Objective To explore the effect of Jiangzhipailuan decoction in regulating PPARα( belong to the nuclear receptor family of ligand-activated transcription factors ), PGC- 1α ( peroxime proliferator activated releptour)and SREBP-1c( belong to the baichelix-loop-helix-leucine zipper class of transcription factors), SCAP( SREBP cleavage activating protein) related to lipid metabolism in the treatment of polycystic ovarian syndrome. Methods 84 patients suffered polycystic ovary syndrome were randomly divided into 4 groups: one received traditional Chinese medicine treatment, one western medicine treatment, one combination therapy and one as the control group. Traditional Chinese medicine group was treated with Jiangzhipailuan decoction treatment for 3 months, western medicine group was treated with up to Diane-35 ( ethinyl cyproterone tablets) for three cycles, while the combination therapy group was treated with traditional Chinese medicine ,western medicine as well as combined treatment for 3 courses. Results In the combination therapy group the PPARα, PGC-1α and decreased SREBP-1c, SCAP copy number was significantly improved ,and body mass index was significantly lowered. The total improvement rate of menstrual in three groups were 71.42% ,75.00% ,92.86% respectively. Conclusion Jiangzhipailuan decoction played a prominent role in regulating PPARα,PGC-1α and SREBP-1c,SCAP related to lipid metabolism in the treatment of polycystic ovarian syndrome.

Objective To investigate the risk factors of pancreatic fistula after pancreaticoduodenectomy (PD).Methods The clinical data of 186 patients who received PD at the Second Affiliated Hospital of Kunming Medical College from May 2000 to May 2010 were retrospectively analyzed.All patients were divided into pancreatic fistula group (39 patients) and non-pancreatic fistula group ( 147 patients).Risk factors of pancreatic fistula after PD were screened out from 20 factors by univariate and multivariate analysis.The univariate analysis was carried out by chi-square test or Fisher exact test,and the muhivariate analysis was done by Logistic regression.Results Thirty-nine patients were complicated with pancreatic fistula,including 26 in grade A,10 in grade B and 3 in grade C.The results of univariate analysis showed that duration of preoperative jaundicc,loss of body weight at 6 months before operation,preoperative total bilirubin level,preoperative albumin level,postoperative albumin level,length of pancreas dissected,pancreatic tube diameter,pancreatic texture and time of abdominal drainage tube pull out were high risk factors of pancreatic fistula ( x2 =34.990,20.480,8.212,10.890,13.561,11.505,13.820,4.539,36.590,P ＜ 0.05).The results of multivariate analysis showed that duration of preoperative jaundice ＞ 8 weeks,loss of body weight at 6 months before operation ≥ 10％,pancreatic tube diameter ＜ 3 mm,soft pancreatic texture and time of abdominal drainage tube pull out ＞ 5 days were the independent risk factors of pancreatic fistula ( OR =2.229,3.383,1.437,1.273,11.939,P ＜ 0.05).Conclusion Duration of preoperative jaundice ＞ 8 weeks,unconscious loss of body weight ≥ 10％ within 6 months before operation,pancreatic tube diameter ＜ 3 mm,soft pancreatic texture,time of abdominal drainage tube pull out ＞ 5 days would increase the risk of pancreatic fistula after PD.

Objective To summarize the adverse reactions of blepharospasm (BSP) and hemifacial spasm (HFS) after botulinum toxin A (BoNT-A) injection and offer corresponding responses.Methods Clinical data of 163 BSP patients and 221 HFS patients,admitted to and subjected to BoNT-A injection in our hospital from September 2017 to October 2019,were analyzed retrospectively.Albert and Cohen evaluation scale was used to evaluate the therapeutic efficacy after injection.All adverse reactions were recorded and corresponding responses were proposed.Results The effective rates of BoNT-A injection for BSP and HFS were 97.5％ and 100％,respectively.The most common early-onset adverse reactions were local pain (BSP:13.5％;HFS:17.2％) and hematoma (BSP:3.7％;HFS:4.5％);the late-onset adverse reactions included dry eyes/epiphora (BSP:9.8％;HFS:11.3％),incomplete closure of eyelid (BSP:20.2％;HFS:20.4％),facial stiffness (HFS:39.4％) and asymmetry (HFS:11.8％),and eyelid edema could be noted in a few patients (BSP:1.2％;HFS:1.4％).The main measures on reducing or avoiding adverse reactions after injection included appropriate injection apparatus,accurate injection sites,exact drug doses,and consideration of the individual differences of patients.Conclusion BoNT-A is effective in the treatment of BSP and HFS,but it is necessary to avoid early-onset and late-onset adverse reactions to maximize the benefits of patients.

Objective To explore the effects of nursing specialty construction on vascular crisis in patients after replantation of severed finger.Methods A case control study was conducted, and 151 patients ( 203 fingers) of microsurgery in a hospital from January to December 2015 were selected as the observation group, and 143 patients ( 195 fingers) were selected as the control group. Patients in the control group received routine postoperative nursing, while patients in the observation group were given special technologies and special nursing measures which included " self-help pain management techniques""decubitus nursing technology" " warm comfortable security technologies" " cut flush bloodletting technologies" and "five-love service" through the construction of special nursing specialty; SPSS 17. 0 statistical software was used to analyze the incidence rate of vascular crisis in two groups. Results In the observation group, 151 cases, 203 fingers received replantation, and the incidence rate of arterial crisis was 2.0%;the incidence rate of venous crisis was 2.5%. In the control group, 143 cases, 195 fingers received replantation and the incidence rate of arterial crisis was 7.7%;the incidence rate of venous crisis was 9.2%. According to the statistical analysis, there was significant difference between two groups ( P<0. 05 ) . Conclusions Through the construction of nursing specialty, the implementation of special nursing technology and special nursing service, can effectively reduce the incidence of vascular crisis and improve the innovation ability and professional level of the nurses, and promote the sustainable development of nursing.