Functional cerebral asymmetries during the menstrual cycle: a cross-sectional and longitudinal analysis

This study aims at answering two basic questions regarding the mechanisms with which hormones modulate functional cerebral asymmetries. Which steroids or gonadotropins fluctuating during the menstrual cycle affect perceptual asymmetries? Can these effects be demonstrated in a cross-sectional (follicular and midluteal cycle phases analyzed) and a longitudinal design, in which the continuous hormone and asymmetry fluctuations were measured over a time course of 6 weeks? To answer these questions, 12 spontaneously cycling right-handed women participated in an experiment in which their levels of progesterone, estradiol, testosterone, LH, and FSH were assessed every 3 days by blood-sample based radioimmunoassays (RIAs). At the same points in time their asymmetries were analyzed with visual half-field (VHF) techniques using a lexical decision, a figure recognition, and a face discrimination task. Both cross-sectional and longitudinal analyzes showed that an increase of progesterone is related to a reduction in asymmetries in a figure recognition task by increasing the performance of the left-hemisphere which is less specialized for this task. Cross-sectionally, estradiol was shown to have significant relationships to the accuracy and the response speed of both hemispheres. However, since these effects were in the same direction, asymmetry was not affected. This was not the case in the longitudinal design, where estradiol affected the asymmetry in the lexical decision and the figural comparison task. Overall, these data show that hormonal fluctuations within the menstrual cycle have important impacts on functional cerebral asymmetries. The effect of progesterone was highly reliable and could be shown in both analysis schemes. By contrast, estradiol mainly, but not exclusively, affected both hemispheres in the same direction.     

血清孕酮、β-HCG水平在异位妊娠诊断中的作用研究

目的:探讨血清孕酮、HCG在早期诊断异位妊娠中的价值。方法:采用放射免疫方法(RIA)测定我院2009年1月～2010年1月来门、急诊确诊异位妊娠120例患者(异位妊娠组)血孕酮、β-HCG水平,并测定同期确诊的86例先兆流产(先兆流产组)和72例难免流产(难免流产组)作对比研究。结果:异位妊娠组血清孕酮值显著低于其它两组(P<0.05);异位妊娠组β-HCG值与先兆流产组差异显著(P<0.05),但与难免流产组间无差异(P>0.05)。48h后血清β-HCG值上升幅度≥50%者中,仅10.3%为异位妊娠,89.7%为先兆流产;在下降幅度≥50%者中,82.8%为难免流产,17.2%为异位妊娠。结论:血清孕酮检测简便、快捷,可作为一种早期诊断异位妊娠的手段,β-HCG值间隔48h测定对异位妊娠的鉴别诊断有一定意义。     

血清β-HCG与孕酮联合测定对早期异常妊娠的诊断价值

目的通过监测血清β-HCG与孕酮水平,探讨其在诊断早期异常妊娠的临床价值。方法将我院收治的318例早期异常妊娠患者按照妊娠结局类型分为先兆流产组136例、难免流产组104例和异位妊娠组78例,并对三组血清β-HCG与孕酮水平进行监测。结果当日检测异位妊娠组β-HCG值及孕酮均最低;48h后检测异位妊娠组血清β-HCG值变化很小(P>0.05),而先兆流产组血清β-HCG值上升或难免流产组β-HCG值下降变化显著(P<0.05)。结论血清β-HCG与孕酮水平的联合监测对早期异常妊娠的诊断和治疗有重要的临床意义。     

黄体酮对大鼠局灶性脑缺血后血脑屏障的保护

目的研究黄体酮对局灶性脑缺血后血脑屏障的保护作用。方法将48只老年大鼠随机分为假手术组（Sham）、脑缺血组（Ischemia）、安慰剂组（Vehicle）、黄体酮组（PROG）,每组12只,其中6只用来进行梗死体积测定,6只用来测定血脑屏障连接粘附分子-A（junctional adhesion molecule-A,JAM-A）。利用大脑中动脉栓线阻断法（middle cerebral artery occlusion,MCAO）造成大鼠局灶性脑缺血损伤模型,通过氯化四唑（tetrazolium chloride,TTC）染色测定梗死体积,应用Western blot技术检测JAM-A蛋白水平的表达。结果黄体酮能有效减少脑梗死体积和血脑屏障的破坏;黄体酮能在蛋白水平阻断JAM-A的下调。结论黄体酮能通过阻断JAM-A的下调减少脑缺血后血脑屏障的破坏,减小脑梗死体积。     

雌激素孕激素及受体在肝门部胆管癌中的表达

目的探讨雌、孕激素(ER、PR)及其受体在肝门部胆管癌的发生中的作用。方法应用放射免疫法测定42例肝门部胆管癌患者血中的雌、孕激素水平；应用免疫组织化学法，检测其组织中ER及PR表达水平。结果42例肝门部胆管癌患者中，雌、孕激素高于正常者分别占73．8％和69．0％，ER及PR阳性表达率分别为66．7％、和64．3％。与对照组相比，雌、孕激素水平及受体表达具有明显差异。结论肝门部胆管癌患者中，多数雌、孕激素水平高，ER及PR表达率高。雌、孕激素及受体可能在肝门部胆管癌发生和发展过程中起重要作用。     

乳腺癌组织PTEN和nm23蛋白表达与乳腺癌生物学特性相关性的探讨

目的研究ER、PR、nm23及PTEN基因蛋白在乳腺癌中的表达及临床病理意义。方法采用免疫组织化学S—P法,检测石腊包埋42例乳腺癌组织和12例乳腺小叶增生中PTEN蛋白、nm23蛋白、ER和PR的表达水平。结果PTEN在乳腺癌高表达比乳腺小叶增生低（P〈0．05）。PTEN基因表达与肿瘤大小、临床分期、组织分级和肿瘤复发无相关性,小于45岁患者PTEN表达比大于45岁偏低（P〈0．05）;PTEN高表达与腋淋巴结转移情况有显著负相关性（P〈0．01）;与ER受体呈正相关性。PTEN基因高表达与远处转移有负相关性（P〈0．05）;与5年生存率呈正相关性（P〈0．01）。乳腺恶性肿瘤组织中nm23高表达率与良性组织比较差异无显著性（P〉0．05）。nm23基因表达与肿瘤大小、临床分期、组织分级、肿瘤复发及年龄无相关性,nm23高表达与腋淋巴结转移情况有显著正相关性（P〈0．001）,nm23高表达与患者远处转移有显著负相关性（P〈0．001）。与患者5年生存率有正相关性（P〈0．05）。结论nm23与PTEN表达异常与乳腺癌发生发展密切相关,联合检0n．4ER、PR、nm23及PTEN基因的表达可作为一种预测乳腺肿瘤预后和恶性程度的指标。     

3,5-甾二烯化合物的合成及抗早孕活性

以18-甲基-17β-羟基-17α-乙炔基-雌甾-4-烯-3-酮(18-甲基炔诺酮),17β-羟基-17α-乙缺基-雌甾-4-烯-3-酮(炔诺酮),17β-羟基-17α-乙炔基-雄甾-4-烯-3-酮(妊娠素)和17a-羟基孕甾-4-烯-3,20二酮(17α-羟基黄体酮)为原料,经NaBH,还原、脱水、双键转位和酯化等反应合成一系列3,5-甾二烯化合物,用¹HNMR和MS证明了它们的结构。动物筛选结果表明,17β-丙酰氧基-17α-乙炔基-雌甾-3,5-二烯(IV_b2有明显的抗早孕活性。中断早期妊娠的作用似与其雌激素活性有关。     

黄体酮、雌二醇对豚鼠离体胆囊肌条收缩的活动影响

目的：观察不同阻断剂对黄体酮、雌二醇效应的影响。方法：将豚鼠胆囊制备成平滑肌条标本,固定在浴槽中,连接张力换能器。用8个灌流肌槽同时记录胆囊肌条的自发收缩。结果：黄体酮和雌二醇均抑制胆囊肌条的收缩活动;雷尼替丁可阻断雌二醇对豚鼠胆囊肌条的抑制作用,而六烃季胺、消炎痛、心得安和L－NNA无此作用;实验中所用的阻断剂均未阻断黄体酮对豚鼠胆囊肌条的抑制作用。结论：雌二醇对胆囊肌条的抑制作用可被雷尼替丁阻断。黄体酮对胆囊肌条的作用可能是直接作用于平滑肌。     

血清雌三醇、孕酮联合测定监测硝酸甘油静脉注射治疗先兆早产的临床研究

目的观察硝酸甘油静脉注射治疗先兆早产的临床效果。测定雌三醇（E3）、孕酮（P）的变化，探讨其作用机理。方法102例先兆早产患者随机分为硫酸镁加硫酸舒喘灵常规治疗组55例，和静脉注射硝酸甘油组47例。两组孕妇治疗前后分别抽取外周静脉血，采用放射免疫分析法测定血清中E3，电化学发光法测定血清中P水平。观察两组孕妇用药前后复查E3、P的变化及治疗效果，以及分娩启动先兆早产与E3、P的关系。结果①硝酸甘油组：先兆早产孕妇在24h内宫缩消失，有效率91．48％。延长至37w分娩的孕妇为93．69％。治疗后宫缩消失时间（20．19±10．64）h。硫酸镁加硫酸舒喘灵组：先兆早产孕妇在72h内宫缩消失，有效率89．09％。延长至37w分娩的孕妇为83％。治疗后宫缩完全消失时间（58.95±25.28）h。硝酸甘油组延长先兆早产孕妇孕期效果明显优于硫酸镁组（P〈0.01）。②硝酸甘油组孕妇血浆中E3水平由治疗前的（76．72±44．86）ng／L，显著下降至治疗后的（67．14±35．47）ng／L。两组比较，差异有显著性（P〈0．05）。硫酸镬组孕妇血浆中E3水平治疗前（77．67±36.17）ng/L，治疗后上升为（87．66±35．58）ng/L。差异无显著性（P〉0．05）。③硝酸甘油组孕妇血浆中P水平治疗前（106．23±40．17）ng／L，明显上升至治疗后的（115．66±41．33）ng／L。硫酸镁组孕妇血浆中P水平治疗前（107．78±38．25）ng／L，治疗后显著上升为（120.8±39．27）n∥L，差异有极显著性（P〈0．01）。结论先兆早产与E3水平的增高，孕酮水平的降低有关。硝酸甘油静脉注射后，孕妇血中E3水平降低，孕酮水平增高。达到治疗先兆早产的目的。硝酸甘油静脉注射是一种安全有效的抗早产药物。     

Quality of embryos transferred and progesterone levels are the most important predictors of live birth after fresh embryo transfer: a retrospective cohort study

Purpose

To identify the independent predictors of live birth following IVF, and to assess the role of cohort-specific parameters, including antral follicle count (AFC), the number of oocytes retrieved, the total number of embryos, and the total number of good-quality embryos, in fresh IVF cycles.

Methods

A retrospective cohort study of 2,525 infertile women undergoing IVF between 2002 and 2007. The hypothesis that the number and quality of embryos transferred capture the effects previously attributed to cohort-specific variables was examined using mediation analysis and spline analysis. Independent predictors were identified by a bootstrap algorithm. Multivariable logistic regression was performed and the proportion of explained variation was measured to compare the relative importance of transfer-specific vs. cohort-specific predictors.

Results

The number of good-quality embryos transferred and progesterone level on the day of hCG administration ranked as the two most important predictors of live birth. Prospects of pregnancy started to decrease after progesterone level exceeded 0.6 ng/ml. The achievement of live birth in a fresh IVF cycle is primarily determined by the number and quality of embryos transferred, rather than by embryo cohort-specific variables.

Conclusions

The associations between cohort-specific variables and live birth in a fresh IVF cycle are completely mediated by the quality of embryos transferred. Progesterone level on the day of hCG administration is an independent predictor of pregnancy and merits further investigation.