随着国家三孩政策的开放,有生育需求的男性越来越多,越来越注重生殖健康.长期以来,癫痫患者生殖健康的关注主要在女性群体中,而对于男性癫痫患者生殖健康的研究较少.但据流行病学统计,男性癫痫患者多于女性.此外,有研究发现癫痫本身与抗癫痫药物对男性生殖功能均会产生不利影响.本文对癫痫本身与抗癫痫药物对男性癫痫患者生殖功能产生不利影响的作用机制作一综述.

目的 通过分析基线资料、精液、性激素和性功能相关指标,了解男性癫痫患者(Male patients with epilepsy,MPWE)与健康男性的差异,探讨影响MPWE生殖功能的相关危险因素,降低不育风险.方法 收集2019年2月-2020年2月在大理大学第一附属医院神经内科住院和门诊就诊的112例MPWE资料.选取与调查组年龄相匹配的健康男性志愿者67名作为对照组.所有研究对象完成精液及性激素指标检测.有性生活经历者需完成国际勃起功能指数量表简化版问卷(IIEF-5)和早泄诊断工具自测量表(PEDT).MPWE完成其生活质量评定量表(QOLIE-31).比较MPWE与健康对照者的基线资料、精液质量、性激素水平和性功能问卷评分.此外,根据男性生殖功能异常诊断标准,将MPWE分为生殖功能异常组和正常组,采用单因素分析及二元Logistic回归分析,MPWE生殖功能的相关危险因素.结果 与健康对照组相比,MPWE已婚和已育的比例、睾酮水平、精子浓度、精子存活率和IIEF-5得分显著降低(P＜0.05).MPWE生殖功能异常组与正常组相比,年龄、体重指数、癫痫发作频率和药物类型存在显著差异(P＜0.05);QOLIE-31量表得分中,异常组的总分和精力显著低于正常组(P＜0.05).二元Logistic回归分析提示,精力[B=-0.033,OR=0.967,95％CI(0.937,0.999)],年龄[B=0.879,OR=2.408,95％CI(1.070,5.416)],癫痫发作频率[B=1.788,OR=5.976,95％CI(2.031,17.589)].结论 MPWE的生殖功能较健康男性低下,且总分、精力、年龄、体重指数、癫痫发作频率和药物类型会明显影响MPWE的生殖功能.其中精力、年龄和癫痫发作频率是影响MPWE生殖功能的独立危险因素,且生殖功能异常与年龄和癫痫发作频率呈正相关,而与精力得分呈负相关.

目的 观察甘草苷对脑卒中后抑郁(PSD)大鼠额前皮质脑源性神经营养因子(BDNF)及凋亡因子Bax、Bcl-2蛋白表达的影响.方法 随机选择SD大鼠10只为正常对照组.另50只SD大鼠用线栓法建立局灶性脑缺血大鼠模型后,随机分为脑卒中组、PSD组、甘草苷组、西酞普兰组和生理盐水组,每组10只,后4组大鼠再建立PSD模型.造模第43天时,各组大鼠额前皮质取材,用免疫荧光染色测大鼠BDNF和Bax、Bcl-2阳性细胞表达;用Western blot测各组BDNF和Bax、Bcl-2蛋白表达.结果 各组大鼠额前皮质均可见BDNF、Bax及Bcl-2发红色荧光的阳性细胞表达.与正常对照组比较,PSD组大鼠BDNF及Bcl-2吸光度(A)值明显降低,Bax A值明显升高(P＜0.05);与甘草苷组比较,PSD组、脑卒中组及生理盐水组大鼠BDNF、Bcl-2 A值明显降低,Bax A值升高(P＜0.05);与西酞普兰组比较,PSD组大鼠BDNF、Bcl-2 A值明显降低(P＜0.05),Bax A值明显升高(P＜0.05).与正常对照组比较,PSD组大鼠BDNF、Bcl-2蛋白表达明显减少(P＜0.05),Bax蛋白表达明显增多(P＜0.05);与甘草苷组比较,PSD组、脑卒中组及生理盐水组大鼠BDNF、Bel-2蛋白表达明显减少,Bax蛋白明显增多(P＜0.05);与西酞普兰组比较,PSD组大鼠BDNF(0.151±0.013 vs 0.252±0.013)、Bcl-2(0.199±0.057 vs 0.338±0.062)蛋白表达明显减少,Bax蛋白(0.448±0.023 vs 0.358±0.012)明显增多(P＜0.05).结论 中药甘草苷可能有减少PSD大鼠额前皮质促凋亡因子Bax表达和(或)促进抗凋亡因子Bcl-2及BDNF表达的作用.

Background Previous studies have implicated reduced brain-derived neurotrophic factor (BDNF) expression and BDNF-TrkB receptor signaling as well as microglial activation and neuroinflammation in poststroke depression (PSD). However, the contributions of microglial BDNF-TrkB signaling to PSD pathogenesis are unclear. Material/Methods We compared depression-like behaviors as well as neuronal and microglial BDNF and TrkB expression levels in the amygdala, a critical mood-relating limbic structure, in rat models of stroke, depression, and PSD. Depression-like behaviors were assessed using the sucrose preference test, open-field test, and weight measurements, while immunofluorescence double staining was employed to estimate BDNF and TrkB expression by CD11b-positive amygdala microglia and NeuN-positive amygdala neuron. Another group of PSD model rats were examined following daily intracerebroventricular injection of proBDNF, tissue plasminogen activator (t-PA), or normal saline (NS) for 7 days starting 4 weeks after chronic unpredictable mild stress (CUMS). Results The numbers of BDNF/CD11b- and TrkB/CD11b-immunofluorescence-positive cells were lowest in the PSD group at 4 and 8 weeks after CUMS (P<0.05). PSD rats also showed reduced weight, sucrose preference, locomotion, and rearing compared with controls (P<0.05). The coexpression of BDNF/NeuN- and TrkB/NeuN-positive cells were not significantly different between groups at 4 and 8 weeks after CUMS (P>0.05). Injection of t-PA increased BDNF/CD11b- and TrkB/CD11b-positive cells in the amygdala of PSD rats and normalized behavior compared with NS or proBDNF injection (P<0.05). In contrast, proBDNF injection reduced BDNF and TrkB expression compared with NS (P<0.05). Conclusions These results suggest that decreased BDNF and TrkB expression by amygdala microglia may contribute to PSD pathogenesis and depression-like behaviors.

目的:观察甘精胰岛素联合二甲双胍对老年新发2型糖尿病的治疗效果.方法纳入并分析2017年1月至2018年3月我院收治的老年2型糖尿病患者的临床资料.依据治疗方案的不同分为观察组及对照组.治疗6个月后,比较两组总胆固醇(TC)、低密度脂蛋白(LDL-c)、甘油三脂(TG)、糖化血红蛋白(HbA1c)、胰岛素抵抗指数(HOMA-IR)及胰岛细胞功能指数(HOMA-)的改变.结果:治疗后,两组患者HbA1c及HOMA-IR均显著降低(P<0.05),但观察组显著低于对照组(P<0.05);治疗后两组HOMA-均显著升高(P<0.05),而观察组高于对照组患者的水平(P<0.05).治疗后,两组患者TG、TC及LDL-C水平均降低(P<0.05),但观察组低于对照组(P<0.05).结论:在老年新发2型糖尿病的治疗中,甘精胰岛素联合二甲双胍的临床疗效优于单独使用二甲双胍.

目的:观察胰岛素泵联合二甲双胍强化治疗新诊断2型糖尿病的效果.方法60例新诊断2型糖尿病患者随机分为试验组和对照组治疗20d后评价其临床疗效.结果:治疗后两组血糖均下降(P<0.05),但试验组血糖控制更好,且血糖达标时间更短,血糖完全达标的人数更多,差异有统计学意义(P<0.05).试验组的胰岛素抵抗改善也更明显(P<0.05),胰岛素用量比对照组少,体重增加更少,差异有统计学意义(P<0.05).结论:胰岛素泵合用二甲双胍治疗新诊断2型糖尿病能更有效地控制血糖,减轻胰岛素抵抗和减少体重增加.

辣椒素是辣椒中的一种辛辣成分,可通过结合辣椒素受体,使细胞内钙离子浓度升高,引起神经元及其纤维释放多种神经肽,具有抗炎、镇痛、扩张心血管、保护胃黏膜及抗肿瘤等作用.

寝室作为大学生学习、生活的主要阵地,也是建立和谐人际关系的基础,良好的寝室文明氛围是大学生学习、生活的重要保障.开展并加强寝室文化建设有利于提升学生遵章守纪意识、强化文化修养、树立集体观念.

Objective:to investigate the mental health status of bus drivers in Wangcheng District of Changsha city. Method:self made questionnaire, expert review, by the independent completion of the subjects. Result:the psychological problems such as easy trouble and excitement, headache, and breaking things were more prominent, and the differences of body, hostility, sleep quality and diet were all higher than that of the general population. Conclusion:there is a close relationship between the occurrence of human error and the mental health of drivers in driving safety.

目前,在全国城市广泛开展的社区卫生服务试点和推广工作取得初步成效,显示出其旺盛的生命力和广阔的发展前景.与此同时也面临不少的困难和问题,其中全科医生队伍建设问题突出,全科医学人才的严重匮乏已经成为制约我国社区卫生服务可持续发展的一大"瓶颈".

Objective To investigate the positive rate of 1 types of antigen in different sex and age of the patients with pul-monary infection in Changsha City, and provide a preliminary basis for the study of the prevalence of lung infection in pa-tients with lung infection. Methods 100 patients with pulmonary infection were detected by immune colloidal gold tech-nique, and the urine of 1 patients with lung infection were detected. SPSS12.0 statistical software for statistical analysis. Results Of 100 cases of pulmonary infection were collected in the urine were detected, Legionella urinary antigen was posi-tive in 1 case, total positive rate of 1%;the positive rate of male patients for 2% (1 / 50) and female patients (0 0/50); 41-60 years of age in patients with positive rate was 2.3% (1 / 42) and the rest of the age group of 0. Conclusion Changsha City lung infection in patients with eosinophilic lung infection of Legionella, and there is a certain difference in sex and age, for the further study of thermophilic pneumophila in Changsha City lung infection in patients with epidemic situation provides a preliminary experimental basis for, and for the Legionella disease monitoring and treatment has certain directive significance.

目的：了解湖北大悟县红色文化的历史背景，探讨当地红色老区在现代化进程中的发展定位。方法：采用自编问卷对湖北省大悟县287名居民进行调查结果。结果：湖北大悟县革命精神传承成效欠佳，对待革命精神的态度不一，绝大多数居民比较重视革命精神（61.58%）、非常重视（36.84%）、完全不重视（1.58%）；当地红色老区尚未完全推向市场，旅游服务体系仍处于发展阶段。结论：针对革命精神传承成效及红色老区不完全开发，政府及社会应采取措施，改变革命精神传承现状、加快红色老区的旅游开发、完善旅游服务体系。