Objective To investigate the effect of gastrointestinal lipase inhibitor combined with biguanides on serum estrogens in the treatment of polycystic ovary syndrome with infertility in patients.Methods 72 cases with polycystic ovary syndrome with infertility from Huangyan Hospital Affiliated to Wenzhou Medical University were selected and randomly divided into 2 groups, 36 cases of each group.The control group received conventional therapy, and the treatment group received more with orlistat, serological indicators, clinical symptoms, signs, pregnancy rate and ovulation rate were compared after the treatment.Results Compared with control group, levels of blood glucose and blood lipid index decreased in treatment group after treatment (P<0.05), the levels of luteinizing hormone (LH), follicles estrogen (FSH), estradiol (E2) and testosterone (T) decrease(P<0.05), levels of visfatin (VF) and leptin (LEP) decreased(P<0.05), adiponectin (APN) increased(P<0.05), and levels of BMI, WHR, hirsutism score and ovarian volume decreased (P<0.05).Compared with the control group(69.44%, 55.56%), the ovulation rate and pregnancy rate in the treatment (91.67%, 80.56%) were higher(P<0.05).Conclusion Gastrointestinal lipase inhibitor combined with biguanides could improve the pregnancy rate and ovulation rate in patients with polycystic ovary syndrome with infertility, reduce the levels of estrogens.

Objective To evaluate correlations between CT features and clinical activity index of Crohn’s disease(CD).Methods The CTE datasets from 37 patients with moderate active,severe active and remission stages CD were retrospectively analyzed.To ob-serve imaging features of intestinal wall,parenteral and complications.And analyze whether there was an association between imaging findings and clinical activity.Results A total of 147 bowel segments in 37 cases were involved.Wall thickening (intestinal wall≥4 mm)were observed in 121 segments.An average thickness was (12.1±3.2)mm.There are 42 bowel segments of trilaminar mural stratifica-tion,71 of the double-layed stratification and 34 of non-stratification.Enlarged mesenteric lymph nodes were observed in 20 patients. Comb sign was observed in 27 patients.Higher density of surrounding fat appeared in 22 cases.The other 37 cases inluced 4 cases with abdominal abscess,7 cases with fistula,1 6 cases with intestinal obstruction or stenosis and 1 7 cases of perianal disease.The in-testinal stratification,wall thickening,comb sign,mesenteric fat density increased,abdominal abscess,intestinal stenosis and obstruc-tion were closely associated with clinical activity.Conclusion CTE images could provide information about intestinal wall,parenteral changes and complications of Crohn’s disease,and effectively help identifying remission and active stages of Crohn’s disease.

Objective To compare the levels of murine basophils distribution in different organs and analyze the characteristics of CD4+T cells activation/differentiation regulated by basophils.Methods Firstly,the mononuclear leukocytes were isolated separately from periphery blood,liver,spleen,lung and lymph nodes and the percentages of FcεR I+CD49b+ basophils in different organs were investigated.Secondly,liver basophils were purified by immuno-microbead strategy and co-clutured with different cytokines for 24 h.Apoptosis status of basophils was detected by Annexin V straining method.Thirdly,Mice were subcutaneously implanted with a miniosmotic pump containing 5 μg IL-3.At day 7 after implantation,liver mononuclear cells were harvested and the percentages of basophils were analyzed.Finally,Th1/Th2 polarization influenced by basophils orientated cytokines was investigated when naive OT-Ⅱ CD4 T cells were stimulated with spleen dentritic cells and OVA peptides.Results The percentage of murine basophils in mononuclear leukocytes of liver was significantly higher than that of periphery blood,spleen,lung and lymph nodes under physiological condition.Both of in vitro and ex vivo experiments showed that IL-3 played an inhibitory role on apoptosis of basophils.Cytokines secreted by basophils was investigated to induce Th2 polarization and inhibit Th1 response when naive OT-Ⅱ CD4 T cells were co-cultured with spleen dentritic cells and OVA peptides.Conclusion Th2 response was enhanced and Th1 response was down-regulated by murine basophils,which implied that basophils might participate in the construction of liver specific physiological immuno-tolerant microenvironment.

Objective To observe the effects of shenfu injection (SFI) on the awakening quality of the patients with hepatitis B cirrhosis undergoing splenectomy under general anethesia. Methods Forty patients with hepatitis B cirrhosis and hepatic insufficiency (ASA classⅡ~Ⅲ) underwent splenectomy by general anesthesia. Patients were all sent into the post-anesthesia care unit (PACU) shortly after the operation with unconscious and no spontaneously breathing. They were randomly divided into two groups: SFI treatment group (Group SFI, n =20) and normal saline controlled group (Group NSC, n = 20). SFI group were treated with SFI (1 mL/kg, i. v.) in 10 minutes, and NSC group were treated with normal saline (1 mL/kg,i.v.). The time of eyes opening, extubation of tracheal catheter and the detention time of PACU were recorded. The heart rate (HR) and the average artery presses (MAP) were monitored at 4 time points: before SFI and normal saline administration, 5 min, 15 min, and 45 min after administration. The incidence of restlessness during the patients awakening period was also recorded. Results The time of eyes opening, extubation and the detention time of PACU of SFI group show no significant difference compared with the NSC group (P > 0.05). SFI and normal saline intravenous injection did not cause significant changes on HR and MAP at the time of 5 min , 15 min and 45 min compared to the time of before administration (P > 0.05). The incidence of restlessness during the patients resuscitation period in SFI group were lower than in NSC group (P < 0.05). Conclusion Shenfu injection can effectively improve the awakening quality and decrease the incidence of restlessness of the patients with hepatitis B cirrhosis undergoing splenectomy under general anesthesia during the awakening period in PACU.

Objective To analyze the effect of reconstruction for the proximal or distal femoral defect by a composite of massive frozen allograft and prosthesis replacement. Methods According to Enneking's classification, malignant bone tumors of the proximal or distal femur were widely resected in 28 cases. Reconstruction of the affected hip or knee joint after major joint removal was done by a composite of allograft and prosthesis. A conventional femoral component with a stem long enough to provide good fixation in the femoral shaft was threaded over a customized allograft. After the assembly had been reduced and checked for size and position, the allograft was cemented to the femoral component, and the composite was in turn cemented into the femoral shaft with PMMA. Results 26 patients were followed up from 6 to 78 months with an average of 41 months. 3 cases died within 18 months following operation; 4 case sustained recurrences within 8 months postoperatively, and underwent re-resection; and the others were alive without diseases. All patients had no dislocation, loosening or breakage of prosthesis. X-rays showed the time of bone healing between allograft and host femur was an average of 7.4 months (range, 5 to 11 months), and the rate of bone healing was 92% (24/26). Absorption was seen around allograft greater trochanter of femur in 9 cases and at femoral condyle in 6 cases. 13 cases with total hip composite replacement had good active extension-flexion degrees of an average of 85?( range, 71? to 124?), and 13 with total knee composite replacement had a rang of motion of 92?(range, 68? to 135?). The postoperative average ISOLS scale score of 26 cases by Enneking's system was 26.2 point (range, 22 to 28). Conclusion The clinical result demonstrated the composite of massive frozen allograft and prosthesis replacement has the advantages of both allograft and prosthesis. Its best indications are that the patients with a major femoral defect from benign or low grade malignant tumor have longer survival expectancy.

Objective: To investigate the influence of Swiss ball exercises on clinical efficacy and stability of lumbar vertebra in patients with protrusion of lumber intervertebral disc. Method: Thirty patients with non-acute protrusion of lumber intervertebral disc were divided by gender and clinics orders into control and exercises group. Roland Morris questionaire(RMQ) and visual analogue seale(VAS) were selected as pain assessment. Pain, abdominal and back muscle strength were assessed respectively before treatment, 2 and 4 weeks after Swiss ball exercises. Both Swiss ball exercises and lumbar traction were used in exercises group. Lumbar traction was used in control group. Result: Compared with before treatment, RMQ and VAS scores decreased significantly after 4 weeks in control and exercises groups (P<0.05, P<0.01). Compared with control, RMQ and VAS scores in exercises group decreased significantly after 2 and 4 weeks respectively (P<0.05, P<0.01). Compared with control, abdominal and back muscle strength in exercises group increased significantly after 2 and 4 weeks respectively (P<0.05, P<0.01). Conclusion: The low back pain symptom of patients with protrusion of lumber intervertebral disc decreased significantly and abdominal and back muscle strength increased significantly by beth Swiss ball exercises and lumbar traction. The stability of lumbar vertebra of patients with protrusion of lumber intervertebral disc increased significantly.

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Objective To investigate the effects of aspirin(aspi) on rat cardiac fibroblasts (CFs) proliferation induced by aldosterone(ald) and the underlying molecular mechanisms .Methods Primary CFs from 1-3 day neonatal rats were digested by 0.08%trypsin and then purified by differential adhesion .The rats were divided into four groups:control group, DMEM medium ( free calf serum ) , ald group [ DMEM medium ( free calf serum ) +ald 1 ×10 -8 mol/L ] , aspi group [DMEM medium (free calf serum)+ald 1 ×10 -8 mol/L+aspi 1.11 ×10 -6 mol/L] and spiro group [DMEM medium (free calf serum)+ald 1 ×10 -8 mol/L +spiro 1 ×10 -6 mol/L].The morphology of CFs was assayed by HE staining methods .MTT Methods were used to measure cell proliferation .Western blotting was used to determine protein expression of TGF-β-Smad 2,3,4.Results HE Staining results showed that compared with the control group , ald activated cell proliferation and increased the cell division phase significantly (P<0.01).Compared with ald group, aspi+ald as well as spiro+ald could reduce cell division significantly ( P<0 .05 ) .MTT assay showed that compared with control group , ald could significantly improve the metabolism of MTT in CF (P <0.01).Compared with ald group, aspi +ald as well as spiro+ald could reduce the metabolism of MTT (P<0.01).Western blotting revealed that the expression levels of TGF-β-Smad 2, 3, 4 in CF were significantly increased by the stimulation of ald but were significantly reduced in aspi +ald and spiro+ald groups compared with ald group (P<0.01).Conclusion Aspi can inhibit the proliferation of CFs induced by ald,possibly by down-regulating the expression of Smad 2, Smad3 and Smad4.

Objective To study the characteristics of cognitive development of newborns with auditory event related potentials (aERP).Methods Thirty full-term neonates who were admitted to Changzhou Children's Hospital and met the inclusion criteria, those with neonatal neural behavioral score over 37 and both ears passed the hearing screening, and exclusion criteria, those who suffered from perinatal brain injury, were sclccted randomly.Thcy wcre divided into three groups according to the days of age (group 1 : 1-10 days;group 2:11-20 days;group 3:21-28 days).aERP was recorded with auditory Oddball paradigm.The data were collected and analyzed by Brain Electrical Source Analysis software.Relationship between N2latencies/areas among the three groups and their age was researched with Pearson correlation analysis.Results During the neonatal period, there was a significant negative correlation between N2 latency and neonatal age in days (r=-0.609, P ＜ 0.05), while significant positive correlation was shown between N2 area and the age (r=0.689, P ＜ 0.05).In Fz and Cz leads, the total average waveform diagram of the three groups showed spacious flat, less smoothed curve, and mostly jagged pattern.N2 area in group 1 showed a complex plurality of peaks, and regular, soaring waves, which changed into single wave thereafter, in group 2 and 3.The N2 latencies tended to shorten gradually.Conclusions Neonatal cognitive competence, including concentration and discrimination ability, would be improved with their growth.

To explore the clinical ,pathological and immunohistochemical features of carcinoma with multi-directional differentiation derived from junction of bladder and prostate .We collected clinical data and tissue samples of three typical cases of carcinoma from our hospital .Routine preparation of slides and immunohistochem-ical methods combined with clinical data and pathological changes analysis were adopted .We found that all 3 ca-ses occurred in the elderly lesions involving the bladder and prostate .Dysuria was the main common symptom .All the cases had a history of chronic inflammation in urethral and prostate gland .The following up data showed that survival time in two of them were no more than 15 months.The third patient without chemotherapy who took drugs of bicalutamide,enantone and pamidronate still was alive after 28 months.The pathological changes of these cases had the common features with diversity .They all showed the structure with nests ,papillary,solid,adenoid,single or syncytial cells .The nuclear of cancer cell was enlarged with hyperchromatic feature .The mitotic figures were easily found.The metaplasia and atypical hyperplasia of prostate were all found .The immunohistochemistry results showed positive results for HCK,LCK,p53,p63,PSA,P504S and negative for vimentin and S -100.The average proliferation index of Ki-67 was 77%.