Objective To study the effect of calcitriol combined with metformin in the treatment of polycystic ovary syndrome(PCOS)and its influence on serum monocyte chemotactic factor -1(MCP -1).Methods 96 patients with PCOS were randomly divided into the control group(48 cases)and the the observation group(48 cases).The two groups were treated with metformin tablets,0.25g/time,2 times/d.On the basis of the above treatment,the observation group was given calcitriol,0.25μg/time,1 time /d.The two groups were treated for 3 months.Before and after treatment,the number of common symptoms of PCOS(menstrual scarce,acne,hairy,ovarian volume increase,polycystic change)and the determination of serum MCP -1 changes were summarized.Results Before treatment,the menstruation, acne,hairy,ovarian volume increase,polycystic change in control group were 46 cases,21 cases,32 cases,19 cases, 47 cases,respectively,which were 18 cases,11 cases,18 cases,9 cases and 10 cases after treatment.Before treatment, the menstruation,acne,hairy,ovarian volume increase,polycystic change in observation group were 47 cases,25 cases, 29 cases,22 cases,45 cases,respectively,which were 10 cases,6 cases,10 cases,4 cases and 5 cases after treatment. After treatment,the two groups were treated with less menstruation,acne,hair,ovarian volume and polycystic change (χ2 =9.86,7.25,9.06,10.17,13.42;14.28,12.62,11.28,16.52,19.66,all P <0.05).And after treatment, which of the observation group were significantly better than the control group (χ2 =4.06,4.86,5.62,4.71,9.27,all P <0.05).The serum MCP -1 levels of the control group before and after treatment were (159.64 ±27.12)μg/L, (118.54 ±21.38)μg/L,which of the observation group were (162.57 ±29.06)μg/L,(82.59 ±10.72)μg/L.After treatment,the serum levels of MCP -1 in the two groups were significantly decreased(t =2.968 2,4.163 8,all P <0.05),and the serum MCP -1 level in the observation group was significantly lower than that in the control group (t =2.661 2,P <0.05).Conclusion Calcitriol combined with metformin can significantly improve the efficacy of patients with PCOS,and decrease the expression of MCP -1 in serum.

[Objective]To probe the research and treatment for Hashimoto thyroiditis in Th1/Th2 migration.[Methods]By referring to related literature from both home and abroad,the author tries to analyze and sort the literature and comes to a reasonable conclusion. [Result]There is a lot of experimental re-search on correction of Hashimoto thyroiditis Th1/Th2 migration at home and abroad,but less clinical treatment research.[Conclusion]Th1/Th2 cellmigra-tion is one of the reasons for Hashimoto thyroiditis.It can promote the development of the disease, have something to do with the rise of thyroid autoanti-bodies.

Objective To explore effective coping style of targeted psychodrama on teenager offenders.Methods Targeted psychodrama intervention procedures were designed.60 teenagers selected from juvenile detention jail were randomly divided into experimental group and control group.Psychodrama intervention was applied to the experimental group to test the changes of the two groups before and after the intervention using simplified coping style questionnaire.Results Before the intervention,the positive coping style level of the experimental group was 1.40 ± 0.42,the negative coping style level was 2.19 ± 0.32; after the intervention,the positive coping style level of the experimental group was 2.13 ± 0.36,the negative coping style level was 1.77 ±0.30.The difference of the experimental group's positive response and the negative response were significant before and after the intervention(t =-6.223,P＜ 0.01; t =9.749,P＜0.01).The difference of the control group's positive response and the negative response were not significant (P ＞ 0.05).Conclusion Psychodrama intervention has a positive effect on the criminal teenagers coping styles,and it can improve their social adaptability.

Objective To examine the effects of blood salvage and blood preservation on erythrocyte immunity in adults. Methods Fifty patients of both sexes (22 males, 28 females) aged 25-69 yr undergoing cardiovascular or orthopedic surgery or surgery for spleen rupture or ruptured ectopic pregnancy during which ZITI-2000 autotransfusion system was used to salvage shed blood were enrolled in this study. Blood samples were taken from autotransfusion system after being heparinized, filtered, centrifuged and washed (n = 50) (group Ⅰ) , and also directly from operative field (n = 50) (group Ⅱ). In group Ⅲ blood samples were taken from bank blood after being preserved in citrate-phosphate-dextrose-adenine (CPDA) anticoagulant solution for 2 weeks ( n = 50) . The rosette rate of RBC-C3b receptor (RBC-C3b RR), The rosette rate of RBC-immune complex (RBC-ICR), the percentage of CD35-positive erythrocyte and the content of SOD in erythrocyte were measured. Results The RBC-C3b RR, the percentage of CD35-positive erythrocyte and the SOD content in erythrocyte were significantly lower in group Ⅰ and Ⅲ than in group Ⅱ(P

Objective To observe the correctly positioning rate of left-sided double lumen endobronchial tube by combined adjustment of auscultation,PETCO2 and airway pressure changes.Methods Sixty adult patients undergoing thoracic surgery were intubated with Robertshaw DLTs. DLT position is checked and adjusted by fiberoptic bronchoscope（FOB）. Results In the supine position,successful intubation is 57 cases by three combined methods,one of cases is shallower,two of cases are deeper,satisfactory rate is 95 percents;In the lateral decubitus position,successful intobution is 56 cases by three combined methods,two of cases is shallower,two of cases are deeper,satisfactory rate is 93.4 percents.Conclusion Three combined methods that are simple,reliable can be used repeatedly during postural changes without increasing the opportunities for injury,it is clinically a very good approach,but the absolute scope of safety is very small,FOB is necessary for positioning.

Objective To investigate the effect of propofol on the intracellular calcium ion concentration ([ Ca2+ ]i) in isolated rabbit tracheal smooth muscle cells (TSMCs).Methods The single rabbit TSMC was isolated by acute enzymatic isolation method as described by Cheng et al.The isolated TSMCs were randomly divided into 3 groups ( n =5 each):propofol group (group Ⅰ ),propofol + 2-aminoethoxy-diphenylborate (2-APB) group (group Ⅱ ) and propofol + the blocker ryanodine group (group Ⅲ).In group Ⅰ,the cells were incubated with propofol with the final concentration of 300 μmol/L for 15 min,followed by washing with calcium-free Hank's balanced salt solution (HBSS) for 3 times,acetylcholine 1 μmol/L was then added to the culture medium and [ Ca2+ ]i was recorded.In group Ⅱ,the cells were incubated with 2-APB with the final concentration of 40 μmol/L for 15 min,propofol with the final concentration of 300 μmol/L was then added,the cells were incubated with 2-APB and propofol for another 15 min,followed bywashing with calcium-free HBSS for 3 times,and acetylcholine 1 μmol/L was then added.In group Ⅲ,the cells were incubated with ryanodine with the final concentration of 10 μmol/L for 15 min,propofol with the final concentration of 300 μmol/L was then added,the cells were incubated with ryanodine and propofol for another 15 min,followed by washing with calcium-free HBSS for 3 times,and acetylcholine 1 μmol/L was then added.[ Ca2+ ]i in TSMCs was measured using the fluorescent Ca2+ indicator fluor-3/AM.Results Compared with group Ⅰ,no significant change was found in [Ca2+ ]i in group Ⅱ (P＞0.05),while [Ca2+ ]i was significantly decreased in group Ⅲ (P＜0.05).Conclusion Propofol can decrease the [Ca2+ ]i in isolated rabbit TSMCs,and the mechanism may be related to inhibition of inositol 1,4,5-trisphosphate pathway,but not ryanodine pathway.

Objective To investigate the effects of orphanin FQ (OFQ) on simple and norepinephrineactivated cardiac function in isolated rat heart.Methods Male SD rats aged 3-4 months weighing 250-280 g were anesthetized with intraperitoneal 25% urethane 1.4-1.8 ml.Their hearts were excised and passively perfused with K-H solutionin a Lanngendorff apparatus.A fluid-filled latex balloon was inserted into left ventricle for measurement of developed pressure.Left ventricular systolic pressure(LVSP),left ventricular end-diastofic pressure(LVEDP),left ventricular developed pressure(LVDP=LVSP-LVEDP),HR and±dp/dtmax were measured.Sixty isolated rat hearts were randomly divided into 10 groups(n=6 each):Ⅰ control group (group C);Ⅱ,Ⅲ,Ⅳ OFQ1,OFQ2,OFQ3 group--OFQ 10-6,10-7,10-8 mol/L were administered via perfusion system respectively;Ⅴ OFQ+UFP group--OFQ 10-6 mol/L+UFP-101 (all OFQ antagonist) 10-6 mol/L were administered;Ⅵ NE group--norepinephrine 10-5 mol/L;Ⅶ,Ⅷ,Ⅸ NE+OFQ groups--NE 10-5 mol/L+OFQ 10-6,10-7,10-8 mol/L were administered respectively;Ⅹ NE+OFQ+UFP group--NE 10-5 mol/L+OFQ 10-6mol/L+UFP-101 10-6mol/L.Results LVSP,LVDP and±dp/dtmax were significantly increased while HR was significantly decreased in the 3 OFQ groups as compared with control group.LVSP,LVDP±dp/dt max and HR were significantly increased in the 3 NE+OFQ groups as compared with NE group.Conclusion OFQ has positive inotropic action and negative chronotropic effect on the isolated rat heart.OFQ Can enhance the positive inotropic and chronotropic effect of NE on the heart.

One hundred and two pregnant women with obstructive sleep apnea hypopnea syndrome (OSAHS) and 36 healthy pregnant women( control group)were enrolled in the study.Serum visfatin and macrophage migration inhibitory factor (MIF) levels were detected by enzyme linked immunosorbent assay (ELISA).The results showed that apnea-hypopnea index (AHI),mean arterial pressure(MAP),serum visfatin and MIF levels in pregnant women with OSAHS were significantly higher than those of controls ( all P＜ 0.01 ). In pregnant women,AHI,serum visfatin and MIF levels of patients having OSAHS with hypertension were significantly higher than those of patients with OSAHS only (all P ＜ 0.01 ).Patients with severe OSAHS had higher levels of visfatin and MIF than those with moderate OSAHS,and patients with moderate OSAHS had higher visfatin and MIF levels than those with mild OSAHS ( P ＜0.01 ).The AHI was significantly correlated with MAP,serum levels of MIF and visfatin ( r =0.75,0.71,0.68,respectively,all P ＜0.01 ) in pregnant women with OSAHS.

Objective To evaluate the influences of artifical plasma substitutes on blood coagulation and fibrinoglysisMethods Forty adult patients, ASA grade Ⅰ-Ⅱ, scheduled for selective surgery ,were randomly allocated to receiving intravenous infusion of hydroxyethylh starch(HES group), polygeline (Haemaccel,HAE group), succinylated gelatin (Gelofusine,GEL group), or normal saline (control group) at the rate of 20ml?kg -1?h -1in 60 min ,respectively, with 10 cases in each groupThe venous blood samples were taken before and 1h following the infusion to determine platelet count(PLC),platelet agglutgtination test(PAG), platelet factor 3 availability test(PF 3at), activated partial thromboplastin time(APTT), prothrombin time(PT), thrombin time(TT), fibrinogen(FIB), tissue plasminogen(t-PA) and plasminogen activator inhibitor(PAI:A)Results In HAE group PAG decreased significantly, and PT was prolonged markedly after the infusion(P005)In GEL group only FIB reduced obviously after the infusion ,additionally was remarkably lower than that in control group(P

Objective To compare two methods of patient controlled epidural analgesia (PCEA) with 0 2% ropivacaine plus fentanyl 2?g?ml -1 with or without background infusion for labor Methods Ninety ASA Ⅰ Ⅱ full term primigravidae in active labor who had a single fetus with vertex presentation and were expected to have vaginal delivery were randomly divided into three groups of 30 each: group A received PCEA without background infusion; group B received PCEA with background infusion and group C received no analgesia of any kind and served as control PCEA included a bolus of 4 ml with a 15 minute lock out When the primigravida was in first stage of labor, an intravenous line was established and 5% glucose normal saline 500 1000 ml was being infused When the external cervical os was dilated to 3 cm, epidural catheter was placed at L 2 3 and a test dose of 4 ml was given 5 min later when no signs of subarachnoid injection was evident, block height was tested by pinprick and another 6 ml was given 30 min later in group B background infusion of 0 2% ropivacaine + fentanyl 2?g?ml -1 was started at a rate of 4 ml?h -1 until the second stage of labor began Maternal vital signs (BP, ECG, SpO 2, P ET CO 2), VAS scores, degree of motor block, drug consumption, side effects of PCEA, gas analysis of umbilical venous blood, progress of labor, and Apgar scores were noted Venous blood samples were taken before PCEA and at the end of first stage of labor for determination of serum epinephrine and norepinephrine levels Results There were no significant differences in Apgar scores, blood gas of umbilical venous blood and the durations of first and second stage of labor among the three groups There were no differences in VAS scores, degree of sensory and motor block, serum concentrations of epinephrine and norepinephrine and percentage of cesarean section between group A and B The percentage of cesarean section was significantly higher in control group than that in group A and B Plasma NE and E concentrations at the end of the first stage of labor were significantly higher in control group than those in group A and B The ropivacaine and fentanyl consumption was less and the incidence of itching and percentage of instrumental delivery were lower in group A than those in group B Conclusions PCEA with 0 2% ropivacaine and fentanyl 2?g?ml -1 was safe and effective It reduces the percentage of cesarean section PCEA without background infusion provides the same level of analgesia as PCEA with background infusion with less drugs and side effects