[Objective]To observe the dynamic changes of serum LH levels in different GnRH-along protocols ,and investigate the relationship between GnRH-adosage and LH levels ,and compare the clinical outcomes among different GnRH-a long protocols.[Methods]In this retrospective study,1.0 mg,0.8 mg,0.375 mg long-acting and 0.1 mg/d,0.05 mg/d short-acting GnRH-a long protocols were included from January to June in 2015 at the Reproductive Medicine Center of the First Affiliated Hospital of Sun Yat-Sen University. Serum LH levels were evaluated from a total of 250 women at the four time points,on the day before gonadotropin stimulation(Gn0),the fourth day of Gn stimulation(Gn4),the seventh day of Gn stimulation(Gn7),and the HCG administration day(HCG day),then the relationship between serum LH levels and the dosage of GnRH-a were analyzed. The number of oocytes retrieved,fertilization rate,good quality embryos rate,blastocyst transferred rate,the number of transferred embryos,implantation rate and clinical pregnancy rate were also compared.[Results]Among the long-acting groups,LH levels in 0.375 mg group were higher than those in 1.0 mg and 0.8 mg groups at the four time points(P<0.05). Total Gn dose,duration of Gnstimualtion and HMG dosage of 1.0 mg protocol and 0.8 mg protocol were significantly higher than those of 0.375 mg group(P < 0.05). In addition,the implantation rate showed an increasing tendency when the level of LH increases(P>0.05). In short-acting groups,the LH levels in 0.05 mg/d protocol were significantly lower than those in the 0.1 mg/d group at Gn0,Gn7 and HCG day(P<0.05). Total Gn dose,du?ration of Gn stimulation and HMG dosage did not show significant difference between 0.05mg and 0.1mg group. What′s more,the im?plantation rate in 0.1 mg/d group was higher than in 0.05 mg/d group(P>0.05).[Conclusion]Among the long-acting groups,the smaller amount of GnRH-a was administrated ,the higher LH levels during ovarian stimulation and implantation rate the patients ob?tained. As to the short-acting groups,the LH level and implantation rate in 0.1 mg/d group is higher than those in 0.05 mg/d group.

Objective To explore the prevention and treatment of acute kidney injury (AKI) after gastrointestinal surgical procedures.Method We retrospectively analyzed the data of patients underwent gastrointestinal surgery in recent 2 years in the First Affiliated Hospital of Kunming Medical University and the First People's Hospital of Yunnan Province. Result The incidence of AK1 was 2.1%. Elderly patients with basic diseases had poorer prognosis than non-elderly patients. Conclusion In the patients after gastrointestinal Surgery, early rehydration, diuresis, ant-infection and preventive hemodialysis can achieve the goal of prevention and treatment of acute kidney injury in early stage.

Objective To analyze the hepatitis B virus infection with extreme reduction of cholinesterase(CHE)not caused by liver synthesis dysfunction,and to explore its clinical significance.Methods The clinical data of 2 rare cases hospitalized in the 3rd people's hospital of Kunming in July 2021 and February 2022,including liver function,coagulation function,hepatitis B markers,hepatitis B virus volume,and whole exon sequencing,were collected and analyzed,and literature was reviewed.Results CHE was extremely reduced in 2 patients with HBV infection,liver synthesis function was good,and whole exon sequencing showed the presence of butyrylcholinesterase(BCHE)gene mutation.Conclusion The extremely low CHE in this case is not due to liver function disorder.Exon sequencing detected mutations in the BCHE gene in two patients.Screening for BCHE mutations may be necessary in patients with extremely low cholinesterase levels not due to liver dysfunction.

Objective To indentify the cognitive status of Chinese patients to acne and the influencing factors to theirs' cognitive status,so as to provide solid evidences for the prevention and treatment of acne.Methods A self-designed questionnaire was made to conduct this survey of 16,156 acne patients,who seeked to the treatment in the dermatological departments from 112 hospitals in China.The survey consisted of several parts,including the general status of patients,the patients' cognition of occurrence,development and risk factors of acne,whether the first choice was seeking treatment at the hospital when the patients had acne and the condition of selection of skin care products.The factors were analyzed,which could impact the cognition of the patients' behavior of treatment,how did the patients' cognition to influence their medical behavior and skin care as well as the consistency of assessment of the severity of acne by doctors and patients themselves.Results The acne patients studied had the best knowledge of "acne is a skin disease","it not only occurs in the period of adolescence" and "the disease can be prevented and cured",which accordingly accounted for 80.65％,69.16％ and 65.49％ of the total patients respectively.However,the awareness of acne patients to heredity,high sugar and dairy products as risk factors for acne was insufficient,which accounted for 48.72％,42.40％ and 18.25％ of the total patients,respectively.Gender,age,educational level,occupation and health knowledge were the main factors affecting the cognitive level of patients;the survey also found that men,patient with educational level of junior high or even lower educational condition,occupation of labor workers or farmers and patients were lack of health education with poor knowledge of the genetics and dietary were risk factors for acne;patients with age over 36 years or with mild illness had poor knowledge of dietary risk factors for acne;the difference was statistically significant (P＜0.05).The analysis of the influence of cognitive status on medical treatment behavior and skin care showed that the better the cognition,the higher the probability of patients would choose medical treatment as the first choice as well as choosing functional skin care products;the difference was statistically significant (P＜0.05).The consistency of assessment of the severity of acne by doctors and patients was poor (Kappa value ＜0.4),and the assessment of severity of acne by patients was more serious than doctors' assessment.Conclusions Patient's cognitive status will affect their medical behavior and skin care,and there is also a phenomenon that patients have a more serious assessment of their acne condition.It is suggested that health education for acne patients should be strengthened in clinical medicine so as to improve their knowledge of acne as well as preventing from acne effectively.