Objective Polycystic ovary syndrome(PCOS)is the common endocrine diseases of reproductive age women and is characterized by obesity clinically.TCMholds that the fat is more likely to have phlegm -dampness constitution.So there is a close correlation between each other.This article mainly from the perspective of phlegm wet treatment fueling PCOS research.

Objecive To evaluate the causes of 60 cases for clinical failure in post crown.Methods Sixty cases with failure in post crown cure were entered the study.The causes of failure were analyzed.Results Among the 60 cases with failure in post crown cure,38 cases were due to the crown'loosing or broken away,12 cases with the broken dental crown,10 cases with periapical periodontitis,6 cases with broken root.Conclusions It was the loosing or broken away of post crown,periapical periodontitis,dental crown and root broken consist of the main causes for clinical failure in post crown.

Objective To evaluate the efficacy of Jianpi-Gushen decoction combined with vitamin E and human chorionic gonadotropin for the patients with threatened abortion in early pregnancy. Methods A total of 154 patients with threatened abortion who met the inclusion criteria were divided into two groups by a random digital table, with 77 patients in each. The control group was treated with intramuscular injection of human chorionic gonadotropin (HCG) combined with vitamin E, while the observation group was treated with Jianpi-Gushen decoction based on the treatment of control group. The levels of serum β-HCG were detected by radioimmunoassay before and after treatment, and the levels of progesterone were detected by electrochemiluminescence assay, and the efficacy was evaluated. Results The total effective rate in the observation group was 90.9% (70/77), and control group was 77.9% (60/77). The difference between two groups was significantly different (χ2=4.936, P=0.026). The serum β-HCG level (22383.41 ± 4387.67 mIU/ml vs. 15728.66 ± 3375.93 mIU/ml, t=5.614) and progesterone level (58.53 ± 18.77 nmol/L vs. 43.45 ± 17.46 nmol/L, t=2.674) in the observation group after treatment were higher than those in the control group (P<0.01). Conclusions The Jianpi-Gushen decoction combined with vitamin E and HCG could increase the levels of serum β-HCG and progesterone and improve the clinical effect.

OBJECTIVE To assess the skills and key points with frontal ostium in Draf IIa endoscopic frontal sinus surgery.METHODS We retrospectively reviewed 607 cases of patients who underwent endoscopic sinus surgery between September, 2004 and December, 2007, 84 cases(147 sides)of patients who underwent Draf IIa endoscopic frontal sinus surgery.The period of follow-up were 7 to 40 months.RESULTS All of 84 cases(147 sides) of patients, frontal ostium drainage was restored in 58 cases(102 sides, 69%), improved in 16 cases(28 sides, 19 percent), invalid in 10 cases(17 sides, 12%).CONCLUSION Endoscopic sinus surgery is an effective way for the treatment of chronic frontal sinusitis.Draf IIa endoscopic frontal sinus surgery is an easy and useful technique to restore the drainage of frontal ostium.

Objective To investigate the injury caused by hydrogen peroxide (H2O2) on human renal tubular epithelial cell (HKC) and its effect on calcium oxalate (CaOxa) crystal crystallization time before and after the injury. Methods The injury degree of HKC by H2O2 was measured by detecting the cell survival rate and the concentration change of malonaldehyde (MDA). CaOxa crystallization was investigated by scanning electron microscopy (SEM). Results Control cells induced only a small amount of calcium oxalate dihydrate (COD) crystals, while the injured cells not only induced calcium oxalate monohydrate (COM) crystals, but also increased the number and aggregation of CaOxa crystals. After incubating with CaOxa supersaturated solution, the control group HKC cells could be injured as well. Conclusions H2O2 can cause oxidative damage on HKC. The injured HKC promotes the nucleation and aggregation of COM crystals. In the body environment, the long-term presence of crystals in urinary tract is a risk factor for stone formation.

Objective To investigate healthcare-associated infection(HAI)in patients in a cancer hospital,provide reference for controlling HAI in cancer patients,and guide rational use of antimicrobial agents.Methods Clinical data of patients in a cancer hospital between August 2006 and July 2012 were analyzed retrospectively.Results The incidence of HAI case was 1 .53% (2 060/134 389),and annual incidence showed a downward trend.The main in-fection site was lower respiratory tract (46.46%,n=957),followed by bloodstream (15.63%,n=322),abdominal and pelvic (14.03%,n=289).The main pathogens were Pseudomonas aeruginosa (16.16%,n=350),Staphylo-coccus aureus (9.97%,n=216),Klebsiella pneumoniae (9.79%,n=212),Escherichia coli (9.65%,n=209), and Candida albicans (6.51 %,n=141 ).Gram-negative bacilli,including Klebsiella pneumoniae and Escherichia coli ,were sensitive to carbapenems and β-lactamase inhibitors.Conclusion Lower respiratory tract is the major HAI site in patients with cancer,and gram-negative bacteria are the main pathogens.Carbapenems andβ-lactamase inhibitors are recommended for the empirical treatment of HAI in cancer patients.

Objective To analyze the clinical significance of endometrial abnormalities in patients with breast cancer after oral administration of tamoxifen, and to determine the risk factors for endometrial malignancy. Methods We collected data from 135 patients with breast cancer who underwent surgery for endometrial abnormalities after oral administration of tamoxifen at the Department of Gynecology from September 2011 to December 2017. According to the pathological results obtained, the patients were divided into groups A (benign endometrial lesion) and B (precancerous and malignant endometrial lesion). The relationships between endometrial malignancy and factors including age, menopausal status, body mass index, endometrial thickness, abnormal uterine bleeding, oral dose of tamoxifen, duration of oral medication, and complications (hypertension and diabetes) were compared between the groups. Results There were 124 patients in group A and 11 patients in group B. The difference in the incidence of abnormal uterine bleeding, which was a risk factor for endometrial malignancy, was significant different between the groups (P ＜ 0.05). Conclusion Physicians should pay close attention to abnormal uterine bleeding in patients taking tamoxifen after surgery for breast cancer. Hysteroscopy should be used to confirm the nature of lesions, and patients without symptoms should be followed up.

Endometrial cancer is a common malignancy of the female reproductive system. Despite improvement in living standards, the incidence of endometrial cancer is increasing due to the lack of effective screening. Early detection of endometrial cancer and precancerous lesions can significantly improve prognosis and survival. At present, China lacks a method for screening endometrial lesions comparable to that for cervical cancer screening. A recently introduced endometrial sampler has the advantages of simple operation, low cost, and minimal trauma, and is gradually being accepted for clinical screening of endometrial cancer and precancerous lesions in other countries.This study aims to explore current screening methods for endometrial cancer and precancerous lesions and the clinical application of an endometrial sampler for screening.

OBJECTIVE To study the changes of symptoms and signs of laryngopharyngeal reflux diseases(LPRD) after treatment with esomeprazole.METHODS The suspected LPRD patients were treated with esomeprazole for 8 weeks.Reflux finding score(RFS) and reflux symptoms index(RSI) score were evaluated before and after treatment.RESULTS In RSI,84％ of the patients had the symptom of hoarseness or a problem with voice,87％ had clearing of throat,71％had excess throat mucus,58％ had difficulty swallowing food,52％ had coughing after eat or after lying down,68％ had breathing difficulties or chocking episodes,79％ had troublesome or annoying cough,92％ had lump in your throat or sensation of something sticking in throat,and 32％ had heartburn,chest pain,indigestion or stomach acid coming up.In the RFS,45％ of the patients had pseudosulcus,57％ had ventricular obliteration,94％ had erythema/hyperemia,85％ had vocal cord edema,82％ had diffuse laryngeal edema,83％ had posterior commissure hypertrophy,10％ had granuloma/granulation,and 58％ had thick endolaryngeal mucus.The RSI and RFS score had statistical difference before and after treatment(P＜0.001).CONCLUSION The main symptoms of LPRD were lump in throat or sensation of something sticking in throat,clearing of throat and hoarseness or a problem with voice.The main signs of LPRD were erythema/hyperemia,vocal cord edema and posterior commissure hypertrophy.The PPI has marked improved in symptoms and signs of LPRD.

Tumor-derived exosomes (TEXs) are small membrane vesicles secreted by tumor cells.They contain various proteins and RNA which make they serve as functional mediators in cell interaction.TEXs can alter the components of extracellular matrix and induces epithelial-mesenchymal transition of tumor cells,which enhance the invasiveness of tumor cells.TEXs regulate immunity through multiple pathways,allowing circulating tumor cells to escape immune surveillance.TEXs promote pre-metastatic microenvironment in target organ before metastasis and induce angiogenesis after circulating tumor cells colonization.Understanding the role and mechanism of TEXs in this process can effectively block relevant signaling pathways which may provide new targeted therapies for clinic.