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 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 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.

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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:Study on the clinical application and analysis of structured electronic medical records in our hospital in last.Methods: Discharged patients data selected from July 2012 to June 2014, using statistical methods for data processing, 8000 case files were divided into two groups: Group A and Group B.Results: After comparing the two groups of two groups of data, and ultimately disease coding accuracy rate 94.88%, fill in the correct rate increased 88.38%, missing rate decreased 4.63%, two groups had no significant difference data; The quality of writing the doctor increased gradually, the error rate tends to be stable, structured clinical application to control.Conclusion: Sequential specification writing medical doctor, scientific analysis of medical record information, the clinical application of structured electronic medical records the error rate is reduced in the operation, improve the accuracy, more standardized, accurate, standardized.

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

Objective To investigate the effects of propofol on apoptosis following focal cerebral ischemia-reperfusion in a rat model of reversible middle cerebral artery occlusion(MCAO) .Methods Twenty-four male SD rats weighing 300-500 g were randomly divided into 3 groups: group I sham operation; group Ⅱ MCAO + normal saline; group Ⅲ MCAO + propofol. MACO was produced by insertion of a 2-0 nylon filament with rounded end into internal carotid artery toward brain until resistance was encountered. The depth of insertion was about 2 mm. The filament was withdrawn after 2 h for reperfusion. In group I (sham operation) carotid artery was exposed but no filament was inserted. In group Ⅲ (propofol) intraperitoneal propofol 100 mg?kg-1 was administered 20 min before reperfusion; while in groupⅡ(normal saline) normal saline was given instead of propofol 20 min before reperfusion. At the end of 2 h reperfusion the animals were decapitated and the brain was removed. Apoptosis was identified by TUNEL technique. Cellular structure was examined under light microscope. Results Propofol significantly inhibited neuronal apoptosis following focal cerebral ischemia-reperfusion. Swelling and necrosis of the neurons were significantly attenuated in group III . Conclusion Propofol protects neurons against focal cerebral ischemia-reperfusion in rats.

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.