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.

Accidents, Occupational ; Acute Disease ; Adult ; Humans ; Male ; Sulfuric Acid Esters ; poisoning

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.

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.

Background:The clinical presentation of eosinophilic gastroenteritis( EG)is nonspecific and has not received much concern by physicians and pathologists. The diagnosis of EG was delayed in many cases. Aims:To explore the clinical features of EG. Methods:The clinical,laboratory,endoscopic and radiologic features and treatment in patients who were diagnosed as EG from October 2011 to September 2013 in Zhongshan Hospital, Fudan University were analyzed retrospectively. Results:Median age of 10 EG patients was 41. 9 years. Four patients had a history of allergy or asthma. The time from onset to diagnose was 25 days on average. The most common symptoms were abdominal pain with bloating, diarrhea or vomiting. Eight patients had hypereosinophilia. Abdominal CT revealed uniform edema or stratified thickness of intestinal wall or ascites in 7 patients. Endoscopy revealed erythema,edema and erosion in antrum,duodenum or jejunum in 6 patients. All cases were confirmed as having eosinophilic infiltration by mucosal biopsy or examination of ascites. Seven patients were successfully treated with corticosteroid. One patients experienced relapse after discontinuing corticosteroids during following up. Conclusions:EG may be more common than previously recognized and should be considered in the differential diagnosis of unexplained abdominal pain with peripheral eosinophilia or uniform edema or stratified thickness of intestinal wall. Multiple biopsies in multiple sites including descending duodenum and pathological examination for finding eosinophil infiltration are the keys to confirm the diagnosis. Corticosteroids are effective in relieving symptoms and improving eosinophilia.

Objective To establish a candidate reference method for the determination of serum lithium based on ion chromatog-raphy and evaluate its analytical performance.Methods A simple sample treatment procedure,which can be remove the proteins and/or organics in human serum,has been developed for the determination of serum lithium.Method precision was evaluated with different concentration of fresh human serum and EQA sample RELA-A/B.Method accuracy was investigated with the recovery ex-periments in fresh human serum and RELA-A/B sample.Results The linear equation was Y =0.817 1X -0.001 3 with a correla-tion coefficient of 0.999 95 under the optimum experimental conditions,the detection limit (3S/N)for lithium was 6 μg/L and the imprecision was less than 1.0%.The results of the recovery experiments indicated that the recoveries were reasonable for the deter-mination of serum lithium,in a range of 99%-101%.Conclusion The candidate reference method of lithium was successfully es-tablished and which can be used for traceability and standardization.It may provide an effective way for routine testing of lithium traceable to the reference method/reference material.

In this study, indomethacin (IND) loaded solidified-polymeric micelles (IND-SPM) were prepared. Their in vitro characteristics were investigated. Methoxy-poly(ethylene glycol) poly(D, L-lactide) copolymer (mPEG-PDLLA) was used as IND carrier. The preparation of IND-SPM was conducted by solution-absorption method and evaporation by rotary evaporator. Polyplasdone XL-10 was used as adsorbent. The solution-absorption method was conducted by the following procedure; IND and mPEG-PDLLA were dissolved in acetone, followed by addition of polyplasdone XL-10 and stirred to obtain a suspension. The powder of IND-SPM was simply obtained after the organic solvent was completely evaporated. More than 90% (w/w) of IND (20 mg) in the powder was dissolved in 250 mL PBS within 30 min. DSC, 1H NMR and SEM results proved that IND was encapsulated within mPEG-PDLLA. The solubility of IND in the system increased 4.6 times with the highest amount of copolymer. The solidified particles were found to be suitable for the formulation of tablets or capsules.