Nearly half a century,an increasing number of studies have found that the puberty of human being is at early trends.Puberty is the process of physical changes involving reproductive system maturation and the acquisition of fertility,by the combination effects of nervous system,endocrine system and the environment.Pubertal timing is a relative concept and the process of pubertal development can be shown as early,timely or relatively late as compared with a reference group.This article mainly focuses on related influencing factors of pubertal timing including genetic factor,childhood obesity,growth pattern (intrauterine growth retardation,catchup growth,adiposity rebound),psychosocial stress (poor family emotional environment,father absence,international adoption),environmental endocrine disrupting chemicals with their mechanism and significance.The exploration of relevant risk factors of early puberty can provide scientific evidence for formulating relevant policies and targeted prevention.

Children with primary vesicoureteral reflux(VUR) are often complicated with urinary tract infection and voiding dysfunction.It often leads to kidney scarring,renal atrophy,hypertension,kidney dysfunction and a series performance of reflux nephropathy.In serious cases it can even progressed to end-stage renal disease.Now,with the accumulated experience of VUR treatment,the diagnosis strategy and the treatment remains certain amount of controversy.Whether the surgery or non-surgical treatment,the results are still not satisfactory,the pathogenesis of VUR is still unclear,the further study and exploration for the pathogenesis of VUR is required.

Objective To observe the effect of ejiao huangqi koufuye and iron sucrose injection in the treat-ment of postpartum anemia,to provide reference for clinical treatment.Methods 100 postpartum anemia women met the inclusion were randomly divided into 50 cases of observation group and 50 cases of control group.The control group was given iron sucrose injection 200mg for 3d,the observation group was given ejiao huangqi koufuye for 30d, twice daily and 10ml once.The blood was exsanguinated for detecting RBC,Hb,HCT,SF,TIBC.The improvement of symptoms and signs were observed and the effect was assessed.Results The RBC,Hb,HCT,SF of the observation group and control group after treatment were (2.14 ±0.74)×10 12 /L and (3.32 ±1.15 )×10 12 /L,(97.85 ± 22.44)g/L and (109.72 ±18.54)g/L,(36.42 ±8.39)% and (41.10 ±7.38)%,(22.26 ±1.76)mg/L and (32.2 ±2.1)mg/L,which were significantly higher than before treatment (t =3.065 and 5.614,3.411 and 3.961, 3.317 and 5.062,6.448 and 9.332,both P <0.05 ),TIBC were (70.82 ±13.23 )μmol/L and (62.41 ± 13.37)μmol/L,which were significantly lower than before treatment(t =4.607 and 7.302 respectively,all P <0.01).After treatment,the RBC,Hb,HCT,SF of the observation group were significantly higher than the control group,the TIBC was significantly lower than the control group,the differences were statistically significant(t =3.826, 3.733,3.395,4.776,3.524,all P <0.05).The total effective rate of the observation group was 94%,which was sig-nificantly higher than 82% of the control group,the difference was statistically significant(χ2 =8.401,P <0.05). The incidence rate of adverse reactions of the observation group was 4% (2 /50),which of the control group was 6%(3 /50),the difference was not statistically significant(χ2 =0.211,P >0.05).Conclusion The ejiao huangqi kou-fuye and iron sucrose injection has exact clinical efficacy in the treatment of postpartum iron deficiency anemia,can effectively promote bone marrow erythropoiesis,anemia symptoms,it is worthy of clinical use.

The fractional exhaled nitric oxide(FeNO)has been applied more and more widely in disorders of respiratory system,and is considered to be one of the most promising markers of expiration in monitoring the development and outcome of respiratory inflammatory airway disease.This paper is to review the application and prospect of FeNO in bronchiolitis in children.

Objective To investigate the effect of hypoxia/reoxygenation on apoptosis of rat hypertrophic cardiomyocytes and the metabolic pathway changes of hypertrophic cardiomyocytes by dichloroacetate.Methods The isolated ventricular cardiomyocytes from neonatal Wistar rat were cultured and purified with differential attachment,then BrdU was added to reduce the rate of non-myocytes.The cultured cells were identified by morphology,spontaneous contraction and specific immunocytochemical stain.Hypertrophic cardiomyocyte model induced by angiotensin Ⅱ was set up and assessed by -Leu incorporation.The cultured media were replaced by low glucose DMEM before hypoxia.The cardiomyocytes were incubated at 37 ℃ in an air-tight incubator containing 92% N_(2),5% CO_(2),3% O_(2) for 24 h to simulate hypoxia,then under the condition of 23% O_(2),5% CO_(2) for 4 h to simulate reoxygenation.Apoptotic cells was evaluated by a modified TUNEL assay(DeadEnd~(TM) Colorimetric TUNEL).Results The apoptotic rate of cardiomyocytes increased with time prolongation of hypoxia/reoxygenation(H/R).The apoptotic cell model induced by H/R in rat hypertropic cardiomyocytes was established successfully.When the hypertropic cardiomyocytes were pretreated with Dichloroacetate,the apoptotic rate decreased in a dose-dependent manner.The metabolic pathway changes had effect on the apoptosis of rat hypertrophic cardiomyocytes.Conclusion By collagense digestion,it is convenient to obtain primary neonatal Wistar rat ventricular cardiomyocytes. This method is one of vital research tools in the fields of cardiac hypertrophy.Angiotensin Ⅱ could accelerate cellular proliferation,structural protein biosynthesis and cardiac hypertrophy.Dichloroacetate has the effect of antiapoptosis.

Objective:To explore the clinical curative effect of Gankening in treating chronic nonproductive cough based on syndrome differentiation.Method:90 cases were allocated to two groups randomly,the treatment group(60 cases) treated with Gankening based on syndrome differentiation and the control group(30 cases) treated with Zhisou Powder and Beilai.The composite effect of the two groups,the curative effects of every syndrome pattern in the treatment group before and after treatment and the relationship between the symptom index and the curative effect were observed.Result:The clinical effects of the treatment group were markedly exceeded the control group.In the treatment group,the clinical control rate was 53.33%(32 cases),markedly effective rate was 30%(18 cases),the(effective) rate was 13.33%(8 cases) and the total effective rate was 96.67%.There was distinct difference in the treatment group before and after treatment(P

Objective:To compare the efficacy and safety of Novoiaped 30 and NovoMix 30 Flexpen in the therapy of type 2 diabetes mellitus(DM). Methods:A multicenter,randomized,and controlled clinical trial of Novorapid 30R and Novomix 30 Flexpen was performed in XinQiao Hospital in Chongqing China. One hundred and fifty patients with type 2 DM received Novorapid 30R therapy and sixty patients received NovoMix 30 Flexpen for 12 weeks respectively. Results:(1)At the end of 12-week treatment,significant improvements in HbA1C and fasting plasma glucose(FPG) levels were shown in both groups, HbA1C decreased 1.08% and 1.01%,and FPG decreased 2.0mmol/L and 2.2mmol/L,in Novorapid 30R and NovoMix 30 Flexpen group respectively(all P0.05). (2)2hpG decreased 3.79mmol/L and 3.05mmol/L,Novorapid 30R was better than Novomix 30 Flexpen,The difference was statistically significant between two groups(P

Objective To study the analgesic effect of sufentanil combined with Dezocine in endoscopic resection of fallopian.MethodsA total of 188 patients with tubal pregnancy from April 2013 to December 2014 in Haining central hospital were enrolled in the study, they were randomly divided into two groups (n=94).On the basis of conventional intravenous analgesia, the patients in control group was were received sufentan, the observation group were given sufentan combined with dezocine.The score of pain at different time points after operation, the Ramsay sedation score, and the level of IL-6 and IL-10 were compared.The adverse reactions were compared between the two groups.ResultsThe score of VAS in the observation group was significantly lower than that in the control at 4h, 8h, 12h and 24h after operation (P<0.05).The score of VAS in the two groups were similar at 48h after operation;the Ramsay score in the observation group was significantly higher than that in the control group(P<0.05) at five time points (4h, 8h, 12h, 24h and 48h after operation);when compared Compared with the indexes before operation, the level of IL-6 was significantly increased in the two groups at 24h and 48h, but the observation group increased less, the IL-6 in observation group was lower than that in the control group at the two points(P<0.05);while the IL-10 was higher than that beforeoperation, and the observation group was more higher(P<0.05).The adverse reactions in the two groups were mainly dizziness, nausea, pruritus and lethargy, and the incidence was only 12.8% in the observation group, which lower than that in the control of 29.8%(P<0.05).ConclusionIt which dazocine combined with sufentanil had a good analgesic effect in the process of analgesia in gynecological laparoscopic resection of fallopian tube after the operation.The VAS score and Ramsay sedation score was improved significantly.The levels of inflammatory factors were lower, and the incidence of adverse reaction was significantly reduced.It is a reliable method for clinical intravenous analgesia.

Objective:To explore the application of fetal multi-organ hemodynamics in the detection and evaluation of oxygen supply and blood supply for fetus in the third trimester of pregnancy. Methods: 42 pregnant women with gestational diabetes mellitus and 42 healthy pregnant women were divided into observation group and control group, respectively. All of the fetuses of pregnant women received Doppler ultrasound examination, and the pulsatility index(PI), resistance index(RI) and systolic/diastolic(S/D) ratio of umbilical artery (UA)and middle cerebral artery (MCA) of every fetus in the two groups were observed. Besides, the number of fetal distress was recorded and the relationship between fetal distress rate and gestational diabetes mellitus were calculated.Results:The PI, RI and S/D of MCA of fetuses of pregnant women with gestational diabetes mellitus was significantly higher than that of healthy pregnant women (t=7.52,t=6.04, t=8.69,P<0.05). And the PI, RI and S/D of UA of fetuses of pregnant women with gestational diabetes mellitus also was significantly higher than that of health pregnant women (t=11.95,t=9.78,t=8.95, P<0.05). Besides, the fetal distress rate of observation group was significantly higher than that of control group (x2=19.56,P<0.05).Conclusion: The fetal blood flow information which obtained from Doppler ultrasound has very importantly value in the diagnosis of gestational diabetes mellitus, and it verifies the relationship between fetal distress rate and gestational diabetes mellitus. It provides beneficial basis for the prevention and treatment of the gestational diabetes mellitus in the clinical practice.

Objective To compare the value of dynamic contrast-enhanced MRI(DCE-MRI) and diffusion weight-imaging(DWI) in differentiating hepatic epithelioid angiomyolipoma (HEAML) from hepatocellular carcinoma(HCC).Methods The MR data of 15 HEAML and 50 HCC proved surgically and pathologically were analyzed retrospectively.The DCE-MRI and DWI were performed preoperatively.The size, location, margin, T1-weighted images(T1WI),T2-weighted images(T2WI) and DWI signal intensity(SI),enhancement pattern, central vessel, early draining vein, pseudocapsule were recorded.The apparent diffusion coefficient (ADC) value was also calculated.The differences of these MR features between two groups were compared statistically.Results There was one lesion in each patient.For all 15 HEAML lesions, early draining vein, central vessel and pseudocapsule were displayed in 8,11 and 6 lesions, respectively.The wash in and slow out enhancement pattern was shown in 10 lesions and wash in and wash out pattern shown in others (5/15).The mean ADC value was (1.15±0.31)×10-3 mm2/s.For all 50 HCC lesions, early draining vein, central vessel and pseudocapsule were displayed in 6,5 and 45 lesions, respectively.29 lesions were shown as wash in and wash out enhancement pattern and the others (21/50) as wash in and slow out pattern.The mean ADC value was (1.23±0.29)×10-3 mm2/s.There were significant differences in these MR features including draining vein, central vessel and pseudocapsule (P<0.05), but no differences in size, location, margin, SI(T1WI, T2WI and DWI), dynamic enhancement pattern, ADC value(P>0.05) between HEAML and HCC.Conclusion DCE-MRI is more helpful in differentiating HEAML from HCC than DWI.