Objective: To investigate the factors affecting decreased ovarian reserve (DOR) among women of childbearing age, so as to provide insights into prevention of DOR. Methods: Women with DOR at ages of 18 to 40 years that were admitted to Department of Gynecology, Ningbo Women and Children's Hospital during the period from January 2021 to June 2022 were recruited (DOR group), while healthy women at ages of 18 to 40 years during the same period served as normal controls. Participants' demographics, exercise, diet, previous medical history, childbearing history and menstruation were collected using questionnaire surveys. The follicle-stimulating hormone (FSH), luteinizing hormone (LH), anti-Müllerian hormone (AMH) and estradiol (E2) levels were tested. Factors affecting DOR were identified among women of childbearing age using a multivariable logistic regression model. Results: There were 200 participants in the DOR group, with a median (interquartile range) age of 32 (9) years, and 200 participants in the normal group, with a median (interquartile range) age of 29 (12) years. Multivariable logistic regression analysis showed that underweight (OR=2.935, 95%CI: 1.374-6.269), overweight/obesity (OR=2.612, 95%CI: 1.335-5.065), high-oil-high-glucose-high-salt diet (OR=2.653, 95%CI: 1.616-4.357), menstrual disorder (OR=1.977, 95%CI: 1.284-3.041) and lack of exercise (OR=3.392, 95%CI: 2.052-5.606) were statistically correlated with the development of DOR among women of childbearing age. Conclusions Underweight, overweight/obesity, high-oil-high-glucose-high-salt diet, menstrual disorder and lack of exercise are factors affecting the development of DOR among women of childbearing age.

OBJECTIVE:To establish a method for the dissolution determination of Dronedarone hydrochloride tablet,and eval-uate the quality consistency of its generic and original preparations. METHODS:UV spectrometry was performed on the column of 288 nm,dissolution media of Phosphate buffer solution (pH4.5),0.1 mol/L Hydrochloric acid solution [adding into 0.5% sodium dodecyl sulfate(SDS)],Phosphate buffer solution [pH6.8,adding into 0.5%SDS] and water,volume of dissolution medium was 1 000 ml,rotation speed was 75 r/min,the dissolution of generic and original preparations of Dronedarone hydrochloride tablet was detected,and the similarity of dissolution curve was evaluated by calculating the similarity factor (f2). RESULTS:The linear range of dronedarone hydrochloride was 2.147-25.764 μg/ml;RSDs of precision,stability and reproducibility tests were lower than 2.0%;recoveries 4 dissolution media were 99.53%-101.05%(RSD=0.48%,n=9),98.95%-100.05%(RSD=0.39%,n=9), 99.54%-100.20%(RSD=0.24%,n=9)and 98.54%-100.06%(RSD=0.44%,n=9). In the 4 dissolution media,f2 of the dissolu-tion curve of 3 batches of generic and original preparations of Dronedarone hydrochloride tablet was 56,60,63,68,68,52,59, 67,65,68,76,62,respectively. CONCLUSIONS:The method is suitable for the dissolution determination of Dronedarone hydro-chloride tablet;meanwhile,the in vitro dissolution curves of generic and original preparations of Dronedarone hydrochloride tablet show similarity,so the quality consistency is good.

Objective To analyze relevant factors of cervical intraepithelial neoplasia residual or recurrence after loop electri‐cal excision procedure(LEEP) .Methods We observed the patients who were histopathologically confirmed CIN and treated with LEEP in our hospital from January 2006 to September 2012 ,and investigated the postoperative residual and recurrence .Then we an‐alysed relevant factors of residual or recurrence .Results (1)After at least 2 years of follow‐up ,26 cases showed residual or recur‐rence(the residual rate was 0 .97% and the recurrence rate was 4 .08% ) .(2)Overall severity of residual or recurrence had been re‐duced ,but the severity and recurrence of preoperative severity was positively correlated(r=0 .354 0 ,P<0 .05) .(3)Age ,smoking , preoperative high‐risk HPV load ,post‐operative the same type of HPV continuous infection ,endocervical involvement ,lesions in‐vo1ving quadrants ,and post‐operative TCT results between the recurrence group and non‐recurrence group were statistically signifi‐cant different(P<0 .05) .Conclusion CIN residual or recurrence after LEEP might be affected by many factors ,and the treatment should be individualized .

Objective To evaluate the value of the short-segment nerve conduction studies (SSCSs, inching test) in the diagnosis and localization of cubital tunnel syndrome (CubTS).Methods The clinical and electrophysiologic data of 46 patients (92 limbs from 32 men and 14 women, aged from 19 to 59 years, with average age of 41.2 years) with CubTS were collected.The symptoms occurred in unilateral arm in 41 patients and bilateral arms in 5 patients, involving 35 left arms and 16 right arms.SSCSs were performed in both arms in all the 46 patients.Sixty ulnar nerves were studied in 30 healthy control subjects using SSCSs.Results The 51 symptomatic arms with CubTS were abnormal in long segment motor nerve conduction studies.There were 68 abnormal arms ( 51 symptomatic arms, 17 asymptomatic arms ) in SSCSs.The lesions were located 2 cm proximal to the elbow-the elbow segment ( AE2-E ) in 41 arms (44.6%),the elbow-2 cm distal to the elbow segment (E-BE2) in 23 arms (25%), 4 cm proximal to the elbow-2 cm proximal to the elbow segment (AE4-AE2) in 18 arms (19.6%), 6 cm proximal to the elbow-4 cm proximal to the elbow segment (AE6-AE4) in 9 arms (9.8%), 2 cm distal to the elbow-4 cm distal to the elbow segment (BE2-BE4) in 8 arms(8.6%) and 4 cm distal to the elbow-6 cm distal to the elbow segment (BE4-BE6) in 6 arms(6.5%),respectively.Conclusions SSCSs are more sensitive in detecting CubTS than the conventional long segment motor conduction studies.SSCSs could precisely localize the entrapment lesions in patients with CubTS ,might be a useful tool for the detection of ulnar mononeuropathy at the elbow, especially for diagnosing the patients with CubTS who have no clinical features or have a normal long segmental nerve conduction findings.

Objective To evaluate the effects of propofol combined with resveratrol on hepatic ischemiareperfusion (I/R) injury in rats.Methods One hundred and eight male Sprague-Dawley rats,aged 6-7 weeks,weighing 220-270 g,were randomly divided into 6 groups (n =18 each):sham operation group (group S) ; I/R group; solvent group (group TW-80) ; propofol group (group P) ; resveratrol group (group R) ; propofol combined with resveratrol group (group P + R).The animals were anesthetized with intraperitoneal 10 ％ chloral hydrate 3.5-4.0 ml/kg.Liver ischemia was produced by clamping the first hepatic portal for 30 min,followed by 12 h reperfusion.In group P,propofol was infused intravenously at 10 mg· kg-1 ·h-1 starting from 10 min before ischemia until the end of operation.In group R,resveratrol 10 mg/kg was injected intravenously at 10 min before ischemia.In group P + R,resveratrol 10 mg/kg was injected intravenously and then propofol was infused intravenously at 10 mg· kg-1· h-1 starting from 10 min before ischemia until the end of operation.The equal volume of normal saline was given instead in groups S and I/R,and the equal volume of TW-80 was given instead in group TW-80.Six rats in each group were chosen at 3,6 and 12 h of reperfusion and blood samples were taken from the superior and inferior vena cava for measurement of serum alanine aminotransferase (ALT) and aspartate amino transferase (AST) activities.The rats were then sacrificed and livers were removed for microscopic examination and for determination of superoxide dismutase (SOD) and myeloperoxidase (MPO) activities,inducible nitric oxide synthase (iNOS) expression,and malondialdehyde (MDA) and nitric oxide (NO) contents in liver tissues.Results Compared with group S,the serum ALT and AST activities,and MDA and NO contents,MPO activity and iNOS expression in liver tissues were significantly increased,and the activities of SOD were decreased in the other four groups (P ＜0.05).Compared with group I/R,the serum ALT and AST activities,and MDA and NO contents,MPO activity and iNOS expression in liver tissues were significantly decreased,and the activities of SOD were increased in groups P,R and P + R (P ＜ 0.05).Compared with groups P and R,SOD activity was significantly increased,and the other parameters were decreased in group P + R (P ＜ 0.05).The pathological changes were significantly attenuated in groups P,R and P + R compared with group I/R.Conclusion Pretreatment with propofol and resveratrol can attenuate hepatic I/R injury in rats by increasing antioxidation and inhibiting lipid peroxidation and reducing production of endogenous NO,and the combination of the two agents provides better efficacy than etheir alone.

Objective To analyse the clinical practicability and significance of fertility-sparing surgery for women with recurrent borderline ovarian tumors ( BOT).Methods The clinical and pathological recordings of 12 patients suffered from recurrent BOT in the Obstetrics and Gynecology Hospital of Fudan University from Jan.2002 to Dec.2012 were analyzed retrospectively.The menstruation situation , fertility function , recurrence rate and survival after second conservative surgery were collected and analyzed .Results The average onset age of these 12 patients was 26 years, and none of them had procreation before the second operation.The pathological diagnosis were still BOT and the recurrent sites of 10 patients were still restricted to the ovaries.Of the 12 cases, 8 cases of them had normal menstruation functions and 4 cases had less menstrual volumes or longer menstrual periods.Among 6 cases desired for pregnancy after the second operation,4 cases of them were successful.The spontaneous pregnancy rate was 4/6.The mean duration of follow-up was 53 months(range:23-97 months).All recurrent BOT, three cases developed recurrence once more,two cases of them were just be hinted by B ultrasounds and only one cases was approved to be BOT again by a once more surgical pathology.But no disease related deaths occurred.Conclusions The second fertility-sparing surgery may be feasible for women with recurrent BOT who are young and strongly desired for preservation of fertility.The spontaneous pregnancy rate is satisfactory.However, carefully follow-up is still needed.

Objective To explore the clinical application value of the expression levels of serum hypoxia induced factor-1α(HIF-1α),vascular endothelial growth factor(VEGF),carcino-embryonic antigen(CEA)and CA125 in predicting the recurrence or metastasis of colon cancer after radical resection.Methods Totally 123 cases of colon cancer after radical surgery in our hospital from July 2009 to December 2013 were performed the retrospective analysis.The correlation between the serum markers levels with the recurrence or metastasis was dynamically analyzed.Results (1)The HIF-1αand CEA levels after operation in 123 cases of co-lon cancer were decreased significantly compared with before operation;(2)The HIF-1α,CEA and CA125 levels in 39 cases of re-currence or metastasis were significantly increased compared with those in 84 cases of non-recurrence or non-metastasis (P <0.05);(3)in 39 cases of recurrence or metastasis,the HIF-1α and CEA levels in recurrence or metastasis were increased signifi-cantly compared with those after the end of chemotherapy (P <0.05);(4)HIF-1αwas positively correlated to VEGF(P <0.05). Conclusion The serum levels of HIF-1αand CEA in the patients with colon cancer are positively correlated with recurrence or me-tastasis,the dynamically combined detection of serum markers has an important significance for predicting and early find recurrence or metastasis after radical operation in colon cancer.

Objective To explore the clinical significance of neutrophils/lymphocyte(NLR)and platelet/lymphocyte ratioof (PLR)peripheral blood in patients with primary biliary cirrhosis.Methods Retrospectively analyzed 62 patients with PBC and three subgroup patients according to Child-pugh,who were hospitalized in Shanghai Changhai Hospital and Shanghai Changzheng Hospital from January 2010 to July 2015.Enrolled 59 healthy controls.Baseline data and laboratory indicators were extracted,and the correlation between PLR and NLR and disease activity were analyzed.The changes of NLR in 3 pa-tients with PBC were analyzed.3 patients were followed up and their NLRs were recorded before and after therapy.Results Compared with healthy controls,NLR was significantly increased in PBC patients (P<0.05),and not PLR (P>0.05). NLR was positively correlated with TBIL and Mayo risk (R=0.35,0.30,P<0.05),and not ALT,AST or ALP (P>0.05).After therapy,NLRs were significantly reduced in three PBC patients (P<0.05).Conclusion NLR may be a useful biomarker for assessing clinical therapy in PBC patients.

Objective To construct a double luciferase reporter gene vector with PRDM1 gene promoter as target,and establish drug screening cell model in vitro,hope to find small molecule compounds in Chinese herbal medicine library by this model.Methods Total DNA was extracted from 293T cells and it was used for amplifying the fragment contained PRDM1 gene promoter (267 bp/1 257 bp) by PCR.The amplified product was inserted into pGL3-Basic vector.The PCR product and pGL3-PRDM1 vector were verified by sequencing and alignment.The pGL3-PRDM1 and pRL-TK vector were co-transfected into engineer cells.The activity of PRDM1 gene promoter could be assayed by measuring luciferase.The method was optimized by changing ratio of two vectors.Results The highest transfection efficiency and luciferase activity were found in ratio of n(pGL-PRDM1) ∶ n(pRL-TK)=2 ∶1,and with the recombinant luciferase report gene vector contained the length of 1 257 bp amplified fragment transfecting into U266 cells.Moreover,the inductor (5-Aza-CdR) of PRDM1 gene was used for authenticating the method(P＜0.01),the fluoresscence in tensity and promoter activity of PRDM1 gene were enhanced in a dose dependent manner with 5-Aza-CdR.The activity of the promoter of PRDM1 gene was significantly decreased from the concentration of 5 μmol/L of Artemisinid(P＜0.05).The total glucosides of paeoniflorin promoted the promoter activity of PRDM1 gene at a low concentration,and inhibited the promoter activity of PRDM1 gene at a high concentration.Artesunate has no effect on cell proliferation.The effect of total glucosides of paeony on cell proliferation was more complicated.Conclusion A drug selection model targeting PRDM1 gene promoter has been successfully established,and artesunate has been screened to inhibit the promoter activity of PRDM1 gene.

Objective To analyze the results of theoretical test and clinical skills examination of standardized resident training gradua-tion exam in Beijing in recent years, to improve the examination standards and assessment models. Methods The results of theoretical test and clinical skills examination from 2011 to 2016 were collected. The difficulty, degree of differentiation, and factors related with the result of clinical skills examination were analyzed. Results The test paper is difficult with good degree of differentiation from 2014 to 2016. Edu-cation degree and year were not related with the clinical skills (P>0.05), while the hospital level was (P<0.05). Conclusion The standardized training and assessment of residents in rehabilitation medicine need continuously attention. Combined with the results of the assessment and the problems exposed in the assessment, a feasible scheme should be put forward, in order to improve the quality of resident training.