Polycystic ovary syndrome (PCOS)is the most common cause of anovulatory infertility in women of reproductive age, exerting significant impacts on glucose and lipid metabolism, cardiovascular and endometrial deseases, as well as breast, skin, bone, and psychology fields. As a complex, multi-system of endocrine and metabolic disease, PCOS would be recognized as a component of metabolic syndrome in an overall consideration. The clinical treatment of PCOS is expected to turn simply regulating menstruation and ovulation adjustment into the combination of insulin resistance improvement with antihyperandrogen and ovulation treatment comprehensively.

There is a strong support for a role played by adiponectin in the function of ovary and placenta.There is evidence of direct effects of adiponectin on the late stages of folliculogenesis,and additive interactions of adiponectin with insulin and gonadotropins in inducing periovulatory changes in ovarian follicles.Adiponectin has demonstrated a potential effect on ovarian function as well as a possible effect on the formation of placenta,via multiple mechanisms,providing new strategies for the etiology investigation,prevention and treatment of reproductive and related metabolic diseases.

Objective To observe the clinical efficacy of Runchang Xuanfei Shugan Formula in the treatment of slow transit constipation. Methods Totally 94 patients were randomly divided into treatment group and control group, with 47 patients in each group. Treatment group was given Runchang Xuanfei Shugan Formula, one dose per day, half a dose for morning and half a dose for evening, and the control group was given lactulose oral liquid, 15 mL each time, for morning and evening, and citrate moser Billy 5 mg, three times a day orally taken before meals. The treatment course for the two groups were 4 weeks, with three-month follow-up. The defecation symptom score, anxiety and depression score were observed, the colonic transit test meter was performed, and the side effects were recorded. Results The degree of defecation difficulty, defecation frequency, defecation time, abdominal distension and stool quality score of the two groups significantly decreased after treatment (P<0.05), and the treatment group was much lower than the control group after treatment and three months after treatment (P<0.05). The score of anxiety and depression (SAS, SDS) of the treatment group decreased significantly after treatment and three months after treatment (P<0.05), and had significant differences with the control group (P<0.05). The colon function was significantly improved after treatment in both groups (P<0.05), without statistical significance (P>0.05). Conclusion Runchang Xuanfei Shugan Formula can improve clinical symptoms of slow transit constipation, ease anxiety and depression of patients, and promote colon transmission function.

Objective To analyze the status of multiple organ failure in patients with acute poisoning and to investigate the relationship between sequential organ failure assessment (SOFA) and prognosis. Method A retrospective review of 76 patients admitted to emergency intensive care unit in the First Affiliated Hospital of China Medical University for acute poisoning was carried out. Data about heart rate, blood pressure, blood oxygen saturation, blood gas analysis, rutine blood examination (WBC,platelet,albumin, ALT,total bilirubin, BUN,creatinine, CK, CK-MB, blood glucose), dosage of vascular active agents and mental status were documented at admission and 48 h after admission. SOFAs were counted at admission (SOFA ) and 48 h after admission (SOFA ) and then a comparison was made between survivors and victims. Results There was no significant difference in SOFA between survivors and victims ( P = 0.26) , but significant difference in SOFA48 as well as SOFA was shown between survivors and victims (P < 0.01). Multivariate logistic regression analysis indicated that the SOFA48 of renal and nervous systems were the independent predictors with acute poisoning (P = 0.003 and 0.012 respectively). Spearman correlation analysis implicated that ALT,CK-MB, WBC,base excess (BE) and blood glucose (BG) had correlation with SOFAs48. Conclusions SOFA shows its score eorrellated with the prognosis of poisoning with a-cute poisoning and it is a practical method in eveluating the outcome of patients with acute poisoning.

Objective To discuss the health hazards of nurses in the operating room,find out their self-protection awareness,give them defensive education to reduce the damage done to nurses in operating room. Methods Field survey of health hazards in operating room was carried out to find out nurses' self- protection awareness and gave them health propaganda and education. Results There were many health hazards in op-erating room,but nurses' self-protection awareness was low and they knew little about defensive knowledge. Conclusions The curren situation is there are so many disadvantages but nurses in the operating room know little about them,so it is necessary to give them defensive education to protect themselves.

Objective To observe the effect of short-term treatment with metfbrmin on psychological distress and metabolic feature in patients with polycystic ovary syndrome(PCOS).Methods Ninety women were diagnosed as cases of PCOS based on the 2003 Rotterdam criteria.These patients were divided into three groups:group A,consisted of 26 subjects treated with mefformin only; group B,36 cases treated with metformin plus Dane-35 ; and group C,28 cases treated with placebo and Dane-35.The treatment was carried out for 3 months.Clinical and metabolic parameters were observed.The psychological distress was evaluated by the hospital anxiety and depression scale(HAD scale).Results Compared with group C,patients in group A and B showed significantly lower body mass index(BMI),waist circumference (WC),waist-hip ratio (WHR),serum fasting insulin,homeostasis model assessment for insulin resistance (HOMA-IR),total cholesterol (TC),triglyceride (TG),low density lipoproteincholesterol(LDL-C) levels as well as anxiety and depression scores,but higher high density lipoprotein-cholesterol (HDL-C) levels (all P＜0.05).Compared with group A,patients in Group B had significantly higher WC,WHR,and LDL-C levels(all P＜O.05).No significant differences in BMI,TG,HDL-C,anxiety and depression scores were found between group A and B (all P＞0.05).In group A,a positive correlation was found between the changes of metabolic feature (BMI,WHR,and HOMA-IR) and the changes of anxiety and depression scores (all P ＜0.05).Conclusion Short-term treatment with metformin will benefit patients with polycystic ovary syndrome,regarding psychological distress and metabolic features.

The outpatient service system at Shanghai Sixth People's Hospital came into use since April 2009.Data from Jan.2010 to Oct.2010 and interviews with employees of department in question showed a rapid growth of outpatient appointments,a poor handling of outpatients absenteeism,and poor integration among the platforms of the appointments.The development of outpatient services depends on behavioral change of both medical workers and consumers.Some measures could be employed to improve outpatient appointment within the current mechanism.

Objective To explore the effect of early tracheal intubation on hypoxemia and level of blood lactate, C-reactive protein(CRP) in patients with severe intracerebral hemorrhage .Methods Fifty-four patients with severe intracerebral hemorrhage were divided into routine tracheal intubation (routine intubation group,n=25) and early tracheal intubation group(early intubation group,n=29) radomly.In routine tracheal intubation group, tracheal intubation was performed only when respiratory failure occurred .In early intubation group , tracheal intubation was performed as long as hypoxemia which can not be fixed by inspiring oxygen , tongue retropulsion or vomit occurred . Levels of artery blood gas analysis , lactate and CRP were tested before and after 2 h ( lactate ) or 24 h ( CRP ) of tracheal intubation .Heart rate and respiratory frequency were also monitored .Results PaO2 , PaCO2 , SaO2 and heart rate were markedly improved after intubation in both groups , levels of lactate and CRP were evidently reduced after intubation in both groups(all P<0.05).After intubation, the PaO2 of early intubation group was significantly higner and the CRP of early intubation group was significantly lower than that of routine intubation group ( all P<0.05);Before intubation, the PaO2 and SaO2 of early intubation group were significantly higher and levels of lactate and CRP were significantly lower than those of routine intubation group ( P<0.05 ) .Conclusion Early tracheal intubation can improve hypoxemia and reduce the level of lactate and CRP in patients with severe intracerebral hemorrhage .

objective: To produce titanium dioxide hydrogel layer on the pure rough titanium(Ti) surface. Methods: Pure Ti discs( d =15mm) were polished to 600 grind, sandblasted and etched with acid, socked in 60 ℃ 5 mol/L NaOH solution for 24 h and then heated to 600℃ for an hour to get goughening, alkaline and heat treated Ti(RAH). The smooth, rough and RAH surfaces were analyzed with scanning electron microscope(SEM) and energy despersive X ray analysis(EDXA). Results: On smooth surfaces only regular polished grooves could be seen, while holes in different diameters formed on rough surfaces. A porous framework was found on the surfaces of the RAH observed by SEM. EDXA showed that the smooth and rough surfaces were consisted of 100% Ti, while there were a lot ofoxygen and sodium in RAH discs. Apatite formed on the RAH Ti surfaces when it is soaked in simulated body fluid for two weeks. Conclusion: A porous Ti dioxide hydrogel layer forms on the rough titanium substrate during alkaline and heat treatment.

Objective To evaluate the value of MRI in diagnosing the premature closure and other deformities of the growth plate followed physeal injury. Methods Twenty-one children with suspected or known premature closure of the growth plate followed injury were examined with X-ray and MRI. In addition to conventional T 1WI and T 2WI for all cases, 8 were also examined with spectral pre-saturation inversion recovery sequence. The value of MRI in diagnosing and imaging the premature closure of the growth plate (PCGP) was analyzed. Results PCGP was seen in all 21 cases, 6 in the distal femur, 6 in the proximal tibia, and 9 in the distal tibia. 19 patients with angular deformities and 2 cases with both angular and shorten deformities. MRI can much more clearly visualize the cartilage of the growth plate than conventional X-ray. A stripe of low signal intensity through the cartilage of the growth plate indicated premature closure of the growth plate. 8 cases with spectral pre-saturation inversion recovery sequence can visualize the PCGP more clearly than with Spin Echo and Fast Field Echo. Conclusion MRI has an important role in diagnosing and visualizing the PCGP. The configuraton of the PCGP can be accurately mapped with MR imaging and treatment planning is facilitated.