OBJECTIVE:To discuss the effect of Ethinylestradiol and cyproterone acetate tablet combined with metformin on ovulation induction of patients with polycystic ovarian syndrome(PCOS). METHODS:184 PCOS patients were randomly divided into control group(92 cases)and observation group(92 cases). Control group orally received 1 Ethinylestradiol and cyproterone ac-etate tablet in 5 d of menstruation,once a day,it stopped after 21 d,the next cycle of treatment was started on the 5th of with-drawal bleeding. Observation group additionally received 3 Metformin tablet,once a day,without drug withdrawal during menstrua-tion,and lasted for 3 menstrual cycles. After 3 menstrual cycles,all patients received ovulation induction treatment [(50-100 mg clomiphene was orally given from the 5th day of the 4th menstrual cycle,for 5 days,or 75-150 U postmenopausal gonadotropin by intramuscular injection,when the dominant follicle diameter was(19.0±2.0)mm,10 000 U human chorionic gonadotropin(HCG) was intramuscularly injected,the ovulation was continuously monitored and whether there was ovarian hyperstimulation syndrome (OHSS)was observed]. Body mass index(BMI),follicle estrogen(FSH),luteinizing hormone(LH),prolactin(PRL),estradiol (E2)and testosterone(T)before and after treatment,fasting plasma glucose(FPG),fasting insulin(FINS),insulin resistance in-dex(HOMA-IR),pregnancy rate,ovulation rate and the incidences of OHSS and adverse reactions in 2 groups were observed.RE-SULTS:Before treatment,there were no significant differences in the BMI,FSH,LH,PRL,E2,T,FPG,FINS and HOMA-IR between 2 groups(P>0.05). After treatment,BMI,LH,PRL,E2,T,FPG,FINS and HOMA-IR in observation group and LH, E2 and FINS in control group were significantly lower than before,and BMI,PRL,E2,T,FPG,FINS and HOMA-IR in observa-tion group were lower than control group,the differences were statistically significant(P<0.05). The pregnancy rate and ovulation rate in observation group was significantly higher than control group,the incidence of adverse reactions was significantly lower than control group,the differences were statistically significant (P<0.05). And there was no significant difference in the incidence of adverse reactions between 2 groups(P>0.05). CONCLUSIONS:Ethinylestradiol and cyproterone acetate combined with metfor-min can effectively improve insulin resistance of POCS patients,recovery sex hormone secretion,promote ovulation and improve pregnancy rate,with good safety.

Some hormones and glucocorticoid in chronic strss feedback are demonstrated to have significant effects on cancer progression.Recently,as a typical neuropeptide,gastrin releasing peptide (GRP) could mediate chronic stress to promote carcinogenesis through four conceivable mechanisms,such as regulating circadian rhythms,suppressing immunity system,acting as a mitogenic effect and mediating cancer-related psychiatric disorders,et al.

Memory T cells play an important role in the pathogenesis of tumors as a result of the long term of tumor immunity and the heterogeneity of T cells. Great progress in the studies on the generation, classification, mechanism of maintenance and function of memory T cells in tumor immunity have been made in recent years, which may facilitate our understanding of immunological memory and the clinical therapy of tumor.

Objective To investigate the increased cytotoxicity induced by luteolin and cisplatin cotreatment and validate its mechanism.Methods HepG2 cells were pretreated with luteolin for 1 hour or remained untreated and followed by exposure to cisplatin.Cells were stained with Hoechst,and Caspase-3 activity was detected by spectrophotometry.Cell death was detected by LDH release assay.Phosphated C-jun N-terminal kinase (JNK) and total JNK1 were detected by Western blot.Results Luteolin significantly enhanced Caspase-3 activity and HepG2 cells apoptosis by cisplatin.The cell death rates by co-treatment with different concentration of luteolin (0-20 μmol/L) and cisplatin (10 μg/ml) were much higher than cisplatin or luteolin alone treatment.Combined treatment of luteolin (20 μmol/L) with cisplatin (10 μg/ml) killed 47.66 ％ of HepG2 cells.There were significant differences on cell death between combination group and single reagent group (F =535.48,P ＜ 0.01).Combination group showed better efficacy than single reagent group.The Caspase-3 activity of HepG2 cells treated by luteolin (20 μmol/L),cisplatin (10 μg/ml) or luteolin (20 μmol/L)plus cisplatin (10 μg/ml) were 1.94,1.74 and 8.12 times of negative control group respectively.Combination treatment induced sustained activation of JNK signaling pathway.Conclusions Enhancing cisplatin-induced JNK activation by luteolin leads to increased cytotoxicity in HepG2 cells.The combination of luteolin and cisplatin is an effect apporch for improving the anticancer value of cisplatin,which has implications in cancer prevention and therapy.

Objective To discuss application value of intestinal electromyography in patients with hepatic cirrhosis and to observe intestinal myoeletric activity.Methods There were 65 cases of hepatic cirrhosis in expermental group and 30 cases in control group. All the cases were recorded body surface intestinal electromyography using gastrointestinal myoelectric analyzer(WCDF-4B, Hefei , P.R.China). The parameters included average peak range-Ap, main frequency-Fp, average over zero frequency-Fz and special wave form were surveyed.Results Sharp higher Fz abnormal rate and emergence rate of special wave form in hepatic cirrhosis group were higher than in control group,P0 05.Conclusions In hepatic cirrhosis group,Fz was much higher than that in control group. And the intestinal myoelectric activity increased in the patients with hepatic cirrhosis,which represented by appearance of characteristic wave form that was frequent micromigration wave as well as load wave. Those changes accounted for heighten and irregularity of excitability intestinal myoelectric activity. Moreover, it will increase for the incidence of abnormality of intestinal myoelectric activity along with damage degree of hepatic function. Intestinal electromyography is a reliable method to judge intestinal myoelectric activity, the method has characteristics of harmless,free pain, convenient, safty and steady.

Objective To investigate the changes and clinical significance of the plasma growth differentiation factor-15 (GDF-15) in patients with chronic congestive heart failure (CHF). Methods A total of 100 patients with CHF were in?cluded in this study (CHF group), and 30 healthy persons were used as control group. CHF group was divided into heart func? tionⅡgrade (n=35),Ⅲgrade (n=32),Ⅳgrade (n=33) groups in accordance with New York Heart Association (NYHA). And CHF group was also divided into left ventricular ejection fraction (LVEF)<0.4 grade (n=52) and LVEF≥0.4 grade (n=48) groups in accordance with LVEF of patients. The plasma GDF-15 and brain natriuretic peptide (BNP) levels were detected by ELISA. The values of LVEF, left ventricular end-diastolic diameter (LVDd), left ventricular systolic diameter (LVDs) and left ventricular fractional shortening (LVFS) were detected by echocardiography. The correlation of GDF-15, NYHA classifi?cation, BNP and index of echocardiography was analyzed between groups. Results Compared with control group, the levels of BNP, GDF-15, LVDd and LVDs were significantly higher in heart failure group, and values of LVEF and LVFS were sig?nificantly lower (P<0.05). The plasma levels of BNP, GDF-15, LVDd and LVDs were in turn increased in control group, LVEF≥0.4 grade group and LVEF<0.4 grade group. The plasma levels of LVFS were in turn decreased, in control group, LVEF≥0.4 grade group and LVEF<0.4 grade group (P<0.05). There were positive correlations between the plasma levels of GDF-15 and BNP, NYHA, LVDd and LVDs (r=0.524, 0.286, 0.453 and 0.531, P<0.05). The plasma level of GDF-15 was negatively correlated with LVEF and LVFS (r=-0.592,-0.587,P<0.05). Conclusion The plasma level of GDF-15 can be used as a new marker for diagnosis, treatment and prognosis in patients with chronic congestive heart failure.

Adenoma ; pathology ; Carcinoma, Renal Cell ; pathology ; Diagnosis, Differential ; Female ; Humans ; Kidney Neoplasms ; pathology ; Middle Aged

Objective To explore the method of treatment of sunken cheek deformity.Methods The longitudinal platysma-faseial flap was overturned 180 degree upward,the flap's pedicle located in the margin of mandible,and then combined with abdominal dermis fat graft to form as a sandwich,which filled in the sunken area of face.Results Five patients were treated with this method from 2003 to 2007,and satisfactory results were gained but only mild absorption was found in the transplanted tissue area during followed up for 3 months to 3 years.Conclusion Platysma-fascial flaps survive easily with rich blood supply and strong anti-infection,and are also easy to incise and operate as well,which,together with free abdominal dermis fat flap,could increase the amount of the needed tissue.It is a better approach to repair the sunken cheek deformity and in particular suitable for the more serious deformity in patients with sunken cheek.

Objective] To observe the clinical effect of“eliminating the accumulative stagnation and heat with pressing and kneading manipulation”treatment efficacy of children with functional constipation. [Method] Randomly divide 60 cases into control group and treatment group, 30 cases in each;the control one took conventional pediatric tuina method; the treatment one took “eliminating the accumulative stagnation and heat with pressing and kneading manipulation”method. Compare their effects after three courses. [Result] After three courses treatment, in treatment group, 20 cases had marked effect, 8 effective, 2 void, total effective rate 93.33%;in control group, they were respectively 10,12,8 and 73.33%. The comparison of total effective rates had difference of statistical significance(P<0.05). [Conclusion] The method of “eliminating the accumulative stagnation and heat with pressing and kneading manipulation”has better curative effect than the conventional pediatric tuina method. And it is very simple to manipulate, and worthy of being popularized.

Objective To study the distribution and changes of the purulent meningitis in gender,age,region,season and pathogens in children during the past 20 years.Methods All the basic clirical features of purulent meningitis patients less than 17 years old in Children's Hospital of Chongqing Medical University from Jan.1993 to Jan.2013 were analyzed retrospectively.A total of 1 855 patients were divided into 2 groups according to their date of admission.Group A included 666 patients admitted from Jan.1993 to Dec.2002,and group B included 1 189 cases admitted from Jan.2003 to Jan.2013.Then,they were divided into 5 groups according to their ages,including neonate group,＞ 1 month-1 year old aoup,＞ 1-3 years old group,＞ 3-10 years old group,＞ 10-17 years old group.Results Of the 1 855 cases,there were 1 054 cases (56.82％) admitted in the spring and summer,and 1 123 cases (60.54％) were younger than 1 year of age.The ratio of male to female cases was 1.82 to 1.00 and that of country patients to urban patients was 1.40 to 1.00.The distributions were female patients (443 cases,37.26％),urban patients (517 cases,43.48％),and the ratio of patients admitted in the autumn (265 cases,22.29％) and patients younger than 1 year of age (606 cases,50.97％) in group B,which were significantly higher than those [215 cases (32.28％),256 cases (38.44％),102 cases (15.32％),272 cases (40.84％)] of group A (x2 =4.62,4.47,25.51,25.52,all P ＜ 0.05).The predominant isolated bacteria from cerebrospinal fluid were coagulase negative staphylococcus (43/196 cases,21.94％),Streptococcus pneumoniae (32/196 cases,16.33％),Neisseria meningitidis (17/196 cases,8.67％) and Escherichia coli (15/196 cases,7.65％).Coagulase negative staphylococcus and Escherichia coli both accounted for higher rates of pathogenic bacteria in 1 year old than that of pathogenic bacteria more than 1 year old (x2 =4.57,14.37,all P ＜ 0.05),while Streptococcus pneumoniae and Neisseria meningitidis both had higher rates of pathogenic bacteria more than 1 year old and more than 3 years old,respectively (x2 =14.93,19.76,all P ＜ 0.05).Onfly cases in group B with Streptococcus pneumoniae were higher than those in group A (x2 =11.78,P ＜ 0.05),while the other common bacteria in each age group were of no difference between group A and group B.Conclusions There had been some changes in the epidemiological distribution of purulent meningitis during the past 20 years.The main risk factors were male in gender,patients in rural areas,onset in the spring or summer and infants in early age.The predominant isolated bacteria from cerebrospinal fluid were some opportunistic pathogens,including coagulase negative staphylococcus,Streptococcus pneumoniae,and Escherichia coli.Streptococcus pneumoniae meningitis was increased during the past 10 years.