Objective To evaluate the ovulation effect of ethinylestradiol and cyproterone acetate combined with metformin on obesity type polycystic ovary syndrome (PCOS).Methods Sixty-two patients with obesity type PCOS were divided into 2 groups by random digits table method:control group (30 cases) was treated with letrozole;observation group (32 cases) was treated with letrozole after 3 months treated with ethinylestradiol and cyproterone acetate combined with metformin.The weight,body mass index (BMI),glycometabolism indexes [fasting plasma glucose (FPG),fasting insulin (FINS) and homeostasis model of assessment for insulin resistance index (HOMA-IR)],hormone [follicle-stimulating hormone (FSH),luteotrophic hormone (LH),estradiol (E2) and testosterone (T)] before and after treatment and ovulation rate and pregnancy rate were compared between 2 groups.Results There were no statistical differences in weight,BMI,FPG,FINS and HOMA-IR in control group between before treatment and after treatment (P ＞ 0.05).The indexes in observation group after treatment were significantly lower than those before treatment [(55.76 ± 2.69) kg vs.(64.42 ± 4.93) kg,(21.52 ± 1.43) kg/m2 vs.(25.74 ± 1.58) kg/m2,(4.46 ± 0.89) mmol/L vs.(5.69 ± 2.01) mmol/L,(12.24 ± 1.82) mU/L vs.(22.88 ± 2.06) mU/L,2.94 ± 1.76 vs.5.27 ± 1.18],there were statistical differences (P＜ 0.05).There were no statistical differences in FSH and E2 in 2 groups between before treatment and after treatment (P ＞ 0.05).There were no statistical differences in LH and T before treatment between 2 groups (P ＞ 0.05),but after treatment were significantly lower than before treatment [control group:(10.33 ±0.57) mU/L vs.(15.63 ± 1.32) mU/L and (1.22 ±0.96) μg/L vs.(2.21 ± 1.24) μ g/L;observation group:(9.07 ± 0.82) mU/L vs.(16.18 ± 1.24) mU/L and (0.71 ± 1.24) μ g/L vs.(2.43 ± 1.52) μ g/L],furthermore the observation group was lower,there were statistical differences (P ＜ 0.05).The ovulation rate and pregnancy rate in observation group were significantly higher than those in control group [78.12％(25/32) vs.53.33％(16/30) and 53.12％(17/32) vs.26.67％(8/30)],there were statistical differences (P ＜ 0.05).Conclusion Ethinylestradiol and cyproterone acetate combined with metformin is more effective on obesity type PCOS,which can improve the ovulation rate and pregnancy rate.

Objective To investigate the safety of argon plasma coagulation (APC) with submucosal injection for colon polyps.Methods A total of 30 sets of fresh sigmoid colon from healthy pigs were assigned to control group to receive direct APC,and to treatment group to receive APC with submucosal injection,respectively.After same time and energy of APC,each specimen was sampled for pathological evaluation and the damage extent was determined as mucosa,submucosa (superior 1/3,middle1/3,inferior 1/3),and muscularis propria.Ten cases of colon sessile polyps with diameter of about 1-2 cm,elevated within 3mm by endoscopic ultrasonography(EUS).Direct APC or APC with submucosal injection were performed,respectively,and the difference was observed by EUS.Results In 30 cases of control group,the injury depth of 5 cases reached to the muscularis propria and of 25 cases to submucosa layer,among which 4 cases showed damage to superior submucosa 12 middle submucosa and 9 inferior submucosa.In 30 cases of treatment group,there was no damage to muscularis propria.The injury depth of 26 cases reached submucosa layer,among which 22 cases showed damage to superior submucosa,4 middle submucosa.The results showed significant difference between two groups (P ＜0.01).In patients who underwent APC with submucosal injection,EUS showed effective isolation of mucosa and muscularis propria.It confined the injury to the mucosal layer.Without treatment of submucosal injection in advance,it seemed easier to damage the submucosa and muscularis propria.Conclusion Submucosal injection can protect the colon injured by APC,and may reduce the risk of colon perforation by APC for colon polyps.

Objective To evaluate the polyethersulfone(PES)hollow fiber membrane automatic plasma collector and its efficiency for separating plasma.Methods The plasma was collected by using the automated plasma collector with an innovating PES hollow fiber membrane plasma separator incorporated into a plasmapheresis device,using single needle.The concentration of total plasma protein was determined by Bio Rad method.Results 1)The sieving coefficients were over 95% during the plasma collection, and were stable.2)As the hematocrit (Hct) increased, the plasma collection rate decreased, but the plasma separation efficiency increased.At constant Hct of 0.45,the plasma filtration rate was 23.6ml/min,and the plasma separation efficiency was 52%.It took 20min to collect 200mL plasma.3)The maximum hemolysis rate after several circulation of collection was below 2.5%.Conclusion The plasma collection was satisfactorily performed, and the yield of plasma protein components was nearly the same as the plasma in whole blood.The PES membrane collector had a comparatively high efficiency of plasma separation.

Objective　To evaluate the diagnostic value of MR I、CT、DSA for cerebral arteriovenous malformation(AVM). Methods　A total of 40 case of AVM were examined with imaging methods in which 19 MRI, 30 CT and, 12 DSA. Combination of two or three kinds of eximinations were perfo rmed in 20 and 4, respectively. Results　Diagnostic accordance r ate rate of CT was 70%, sensitivity and specificity of MRI were 100% and 84% res pectiv ely, diagnostic accordance rate of DSA was 92%. Conclusion　MRI,CT,D SA can play important roles in the diagnosis of AVM. MR and DSA are superior to CT. DSA could reveal the circulation time and the stealing blood situation of AV M and thus suggests the applicability of interventional embolization therapy.

Objective To investigate the SENP1 and c-myb gene expression and their correlations in bone marrow specimens in the patients with acute lymphoblastic leukemia (ALL ) to provide the basis for expounding the role ,mechanism and prognosis of SENP1 and c-myb in ALL .Methods 31 patients diagnosed with ALL (22 cases of B-ALL ,1 case of T-ALL and 8 cases of uncate-gorized ALL ;6 cases in the low/medium risk group ,25 cases in the high risk group) and 31 patients with proliferative bone marrow and hyperplastic anemia diagnosed by the morphology were taken as the control group .The real-time PCR and immunocytochemical staining(SP method) were adopted to detect the mRNA and protein expressions of SENP1 and c-myb in the bone marrow specimens of the ALL patients and the control group .Results The expression of SENP1 and c-myb were both increased in the bone marrow specimens and smears of ALL patients ,which showed the statistical difference compared with the control group (P< 0 .05) ,the Pearson correlation analysis found that the high expression of SENP1 and c-myb had correlation .The expression of SENP1and c-myb in the low/medium risk group were lower than that in the high risk group ,but the difference had no statistical significance . Conclusion The high expression of SENP1 and c-myb exists in the bone marrow specimens of the ALL patients ,SENP1 and c-myb could possibly have the correlation with the occurrence and development of ALL ;but now the differences of SENP1 and c-myb ex-pression among different risk groups of ALL patients are yet to be proven .

Objective To investigate the effect of deltaNp63(ΔNp63) silencing on the proliferation of pancreatic cancer PANC1 cells.Methods ΔNp63 mRNA level in 23 pairs of pancreatic cancer and adjacent tissue specimen was detected by real-time PCR, andΔNp63 protein in human normal pancreatic ductal cell line HPDE6-C7 and pancreatic cancer cell line PANC1, CFPAC1 and BXPC3 was detected by Western blot. PANC1 cells were transfectedΔNp63 specific siRNA (ΔNp63-siRNA ) and scramble siRNA ( Con-siRNA ) using liposome, and untransfected cells served as control.ΔNp63 mRNA and protein was detected by real-time PCR and Western blot to validate the silencing ofΔNp63 expression.MTT assay and BrdU method were used to detect the proliferation and DNA synthesis of transfected PANC1 cells.Results TheΔNp63 mRNA expression in pancreatic cancer tissues and matched adjacent normal tissues was 0.99 ± 0.07 and 0.70 ±0.07, respectively.ΔNp63 mRNA expression in pancreatic cancer tissue was significantly up-regulated compared with that in the normal tissue (P=0.0034).TheΔNp63 protein expression in HPDE6-C7, PANC1, CFPAC-1 and BxPC3 cells was 0.97 ±0.09,3.06 ±0.16,2.57 ±0.11 and 2.45 ±0.08, respectively.TheΔNp63 protein level in pancreatic cancer cells were higher than that in HPDE6-C7 cells (P<0.001).ΔNp63 mRNA level in control, Con-siRNA and ΔNp63-siRNA group was 0.97 ±0.07,0.97 ±0.07 and 0.28 ±0.03, respectively, andΔNp63 protein expression level was 0.97 ±0.06,1.00 ±0.10 and 0.26 ±0.03.The expression ofΔNp63 mRNA and protein inΔNp63-siRNA group were significantly down-regulated comparing with those in Con-siRNA group (P<0.01).Significant inhibition on cell proliferation was observed in ΔNp63-siRNA group, which was statistically different from that in control and Con-siRNA group.The A490 value (DNA synthesis) of control, Con-siRNA andΔNp63-siRNA group was 0.55 ±0.04, 0.56 ±0.01 and 0.55 ±0.00 at 24 h after transfection, and 0.84 ±0.05,0.87 ±0.07 and 0.71 ±0.05 at 48 h after transfection.The DNA synthesis inΔNp63-siRNA group was significantly down-regulated compared with that in control and Con-siRNA group (P<0.05).Conclusions Knockdown ofΔNp63 could greatly inhibit the proliferation and DNA synthesis of pancreatic cancer PANC1 cells.

Objective To investigate the correlationship between depressed behaviors and interleukin-1β (IL-1β) in brain tissue in mice which are insensitive to fluoxetine,and to mimic the treatment resistant depression (TRD) in clinical condition.Methods 50 BALB/c mice were randomly divided into Control group (Control),Chronic unpredictable mild stress (CUMS) group and CUMS+fluoxetine group.Mice in Control group were raised ad libitum for 9 weeks,those in CUMS group received CUMS for 9 weeks and those in CUMS+fluoxetine group received 8 weeks' CUMS followed 1 week' s treatment with Fluoxetine(10 mg · kg-1 · d-1).At the end of the 9th week,mice in(CUMS + treatment)group were selected into antidepressant treatment-resistant mice(ATRM) as no remission and Depression Group (DM) as symptoms improved.Body mass test (BMT),open field test (OFT) and forces swim test (FST) were completed respectively in these 4 groups at the endpoint of the experiment,and the brain tissue were extracted after the tests for IL-1β Elisa test.Results (1) BMT:there was no effect of weightgain in ATRM after 1 week' s therapy with Fluoxetine.There was no difference in body-weight between ATRM ((18.56±7.56) g) and CUMS ((19.03± 8.58) g) mice,while compared with Control ((24.56±5.45) g) and DM mice ((20.12±9.17) g) ATRM and CUMS mile's body weight were significantly lower (P＜0.05).(2)OFT and FST:in OFT,there was no significant difference in of horizontal moving distance(F=0.355) either in the frequencies of entering the central zone (F=0.327) among the 4 groups;in OFT,the immobility time of ATRM ((241.50 ± ± 36.55) s) was significantly longer than that in DM ((156.00± 25.47) s) (F=13.573,P＜0.05).(3) Elisa test of IL-1β:the brain' s IL-1β serum level in ATRM ((164.90±46.70) pg/mg) was higher than those in Control ((69.68±6.56) pg/mg)),and DM ((93.09±4.65) pg/mg) (P＜0.01),while no difference with that in CUMS mice.Additionally,the depressive behaviors in ATRM showed its positive correlation with the IL-1β level in CNS (r=0.669,P=0.006).Conclusion CUMS can elicit the refractory depressive symptoms in BALB/c mice to simulate TRD' s characteristic,and the elevated level of IL-1 β within brain tissue may play an important role in the development of TRD.

Objective To explore the imaging method and the value of clinical application of spiral CT virtual endoscopy(CTVE)to stomach.Methods After 36 patients took the aerosis agent or 5% contrast medium,virtual endoscopic images were obtained by using GE-Navigator smooth image model and multiplanar reconstruction.Results Two types of contrasts complemented each other.Normal gastric structure,stenosis and obstruction were clearly visualized in 36 patients.Conclusion CTVE can provide a noninvasive diagnostic method,supplemented to fiberoptic endoscopy,but its sensitivity and specificity should be improved.

Objective To evaluate the effects of different dosage of aspirin and clopidogrel on the platelet inhibition rate by thromboelastography (TEG)before stent-assisted embolization of aneurysms. Methods The clinical data of 57 patients with unruptured aneurysms treated by stent-assisted coil embolization in General Hospital of Nanjing Military Command were analyzed retrospectively. The patients were divided into a low dose group (aspirin 100 mg + clopidogrel 75 mg,26 cases)and a high dose group (aspirin 300 mg +clopidogrel 75 mg,31 cases). All the patients were treated with aspirin and clopidogrel before surgery. The blood samples were collected on day 3 after oral administration with anti-platelet aggregation drugs. TEG was used to detect the arachidonic acid (AA )-induced inhibition rate of platelet aggregation and adenosine diphosphate (ADP)-induced inhibition rate of platelet aggregation. The platelet inhibition and drug resistance,as well as ischemic complications in the perioperative period between the two groups were compared. Results (1 )The platelet inhibition rates:there was no significant difference in the inhibition rates of platelet aggregation of AA and ADP between low dose group and high dose group at day 3 after oral antiplatelet drugs [AA inhibition rate:(76 ± 21)% vs. (80 ± 21)%;ADP inhibition rate:(72 ± 26)% vs. (73 ± 29 )%;all P >0. 05 ]. (2 )Drug resistance:in the low dose group,the patients of aspirin and clopidogrel resistant were 2 cases(7. 7%)and 1 case(3. 8%),and the patients in high dose group were 3 cases (9. 7%)and 4 cases(12. 9%). No statistical significant difference in the aspirin and clopidogrel resistant was detected in the two groups (all P>0. 05). (3)The ischemic complications in the perioperative period:there was 1 case (3. 8%)with ischemic complications in the low dose group,and 2 cases (6. 5%)in the high dose group. There was no significance difference in the incidence of ischemic complications between the two groups(P >0. 05). Conclusion For patients treated with stent-assisted embolization of aneurysms,no difference could be detected in the inhibitory effect of platelet aggregation between low and high dose groups of aspirin.

Objective To investigate the diagnostic value of high frequency color Doppler ultrasound combined with gastrointestinal filling in infants with duodenal obstruction . Methods One hundred infants who were suspected with duodenal obstruction underwent both gastrointestinal ultrasound and upper gastrointestinal tract ,put the surgical results as the ?gold standard ,the values of ultrasonic and upper gastrointestinal tract in the diagnosis of pediatric congenital duodenal obstruction were compared . Results The diagnostic accuracy of ultrasound and upper gastrointestinal tract in duodenal obstruction was 100%and 94% respectively ,the difference was statistically significant ( P = 0 .041) . The accuracy rate of obstruction location was 98 .04% and 84 .31% respectively , also was considered to denote statistical significance ( P = 0 .023 ) . The total diagnostic accuracy of congenital disorders caused by duodenal obstruction was 89% and 49% respectively ,and P = 0 .001 implies statistically significant difference . Conclusions There is a high diagnostic accuracy in high frequency ultrasound combined with gastrointestinal filling in children with congenital duodenal obstruction ,and the diagnosis of some diseases is better than that of the upper gastroenterography .