Objective To investigate the effect of Yishen Shugan Yangxue decoction combined with Climen on patients with DOS.Methods 140 patients with DOS who were admitted to our hospital between June 2013 to August 2014 were randomly divided into two groups,70 cases in each groups. The control group were treated with Climen hormone replacement therapy, and the observation group were treated with Yishen Shugan Yangxue decoction combined with Climen. The clinical efficacy, menstrual, the number of antral follicles and pregnancy outcomes were observed. Results The total effective rate of treatment in the observation group (84.3%) was significantly higher than the control group (P<0.05). The scores of menstrual blood volume etc.was significant lower than the control group, the number of antral follicles was significant more than the control group (P<0.05). The baby holding rate of the observation groupwas 62.9%, were significant higher than the control group(P<0.05). Conclusion Yishen Shugan Yangxue decoction combined with Climen can effectively improve menstruation, increase the number of antral follicles, and improve the baby holding rate.

Objective To evaluate the value of bedside index for severity in acute pancreatitis (BISAP) in predicting the severity and prognosis of acute pancreatitis (AP) by comparison with traditional scoring systems.MethodsFour hundred ninety-seven patients of AP admitted into Wuxi People's Hospital from January 2005 to December 2010 were studied retrospectively.BISAP,APACHE Ⅱ,Ranson and Balthazar CT (CTSI) scores were calculated,respectively,in order to evaluate the severity.The AUC of ROC was used to evaluate the ability of BISAP and the other scoring systems in predicting the severity of AP and the occurrence of pancreatic necrosis,organ failure and mortality.Results Among 497 patients,mild acute pancreatitis (MAP) was identified in 396 patients and severe acute pancreatitis (SAP) in 101 patients.The gender,age and etiological factors between MAP and SAP were not statistical different.The BISAP,APACHE Ⅱ,Ranson scores of the 4 9 7 patients were 1.08 ± 1.01,5.79 ± 4.00,1.69 ± 1.59,and the scores were intercorrelated(r =0.612,0.568,0.577,P ＜0.001).In addition,the BISAP,APACHE Ⅱ,Ranson scores of SAP patients were significantly higher than those in MAP patients.The AUC of BISAP for SAP was 0.762(95％ CI 0.722 ～0.799),when the cutoff value was 2,the sensitivity,specificity,positive predictive value (PPV),negative predictive value ( NPV ) were 63.39％,83.08％,48.1％,89.4％ ; the AUC of BISAP for pancreatic necrosis was 0.711 (95％ CI 0.612 ～ 0.797),when the cutoff value was 2,the sensitivity,specificity,PPV,NPV were 84.6％,46.7％,35.5％,89.7％ ; the AUC of BISAP for organ failure was 0.777( 95％ CI0.683 ～ 0.854),when the cutoff value was 2,the sensitivity,specificity,PPV,NPV were 93.1％,51.4％,43.5％,94.9％ ; the AUC of BISAP for mortality was 0.808(95％ CI 0.718 ～0.880),when the cutoff value was 3,the sensitivity,specificity,PPV,NPV were 83.3％,67.4％,25.6％,96.8％.In the cases of SAP,the ability of BISAP and the other scoring systems in predicting the prognosis showed no statistical difference.ConclusionsThe BISAP has the prediction ability for AP severity and prognosis similar to other scoring systems,and it consists of only 5 parameters and can be completed in the fast 24 h of admission,therefore it can be used for early predication of SAP,which is worth of clinical application.

Objective:To investigate the correlation between the level of anti Mullerian hormone (AMH) in serum and ovarian interstitial blood flow in patients with polycystic ovary syndrome (PCOS).Methods:The clinical data of 88 patients with PCOS (PCOS group) admitted to Jiangshan Hospital of Traditional Chinese Medicine from June 2019 to June 2022 and 50 women of the same age who underwent physical examination during the same period (normal control group) were collected retrospectively. The patients in the PCOS group were divided into two subgroups according to the homeostatic model assessment for insulin resistance index (HOMA-IR) evaluated by the steady-state model. Among them, patients with HOMA-IR ≥ 2.69 were divided into the insulin resistance subgroup (PCOS-IR subgroup, 50 cases), and patients with HOMA-IR<2.69 were divided into the non-insulin resistance subgroup (PCOS-NIR subgroup, 38 cases). The level of AMH were measured by electrochemiluminescence, and ovarian interstitial blood flow indicators, including peak blood flow velocity (PSV), pulsation index (PI), and resistance index (RI) were monitored. Pearson correlation test was used to analyze the correlation between serum AMH and insulin resistance and ovarian interstitial blood flow. Meanwhile, Logistic linear regression model was used to analyze the influencing factors of ovarian interstitial blood flow in patients with PCOS.Results:The levels of AMH, HOMA-IR and PSV in the PCOS group were higher than those in the normal control group: (2.13 ± 0.84) μg/L vs. (0.84 ± 0.29) μg/L, 4.6(2.0, 8.4) vs. 1.8(0.5, 3.9), (10.05 ± 1.52) cm/s vs.(6.78 ± 0.89) cm/s; the PI and RI in the PCOS group were lower than those in the control group: (1.14 ± 0.26)% vs. (2.01 ± 0.53)%, (0.37 ± 0.18)% vs. (0.85 ± 0.33)%, there were statistical differences ( P<0.05). The levels of AMH, HOMA-IR and PSV in the PCOS-IR subgroup were higher than those in the PCOS-NIR subgroup: (2.68 ± 0.81) μg/L vs. (1.59 ± 0.43) μg/L, (10.74 ± 2.32) cm/s vs. (7.93 ± 1.90) cm/s, 7.2(3.1, 15.8) vs. 2.1(0.6, 5.3); the PI and RI in the PCOS-IR subgroup were lower than those in the PCOS-NIR subgroup: (0.88 ± 0.35)% vs. (1.52 ± 0.50)%, (0.29 ± 0.04)% vs. (0.51 ± 0.05)%, there were statistical differences ( P<0.05). Pearson correlation analysis showed that the level of AMH were positively correlated with PSV and HOMA-IR ( r = 0.694 and 0.540, P<0.05), but negatively correlated with PI and RI( r = - 0.687 and - 0.692, P<0.05). Logistic linear regression model analysis showed that AMH and HOMA-IR were risk factors for ovarian interstitial blood flow in patients with PCOS( P<0.05). Conclusions:The serum AMH level in patients with PCOS is abnormally high and increases with insulin resistance. At the same time, the imbalance of AMH expression plays an important role in the increase of abnormal ovarian interstitial blood flow.

OBJECTIVETo investigate the expression profile of serum micro (mi)RNAs in cholangiocarcinoma (CCA) and investigate the regulatory contribution of miRNAs to the invasive and metastasis.

METHODSMicroarray analysis was carried out using serum samples collected from 30 patients with CCA, bile duct cancer tissues and the corresponding normal tissues collected from 10 patients, and serum samples from 50 healthy volunteers. The miRNAs identified as dysregulated in CCA were verified by RT-PCR. Focused analysis on miR-224 was carried out using the human CCA cell lines HCCC-9810 and RBE to investigate the role of this miRNA in IL-6 expression (using IL-6 induction), cell growth, invasiveness and metastasis (using miR-224 mimic transfection). The one-way ANOVA test was used for statistical analysis.

RESULTSForty-three miRNAs were dysregulated in CCA (vs. non-CCA, P<0.01), of which 22 were upregulated and 21 were downregulated. RT-PCR data showed that the miR-224 was significantly upregulated in serum as well as in cancer tissue from CCA patients. Induction of HCCC-9810 and RBE cells with IL-6 showed a time-dependent upregulation of miR-224. Furthermore, the HCCC-9810 and RBE cells transfected with miR-224 mimic showed enhanced cell growth, invasiveness and migratory ability.

CONCLUSIONIL-6 may promote the invasive and metastatic properties of CCA through upregulated miR-224. Studies of the differentially expressed serum miRNAs in CCA may help to further elucidate the pathogenic processes of this disease and aid in the development of a novel and effective therapeutic strategy.

Bile Ducts, Intrahepatic ; Cell Line, Tumor ; Cell Proliferation ; Cholangiocarcinoma ; Down-Regulation ; Humans ; Interleukin-6 ; MicroRNAs ; Microarray Analysis ; Neoplasm Invasiveness ; Neoplasm Metastasis ; Transfection ; Up-Regulation

Objective:To investigate the effect of hysteroscopic cold knife technique on the treatment effect and postoperative inflammatory response in patients with intrauterine adhesion by regulating the expression of microRNA (miR)-29b.Methods:The clinical data of 166 patients with intrauterine adhesion in Zhejiang Medical and Health Group Hangzhou Hospital from January to December 2018 were retrospectively analyzed. Among them, 83 cases were treated by hysteroscopic cold knife technique (cold knife group) and 83 cases were treated by hysteroscopic electrosurgical operation (electrosurgical group). The operation time and hospitalization time were compared between 2 groups. The patients were followed up 3 months after operation, and the change of menstrual volume were observed; at the same time, the patient underwent hysteroscopy, and the changes of intrauterine morphology were observed in order to evaluate the efficacy; the interleukin (IL)-6, IL-8, tumor necrosis factor (TNF)-α, C-reactive protein (CRP) and miR-29b relative expression in endometrial tissue were detected.Results:The operation time and hospitalization time in cold knife group were significantly shorter than those in electrosurgical group: (20.01 ± 1.93) min vs. (26.46 ± 2.25) min and (3.84 ± 1.43) d vs. (5.01 ± 1.18) d, and there were statistical differences ( t= 12.134 and 4.051, P<0.05). The menstrual volume and intrauterine morphology efficacy in cold knife group were significantly better than those in electrosurgical group, and there were statistical differences ( P<0.05). The IL-4 and miR-29b 3 months after operation in cold knife group were significantly higher than those in electrosurgical group: (33.54 ± 5.61) mmol/L vs. (21.34 ± 3.62) mmol/L and 1.59 ± 0.42 vs. 1.16 ± 0.31, the IL-8, TNF-ɑ and CRP were significantly lower than those in electrosurgical group: (18.23 ± 3.67) mmol/L vs. (31.59 ± 7.20) mmol/L, (9.41 ± 1.41) mmol/L vs. (12.64 ± 2.24) mmol/L and (7.58 ± 1.59) mg/L vs. (11.06 ± 2.15) mg/L, and there were statistical differences ( P<0.01). Pearson correlation analysis result that IL-4 was positively correlated with miR-29b ( r=0.438, P<0.01), and the IL-8 and TNF-ɑ were negatively correlated with miR-29b ( r=-0.295 and -0.377, P<0.01). Conclusions:Hysteroscopy cold knife technique can shorten the operation time and hospitalization time of the patients with intrauterine adhesion, and significantly improve the curative effect by promoting the expression of miR-29b and anti-inflammatory factors.

Objective To investigate the relationship between occupational noise exposure and glycated hemoglobin (HbA1c) levels, as well as prediabetes diagnosed by HbA1c. Methods A total of 1 181 workers from a cigarette factory were selected as the research subjects using a judgment sampling method. Workers were divided into control, low-level noise exposure and high-level noise exposure groups, consisting of 236, 359, and 586 individuals, respectively. The blood sample was collected for HbA1c test and occupation noise exposure intensity in workplace was detected by an area-sampling method. Results There were no statistical significant differences in HbA1c levels and prediabetes prevalence among the three groups of workers (all P>0.05). After adjusting for potential confounding factors such as years of service, gender, smoking, pack-years of smoking, alcohol consumption, and body mass index, multiple linear regression analysis showed that the high-level noise exposure group had higher HbA1c level than the control group (P<0.05). Multivariable logistic regression analysis results showed that the high-level noise exposure group had higher risk of prediabetes compared with the control group (P<0.05). Conclusion Occupational noise exposure could be a risk factor for the increased HbA1c levels and prediabetes incidence among the occupational population. More attention should be paid to the effects of occupational noise exposure on the HbA1c level in occupational health surveillance.

Ulcerative colitis (UC) is a non-specific, chronic and relapsing intestinal inflammatory disease with unknown etiology. Biological agents had been used to treat UC, and efficacy was superior to traditional therapeutic drugs, however, many problems followed. This article reviewed the application of biological agents in the treatment of moderate-to-severe UC, therapeutic drug monitoring, special conditions occurred during the use of biological agents and their management.

Inflammatory bowel disease (IBD) is a chronic non-specific inflammatory digestive tract disease with unknown etiology. Patients with IBD are recommended to take life-long follow-up and treatment due to the long disease course and repeated recurrence of disease. With the development of ultrasound technology, trans-abdominal bowel ultrasound has been brought into focus in recent years because of its high sensitivity, specificity, free of radiation, convenience and economy. This article reviewed the characteristics of ultrasound of IBD and the application and value of trans-abdominal bowel ultrasound in IBD.