脑垂体移植的实验研究 Ⅲ 移植垂体的內分泌功能重建

本文在两种基因型不同的兔间行垂体移植术,以PRL、LH、T_4水平检测植于下丘脑正中隆起下方的垂体内分泌功能的重建情况。短期观察表明。仅在免疫抑制剂联合治疗下,植入的幼兔垂体才能存活,有分泌功能,且受下丘脑激素调控。而植入的成年兔垂体,应用了免疫抑制剂仍不能克服排异,移植没有成功。     

兔下丘脑-垂体移植的内分泌功能研究

目的：探讨幼兔的下丘脑—垂体异体异位移植后内分泌重建的可能性。方法：以徒手定向穿刺成兔垂体区，射频毁损垂体建立去垂体动物模型，将制备好的幼兔的下丘脑-垂体组织植入模型兔的臀部肌肉内，放免测定术后1、3及8W血清T4、PRL、GH水平。结果：垂体去除组上述激素水平持续下降。移植组术后8W上述激素恢复到术前水平。结论：下丘脑-垂体细胞的异体异位移植，内分泌过继可靠。     

新生鼠垂体颅内移植后激素水平及组织学观察

大白鼠28只,分为3组。正常对照组15只不手术,垂体切除组8只,垂体移植组5只。移植组采用新生鼠垂体颅内移植。术后4周取血标本测血清泌乳素、T_3、T_4水平,后以10%福尔马林心内注射处死全部动物并固定。结果示,光镜下移植组织全部成活,血激素水平及靶腺器官组织学检查表明移植组织有部分内分泌功能。     

颅脑损伤后垂体前叶功能紊乱的临床分析

目的探讨急性颅脑损伤(TBI)患者垂体前叶功能紊乱的临床特点。方法选取我院2013年10月至2014年10月TBI后78例患者,采用放射免疫定量分析法对血清PRL、FSH、LH和TSH水平进行测定。结果急性颅脑损伤后早期血PRL、FSH、LH水平较与照组比较差异显著(P0.05),PRL、FSH、LH水平随时间推移逐渐降至正常范围。不同程度颅脑损伤垂体前叶激素水平比较中,轻、中、重型颅脑损伤组PRL、FSH、LH水平均高于对照组,但中型、重型组激素水平与对照组差异显著(P0.05),本次统计显示颅脑损伤程度越重,上升的幅度越大。结论颅脑损伤后会在1周内引起垂体前叶功能紊乱,PRL、FSH、LH水平会明显升高,颅脑损伤后垂体前叶激素水平与损伤程度有关。     

冻存兔脑垂体移植后内分泌功能重建

本文以正常对照、垂体全切除和新鲜新生兔脑垂体移植组为参照，探讨了冻存再植垂体的内分泌功能重建。结果表明，冻存再植垂体体内成活，并有分泌功能。环孢素Ａ（ＣｓＡ）的服用对新鲜垂体移植组作用显著，但在冻存垂体移植组无显著效应，提示冷冻保存改变了移植物的免疫原性     

糖尿病性功能减退患者血清内分泌功能的变化

目的:通过测量糖尿病性功能减退(ED)患者血清中内分泌功能的变化,探讨ED的发病与内分泌功能的关系。方法:选取糖尿病ED患者32例(A组),无糖尿病的ED患者32例(B组),采用荧光分辨免疫学方法分别测定两组血清中PRL、FT3、FT4、TSH、E2、T、FSH、LH的变化。结果:A组患者血清中甲状腺功能PRL水平均在正常范围内,与正常人无明显差异,其中8例糖尿病ED患者血清中T水平轻度减轻,且FSH、LH轻度下降,B组患者PRL、FT3、FT4、TSH、T水平均无明显变化。结论:糖尿病ED病人腺垂体功能可能受损。     

大鼠自体垂体移植功能重建成功

将WKY 大鼠自体垂体移植于正中隆起下方的促垂体区或颈部皮下,2周后大鼠体温恢复正常,体重逐渐增加.3周后血清PRL、TSH 水平达术前正常水平.提示移植垂体功能恢复正常.     

盐酸纳洛酮对颅脑伤垂体激素和甲状腺激素的影响

目的探讨颅脑伤后早期应用纳洛酮对改善垂体前叶激素和甲状腺激素紊乱的作用及其临床意义。方法40例颅脑伤患者分为常规治疗组18例和纳洛酮治疗组22例，分别测定其入院时、入院后第1、2、3天的垂体前叶激素和甲状腺激素水平，并对结果进行统计学处理。结果纳洛酮治疗组PRL较常规治疗组差异有显著性，且LH、PRL呈现时间效应。结论颅脑损伤可引起垂体前叶激素及甲状腺激素分泌紊乱；而脑外伤后早期应用纳洛酮可促进垂体前叶激素及甲状腺激素的早期恢复，纠正内分泌紊乱。     

双侧卵巢肿瘤手术后的全身内分泌变化

对31例因卵巢肿瘤而作双侧卵巢肿瘤手术后的患者进行随访,其中20例妇女测定了血清T_3、T_4、TSH、E_2、FSH、LH、PRL、睾酮、孕酮、皮质醇10种激素的浓度。结果。PRL升高者占60％;T_3、T_4或TSH升高者占50％;睾酮、皮质醇升高者各占20％;FSH、LH升高者占35％;孕酮和E_2升高者各占15％。以上结果提示,双侧卵巢手术后患者的性激素变化较小,而甲状腺、肾上腺、垂体激素的变化极大。     

人脑垂体移植的初步报告

本文报告9例席汉氏综合征用胎儿脑垂体移植治疗,将1～4个新鲜脑垂体经口-鼻-蝶入路移植于促垂体区.手术无死亡率和并发症,术后给以环孢素以抑制急性排斥反应,并定期测定内分泌水平.随访观察12～30个月(平均16个月),临床症状均有不同程度的改善,内分泌水平较移植前显著增高,表示脑垂体移植存活并发挥其内分泌功能.     

An experimental study of pituitary transplantations in rabbits.

Experimental pituitary transplantations were carried out between the New Zealand white and American chinchilla rabbits. These two kinds of experimental rabbits were of different genotypes. The grafts were transplanted underneath the median eminences of the recipients after hypophysectomy. The rabbits with the transplants were treated with cyclosporine (CsA) and prednisone for the first month. Blood samples were taken at regular intervals for the determinations of serum thyroxine, prolactin and luteinizing hormone. The results suggested that neonatal grafts could survive and function almost normally with the aid of CsA and prednisone, but not without them. The results also disclosed that the interrelationship between the pituitary graft and the host's hypothalamus could be established. Pituitary transplantation from adult rabbit donors failed even though the recipients had been treated with CsA and prednisone in our experiment.

     

Testicular dysfunction in men with sickle cell disease

In order to assess the role of the gonads and anterior pituitary gland in the production of poor quality semen of males with homozygous sickle cell disease (SCD) serum gonadotrophins, namely follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin and serum testosterone, were assayed radioimmunologically in 33 men with sickle cell disease and in 29 age-matched normal control subjects. Our results show a significantly lower mean serum testosterone, a higher mean FSH and prolactin in SCD subjects than in normal controls. No single SCD subject had significantly low serum testosterone associated with low FSH, LH or prolactin. The tendency for higher gonadotrophins associated with lower testosterone in subjects with SCD suggests that the hypothalamic/pituitary function in these patients is intact and that the primary fault leading to poor sperm production lies in the testes.     

肿胀吸脂联合乳晕下弧形切口治疗中重度男性乳房肥大症

目的探讨肿胀麻醉吸脂联合乳晕下缘弧形微创切口腺体切除术治疗男性乳房肥大的方法和临床疗效。方法自2002年4月—2012年6月,收治29例男性乳房肥大患者。年龄16～47岁。单侧3例,双侧26例。其中脂肪型14例,脂肪混合型13例,腺体型2例。其中3例PRL、LH、FSH、E2水平增高,睾酮水平较低;其余患者体内相关激素水平正常,以上患者均采用肿胀吸脂联合乳晕下弧形切口腺体切除术。结果 1例患者于术后2 d出现皮下血肿,经对症处理后最终一期愈合;1例乳头下乳腺组织残留过多,经二次整复后效果满意,其他病例切口均Ⅰ期愈合。未见乳头、乳晕缺血、坏死及乳头感觉功能减退等并发症发生。20例患者随访,随访日期6～24个月,乳房外形良好,无复发。结论肿胀吸脂联合乳晕下弧形切口腺体切除术具有瘢痕小、安全性高、外观自然、患者满意度高等优点,是目前治疗男性乳房发育有效方法之一。     

An association of elevated serum prolactin with phthalate exposure in adult men

Objective To investigate the associations of hormone circulation with phthalate exposure in adult men. Methods Semen and serum samples were collected from 118 men who were suspected of infertility. Phthalate diesters including dibutyl phthalate (DBP) and diethylhexyl phthalate (DEHP) in both semen and serum samples were measured, along with serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T), estradiol (E 2 ) and prolactin (PRL). Results Serum PRL was positively as...     

Cyclosporine treatment in idiopathic membranous nephropathy nephrotic syndrome in adults: a retrospective study spanning 15 years

Background  Cyclosporine is effective in treating nephrotic syndrome (NS) with idiopathic membranous nephropathy (IMN) in adults. But high relapse rate remains a major concern. The way to manipulate cyclosporine is inconclusive. The aim of this study was to introduce the way how to titrate the cyclosporine to maintain complete remission without relapse.

Methods  Patients with biopsy-proven IMN with NS treated with cyclosporine for at least 1 month from 1996 to 2011 at Peking Union Medical College Hospital were reviewed.

Results  Mean age of the 51 eligible patients was 52 years, with 39 men. Mean proteinuria was (7.47±3.14) g/d, serum albumin (24.50±6.29) g/L, and serum creatinine (82.62±21.18) mmol/L. Cyclosporine was commenced at a mean dose of (3.46±0.63) mg·kg^-1·d^-1. Oral prednisone (0.40±0.29) mg·kg^-1·d^-1 was given concomitantly in 38 patients. Cyclosporine was administered for a median of 16 months (range 1–93 months) and stopped in non-responders by month six. By month 3 (n=47), the number in complete remission (CR) and partial remission (PR) was 3 and 24, which shifted to 12 and 17 by month 6 (n=41). Male gender, heavy proteinuria, low serum albumin level, and high serum creatinine level were significant determinants in poor response by month six (P <0.05 in all variables compared with responders). There was a significant reversible serum creatinine increase within 25% during month 3 to 12 (P <0.05 in all variables compared with baseline value). Eleven patients maintained cyclosporine for more than 24 months with a cyclosporine dose of (1.04±1.06) mg·kg^-1·d^-1. Nine patients were in CR. Renal function, systolic and diastolic blood pressure remained stable. Renal impairment (>30% rise of serum creatinine), secondary infection, hypertension, gingival hyperplasia and liver impairment occurred in 6, 4, 10, 4, and 1 patients, respectively.

Conclusions  The observation time for cyclosporine to effectively induce CR of NS in IMN adults should be at least six months. Long-term and low-dose of cyclosporine therapy is safe and effective to maintain CR in those responders.

     

芍药甘草丸对精神分裂症患者高催乳素血症的影响

目的 观察不同配比的芍药甘草丸对利培酮所致女性精神分裂症患者血清催乳素的影响。方法 120 例患者随机分为A 组 40 例（利培酮）、B 组 40 例（芍药∶甘草＝ 1∶1,利培酮）、C 组 40 例（芍药∶甘草＝ 2∶1,利培酮）,观察治疗前、治疗4 周、治疗 8周、治疗12 周后3 组患者血清催乳素水平变化,采用阳性与阴性症状量表（PANSS）评定治疗前后效果,采用副反应量表（TESS）评定治疗前后药物不良反应。 结果 治疗4 周、8 周、12 周后,B 组、C 组与A 组患者比较,血清催乳素水平均明显下（P<0.05）,C 组与 B 组患者比较,血清催乳素水平均明显下降（P<0.05）。提示芍药甘草丸（芍药∶甘草＝ 2∶1）相对于芍药甘草丸（芍药∶甘草＝ 1∶1）可以更大程度地降低女性精神分裂症患者血清催乳素水平。 结论 芍药甘草丸能降低抗精神病药利培酮所致女性精神分裂症患者血清催乳素水平,但芍药甘草丸尤以 2∶1的配比能最大程度地降低血清催乳素水平,且不影响抗精神病药利培酮的临床疗效。     

多囊卵巢综合征患者血清脂肪型脂肪酸结合蛋白水平与性激素及血脂的相关性研究

目的探讨多囊卵巢综合征(PCOS)患者血清中脂肪型脂肪酸结合蛋白(FABP)4浓度的变化与性激素及血脂的相关性。方法对29例PCOS患者及14例正常对照组应用ELISA方法检测血清中FABP4水平,化学发光法检测血清中泌乳素、促黄体生成素、卵泡刺激素、雌二醇和睾酮水平,放射免疫法检测血清中雄烯二酮水平;全自动生化分析仪检测血清中甘油三酯、总胆固醇、高密度脂蛋白-胆固醇(HDL-C)、低密度脂蛋白-胆固醇(LDL-C)浓度;分析FABP4与性激素及血脂的关系。结果PCOS组血清FABP4水平明显高于正常对照组[(24±15)ng/mlvs(9±8)ng/ml,P<0.01]。单因素相关分析显示,FABP4水平与体重指数(r=0.621,P<0.01)及睾酮(r=0.658,P<0.05)呈正相关,与HDL-C(r=-0.331,P<0.05)呈负相关。偏相关分析显示,FABP4与睾酮(r=0.507,P<0.01)呈正相关,与其他因素无明显相关(P>0.05)。结论PCOS患者血清中FABP4的升高可能与PCOS患者的高雄激素血症有关;FABP4可能参与了PCOS的血脂代谢紊乱以及远期心血管疾病的发生。     

癌症患者腺垂体激素分泌功能的变化研究

目的 研究癌症患者腺垂体激素分泌功能的变化。方法 用放射免疫法[fj-2008ps1]测定171例癌症患者与46例正常对照组的泌乳素(PRL)，生长激素(GH)，促卵泡生成激素(FSH)，促黄体生成激素(LH)和促甲状腺激素(TSH)的血清水平。结果 癌症患者组与正常对照组比较患者血清PRLGH，LH和FSH均增高，但TSH无显著差异；肿瘤转移组与非转移组比较则无显著差别；不同脏器恶性肿瘤间垂体激素水平也无显著差异。结论 癌症患者腺垂体激素分泌功能亢进，除TSH水平变化不显著外，其他4种垂体激素水平皆升高显著，这有助于我们了解癌症患者的机体变化。     

生麦芽生物碱对高泌乳素血症模型大鼠激素水平的影响

目的 研究生麦芽生物碱对高泌乳素血症（HPRL）模型大鼠泌乳素（PRL）、雌二醇（E2）、孕酮（P）等激素的影响,初步明确生麦芽回乳作用的有效部位。方法 选用雌性未孕Wistar大鼠,背部皮下注射盐酸甲氧氯普胺注射液制备HPRL模型。造模成功后,各组均胃饲给予相应的药物治疗,连续20 d。末次给药后取血,应用ELISA法检测血清中PRL、E2、P、促卵泡激素（FSH）、促黄体生成素（LH）的含量,观察生麦芽不同提取部位对HPRL大鼠各激素水平的影响。结果 与模型组比较,生麦芽生物碱高、低剂量组大鼠血清PRL水平明显下降（P＜0.01）,高剂量组还可升高E2、P水平（P＜0.05或P＜0.01）。结论 生麦芽生物碱对HPRL模型大鼠有保护作用,其作用机制可能与其对PRL、E2、P激素水平的调节作用有关。