[Summary] Hypogonadotropic hypogonadism (HH) in women is characterized by failure of ovarian function secondary to deficient gonadotropin secretion,resulting from either a hypothalamic or pituitary defect.Estrogenprogestin therapy can induce and maintain secondary sex characteristic and artificial menstrual evcle.If the patient requires fertility,ovulation and even pregnancy can be induced either with exogenous gonadotropins or with pulsatile gonadotropin releasing hormone therapy.In the present article,different ovulation induction therapies of female HH were reviewed.

The plasma level of endogenous digitalis-like substance(EDLS) was measured in 15 patients who underwent cardiac operation under cardiopulmonary bypass (CPB). Blood samples were taken before and after anesthesia induction,immediately before CPB and removing the aortic crossclamp,and at 5,30min after heart rebeating. Resluts showed that the plasma EDLS level slightely decreased after anethesia indction, and significantly decreased immediately before removing the aortic crossclamps and at 5 min after heart rebeating (P

Objective To develop an information gathering soft-ware platform for spleen system inquiry of TCM, and to discuss the practicability and feasibility of applying computer technology to standardizing management of TCM inquiry data. Methods Based on the TCM Spleen System Inquiry Scale, combined with clinical practice of TCM diagnosis and treatment, an inquiry information gathering soft-ware platform for TCM spleen system was designed. The platform was interfaced with B/S structure, and in the use of computer programming languages, the platform possessed the good functions of data collection, storage, query, export and print, etc. In addition to this, by calling the correct algorithm, it contents users with analysis and statistics on the target data set. Results The platform designed has been initially equipped with the functions of collecting, storing, inquiry, deleting, modifying, exporting and printing the inquiry-based four diagnostic data for TCM spleen system diseases. And to some extent, it also achieves standardization and objectification of the collection of TCM Spleen System Inquiry Scale. Conclusion It is practicable and feasible to applying computer technology into standardizing management of TCM inquiry informations. Besides, it could act as the direction for the research of TCM four diagnostic data in the future.

ObjectiveTo evaluate the effect of external fixator,colostomy,repeated debridement and vacuum-assisted closure (VAC) to treat open pelvic fractures concomitant with perineal laceration and infection.MethodsA retrospective analysis was made about 8 cases of open pelvic fractures concomitant with perineal laceration and infection from February 2004 to January 2011.It includes 7 men and 1 woman,with the average age of 36.3 years(ranged from 22 to 59 years).Five cases were injured by traffic accident,2 cases were fall-down from height,and 1 case was crushed by weight.Fractures type according to Tile:3 cases were type B,5 cases were type C.All cases were type I according to Faringer classification.All patients were treated with external fixator according to the displacement of pelvic fractures,early colostomy,repeated debridement,and after infection be controlled,VAC was used to close wound and drainage.Results The eight cases of open pelvic fractures concomitant with perineal laceration and infection were followed up from 6 to 36 months,with the average of 16 months.The infection was healed in all patients,and the body temperature and blood routine got normal.The period from injury to wound closing was from 8 to 43 days,with the average time of 17 days.According to the Majeed evaluation system,the pelvic fractures healing was evaluated after treatment:2 cases were excellent; 3 cases were good; 2 cases were fair;,1 case was poor;,the good to excellent rate was 62.5％.ConclusionThe method of applying external fixator,colostomy,repeated debridement and VAC to treat open pelvic fractures concomitant with perineal laceration and infection is useful.The methods played an active role in controlling infection,reducing infection rates and mortality rates,and shortening the healing time.

Objective To investigate the effectiveness of ilioischial plating through modified Stoppa and iliac fossa approaches for complex acetabular fractures. Methods A consecutive series of 40 patients with complex acetabular fracture were treated operatively from January 2014 to February 2015. Of them, 20 were treated through modified Stoppa plus iliac fossa approaches as an experimental group ( including 12 males and 8 females with a mean age of 46. 8 ± 10. 3 years ) . The anterior column was stabilized with a recon-struction plate for the iliac wing along the iliopectineal line to the pubis in all cases. The posterior column was fixed with a newly developed ilioischial plate running from the ilium to the ischial ramus. The other 20 patients ( 10 males and 10 females with a mean age of 45. 6 ± 11. 7 years ) served as a control group, treated with a reconstruction plate for the conventional posterior column fixation through the Kocher-Langenbeck approach. The 2 groups were compared in terms of operative time, intraoperative blood loss, reduction and functional recovery of the hip. Results The 40 patients obtained an average follow-up of 18 months ( from 8 to 24 months ) . The experimental group reported significantly shorter operation time ( 2. 1 ± 0. 7 hours ) and signifi-cantly less intraoperative bleeding ( 320. 8 ± 100. 4 mL ) than the control group ( 2. 9 ± 0. 6 hours and 621. 6 ± 118. 7 mL, respectively ) ( P <0. 05 ) . According to modified Matta's criteria for reduction, the experimental group had 15 excellent, 3 good, one fair and one poor cases ( giving an excellent to good rate of 90％) while the control group had 17 excellent, one good, one fair and one poor cases ( giving an excellent to good rate of 90％) . According to the modified Merle d'Aubigné and Postel scoring for the functional recovery of the af-fected hip at the final follow-ups, the experimental group had 14 excellent, 3 good, 2 fair and one poor cases ( giving an excellent to good rate of 85％) while the control group had 12 excellent, 4 good, 3 fair and one poor cases (giving an excellent to good rate of 80％). There were no significant differences between the 2 groups in the above comparisons ( P> 0. 05 ) . There were no significant differences in the MOS item short form health survey score and postoperative complication rate between the experimental group and the control group. Conclu-sion Ilioischial plating through modified Stoppa and iliac fossa approaches has advantages of reliable fixa-tion, limited invasion, less intraoperative blood loss and fewer complications for complex acetabular fractures.

Traditional Chinese medicine (TCM) intervention should be concisely and precisely reported in randomized controlled trials (RCTs). Based on State Food and Drug Administration's categories, we recommend reporting the interventions as follows: (1) Single Chinese herbal medicine-based/formula-based/extraction-based intervention includes 1) Name, dosage format and registration; 2) The composition and quality of intervention; 3) Pharmaceutical processing and quality control; 4) Stability of final product and quality control; 5) Function and safety description; 6) Dosage and treatment course; 7) Control group. (2) Active compound-based TCM drug intervention includes 1) Name of active compound(s); 2) Original source of active compound(s); 3) The brief process obtaining active compound(s); 4) Percentage of active compound(s) in final product; 5) Added materials and its quality and quantity control. Besides, the detailed information of intervention can be published as an online supplement in web site.

Evaluating outcome is the primary means by which different medical modalities can be compared with regard to effectiveness. In traditional Chinese medicine (TCM), this focus has prompted practitioners to search for outcome measures that can objectively verify the effectiveness of TCM interventions, especially in the context of randomized controlled trials (RCTs). Commonly used indexes for outcome assessment in RCTs of TCM can be categorized into two types: TCM-specific outcomes such as tongue and pulse characteristics, and Western medicine (WM)-specific outcomes such as blood test and X-ray examination results. Some studies include both types of indicators. During the trial design, it is necessary to consider the rationales of selecting outcome assessments, the purpose and study approach, balance between objective and subjective indexes, standardization of outcome assessment, and standardized outcome indexes. We recommend to report the outcome assessment in RCTs of TCM in the following format: 1) identifying the primary and secondary outcomes based on the purpose and hypothesis of the trial; 2) defining the primary and secondary outcomes clearly; 3) presenting the rationale of selection; 4) presenting the method with aims to standardize the assessment process; 5) presenting the method to improve the reliability of assessment; and 6) stating the termination criteria in the trial.

OBJECTIVE: To discuss the types of control groups in randomized controlled trials (RCTs) of Chinese herbal medicine (CHM), and to provide suggestions for improving the design of control group in future clinical studies in this therapeutic area. METHODS: A search of the Cochrane Library was conducted in July 2005 to identify RCTs of CHM, and 66 RCTs with CHM for type 2 diabetes mellitus were obtained as the basis for further analysis. RESULTS: Of 66 RCTs with CHM for type 2 diabetes mellitus, 61 (92.4%) trials had both a treatment group and a control group. Twenty-seven (40.9%) RCTs compared CHM plus conventional drug vs conventional drug, 24 (36.4%) compared CHM vs conventional drug, 5 (7.6%) compared CHM vs placebo, 3 (4.5%) compared CHM plus conventional drug vs conventional drug plus placebo, 3 (4.5%) compared CHM plus conventional drug vs other CHM, 1 (1.5%) compared CHM vs no treatment, 1 (1.5%) compared CHM plus placebo vs conventional drug plus placebo, 1 (1.5%) compared CHM vs CHM plus conventional drug vs conventional drug vs placebo, and 1 (1.5%) compared CHM vs conventional drug vs CHM plus conventional drug. CONCLUSION: A variety of control groups were used in RCTs of CHM for type 2 diabetes mellitus, including placebo, active, and no treatment control groups. Justification for selecting particular types of control groups were not provided in the trials reviewed in this study. Different control groups may be appropriate according to the study objectives, and several factors should be considered prior to selecting control groups in future RCTs of CHM. RECOMMENDATIONS: (1) Investigators of CHM who design clinical trials should understand the rationale for selecting different types of control groups; (2) Control groups for RCTs should be selected according to study objectives; (3) Active control groups should select interventions for comparisons that have the strongest evidence of efficacy and prescribe them as recommended; (4) Placebo control groups should select a placebo that mimics the physical characteristics of test intervention as closely as possible and is completely inert; (5) No treatment control groups should only be used when withholding treatment is ethical and objectives outcomes will not be subject to bias due to absent blinding; (6) Crossover control groups may be appropriate in chronic and stable conditions.

Objective To study the methods and effect of minimally invasive percutaneous plate osteosynthesis(MIPPO) on tibial Pilon fracture.Methods 49 cases of tibial Pilon fracture hospitalized,23 cases(group A) with minimally invasive percutaneous plate osteosynthesis(MIPPO) by indirect reduction and 26 cases(group B) with open restoration internal fixation by prospective contrast investigation.Results Compared with group B,the amount of blood loss and complications in group A markedly decreased,the healing of fracture was faster,the functional rehabilitation of ankle joint was more satisfactory.Conclusion Minimally invasive percutaneous plate osteosynthesis(MIPPO)on tibial Pilon fracture can meet the requirements of biological osteosynthesis,degrade soft tissue operation injury,be beneficial to fracture healing and functional rehabilitation of ankle joint.MIPPO is a safe and effective technique of tibial Pilon fracture.

[Summary] Eighteen patients with idiopathic hypogonadotropic hypogonadism( IHH) receiving aromatase-inhibitor( AI) letrozole for at least 3 months were recruited.After 3 months′treatment, LH levels were increased from (2.1 ±1.5) IU/L to (3.6 ±3.7) IU/L(P=0.029), and FSH levels from (2.6 ±1.8) IU/L to (4.3 ±3.4) IU/L (P=0.003).Total testosterol was increased from (87 ±42) ng/dl to (166 ±200) ng/dl(P=0.082), and estradiol wasdecreasedfrom(22.7±18.7) pg/ml to (13.4±10.6) pg/ml(P=0.020).The average testis volume was increased[(14.3 ±3.9 vs 11.2 ±4.9) ml, P<0.01].Sperms were detected in 8 out of 9 patients who did seminal fluid test.The result of general linear model showed that LH(60 min) was significantly related with total testosterol increment( P=0.045) .