、尿素氮及血糖水平变化的重视.

Objective: To perform the quantitative analysis of the membrane fluidity of vascular endothelial cell under the state of the anoxia and reperfusion. Methods: The characteristic fluorescence spectrum of the cultured vascular endothelial cell were comparatively analysed in the animal model of the anoxia-reperfusion injury using the fluorescence polarization method. We quantitatively observed the effects of the anoxia and reperfusion on the membrane fluidity of cultured vascular endothelial cell and protection function of FDP and CAP. Results: The fluorescent spectrum of the vascular endothelial cell labeled by DPH did not change essentially in different times. The change of the curve slope of the fluorescence intensity showed consistency between experimental and control groups. The anoxia and reperfusion injury could reduce fluorescence anisotropy FDP and CAP could significantly protect the cultured vascular endothelial cell from theanoxia injury. Conclusion: The fluorescence polarization technique is a quantitative analysis method with high sensitivity and stability on studying the membrane fluidity of the cultured vascular endothelial cell.