目的 探讨低碳水化合物饮食(LCD)与限制能量平衡膳食(CRD)干预对超重/肥胖多囊卵巢综合征(PCOS)患者的体成分、代谢指标、生殖内分泌指标及妊娠的影响.方法 选择就诊于甘肃省妇幼保健院的PCOS患者285例,将患者分为LCD组、CRD组和对照组,每组95例.分别观察各组干预10周前后和干预结束4周后的体成分变化情况,以及干预前后的内分泌代谢指标变化,并随访1年后的妊娠结局.结果 LCD组和CRD组减重后的体质量指数、体重、体脂率、腰围、腰臀比和内脏脂肪等级均明显低于减重前,差异有统计学意义(P＜0.05),对照组体重、体质量指数值较减重前降低,差异有统计学意义(P＜0.05);LCD组和CRD组减重后的甘油三酯、空腹胰岛素、谷草转氨酶、谷丙转氨酶和尿酸均明显低于减重前,差异有统计学意义(P＜0.05);随访观察1年内失访情况LCD组和CRD组明显低于对照组,LCD组和CRD组PCOS患者干预后临床妊娠率明显高于对照组.结论 LCD和CRD均能有效减重,改善PCOS患者的体成分和内分泌等代谢指标,并能提高妊娠率,但CRD更适合长期减重.

目的 基于生物电阻抗分析法测量与识别多囊卵巢综合征(PCOS)患者多种亚型肥胖及体型特征,为其体重管理评估提供依据.方法应用人体成分分析仪测量1856例PCOS患者的体成分指标.结果 从消瘦到肥胖,体质量指数与人体成分各指标呈正相关关系(P<0.05).不同年龄组间正常体重、超重、肥胖以及体脂肪含量、体脂率、内脏脂肪等级等指标组间差异无统计学意义(P>0.05);18～24岁组与31～35岁组消瘦率以及肌肉量、去脂体重、骨骼肌量等指标差异均具有统计学意义(P<0.05).体脂率联合体质量指数显示,正常体重肥胖型占55.7％,肌肉减少型肥胖占3.1％.四肢肌肉指数检出肌肉减少症者11.8％.结论 PCOS患者中普遍存在体脂肪和(或)肌肉量失衡,识别正常体重肥胖型、肌肉减少型肥胖、肌肉减少症等体型,给予体重管理方案将极具临床价值.

目的 比较传统调查方法(查阅病历与床旁调查相结合,以下简称传统调查)与软件调查方法(医院感染实时监测系统,以下简称软件调查)对医院感染现患率的调查结果,为现患率调查方法的选择提供参考依据.方法 分别采用传统调查与软件调查两种方法对某院2019年11月15日0:00—24:00在院患者进行现患率调查,采用流行病学评价与统计学分析相结合的方法对调查结果进行分析.同时组成专家组,主要对医院感染诊断不明确的病例进行分析讨论,最后明确医院感染实际发生率(以下简称专家确认实际现患率).结果 传统调查、软件调查、专家确认实际现患率分别为1.37％、2.34％、1.62％,医院感染例次现患率分别为1.45％、3.79％、1.70％.传统调查、软件调查与专家确认实际现患率比较,差异无统计学意义(P>0.05).传统调查与专家确认实际现患率一致性为最强,软件调查结果与专家确认实际现患率一致性较好.软件调查与传统调查相比,灵敏度、约登指数较高,漏诊率较低,但误诊率较高.结论 调查医院感染现患率时,如果感染病例治愈信息上报执行率不高,传统调查的可靠性相对更高;如果感染病例治愈信息上报执行率较高,软件调查更优于传统调查.

Objective To determine the effects of genistein (GEN) on the proliferation and differentiation of osteoblasts isolated and cultured from ovariectomized rats. Methods Thirty 3-month-old female SD rats were divided into sham operation group (Sham), ovariectomy model group (OVX) and Gen treatment group (OVX+GEN). Their bone mineral density of whole body of was measured by dual energy X-ray absorptiometry. Three rats out of each group with bone mineral density closest to the mean value were killed after anesthesia, and osteoblasts were isolated and cultured aseptically. Cell proliferation was detected by CCK-8 assay, alkaline phosphatase (ALP) activity was detected by chemical method, and the expression of bone formation related genes Runx-2 and BMP-2 in the obtained osteoblasts was detected by RT-PCR. The number of positive clones of calcified nodules was observed after staining and the calcified area was calculated. Results The results of whole-body bone mineral density showed that the whole-body bone mineral density was significantly lower in the OVX group than the sham group, while that in the OVX+GEN group was significantly higher than that in the OVX group (P < 0.01). The OVX group had significantly lower cell proliferation, ALP activity, expression levels of Runx-2 and BMP-2 and calcified nodule area when compared with the sham group (P < 0.01), while the OVX +GEN group had obviously higher results of above tests than the OVX group (P < 0.01). Conclusion Gen can improve the bone mineral density of osteoporosis in OVX rats, which may be related to its ability to promote osteoblast proliferation, maturation and mineralization.

目的 研究白藜芦醇(resveratrol,R)抗切除卵巢大鼠发生骨质疏松的作用.方法 6月龄Wistar雌性大鼠40只,随机数字表法分为假手术组(Sham)、去卵巢组(OVX)、淫羊藿苷组(I)和白藜芦醇组(R).I组给予25 mg/(kg·d)的淫羊藿苷灌胃,R组给予8.4 mg/(kg·d)的白藜芦醇灌胃,Sham和OVX组灌胃等体积蒸馏水.根据体质量每两周进行一次灌胃剂量调整.8周后待各组间骨密度出现显著性差异后立即处死,统计大鼠体质量并计算大鼠器官指数,检测离体骨密度、骨生物力学、血清生化指标,观察骨组织形态并测量分析骨小梁相关静态参数.结果 各组大鼠体质量并未出现统计学差异,除子宫系数外其他器官指数无统计学差异(P>0.05),但OVX组的子宫指数显著低于Sham组(P<0.05),I组和R组子宫指数显著高于OVX组(P<0.05);与OVX组相比,I组和R组的骨密度、最大载荷、弹性模量、骨形成指标OC以及Tb.N、BV/TV均显著升高(P<0.05),而骨吸收指标TRACP-5b含量和Tb.SP均显著降低(P<0.01);骨组织形态观察结果也显示I组和R组骨小梁网状结构呈致密性增加,骨小梁数目明显变多.R组与I组相比,其各指标平均值略低于I组,差异均无统计学意义(P>0.05).结论 白藜芦醇可能通过增加骨密度、提高骨强度、促进骨形成、抑制骨吸收、改善骨质量从而发挥抗骨质疏松的作用.

目的:探讨标准化营养干预对男性单纯性超重/肥胖患者的影响.方法:纳入符合标准的206例男性超重/肥胖患者,采取标准化饮食营养干预30天,比较干预前后肥胖相关指标体重、体重指数(BMI)、腰臀比(WHR)、腰围(WC)、体脂肪、内脏脂肪面积(VFA)及瘦体组织等相关指标骨骼肌、蛋白质、无机盐、基础代谢的变化.结果:干预后患者体重、BMI、WHR、WC、体脂肪、VFA均较干预前降低(P<0.05);而骨骼肌、蛋白质、无机盐、基础代谢在减重前后差异无统计学意义(P>0.05).结论:标准化营养干预可有效改善超重/肥胖患者体重,而不影响瘦体组织相关指标,对减重后体重的维持具有重要意义.

目的 观察健脾方联合营养指导治疗小儿厌食症的临床疗效,方法 将60例小儿厌食症患者,随机分为两组.对照组采用常规治疗,治疗组给予健脾方治疗,两组均治疗1月后判定疗效.结果 治疗组总有效率为90.0％,对照组总有效率为76.7％,两组总有效率比较差异有统计学意义(P<0.05);治疗后,两组治疗后中医证候积分均低于治疗前,且治疗组优于对照组,差异有统计学意义(P<0.05);治疗后两组患者Zn、Fe、Ca均升高,治疗组较对照组升高明显,(P<0.05).结论 健脾方联合营养指导能够改善小儿厌食症临床症状,疗效显著.

Objective To study the effects of the compound medicine of icariin and puerarin on peak bone mass in rats during growth period, and to explore its possible mechanism. Methods Forty female Sprague-Dawley rats aged 1 month were randomly divided into normal control group( C), icariin group( I), puerarin group( P), icariin and puerarin compound groupc(I+P), 10 in each group. The body weights were recorded once every two weeks, and the bone mineral density was measured by dual-energy X-ray absorptiometry every month. After the bone mineral density of the whole body was significantly different between the control group and drug groups the animals were sacrificed. The right femur and vertebrae were separated to measure the bone mineral density. The biomechanical properties of the femur and vertebra were detected by AG-IS series desktop electronic universal testing machine. The bone formation index osteocalcin, PINP and bone resorption index were determined by ELISA. Changes in the contents of tartrate-resistant acid phosphatase 5b(TRACP 5b) and CTX-1; and changes in trabecular bone related parameters were recorded after magenta-picric acid staining. Results There was no significant difference in body weight between the two groups (P＞0.05). There was no significant difference in whole body bone density after 1 month of treatment (P＞0.05). After 2 months of treatment, the body bone density of the drug-administered group was higher than that of the control group. Whole body bone density, femur and vertebral bone density, femur maximum load value, maximum vertebrae load value and trabecular bone number and area, serum OC and PINP levels increased, while TRACP 5b and CTX-1 levels decreased(P＜0.01) in drug group. The difference from the control group was statistically significant (P＜0. 05). There were significant differences in biochemical parameters and bone histomorphology between the compound drug group and the two-flavor monomer group ( P＜0. 01). There was no significant difference in bone mineral density and biomechanics, but the average value was higher than that of the monomer group. Conclusion The combination of icariin and puerarin can effectively increase the peak bone mass in rats.