Objective The report was focused on polycystic ovary syndrome(PCOS) in female adolescents related to homosexual precocious puberty,and the new awareness of its influence on long-term health of homosexual precocious girls.Methods A girl with idiopathic central precocious puberty (ICPP) but diagnosed as PCOS in adolescence was reported and the data were reviewed.Results A girl was diagnosed as ICPP when she was near 8 years old with obesity,but without hyperinsulinemia,then she received the treatment of a 3.75 mg dose gonadotropin hormone analogues (GnRHa) every 28 days.Her gonads development was under control while her growth was arrested.Growth hormone(GH) injection started at 13 months.She stopped all medications when finished GH and GnRHa treatment for 12 months and 25 months.She went to see doctors again because of no menarche after discontinuing medication for nearly 2 years.She appeared obese and acne,hirsutism,athanens negricans and purple purple striae on the skin.Hyperinsulinemia and hypertestosterone were demonstrated.Pelvic B ultrasonography showed polycystic ovary,and she was diagnosed as PCOS.She was ordered to lose weight and to take metformin.And adrenocorticotropic hormone stimulating test was done,and B ultrasonography again ruled out atypical congenital adrenal hyperplasia and tumor of adrenal gland.She got her menarche 1 month later.Twelve months after the PCOS diagnosis and treatment,she had 4 menses,her insulin level decreased,glucose tolerance and her serum testosterone level turned normal.At the same time,the form of ovarian and follicular was significantly reduced.After taking mefformin for 20 months,her height and weight did not change,her menstrual was regular every 35-40 days,each time lasting about 7 days.She was followed up.We also reviewed literatures and learnt that precocious puberty might not be a benign situation and it might have an intrinsic relation to obesity,precocious puberty and PCOS.It might be the cofactors for causing PP and PCOS that accessed luteinizing hormone(LH) secretion and disorder of hypothalamus pituitary gonad(HPG) axis except obesity with hyperinsulinemia.Reported pubertas praecox in childhood developed to PCOS at 30％ with high prevalence of obesity.GnRHa suppressive therapy might relate to PCOS and had disputation for improving final height.There were fewer investigations on adolescent PCOS,and no consensus guideline on it in China.Conclusions Girls with ICPP may develop to PCOS some time later.The clinical features of the reported girl and the knowledge from literatures support the hypothesis that inner relationship between the CPP and the PCOS.The LH high secretion and disorder of HPG axis may be the causes of them; LH treatment on suppressing obesity should be cautious during treatment.The benefit and risk from GnRHa treatment should be evaluated thoroughly.Further clinical research should be conducted on adolescent PCOS.

Objective To explore the experiences of the diagnosis and treatment of urothelial tumor in multiple organs.Methods Clinical data of 10 patients with urothelial tumor in multiple organs were retrospectively reviewed.Urothelial tumors were found in two or more organs at the same time by B ultrasound,IVU,R-P,CTU,MRU,cystoscopy,ureteroscopy and so on before operation.Results 6 cases were operated by radical total nephroureterectomy and partial cystectomy,3 cases were operated by radical total nephroureterectomy and cystectomy with urinary diversion,1 case was operated by partial ureterectomy and total cystectomy.8 of them were alive,1 case was operated by total urethrectomy because of tumor recurrence in the posterior urethra,one died of metastasis tumor 18 months after operation,and the other died 32 month after operation.Conclusions Combined use of various kinds of the diagnostic means (ultrasound,IVU,R-P,CTU,MRU,cystoscopy,ureteroscopy) are important for the diagnosis of urothelial tumor in multiple organs.It needs to select the operate mode according to the tumor staging and grade and the patient's condition.Reinforcement surveillance and close follow up is required after operation.

Akt1 is a serine-threonine protein kinase that has been implicated in the control of cellular metabolism,survival and growth.Elevated expression of Akt1 has been noted in a significant percentage of human tumors,promoting cellular metastasis.Conversely,some studies have revealed hyperactivated Akt1 inhibited the invasiveness and metastasis of breast cancer cells.To clarify the definite effect of Akt1 on tumorigenesis and development,Akt1 was silenced by RNAi in the highly metastatic murine breast cancer 4T1 cells.Akt1 silencing didn't affect the proliferation of breast cancer cells in MTT assay,while reduced the migration in Transwell assay.Consistent with the above results,Akt1 silencing didn't change the primary tumor weight,but significantly suppressed lung metastasis of 4T1 cells.These observations indicated Akt1 plays an important role in murine breast cancer metastasis,and suggested that Akt1 might be a therapeutic target for breast cancer metastasis.

Background:As postoperative intra-abdominal septic complications( IASCs)in Crohn’s disease( CD)are difficult to manage,it is of great importance to prevent this condition in CD patients after surgery. Till now,there are no large sample studies on risk factors for postoperative IASCs in CD in China. Aims:To determine the risk factors for postoperative IASCs in CD for guiding the formulation of preventive strategies. Methods:This retrospective study was based on a computerized database of CD patients who had undergone surgery for CD complications between 1999 and 2014 at Nanjing General Hospital of Nanjing Military Command,PLA. Patients were divided into IASCs group and non-IASCs group. Thirty potential variables were selected,and both univariate and multivariate( Logistic regression)analyses were performed to identify the risk factors for IASCs after surgery. Results:Seven hundred and sixteen operations were reviewed,and IASCs occurred in 41 cases(5. 7%). By univariate and multivariate analyses,IASCs were significantly associated with one stage anastomosis(OR=1. 656,95% CI:1261-3. 279),preoperative low albumin level( <30 g/L)(OR=1. 457,95% CI:1. 152-2. 368),preoperative high CRP level( >10 mg/L)(OR=8. 641,95% CI:3. 376-16. 364),preoperative steroids use ≥3 months(OR=3. 785,95% CI:1. 237-4. 671)and presence of intra-abdominal abscess or infection at the time of surgery(OR=1. 784,95% CI:1. 155-3. 826). However,enterostomy(OR =0. 125,95% CI:0. 062-0. 561)and preoperative enteral nutrition ≥ 1 month( OR =0. 147,95% CI:0. 078-0. 781 ) were found to be the independent protective factors. Conclusions:Malnutrition,active CD and preoperative long-term steroids use increase the risk of postoperative IASCs in CD. Patients with these risk factors should not receive immediate surgery. If surgery is inevitable, enterostomy instead of resection and anastomosis should be the first choice. Preoperative enteral nutrition is helpful for reducing the occurrence of IASCs after surgery.

Objective To investigate the effects of ciprofloxacin on anastomotic stoma,small intestinal inflammation and fibrosis in interleukin-10 knock-out mice (mice model of Crohn′s disease (CD)) after ileocaecal resection.Methods Twelve interleukin-10 knockout male C3H/HeJBir mice were evenly divided into control group and ciprofloxacin group.The mice model was established with ileocaecal resection and ileocolostomy.There was no intervention in control group.Ciprofloxacin (50 mg/kg per day)was orally administrated in ciprofloxacin group for four weeks.All the mice were executed.The intestine around anastomotic stoma was taken for hematoxylin-eosin (HE)and Sirius red staining and histological scoring.The level of interferon (IFN)-γand tumor growth factor (TGF)-βin intestine around anastomotic stoma and small intestine was detected by enzyme-linked immunosorbent assay (ELISA) method.The content of procollagen α1 was determined by real-time polymerase chain reaction.The data were analyzed by t test.Results The inflammatory reaction level of anastomotic stoma and small intestine in mice of ciprofloxacin group (2.50±0.55 and 1 .67±0.52)was significantly lower than those of control group (3.67±0.63 and 2.83±0.75 ,t=-8.273,-5 .188,both P <0.05 ).The IFN-γof anastomotic stoma and small intestine also significantly decreased ((0.72 ±0.22 )pg/mg vs (1 .76 ±0.43 )pg/mg, (0.23±0.12)pg/mg vs (0.78 ± 0.52 )pg/mg;t = - 7.354,- 5 .268,both P < 0.05).However, ciprofloxacin could not significantly decrease fibrosis in anastomotic stoma and small intestine of CD mice. There was no significant difference in the level of TGF-βcompared with control group.Conclusions The role of ciprofloxacin in improving inflammatory reation in anastomotic stoma of CD mice was limited. Maintenance therapy may be necessary to reduce the relapse of anastomotic stoma diseases.

To observe the protective effects of drug-contained serum of Lingqi Huangban Granule (LQHBG), a compound traditional Chinese herbal medicine, on oxidative stress-induced injury in rabbit retinal pigment epithelial (RPE) cells in vitro.

Resistance to the thyroid hormone is a rare and hereditary thyroid disease,the signs and symptoms are diverse and the onset is hidden.It is often misdiagnosed as a common thyroid disease and given inappropriate diagnosis and treatment.Improper diagnosis and treatment would cause adverse effect on growth and development of sick children.It is necessary to improve awareness,understanding and mastery of this disease,so as to improve the level of clinical diagnosis and treatment.

OBJECTIVE:To evaluate the clinical effects of urapidil on cardiovascular response induced by sympathetic stimulation during front approach cervical vertebra operation.METHODS:One hundred and twenty patients undergoing front approach cervical vertebra operation were randomly divided into three groups.Patients in URA group treated with0.5mg/kg urapidil and patients in NIC group treated with5?g/kg nicardipine when systolic blood pressure(SBP)and heart rate(HR)increased by sympathetic nerve stimulation during the operation.And patients in COM group only increased their anesthesia degree with isoflurane at the same situation.The patients’SBP and HR were observed and compared among three groups at the time before the sympathetic nerve stimulation,and5minutes and10minutes after the drugs treatment respective?ly.RESULTS:The patients’SBP and HR in URA group had no significantly increase after administration of urapidil.In NIC group,although the patients’SBP had no significantly increase,the patients’HR increased significantly after nicardipine was used.But the patients’SBP and HR increased significantly after improved anesthesia degree with isoflurane.CONCLUSION:Urapidil has better effect on sympathetic cardiovascular response during the front approach cervical vertebra operation com?pared with nicardipine.

ObjectiveTo review the major complications in patients after transurethal electrovaporization of the prostate (TUVP) and transurethal plasmakinetic resection of the prostate (PKRP) retrospectively and to analyze the causes and management.MethodsClinical data of 92 cases of patients after TUVP and 226 cases after PKRP were reviewed retrospectively.The patients' relevant circumstances including subjective symptoms,objective indexes and the major long-term complications were followed up about 1-,3-,and 5-year after operation.Different therapeutic methods were chosen according to different causes of the complications.ResultsThere were no significant differences (P ＞ 0.05 ) between TUVP group and PKRP group in IPSS (7.3±2.8,7.2±2.5),QOL (2.6±0.7,2.7 ±0.5),Qmax[ (25.2±3.5),(25.5 ±3.8) ml/s] and PVR [(18.7 ±5.4),(17.8 ±6.3)ml].The incidences of bladder neck restriction was about 1.1％,3.3％,and 2.3％ after 1,3,and5 years in patients after TUVP,and 0.9％,2.7％,and 1.8％ after PKRP accordingly.For urethral stricture,it was about 3.3％,2.2％,and 1.1％ after TUVP,and 3.1％,2.2％,and 0.9％ after PKRP.For residual prostatic hyperplasia,it was about 1.1％,2.2％,and 4.5％ after TUVP,and 1.3％,2.7％,and 3.7％ after PKRP accordingly.ConclusionsTUVP and PKRP are effective and safe treatment options for BPH.The major long-term complications after TUVP and PKRP are bladder neck restriction,urethral stricture and residual prostatic hyperplasia.Regular and long-term follow-up is required for patients after TUVP and PKRP.Different therapeutic methods should be chosen according to different causes of the complications after operation.

Objective To investigate the effect of putative periodontopathogenic bacteria on the development of drug-induced gingival overgrowth(GO) in renal transplant recipients. Methods A total of 57 patients undergoing cyclosporine treatment were divided into two groups according to GO index: with gingival overgrowth( group A) and without gingival overgrowth (group B). Demographic, pharmacologic and periodontal data were analyzed. The real-time polymerase chain reaction (PCR) method was used to detect and quantify five putative periodontopathogenic bacteria, including Porphyromonas gingivalis (Pg),Actinobacillus actinomycetemcomitans ( Aa), Prevotella intermedia ( Pi ), Treponema denticola ( Td ) and Tannerella forsythia(Tf) in subgingival samples. Moreover, the relationship between the bacterial amount and the severity of GO was analyzed. Results Group A presented a significantly higher plaque index,sulcus bleeding index and probing depth than group B( P < 0. 01 ). The occurrences of Pg, Td, and Tf in the group A(96% ,82% and 89% ) were significantly increased compared with those in the group B (69%,55% and 66%, P < 0. 05), respectively. The prevalence of Pg, Td, and Tf in the group A (79%)was markedly higher than that in the group B( 38z% , P <0. 01 ). The bacterial amount of Pg, Td, Tf and Pi were enhanced along with the severity of GO. However, the bacterial amount of Aa had no difference between two groups. Conclusions Pg, Td, and Tf may have a significant relationship with the development of GO.