Objective To understand the correlation between insulin resistance(IR) and adrenal androgen excess in adolescents with polycystic ovary syndrome (PCOS). Methods According to BMI, 90 adolescents with PCOS were divided to groups of normal weight PCOS(NW-PCOS,33 cases,BMI<25.0 kg/m2) and obesity PCOS(OB-PCOS,57 cases, BMI≥ 25.0 kg/m2),and 15 normal weight healthy girls matched for age as controls.All patients had normal OGTT.Acute ACTH stimulating test was performed on patients, and cortisol (F), 17-hydroxyprogesterone(17-OHP), dehydroepiandrosterone(DHEA) during ACTH testing at 0 and 60 minute (steroid0 and steroid60) were determined. Results Compared with controls, NW-and OB-PCOS patients showed significantly greater levels of total testosterone (T), Luteotropic hormone(LH), FIns, 2 hIns, and HOMA-IR(P<0.01).The freqnencies of hirsuties and acne, and serum level of FIns, 2 hIns, and HOMA-IR were significantly higher and LH levels were much lower in the group of OB-PCOS than those in NW-PCOS(P<0.05 and P<0.01).ACTH stimulating test showed that PCOS patients had significantly higher levels of basal 17-OHP0, DHEA0, as well as 60-minute ACTH-stimulated levels (Steroid60) of 17-OHP60、DHEA60, and net increase of 17-OHP(Δ17-OHP)as compared with normal controls(P<0.05 and P<0.01).The 60-minute ACTH-stimulated levels of 17-OHP60, DHEA60,Δ17-OHP, and ΔDHEA were also higher in group of OB-PCOS than those in group of NW-PCOS(P<0.05 and P<0.01), and there were no obvious discrepancies in basal 17-OHP0, DHEA0 between OB-PCOS and NW-PCOS groups.Spearman correlation analysis showed that in group of OB-PCOS, HOMA-IR value was significantly associated with BMI, 17-OHP60, Δ17-OHP, DHEA60, ΔDHEA(P<0.05 and P<0.01); whereas in group of NW-PCOS, HOMA-IR was associated only with BMI(P<0.01). Conclusions The significantly higher basal and ACTH-stimulated levels of 17-OHP and DHEA indicates adrenal hyperresponsiveness in adolescents with PCOS.Adrenal androgen excess appears to be closely associated with insulin resistance in obese adolescents with PCOS

Objective To investigate the effect of position ventilation(PPV) on oxygenation,the airway sputum drainage and hemodynamic of acute respiratory distress comprehensive syndrome(ARDS).Methods From June 2015 to April 2016,13 cases with moderate or severe ARDS were researched.The changes of PaO2,PaCO2,SpO2,PaO2/FiO2 and airway sputum drainage were observed as well as HR,MAP,CVP,CO,CI,SVV,etc.Results Totally 56 PPV were taken.Compared with pre-treatment of PPV,the number of PaO2 and PaO2/FiO2 increased from (74.7±13.18) mm Hg and 168.65±22.12 to (92.13±17.82) mm Hg and 208.80±24.04(P<0.05) respectively;SpO2 and airway sputum drainage increased from (95.32±2.76)% and (7.84±1.68)mL to (97.04±1.84)% and (13.25±3.55)mL(P=0.000).However,there were no significant differences in HR,MAP,CVP,CO,CI and SVV(P>0.05).Conclusion PPV can effectively improve oxygenation in patients with ARDS and promote airway sputum drainage,and hemodynamic effects are not obvious.However,nursing intervention still should be strengthened.

Objective:To compare the shear bonding strength between two kinds of veneering ceramics respectively bonded to Vita Mark II.Methods:Vita Mark II samples were prepaired in the size of 8 mm ×6 mm ×2 mm.Veneering ceramic VM9 and Titankeram-ik were sintered on the Vita Mark II blocks respectively(n =1 0).The shear bond strength of each specimen was measured,the failure mode of the fracture surface was observed by SEM.The element in the bonding interface was analysed by field emission scanning elec-tron microscope(FE-SEM).Results:The values of shear bond strength (MPa)of VM9 and Titankeramik groups were 36.1 7 ±8.91 and 42.07 ±8.31 respectively(P >0.05).SEM observation showed tight bond between the two materials,FE-SEM results showed penetration of Al element from MarkⅡblock into veneering porcelain VM9 or Titankeramik.Conclusion:Veneered porcelain of VM9 and Titankeramik can be used as the individual veneering ceramics for Vita Mark II blocs.

Objective:To research the value of diagnosis of traumatic rib fractures by multislice CT VRT and DR plain film. Methods: Seventy-two cases of traumatic rib fracture patients were diagnosed by DR film and multislice CT VRT. Results:Multiple rib fractures than single, most of them occurred in the 4-10 ribs and axillary segment, 97.2%of 16-slice spiral CT three-dimensional reconstruction of patients with rib fracture diagnosis rate significantly higher than DR plain film diagnosis rate 80.3%(x2=19.15, P<0.01), DR plain film missed rib fractures are mainly located in the costal cartilage (58.1%), 16-slice spiral CT reconstruction is still found 19 other fractures and lung complications 16cases. Conclusion:16-slice CT the thin layer VRT diagnosis of rib fractures greatly improves the diagnostic accuracy.

Objective To investigate the correlation between serum adiponectin level and severity of coronary artery disease.Methods We measured the serum concentrations of adiponectin in 135 patients whom had received CAG.The severity of coronary artery lesion was evaluated by Gensini score,the number of stenosis vessel and clinical manifestation.Results The serum concentrations of adiponectin in Gensini score 0 group(74.53?30.76 ng/mL)and score 40 group(28.96?11.87 ng/mL)(P40 group were lower than those in score 20-40 group(P

Objective To explore the activities of daily living (ADL) and related factors of patients with Parkinson's disease (PD). Methods118 PD patients were assessed with the ADL scale, Unified Parkinson Disease Rating Scale-Ⅲ (UPDRS-Ⅲ), the Hamilton Rating Scalefor Anxiety (HAMA) and Hamilton Rating Scale for Depression (HAMD). Results ADL score in all the patients was (40.75±14.63); ADLscore was higher in anxiety or depression group than in non-anxiety or non-depression group respectively (P<0.05). Scores of UPDRS-Ⅲcorrelated with the ADL (r=0.506, P=0.000). Conclusion ADL decreases in PD patients, especially those with anxiety and depression. Themotor disorder of PD patients correlated with ADL.

Objective To discuss the application of Chinese version of Speech intelligibility rating (SIR) in e-valuating the speech intelligibility of Chinese children with hearing disorder ,and analyze its scorer reliability .Meth-ods 50 children with cochlear implants or hearing aids were interviewed using SRI Chinese version .Each child was rated by a parent and a speech and language therapist .The reliability of scores was analyzed with Spearman correla-tion coefficient ,Kendall's coefficient of concordance and Kappa coefficient .Results The complete agreement was foud in 34 cases(68% ) ,with a disagreement of one category in 14 cases(28% ) ,and a disagreement of 2 categories was found in 2 cases (4% ) .Spearman correlation coefficient was 0 .885 ,Kendall's coefficient of concordance was 0 .801 ,Kappa coeffi-cient was 0 .593 ,the result was statistically significant (P<0 .001) .Conclusion SRI Chinese version has good reliability and is helpful in evaluating Chinese speech producing ability of children with hearing disorder in everyday life .

Escherichia coli ; genetics ; pathogenicity ; Humans ; Infant, Newborn ; Virulence ; genetics

Objective To discuss decision of the safety margin of esophagus in the radical gastrectomy of adenocarcionma of esophagogastric junction.Methods The length of esophageal resection margin of intraoperative,postoperative and pathological large slice under the microscope of 50 cases adenocarcionma of esophagogastric junction underwent radical gastrectomy were measured,and the proximal invasive length of esophagus in large pathological slice were also measured,and the relationship between it and pathological factors was analyzed.Determined the minimum safety cut edge distance.Results In 46 of 50 patients,proximal intramural spread of the tumor was observed.The invasive length of tumor from 0.1 cm to 3.5 cm.The invasive length of tumor was <1.0 cm with 11 patients,1.0-1.5 cm with 19 patients,1.5-3.0 cm with 15 patients,in only 1 patient was the distance of spread 3.5 cm.Invasive length of adenocarcionma of esophagogastric junction had a significant difference between the groups in different pathological factors(P<0.001).Conclusion The length of 3.5 cm is the safety margin of esophagus in the radical gastrectomy of adenocarcionma of esophagogastric junction(SiewertⅡ,Ⅲ type) by abdominal incision.