This article discusses the experience of professor SUN Wei-feng in diagnozing and treating PCOS(polycystic ovary syndrome) from four aspects:the cuase of the disease,the thought of treatmeat,the differentiation of syndrom,and the experience of treatment,combination of prescriptions.Professor SUN thinks that its pathology basis is deficiency of kidney and blood stasis,and points out that the method of tonifying kidney and promoting blood could be considered as the basic way of treat PCOS in TCM,the treatment cycle of the TCM is the important links to this disease,it should according with the different syndroms to use different methods on clinic.

AIM: To observe the pathological role of 3-nitrotynosine (3-NT) on Escherichia coli LPS-induced vascular hyporeactivity in rats and the therapeutic effect of antioxidants. METHODS: Forty male SD rats weighting from 200 g to 250 g were randomly divided into four groups: the control group (n=10); LPS shock group (n=10); uric acid-treated group (n=10); melatonin-treated group (n=10). 6 h after LPS shock, phenylephrine (0.5-2.5 ?g?kg -1) was applied intravenously to all groups and the percentage increase in MAP was detected, respectively. The concentration-response curve of aorta rings from all groups rats were obtained by cumulative addition of phenylephrine (PE), and PE E_ max, EC_ 50 were calculated. The concentrations of plasma malondialdehyde (MDA), nitrate/nitrite and 3-NT were assayed in all groups 6 h after LPS shock. RESULTS: The MAP level induced by PE significantly decreased to 54.60% in LPS shock rats compared with the control (P

Objective To observethe effect of continuous veno-venous hemofiltration (CVVH) on serum level of antibrain-antibody (ABAb) in patients with severe traumatic brain injury.Methods Thirtysix patients with severe traumatic brain injury were randomly divided into control group (19 patients) and CVVH group (17 patients).The control group accepted conventional treatment,the CVVH group accepted CVVH treatment additionally for 7 d.ELISA was used to measure serum level of ABAb at 1,3,5,7,14 d after treatment.The change of ABAb in serum of each group was observed.The scores of Glasgow coma scale (GCS) was assessed everyday.Results The level of ABAb in CVVH group was significantly lower than that in control group from the third day after treatment[the third day:(1.28 ± 0.25) kU/L vs.(1.33 ± 0.30) kU/L;the fifth day:(1.37 ±0.17) kU/L vs.(1.42 ±0.22) kU/L;the seventh day:(1.45 ±0.37) kU/L vs.(1.52 ± 0.35) kU/L;the fourteenth day:(1.49 ± 0.41) kU/L vs.(1.67 ± 0.39) kU/L,P ＜ 0.05 or ＜ 0.01].The scores of GCS in CVVH group was significantly higher than that in control group from the seventh day after treatment [the seventh day:(6.95 ± 1.24) scores vs.(5.74 ± 1.51) scores;the fourteenth day:(9.29 ± 1.76) scores vs.(7.22 ± 1.24) scores] (P ＜ 0.01).Conclusion CVVH can decrease the level of ABAb and improve the prognosis.

Objective To investigate the role of protein O-linked N-acetyl-glucosamine (O-GlcNAc) modification in glutamine-induced improvement in the vascular hyporeactivity in rats with septic shock.Methods Thirty-two adult male Sprague-Dawley rats,aged 2-3 months,weighing 250-300 g,were randomly divided into 4 groups (n =8 each):sham operation group (S group); septic shock group (C group); glutamine group (G group) ; alloxan group (A group).Septic shock was induced by cecal ligation and puncture (CLP).In G and A groups,glutamine 0.75 g/kg was infused intravenously over 30 min at 1 h before CLP,and in addition alloxan 90 mg/kg was infused intraperitoneally in A group.Phenylephrine (PE) 0.5,1.0,2.0,and 2.5 μg/kg was injected intravenously at 20 min intervals at 6 h after CLP and the percentage increase in mean arterial pressure (MAP) was calculated.The thoracic aorta rings were isolated to perform the isolated vascular tension experiment.The concentration-response curve of PE was obtained in tension experiments,and the PE maximum efficacy (Emas) and median effective dose ( EC50 ) were calculated.The expression of O-GlcNAc modification and iNOS content in the thoracic aorta were detected in all groups.Blood samples were taken to determine the serum concentration of NO.Results Compared with S group,the percentage increase in MAP and Emax were significantly decreased,while the EC50,serum concentration of NO,and expression of O-GlcNAc modification and iNOS content in thoracic aorta were significantly increased in C,G and A groups ( P ＜ 0.05).Compared with C group,the expression of O-GlcNAc modification in the thoracic aorta was significantly increased,and EC50 was significantly decreased in G group,and the percentage increase in MAP and Emax were significantly increased,while the serum concentration of NO,and content of iNOS in the thoracic aorta were significantly decreased in G and A groups ( P ＜ 0.05).Compared with G group,the EC50,serum concentration of NO,and content of iNOS in the thoracic aorta were significantly increased,while the percentage increase in MAP,Emax and expression of O-GlcNAc modification in the thoracic aorta were significantly decreased ( P ＜ 0.05 ).Conclusion Glutamine improves the vascular hyporeactivity through increasing the level of protein O-GlcNAc modification in rats with septic shock.

Objective To summarize and classify the CT manifestations of chest wall tuberculosis and to investigate the relationship between CT classification and clinical operation method.Methods CT data of 142cases was collected from patients that were confirmed by surgical pathology of chest wall tuberculosis.Bone algorithm reconstruction and volume rendring three-dimensional reconstruction were applied to observe ribs.Results Four types were classified according to the CT manifestations.Type Ⅰ:27 cases pleural tuberculoma,and all of which were conducted simple removal of lesions.Type Ⅱ:18 cases sternum or ribs tuberculosis,which were conducted surgical removal of the invaded frame and the surrounding lesions in caseous necrosis and all the tuberculous granuloma.Type Ⅲ:21 cases rib outboard tuberculosis,of which 12 cases were conducted simple removal of lesions and 9 cases removal of lesions and small segment of ribs.Type Ⅳ:76 cases hybrid,of which abscess excision plus rib resection in 65 cases and resection with chest wall abscess (muscle) between ribs and rib resection with padded muscle flap surgery in 11 cases.Conclusions CT can clearly show the location,size,scope of involvement of the chest wall tuberculosis,and selecting the preoperative surgical strategy based on CT classification can provide guidance for operation.

With the aging of the population,management of cancer in the elderly aged people represents a priority for health care.However,fewer evidence-based data are available to promote the treatment of these patients.Comprehensive geriatric assessment (CGA) is developed recently as a multi-disciplinary in-depth evaluation to assess life expectancy and risk of morbidity from cancer in elderly patients,which is helpful for physicians to develop a coordinated plan for cancer treatment and to provide appropriate interventions to decrease the risk of morbidity and mortality.

Objective To investigate the effects of O-GlcNAc modification on gintamine (Glu)-induced heat shock protein 70 (HSP70) expression in LPS-treated rat cardiomyocytes.Methods Primary cultures of neonatal rat cardiomyocytes were randomly divided into 6 groups:group Ⅰ control(group C);group Ⅱ Glu;group Ⅲ LPS;group Ⅳ Glu+LPS;group Ⅴ Glu+LPS+Alloxan and group Ⅵ Gln+LPS+PUGNAc.In group C double distilled water 25 μl was added.In group Ⅱ-Ⅵ the cells were exposed to the sanle concentrations of Glu (5 mmol/L)and LPS(4 μg/ml) except Alloxan (an inhibiter of O-linked β-N-acetyl glucosamine transferase/OGT) (1 mmol/L) and PUGNAc (an inhibitor of O-linked β-N-acetyl glucosaminidase/OGA)(100μmol/L).After being incubated for 6 h,cardiomyocyte viability,O-GlcNAc modification level and HSP70 expression level were measured.Results There was no significant difference in cell viability among the six groups.The levels of O-GlcNAc modification and HSP70 expression were significantly higher in group Ⅱ-Ⅵ than in group Ⅰ,were significantly higher in group Ⅳ and group Ⅵ than in group Ⅲ,were significantly lower in group Ⅴ and higher in group Ⅵ than in group Ⅳ.Conclusion O-GlcNAc modification may be involved in Glu-induced HSPT0 expression in LPS-treated cardiomyocytes.

Objective To investigate the role of O-linked N-acetylglutamine (O-GlcNAc) modification in glutamine-induced myocardial heat shock protein (HSP70) expression in a rat model of endotoxic shock. Methods Thirty-two 8 weeks old male SD rats weighing 250-300 g were randomly divided into 4 groups (n = 8 each):group Ⅰ control (group C); group Ⅱ LPS; group Ⅲ G+ LPS and group glutamine + LPS (group A + G + LPS). Endotoxic shock was induced by iv administration of LPS 10 mg/kg in group Ⅱ , Ⅲ and Ⅳ.Glutamine 0.75 g/kg was administered iv at 1 h before iv LPS in group Ⅲ and Ⅳ . Alloxan (an inhibitor ofO-linked N-acetylglucosamine transferase) 50 mg/kg was administered iv together with glutamine at 1 h before LPS in group Ⅳ. The animals were sacrificed at 6 h after iv LPS administration. Their hearts were removed for determination of the expression of O-GlcNAc and HSP70 in myocardium. Results Intravenous LPS significantly up-regulated the expression of O-GlcNAc and HSP70. Glutamine pretreatment further increased the expression of O-GlcNAc and HSP70. The glutamine pretreatment induced increase in O-GlcNAc and HSP70 expression was abolished by concomitant administration of alloxan. Conclusion O-GlcNAc modification may be involved in glutamine-induced myocardial HSP70 expression in endotoxic shock.

Objective To investigate the effects of sevoflurane on the systemic inflammatory response and cardiopulmonary function in septic shock rats. Methods Thirty-two SD rats, 8-10 months old, weighing 250-300 g, were randomly divided into 4 groups (n = 8 each): sham operation group (group S), cecal ligation and puncture (CLP) induced septic shock group (group CLP) , sevoflurane I group (group SEV, ) and sevoflurane II group (group SEV,). The abdomen was opened but CLP was not performed in group S. The septic shock was induced by CLP as described by Baker et al. Group SEV, and SEV, inhaled 2.4% sevoflurane for 30 min at 1 h and 3 h after the successful establishment of the model respectively. At 1, 3 and 5 h after septic shock, MAP and HR were recorded and arterial blood samples were taken for blood gas analysis and determination of plasma concentrations of TNF-α, IL-1, MDA and NO. The left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular fractional shortening (LVFS) and cardiac output (CO) were also detected 5 h after septic shock. The animals were killed after the detection of cardiac function. The lungs were removed for determination of W/D lung weight ratio and Evans blue (EB) content. The tissues from the heart, lung, liver and kidney were taken for detection of NF-kB activity by electrophoretic mobility shift assay (EMSA) ResultsMAP was significantly lower, HR higher, LVEDD, LVESD, LVFS, CO, pH value, PaO2 and PaCO2 lower, and W/D lung weight ratio, EB content, plasma concentrations of TNF-α, IL-1, MDA and NO, and NF-kB activity in the heart, lung, liver and kidney tissues higher in group CLP, SEV, and SEV2 than in group S (P < 0.05). NF-kB activity in the heart, lung, liver and kidney tissues and plasma concentrations of TNF-α, IL-1, MDA and NO were significantly lower in group SEV, than in group CLP and SEV2 ( P < 0.05 ), but no significant differences were found in the other indices between group SEV, and CLP and between group SEV1 and SEV2 ( P > 0.05). Conclusion Inhalation of 2.4% sevoflurane for 30 min 1 h after septic shock can inhibit the systemic inflammatory response slightly, but can not improve the cardiopulmonary function in rats with CLP-induced septic shock.

Objective To investigate the effects of macmphage migration inhibitory factor (MIF) on glucocorticoid (GC) re]ease and glucocorticoid recer (GR) in mts.Methods Test Ⅰ Thirty-two male SD rats weighing 250-300 g were randomly divided into 4 groups(n=8 each):control group(C),low dose recombinant MIF (rMIF) group (rMIF-L),middle dose rMIF group (rMIF-M) and high dose rMIF group (rMIF-H).The animals received l ml normal saline via the right femoral vein in group C.The animals received rMIF50.100 and 200 ng in l ml normal saline though right femoral vein in group rMIF-L,rMIF-M or rMIF-H respectively.Blood samples were taken from left femoral artery immediately before inection(T0,baseline),and at 5 min,3 h,6 h.12 h and 24 h after injection of rMIF(T1-5) for determination of serum concentration of corticosterone.Test Ⅱ Primary cultured neonate rat(2-3 days)myocardial ceils were randomly divided into 3 groups(n=24 each):group C,group rMIF-L and group rMIF-M.The ceUs in group C,rMIF-L and rMIF-M wefe incubated with DMEM.rMIF 50 ng+DMEM and rMIF 100 ng+DMEM for 3 h respectively.The expression of GR and HsPg0 wag determined by Western blot.ResuBs Test Ⅰ The serum concentration of corticosterone was signifieemily higher in the other 3 groups than in group C at T1-5(P<0.05).The sertlm concentration of corticostemne was significantly increased at T1-5 in group rMIF-L,rMIF-M and rMIF-H compared with the baseline values(P<0.05).Test Ⅱ HSP90 expresion was significantly lower in the other two groups than in group C(P<0.05).Them was rio signifieanf difference in HSP90 expression between group rMIF-L and group rMIF-M(P>0.05).There was no significant difference in GR expression among the 3 groups ( P > 0.05). Conclusion MIF druing sepsis can weaken GR function through down-regulating HSP9O expression, resulting in CC resistance.