Polycystic ovary syndrome (PCOS) is of multiple etiological factors and clinical manifestations characterized by chronic anovulation and hyperandrogenism. A great deal of studies confirm that insulin resistance (IR) might be one of the mechanisms in the development of PCOS. This article reviews the pathogenesis of IR in PCOS.

Polycystic ovary syndrome(PCOS)is a syndrome of multiple etiological factors and clinical manifestations.It's essential pathophysiological signs are chronic anovulatory and hyperandrogenism.Recent studies have dominated that PCOS is an endocrine metabolic disease characterized by insulin resistance(IR)and is a component of Metabolism syndrome(MS).Several factors related to MS and the ultima angiocardiopathy change exist in PCOS.

Objective:To study the effect of androgen on osteoporosis(Op) in male rats.Methods: Thirty-two 15-week-old male Spague-Dawley rats underwent orchidectomy and then were randomly divided into 3 groups: a normal controls,a model and a andriol treated group.Biochemical markers,bone density(BMD) and bone histomorphometry were investigated after 28 weeks.Results: Orchidectomy caused a significantly decreased in the level of testosterone(P

Objective To assess the association of obesity, serum lipid levels and insulin resistance with leptin in Nanjing population. Methods One hundred and eighty eight subjects aged 22～81 years in Nanjing were divided into three groups according to BMI and dignosis criteria of diabetes: normal group, obese group and diabetes group. Their weight, height, waist, abdomen and hip circumferences were measured. Total cholesterol, triglycerides, low density lipoprotein cholesterol, high density lipoprotein cholesterol, apoA, apoB, fasting plasma glucose (FPG), true insulin (TI), immunoreactive insulin (IRI) and leptin were also measured. ISI 1=1/(FPG?TI) and ISI 2=1/(FPG?IRI) as insulin sensitivity indexes were used to analyse the relation between leptin and insulin resistance. Results Fasting serum leptin level was associated with sex (four fold as high in women as that in men). BMI was the second strongest determinant of leptin. Leptin was positively correlated with TI (r=0.32, P

Objectives: To explore the epidemiological distribution of body mass index(BMI),waist to hip ratio(WHR) and abdominal circumference in population of Nanjing,Jiangsu Province. Methods: BMI, WHR and abdominal circumference were measured on 3 445 healthy cases aged 18～90 of Nanjing. Epidemiological distribution of BMI,WHR and abdominal circumference were analyzed according to sex and age. Results:The total mean BMI was( 23.28 ?3.49)kg/m 2, and the BMI in male was higher〔(23.80?3.36)kg/m 2〕 than that in female 〔(22.25? 3.49)kg/m 2〕( t =12.75, P

ObjectiveTo evaluate the implication of ultrasonographic features of primary breast cancer tumors and axillary lymph nodes in predicting axillary lymph nodes metastasis in patients with breast cancer.MethodsA total of 108 patients with breast cancer were underwent examination of primary breast tumors and axillary lymph nodes by high frequency linear-array probes of ultrasound.The ages of patients,locations of primary tumors,numbers of tumors,maximum diameters of tumors,the longitudinal transverse axis ratio of tumors,mass boundary,ultrasonic patterns,micro-calcification,classification of blood supply,color pixel density(CPD),peak systolic velocity,resistance index,the longitudinal transverse axis ratio of axillary lymph nodes and maximum cortical thickness of axillary lymph nodes were recorded.ResultsOut of 108 patients with breast cancer,the longitudinal transverse axis ratio of tumor were greater than 1 in 75 (69.4 ％ ),micro-calcification in 57(52.8 ％ ),classification of blood supply were Ⅱ - Ⅲ in 57 (52.8％ ),CPD were greater than or equal to 10％ in 48 (44.4％),maximum cortical thickness of axillary lymph node were greater than or equal to 3 mm in 51 (47.2％),and longitudinal transverse axis ratio of lymph nodes were less than 1.5 in 59 (54.6％).Univariate analysis revealed that these six parameters were correlated to the axillary lymph node metastasis in breast cancer ( P ＜0.05).However,ages of patients,location of tumor in the breast,numbers of tumors,maximum diameters of tumors,mass boundary,ultrasonic patterns,peak systolic velocity and resistance index were not related to the axillary lymph node metastasis( P ＞0.05).Multivariate logistic regression analyses showed that CPD (OR:16.337,95％ CI:4.537- 58.826),longitudinal transverse axis ratio of lymph nodes (OR:3.754,95％ CI:1.269- 11.108) and microcalcificationand (OR:3.033,95 ％ CI:1.040 - 8.840) were risk factors of axillary lymph nodes metastasis in patients with breast cancer.ConclusionsThe application of ultrasonography in patients with breast cancer is useful in predicting axillary lymph nodes metastasis.

Objective To evaluate the efficacy of preoperative biliary drainage (PBD) in the pancreaticoduodenectomy for malignant obstructive jaundice.Methods Database including PubMed,EMBASE,Cochrane Central Register of Controlled Trials,Academic Degree Dissertation Database and Conference Database were searched with malignant obstructive jaundice,pancreaticoduodenectomy,preoperative biliary drainage,comparative study.Literatures about the randomized controlled trials of PBD (PBD group) and efficacy of early surgery (ES group) in the pancreaticoduodenectomy were retrieved from January 2001 to December 2013,and then a Meta analysis was carried out based on the data.The count data were analyzed using the odds ratio (OR),relative risk (RR) and 95％ confidence interval (95％ CI),and the measurement data were analyzed using mean difference (MD) and 95％ CI.The heterogeneity of the data was analyzed using the I2 test.Data were integrated by fixed or random effect model.Results Twelve literatures including 1 982 patients were selected.There were 1 029 patients in the PBD group and 953 in the ES group.The results of Meta analysis showed that the operation time,volume of blood loss and rate of postoperative wound infection in the PBD group were significantly different from those in the ES group (MD =10.50,107.92,95％ CI:6.34-14.66,16.43-199.42;RR =1.62,95％CI:1.19-2.21,P ＜0.05).There were no significant differences in the postoperative mortality,incidence of pancreatic fistula,incidence of bile leakage,incidence of delayed gastric emptying and duration of hospital stay between the 2 groups (RR=0.69,95％CI:0.52-0.92;OR =0.68,1.35,95％CI:0.38-1.21,0.93-1.95;MD =0.69,95％CI:-0.67-2.05;RR =0.00,95％ CI:-0.02-0.01,P ＞0.05).Conclusion PBD in the pancreaticoduodenectomy for malignant obstructive jaundice cannot reduce postoperative mortality and incidence of complications in patients,and should not be used as the conventional management in the perioperative period.

The condition of patients with severe traumatic brain injury (sTBI) complicated by corona virus 2019 disease (COVID-19) is complex. sTBI can significantly increase the probability of COVID-19 developing into severe or critical stage, while COVID-19 can also increase the surgical risk of sTBI and the severity of postoperative lung lesions. There are many contradictions in the treatment process, which brings difficulties to the clinical treatment of such patients. Up to now, there are few clinical studies and therapeutic norms relevant to sTBI complicated by COVID-19. In order to standardize the clinical treatment of such patients, Critical Care Medicine Branch of China International Exchange and Promotive Association for Medical and Healthcare and Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Chinese expert consensus on clinical treatment of adult patients with severe traumatic brain injury complicated by corona virus infection 2019 ( version 2023) based on the joint prevention and control mechanism scheme of the State Council and domestic and foreign literatures on sTBI and COVID-19 in the past 3 years of the international epidemic. Fifteen recommendations focused on emergency treatment, emergency surgery and comprehensive management were put forward to provide a guidance for the diagnosis and treatment of sTBI complicated by COVID-19.