AIM:To retrospectively analyze the lipid metabolism disturbance and subacute inflammation within the microenvironment of follicular fluid between Chinese polycystic ovarian syndrome ( PCOS ) patients and the controls . METHODS:Serum lipid indexes , steroid hormone levels , and inflammatory cell counts were analyzed .The inflammatory cytokine and apolipoprotein levels were detected in the serum and follicular fluid .The mRNA expression of apolipoproteins and cytokines in the granulose cells was determined by real-time PCR.RESULTS: PCOS patients showed typical obesity accompanied with hyperlipidemia and hyperandrogenemia .Significantly elevated inflammatory cell number and cytokine lev-els were detected in both serum and follicular fluid .The mRNA expression levels of the inflammatory cytokines and apoli-poproteins in the granulose cells from the PCOS patients were higher than those from the controls .CONCLUSION:Elevat-ed apolipoproteins reflect systematic hyperlipidemia in the follicular fluid .Serum lipids and cytokines penetrate follicle-ser-um barrier and get into follicle fluid .Meanwhile , increased intake of apolipoproteins or elevated synthesis of cytokines ( IL-1, IL-6 and TNF-α) by granulose cells could also be crucial to stabilize microenvironment of follicular fluid .Oocyte and subsequent embryos are sensitive to the originaal follicular environment .The lipid metabolism disturbance , inflammatory cell infiltration and hyperandrogenemia may possibly disturb oocyte developmental potential .

OBJECTIVETo explore the effects of sacral canal injection on nerve root local inflammatory factors in rat model with lumbar disc herniation, in order to identify its mechanism of treatment.

METHODSForty-eight male SD rats were randomly divided into sham operation group(group A), model group (group B), Chinese medicine group(group C) and western medicine group(group D). There were 12 rats in each group. The model of lumbar disc herniation was established using compression and inflammatory stimulation in group B, C, D. All rats were given epidural catheterization and group A and B with physiological saline (1 ml/kg), group C with mixed liquor of 2% lidocaine and compound Danshen injections and physiological saline (2:2: 16) and group D with mixed liquor of 2% lidocaine and triamcinolone acetonide injection and physiological saline (2:2:16), once a week for a total of three treatments. Four rats were killed every 1 week after injection for once, and the inflammatory factors of tumor necrosis factor (TNF-alpha), prostaglandin E2 (PGE2), interleukin-l (IL-1) and interleukin-6 (IL-6) were detected by ELISA method.

RESULTSThe levels of TNF-alpha, PGE2, IL-1 and IL-6 in compressed nerve tissues in group B were increased than those of group A (P < 0.01). The levels of PGE2, IL-1 and IL-6 in group C and D were decreased than those of group B, and group D was much less(P<0.05). There was no significant difference in level of TNF-alpha among group B, C, D (P > 0.05).

CONCLUSIONCompound compression with inflammatory stimulation can lead to massive release of inflammatory mediators, such as TNF-alpha, PGE2, IL-1 and IL-6. Both injection with compound Danshen injections and triamcinolone acetonide injections by sacral canal can reduce the levels of part inflammatory mediators (PGE2, IL-1 and IL-6), and the effect of Glucocorticoid is better than Danshen (P < 0.05).

Animals ; Dinoprostone ; analysis ; Disease Models, Animal ; Injections ; Interleukin-1 ; analysis ; Interleukin-6 ; analysis ; Intervertebral Disc Displacement ; drug therapy ; immunology ; Lumbar Vertebrae ; Male ; Rats ; Rats, Sprague-Dawley ; Salvia miltiorrhiza ; Spinal Nerve Roots ; immunology ; Triamcinolone Acetonide ; administration & dosage ; Tumor Necrosis Factor-alpha ; analysis

OBJECTIVE:To provide reference for improving pharmaceutical consultations and the quality of pharmaceutical care. METHODS:The records of pharmaceutical consultations were collected from medication consultation center of Huilong-guan district in our hospital during Jan. 2014-Dec. 2016,and then summarized in terms of consultants composition,consultation form,consulting contents and drugs consulted,while Pareto Diagram was used to analyze the main and minor factors of consult-ing contents. RESULTS:The medication consultation center provided pharmaceutical consultations 20353 cases during 2014-2016. Main consultants were patients (20039 cases,98.5%). A total of 6307 persons were involved,mostly female (3646 persons,57.8%). Face to face was the most common consulting method (19440 cases,95.5%). There were 13 types of consulting contents,among which usage and dosage and guidance for special formulation use were the main factors,including 10392 cases (51.1%) and 3844 cases (18.9%). Among 20353 cases of pharmaceutical consultations,18874 cases of in-volved drugs,and involved 11 categories,mostly respiratory drugs (11756 cases,62.3%). CONCLUSIONS:Usage and dos-age and guidance for special formulation use are the main contents of pharmaceutical consultations in the hospital district. The services of pharmaceutical consultations for patients,physicians and nurses provided by pharmacists can solve the questions on medications,and can promote rational drug use in clinic.

Vacuum erection device (VED), used to treat radical prostatectomy (RP)-associated erectile dysfunction, has attracted considerable attention. However, the optimal negative pressure remains to be determined. This investigation explored the optimal pressure for VED therapy in penile rehabilitation. Thirty-six 9-week-old male rats were randomly divided into six groups: control groups (sham group, bilateral cavernous nerve crush [BCNC] group) and VED therapy groups (-200 mmHg group, -300 mmHg group, -400 mmHg group, -500 mmHg group). BCNC group and VED therapy groups underwent BCNC surgery. Intracavernosal pressure (ICP)/mean arterial pressure (MAP) ratio was calculated to assess erectile function. Masson's trichrome (MT) staining, terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay, immunohistochemistry, and real-time polymerase chain reaction (RT-PCR) were performed to explore cellular and molecular changes of the penis. Compared to the BCNC group, ICP/MAP ratios in all VED treatment groups were improved significantly (all P 0.05), but there were no statistically significant differences among VED therapy groups. With increased pressure, complications gradually emerged and increased in frequency. Expression of molecular indicators, such as endothelial nitric oxide synthase (eNOS) and alpha-smooth muscle actin (a-SMA), increased after VED therapy, and hypoxia-inducible factor 1a (HIF-1a) and transforming growth factor beta (TGF-B) decreased. In addition, VED therapy improved the outcomes of MT and TUNEL assay. This investigation demonstrated a pressure of -200 mmHg in a rat model is optimal for VED therapy for penile rehabilitation after RP. No further benefits were observed with increased pressure, despite an increase in complications.

Objective To determine the agreement of interobserver and intraobserver in diagnosing early glaucoma by optic disc morphology,and to explore the efficacy of established methods for evaluating glaucomatous optic discs.Design Prospective study. Participants Clinicians and evaluating methods for glaucomatous optic discs.Methods 120 digital fundus photographs were enrolled including early glaucoma eyes(67 cases)and non-glaucoma eyes but with glaucomatous appearance(53 cases),which were collected in Tongren Hospital.Thirteen ophthalmologists as observers were divided into three groups:GroupⅠ(5 clinicians)were trained with stan- dardized methods for evaluating glaucomatous optic disc damage recently.GroupⅡ(4 clinicians)were ophthalmologists majoring in glaucoma.GroupⅢwere ophthalmologists not specializing in glaucoma.In general groupⅡandⅢ,none had been trained with the es- tablished criteria.Observers evaluated the photos 3 times,with an interval time of 3 days.Kappa statistics were used to evaluate agree- ment between the intraobserver and interobserver.Main Outcome Measures Interobserver and intraobserver agreement,kappa value. Results In GroupⅠ,4 clinicians were in almost perfect agreement,1 clinician was in substantial agreement,kappa value ranging from 0.779(90.0%)to 0.966(98.3%).In GroupⅡ,almost perfect agreement occurred in 2 clinicians,substantial in 1 clinician and moderate in 1 clinician,kappa value ranging from 0.506(82.5%)to 0.866(93.3%).In GroupⅢ,the agreements in 4 clinicians were substantial, moderate,fair,and slight,respectively,kappa value ranging from 0.094(54.2%)to 0.778(89.2%).In term of interobserver agreement for glaucoma diagnosis,kappa values in GroupⅠranged from 0.768 to 0.983,in GroupⅡ0.354-0.834,in GroupⅢ0.335-0.737,respec- tively.Conclusions Intraobserver and interobserver agreement rates in early glaucoma diagnosis are substantially improved through training on optic disc morphologic evaluation methods.Establishing the diagnosis criteria for glaucomatous optic disc damage can raise the correct rate of diagnosis.

Objective To investigate the renal level of 1o-hydroxylase and the change of serum calcium in rats with severe acute pancreatitis,and their correlation.Methods Eighty male Wistar rats were randomly (random number) divided into two groups:sham operation group (SO group),severe acute pancreatitis group (SAP group),and each group was further randomly divided into 1 h,3 h,6 h,and 12 h subgroups (n =10).Severe acute pancreatitis model was made by retrograde infusion with 5％ sodium taurocholate solution into the biliopancreatic duct,rats were sacrificed at 1 h,3 h,6 h,and 12 h separately after modeling.The levels of serum amylase,serum calcium,serum urea nitrogen,serum creatinine,serum 1,25-dihydroxy vitamin D3 were measured,and the level of lα-hydroxylase protein in the kidney was determined with immunohistochemistry and Western blotting.The histopathologic changes of kidney tissue were observed under light microscope and the changes of the proximal tubular epithelial cell were observed under electron microscope.Results Compared with SO group,the levels of serum amylase,serum urea nitrogen,and serum creatinine were higher in SAP group,but the levels of serum calcium and 1,25-dihydroxy vitamin D3 decreased at 3,6,and 12 h,and the renal level of 1 α-hydroxylase also decreased at 3,6,and 12 h after modeling.In SAP group,the levels of serum calcium,serum 1,25-dihydroxy vitamin D3 and the renal level of 1 α-hydroxylase gradually decreased,and the renal level of 1 α-hydroxylase and the level of serum 1,25-dihydroxy vitamin D3 had positive correlation at 3 h,6 h,and 12 h (r =0.93,P ＜0.01; r=0.951,P ＜0.01; r =0.92,P ＜0.01; r =0.878,P ＜0.01),and the renal level of 1α-hydroxylase and the level of serum calcium had positive correlation at 3 h,6 h,and 12 h (r =0.975,P ＜0.01; r=0.946,P＜0.01; r=0.747,P＜0.01).Conclusions Intheearly course of SAP,the lowered activity of 1 α-hydroxylase may play an important role in the development of hypocalcemia.

A series of surveillance and management actions was taken to minimize out-of-plan re-operations. These actions include: 1) Building and completing the surveillance and management mechanism against unplanned re-operations; 2) Building a real-time surveillance and reporting mechanism; 3) Enhancing quality control and continuous improvement at the operating departments; 4) Enhancing the supervision on regulations implementation by quality control departments of the hospital; 5) Enhancing quality control for medical records; 6) Building a feedback mechanism for surveillance results; 7) Building a penalty and reward mechanism. Efforts for one year and a half on such surveillance and management proved successful, as the incidence of out-of-plan re-operations fell from 1.7% before these actions to 1.0% afterwards.

Objective The surgery time for patients with infective endocarditis (IE) has been transformed.It has been supported that,for the patients with surgical indications,the surgery time should be as early as possible to improve the clinical outcome.The purpose of the research is to identify whether the patients with IE could get further benefit from early surgery.Methods Between June 1996 and July 2011,135 IE patients'data has been collected retrospectively,all of whom were verified through the modified Duke categories.The patients were devided into group A( the new therapeutic schedule group after 2008 ) and group B( the traditional therapeutic schedule group before 2008 ) by the year of 2008.The end points of observation were death associated with IE,cardiac failure,embolism,and re-infection.The comparison between the groups was by means of non-parameter rank and inspection test,variance analysis,t test,chi-square test,fisher exact test.The outcome comparison between the groups was via the Kaplan-Meier survival analysis.Results There were no significant differences in baseline data between the groups.No survival differences could be observed via the Kaplan-Meier analysis( Log Rank P =0.189).During the following-up visit,compared with the patients in group B,the mortality in group A is lower(9.4％ vs.23.0％,P=0.016),the incidence of heart failu re was less in group A (5.4％ vs.26.2％,P ＜0.001 ).No differences could be found in re-infection between the two groups(0 vs.4.9％,P =0.112 ). More patients in group A underwent surgery (67.6％ vs.32.8％,P ＜0.001 ).Conclusion The new therapeutic sehedule of IE coull reduce the mortality rate and promote the cardiae funetion.The incidence of re-infeetion didn't increase.

Objective: To investigate the effect of icariin on the proliferation, differentiation, and the mRNA expressions of Cbfαl, BMP2, BMP4 of rat osteoblasts. Methods: Primary rat osteoblastic cells were obtained by sequentia collagenase/trypsin enzyme digestion from calvarial bones of new born ( within 24 h) SD rats and were identified by Alkaline phosphatase and alizarin red staining. The passage 3-5cells were treated with icariin at the concentration of 0 mol/L, 10~(-8)mol/L, 10~(-7)mol/L, 10~(-6)mol/L,10~(-5)mol/L, 10~(-4)mol/L for 24 h, 48 h, 72 h, and the proliferation of the cells was measured by CCK-8assay. The proliferation index was detected by Flow Cytometry and the activity of alkaline phosphatase was determined by p-Nitrophenyl phosphate (pNPP) method after being treated with icariin at the concentration mentioned above for 48 h. The total cellular RNA was extracted 48 h after being treated with icariin at the concentration of 10~(-6)mol/L, and the expressions of Cbfα1, BMP2, BMP4 mRNA were examined by real-time PCR. Results: Icariin showed no effect on the proliferation of osteoblasts, but improved ALP activity. The Cbfα1, BMP2, BMP4 mRNA were significantly upregulated after icariin treatment. Conclusion: Icariin could promote the differentiation ability of rat osteoblasts through upregulating the Cbfα1, BMP2, BMP4 mRNA expressions.

BACKGROUND:Currently, there are few reports on the effect of nickel-chromium (Ni-Cr) al oy porcelain-fused-to-metal (PFM) restoration on subgingival flora of abutment.
OBJECTIVE:To investigate the effect of the Ni-Cr al oy PFM restoration on subgingival flora ratio of abutment.
METHODS:Nine patients (12 teeth) who suspected that Ni-Cr al oy PFM could affect their health and therefore came to hospital to ask for removal of the prosthesis were selected in this study. Their subgingival plaques of abutment were obtained before and 1 month, 3 months after the Ni-Cr al oy PFM restorations were removed, respectively, and the changes of subgingival flora were observed and analyzed by the method of denaturing gradient gel electrophoresis.
RESULTS AND CONCLUSION:The images of denaturing gradient gel electrophoresis in subgingival bacteria of experimental group had significant changes at 1 and 3 months after Ni-Cr al oy PFM restorations removed, furthermore, there were significant differences in the images of denaturing gradient gel electrophoresis at 1 and 3 months. In addition, the specific bands were selected from denaturing gradient gel electrophoresis image that appeared before Ni-Cr al oy PFM restorations removed and weakened or disappeared after the removal of restorations, then 16S rDNA sequence in the specific bands were analyzed. The results showed that the gene sequences of these bands were closest related to Eikenel a corrodens, Campylobacter rectus and Eubacterium saphenu. These findings indicated that the Ni-Cr al oy PFM restorations would result in the changes of the proportion of subgingival microflora and increases in the detection rates of some periodontal pathogens.