Objective To observe the effects of berberine ( BBR) combined with ethinylestradiol cyproterone acetate in the treatment of obese women with polycystic ovary syndrome ( PCOS) and the influence on vascular endo-thelial function.Methods 50 patients with PCOS were randomly divided into two groups.The observation group was given ethinylestradiol cyproterone acetate 1 piece of qn, BBR 300 mg tid.The control group was given placebo to replace BBR,the other treatment was the same as the observation group.The patients were treated for three menstrual cycles.The two groups were regulated the way of life.Before and after treatment,the body mass index (BMI),waist hip ratio (WHR),follicle-stimulating hormone (FSH),luteinizing hormone (LH),testosterone (T),fasting blood glucose ( FPG ) , fat cholesterol ( TC ) , triglycerides ( TG ) , insulin resistance index ( HOMA -IR ) , select E (E-selection),von willebrand factor (vWF) were tested.Results After treatment,these indicators of fat,sugar, insulin resistance,lipid metabolism disorders of sex hormone,vascular endothelial function in the observation group were more improved than the control group [(23.01 ±1.37),(0.81 ±0.03),(7.85 ±0.98),(4.12 ±0.55), (1.87 ±0.23),(2.56 ±0.67),(7.80 ±2.14),(1.46 ±0.78),(37.13 ±9.02),(142.15 ±43.26)vs (23.57 ± 1.40),(0.86 ±0.04),(87.22 ±11.38),(4.88 ±0.58),(2.25 ±0.24),(4.55 ±0.97),(9.96 ±3.20),(1.67 ±0.80), (24.36 ±7.48),(116.27 ±33.56)],there were statistically significant differences(t=3.85,3.92,4.28,4.32, 4.43,9.14,9.06,6.37,11.35,14.58,all P<0.05).Conclusion BBR combined with ethinylestradiol cyproterone acetate in the treatment of PCOS is not only effectively improved many pathophysiological changes,such as IR,high androgen levels,also protected vascular endothelial function,thereby reducing the risk of cardiovascular disease.

Objective:To summarize the atypical manifestations and treatment strategies of serous microcystic neoplasm of the pancreas.Methods:Review the case data of 11 cases of pancreatic serous microcystic adenoma with atypical preoperative clinical imaging findings admitted to Peking Union Medical College Hospital from July 2008 to October 2019, and summarize their clinical manifestations, CT/MRI features, and preoperative clinical diagnosis, surgical methods, postoperative conditions.Results:The median age of the 11 patients was 50 (46-66) years old, 7 females, and 4 males. There were 8 cases with back pain and 6 cases with weight loss. The preoperative imaging examination found that the lesion was located in the head and neck in 8 cases, with pancreaticobiliary duct dilatation in 7 cases, suspected vascular invasion in 3 cases, and pancreatic parenchymal atrophy in 2 cases, 3 cases showed rich blood supply and solid space, and 2 cases were connected to the pancreatic duct. Preoperative diagnosis of pancreatic malignant tumors accounted for 4 cases, neuroendocrine tumors in 3 cases, solid pseudopapillary tumors in 3 cases, and intraductal papillary mucinous tumors in 1 case. All patients underwent surgical treatment, 3 cases of distal pancreatectomy (2 cases of using Kimura method to protect the spleen), 3 cases of pancreaticoduodenectomy, 1 case of total pancreatectomy, 2 cases of pancreatic head resection with duodenum preservation, 2 cases of local resection. All patients had no early postoperative deaths. There were 2 cases of grade B pancreatic fistula, 2 cases of biochemical leakage, 1 case of postoperative abdominal hemorrhage, and 2 cases of delayed gastric emptying, all of which were cured after active treatment. The median postoperative hospital stay was 18 (7-63) days.Conclusions:Pancreatic serous microcystic neoplasm could be accompanied by atypical features such as pancreatic/bile duct dilation, parenchyma atrophy, or even present vessel invasion. Understanding the atypical clinic and image features would help improving differential diagnosis and treatment. For those with invasive features, surgical exploration should be recommended.

Objective To investigate the effect of silencing MFG-E8 gene on the sensitivity of SKOV3 cells to anticancer drugs and related mechanisms. Methods SKOV3 cells were transfected with MFG-E8 siRNA (Msi) and NC siRNA (Csi), respectively and the efficiency of transfection was confirmed by Western blot. The sensitivity of SKOV3 cells to cisplatin was observed by CCK-8 assay after transfection. The mRNA expression of ABCB1 and ABCC1 were detected by qRT-PCR. Effect of silencing MFG-E8 on the expression of ETM-related protein was detected by qRT-PCR and Western blot. Results MFG-E8 siRNA could effectively silence the expression of MFG-E8 protein. With the increasing drug concentration, the proliferation inhibition rate of each group also increased, and the cell proliferation inhibition rate of MFG-E8 siRNA group increased significantly (P < 0.01). Compared with NC siRNA group, downregulation of MFG-E8 expression led to decreased SKOV3 cell proliferation at 48h or 72h after 3 μg/ml cisplatin treat ment (P < 0.05). qRT-PCR results showed that the mRNA expression of ABCB1 and ABCC1 in Msi group were significantly lower than those in Csi group. qRT-PCR and Western blot results showed that silencing MFG-E8 gene down-regulated the mRNA and protein expression of N-Cadherin, Vimentin and Snail and up-regulated the expression of E-Cadherin. Conclusion Silencing the MFG-E8 gene can increase the sensitivity of SKOV3 cells against anti-tumor drugs and down-regulate the mRNA expression of ABCB1 and ABCC1, which may be related to the inhibition of EMT progression.