OBJECTIVE:To observe clinical efficacy of clomiphene combined with metformin in the treatment of polycys-tic ovary syndrome. METHODS:112 patients with polycystic ovary syndrome admitted in gynaecology and obstetrics depart-ment of our hospital were selected,and randomly divided into control group and observation group,with 56 cases in each group. Control group was treated with clomiphene orally,since fifth day of menstruation,once a day,50 mg/time;observa-tion group was additionally treated with metformin orally,30 min before meal,3 times a day,500 mg/d. Treatment course last-ed for 2 months. Biochemical indicators,control time of disease,actual treatment time,HOMA-IR,HOMA-β and clinical effi-cacy of patients were observed in two groups. RESULTS:After treatment,LH,FSH,T and FINS of patients in observation group were lower than before treatment and control group,with statistical significance(P<0.05);control time of disease and actual treatment time of observation group were significantly shorter control group (P<0.05),with statistical significance;HOMA-IR and HOMA-β of observation group were significantly lower than those of control group,with statistical significance (P<0.05);clinical effective rate of patients in observation group was significantly higher than control group,with statistical significance (P<0.05). CONCLUSIONS:Clomiphene combined with metformin in the treatment of polycystic ovarian syn-drome can improve biochemical indicators,shorten control time of disease and actual treatment time and enhance clinical effi-cacy.

Starting on the research findings from a study on cancer patients decision making,the author tried to further analyze the Doctor-Patient-Relationship in China from the historical perspective.Having the disease re-moved or treat the patient responsibly,represents different meaning and implication on how a society regards the medicine as profession,and how define the role of physicians.Considerations on these issues are hoped to facilitate the improvement of doctor-patient relationship in China.

Based on the peak value of power spectral density (PPSD) and corresponding frequency (CF), an approach that performs electroencephalogram (EEG) feature extraction during imaginary right and left hand movements was proposed. The data were gained from brain computer interface competition in 2003 provided by Graz University of Technology. The EEG signals between 8-16 Hz were decomposed by db3 wavelet packet at three levels. The PPSD and CF of electrodes C3 and C4 were defined as the EEG feature vectors and calculated respectively. The left and right hand motor imaginary tasks were distinguished by the time-variable linear classifier. The proposed method was applied to the test data for 140 trials. The satisfactory results were obtained with the highest classification accuracy 89.29%. The maximum mutual information was 0.622 8 bit, and the signal-to-noise ratio (SNR) was 1.371 3. The PPSD and its CF on electrodes C3 and C4 between 8 and 16 Hz were coincident with event-related desynchronization (ERD) and event-related synchronization (ERS). This method is simple, quick, and promising for on-line brain computer interface system.

Objective To evaluate the effects of fasudil on neointima hyperplasia in rat carotid artery balloon-injury model,and explore the potential molecular mechanisms of this effect.Methods Totally 30 male Sprague-Dawley (SD) rats were randomly divided into sham operation group,balloon injury group,2.5 ml/kg fasudil intervention group,5 ml/kg fasudil intervention group,10 ml/kg fasudil intervention group.The intima-to media(I/M) area ratio of neointima was calculated at 14th day after operation; the protein expression of proliferating cell nuclear antigen(PCNA) was measured by immunohistochemical and the integrated optical density (IA) was calculated.As the marker of oxidative stress,the levels of 8-hydroxy-2'-dcoxyguanosine (8OHdG) and malondialdehyde (MDA) were measured by enzyme-linked immunosorbent assay (ELISA).The expressions of phosphorylated and non phosphorylated Ras,mitogen activated protein kinase kinase (MEK1/2) and extracellular signal regulated kinase (ERK1/2) were measured by Western blot.Results The I/M ratios were (0.22 ± 0.01) in sham operation group,(2.71 ± 0.23) in balloon injury group,( 1.72 ±0.24)in 2.5 ml/kg fasudil intervention group,(1.23±0.11)in 5 ml/kg fasudil intervention group,(0.85±0.12)in 10 ml/kg fasudil intervention group.As compared with sham operation group,I/M area ratio was increased in balloon injury group,and three fasudil intervention group inhibited neointima hyperplasia in a dose-dependent manner (all P＜0.01).The IA indexes were(15.11 ±1.42),(53.42±2.30),(45.25±1.62),(22.55±0.88) and(19.61±0.79) in the above five groups,respectively,showing the fasudil inhibited PCNA expression (all P＜0.01).Fasudil also inhibited the levels of 8-OHdG and MDA in a dose-dependent manner [8OHdG:(54.34±4.50)μg/kg,(106.81 ± 6.67)μg/kg,(94.21 ± 3.34) μg/kg,(65.58 ± 5.13) μg/kg,(51.32 ± 2.34) μg/kg; MDA:(19.94 ± 0.65 ) μmol/kg,( 58.83 ± 2.81 ) μmol/kg,(48.94 ± 1.35 ) μmol/kg,(40.62 ± 3.24 )μmol/kg,( 36.85 ± 0.91)μmol/kg (all P＜0.01)].Compared with balloon injury group,the relative expressions of Ras in three fasudil intervention group were 0.49±0.12,0.39±0.13,0.20±0.23 vs.0.62±0.10(P＜0.05 or,P＜0.01); MEK1/2 0.35±0.14,0.29±0.09,0.11±0.12 vs.0.56±0.1(P＜0.05 or,P＜0.01); ERK1/2 0.48±0.15,0.32±0.08,0.12±0.09 vs.0.64±0.13(P＜0.05 or,P＜0.01).The activations of ERK1/2,MEK1/2 and Ras were strongly suppressed in fasudil treated samples on day 14 after balloon injury.Conclusions Blockade of oxidative stress and Ras MEK1/2 ERK1/2 pathway is involved in the fasudil attenuating of balloon injury-induced neointima hyperplasia

Objective To observe the effect of comfort care on psychological status and life quality of patients undergoing interventional treatment of coronary heart disease. Methods 86 cases patients with coronary heart disease were randomly classified into the observation group and the control group with 43 cases in each group. The observation group was treated with comfort care and the control group was treated with normal nursing. The psychological status and life quality between the two groups were compared. Results Compared with pre-nursing, not only physiological function, independence, spiritual beliefs, social relations and quality of life but also SAS and SDS in the observation group were significantly improved after nursing. However, there were no significant differences in the control group. Moreover, the scores of life quality and anxiety and depression were significantly better than those in the control group. Conclusions Comfort care on patients with coronary heart disease can improve anxiety and depression status, servicing satisfaction and life quality of patients.

Objective To observe the effect of nursing intervention on anxiety and depression status and life quality of patients with chronic heart failure (CHF). Methods 124 cases patients with CHF were randomly classified into the observation group and the control group with 62 cases in each group.The observation group was treated with nursing intervention,the control group was treated with routine nursing.The anxiety and depression status and life quality between the two groups were compared. Results Compared with pre-nursing,not only SAS and SDS score but also physical function,role function,emotional function,social function and quality of life in the observation group were significantly improved after nursing.However,there were no significant differences in the control group.Moreover,the scores of anxiety and depression and life quality were significantly better than those in the control group. Conclusions Nursing intervention for patients with CHF can improve anxiety and depression status and life quality of patients.

Objective To investigate the clinical associated risk factors which affect the postpartum urinary incontinence ,providing theoretical basis for early prevention and treatment of this disease . Methods The clinical data of 60 cases who diagnosed postpartum urinary incontinence were collected ,and established database ,and apply regression analysis method were used to analyze the clinical associated risk factors .Results The results showed that BMI(OR=2.534,95%CI:0.975 ~6.489 ),fetal weight (OR =2.342,95%CI:0.723 ~6.575) second stage (OR=3.346,95%CI:0.635~6.673).Conclusion high BMI,fetal weight is heavy,prolonged second stage was re-lated risk factors with postpartum urinary incontinence .

Diabetic ketoacidosis is one of the most common causes of death in the pediatric diabetes,and it is also one of the most common endocrine emergencies in children.With the further studies of this disease,more attentions are paid to the central nervous damage about DKA.The mechanisms about DKA-related cognitive dysfunction from the macro to the micro are constantly updated.This article gives a review on the pathogenesis of the cognitive dysfunction due to DKA.

Objective To observe the influence of parturients hemodynamics and curative effect of preventing hypotension syndrome by using hypotension syndrome prevention bracket in cesarean section with spinal anesthesia.Methods One hundred parturients of cesarean section,ASA grade Ⅰ-Ⅱ,were divided into two groups according to whether the use of hypotension syndrome prevention bracket with 50 cases each:observation group and control group.Control group in anesthesia after the success of the surgery made bed left tilt 15°,and observation group in anesthesia after the success immediate used hypotension syndrome prevention bracket.In the two groups,the change of systolic blood pressure (SBP),diastolic blood pressure (DBP),heart rate (HR),mean arterial pressure (MAP),the incidences of hypotension syndrome and nausea and vomiting during and after operation,and anesthesia to uterine incision time and anesthesia time were observed.Results There was no significant difference in anesthesia to uterine incision time,anesthesia time,intraoperative infusion quantity,amount of bleeding between the two groups (P ＞ 0.05).The incidences of hypotension syndrome and nausea and vomiting in observation group were 8.00％ (4/50) and 4.00％ (2/50),in control group were 42.00％ (21/50) and 24.00％ (12/50),there were significant differences between the two groups (P ＜ 0.05).The observation group at 5 min after anesthesia SBP,DBP,MAP were (106.12 ± 12.91),(57.26 ± 11.43),(73.57 ± 11.03) mm Hg (1 mm Hg =0.133 kPa),and the control group were (95.44 ± 19.53),(50.15 ± 15.53),(66.36 ± 15.64) mm Hg,there were significant differences between the two groups (P ＜ 0.05).The observation group at 10 min after anesthesia SBP,DBP,MAP were (104.35 ± 11.86),(55.92 ± 10.81),(72.54 ± 10.37) mm Hg,the control group were (102.31 ± 15.48),(55.12 ± 11.89),(70.72 ± 11.33) mm Hg,there were significant differences between the two groups (P＜ 0.05).The observation group at 3 min after the delivery of fetus and the end of operation DBP,MAP were (54.13 ± 9.14) and (62.63 ± 8.61) mm Hg,(68.13 ± 10.40) and (80.88 ± 9.05) mm Hg,the control group were (49.24 ± 11.55) and (58.04 ± 11.67) mm Hg,(70.57 ± 8.58) and (75.35 ± 10.41) mm Hg,there were significant differences between the two groups (P ＜ 0.05).Conclusion Cesarean section parturients using hypotension syndrome prevention bracket can reduce the occurrence of hypotension syndrome,which can help to maintain the stability of parturients hemodynamics,it is worth of clinical promotion.

Objective To investigate the incidence rate and risk factors of obstetric emergency hysterectomy.Methods The clinical data of childbirth puerpera in Shangqiu four municipal hospitals were retrospectively analyzed,80 patients underwent routine obstetric emergency hysterectomy were selected as hysterectomy group,56 postpartum hemorrhage patients without uterus excision were randomly selected as control group.The related risk factors of obstetric emergency were analyzed.Results (1) The total delivery number was 65 259 cases,cesarean rate was 47.46％ (30 972/65 259),postpartum hemorrhage rate was 4.61％ (1 429/30 972),and uterus removal rate of cesarean section was 0.18％ (56/30 972),vaginal delivery postpartum hemorrhage rate was 3.28％ (1 124/34 287),in the courtyard the vaginal delivery emergency uterus removal rate was 0.03％ (12/34 287).The postpartum hemorrhage rate and obstetrics emergency uterus removal rate were higher than vaginal delivery,the differences were statistically significant (x2 =77.22,33.24,all P ＜ 0.05).(2) The results of the single factor analysis showed that,placenta previa and implant,placental abruption,merge multiple or huge uterine fibroids,uterine rupture,blood coagnlation dysfunction,armount of bleeding ＞ 2 000ml,vanda operation with oxytocin rate between the two groups,there were significant differences(P ＜ 0.01).(3) The results of unconditional multi-factor Logistic regression analysis showed that,placental abruption,uterine rupture,merge multiple or huge uterine fibroids,blood coagulation dysfunction,amount of bleeding ＞ 2 000ml were independent risk factors which lead to obstetric emergency hysterectomy.Vanda operation with oxytocin and hysterectomy had negative correlation.Conclusions Obstetric emergency hysterectomy was related with a variety of factors.Strengthen the perinatal health care,and actively prevent emergency hysterectomy can reduce the dangerous factors of uterus removal rate and has important significance.