Objective:Compared to older men, Alzheimer’s Disease (AD) is more common in older women, who present with higher levels of pathological tau and accelerated memory decline, although it is unclear why. Furthermore, sleep complaints increase with age, with older women reporting worse sleep quality than older men, and past studies have linked sleep disturbances to tau. Because of the life-long “verbal memory advantage” in women over men, nonverbal memory may more accurately reflect tau burden in women since sex differences are not as apparent. Here, in a sample of older women in the Women Inflammation Tau Study (WITS), we examined the associations between subjective sleep quality, tau in temporal regions, and memory, and whether tau would be more strongly related to nonverbal memory than verbal memory.Participants and Methods:In WITS, women have elevated AD polygenic hazard scores and have mild cognitive impairment as indicated by the telephone Montreal Cognitive Assessment (range:13-20). This preliminary sample of 20 women (aged 72.0±3.7) completed the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality in 7 domains of sleep health over the past month. A global score (range:0-21) is calculated, with a score >5 indicative of being a poor sleeper. Participants also underwent positron emission tomography (PET) with the 18F-MK6240 tracer and T1-weighted magnetic resonance imagining (MRI) to determine tau deposition. Standardized uptake value ratio (SUVR) was calculated using the inferior cerebellum grey matter as the reference region, which was created from Automated Anatomic Labeling atlas in native T1 space. The region of interest (ROI) was a composite meta-temporal region. The Rey Auditory Verbal Learning Test (RAVLT) and Logical Memory (LM) Story A and B were administered to assess verbal memory. The Brief Visuospatial Memory Test-Revised (BVMT-R) was administered to assess nonverbal memory. Analysis focused on the delayed recall scores from the memory tests. Partial correlation was used to analyze the associations between PSQI global score, tau-PET SUVR in meta-temporal ROI, and memory delayed recall scores, while adjusting for age and education years.Results:8 women were poor sleepers indicated by the PSQI global score (mean:4.9±2). Worse subjective sleep quality was associated with greater tau in meta-temporal ROI (r=0.63, p=0.005) and lower BVMT-R delayed recall (r=-0.46, p=0.05). Sleep quality was not significantly related to either RAVLT or LM delayed recall (all p’s>0.40). Tau in meta-temporal ROI was not significantly associated with nonverbal (p=0.23) or verbal memory (all p’s>0.40) delayed recall.Conclusions:In this preliminary analysis, subjective sleep quality was linked to temporal tau deposition and nonverbal memory delayed recall, which may suggest that poor sleep exacerbates pathogenesis of tau that leads to memory difficulties in older women at increased risk for AD. Although tau was not significantly related to any memory measures, we will explore whether tau will mediate or moderate the relationship between sleep quality and nonverbal memory once we are powered to do so. Continual evaluation and treatment of sleep may be imperative in mitigating AD risk, especially for older women, however, future longitudinal studies will be necessary to investigate this.

AbstractBackgroundOptical coherence tomography (OCT), is an advanced, noninvasive technology that can provide the images of retinal structure, including peripapillary retinal nerve fiber layer (pRNFL), macular retinal thickness (MRT), as well as macular volume (MV). However, whether the retinal structure varied in Alzheimer's disease (AD) patients was still unclear. This study aims to detect the retinal changes of AD patients and explore their correction with severity of disease and classic biomarker.Method78 AD patients and 188 HC matched with age and sex were enrolled in this study. The pRNFL thickness, MRT and MV were assessed using OCT. In addition, Aβ42, Aβ40 and tau protein in plasma were detected using Simoa technology.ResultThe results showed that the pRNFL thickness of AD patients was significantly thinner than HC (96.76±10.44 vs 101.4±17.74, p=0.023). Compared with HC, MRT and MV were reduced in AD patients, but the differences were not significant(p>0.05). Furthermore, the pRNFL thickness was significantly negatively correlated with MMSE (r=‐0.362, p=0.005) and disease duration (r=‐0.295, p=0.002); In addition, the pRNFL thickness was positively correlated with t‐tau protein in plasma(r=0.409, p=0.002); while negatively correlated with Aβ42/40 in plasma(r=‐0.277, p=0.041). However, there was no significant correction between neither MRT nor MV and MMSE, disease duration, Aβ42, Aβ40 and tau protein in plasma (p>0.05).ConclusionThese results supported that pRNFL thickness measured using OCT may serve as a useful predictor of AD.

目的 通过分析孕早期胚胎停育与正常胚胎绒毛组织中microRNA-126(miR-126)、血管内皮生长因子(VEGF)的表达差异,探讨其在早期胚胎停育中的相关性.方法 收集孕早期胚胎停育和正常胚胎绒毛组织各28例作为胚胎停育组和对照组,采用逆转录-聚合酶链反应(RT-PCR)检测两组miR-126和VEGFmRNA表达水平的变化.结果 ①两组绒毛组织中均有miR-126表达,胚胎停育组绒毛组织中miR-126的表达高于对照组,但差异无统计学意义.②胚胎停育组绒毛组织中VEGF的表达低于对照组,差异有统计学意义.③胚胎停育组绒毛组织中miR-126与VEGF的表达呈负相关;对照组绒毛组织中miR-126与VEGF的表达呈正相关.结论 ①胚胎停育绒毛组织中VEGF的表达低于正常胚胎.②VEGF的表达变化与胚胎停育的发生有一定的相关性.

Objective: To understand the trace element changing rules of pregnant woman in different gestation periods and in different ages in Xiangtan area and its deficiency situation,so as to provide theory basis for reasonable supplementation of the blood serum trace element,and enhance the gestation period health care.Methods: According to the pregnancy time,255 pregnant women in observation group were divided into Early pregnancy group(≤12 weeks),Mid-term pregnancy group(12~28 weeks),Late pregnancy group(≥28 weeks).Simultaneously,45 cases of health non-pregnancy woman were selected as the control group.Women in observation group were also divided according to the age into above 30 years old group(the age ≥30 years) and Under 30 years old group(the age 30 years).The atomic absorption spectrophotometric method was used to determine the blood serum contents of 5 kinds of elements like iron,calcium,zinc,magnesium and copper of women in different gestation period and different ages.Their deficiency situations were also calculated and analyzed.Results: The average value of trace element of pregnant women indifferent gestation periods and ages had statistical difference(P0.05),indicating that the unbalanced degree of trace element was related with the gestation period and the age.The lack of iron,zinc and calciumin in different gestation periods had statistically significant difference as compared with the control group(P0.05).The above 30 years old group also had obvious difference in the iron,calcium,zinc as compared with the Under 30 years old group(P0.05).Conclusion: The gestation period woman in different gestation periods and ages had different trace element contents in Xiangtan area.The pregnant woman should according to pregnant weeks and their ages strengthen reasonably the trace element supplement of iron,calcium,zinc and so on,so that can avoid the adverse accidents in gestation period.

Objective:To investigate the gynecological clinic detection rate,proportion and age distribution of vaginal microflora imbalance.Methods:Gram staining gynecological clinic patients with clinical symptoms of vaginal secretions,detection of vaginal pH.Results:Vaginal microbial disorder detection rate was 51.33%,vulvovaginal candidiasis accounted for 28.99%,bacterial vaginosis accounting for 8.57%,trichomoniasis vaginosis was 2.03%,mixed vaginitis was 0.48%,undefined vaginal microbial imbalance was 59.92%.Vaginal microbial disorders in patients composition of each age group:<20 years old was 2.4%,21-30 age group was 32.7%,31-40 age group was 38.2%,41-50 age group was 21.7%,>50 years old group was 5.0%,all kinds of vaginal micro-ecological imbalance,the median age in addition to mixed vaginitis was in 21-30 years old,the other are in the 31-40 years of age.Conclusions:Vulvovaginal candidiasis were higher than bacterial vaginosis,trichomonas vaginitis and mixed vaginitis.Vulvovaginal candidiasis,bacterial vaginosis,trichomonas vaginitis and mixed vaginitis were predilection in reproductive age females.In addition to inflammation of the vagina,there are most of the vaginal microbial disorders need to define.

The synthesis secretion,metabolism and regulation of thyroid hormones during pregnancy change with gestational ages.Hypothyroidism during pregnancy is not only associated with all increased risk of abortion,premature delivery,hypertensive disorders in pregnancy,abnormal glucose metabolism of pregnancy,but also a deleterious effect of the fetal development.An early supplementation with levothyroxine might reduce these risks.

目的:了解妇科门诊妇女阴道微生态平衡失调者白带异常检出率、构成比和年龄分布情况.方法:收集2009年11月-2010年1月在中南大学湘雅二医院妇科门诊就诊的有明显症状妇女的阴道分泌物,采用革兰染色及阴道pH试纸方法检测,同时以问卷方式采集受试者基本资料,并进行相应的统计学处理.结果:4025例患者中有2066例白带检测异常,总检出率为51.33％,其中外阴阴道假丝酵母菌病占28.99％,细菌性阴道病占8.57％,滴虫性阴道病为2.03％,混合性阴道炎为0.48％,未定义及未分类的阴道微生态失调为59.92％.阴道微生态失调妇女各年龄构成中＜21岁组为2.4％,21～岁组为32.7％,31～岁组为38.2％,41～岁组为21.7％,＞50岁组为5.0％.各种阴道微生态失调的中位数年龄中除混合性阴道炎位于21～30岁,其他均位于31～40岁.结论:阴道微生态平衡失调中外阴阴道假丝酵母菌病构成比明显高于细菌性阴道病、滴虫性阴道炎及混合性阴道炎.外阴阴道假丝酵母菌病、细菌性阴道病、滴虫性阴道炎及混合性阴道炎均好发于生育期年龄女性.除上述阴道炎症外,尚有大部分阴道微生态失调需要定义.

<正>体外受精(IVF)取卵日要求配偶提供足够数量和质量的精子,而男性配偶成功射精是IVF成功的基本保证。我中心对818对夫妇实施IVF,其中6例男性配偶在取卵日因较长时间不能射精,通过心理行为疗法、物理刺激等处理无效后给予伐地那非口服,取精效果满意,现报道如下。

Objective: To develop a rapid,economical and efficient approach for molecular detection of 22ql1.2 microdeletion in patients with congenital heart diseases(CHD).Methods: Five repeat markers(D22S941,D22S944,D22S264,D22S311,D22S306)located in the proximal region of chromosome 22q11 were selected in this study.Twenty patients with congenital heart disease and their unaffected parents were analysized by using PCR method to screen 22q11 microdeletion.Results: Four cases may have the deletion at chromosome 22ql1.The deletions were confirmed further by fluorescence labeling PCR and one patient had the 22q11 deletion.Conclusion: This study demonstrated that genotying of STR markers was a useful means of screening 22q11 microdeletion for its easy experimental procedures,cost effectiveness,while fluorescence labeling PCR-STR typing method can be used in this microdeletion diagnosis,because that it was accurate and effective.

Objective:To study the pathogenicity of Ureaplasma urealyticum serotype 3(Uu3) and 8(Uu8) with the same concentration in Female Rabbits,s Reproductive tract.Methods:Fifty-two oestradiol-treated adult female rabbits were randomly divided into group A,B,C and D.Ureaplasma urealyticum serotype 3,8,3 and 8,with the same concentration of 106copy/g while 4 rabbits of control group(group D) inoculated sterile medium.They were detect Uu from cervical secretions by fluorescent quantitative polymerase chain reaction(FQ-PCR) at 1,3,7,14,21,35,49,63,77,91,105 days.They were necropsied at 14,105 days of postinoculation randomly to observing tissues of cervix,endometria,fallopian tube by light microscope and cervical mucosa by scanning electron microscope.Results:①The total positive rabbits of Uu in three experimental groups show a significant difference(P0.05) ,which were 27.3%(25/88) ,55.7%(49/88) ,69.3%(61/88) .But before 35 days,the positive rate of the three experimental groups at the same time point in all of Female rabbits infected cervical secretions does not show a statistically significance(P0.05) ,and the positive rate descended as the days of postinoculation lasting.The highest positive rates of three experimental groups were 87.5%(7/8) ,100.0%(8/8) ,100.0%(8/8) at 1 d after inoculation,but the conlisation didn't persist at 105 d.All rabbits of control group were negative.②There was not statistical difference in the quantity of Uu among experimental groups(P0.05) .Their peak level were 364×104copy/g,401×104copy/g,493×104copy/g,reached at 1d,but the FQ-PCR values reduced as the days of postinoculation lasting.In the same experimental group at different time points,the concentrations was a significant difference(P0.05) .③The total pathogenicity rates of three groups were significantly different(P=0.015) ,which were 31.3%(5/16) ,62.5%(10/16) ,81.3%(13/16) .But there were not statistical difference among experimental groups at 14 days(P0.05) ,but 105 days later the pathogenicity rates of three groups were significant different(P=0.041) .None of control group was positive.Conclusions:①In female rabbits's reproductive tract,the pathogenicity of each experimental group was shown when inoculatin Uu with FQ-PCR value is 106copy/g.the pathogenicity rates of three groups were significantly different.the pathogenicity of the mixed group(group C) was the highest and Uu3 group(group A) the lowest,Uu8 group(groupB) was the Second.②In Female Rabbits,s Reproductive tract,the infectivity and quantatitive value were significant different among experimental groups,the infectivity and quantatitive value of the mixed group(group C) was the highest and Uu3 group(group A) the lowest,Uu8 group(group B) was the Second when inoculating Uu with the same concentration.③The pathogenic concentration of Uu3 and Uu8 may differ,Uu8 may be 106copy/g,so further research is needed confirm it.

唐氏综合征(Down syndrome,DS),又称先天愚型,是由于第21对染色体三体变异所致的疾病.本病在新生儿中的发病率为1/800～1/600,母亲年龄愈大,发病率愈高,约有60%的患儿在妊娠早期即发生流产,因此实际发病率高于新生儿发病率[1].

目的:观察补肾化痰祛瘀中药联合克罗米芬治疗多囊卵巢综合征所致不孕的临床疗效。方法:将多囊卵巢综合征不孕患者76例随机分为治疗组(38例)与对照组(38例),治疗组采用补肾化痰祛瘀中药联合克罗米芬治疗,对照组采用克罗米芬治疗,观察两组患者排卵率、妊娠率及并发症。结果:治疗组38例,治疗74个周期,有64个周期排卵,周期排卵率达86.49%,38例中有19例妊娠,总妊娠率为50.00%,未发生卵泡过刺激综合征(OHSS)、黄素化未破裂卵泡综合征(LUFS)。对照组38例,治疗76个周期,有67个周期排卵,周期排卵率为88.16%,有10例妊娠,总妊娠率26.32%,有2例并发LUFS,1例因用药中途发生OHSS中断治疗。两组排卵率比较差异无统计学意义(P>0.05);妊娠率及周期妊娠率比较,差异有统计学意义(P<0.05),治疗组的疗效优于对照组。结论:补肾化痰祛瘀中药联合克罗米芬治疗PCOS所致不孕疗效明显优于单纯的克罗米芬治疗。

[目的]探讨妊娠期高血压疾病合并急性左心衰竭的正确诊断治疗和分娩方式对围生儿预后的影响.[方法]将2006年3月至2009年3月在本院产科确诊为妊娠期高血压疾病合并急性左心衰竭的80例病人分为剖宫产组及阴道分娩组进行回顾性分析,并对两组病人的新生儿窒息情况进行比较.[结果]80例病人在24 h内心衰控制,所有病人均在产后7～10 d出院.剖宫产出生69例,出生围产儿71例,其中2例为双胎,出生轻度窒息20例(33.89%),重度窒息4例(6.78%),阴道分娩11例,轻度窒息4例(30.77%),重度窒息1例(7.69%),死亡0例,两组比较差异无显著性.[结论]对妊娠期高血压疾病合并急性左心衰竭患者纠正心力衰竭并适时终止妊娠是治疗的关键,单纯剖宫产并不是降低新生儿窒息发生率和围产儿死亡率的唯一选择.同时应加强产科、儿科配合,主张新生儿科医师进入产房、手术室监护,有望提高新生儿窒息抢救成功率及围产儿存活率.

Objective: To investigate the correlation between the level of serum folic acid(FA) and homocysteine(Hcy) and birth defects,and the value in prenatal diagnosis.Methods: 19 pregnant women who were high risk by prenatal screening and had congenital abnormal fetus by prenatal diagnosis were selected as group A;60 pregnant women who were high risk by prenatal screening and had normal fetus by prenatal diagnosis were selected as group B;26 pregnant women who were low risk by prenatal screening and had the fetal who weren′t discovered CHD,NTD and CL by type B ultrasonic(part of them were examined by color ultrasonic) and also weren't discovered those malformation post partum by neonate examination were selected as group C.The concentration of serum FA was measured by the time-resolved immunofluorometric assay(TRIFMA).The concentration of serum Hcy was measured by the chemiluminescent immunoassay.Results: 1.The mean of serum FA in the group A,group B and group C was 18.90±5.65 nmol/l,25.40±8.06nmol/L and 36.46±11.27nmol/l,respectively.There were significant correlation in the three groups(P<0.01).2.The mean of serum Hcy in group A,group B and group C was 19.62±6.01μmol/L,15.78±2.29μmol/L and 13.05±2.10μmol /L,respectively.There were very significant correlation in three groups(P<0.001).3.Statistical analysis show the negative correlation between serum FA and Hcy in three groups(P<0.05).Conclusion: 1.The low-level of maternal serum FA and high-level of maternal serum Hcy indicated that there were significant effect in birth defects.2.Statistical analysis showed the negative relationship between serum FA and Hcy,indicated that serum FA abnormity played a important effect in Hcy.3.The concentration of serum FA was less than 21.55nmol/L or or and serum Hcy was more than 19.90μmol/L may be the important symbols of prenatal diagnosis of the pregnant women who were high risk by prenatal screening.

Objective: To probe the influencing factors of dysspermia by masturbation for semen routine examination. Methods: 220 patients who accepted semen routine examination completed the general information questionnaire, sex life scale of ENRICH(Olson) and Symptom Checklist90 (SCL-90) after acquiring the semen. To compare each variable between 31 patients with dysspermia and 189 patients without dysspermia by t test or chi-square test. The variables which had statistic significance were regarded as independent variable, with or without dysspermia was regarded as dependent variable, then screened the influencing variables by Logistic regression analysis. Results: The six variables to be selected into regression equation were the attitude of his wife, sexual activity factor score, the environment, SCL-90 score, age and masturbation history. Conclusion: Wife's negative manner, not harmonious sexual relationship between husbands and wives , the crude environment, high stress disorder pressure, big age and having no masturbation history were the major influencing factors on dysspermia by masturbation during semen routine examination.

Pregnancy stress may significantly elevate the level of CRH and cortisol, which contributes to the bad pregnancy outcomes like premature delivery, low birth weight infant even hypertensive disorders complicating pregnancy. It also has close relationship with postpartum depression. In addition, it has a bad influence on offsprings’ mental growth, behavior development and the development of central nervous system.

Congenital heart defect(CHD)is a frequent congenital abnormality in neonatus.Mostly,it results from a complex mixture of environmental and genetic factors.Cardiogenesis requires a complex process of events including proliferation,migration,differentiation and morphogenetic interactions involving cells from several embryonic origins.A great deal of genes function and interact in the complex process.Gap junction channels formed by connexin43(Cx43)protein are important in cardiac morphogenesis and Cx43 gene is thought to be associated with CHD.High density of homolysteine is an independent clastogenic factor and can deduce CHD.Recent work has elucidated that Cx43 gene defect and hyperhomocystinemia closely correlates with CHD.we review the relation between Cx43 gene defect,homocysteine and CHD respectively.

Endometriosis is a common gynecologic problem,of which the etiology and mechenism is not very clear.More and more animal experiments and environmental epidemiological studies suggested that environmental toxins such as dioxin seemed to play an important role in pathogenesis of endometriosis.However,whose potential mechanisms are unclear although it is think that it maybe caused by many ways.This article reviews related evidence and possible mechanism of endometriosis resulting from Dioxin and metabolic enzyme of enviromental toxin.

目的 探讨在不同女性生殖道中解脲脲原体(Uu)生物一群的耐药性.方法 选择40例健康体检者和244例妇产科疾病患者,排除衣原体、滴虫、念珠菌、淋球菌及以加德纳菌感染.取其宫颈管分泌物进行支原体培养并同时行药物敏感试验.对于培养结果阳性的样本提取DNA进行PCR扩增,确定其血清型.结果 (1)Uu生物一群分离阳性率为60.5%(172/284).其中健康体检者、不孕症、不良孕产、盆腔炎及阴道炎患者中的阳性率分别为:50%(20/40),46.3%(38/82),58.3%(28/48),66.7%(24/36),79.5%(62/78).提示Uu生物一群在女性不同妇科疾病中的分布存在差异(P＜0.05).(2)药敏试验结果 显示对Uu生物一群较为敏感的药物分别为:强力霉素98.8%,阿歧霉素97.7%,交沙霉素96.5%.耐药率分别为:环丙沙星62.8%,司帕沙星44.2%,可乐必妥43%.敏感性差异有统计学意义(P＜0.05).结论 女性生殖道中Uu生物一群主要对喹诺酮类药物耐药,敏感药物主要为强力霉素,阿歧霉素及交沙霉素,尤其强力霉素的敏感性达到了98.8%,近期内可作为治疗Uu生物一群的一线用药.

Birth defect is one of the important factors that could affect the quality of the population seriously.The reasons for it are divided into genetic factors and environmental factors. There are 1/3 of birth defects caused solely by genetic or environmental factors. Additionally,over 2/3 of birth defects is caused by both genetic and environmental factors. Therefore, we are able to take appropriate preventive and treatment measures only by studying and understanding the causes of birth defects deeply and analyzing dialectically on the roles of different environmental factors in birth defects. By this way, we may improve the quality of the population which is of great practical significance.