Objective To observe the effect of rosiglitazone combined with ethinylestradiol cyproterone on treatment of polycystic ovary syndrome (PCOS).Methods Sixty-eight cases with PCOS combined with insulin resistance (experimental group) and 68 cases with PCOS combined without insulin resistance (control group) were selected.The patients in experimental group were given rosiglihtazone combined with ethinylestradiol cyproterone,the patients in control group were not given rosiglitazone.The level of seurm adiponectin and lepfin was measured before and after treatment in two groups,body mass index (BMI),Homeostasis model assessment of insulin resistance index (HOMA-IR) was calculated before and after treatment in two groups,and drug adverse reaction was observed.Results There was no significant difference in serum adiponeetin,leptin,BMI before treatment between two groups (P ＞ 0.05).HOMA-IR in experimental group was higher than that in control group (3.90 ± 0.87 vs.2.15 ± 0.62),and there was significant difference (P ＜ 0.05).BMI,leptin after treatment in experimental group and control group was decreased compared with that before treatment [experimental group:(25.41 ± 1.01) kg/m2 vs.(30.11 ± 1.51) kg/m2,(0.25 ± 0.08) μ g/L vs.(0.44 ± 0.11) p g/L; control group:(26.68 ± 1.12) kg/m2 vs.(30.55 ± 1.42) kg/m2,(0.23 ± 0.1 0) μ g/L vs.(0.39 ± 0.23) μ g/L],adponectin was increased compared with that before treatment [experimental group:(1.39 ± 1.10) μ g/L vs.(0.89 ± 0.15) μ g/L;control group:(1.42 ± 1.05) μ g/L vs.(0.91 ± 0.44) μ g/L],and HOMA-IR after treatment (2.09 ± 0.68) in experimental group was lower than that before treatment,and there was significant difference (P ＜ 0.05).There was no significant difference between two groups (P ＞0.05).Experimental group did not appear obvious drug adverse reaction in the process of treatment.Conclusion Ethinylestradiol cyproterone can improve metabolic disorders indicators,PCOS combined with insulin resistance should add rosiglitazone to improve insulin resistance.

Chronic atrophic gastritis, which is the precancerous lesions of gastric cancer, has no good effect in west-ern medicine treatment. However, traditional Chinese medicine (TCM) has achieved certain effect in recent years. This article mainly discussed from aspects of etiology and pathogenesis, syndrome differentiation, therapies and for-mulas, acupuncture treatment, famous doctors’experiences, and integrative medicine treatment. The research pro-gress was summarized on TCM treatment and integrative medicine of this disease in recent 5 years.

Objective To evaluate the usefulness of color Doppler ultrasonography in differential diagnosis of cervical lymphadenopathy by depicting the intranodal vascular pattern. Methods One hundred and twenty lymph node lesions in 113 patients who underwent color Doppler flow imaging were grouped as reactive lymphadenitis ( n =25), tuberculosis ( n =14), lymphoma ( n =41), and metastasis ( n =40). The vascular patterns of hilar type, central type, peripheral type and mixed type were assessed. Results Most reactive lymph nodes( 92.0%) and lymphomatous nodes( 75.6%) showed hilar vessels,lymphomatous nodes also frequently demonstrated peripheral vessels( 75.6%).Central vessels or peripheral vessels were frequent in metastatic nodes( 60.0% and 57.5%, respectively).The intranodal vascular distribution in tuberculous nodes was simulated malignant disease. Avascularity was observed in 2 of 25 reactive lymph nodes and 1 of 14 tuberculous nodes. Conclusions Central vessels or peripheral vessels were mainly found in malignant lymphadenopathy,and the presence of hilar vessels is suggestive of benign lymphadenopathy. However, there is overlap of appearance between benign and malignant disease.

Acromegaly is a commonly functional pituitary tumor. Standardized managements are crucial for the patients. Chinese Expert Consensus on the Diagnosis and Treatment of Acromegaly(2020) has been updated in 2020 based upon latest advance. This essential introduction about genetic causes would further guide and standardize the management of acromegaly.

Objective To summarize continuous veno- venous hemofiltration (CVVH) treatment of infants with complex congenital heart disease in children with acute renal failure after treatment. Methods A retrospective analysis was carried out in six cases of infants with congenital heart disease with application of CVVH. The children were given monitoring and anticoagulant treatment. The renal function, electrolytes and urine volume were compared before and after the treatment. Results The amount of urine increased, blood circulation and electrolytes remained stable in six patients 17.5-135.0 hours after CVVH. Conclusions The CVVH therapy can be applied to treat infants with congenital heart disease complicated with acute renal failure, but CVVH treatment should focus on anticoagulants and blood volume since complicated state of illness, low age, low body weight of children patients.

Objectives To investigate the regularity of fluctuation and clinical senses of serum c reactive protein (CRP) level in patients with acute cerebral infarction (ACI) Methods 100 subjects (56 males and 44 females) were divided into five groups including 24 large artery arteriosclerosis (LAA), 27 small artery occlusion (SAO), 2 cardiac embolism(CE), 34 other Certain(OC) and 13 undetermined etiology according to Trial of ORG 10172 in Acute Stroke Treatment (TOAST) Through enzyme linked immunoabsorbent assay (ELISA), we detected and analyzed CRP levels of 100 inpatients Results The risk factors of stroke included coronary heart disease , hypertension, diabetes and intoxication of CO and so on Among the above mentioned, the level of CRP and rate of positive CRP of patients who poisoned by CO was the highest That of coronary heart disease group was lower However, there was no notable difference between hypertension and diabetes groups Conclusions CRP may play a certain role in the occurrence and development of ACI It represents different levels in different types of stroke

ObjectiveTo investigate the value of ultrasonography in the diagnosis of the papillary thyroid microcarcinoma (PTMC) in patients with Hashimoto’s thyroiditis (HT).MethodsThis retrospective study used data from Ruijin Hospital of Shanghai Jiaotong University of Medicine during November 2012 to December 2013. A total of 111 small thyroid nodules (75 PTMC/36 benign nodules) with 107 HT cases which were pathologically conifrmed were included in this study. The sonographic characteristics of nodules were investigated, including nodule aspect ratio, shape, border, margin, acoustic halo, internal structure, echo level, microcalciifcations, rear acoustic attenuation, vascular pattern and extent of the blood supply and the types of thyroid tissue echogenicity. Chi-square test and Fisher′s exact probability method was used to compare the differences of the sonographic characteristics between the benign nodules and malignant nodules. With surgical pathology as the gold standard, computing the value of ultrasonography in the diagnosis of PTMC with HT, including the sensitivity, speciifcity, diagnostic accuracy, positive predictive value and negative predictive value.ResultsA total of 111 thyroid tiny nodules (75 PTMC/36 benign nodules) with 107 HT cases which were pathologically conifrmed were included in this study. The results showed 111 small thyroid nodules as solid hypoechoic. Four indexes between PTMC and benign nodules had statistical signiifcance, such as margin, microcalciifcations, vascular pattern and extent of the blood supply. The other six indexes between PTMC and benign nodules had no statistical significance, such as aspect ratio, shape, border, acoustic halo, rear acoustic attenuation and the types of thyroid tissue echogenicity. Ultrasound diagnostic accuracy of small tyroid nodules in patients with HT was 74.77% (83/111). The sensitivity, specificity, diagnostic accuracy, positive predictive value and negative predictive value of the ultrasound diagnosis of PTMC were 93.33% (70/75), 36.11% (13/36), 74.77% (83/111), 75.27% (70/93), and 72.22% (13/18), respectively.ConclusionsCompared with general population, some classic ultrasound features became less effective in patients with HT. However, ultrasonography has some differential diagnostic value in these cases.

Objective: To explore influence of trimetazidine on cardiac function, levels of inflammatory factors, brain natriuretic peptide (BNP) and homocysteine (Hcy) in patients with congestive heart failure (CHF) and its therapeutic effect.Methods: A total of 120 patients diagnosed as CHF in our department were selected.According to random number table, they were randomly and equally divided into routine treatment group and trimetazidine group (received trimetazidine based on routine treatment group, 20mg/time, twice/d), both groups were treated for six months.Left ventricular relaxation time (LVRT), E peak decrease time (EDT), early diastolic peak velocity/late diastolic peak velocity (E/A), left atrial diameter (LAD), levels of interleukin (IL)-6, tumor necrosis factor (TNF)-α, BNP and Hcy were measured and compared between two groups before and after treatment.Results: After six-month treatment, total effective rate of trimetazidine group was significantly higher than that of routine treatment group (93.3% vs.80.0%, P=0.032);compared with routine treatment group after treatment, there were significant reductions in LVRT [(92.1±4.6)ms vs.(74.5±2.7)ms], EDT [(165.3±5.1)ms vs.(139.2±3.9)ms] and LAD [(41.1±2.6)mm vs.(33.1±1.8)mm], and significant rise in E/A [(0.89±0.21) vs.(1.16±0.51)] (P<0.01 all);and significant reductions in serum levels of IL-6 [(16.3±2.8) ng/ml vs.(11.3±1.3) ng/ml], TNF-α [(3.17±0.99) ng/ml vs.(2.01±1.12) ng/ml], BNP [(311.4±27.9)pg/ml vs.(278.2±31.3) pg/ml] and Hcy [(15.6±4.2) pg/ml vs.(11.3±2.7) pg/ml] in trimetazidine group, P<0.01 all.Conclusion: Trimetazidine can significantly improve heart function, reduce inflammatory factor levels and inhibit atrium remodeling in patients with congestive heart failure, and the therapeutic effect is significant.

Objective To analyze the pathogenesis, clinical features, treatment and prognosis of pulmonary hypertension (PHT) in systemic lupus erythematosus (SLE) patients. Methods Thirty-eight patients admitted during Jan 2001 to Aug 2008 were diagnosed as SLE associated with PHT and were analyzed retrospectively. Results All cases were female with the mean age of 35.7 yds. The mean period from PHT to the diagnosis of SLE was 2.3 years. Three cases were severe PHT with remarkable heart failure. Twenty-seven eases demonstrated Raynaund's phenomenon. Antinuclear antibody (ANA) was positive in all 38 cases and the titer was 1:320. Anti-DNA antibody, anti-Sin antibody, anti-U1RNP antibody and anti-SSA, anti-SSB were positive in 21 cases, 16 cases, 15 cases, 8 cases respectively. Antiphospholipid antibody and rheumatoid factor (RF) were elevated in 4 cases and 13 cases respectively. Seven cases were involved in lung fibrosis and pulmonary function test showed mild to moderate restrictive abnormality in these 7 cases. After treated with the combination of steroid and immunosuppressive agents, one case died on the 10th day and 2 cases died in 2 to 3 years after the diagnosis was established. The other 35 cases stayed stable. Conclusion PHT is one of the severe complications of SLE and often accompanied by poor outcome. Therefore early diagnosis and early combined therapy is very important.

Objective To investigate the ultrasonographic manifestations of traumatic neuroma after neck dissection in papillary thyroid carcinoma (PTC).Methods A retrospective analysis was performed in 21 patients with 26 lesions who underwent neck dissection.The ultrasonographic characteristics were reviewed,including numbers,location,size,shape,margin,echogenicity,with or without direct continuity to the nerve fiber,the presence of internal hyperechogenicity and blood supply.Results Among the 26 lesions of 21 patients,25 lesions were in the lateral cervical area while the other one was in the central cervical area.The mean shortest diameter of the lesions was (3.5±1.0)mm and that of longest diameter was (9.1±2.9)mm.Totally 13 lesions were oval in shape and the other 13 were round.The clear margin was found in 13 lesions and fuzzy margin was observed in another 13 lesions.All the lesions were heterogeneously hypoechoic.The presence of internal hyperechoic areas were found in 16 lesions.The direct continuity with the nerve fiber was found in 20 lesions,while the other 6 lesions were not continued to the nerve directly.Color Doppler flow imaging showed that 20 of the 26 lesions existed a little blood flow signal and the other 6 lesions showed no flow signal.During the ultrasound-guided fine-needle aspiration biopsy (US-FNAB),21 patients complained about the intolerable serious pain and the pain relieved when the needle removed.Conclusion Traumatic neuromas are hypoecho lesions located in the operation area after neck dissection in PTC with distinctive ultrasonographic features,especially the direct continuity with the nerve fiber,as well as the clinical histories and sharp pain during US-FNAB,which can help to diagnose.