OBJECTIVE:To discuss the effect of Ethinylestradiol and cyproterone acetate tablet combined with metformin on ovulation induction of patients with polycystic ovarian syndrome(PCOS). METHODS:184 PCOS patients were randomly divided into control group(92 cases)and observation group(92 cases). Control group orally received 1 Ethinylestradiol and cyproterone ac-etate tablet in 5 d of menstruation,once a day,it stopped after 21 d,the next cycle of treatment was started on the 5th of with-drawal bleeding. Observation group additionally received 3 Metformin tablet,once a day,without drug withdrawal during menstrua-tion,and lasted for 3 menstrual cycles. After 3 menstrual cycles,all patients received ovulation induction treatment [(50-100 mg clomiphene was orally given from the 5th day of the 4th menstrual cycle,for 5 days,or 75-150 U postmenopausal gonadotropin by intramuscular injection,when the dominant follicle diameter was(19.0±2.0)mm,10 000 U human chorionic gonadotropin(HCG) was intramuscularly injected,the ovulation was continuously monitored and whether there was ovarian hyperstimulation syndrome (OHSS)was observed]. Body mass index(BMI),follicle estrogen(FSH),luteinizing hormone(LH),prolactin(PRL),estradiol (E2)and testosterone(T)before and after treatment,fasting plasma glucose(FPG),fasting insulin(FINS),insulin resistance in-dex(HOMA-IR),pregnancy rate,ovulation rate and the incidences of OHSS and adverse reactions in 2 groups were observed.RE-SULTS:Before treatment,there were no significant differences in the BMI,FSH,LH,PRL,E2,T,FPG,FINS and HOMA-IR between 2 groups(P>0.05). After treatment,BMI,LH,PRL,E2,T,FPG,FINS and HOMA-IR in observation group and LH, E2 and FINS in control group were significantly lower than before,and BMI,PRL,E2,T,FPG,FINS and HOMA-IR in observa-tion group were lower than control group,the differences were statistically significant(P<0.05). The pregnancy rate and ovulation rate in observation group was significantly higher than control group,the incidence of adverse reactions was significantly lower than control group,the differences were statistically significant (P<0.05). And there was no significant difference in the incidence of adverse reactions between 2 groups(P>0.05). CONCLUSIONS:Ethinylestradiol and cyproterone acetate combined with metfor-min can effectively improve insulin resistance of POCS patients,recovery sex hormone secretion,promote ovulation and improve pregnancy rate,with good safety.

Objective To explore the effect of Yangxueqingnao granule in treatment of cerebral small vessel disease (SVD)patients with mild cognitive dysfunction (MCI).Methods 52 patients with SVD related MCI were selected.They were treated with Yangxueqingnao granule,each 4.0 g,3 times a day,3 months for a course of treat-ment.Montreal cognitive scale (MoCA),simple mental state scale (MMSE)and event related potential (P300)were detected before and after treatment,and the clinical effect was observed.Results After a course of treatment by Yan-gxueqingnao granule,the cognitive function and memory of 52 patients were improved to some extent.In addition to the attention of an MoCA meter to a foreign project[Visual space:before taking the medicine (2.92 ±0.26)points,after taking the medicine (3.25 ±0.66)points;Named:before taking the medicine (2.26 ±0.70)points,after taking the medicine(2.92 ±0.49)points;Language:before taking the medicine (1.47 ±0.70)points,after taking the medicine (2.17 ±0.98)points;Abstraction:before taking the medicine (0.45 ±0.38)points,after taking the medicine (0.68 ±0.63)points;Delayed recall:before taking the medicine (1.67 ±0.74)points,after taking the medicine (2.52 ±1.50)points;Directional:before taking the medicine (4.73 ±0.35 )points,after taking the medicine (5.52 ±0.57)points ]and total score[Before taking the medicine (18.75 ±0.66)points,after taking the medicine (19.12 ±1.45)points],the differences were statistically significant (the total score:t =7.56,P =0.000;Visual space:t =5.86,P =0.002;Named:t =5.42,P =0.000;Be careful:t =1.23,P =0.121;Language:t =4.52,P =0.000;Abstraction:t =2.65,P =0.001;Delayed memory:t =7.96,P =0.000).While the total score of MMSE scale [before taking the medicine (25.36 ±1.89)points,after taking the medicine (28.53 ±2.91 )points],memory [before taking the medicine (2.64 ±0.42)points,after taking the medicine (2.75 ±0.53)points]and recall [before taking the medicine (1.52 ±0.48)points,after taking the medicine (1.98 ±0.78)points ],the differences were statistically significant(the total score:t =2.78,Memory:t =1.95,Recall:t =3.43,all P <0.05).P300 before and after treatment[before taking the medicine P300 latency of (389 ±21)ms,after taking the medicine P300 latency of (341 ±18)ms)],the difference was significant (t =12.514,P <0.001).Conclusion Yangxueqingnao granule had therapeutic effect in patients with SVD -MCI.

Objective To probe into a doctor-seeking medical management model for China's urban hypertension patients under medical insurance, and enhance the level and quality of medical insurance management. Methods Hypertension patients were surveyed with a structured questionnaire, and the staff at community health centers and medical insurance management centers received qualitative interview. Results The hypertension patients are found to see doctors mostly at community health centers and tertiary hospitals; complaints among hypertension patients for existing medical insurance vary with their areas, mostly targeting on complicated reimbursement procedure, high threshold of medical insurance payment and low level of reimbursement. Recommendation Experiment with the single-disease payment for hypertension, with the total prepayment in per capita and per disease; greater efforts in hypertension control in communities, with more favorable medical insurance policies for communities;elevated collaboration with medical institutions at all levels, and building and standardizing the management information network for hypertension patients.

Objective To observe the effect of scalp acupuncture combined with speech training on language development delay in mental retardation children. Methods 40 cases were divided into 2 groups, 20 cases in each group. The observation group was treated with scalp acupuncture combined with speech training. The control group was treated with speech training. They were assessed with the development quotient (DQ) of adaptability and language of Gesell Developmental Schedules before and 3 months after the treatment. Results DQ of adaptability and language improved after treatment in both groups (P<0.05), and improved more in the observation group than in the control group (P<0.05). Conclusion Scalp acupuncture combined with the speech training is more effective on language development delay in mental retardation children.

OBJECTIVE: To evaluate the quality of Gentiana scabra in Qingre jiedu oral solution. METHODS: HPLC method was established to determine the content of gentiamarin in the oral solution. 299 batches of Qingre jiedu oral solution in circulation were measured and evaluated. RESULTS: Developed HPLC method is simple and reliable. The quality of Qingre jiedu oral solution in circulation is not satisfied. CONCLUSION: Great importance should be attached to the manufacture procedures monitoring of Qingre jiedu oral solution and quality control of G. scabra.

Objective To explore microRNA (miRNA) expression patients with β-thalassemia major.Methods MiRNA differential expression were detected in β-thalassemia major by miRNA microarray analysis and quantitative real-time PCR.Results The results of miRNA array showed that 26 differential expression miRNAs were up regulated and 30 differential expression miRNAs were down regulated.Hsa-miR-618 which expression was up regulated and hsa-miR-103a-2-5p which expression was down regulated were selected for quantitative real-time PCR detection.It was showed that the expression tendency of hsa-miR-618 and hsa-miR-103a-2-5p were consistent.So the method of miRNAs array was reliable.The target genes of 17 miRNAs which were up regulated and 24 miRNAs which were down regulated were predicted by using database software.Conclusion It is notable that the differential expression of miRNAs in patients with β-thalassemia major.It will be afforded new direction and thinking for the mechanism research and disease treatment through the further research of the miRNAs regulation pathway in β-thalassemia major.

Child ; Female ; Humans ; Paraquat ; poisoning ; Poisoning ; therapy ; Young Adult

Patient engagement is considered as one pillar of new stage of health care reform and new vitality of health care quality improvement.In recent years,the rapid development of E-Health technology provides richer opportunities for patients to actively participate in health care.The article concludes the basic connotation of patient electronic engagement and proposes the framework on the basis of foreign actions as well as literature reviews,expounds the type,media and methods of patient electronic engagement as well.From the views of projects support,patient education and information rights,feasible policy measures are proposed for patient electronic engagement advancement under E-Health environment.

Objective To explore the effect of ilomastat combined with chemotherapeutic drug capecitabine on human laryngeal cancer hep-2 cell .Methods hep-2 cells were treated by ilomastat and capecitabine alone and their combination .The untreated group was taken as the control group .The proliferation activity of the hep-2 cells was analyzed by MTT assay ,and the Jin′s Q was adopt-ed to assess the characters of combination medication of ilomastat and capecitabine ;the expression level of MMP-9mRNA in hep-2 cell was detected by RT-PCR;the apoptosis rate of hep-2 cell was detected by the flow cytometry .Results Both ilomastat and capecitabine had the inhibiting effect on the proliferation of hep-2 cell ,and the combination of ilomastat and capecitabine increased the cell inhibitory rate(P<0 .05) ,the interaction between ilomastat and capecitabine was the synergistic effect when the combined concentration was (8+100)μg/mL ,while the interaction between ilomastat and capecitabine was the additive action when the com-bined concentration was (40+ 400)μg/mL ;RT-PCR analysis showed that compared with control group ,the expression level of MMP-9mRNA in the single ilomastat group and the combination group were both decreased (P< 0 .05) ,and the expression of MMP-9mRNA in the combination group was lower than that in the single ilomastat group (P<0 .05);the flow cytometry indicated that the apoptosis rate of hep-2 cell in the single ilomastat group and the single capecitabine group were both higher than that in the control group(P<0 .05) ,and the apoptosis rate in the combination group was higher than that in the other groups (P<0 .05) .Con-clusion Ilomastat combined with capecitabine can obviously enhance the inhibition and apoptosis-induced ability of single drug on laryngeal cancer hep-2 cell ,the action mechanism of ilomastst is down-regulation of the expression level of the MMP-9 mRNA .

Objective To study the regulatory ability of peroxisome proliferator-activated receptor ?(PPAR?) ligands to the inflammatory response in human gallbladder epithelial cells. Methods Culture human gallbladder epithelial cells and identify them . Cells were treated for 24 hours with 0, 10 ?mol/L, 20 ?mol/L, 30 ?mol/L, 50 ?mol/L and 100 ?mol/L of Ciglitazone during cellular growth peak(5th day), then stimulated them with hIL-1? 5 ng/ml for 2 hours and measured the concentration of IL-6、IL-8 and TNF-? in cellular supernatants by riadioimmunoassay. Results Contrasted with control group, the expression of IL-6 and IL-8 in each test group were inhibited ((P