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.

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.

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 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.

Objective To evaluate positive p-mTOR expression and its significance in gastric cancer.Methods Original studies published for the correlation between p-mTOR and clinicopathological parameters as well as prognostic significance were enrolled from Cohrane Library,Pubmed,EMbase database and CBM,CNKI.Analyses were performed by software REVMAN 5.0.Age,gender,TNM stage,lymph node metastasis,type were analyzed using pooled odds ratio (OR) with 95％ confidence interval (CI),and OS were analyzed using pooled hazard ratio (HR) with 95％ CI.Results Seven studies including 2 477 gastric cancer patients were enrolled in the meta analysis.p-mTOR expression was positive in 1 089 of the cases.p-mTOR positive expression was correlated with age,OR =0.74,95％ CI:0.62-0.89,dcpth of invasion OR =0.76,95％ CI:0.60-0.97,lymph node metastasis,OR =1.95,95％ CI:1.59-2.39,TNM stage,OR =0.57,95％ CI:0.38-0.84,type,OR =0.64,95％ CI:0.50-0.83,and OS,HR =1.86,95％ CI:1.60-2.16.Gastric cancer patients with p-mTOR positive expression tend to be younger,had a higher risk of lymphatic invasion,later TNM stage and poor prognosis.Its positive expression had no relation with the gender.Conclusion p-mTOR positive expression is a significant predictor for advanced TNM stage,more lymph node metastasis,intestinal type and poorer OS.

The main teaching methods for medical students and residents are didactic teaching,rote learning and apprenticeship.Although these teaching methods can be good for imparting knowledge,they are obviously insufficient for the training of technical skills,team cooperation and complex decision making.Application of biomedical engineering simulation in the anesthesia teaching can partially compensate for the insufficiency.The progress of biomedical engineering simulation in anesthesia teaching is reviewed and the educational trend was explored.

Objective To investigate and observe the influence degree of continue nursing for the self -effi-cacy and compliance of patients with coronary heart disease.Methods 90 patients with coronary heart disease were selected as the research subjects,and 90 cases were divided into control group(conventional nursing of coronary heart disease group) 45 cases and observation group(continue nursing group) 45 cases by the method of random number table.Then,the self -efficacy,treatment compliance and satisfaction degree for the nursing of the two groups before the nursing and at first,second and fourth week after the nursing were compared.Results The self -efficacy and treatment compliance of the two groups before the nursing had no significant differences (all P >0.05),while the very high rates of the observation group's self -efficacy at first,second and fourth week after the nursing were 40.00%, 57.78% and 77.78% respectively,the higher rates of treatment compliance were 64.44%,84.44% and 97.78%respectively,the total satisfaction rates for the nursing were 97.78%,100.00%,100.00% respectively,which were all higher than those of the control group(all P <0.05),the differences were significant.Conclusion The influence of continue nursing for the self -efficacy and compliance of patients with coronary heart disease are more active,and it is more definitely to the patients,so the nursing mode is more suitable to patients with coronary heart disease.

Objective To study the relationship of plasma endotoxin (ET) level and renal function damage in patients with obstructive jaundice(OJ). Method The level of plasma ET、creatinine (Cr) or blood urea nitrogen ( BUN ) and endogenous creatinine clearance rate (Ccr ) were determined before and after operation in 30 patients with OJ(OJ group), and 21 cases of chronic cholelithiasis without jaundice (control group). Results The plasma ET level of peripheral blood was increased more significantly (P