Objective To investigate the effects of insulin-like growth factor Ⅰ (IGF-Ⅰ) and insulin-like growth factor binding-protein 1 (IGFBP-1) on development of ovarian follicles during gonadotropin stimulation in in-vitro fertilization (IVF) program. Methods Enzyme-linked immunosorbent assay (ELISA) and radioimmunoassay were used to determine the levels of IGF-Ⅰ, IGFBP-1 and estradiol (E 2) in serum and follicular fluid obtained during oocyte pick-up (OPU) in 32 IVF-embryo transfer cycles. Results (1) Serum IGFBP-1 levels increased with growth of follicles [(3 5?1 0) ?g/L during OPU, (2 1?0 5) ?g/L before stimulation, P 0 05]. Significant positive correlation was found between serum IGFBP-1 and serum E 2 [(3 5?1 0) ?g/L, (3 293? 1 361) pmol/L, r =0 41, P

Objective To observe the relationship among follicular development and insulin-like growth factor Ⅰ (IGF-Ⅰ) and IGF-Ⅰ receptor (IGF-ⅠR) mRNA during ovulation stimulation period in an in-vitro fertilization (IVF) program. Methods IGF-Ⅰ levels in serum samples obtained before (menstrual day 3) and after stimulated (at the time of ovum pick-up) and follicular fluid samples were measured by ELISA. The expression of IGF-Ⅰ mRNA in the granulosa cell obtained from follicular aspiration was determined by RT-PCR. Results There was no significant difference between IGF-Ⅰ levels of serum samples before or after stimulated and follicular fluid. In patients with less than 4 follicls (diameter≥14 mm) at the time of ovum pick-up the IGF-Ⅰ mRNA level was significantly lower than that in patients with more than 4 follicles. Conclusion The serum IGF-Ⅰ levels fail to predict the numbers of follicular development; the levels of IGF-ⅠR mRNA in granulosa cells forecast the responsiveness of ovary to the stimulation of gonadotropins in an IVF program.

Objective　To investigate the number of follicles and insulin-like growth factor I receptor (IGF-ⅠR) in stimulated cycles. Method　IGF-ⅠR mRNA and IGF-ⅠR in granulosa cells obtained during oocyte retrieval were respectively measured by reverse transcript polymerase chain reaction （RT-PCR） and Western blot technique. Results　The expression of IGF-ⅠR mRNA in poor responders (follicles≤3) was much lower than in normal responders (follicles 4～13) and high responders (follicles≥14) (1.70±0.23, 2.92±0.49,4.22±1.50 respectively). Similar results were obtained for IGF-ⅠR (1.32±0.31, 2.01±0.72, 4.39±2.31 respectively). Conclusion　The expression of IGF-ⅠR correlated with the effects of gonadotropin hormone on follicular development.

Objective To compare clinical efficacy and complications of three operation methods for treating the localized and high risk prostate cancer.Methods From July 2006 to July 2010,102 cases with localized and high risk prostate cancer were included in the study.Among them,51 cases received open radical prostatectomy (Group A).Their characters included aged (63.7±7.9),PSA (31.8±6.6) μg/L,Gleason scores (8.5±0.5).In this group,T2c stage was diagnosed in 38 cases and T3a stage in 13 cases.32 cases received laparoscopic radical prostatectomy(Group B).Their characters included aged (64.4± 8.3),PSA (29.9±5.2) μg/L,Glcason scores (8.7±0.4).In this group,T2c stage was diagnosed in 21 cases and T3a stage in 11 cases.19 cases received 125I implantation (Group C).Their characters included aged (61.4± 7.4),PSA (30.6±.5.7)μg/L,Gleason scores (8.6±0.6).T2v stage was found in 8 cases and T3a stage in 11 cases.Operation time,amount of bleeding,hospitalization time,drainage time,gastrointestinal function recovery time,medical expenses and survival and recurrence rate in 1 year,3 years,5 years were compared within those groups.Results Operation time in three group were (232.6±38.4) min,(186.3±31.4) min,(35.4±14.6) min,respectively.Amount of bleeding in three group were (413.6±132.4) ml,(273.9± 77.4) ml,(19.4±4.4) ml,respectively.Hospitalization time in three group were (20.9±3.7) d,(15.6± 2.2) d,(6.4±2.6) d respectively.Drainage time in three group were (8.3±1.8) d,(7.5±0.9) d,(3.2± 0.8) d,respectively.Gastrointestinal function recovery time in three group were (4.1 ±0.6) d,(3.2± 0.4) d,(0.4±0.1) d,respectively.Medical expenses in three group were (23±4) thousand yuan,(32±3) thousand yuan,(45t3) thousand yuan respectively.All those items exhibited the significantly statistical difference (P＜0.05).The survival and recurrence rates had no significant difference during the follow-up in three groups.Conciusions Compared to the open radical prostectomy and laparoscopic radical prostectomy,particle implantation for prostate cancer had advantages in minimally invasive,less bleeding,short operation time,fast recovery and protection for Intestinal function.

OBJECTIVE：To explore the possible mechanism of astragalus in improving cardiac function.METHODS：To observe the effects of astragalus,added to basic anti-heart-failure therapy,on cardiac function and TNF in 45 cases of thronic heart failure.RESULTS：In comparison with basic therapy group,the improvement of cardiac function was more obvious and the level of serum TNF-α was lower in astragalus group.CONCLUSION：Astragalus probably has the action of decreasing TNF resulting in improvement of cardiac function.

OBJECTIVE:To discuss the correlation between Interntion Normalized Ratio(INR)with concentration of warfarin enantiomer and dose density after cardiac valve replacement. METHODS:The plasma concentration of R-warfarin or S-warfarin, dose of unit weight and INR of 176 patients with anticoagulation after cardiac valve replacement in each time point were moni-tored,and the correlation of INR and warfarin plasma concentration or dose was observed. RESULTS:Doses of all patients in 24-288 h were significantly higher than 0 h,the differences were statistically significant(P<0.001),the dose was fluctuated within a certain range after 96 h,and compared with 96 h,there were no significant differences(P>0.05). Average plasma concentration of R-warfarin or S-warfarin had consistent trend,plasma concentration of enantiomers was fluctuated within a certain range after 108 h,there were no significant differences(P>0.05). Compared with 0 h,there was no significant difference when INR was 12 h (P>0.05),it increased significantly in 36 h and had been increasing,then fluctuated within a certain range after 108 h,compared with 108 h,there were no significant differences(P>0.05). The correlation coefficient between INR and unit weight dose of warfa-rin in 60 h>36 h>12 h,it showed correlation(P<0.001). There was certain correlation between plasma concentration of warfarin and dose density in 12,36 and 60 h. CONCLUSIONS:The correlation between plasma concentration of warfarin and unit weight dose is stronger than the correlation between INR and unit weight dose. When combined with other coagulation,it may help to man-age warfarin dose.

Objective To explore the expressions of CK20, S100A7 and substance P (SP) in different stages of psoriatic lesions and their relationship. Methods A total of 19 patients, who had received irregular treatment for psoriasis and had both progressive and healed psoriatic lesions, were enrolled in this study. Skin tissue specimens were obtained from perilesional normal skin, progressive lesions and healed lesions of these patients and subjected to immunohistochemical analysis of expressions of CK20, S100A7 and SP. Results The relative expression level (absorbance value obtained from immunohistochemical analysis) was 7683.80 ± 6134.55,18305.04 ± 13171.30, 7257.53 ± 4417.75 for CK20, 8789.05 ± 6240.91, 18058.01 ± 16537.18, 9295.65 ±9310.02 for S100A7, 3242.51 ± 3775.41, 9364.98 ± 7596.64, 2910.85 ± 3349.46 for SP, respectively, in normal skin, progressive lesions and healed psoriatic lesions. A significant increase was observed in the expressions of CK20, S100A7 and SP in progressive lesions compared with normal skin and healed lesions, whereas no statistical difference was noted in those between normal skin and healed lesions (P ＞ 0.05 ). The expression of CK20 was positively correlated with that of S100A7 and SP (r = 0.779, 0.876, both P ＜ 0.05 ). Conclusion The pathogenesis of psoriasis seems to be associated with the changes in the number of Merkel cells.

Objective:To investigate the values of genetic polymorphisms of excision repair cross-complementation group 1 (ERCC1), thymidylate synthase (TS), glutathione-S-transferase P1 (GSTP1) and methylenetetrahydrofolate reductase (MTHFR) in predicting the prognosis of advanced esophageal cancer patients treated with cisplatin/fluorouracil chemotherapy.Methods:One hundred and seven patients with advanced esophageal cancer were enrolled in this study, 98 of which were eligible for analysis. All patients received cisplatin/fluorouracil chemotherapy repeated every three cycles. Genetic polymorphisms examined herein included those in the genes coding ERCC1, TS, GSTP1 and MTHFR. Then the relationships between genetic polymorphisms and response rate (RR) and progression free survival (PFS) time were analyzed. Results:The patients with A/A or A/C genotype in ERCC1-C8092A had a higher response rate and longer PFS than the patients with C/C genotype (P=0.010,P=0.008);the patients with 2R2R or 2R3C or 3C3C genotype in TS-5'UTR had a higher response rate and longer PFS than the patients with 2R3G or 3C3G or 3G3G (P=0.007,P=0.018). There was no significant relationship between RR and PFS and other genetic polymorphisms. Conclusion:The advanced esophageal cancer patients with A/A or A/C genotype in ERCC1-C8092A and/or 2R2R or 2R3C or 3C3C genotype in TS-5'UTR were more sensitive to cisplatin/fluorouracil chemotherapy.

Objective To compare the efficacy and safety of three different methods of laparoscopic common bile duct exploration (LCBDE).Methods The clinical data of patients with LCBDE treated in our hospital by the same surgeon from January 2010 to December 2012 were retrospectively analyzed.These patients were divided into three groups according to the 3 surgical methods:Group A:15 patients were treated with laparoscopic transcystic common bile duct exploration (LTCBDE).Group B:85 patients were treated with laparoscopic common bile duct exploration followed by primary duct closure (LCBDEPDC).Group C:20 patients were treated with laparoscopic common bile duct exploration and T tube drainage (LCBDE-TD).The study measured the TBIL,inner diameter of common bile duct,costs,length of operation,postoperative hospital stay,peritoneal drainage time,and operation-related complications.Results The operations were successfully carried out in the 3 groups of patients.When compared with group C,group A and group B had significantly shorter operative time,shorter postoperative hospital stay,shorter peritoneal drainage time,lower hospital costs,and earlier return to work (P＜0.05).The only significant difference between group A and group B was the peritoneal drainage time.There was no significant difference in the incidences of postoperative complications between the 3 groups (P＞0.05).Conclusions The three different methods of LCBDE had their own indications.LTCBDE was better than primary suture,and LCBDEPDC was better than T-tube drainage after laparoscopic common bile duct exploration.

Objective To investigate the preventive effect of postoperative pancreatic leakage by continuous invaginated pancreaticoenterostomy in pancraticoduodenectomy. Methods Twenty-twopancraticoduodenectomy procedures were performed by continuous invaginated pancreaticoenterostomy with 4-0 absorbable suture and the results were compared with those of 12 end-to-side invagination interrupted suture procedures and 23 pancreatic duct jejunum anastomosis procedures. Results All continuous invaginated pancreaticoenterostomy cases were performed successfully with the average time of 13 minutes, and one biliary leak occurred postoperatively; and there was no pancreatic anastomotic leak and no death. The mean hospital stay of the patients was 15 days. While the mean time of end-to-side invagination interrupted suture procedures was 20 minutes, one biliary leak and one abdominal infection occurred, and one patient died of abdominal bleeding. The mean time of pancreatic duct jejunum anastomosis procedures was 18 minutes, and one pancreatic leak and one upper gastrointestinal bleeding occurred. The mean postoperative hospital stay of these patients was 19 days. Conclusions Continuous invaginated pancreaticoenterostomy is applicable to any situation in the residual pancreas, and has the advantages of easy to operate, time saving and less complications, thus it is an effective improvement of pancreaticoenterostomy.