Objective To investigate the association of prehepatic fat thickness with insulin resistance in women with polycystic ovarian syndrome (PCOS).Methods Thirty-five PCOS patients and 39 controls were randomly enrolled in the study.Prehepatic fat thickness was detected by ultrasound,and fasting glucose (FBG),fasting insulin (FINS),and serum lipids were detected.The homeostasis model assessment of insulin resistance (HOMA-IR) was used to calculate insulin resistance.Results Prehepatic fat thickness was significantly higher in PCOS patients than healthy controls,and prehepatic fat thickness were significantly correlated with HOMA-IR (P ＜ 0.05).The receiver operating characteristic (ROC) curve demonstrated that prehepatic fat thickness had higher sensitivity and specificity in diagnosing PCOS with insulin resistance.Conclusions This study demonstrates that prehepatic fat thickness significantly correlates with insulin resistance and can be used as the markers of insulin resistance in PCOS patients.

Humans ; Nephritis, Interstitial ; diagnosis ; therapy ; Uveitis ; diagnosis ; therapy

AIM: To detect the role of fibrinogen activity (Fa) in the progress of coronary artery disease (CHD).METHODS:Fa was measured with hemorheology methods in patients with CHD stable phase (n=30) and angina pectoris (n=27).RESULTS: (1) Levels of plasmatic fibrinogen and plasmatic viscosity in patients with CHD were higher than that of control group (P

BACKGROUND:Both osteopontin and leptin are closely linked to bone metabolism, therefore, which may be related to the attack of femoral head necrosis. OBJECTIVE:To study the correlation of serum osteopontin and leptin in the development of femoral head necrosis. METHODS:Thirty-one patients with femoral head necrosis (case group, including 11 cases of ARCO II, 10 of ARCO III, 10 of ARCO IV) and 10 healthy adults (control group) were selected as the research objects. Enzyme-linked immunosorbent assay was used to determine the levels of osteopontin and leptin in serum folowed by statistical analysis. RESULTS AND CONCLUSION:In the case group, the serum levels of osteopontin and leptin were significantly higher than those in the control group (P < 0.05). But the serum levels of osteopontin and leptin showed no correlation between the two groups. These findings indicate that the serum levels of osteopontin and leptin are both elevated in patients with femoral head necrosis, which maybe play a role in the pathogenesis of femoral head necrosis, but there is no obvious correlation.

Objective To investigate the relationship between electrical stimulus intensity and postopera-tive complications of puncture trigeminal ganglion radiofrequency thermocoagulation (PTGRT). Methods 86 pa-tients with trigeminal neuralgia (TN) on the second and the third branch underwent trigeminal ganglion radiofre-quency thermocoagulation in Xuanwu Hospital , Capital Medical University from June 2013 to December 2015 enrolled in this study. Electrical stimulus intensity in surgery and postoperative pain VAS score , numbness score, masseter muscles score and complications were recorded at 0, 24 and 48 hours post-surgery. Correlations among electrical stimulus intensity in surgery and postoperative pain VAS score,numbness score, masseter mus-cles score were analyzed. Result The 86 patients had different degrees of facial numbness , some patients had different degrees of masseter weakness , and 2 patients had mild sialorrhea in two days after PTGRT without serve complications. Eighty-three patients (96.51%) had no pain, and VAS score wass 0 at 0, 24 and 48 hours post-PTGRT. Electrical stimulus intensity in surgery had apparent negative correlation with numbness score at 0 , 24 and 48 hours popst-PTGRT (P < 0.01), with negative correlation with masseter muscles decreasing at 48 hours post-PTGRT (P < 0.05). Conclusion Suitable temperature and time in PTGRT were needed to be chose ac-cording to the electrical stimulus intensity.

Objective To evaluate the efficacy of different doses of dexmedetomidine combined with propofol for drug-induced sleep endoscopy (DISE) in the patients with snoring.Methods Sixty patients with snoring,aged 24-62 yr,with body mass index of 24-37 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective DISE,were randomly divided into either group Ⅰ or group Ⅱ,with 30 patients in each group.In Ⅰ and Ⅱ groups,dexmedetomidine was infused over 10 min in a loading dose of 0.4 and 0.8 μg/kg,respectively,followed by an infusion of 0.4 μg · kg-1 · h-1.At 15 min of dexmedetomidine infusion,propofol was given by target-controlled infusion with the initial target plasma concentration (Cp) of 1.0 μg/ml.At 2 min after the target effect-site and plasma concentrations were balanced,the Cp of propofol was increased/decreased by 0.2 μg/ml to maintain the Cp of propofol stable during DISE.Bispectral index (BIS) value was recorded before anesthesia (T1),at 10 and 15 min of dexmedetomidine infusion (T2,3),at 2 min after the target effect-site and plasma concentrations were balanced (T4),at the beginning of DISE (T5),when the fiberoptic laryngoscope was placed at the site of oropharynx (T6),at the end of DISE (T7),at emergence (T8),and while discharge from the examination room (T9).Richmond Agitation Sedation Scale (RASS) scores were recorded at T1-4.Sleep was recorded within 15 min of dexmedetomidine infusion.The emergence time,discharge time,and anesthetics-related adverse events were recorded.Results All the patients completed DISE successfully.BIS values were maintained at 75-90,and RASS scores ≤ 4 during dexmedetomidine infusion.BIS values were maintained at 65-75 during DISE.Compared with group Ⅰ,BIS values were significantly decreased at T4,and RASS scores were significantly increased at T2-4,the sleep rate was significantly increased within 15 min of dexmedetomidine infusion,the Cp of propofol was significantly decreased during DISE,the emergence time was significantly prolonged (P＜0.05),and no significant change was found in the discharge time and anesthetics-related adverse events in group Ⅱ (P＞ 0.05).Conclusion Dexmedetomidine infused at 0.4 μg · kg-1 · h-1 after infusion of a loading dose of 0.8 μg/kg combined with propofol provides better efficacy for DISE in the patients with snoring.

Objective To investigate the incidence and influencing factors of aldosterone escape in patients with non-diabetic nephropathy by RASI-therapy. Methods A total of 104 patients with non-diabetic nephropathy were treated with ARB or combination therapy of ACEI and ARB in a mean follow-up period of 12 months. Aldosterone escape was determined according to the change of plasma aldosterone concentration before and after treatment during 6-month and 12-month ACEI/ARB treatment, while the influencing factors of aldosterone escape in patients with non-diabetic nephropathy was also analyzed after therapy with RASI . Results In 12 months, the incidence of aldosterone escape was significantly higher than that in 6 months (26.92% vs. 14.42%, P = 0.007). After 12-month treatment, the difference was statistically significant in incidence of aldosterone escape among different stages of CKD (P = 0.027). Compared with 6-month incidence of aldosterone escape in the losartan group, 12-month incidence increased evidently (P = 0.020). The Ald level was positively correlated with urinary protein excretion and the Scr level (r = 0.431, P = 0.003 and r = 0.336, P = 0.009, respectively), and negetively correlated with levels of the eGFR (r = -0.275, P = 0.006). Univariate Logistic regression demonstrated that risk factors of aldosterone escape included pre-treatment values of the urinary protein excretion (OR = 3.671, P = 0.028) and the eGFR (OR = 0.972, P = 0.019). Multivariate Logistic model revealed pre-treatment values of the eGFR was positively associated with aldosterone escape (OR = 0.970, P = 0.012). Conclusion The incidence of the aldosterone escape increases along with the time of treatment. Renal function has correlated with aldosterone escape and pre-treatment value of the eGFR is an independent risk factor of aldosterone escape.

Objective:To compare the difference on the positive detection rate of the main aeroallergens and food allergens specific IgE measured with the systems between fluorescence enzyme immunoassay(FEIA, referred to as ImmunoCAP system)and western blot(referred to as Allergy Screen system), in order to provide a basis for the rational application of methods and interpretation of the test results.Methods:The clinical information and sIgE test results data were collected from a total of 458 cases of allergic diseases from October 2017 to April 2019 in the outpatient clinic of Allergy Department in Beijing Children′s Hospital.All of the 458 cases were detected for a panel of common aeroallergens and food allergens sIgE level in their serum with the Allergy Screen system.Simultaneously, the above 141 cases were detected main aeroallergen and food allergen sIgE with ImmunoCAP system, while 303 cases only for aeroallergens and 14 cases only for food allergens.All of the cases were divided into three different phenotype groups according to the main target organ and diagnosis such as airway allergic disease group( N=293), skin allergic disease group( N=14)and multi-system allergic disease group( N=151). Meanwhile, three different age groups were referred to as <3 years old group( N=97), 3 to 6 years old group(3 years and 6 years included)( N=186)and >6 years old group( N=175). The same kinds of the allergens included in the two systems were house dust mite(HDM), cat dander, dog dander, egg white, milk, crab, shrimp, therefore data of sIgE to those seven allergens were compared. Results:In all the enrolled cases, the positive detection rate of HDM, egg white and milk sIgE detected by ImmunoCAP system were significantly higher than those by Allergy Screen system(30.6%, 36.1% and 43.2% vs 21.2%, 21.3% and 21.3%). Among the disease groups, the positive detection rate of HDM sIgE detected by ImmunoCAP system was significantly higher in the airway allergic disease group and multi-system allergic disease group than those by Allergy Screen system, respectively(33.7% and 24.6% vs 23.4% and 16.2%). The positive detection rate of egg white and milk sIgE detected by ImmunoCAP system in the multi-system allergic disease group was significantly higher than those by Allergy Screen system, respectively(47.6% and 47.6% vs 26.2% and 25.2%). There was no significant difference in the positive detection rate of cat dander, dog dander, crab and shrimp sIgE among the disease groups.The positive detection rate of HDM sIgE detected by ImmunoCAP system in all of the age groups were significantly higher than those by Allergy Screen system, respectively(14.9%, 26.9% and 42.3% vs 5.7%, 17.6% and 32.6%). The positive detection rate of cat dander sIgE detected by ImmunoCAP system in <3 years old group was significantly lower than that by Allergy Screen system(6.9% vs 16.1%). The positive detection rate of egg white sIgE detected by ImmunoCAP system in the <3 years old group and the 3 to 6 years old group were higher than those by Allergy Screen system, respectively(47.1% and 33.3% vs 32.4% and 15.0%). The difference in the positive detection rate of milk sIgE detected by these two methods in the <3 years old group and the 3 to 6 years old group was similar to the egg white.Conclusion:According to the analysis of seven kinds of major aeroallergen and food allergen sIgE results, there are differences between the two methods to detect HDM, cat dander, egg white and milk sIgE.It depends on the type of allergic disease and age.The positive detection rates of dog dander, crab, and shrimp sIgE detected by the two methods are consistent.In clinical application, comprehensive analysis should be made, testing methods should be selected rationally, and the results should be interpreted scientifically.

10.3969/j.issn.2095-4344.2013.23.026

Objective To summarize the diagnosis and surgical treatment of hepatic focal nodular hyperplasia (FNH). Methods The clinical data of 63 patients with FNH proved by pathology were analyzed retrospectively. Results The disease mainly affected young to middle aged, 50 cases (79. 4% )were of 31-50 years old. Male and female ratio was 2.94: 1. Fifty-six patients (89%) were asymptomatic, 3 cases were HBsAg positive (4.8%). Liver function was basically normal (92. 1%),5 cases (7.9%) were with elevated level of total bilirubin and rGT. AFP, CEA and CA19-9 was all negative. FNH occured as a single node in 95.2% cases, ranging from 1.5 cm to 17 cm in diameter ( average 4. 5 cm). Of these patients, 25 lesions were present in the left lobe, 29 in the right lobe, 6 in the mid lobe, and 3 in the caudate lobe. A big central artery was found in 2 cases (3. 2% ) as found by color Doppler ultrasound. CT scan showed transient immediate enhancement in 96. 8% (61/63) of patients, with central scar in 6 cases. MRI demonstrated early vigorous enhancement in 93. 7% (59/63) of patients, with central scar in 5 cases. All patients underwent surgical resection; including local resection in 34 cases;segmentectomy or hepatectomy in 13 cases; hemihepatectomy in 13 cases. There was no postoperative mortality and major complications. Conclusions FNH is a kind of hepatic benign disease and characteristic of high preoperative misdiagnosis rate (25. 4% ).