Anti-müllerian hormone (AMH) is mainly produced by the granulose cells of the developing preantral and antral follicles in women and a reliable marker of the reproductive function of women.The mean terminal t1/2 of AMH is calculated as (27.6 ± 0.8) h.Serum concentration of AMH declines by 5.6％ per year and several reproductive and lifestyle factors are associated with age-specific AMH levels.AMH can be applied to predict the precise age of the menopause and is a marker of ovarian reserve in women of 25 year old and older.Iu the field of assisted reproductive technologies,AMH is beneficial in the individualization of stimulation protocols at controlled ovarian hyperstimulation and may be positively associated with clinical pregnancy rates,live-birth rates and twin gestation after assisted reproduction.The researches of AMH may be helpful in the studies of mechanism of polycystic ovary syndrome (PCOS).AMH measurement may be included as a diagnostic criterion of PCOS and a useful predictive marker for the efficiency of the treatment of PCOS.AMH has been also shown to inhibit tumor growth in vitro and in vivo and can be used as a tumor marker in granulosa cell tumors.By using AMH,ovarian reserve damages caused by different kinds of diseases and treatments,including rheumatoid arthritis,laparoscopic surgeries of endometriomas,chemotherapy of female cancers have been studied.Some researchers have begun to pay attention to the potential relationship between AMH and the function of human brain.In the future,the applications of AMH maybe probably do significant contributions to make ideal and individualized treatment programs in more and more related fields.

Objective To establish D-dimer normal reference range in pregnant and postpartum women in Zhejiang Han population.Methods Plasma samples were collected from 669 healthy pregnant women, 578 healthy postpartum women, 8 venous thrombosis or DIC patients and 80 healthy non-pregnant women in Women′s Hospital, School of Medicine, Zhejiang University from March 2009 to August 2010.According to different gestational week, postpartum days and delivery pattern, the healthy pregnant and postpartum women were stratified into 3 groups: (1) ≤13 weeks (n=120), 14-20 weeks (n=120), 21-27 weeks (n=145), 28-34 weeks (n=147), ≥35 weeks (n=137);(2) The first day after vaginal delivery (n=163), the second day after vaginal delivery (n=121);(3) The first day after cesarean sections (n=166), the second day after cesarean sections (n=128). These groups were further stratified based on age: ＜30 years old and ≥30 years old.All blood samples were drawn in citrate sodium anticoagulated blood.D-dimer concentration was determined by STA-R Evolution coagulation analyzer.Since D-dimer concentration showed non-normal distribution, the normal values (one-tailed) were established by using (P95) percentile method.The results of 8 patients were used to validate the established normal values.Results In the group of ＜30 years old, the D-dimer values[M(P25-P75)]in group of ≤13 weeks, 14-20 weeks, 21-27 weeks, 28-34 weeks, ≥35 weeks and healthy non-pregnant women were 0.25(0.17-0.37), 0.51(0.38-0.75), 0.75(0.57-1.10), 1.14(0.80-1.48), 1.60(1.14-1.89) and 0.20(0.10-0.28) mg/L, respectively, which showed statistical difference(H=239.24, P＜0.05).In the group of ≥30 years old, the D-dimer values of the above different groups were 0.28(0.14-0.38), 0.50(0.36-0.65), 0.83(0.59-1.41), 0.93(0.68-1.37), 1.47(1.22-1.84) and 0.17(0.12-0.25) mg/L, respectively, which also showed statistical difference(H=127.75, P＜0.05).In the group of ＜30 years old, the D-dimer values were 2.45(1.51-3.77), 1.30(0.97-1.96), 2.68(1.52-3.74) and 1.55(1.10-2.10) on the first and second day after vaginal delivery and cesarean section, respectively, which showed statistical difference (H=64.85,P＜0.05).In the group of ≥30 years old, the corresponding values were 2.20(1.33-3.54), 1.33(1.02-2.14), 2.27(1.66-3.17) and 1.62(1.26-2.69), respectively, which also showed statistical difference(H=18.64, P＜0.05).D-dimer normal values were established based on different gestational week, postpartum days and delivery pattern.The normal values of ≤13 weeks, 14-20 weeks, 21-27 weeks, 28-34 weeks and ≥35 weeks were ≤0.64 mg/L, ≤1.54 mg/L, ≤2.60 mg/L, ≤3.01 mg/L and ≤3.19 mg/L, respectively. The normal values of 1st day after vaginal delivery, 2nd day after vaginal delivery,1st day after cesarean sections and 2nd day after cesarean sections were ≤7.83 mg/L, ≤3.29 mg/L, ≤9.95 mg/L and ≤3.80 mg/L.All 8 patients showed positive results with the above normal values.Conclusion D-dimer normal values in pregnant and postpartum women in Zhejiang Han population are established, which can improve the application values of D-dimer in the pregnant and postpartum population.

[Objective] To disuse the traumatic mechanism,clinical feature and treatment of the occult osteochondral avulsion of the posterior ankle joint.[Method]The data of 6 patients had been reviewed.From 2003.9 to 2006.6,6 patients had been treated,including 4 male and 2 female,with the average ages of 31.7 years(27~38 years).They all had injury history of their ankle but no fracture or dislocation had been found in X-ray film immediatey after the trauma.Four of them had been treated by plastic cast fixation of their ankle for 3 weeks,2 received treatment without fixation,but all the patients suffered pain and tenderness in the medial-posterior or the lateral-posterior of the ankle with leg or/and food radiation.The symptoms were persistent even when they were rest.The diagnosis of osteochondrl avulsion fracture had not been made until they were admitted in 4 mouth to 1 year after the injury.The fractured bone debris were showed by X-ray film and CT scan.All patients had been treated by operation of ablating the fractured fragment.[Result]All symptoms in the ankle had disappeared 2~3 days after the operation and no recurrence during 6 mouth to 2 years follow up.[Conclusion]It shoud be attaching importance to the occult osteochondral avulsion in early time after ankle injury,and when the diagnosis is made,operation is the appropriate treatment.

OBJECTIVE:To evaluate the economic effectiveness of three angiotension-converting enzyme inhibitor(ACEI) in treating patients with essential hypertension.METHODS:186 patients with essential hypertension were randomly divided into three groups receiving enalapril,fosinopril and perindopril respectively.The results were evaluated with pharmacoeconomic analysis.RESULTS:In treatment of hypertension,enalapril was minimal in cost.CONCLUSION:Therapeutic effect will be improved and cost decreased when pharmacoeconomic cost-effectiveness analysis is used.

Objective To investigate the correlation between carotid artery intima media thickness (IMT) and cerebrovascular hemodynamic analysis (CVA) and the diagnostic value in ischemic stroke.Methods Using colour Doppler IMT,IMT/D ratio and CVA were performed in 120 patients with hyperacute and acute ischemic stroke as compared with the health controls.Results IMT and IMT/D ratio were higher in patients with ischemic stroke than the health aduts. Vmean and Qmean in ischemic stroke hyperacute group were lower, and R,DR were higher obvious in hyperacute group than that of acute group. IMT and IMT/D ratio were negatively correlation with Vmean and Qmean and positively correlation with R and Zc.Conclusion The measurement of carotid artery IMT and CVA have clinical significance in early diagnosis of ischemic stroke.

The effect of gelatin on anaero-cultivation of Bifidobacterium adolescent is and stabilization of its living cell in dried preparation was investigared. It was shown that the well-distributed mixture of gelatin and medium could have a cushioning effect on pH reduction resulting from acid-production while incubating, and the dried mixture comprising living cell of bifidobacterium adolescentis was prepared, in which the stability and viability of cell come from cultures of gelatin mixture was increased compared with that without gelatin mixture. It was shown that oxygen toxicity to anaerobic cell was well reduced because of cell immobilization by the gel mixure after drying with saccharide substance , and then fermentable dynamics in 50L fermentor was tested as well as the relationship of growth kinetics, pH, dissolved oxygen rate, and content of soluble solids.

AIM: There has been accumulating evidence demonstrating that activators for peroxisome proliferator-activated receptor ? (PPAR?) have antiinflammatory, antiatherogenic, and vasodilatory actions. We investigated the effect of PPAR? activator, fenofibrate, on trombin-induced endothelin-1 (ET-1) expression in cultured vascular endothelial cells. METHODS: Bovine aortic endothelial cells (BAECs) were treated with the PPAR? activator, fenofibrate. The ET-1 concentrations were evaluated by radioimmunoassay. Reverse transcription-polymerase chain reaction (RT-PCR) was used to detect the ET-1 mRNA expression. RESULTS: Thrombin(10U/L) induced ET-1 release in BAECs [(22.4?4.7) nmol/g protein vs control (13.2?1.6) nmol/g protein, P

OBJECTIVE:To establish HPLC method for simultaneous determination of estazolam and diazepam in serum METHODS:The mobile phase consisted of methanol-water-triethylamine-acetic acid(55∶45∶0 5∶0 35)and the ?max was 254nm Phenytoin was adopted as the internal standard The drugs were extracted by diethyl ether under the alkaline condition RESULTS:The calibrating curves of estazolam and diazepam were linear in the ranges of 0 52～38 62?g/ml and 0 50～40 16?g/ml respectively CONCLUSION:The method was appropriate for determination of estazolam and diazepam qualitatively and quantitatively in intoxication accident

Background Evidence-based medicine (EBM) has been widely applied to solve clinical issues internationally,however,the awareness of oculists in China still is dissatisfied,and the relevant issue survey can offer the training guidance.Objective This study was to survey the status of the cognition and practice of EBM in ophthalmologists in China and analyze the problems in their EBM practice.Methods Two hundred and thirty-three ophthalmologists were enrolled in the 18th Congress of Chinese Ophthalmological Society in August,2013.A survey about EBM was performed by self-made questionnaire,including general data from the surveyors,the way and channel of understanding EBM,the attitude toward EBM,clinical practice of EBM and influencing factors.The educational background,professional qualifications,ranked distribution of hospitals which surveyors came from,size of the citys and attribute of hospitals were stratified and analyzed.SPSS 17.0 software was used for statistical analysis.Results A total of 233 questionnaires were distributed,and 233 were regained with the response rate 100％,and 214 valid questionnaires were included,with the effective rate 91.8％.50.5％ of the respondents (104/206) knew EBM in university.The proportion of those believe EBM initially as medical students was 41.8％,and 49.1％ (102/208) were aware of EBM in recent 8 years.And 47.7％ (101/211) believed that EBM should be given priority in clinic,and 7.5％ (16/211) were indifferent to EBM.Only 3.8％ (8/211) surveyors thought EBM to be little important.The proportion of the respondents choosing ‘ know’ or ‘ moderately-know’ were 69.1％ (148/214),35.0％ (75/ 213),21.5％ (46/213) and 57.4％ (121/211) respectively in EBM,Meta analysis,Cochrane as well as Preferred Practice Patterns (PPPs) with a higher receiving degree in well-educated individuals (P =0.000,0.000,0.001,0.000).EBM was well practiced in 11.7％ (25/211) oculists,with a higher using frequency in senior ophthalmologists,and 17.8％ (89/495,frequency) oculists consulted the EBM literature to resolve problems in clinic,with a significant difference in the using frequency of EBM among the different educational background subjects (x2=13.406,P=0.037).The top three barriers which affected the application of EBM in clinical practices were lack of time and the limited energy,feeling it difficult to evaluate the evidence correctly as well as the absence of cases proving the efficacy to treat based EBM.The type of EBM evidence mostly used by respondents was medical database (36.7％),and CNKI (33.5％) and PubMed (38.4％) were the mostly used Chinese and English database,respectively.Respondents who have never searched the Chinese or English database occupied up to 7.3％ and 17.2％,respectively.Conclusions The cognition degree and applying frequency are still lower in ophthalmologists in China.The training of EBM should be strengthened in medical students.The guidance measurement should be taken to encourage eye doctors to apply EBM.

Background Randomized controlled trial (RCT) can offer high quality of evidence for the medical decisions.Consolidated standards of reporting trials (CONSORT) statement,an international criteria for RCT report,is a guideline and methodology of RCT report.However,the assessment and application of RCT according to CONSORT are dissatisfactory in China.Objective This study was to evaluate the reporting quality of ophthalmic diseases related RCTs published in SCI journals from mainland China and offer a good methodology of RCT report.Methods The RCT literature were searched on PubMed database according to Ophthalmology, Eye and all of their inferior subjective terms,and the published papers were limited in mainland China and before March,2013.Included papers were evaluated independently and checked by two searchers.The methodology and results of all retrieved papers were stratifiedly analyzed by the year of CONSORT published and revised.Results Sixty eligible RCTs were assessed,and the intervention methods were primarily surgery trials (34/60).Forty-four papers presented the comparison study of two groups with the median sample size of 76.0.Only 22％ (13/60) trial reports gave the clear identification of RCT in the title.Majority of papers described trial design,eligibility criteria for participants,detail of interventions and outcome measures.Twelve pieces of articles reported how sample size was determined,and 41 pieces referred settings and locations,but only 6 pieces recorded interim analyses and stopping guidelines.After CONSORT 2010 Statement was published,the proportion of trial reports that included details of the randomization had little improvement (RR=1.06,95％ CI:0.62-1.82).Only 42％ trial reports (25/60) offered a description about blinding method.Conclusions RCT reports related to ophthalmic diseases from mainland China in SCI journals are still flawed with certain shortcomings.Following the guidance of the CONSORT statement can improve the quality of ophthalmic diseases related RCT from mainland China.