Objective:To investigate the clinical characteristics and offer diagnostic and therapeutic approaches for adult-onset idiopathic hypogonadotropic hypogonadism(AIHH).Methods:Clinical, laboratory, and imaging data, as well as follow-up information, of three male patients diagnosed with AIHH at the Department of Endocrinology and Metabolism of Nanfang Hospital, Southern Medical University, were systematically reviewed and analyzed.Results:All three patients were male, with a median age of 39 years(range, 22 to 40). Two patients reported symptoms of enlarged breasts and reduced sexual function, while one case solely reported a decline in sexual function. Physical examination showed that the median length of the penis was 6 cm(range, 5 to 6 cm), and the bilateral testicular volume was 7.96 mL(4.70-8.82 mL). Basal hormone levels at the time of initial visit to our hospital as follows: the median testosterone level was 0.32 ng/mL(0.24-2.96 ng/mL), median follicle stimulating hormone(FSH) level was 0.56 mIU/mL(0.1-0.75 mIU/mL), and the median luteinizing hormone(LH) level was 0.69 mIU/mL(0.1-1.03 mIU/mL). The levels of other hormones secreted by the anterior pituitary gland were normal. Hypothalamic-pituitary magnetic resonance imaging(MRI) showed that 1 patient had a pituitary microadenoma. Three patients were treated with pulsatile GnRH or gonadotropins, one of which had hypothalamic-pituitary-gonadal(HPG) axis function reversal after GnRH pulse pump therapy and lasted for 1 year, but then still had irreversible reduction.Conclusion:AIHH is marked by adult-onset disease and idiopathic hypogonadism. Enhancing fertility remains a critical requirement for these patients. Pulsatile GnRH treatment or gonadotropin therapy, as viable treatments, exhibit therapeutic effects, albeit with occasional fluctuations. Therefore, the emphasis lies in the timely consideration of fertility preservation.

Complete androgen insensitivity syndrome(CAIS) is characterized by lack of androgen response in target organs due to androgen receptor dysfunction, resulting in feminized external genitalia. Individuals with CAIS are typically advised to live as females. This article reports a patient diagnosed with CAIS and gender dysphoria in adulthood. Following the removal of a left pelvic mass, pathology indicated cryptorchidism with a concurrent Leydig cell tumor. Genetic testing revealed a deletion mutation in exon 3 of androgen receptor gene. During follow-up, the patient underwent gender reassignment, transitioning socially from female to male. This case provides new insights into gender allocation for CAIS patients.

Implantation of drug-eluting stents (DES) is one of the most effective treatment for intraluminal vascular diseases such as vascular stenosis caused by atherosclerosis. Antiproliferative drugs offered by could significantly reduce the restenosis of blood vessels, which is beneficial to interventional therapy in more advanced and complex vascular diseases. This review sumarizes the state-of-the-art of the DES based on the function of loaded drug and material of the stents. We hope this review can provide basic information of DES for clinicians and researchers to make more rational choices in practical applications. Moreover, this review also propses the prospects of drug-loaded stents.

As one of the stimulus-response polymeric intelligent materials, shape memory polymers have been widely applied in biomedicine due to their better biocompatibility, higher controllability, stronger deformation restorability and biodegradability compared with shape memory alloys and shape memory ceramics. This review will introduce the structural principles of shape memory polymers and summarize their applications in the treatment of vascular diseases, especially in endovascular therapy. At the same time, the related technical problems and the future of shape memory polymers are prospected. With the continuous development of processing technology and materials, it can be predicted that shape memory polymers will be more widely used in the medical field.

Objective To investigate the adverse reaction of gastric cancer patients after inquiry application of bevacizumab combined with chemotherapy,and put forward some corresponding preventive measures.Methods Sixty-five cases patients with gastric cancer who were treated with advanced gastric cancer radical operation application of bevacizumab in combination with chemotherapy in the Central Hospital of Jiangmen from January 2012 to January 2014,including 41 male,24 female,with the average age of 48.7 years old.The adverse reactions were observed,and give the corresponding prevention and control measures on the basis of the adverse reaction conditions,the experience in the prevention and treatment were summarized according to the therapeutic effect with clinical and related literature.Results The adverse reactions caused by bevacizumab combined with chemotherapy in patients with gastric cancer including proteinuria (a total of 24 cases(37％),including 18 cases(27.8％) of (+),6 cases(9.2％) of (+ +)),gastrointestinal reaction(a total of 10 cases (15.4％),including 8 cases (12.3 ％) of grade Ⅰ,2 cases (3.1％) of grade Ⅱ),thrombosis (a total of 20 cases(30.7％),including 13 cases of grade Ⅰ (20％),7 cases(10.7％) of grade Ⅱ) and hypertension(a total of 11 cases(16.9％),including 9 cases(13.8％) of grade Ⅰ,2 cases(3.1％) of grade Ⅱ).Bevacizumab combined with chemotherapy in the treatment of gastric cancer patients with partial remission in 41 cases (63.1％),10 cases (15.4％) of stable disease progression,14 cases (21.5％) of disease progression,the complete remission rate was 63.1％.For adverse reactions of proteinuria,patients with asymptomatic proteinuria,if patients with urinary protein detection results for (+),without special treatment,when patients with urinary protein detection for (+ +),given the observation,if patients with urinary protein was more than or equal to 2 g/24 h,paused bevacizumab until proteinuria＜2 g.When the patients with digestive system damage,such as ALT and AST elevation,given the treatment of liver until the two hepatic enzymes returned to normal;patients with gastrointestinal reactions were nausea and vomiting,asked patient to light diet and regular esophagoscopy,if the patients appeared visceral fistula immediately.stopped bevacizumab.For patients with thrombosis,should be closely monitored in patients with signs,once found regardless of any level of embolism events,all immediately stopped the chemotherapy drugs.For the main adverse reactions of hypertension,given patients with proper medication explain before the treatment to reduce the fear,tension,and avoiding mood disorders which lead to an increase in blood pressure,blood pressure should be regularly detected in patients who use drugs,if patients occurred a sharp rise in blood pressure during the treatment,immediately stopped bevacizumab and given antihypertensive treatment.Conclusion Clinicians should take the possible corresponding prediction in patients underwent application of bevacizumab in combination with chemotherapy on the possible different adverse reactions according to the actual situation of patients,and take corresponding preventive measures,can to some extent avoid serious adverse reaction occurred,and improve the quality of life of the patients.

Objective To observe the short-term efficacy and adverse drug reaction of Photofrin photodynamic adjuvant therapy for advanced colorectal cancer in young persons.Methods Selected 23 cases consecutives diagnosed as advanced colorectal cancer in young persons from September 2010 to February 2014 arriving in the Central Hospital of Jiangmen as the experiment group who were received Photofrin photodynamic therapy,and chose 30 consecutives diagnosed as advanced colorectal cancer as the control group who were received radiotherapy and chemotherapy.Using Photofrin in 2 mg/kg photosensitizer, the speed of intravenous infusion,48 hours after endoscopic into optical fiber, laser irradiation and treated with 630 nm intensity,2 days after endoscopic removal of necrotic tissue and the original lesions and new lesions were found to give according to the specific circumstances, after the removal of necrotic tissue lesions.Then compare the effects and complications.Results The total efficacy rate in experiment group was significantly more than control groupthe differences were significant (69.57％ vs.40.00％, P =0.035).The in-hospital time in experiment group was significantly less((13.47±4.46) h vs.(19.72± 5.21) h, P =0.036).The adverse drug reaction rate in experiment group was significantly lower thant the control group (30.43％ vs.50.00％ ,P=0.021).Conclusion The Photofrin photodynamic therapy for advanced colorectal cancer in young persons may greatly improve clinical effect and decrease complication.

Tumor is one of the most serious problems threatening people's life in the 21 st century. Antitumor vaccine becomes a hot research spot of tumor therapy for low toxicity, specificity and durability. Efficient recognization and presentation of tumor antigen contribute to the foundation of an powerful anti-tumor immunologic response. Along with the deepen apprehension of the immunity mechanism and high development of the biochemical technology, a great number of new vaccines emerge and show us some favors. And DNA vaccine and DC vaccine attract most sights for their advantage in antigens expression and presentation.They become the strong weapon for tumor immunity therapy. This is a review about the mechanism, development and current problem of DNA vaccine and DC vaccine.

Objectives To investigate the epidemiological and clinical characteristics of dyslipidemia as well as its treatment and influence on accompanying diseases in impaired glucose status among inpatients. Methods A cross-sectional survey was conducted among the inpatients registered in ten university hospitals of Guangdong, China during the week before the Diabetes Day in 2004. The fasting blood glucose (FBG), lipid profiles, BMI, waist to hip ratio (WHR) and concomitant disorders of the first screen during the hospitalization period were recorded. Those who had FBG level from 5.6 to 6. 9 mmol/L and not been previously diagnosed diabetes (PDM) underwent oral glucose tolerance test (OGTF). Results Of the 8753 inpatients investigated, 1067 eases had complete medical records(CMR case) including PDM cases and previously non-diagnosed diabetes ones with FBG ≥ 5. 6 mmol/L. Of the previously non-diagnosed diabetes cases with FBG levels from 5.6 to 6.9 mmmol/L, 65.8% accepted OGTT. Of the CMR cases, 41.9% had PDM, 21.7% was newly diagnosed diabetes mellitus (NDM), 29. 1% had impaired glucose regulation (IGR) and only 7.3% had normal glucose tolerance (NGT). The TG levels in NDM and PDM group were higher than those in IGR and NGT group (P < 0.05, respectively). The HDL-C levels in IGR, NDM and PDM group were lower than those in NGT group (P < 0.05, respectively). Sixty-nine point six percent of the diabetes mellitus (DM) inpatients was accompanied with dyslipidemia and the rate was higher than those in NGT (56.4%) and IGR inpatients (52.5%, P <0.05, respectively). Only 22. 8% of the PDM inpatients underwent treatment of dyslipidaemia and just 3.4% achieved the target suggested by the guideline of ATP-Ⅲ. BMI was higher and waistline longer in the PDM and NDM inpatients than those in the NGT cases (P <0.05, respectively). Seventy-two point eight percent of the PDM inpatients was complicated with more than one type of vascular diseases. Nine point seven percent and 0. 2% of the NDM inpatients were tormented by diabetic nephropathy and diabetic retinopathy respectively. Conclusions More inpatients with accompany DM or IGR had concomitant dyslipidemia than those with NGT, which included hypertriglyccridemia, hypo-high-density lipoproteinemia and metabolic syndrome. Concomitant vascular diseases were more frequently found in PDM inpatients than in the others. Some of the NDM and IGT inpatients were complicated with microvascular diseases.

Pancreatic cancer is one of the most malignant diseases.With the development of biology,its pathogenesis has become more and more clear.There are a lot of signal pathway aberrant in pancreatic cancer cell including Notch signal pathway,k-ras signal pathway,hedghog signal pathway,NF-κB signal pathway and so on.Because of the widespread of NF-κB signal pathway aberration in pancreatic cancer cell,we think that NF-κB play a key role in the various kinds of aberrant signal pathways.So the NF-κB relative sighal pathways in pancreatic cancer are reviewed in this atticle.

Objective To clone the human Islet neogenesis associated protein(rhINGAP)gene,express the gene extraeellulary in Pichia yeast for.further study on biological function and animal test on INGAP.Methods INGAP gene Was amplified with PCR and inserted into the recombinant plasmidα/pUC18.Then,the fusion gene of α and INGAP was digested and inserted into the expression plasmid pPIC9K.The positive recombinant plasmid which integrated INGAP Was confirmed by restriction enzyme digestion and sequencing,and it Was linearized with Sal Ⅰ digestion and transfered into the yeast host strain GS115 through electroporation.The yeast transformants that harbor the desired gene INGAP with high copy were selected by the auxotroph mediam G418,and verified by PCR.The condition of hake-flask culture was optimized,and the recombinant human INGAP Was induced expression with methanol as the only Carbone source.The antigen activity of the desired protein Was detected by Western blotting and ELISA method.Results Recombinant plasmid αINGAP/pPIC9K were successfully constructed and three positive Pichia yeast transformants were obtained.The expressed protein had satisfactory antigen activity,which Was confirmed by the Western blotting and ELISA method.Conclusions Pichia yeast expressing human Islet neogenesis associated protein (rhINGAP)gene was successfully constructed.