Objective To research the effect of letrozole combined with clomiphene on women with polycystic ovary induced infertility and the effect on matrix metalloproteinases-9(MMP-9),vascular endothelial growth factor(VEGF)and hepatocyte growth factor(HGF)levels.Methods 108 patients with polycystic ovary syndrome combined with infertility from February 2013 to August 2015 in our hospitolwere divided into control group and experimental group by lottery,54 cases in each groups,control group treated with clomiphene,the experimental group based on control group treatment with letrozole,the linical curative effect,MMP-9,VEGF and HGF level,sex hormones,insulin resistance index,adverse drug reactions of two groups were compared.Results The number of ovulation,advantage of ovulation number,normal rate of menstruation,ovulation rate and pregnancy ratesofin experimental group was higherthan the control group,the difference was statistically significant(P<0.05).The MMP-9,VEGF and HGF levels of experimental group was lower than the control group,the difference was statistically significant(P<0.05).The sex hormone level of experimental group was better than that of control group(P<0.05).The adverse reactions was no differences between the two groups.Conclusion The efficacy of letrozole combined with clomiphene in treatment of polycystic induced infertility,can inhibits MMP-9,VEGF and HGF expression,and with high safety.

Background and purpose:The clear-cell cancer ovarian cancer have worse prognosis than the other ovarian cancer.The patient's survival rate of the clear-cell ovarian cancer has been analyzed in this article in order to study the effect of the treatment with CAPcytoxan(CTX),cisplatinum(DDP),epiadriamycin(E-ADM)plus mitomycin(MMC).Methods:33 cases(group A)with clear-cell ovarian cancer between Jan.1th 1999 and Dec.31th 1999 were compared to 37 cases(B group)with other pathological ovarian cancer.All cases underwent the tumor reductive surgery and been capable of remain the residual tumor size less than 1 cm.Patients in the two groups all underwent CAP based chemotherapy,and patients in group A with additional MMC chemotherapy at the same time.Group A had been compared with the clear-cell ovarian cancer with the CAP protocol(group C,stage Ⅰ/Ⅱ 15 cases,stage Ⅲ/Ⅳ 9 cases).Results:There was significant statistical different value of the CA125 in stage Ⅰ/Ⅱ before operation and no significant statistical difference for stage Ⅲ/Ⅳ between the two groups.There were significant decrease in the CA125 value for the stage Ⅰ/Ⅱ and no significant decrease for stage Ⅲ/Ⅳ between two groups after three and six courses chemotherapy.There were 11(33.33%)cases developed with endometriosis and 7(21.21%)with deep venous thrombosis(DVT),however the DVT had no direct correlation to the survival rate.The average survival time for stages Ⅰ/Ⅱ in group A and B was(38.3?2.4),and(38.3?2.7)months,compared to(20?3)and(34?4)months in stage Ⅲ/Ⅳ,respectively.There was no significant statistical difference(P=0.471)in four-year survival rate between groups A and B with stage Ⅰ/Ⅱ and there was significant statistical difference(P

Objective To compare the characteristics of MRI, CT, single photon emission computed tomography(SPECT) and transcranial Doppler sonography(TCD) in patients with spongiform leukoencephalopathy after inhaling heroin vapor. Methods Seventeen patients were investigated. MRI or CT was scanned in 17 patients, SPECT in 9 patients′ and TCD in 11 patients. Results MRI or CT: Brain MRI and CT revealed extensive symmetric white matter involvement of bilateral cerebral and cerebellar hemispheres and the brainstem.The lesions, which showed no contrast enhancement, were hypodense on CT and hypointense on T 1 weighted and hyperintense on T 2 weighted MRI. SPECT: The regional cerebral blood flows(rCBF) of white matter involvement on bilateral cerebral and cerebellar hemispheres was reduced obviously. The rCBF of temporal lobes, parietal lobes, occipital lobes, cerebellar hemispheres, and basal ganglion was reduced in varying degrees. TCD: The systolic peak became sharpened, and end diastolic flow velocity and mean flow velocity were reduced obviously and pulsatility index was increased markedly in patients with spongiform leukoencephalopathy after inhaling heroin vapor. Conclusion The characteristic manifestations of MRI and CT imaging may be regarded as the main foundation of diagnosing spongiform leukoencephalopathy after inhaling heroin vapor; SPECT and TCD can help comprehend the changes of hemodynamics of cerebral vessels and the degree of cerebral ischemia in patients with spongiform leukoencephalopathy after inhaling heroin vapor.

Objective To explore the stress perception among acute myocardial infarction (AMI) patients during acute stage.Methods Phenomenological method of qualitative study was adopted.18 AMI patients during the acute stage of 3～4 days after the onset of the disease were interviewed.Results Stress made AMI patients hard to accept the fact of illness,worry about the treatment of illness and the impact on future life,be difficult to alter living habits,be hard to relieve negative emotion.Conclusions AMI patients during acute stage will experience different levels of psychological stress.Stress management should be fabricated and effective measures should be adopted to relieve their negative emotions in terms of inducing factors.

Background and purpose:The greastest diameter of cervical cancer with stage Ⅰ_(b2) disease was more than 4 cm in diameter. surgery as the fi rst priority was diffi cult in these patients, bleeding was the most frequent adverse effect. This article studied the effect of the cervical cancer with stage Ⅰ_(b2) disease underwent neoadjuvant chemotherapy with gemcitabin plus cisplatinum(DDP). Methods:23 cases (A groups) stage Ⅰ_(b2) cervical cancer were treated with gemcitabin 1.5 g/m2 iv infusion at d1, plus cisplatinum(DDP) 20 mg/m2 iv infusion at d1-3. The interval between the two cycles was two weeks.19 cases (B groups) were treated with cisplatinum(DDP) 20 mg/m2 iv infusion at d1-3,plus VCR 1.5 g/m2 iv infusion at d1, and BLM 10 mg/m2 im at d1-3, The interval between the two cycles was three weeks. The assessment for clinical effect and side effect were conducted for the patients with completion of at least two cycles of chemotherapy. Results:42 cases were enrolled in this trial. There was signifi cant(P=0.004) difference between the two groups with the shrinkage of the greatest diameter after neoadjuvant chemotherapy. The main toxicities were myelosuppression. There was signifi cant (P

AIM: To determine the antioxidant and the immunoregulatory effects of Centella asiatica extracts. METHODS: Centella asiatica was extracted with alcohol and different organic solvent. The content of polyphenol was determined by Folin-ciocalteau method. The efficacy of the extracts to scavenge the hydroxy radical (OH·), 1,1-diphenyl-2-picryl-hydrazyl radical (DPPH·) and intra-cellular reactive oxygen species (ROS) was measured. Lymphocyte proliferation was assessed to observe the influence of Centella asiatica extracts. RESULTS: (1) Centella asiatica was found to have abundant polyphenol extrated from different phases and in a descending order as follows: ethyl acetate extracts>n-butanol extracts>water extracts>ligarine extracts. (2) Extracts of Centella asiatica exhibited the scavenging efficacy of OH· and DPPH· free radicals, in which the acetic ether extracts showed the significant effect. (3) The acetic ether extracts had significant ability to inhibit the generation of ROS in stimulated lymphocytes. (4) The acetic ether extracts suppressed the lymphocyte proliferation. (5) The active ingredient was identified as flavone. CONCLUSION: Flavones in the Centella asiatica posseses antioxidant activity and effectively inhibits lymphocyte proliferation, showing ability of immunosuppre-ssion.

Objective To investigate the level of care burden and self efficacy of caregivers of patients with spinal cord injury,and analyze their correlation.Methods By convenience sampling method,150 cases of spinal cord injury patients and their caregivers were investigated with Zarit Caregiver Burden Scale and general self-efficacy scale.Results The score of care burden of caregivers with spinal cord injury was (52.91 ± 11.56) points,self-efficacy score of caregivers was (19.63 ± 4.85) points.The score of care burden of caregivers and self-efficacy was highly negatively correlated.Conclusions We should pay more attention to improve the self-efficacy of caregivers of patients with spinal cord injury (SCI),in order to mitigate the care burden,improve care ability and health level of the patients' families.

Objective To detect mitochondrial gene 3243 A to 1507 Chinese and analyze their clinical characteristics.Methods Classical PCR－ RFLP was used to detect the mutation and statistical analysis was performed on the data after stratification in accordance with presence or absence of diabetes.Results (1)In this study,prevalence of mitochondrial gene 3243 A to G mutation was 1.16～ 1.20％ .(2)Compared with MDM(mitochondrial diabetes),M－ NGT(normal glucose to lerance with mutation)showed no significant difference in body fat parameters,blood lipid and C－ peptide except for early onset and hearing loss(P=0.0028).(3)Compared with type 2 DM,MDM presented characteristics of early onset,weight loss,hearing loss,islet cell function decrease and maternal hereditary.Conclusion Follow－ up should be given to the carrying the mitochondrial gene 3243 A to G mutation but presenting generally normal clinical manifestation in order to give the patient in－ time diagnosis and treatment.

Objective To investigate the real situation of the burden of the caregivers who take care of patients with spinal cord injury.Methods Using phenomenological research methods of qualitative study,information of 15 family caregivers of patients with spinal cord injury were collected through semi-structured interviews in Jiangxi province,and data were analyzed with Colaizzi 7-step analysis method.Results Four themes were summarized:weak social support system,heavy economic burden,insufficient care ability,mental and physical exhaustion; mental and physical exhaustion concluded three sub-themes:burnout,lifestyle changes,sad/helplessness.Conclusions Care burden of caregivers of patients with spinal cord injury includes four aspects:social,physical,psychological,and less caring capacity.Care workers should be concerned about the health status of the caregivers,give targeted care intervention,so that caregivers can be adapted to the caregivers' role,maintain and promote a high level of health of the patients and their families.

Objective To design nursing occupational safety and health curriculum reasonably.Methods With a semi-structured interview outline,focus group interviews among eight clinical nursing and nursing education specialists were conducted to develop the occupational safety and health curriculum design.Results It was important to set up nursing occupational safety and health curriculum.The main object,contents,teaching and evaluation methods were identified.Conclusions Occupational safety and health curriculum can be involved in nursing curriculum system to reduce occupational hazards and maintain physical and mental health of nursing students.