Objective To observe the clinical efficacy ofTong Yuan(short forTong Du Tiao Shen,Yin Qi Gui Yuan, referring to unblocking the Governor Vessel, regulating mind, and guiding qi back to the origin) needling method plus Letrozol and human chorionic gonadotropin (HCG) in treating refractory sterility caused by polycystic ovary syndrome (PCOS).Method Sixty clomiphene citrate-resistant PCOS-induced sterility patients were recruited and randomized into two groups. The treatment group was intervened byTong Yuanneedling plus Letrozol and HCG, while the control group was intervened only by Letrozol and HCG, both for 3 months. Prior to and after the treatment,the levels of estradiol (E2), follicle stimulating hormone (FSH), luteinizing hormone (LH), and testosterone (T) were detected; the endometrium, ovulation and pregnancy rates were also observed.Result After 3 menstrual cycles, the level of FSH increasedsignificantly (P<0.05), LH decreased significantly (P<0.05), LH/FSH declined significantly (P<0.05), and the level of T also dropped significantly (P<0.05) in both treatment group and control group; the level of E2also dropped significantly after the treatment in both groups (P<0.05), and the decrease in the treatment group was more significantly than that in the control group (P<0.05). The ovulation and pregnancy rates in the treatment group were significantly higher than those in the control group (P<0.05).Conclusion Tong Yuanneedling plus Letrozol and HCG can significantly down-regulate the levels of LH, E2and T, up-regulate the level of FSH, effectively improve the internal reproductive environment of refractory PCOS patients, and enhance the ovulation and pregnancy rates.

Epilepsy is one of the common diseases of nervous system, and its pathogenesis is complex. More and more attention has been paid to the role of glucose metabolism disorder in seizures. In recent years, the related researches are in the ascendant. In this paper, we summarize the different biochemical mechanisms that contribute to the disturbance in glucose metabolism in epilepsy patients, including glucose transport, glycolysis, aerobic oxidation of glucose, synthesis and decomposition of glycogen and glycolism.

OBJECTIVETo observe the clinical efficacy and action mechanism of acupuncture for ovulatory disorder infertility of ovarian induction period with clomiphene citrate (CC).

METHODSThrough retrospective analysis, 36 patients with ovulatory disorder infertility were divided into CC group (16 cases) and acupuoture group (20 cases) by method. The patients in the CC group were treated with oral administration of CC (50 mg) for 5 days from the 5th day of menstruation; based on the treatment of CC, patients in the acupuncture group were treated with acupuncture; the group A of acupoint was mainly consisted of acupoints of the conception vessel and the three meridians and front- acupoints in abdomen; the group B of acupoint was mainly consisted of acupoints of the governor vessel and back- acupoints. The two groups of the acupoints were selected alternately, combined with the -guan points (Taichong (LR 3)、Hegu (LI 4)) and five- points. The needles were inserted with flying needling method, and the needles were retained for 30 min per treatment; acupuncture was given once every other day. All the patients were treated for 2 months, and treatment stopped if pregnancy occurred. The pregnancy rate, cycle ovulation rate, maximum diameter of follicle, endometrial thickness and adverse effects were compared between the two groups.

RESULTSThe pregnancy rate of the acupuncture group was 75.0% (15/20), which was superior to 37.5% (6/16) in the CC group (<0.05). The cycle ovulation rates of two groups were 70.4% (19/27, >0.05). The maximum diameter of follicle and the endometrium thickness in the acupuncture group were superior to those in the CC group (both <0.05). The incidence of adverse effects in the acupuncture group was 0% (0/20), which was lower than 18.8% (3/16) in the CC group (<0.05).

CONCLUSION acupuncture combined with CC could improve the quality of follicle and the receptivity of endometrium in patients with ovulatory disorder infertility, so as to improve the pregnancy rate, which could be used as a safe and effective means to cooperate with modern assisted reproductive technology.

OBJECTIVES: Metformin is the basic drug for treating diabetes, and the plateau hypoxic environment is an important factor affecting the pharmacokinetics of metformin, but there have been no reports of metformin pharmacokinetic parameters in patients with diabetes mellitus type 2 (T2DM) in the high-altitude hypoxic environment. This study aims to investigate the effect of the hypoxic environment on the pharmacokinetics and assess the efficacy and safety of metformin administration in patients with Type 2 diabetes mellitus (T2DM). METHODS: A total of 85 patients with T2DM taking metformin tablets in the plateau group (n=32, altitude: 1 500 m) and control group (n=53, altitude: 3 800 m) were enrolled according to the inclusion and exclusion criteria, and 172 blood samples were collected in the plateau group and the control Group. A ultra-performance liquid chromatography/tandem mass spectrometry (UFLC-MS/MS) method was established to determine the blood concentration of metformin, and Phoenix NLME software was used to establish a model of pharmacokinetics of metformin in the Chinese T2DM population. The efficacy and serious adverse effects of metformin were compared between the 2 groups. RESULTS: The population pharmacokinetic modeling results showed that plateau hypoxia and age were the main covariates for model building, and the pharmacokinetic parameters were significantly different between the plateau and control groups (all P<0.05), including distribution volume (V), clearance (CL), elimination rate constant (Ke), half-life(T_1/2), area under the curve (AUC), time to reach maximum concentration (T_max). Compared with the control group, AUC was increased by 23.5%, T_max and T_1/2 were prolonged by 35.8% and 11.7%, respectively, and CL was decreased by 31.9% in the plateau group. The pharmacodynamic results showed that the hypoglycaemic effect of T2DM patients in the plateau group was similar to that in the control group, the concentration of lactic acid was higher in the plateau group than that in the control group, and the risk of lactic acidosis was increased after taking metformin in the plateau population. CONCLUSIONS Metformin metabolism is slowed down in T2DM patients in the hypoxic environment of the plateau; the glucose-lowering effect of the plateau is similar, and the attainment rate is low, the possibility of having serious adverse effects of lactic acidosis is higher in T2DM patients on the plateau than on the control one. It is probably suggested that patients with T2DM on the plateau can achieve glucose lowering effect by extending the interval between medication doses and enhancing medication education to improve patient compliance.
Humans ; Diabetes Mellitus, Type 2/drug therapy* ; Metformin/therapeutic use* ; Acidosis, Lactic ; Tandem Mass Spectrometry ; Hypoxia ; Glucose