OBJECTIVETo explore the molecular biological mechanism of ZHU's Tiaojing Cuyun Recipe (TCR) for treating anovulatory infertility patients with Shen deficiency syndrome (SDS) by observing its clinical efficacy.

METHODSUsing randomized blocking methods, 80 patients were assigned to the treatment group (40 cases) and the control group (40 cases). Patients with regular menstrual cycle started medication from the 5th day of menstruation. Those with irregular menstrual cycle first took progesterone till withdrawal bleeding ,and then started medication from the 5th day of vaginal bleeding. Patients in the treatment group took ZHU's TCR, one dose per day, while those in the control group took Clomifene Citrate (CC), 50 mg per day. Three menstrual cycles consisted of one therapeutic course, a total of 2 courses. Clinical efficacy such as pregnancy rates and abortion rates were observed. Ovulation indices (the maximal diameter of mature follicles, luteinized follicles, ovulational follicles, and the endometrial thickness on the ovulation day), SDS, and integrals of menstrual symptoms were monitored before and after treatment. Serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH) , and estradiol (E2) were determined using chemiluminescent immunoassay before treatment and after on therapeutic course. Serum levels of activin A (ACTA), inhibin B (INHB), and follistatin (FS) were detected using double antibody sandwich ELISA.

RESULTSCompared with the control group, the pregnancy rate was obviously elevated and the abortion rate was obviously lowered in the treatment group (P <0. 05). Ovulation rates of mature follicles and luteinizing follicles decreased more in the treatment group (P < 0.05). Compared with before treatment, integrals for SDS were lower, the maximal diameter of pre-ovulational follicles was increased, and integrals for menstrual symptoms in non-pregnant patients of the two groups were obviously lowered. Meanwhile, the endometrial thickness on the ovulation day was increased in the treatment group after treatment, but reduced in the control group (P < 0.05, P < 0.01). Compared with the control group, integrals for SDS were decreased, and the maximal diameter of pre-ovulational follicles was lowered in the treatment group after treatment (P < 0.05, P < 0.01). Integrals for SDS and the difference in the endometrial thickness on the ovulation day were increased, but the difference in the maximal diameter of pre-ovulational follicles were reduced (P < 0.05, P < 0.01). In the treatment group serum levels of E2 and ACTA increased more after one therapeutic course than before treatment (P < 0.01), but serum levels of INHB and FS decreased more after one therapeutic course than before treatment (P < 0.05). In the control group serum levels of FSH and ACTA increased more, and the serum level of FS decreased more after one therapeutic course than before treatment (P < 0.05, P < 0.01). Compared with the control group, serum levels of FSH and ACTA increased more, and serum levels of INHB decreased more in the treatment group after one therapeutic course than before treatment (P < 0.05, P < 0.01).

CONCLUSIONSZHU'sTCR could improve SDS of anovulatory infertility patients, regulate the follicular development, and elevate the pregnancy rate. Its actions might be associated with regulating their sex hormones, expressions of ovary local factors such as INHB, ACTA, and FS.

Activins ; Clomiphene ; Drugs, Chinese Herbal ; therapeutic use ; Estradiol ; Female ; Follicle Stimulating Hormone ; Follistatin ; Humans ; Infertility, Female ; complications ; therapy ; Inhibins ; Luteinizing Hormone ; Medicine, Chinese Traditional ; Ovarian Diseases ; Ovarian Follicle ; Ovulation ; Progesterone

AIM:To evaluate the efficacy of Wuling Capsule(xylaria) in treating senile systolic hypertension. METHODS: Sixty-four patients with senile systolic hypertension were randomly divided into two groups.Both the treated group and the control group were treated with anti-hypertensive for 4 weeks,but the treated group received Wuling Capsule.Therapentic effects were evaluated with HAMA.Noninvasive resting blood pressure was taken every day after treatment,and dynamic blood pressure before and after treatment. RESULTS: HAMA in both groups decreased somewhat but blood pressure in the treated group was lower than that in the control group,remission rate of the treated group was greater than that in the control group.Treatment period of the treated group was shorter than that of the control group. CONCLUSION: Wuling Capsule can relief anxiety in senile hypertension patients,and it can rise the control rate of blood pressure,and also shorten the treatment period.

Objective To investigate the potential effect of hypoxia on adhersion and invasion of human cervical carcinoma cells HeLa. Methods Reverse transcription-polymerase chain reaction (RT-PCR) was used to investigate the level of HIF-1? mRNA and E-cadherin mRNA of HeLa cells cultured under normoxia, 5%O2, 3%O2, 1%O2. The invasiveness of HeLa cells was investigated by transwell chamber assay. Results Under the condition of normoxia, 5%O2, 3%O2 and 1%O2, the optical density ratio of HIF-1? mRNA/?-actin was (0.423?0.116), (0.764?0.111), (1.687?0.126) and (0.215?0.099), showing that the level of HIF-1? mRNA had a tendency of first inceasing and then decreasing with the decreasing oxygen content. The optical density ratio of E-cadherin/?-actin was (1.045?0.171), (0.719?0.114), (0.386?0.105) and (0.157?0.063), showing a decreasing tendency with the decreasing of oxygen content. The invasiveness of HeLa cells was (112.5?20.7), (254.3?27.5), (333.6?45.2) and (124.5?24.6), showing that the invasiveness of HeLa cells had a tendency of first inceasing and then decreasing with the decreasing oxygen content. Conclusion Moderate hypoxia up-regulates the mRNA levels of HIF-1?, and down-regulates the mRNA levels of E-cadherin, and enhances the tumor invasiveness. The possible mechanism is the increasing mRNA levels of HIF-1?.

Objective To review clinical characteristics and treatment of multiple endocrine neoplasia type 2A (MEN-2A).Methods The clinical data of 13 patients with MEN-2A admitted to our hospital between 1988 and 2011 were retrospectively reviewed.All 13 cases were diagnosed as pheochromocytoma with medullary thyroid carcinoma,presenting no hyperparathyroidism,including 8 cases who had medullary thyroid carcinoma before pheochromocytoma and 5 cases who had medullary thyroid carcinoma and pheochromocytoma simultaneously.All 13 cases underwent resection for pheochromocytoma; 9 cases had bilateral adrenal resection,including 4 cases undergoing laparoscopic resection for pheochromocytoma.Thyroidectomy with bilateral dissection of regional lymph nodes was performed in 10 patients,and nodule enucleation was performed in 3 remaining patients.Results Adrenal pathology reported pheochromocytoma in all cases,including 3 malignant cases.Thyroid pathology reported medullary thyroid carcinoma in all cases.All 13 patients were followed-up visit,10 cases survived and 3 died from distant metastasis of medullary thyroid carcinoma.Conclusions MEN-2A is a rare disease.Surgery is the only treatment for this disease ; when patients have both pheochromocytoma and medullary thyroid carcinoma,to first remove the pheochromocytoma is preferable.

Objective To discuss the relevance between the serum prostate specific antigen (PSA) level and the prostatic cancer biopsy detection rate after tamsulosin treatment for patients with lower urinary tract symptoms and elevated PSA level.Methods 168 patients with lower urinary tract symptoms and elevated PSA level were divided into two groups according to the serum PSA level change after tamsulosin treatment:in the first group,serum PSA level decreased slightly (PSA≥4.0 ng/ml and PSA decrease＜20％);in the second group,serum PSA level decreased obviously (PSA＜4.0 ng/ml or PSA decrease≥20％).Tamsulosin treatment was given in 0.2 mg/d for two months.Prostate gland aspiration biopsy was performed at the end of tamsulosin treatment.Result For the 68 patients of the first group,after tamsulosin treatment,the tPSA level increased from (8.11 ±2.09)ng/ml to (9.05±3.13)ng/ml,in which 38 patients (55.88％,38/68) were confirmed as the prostatic cancer by pathology.For the 100 patients of the second group,after tamsulosin treatment,the tPSA level decreased from(7.80±3.79)ng/ml to (5.19±2.32)ng/ml,in which 6 patients (6％,6/100) was confirmed as the prostatic cancer by pathology.There was significant statistical differences of prostate aspiration biopsy detection rate between the two groups(x2=23.53,P＜0.05).For patients with lower urinary tract symptoms who received tamsulosin treatment,the sensibility of PSA increased to 86.4％,specificity increased to 75.8％,the rate of avoiding aspiration was 55.9％,and the rate of correct diagnosis was 78.5％.Conclusion Tamsulosin treatment can increase the prostatic cancer diagnostic positive rate and decrease the aspiration rate in patients with lower urinary tract symptoms and elevated serum PSA level in a certain extent.

Objective:To observe the clinical effect of different background volumes of ropivacaine in continuous tibial nerve block of postoperative analgesia after calcaneal surgery.Methods:This study was a prospective,randomized,controlled study.Sixty cases of calcaneal visual analogue scale (ASA)ⅠorⅡundergoing elective surgery were selected and randomly assigned to two groups,thirty cases in each group.The patients received popliteal fossa posterior tibial nerve block using ultrasound guided.The con-tinuous stimulation catheter was inserted after successful position and the 0.2%ropivacaine was injected. The background volumes of the A and B groups were 5 mL/h and 3.2 mL/h.The VAS score,the senso-ry block and motor block of tibial nerve and common peroneal nerve,and the satisfaction of the patients at h 12,h 24 and h 48 were recorded after catheter insertion.Results:The VAS scores at the three time points (h 12,h 24 and h 48)on the two groups of the patients were compared,and the difference was not statistically significant (P >0.05).The difference of the sensory block and the motor block of the tibial nerve at the three time points (h 12,h 24 and h 48)on the two groups of the patients were also compared,and the difference was not statistically significant (P>0.05).The difference of the sensory block and the motor block of common peroneal nerve at h 48 hs was statistically significant,group A was higher than the group B (P<0.05).The difference of the patient satisfaction at the three time points (h 12,h 24 and h 48)on the two groups was not statistically significant (P>0.05).Conclusion:The use of 0.2% ropivacaine with the background volume of 3.2 mL/h in continuous tibial nerve block can pro-vide good analgesia and reduce the incidence of the sensory block and motor block of the common perone-al nerve.

Objective To explore the teaching effects of theory and practice integrated teaching model in small class teaching of ENT nursing. Methods Two classes of nursing students from grade two were randomly selected as experiment group and control group with 120 students in each group. The experiment group was treated with theory and practice integrated teaching model in small class and the control group with traditional practice. The teaching effects of the two groups were compared by test results as well as questionnaire survey . Result The teaching effect in the experiment group was significantly better than that of the control group (P<0.05). Conclusion The theory and practice integrated teaching model in small classes can promote the students' interest in learning and mobilize their initiative and enthusiasm to master theoretical knowledge and specialist skills.

Objective To evaluate retroperitoneal laparoscopic surgery in the treatment of primary aldosteronism. Methods Retroperitoneal laparoscopic surgery was performed in 90 patients with primary aldosteronism (92 sites on either or both sides).Their clinical indicators were compared with those of 30 cases undergoing open surgery. Results Retroperitoneal laparoscopic procedures were successfully performed in 91 of the 92 sides.In these successful cases,mean operative time was 93 minutes (compared with 114 minutes in open surgery cases),mean volume of blood loss was 36 ml (compare with 87 ml),mean postoperative hospital stay was 6.8 d(compared with 11.0 d),mean time to flatus was 1.6 d (compared with 3.1 d),and mean time to walk around was 2.1 d(compared with 3.3 d), P

0.05).In the 16 cases,17 retroperitoneal laparoscopic excisions of pheochromocytoma were successful,only 1 was converted to open surgery due to intraoperative bleeding. The mean operative time was 85?31 (range,45 to 150) min in laparoscopic surgery group vs 155?39 (90 to 240) in open surgery group (P

Objective To evaluate the feasibility of transperitoneal laparoscopic adrenalectomy for 3 patients with primary aldosteronism who previously underwent ipsilateral adrenal surgery or nephrectomy. Methods From October 2003 to March 2004,transperitoneal laparoscopic adrenalectomy was performed on 3 male patients with primary aldosteronism,including 2 patients (39 and 72 years,respectively) who had previously undergone ipsilateral retroperitoneal laparoscopic partial adrenalectomy for Conn’s adenoma and 1 patient (42 years) who had previously undergone ipsilateral open nephrectomy for renal tuberculosis. Results Transperitoneal laparoscopic adrenalectomy was successfully performed on all the 3 patients; no complication occurred.The mean tumor size was average 1.7 cm in greatest dimension;the mean operative time was average 93 min;the mean estimated blood loss was average 18 ml,and no one needed blood transfusion.The postoperative food intake time was average 17 h,and postoperative hospital stay was average 5.0 d. Conclusions Although scar and adhesion of previous operation may present more difficulties in the subsequent operation,it is feasible to perform transperitoneal laparoscopic adrenalectomy through different surgical access on the patients who have previously underwent ipsilateral retroperitoneal adrenal or nephric surgery.