Objective:To measure the basal concentration of cortisol and analyze its associations with correlative factors in patients with Polycystic Ovarian Syndrome(PCOS).Methods:34 obese(or overweight)and 50 normally-weighed women with PCOS and 21 age-matched healthy women were recruited.Fasting plasma cortisol,insulin,glucose and insulin sensitivity(with euglycemic clamp technique)were measured.Results:Basal cortisol level in the obese or overweight patients with PCOS was lower than in normal weight PCOS and control groups(P

0.05.Conclusion:The prior glucose bolus does not affect the following euglycemic clamp.The Botnia clamp is a useful method for simultaneous independent assessment of insulin secretion and insulin sensitivity.

Humanistic spirit is the core of narrative medicine, which belongs to the cross field of medicine combined with literature. It is helpful to bridging the gap between technology and human nature, breaking the diaphragm between doctors and patients, and establishing doctor-patient emotional community. The narrative medicine can also be seen as humanistic medicine and let the medical hu-manistic spirit carry forward. In this article, author discussed the narrative medical background and medical value and how to cultivate medical narrative, and then explored whether the narrative medicine can become a way of cultivating medical humanistic spirit.

Objective To evaluate the operation and review the clinical effectiveness of arthroscopic tenodesis through double-needles positioning approach to treat proximal lesions of Biceps tendon.Methods From January 2010 to January 2013,55 patients (25 men,30 women) with the mean age of 52.4 (range,37-65) years old who underwent arthroscopic tenodesis through double-needles positioning portal to treat proximal lesions of Biceps tendon were retrospectively analyzed.Shoulder pain of all the patients occurred in pre-operation and aggravated at the time of abduction shoulder joint,which affected the normal life for reasons of weakness.Diagnosis of magnetic resonance imaging (MRI) was proximal lesions of Biceps tendon,which was failed to respond to conservative management of six months.All patients underwent biceps tenodesis under arthroscopy with fixation of two suture anchors through bone,and removed tendon stump finally.All the portals of operation and observation of tendon fixation used double-needles positioning portal.We recorded the general condition of shoulder as the level of pain,sphere of activity,active forward flexion and intensity of adduction in pre-operation,3 months,6 months,12 months and 18 months after operation with American Shoulder and Elbow Surgeons (ASES),shoulder function score of Constant-Murley (Constant) and University of California,Los Angeles (UCLA).Then all data were analyzed statistically.Results All patients were operated successfully and got the mean follow-up of 20 months (range,18-24).The result of MRI showed well healing of tendon without rupture.The shoulder function had basically recovered.In pre-operation,ASES,constant and UCLA scores was 10.22±3.02,35.89±7.25,8.53±2.07 respectively.In 18 months after operation,the scores were 32.07± 1.26,89.75±4.07,31.87±2.07 respectively.The outcomes demonstrated that all scores in 18 months after operation had significantly improved,compared to pre-operation.Conclusion The technique of arthroscopic tenodesis through double-needles positioning approach to treat proximal lesions of Biceps tendon is reliable and simple,and can achieve satisfactory clinical outcomes.

The purpose is to report a case of chordoma, which orignated from sphenoid sinus and encroach on sella, metasella and clivus. We comprehensively analyzed the CT and MRI information and diffrentiated the illness from the commonly encountered diseases of sphenoid sinus and sellato improve the accuracy before surgery.
Chordoma ; pathology ; Humans ; Male ; Middle Aged ; Paranasal Sinus Neoplasms ; pathology ; Sphenoid Sinus ; pathology

OBJECTIVE: To investigate the result of child-type micro-sensitive mattress sleep monitor on obstructive sleep apnea-hypopnea syndrome in children. METHOD: The PSG and child-type micro-sensitive mattress sleep monitor were synchronously performed on 58 cases of children with OSAHS. The breathing and sleep metrics were compared. RESULT: By PSG monitoring, 41 cases were diagnosed as mild OSAHS, 14 cases were moderate and 3 cases were severe. The results of mattress system monitoring showed mild OSAHS in 37 cases, 16 cases of moderate and severe OSAHS in 5 cases. Seven patients diagnosed as mild OSAHS monitored by PSG were classified as moderate by mattress system monitoring; three cases diagnosed as mild OSAHS by mattress system monitoring system were diagnosed as moderate by PSG. Among 14 cases of children diagnosed as moderate by PSG, three cases were diagnosed as mild by mattress system monitor and two cases as severe. Children diagnosed as severe by PSG got the same result by mattress system monitor. Two kinds of sleep monitoring methods were compared and there were no statistically significant difference in AHI (t = 2.316, P > 0.05), deep and shallow sleep constituent ratio (t = 2.280, t = 2.388, PF > 0.05). while there was significant difference in REM period Sleep constituent ratio (t = 3.135, P < 0.01). CONCLUSION Child-type micro-sensitive mattress is in good agreement with the PSG for diagnosing OSAHS in children, which can be used as a monitoring method in clinical work.
Child ; Child, Preschool ; Female ; Humans ; Male ; Polysomnography ; instrumentation ; methods ; Sleep Apnea, Obstructive ; diagnosis

Objective To survey the clinical ability of diagnosis and treatment of diabetic foot among district medical clinical staffs.Methods 55 medical staffs were questionnaired about the diabetic foot knowledge before and after a technical training course.Results (1) After training,the clinical ability of diabetes physical examination,the features of diabetic foot identification,diabetic foot prevention and treatment,diabetic foot health education and the muhidisciplinary team of diabetic foot organization improved.The medical staffs got to know how to organize a multidisciplinary team of diabetic foot.The difference was significant(P＜0.05).(2)The professional category of medical personnel(OR=19.464,95％ CI=1.837-206.243),the history collection and physical examination of diabetic foot (OR=34.825,95％ CI=3.486-347.875)were the influent factors of antibiotic selection when diabetic foot were infected.Conclusion Targeted diabetic foot training is effective to improve the clinical diagnosis and treatment level of district medical staffs.

Objective To evaluate the efficacy of metformin(MTF) in treatment of clomiphene (CC)-resistant patients with polycystic ovary syndrome (PCOS).Methods The published articles of randomized controlled trial (RCT) of comparison of MTF combined with CC and CC alone in treatment of CC-resistant PCOS were searched in PubMed,EMBASE,OVID,EBSCO databases and Cochrane Library,and these studies were screened under inclusion and exclusion criteria.The quality of included studies and extract data of comparison of ovulation rates and pregnancy rates were evaluated.And the Meta-analysis using statistic software RevMan 5.0 was completed.ResultTotal of 333 patients in total 8 trials were included.Meta analysis showed that MTF plus CC led to a significantly higher clinical ovulation rate ( OR =7.31,95 ％ CI:2.57 - 20.76,P ＜ 0.05 ) and pregnancy rate ( OR =7.93,95 ％ CI:2.45 - 25.63,P ＜ 0.05 ) than that of CC alone.Conclusion MTF can increase ovulation and pregnancy rates of CC-resistant PCOS women.

Objective To study the effects of the intensive treatment with continuously subcutaneous in-sulin infusion(CSII) in patients with gestational diabetes and the nursing during the treatment. Methods From Jan 2007 to Aug 2008, 42 patients with gestational diabetes underwent continuously subcutaneous insulin infu-sion, and a standard nursing plan of patients was made up before treatment. The efficacy of treatment and nursing were analyzed. Results After using the CSII, the blood glucose of all patients was controlled at normal level after 7.0±1.5d. 88.1% of patients were satisfied with the effect and one patient was dissatisfied with the treatment because of losing the fetus for sever bleeding caused by placenta previa. 40.5% of patients with different degrees of anxiety accepted CSII therapy after psychological care by nurses;In 9.5% of patients the infusion bump a-larmed because of needle blockage or infusion tube bending, it restarted working and ran normally once the needle replaced or bending tube unwinded. 7.1% of patients developed hypoglycemia during CSII and recovered after eating. Conclusions Intensive treatment with CSII in gestational diabetes patients can effectively control blood glucose level The effect can be improved by taking specific nursing measures.

ObjectiveTo explore the effects of short-term high-fat diet on expression of peroxisome proliferator-activated receptor-γ-coactivator 1α (PGC1α) in hypothalamus of rats. Methods18 male SD rats were randomly divided into 2 groups: the normal control group (NC) and the high-fat group (HF). After two-week adaptive feeding, the 2 groups were given control diet and high-fat diet respectively for 3 days. Body weight and energy intake were recorded every day. Random blood glucose of caudal vein was measured before and after intervention. The mRNA and protein levels of PGC1α, UCP2 and CPT1a in hypothalamus were detected by quantitative RT-PCR and Western Blot. ResultsAfter the three-day treatment, the energy intake in HF group was significantly increased compared with that in NC group (75.7 ±5. 02 vs 60.4 ±4.53 kcal/d, P ＜0.05). However,the body weight, food intake and blood glucose level were not significantly changed. The mRNA level of PGC1α was significantly decreased (P ＜0.05 ), while no significant difference was observed in protein levels. Conclusion Short-term high-fat diet downregu]ates the expression of PGC1α mRNA in hypothalamus of rats.