Objective To evaluate the effect of metformin in treating adolescent polycysfic ovary syndrome (PCOS).Methods Group A [ the metformin and medroxyprogesterone acetate (MPA) group ] was made of 135 adolescents with PCOS taking metformin,and MPA if no menstruation came,while group B ( the control group) consisted of 45 patients taking MPA every two months.Endocrinologic profiles and ovulation were evaluated before and after six months treatment.Results ( 1 ) All patients suffered from anovulation before treatment.( 2 ) Ovulation failure was successfully improved in 74.81％ ( 101/135 )of patients in group A after 6 months,which was significantly higher than that before treatment.In group B,no case recovered ovulation.(3) In group A,fasting serum insulin,homeostasis model assay for insulin resistance ( HOMA-IR),total testosterone,LH were significantly decreased.(4) The retrieval of ovulation was negatively correlated with fasting insulin and HOMA-IR ( both P＜0.05 ). Conclusions ( 1 ) Metformin effectively improves ovulation function and reproductive endocrine parameters in adolescent girls withPCOS.(2) Recovery of ovulation is associated with the decrease of serum insulin.

Objective To analyze the occurrence of insulin resistance ( IR ) and abnormal glucose metabolism in adolescent polycystic ovary syndrome (PCOS). Methods PCOS group included 141 patients aged 15-19 years old, who were diagnosed as PCOS according to criteria by reference to the European Society of Reproduction and Embryology/American Society for Reproductive Medicine proposed in 2003, at Rotterdam; and 266 age-matched female students,with regular menstrual cycles and no family history of diabetes, were enrolled in control group. Fasting insulin(FINS),fasting plasma glucose(FPC) ,and homeostasis model assessment for insulin resistance ( HOMA-IR) were measured in control group. 73% percentile value of control group was set as physical upper limits of FINS and HOMA-IR. PCOS patients were divided into obese ( OB-PCOS) and non-obese (NOB-PCOS) groups, and oral glucose tolerance test(OGTT) were performed. Results According to 75% percentile value of control group,the physical upper limits of FINS and HOMA-IR were 13.13 mIU/ L and 2.69, respectively. FINS and HOMA-IR values in PCOS group were higher than those in control group [ (17.68±16. 13 vs 10.40±5. 33)mIU/L,2. 64±2.01 vs 2. 01 ±1. 61,both P<0.01]. FINS and HOMA-IR values in OB-PCOS group were higher than those in the NOB-PCOS group [ (22.04± 18.01 vs 13.06± 12. 60) mIU/L,4. 62±3. 87 vs 2.38±2.26,both P<0.01]. In PCOS group,FINS of 75 cases(53.19% )and HOMA-IR of 67 patients(47.52% ) exceeded the physical upper limits. In 79 OB-PCOS patients, FINS of 56 cases (70. 89% ) and HOMA-IR of 52 patients (65.82% ) exceeded the physical upper limits while in 62 NOB-PCOS patients there were 19(30.65% ) and 15 (24. 19% )patients. In PCOS group,2(1.42% ) patients were diagnosed diabetes mellitus,and both FINS and HOMA-IR of these two cases increased. Meanwhile, 12 cases(8.51% ) were impaired glucose tolerance(ICT) ,of whom 11 patients FINS and HOMA-IR increased. Conclusion Pathological IR is prevalent in adolescent PCOS, more severe and popular in obese-PCOS, a part of them with abnormal glucose metabolism.

In order to meet the needs of training targets of medical higher occupational education.the construction and management of labs was explored.The lab construction developed rapidly,and lab management was further standardized to become more scientific.The whole benefits of labs were improved.These offered powerful support of quality to practical teaching and culture of skilled talents.

Self-efficacy is the extent or strength of one′s belief in one′s own ability to complete tasks and reach goals. Self-efficacy affects every area of human endeavor. By determining the beliefs a person holds regarding his or her power to affect situations, it strongly influences both the power a person actually has to face challenges competently and the choices a person is most likely to make. In this paper, the factors affecting self-efficacy, the effects of self-efficacy, the application range and interventions of self-efficacy in clinical disease management are reviewed. It has great significance in the improvement of ability of disease management,disease prognosis and quality of life by lifting the self-efficacy.

Objective To investigate the influence of a multifaceted stroke telehome-care (THC) on extremities function, activities of daily living (ADL) and quality of life in stroke patients with hemiplegia. Methods A total of 52 stroke survivors in department of neurology were randomized to the THC intervention or usual care. The patients in the control group received conventional care, while those in the intervention group were additionally given a THC program over 3 months. The THC intervention includes motor imagery and adaptive strategies. Data collection was undertaken using the Fugl-Meyer Motor Assessment Scale (FMA), the Barthel Index (BI), the Stroke Impact Scale (SIS) at baseline, 3 months, and 6 months. Results At baseline, the scores of FMA, BI, and SIS in the intervention group were 53.62 ± 23.52, 54.04 ± 17.44, 179.96 ± 28.51, and while the scores of the control group were 50.96 ± 19.52, 49.46 ± 15.09, 169.23 ± 28.48. There were no pre-existing differences on any scale between the two groups (t=0.443, 1.012, 1.358, P > 0.05). At 3 months, the scores of FMA, BI, SIS in the control group were 53.54 ± 17.45, 50.77 ± 14.47, 76.19 ± 27.78, and were significantly lower than 78.38 ± 12.54, 74.62 ± 11.22, 228.54±22.63 in the THC group (t=5.895, 6.641, 7.449,P<0.01). At 6 months, the scores of FMA, BI, SIS in the control group were 57.88±17.89, 59.08±13.85, 183.92±26.56, and were significantly lower than 90.58 ± 9.60, 86.54 ± 9.88, 252.19 ± 20.10 in the THC group (t=8.211, 8.233, 10.451, P < 0.01). Conclusions A telehome-care program that provide distance training and education of disabled persons resulted in greater improvements in physical functioning, ADL and quality of life.

Objective To investigate the status of anxiety,depression and self-efficacy, social support among patients with severe burns and analyze their correlation. Methods Eighty-four patients with severe burns were selected by convenience sampling. They were evaluated by Hospital Anxiety and Depression scale (HADS), General Self-efficacy Scale (GSES) and Social Support Assessment Scale (SSAS) and the correlation of two scales was analyzed. Results The anxiety score was 6.62 ± 3.98, depression score was 7.63 ± 4.36, self-efficacy score was 20.94 ± 4.96 and the social support score was 41.40±6.47;Self-efficacy was negatively correlated with the anxiety (r=-0.356, P<0.05) and depression (r=-0.362, P<0.05). Social support was also negatively correlated with the anxiety (r=-0.305, P<0.05) and depression (r=-0.320, P<0.05). Conclusions There is a medium level of anxiety and depression among patients with severe burns. Psychological interventions via increasing the self- efficacy are suggested for the patients with severe burns in the future.

ObjectiveTo understand the urban preference for outpatient pre-registration in large hospitals,and probe into the influencing factors,for recommendations to improve outpatient preregistration at the hospitals.Methods With Nanjing City as an example,the authors used tailoreddesigned questionnaire and qualitative interviews to investigate the preference of 1200 households of local residents regarding outpatient clinical pre-registration service at the tertiary hospitals.Results Age,education and economic factors are found to be the most important influential ones for urban preference in their outpatient pre-registration at large hospitals.Other factors include traditional approaches to outpatient clinic,inconvenience for outpatient pre-registration,and concerns for appointment breaking.Conclusion in order to increase their preference for outpatient pre-registration at large hospitals,hospitals should work to explore and improve approaches for outpatient pre-registration,and better their service quality,which will involve greater participation of both the hospital staff and residents.

Objective To investigate the effects of anticholinergic antidote and rhodosin on the brain injury induced by soman intoxication combined with hypobaric hypoxia in rats. Methods A total of 72 Wistar rats were divided into 4 groups: hypoxia control (HC), hypoxia plus soman (HS), hypoxia plus soman plus anticholinergic antidote (HSAA), and hypoxia plus soman plus anticholinergic antidote plus rhodosin (HSAAR). The animals after soman intoxication (72 ?g/kg) were placed in a hypobaric (62 kPa) apparatus for hypoxic exposure for 48 h. Rats were sacrificed for brain tissue detachment at the time points of 12, 24, and 48 h. Evans blue (EB) content and PLA 2 activity were detected biochemically. CaM concentration was determined by radioimmuno assay. Results Compared with the rats in HC, soman induced significant increases of brain EB, PLA 2, and CaM at 12, 24, and 48 h in HS. Elevated EB, PLA 2, and CaM induced by hypoxia and soman intoxication in rats in group HSAA were obviously attenuated by anticholinergic antidote. More significant decreases of brain EB, PLA 2, and CaM were found in rats in group HSAA. Conclusion Both anticholinergic antidote and anticholinergic antidote plus rhodosin have the preventive effect on rat brain damage induced by soman intoxication combined with hypoxia.

Objective To investigate the effect of home-based motor imagery training on the lower extremity motor function,balance ability and activities of daily living in post-stroke patients. Methods Fifty-six stroke survivors were divided into the control group and the intervention group by random number table method.All the patients got the conventional nursing, rehabilitation booklets and the video tapes which contained physical therapy and occupational therapy. Furthermore, the patients in the intervention group received 6 weeks motor imagery (MI) therapy through an instant messaging client (Tencent QQ), three times a week, 30mins per time. The outcomes were measured before discharge (T0), immediately after the intervention (T1), and 6 weeks (T2) after the intervention using the Fugl-Meyer Motor Assessment Scale (FMA), Berg Balance Scale (BBS), Barthel Index (BI). Results At baseline, the scores of FMA、BBS、BI in the intervention group were (15.12 ± 4.19), (24.50 ± 2.72), (54.04 ± 17.44) points, while in the control group were (14.23 ± 3.67), (23.92 ± 2.82), (49.46 ± 15.09) points. There were no differences on any scale between the two groups at baseline (t=0.810, 0.750, 1.012, P>0.05). At 6 weeks,the scores of FMA, BB, BI in the control group were (14.81 ± 3.50), (29.31 ± 2.43), (50.77 ± 14.47) points, and were significantly lower than (17.38 ± 4.10), (37.38 ± 4.30), (74.62 ± 11.22) pointsin the interventiongroup (t=2.438, 8.326, 6.641, P<0.05 or 0.01). At 12 weeks, the scores of FMA, BB, BI in the control group were (15.54±3.44), (32.35±1.98), (59.08±13.85) points, and were significantly lower than (18.58±4.19), (41.19±3.96), (86.54± 9.88) points in the intervention group (t=2.858, 10.189, 8.233, P<0.01). A main effect of intervention (F=4.158, 63.716, 30.379, P < 0.05) and an interactive effect of time and intervention (F=47.941, 61.029, 29.685, P=0.000) were observed in the model of FMA, BBS, BI using ANOVA of repeated measures. The factors were compared with each other and the difference was statistically significant (P=0.000). Conclusions The home-based MI training can improve the lower extremity motor function, balance ability and activities of daily living in patients with stroke.

Objective To observe the protective effect of asiatic acid on hyperlipidemia golden hamsters induced by high fat diet and explore its mechanism.Methods Hyperlipidemic golden hamsters fed with high-fat diet were administered orally with asiatic acid (8,16,32 mg/kg)for 4 weeks.Levels of serum lipid content,liver histology,hepatic GSH-PX and SOD levels,serum ALT and AST activities were evaluated in golden hamsters,fluorescence quantitative polymerase chain reaction(RT-PCR)is using to examine the liver lecithin cholesterol fatty acyl transferase(LCAT) and class B typeⅠscavenger receptor(SR-BⅠ)mRNA expression. Results Compared with model group,the levels of TC,TG,LDL-C,TC/HDL,ALT and AST in low and mediate asiatic acid groups were all significantly decreased but the levels of SOD and GSH-PX were significantly increased(P<0.01).HE staining results showed that fat deposition in the liver were improved by administration of asiatic acid,and the expression of LCAT and SR-BⅠmRNA were increased.Conclusion Asiatic acid can effectively reduce blood lipid levels,and alleviate liver damage of the hyperlipidemia golden hamsters by lipid regulation and antioxidative ability augmentation.The increased levels of LCAT and SR-BⅠmRNA expression maybe involved in the mechanism of hypolipidaemic effect of asiatic acid.