Objective:To explore the concentration of monoamine neurotransmitter in serum and psychiatric symptoms such as anxiety and depression in infertility patients with and without PCOS(No-PCOS),and the relationship between them.Methods:30 infertility with PCOS were selected as experimental group(EG) and 30 infertility patients without PCOS as control group(CG).They were administered Symptom Checklist(SCL-90).Their monoamine neurotransmitter in serum were determined including norepinephrine(NE),3-methoxy-4-hydroxyphenylglycol(MHPG),5-hydroxytryptamine(5-HT),5-hydroxyindoleacetic acid(5-HIAA),dopamine(DA),homovanillic acid(HVA) and dihydroxy-phenyl acetic acid(DOPAC).Results:The findings indicated that the scores in anxiety and depression subscales of SCL-90 were significantly higher in the PCOS group than those in the No-PCOS(P

Background Studies confirmed that hydroxycamptothecin cause the apoptosis of human Tenon capsule fibroblasts (HTFs) by protein kinase R-like endoplasmic reticulum stress kinase (PERK) single pathway.Autophagy and apoptosis are programmed cell death following stress reaction,so they remain a close association.However,the effect of hydroxycamptothecin on the autophagy of HTFs and its mechanism are still unclear.Objective This study was to explore the promoting effect of PERK signal pathway on hydroxycamptothecin inducing the autophagy of HTFs.Methods This study procedure was approval by Ethic Committee of Nanjing Medical University.Human Tenon capsule tissue was obtained from fresh adult donors.HTFs were cultured and passaged by explant-culture method and identified by immunofluorescence for vimentin and keratin.pLVX-PERK lentiviral packed by 293T cells was transfected into HTFs to obtain stable PERK-knockout cell line by puromycin selection.Then the HTFs were treated with 0.10 g/L of hydroxycamptothecin for 5 minutes and consecutively cultivated for 24 hours,and the untreated cells were used as the control group.Western blot assay was used to detect the expressions of autophagy specific proteins in the cells,including autophagy related gene 5 (ATG-5),Beclin-1,light chain 3 (LC-3).Cyto-ID staining was used to identify the autophagosome in the cells.The experimental results were analyzed and compared between different treating groups.Results The gray scales for the expressions of Beclin 1,ATG-5,LC-3-Ⅰ and LC-3-Ⅱ proteins in HTFs were 0.365:±0.045,0.765 ±0.055,0.120±0.030 and 0.215 ±0.035 in the control group,and those in the hydroxycamptothecin treated group were 0.980±0.070,1.495±0.095,0.585±0.025 and 0.785±0.055,showing a significant decline in the hydroxycamptothecin treated group(P=0.018,0.022,0.007,0.013).The green fluorescence of the autophagosome was stronger in the hydroxycamptothecin treated group compared with the control group.Western blot revealed that the gray scale of PERK expression in the cells was 0.130±0.030 in the PERK-knockout group,with a significant reduce in comparison with 0.765 ±0.055 of the control group (P =0.010).However,no obvious distinctions were seen in the band intensities of the expressions of Beclin-1,ATG-5 and LC-3 proteins between the two groups.Western blot indicated that the grey scale of the PERK expression in the cells was 1.790± 0.060 in the 0.10 g/L hydroxycamptothecin group,which was significantly higher than 0.880 ± 0.070 of the control group (P =0.010).Expression levels (gray scales) of Beclin-1,ATG-5,LC-3-Ⅰand LC-3-Ⅱ in the PERK-knockout+ 0.10 g/L hydroxycamptothecin group were 0.475 ± 0.045,0.390 ± 0.040,0.055 ± 0.015 and 0.075 ± 0.025,which were significantly lowed in comparison with 0.955 ± 0.065,0.765 ± 0.055,0.155 ± 0.015 and 0.280 ± 0.030 of the control+ 0.10 g/L hydroxycamptothecin group (P =0.026,0.031,0.042,0.034).In addition,the fluorescence intensity of autophagosomes was weaker in the PERK-knockout+0.10 g/L hydroxycamptothecin group compared with the control+0.10 g/L hydroxycamptothecin group.Conclusions Hydroxycamptothecin induces the autophagy of HTFs by PERK signal pathway.

Objectives To observe the effects of varied doses of L-thyroxin sodium ( L-T4) on congenital hypothyroidism ( CH) and to determine appropriate dose for early therapeutic intervention. Methods Totally, 108 cases of confirmed CH were divided into two groups (54 in each group). All the cases were administered with L-T4 at varied doses( 10. 1? - 15. 0 ?g ? kg-1? d-1 for large-dose group and 6. 0 - 10. 0 ?g ?kg-1? d-1 for small-dose group) after their parents were trained for basic knowledge of CH by specialists. Their serum levels of T3, T4 and TSH, as well as their body height, weight and head circumference, were measured during follow-up. L-T4 was maintained at doses of 1. 0 - 4. 0 ?g ? kg -1 ? d-1 when their serum levels of T3, T4 and TSH returned to normal. Results All the 108 cases had their clinical symptoms quickly improved and development and growth accelerated after L-T4 substitution. Their serum level of T3 returned to normal in all cases, that of T4 did not return to normal in six cases of large-dose group and in 16 cases of small-dose group, and that of TSH did return to normal in 22 cases of large-dose group and in 39 cases of small-dose group, respectively, after one-month treatment, with a significant difference between the two groups. Cases in large-dose group gained more weight in average than those in small-dose group when they were three months old. Conclusions Early therapeutic intervention for babies with CH with L-thyroxin sodium of 10. 1 -15. 0 ?g ? kg-1? d-1 could quickly correct abnormal function of their thyroid and could avoid abnormal development of their intelligence due to CH.

Objective To judge the effect of plasma exchange (PE) to the patients with severe hepatopath of nonage according to evaluating the change of the liver function of reserve with 13C-methacetin breath test. Methods There are two groups: the case group and the control group. Each group has 30 patients. The patients in the case group were treated by PE. All the patients received 13C-methacetin breath test at before or one week after treatment. MVmax40, CUM40 and CUM120 were present. At the same time, clinical symptoms, glutamate-pyruvate transaminase (ALT), total bilirubin (TBiL) and prethrombin active (PTA) were observed. Results MVmax40, CUM40, CUM120 and PTA were higher, ALT and TBiL were lower in the case group after treatment (t=4.679, 4.752, 5.048, 5.413, 6.208, 7.413, P=0.000,P<0.01). After a week, MVmax40, CUM40, CUM120 and PTA were higher, ALT and TBiL were lower in the case group than that in the control group (t=2.260, 2.247, 2.476, 4.017, 3.250, 3.658, P<0.05). The total effective rates in the case group and the control group were 83.3 % (25/30) and 43.3 % (13/30),which are significant different(χ2 10.335,P<0.01). Conclusion PE can im-prove the liver reservation functionin the severe hepatopath of nonage.

Objective To summarize the cl inical characteristics and imaging features of psittacosis. Methods The clinical features and imaging appearances of 3 cases with acute psittacosis were retrospectively analyzed. The related literature was reviewed . Results The clinical manifestation of psittacosis was high fever in the patients. Physical findings included pulse-temperature dis sociation, localized lung crackles, hepatomegaly, and splenomegaly. Laboratory findings showed elevation of ESR in all cases, and liver dysfunction was present in 2 cases. The counts of white blood cells were normal, but the percent of ne utrophils might be increased. The chest X-ray and CT scan showed air-space co nsolidation and ground-glass attenuation in the lung, and miliary, nodular, or consolidated shadows were found in pathological areas. Pleural effusions were a lso present in 2 cases. Psittacosis was diagnosed from the history of exposure to infected parrots and elevation of the IgG and IgM titer for Chlamydia psittac i. Erythromycin was effective in all 3 patients. Conclusion Although the appearance of psittacosis on clinical findings and chest X-r ay and CT scan is not characteristic, psittacosis can be diagnosed with the comb ination of the history of exposure to infected parrots and laboratory findings. CT scan can reveal the focus earlier and accurately, and catching the imaging f eatures of psittacosis is helpful in differential diagnosis.

Objective To promote the application of the best evidence for supportive care in the management of depression in patients with head and neck cancer, and to improve the quality of clinical care.Methods Follow the three stages of clinical evidence practice of Joanna Briggs Institute (JBI): baseline review, practice change and effect evaluation, the best evidence of supportive nursing in depression management for head and neck cancer patients were retrieved, and 4 quality review indicators were developed. A total of 50 hospitalized head and neck cancer patients and 12 nurses were selected to collect data by means of field observation, interviews and nursing records. The obstacles to the application of evidence were analyzed and a practical scheme was worked out.Results The nurse's implementation rate of the four review indicators increased from 0-90％ at the baseline review to 90％-100％ after the evidence was applied. Except for Indicator 3 "Indicators nurses introduced the pressure on patients and their families to face cancer", the implementation rates of the other three indicators were significantly improved (P<0.01). After the application of evidence, the incidence of depression was decreased (P<0.05). The score of Relaxation, Sleep and Fatigue Management Knowledge Questionnaire was (18.20±14.09) before the application of evidence, which was lower than that after the application of evidence (80.60±12.84), and the difference was statistically significant (t=-23.14, P<0.01). The nurses' score of Supportive Nursing Knowledge Questionnaire before the application of evidence was (63.83±10.78), which was lower than that after the application of evidence (95.5±3.18), and the difference was statistically significant (t=-9.76,P<0.01).Conclusions The evidence-based application program can standardize nurses' supportive nursing behaviors for patients with depressive symptoms, reduce the severity of depression, improve the self-support knowledge level, and improve the quality of depression management in hospitalized patients with head and neck cancer.

AIM:To investigate the anti-fibrotic effect of Panax notoginseng saponins(PNS)in arecoline(ANE)-induced oral submucous fibrosis,and to analyze the effect of PNS on nuclear factor E2-related factor 2(Nrf2)/glu-tamate-cysteine ligase catalytic subunit(GCLC)signaling pathway.METHODS:CCK-8 assay was used to evaluate the effects of different concentrations of PNS and arecoline on the survival rate of human immortalized keratinocyte cell line Ha-CaT.The results of CCK-8 were used to select 75 mg/L arecoline,and 25,50 and 100 mg/L PNS as subsequent experi-mental concentrations.The cells were set as blank control group,model group,and low,medium and high doses(25,50 and 100 mg/L)of PNS groups.The protein and mRNA expressions of collagen type I(COL-I),E-cadherin,Nrf2,GCLC and glutathione reductase(GR)in each group were detected by Western blot and RT-qPCR.Immunofluorescence method was used to detect the entry of Nrf2 into the nucleus.Biochemical kits were used to detect the content of glutathione(GSH),nicotinamide adenine dinucleotide phosphate(NADPH)and malondialdehyde(MDA),and superoxide dis-mutase(SOD)activity in each group of cells.DCFH-DA fluorescent probe was used to detect the content of intracellular reactive oxygen species(ROS).RESULTS:Compared with the blank control group,the protein and mRNA expression of COL-I in the model group was up-regulated,and the protein and mRNA levels of E-cadherin,Nrf2,GCLC,nuclear Nrf2 and GR were down-regulated.The content of NADPH,MDA and ROS in the cells increased,and the content of GSH and the activity of SOD was significantly reduced.Compared with the model group,the protein and mRNA expression of COL-I was down-regulated,and the protein and mRNA expression of E-cadherin,Nrf2,GCLC,nuclear Nrf2 and GR were up-regulated in PNS 50 and 100 mg/L groups.Compared with the model group,the content of NADPH,MDA and ROS in cells decreased,and the content of GSH and the activity of SOD was significantly enhanced(P<0.05 or P<0.01).CON-CLUSION:Panax notoginseng saponins have anti-fibrosis effects in HaCaT cells,and their mechanism may be related to the activation of Nrf2/GCLC signaling pathway,thereby resisting oxidative stress and improving oral submucosal fibrosis.