Objective To study the clinical outcomes of assistant treatment proposals for infertile women with polycystic ovary syndrome (PCOS). Methods PCOS patients were divided into four groups according to the assistant treatment proposals between Jan 2003 and Dec 2007 in Reproductive Medicine Center of the Provincial Hospital Affiliated to Shandong University. The four proposals were letrozole(LE) or clomiphene(CC) citrate ovulation induction group, in vitro fertilization and embryo transplantation group, ultrasound-guided immature follicle puncture group, and in vitro maturation and fertilization of oocytes from unstimulated cycles group. The treatment results were analyzed. Results (1) The ovulation rate was 66% (38/58) vs 47% (21/45). The mean endometrial thickness [ (0. 89±0. 13) vs (0. 78±0. 08) cm] and cervical mucus score (11.9±1.8 vs 9. 9±1.8 ) on the day of human chorionic gonadotropin ( hCG ) administration in LE group were both higher than that in CC group, while mature follicle ( 1.08±0. 28 vs 1.73±0. 59) and serum estradiol level [ (983±138) vs (1676±372) pmol/L] in LE group were lower than that in CC group(P <0. 05). (2) One southend five hundred and eighty-four patients accepted in vitro fertilization-embryo transplantation therapy because of PCOS (PCOS group) and 1615 patients because of tube factors (control group). The patients′ ages and infertility years were matched between the two groups. Total doses of Gn [ (980±1192) vs ( 1194±1389) IU] of PCOS group were lower than those of control group. The mean days of using gonadotropin [ (9.6±1.8) vs (9. 5±1. 8) d], serum estradiol (E2) levels on the hCG day [ ( 15 752±6206) vs (9675±4818) pmol/L], mean obtained oocytes (21±6 vs 9±3), mean fertilized oocytes ( 15±6 vs 7±3) and mean cleavaged oocytes ( 12. 9±5.7 vs 5.7±2. 8 ) of PCOS group were higher than those of the control group( P < 0. 05 ). Moderate and severe ovarian hyperstimulation syndrome (OHSS) rates (4. 86% vs 1.67% ) of PCOS group were higher than that of the control group. The pregnant rate (44. 7% vs 45.0% ) of PCOS group was similar to the control group ( P > 0. 05 ). (3) One hundred and nine PCOS patients were given ultrasound-guided immature follicle puncture therapy. After treatment, the testosterone level, luteinizing hormone (LH) level and LH/follicle stimulating hormone (FSH) ratio of the patients became normal. The basic follicle number decreased. (4) A total of 304 in vitro maturation cycles were performed. After embryo transfer, 76 pregnancies were reported. Conclusions There are many choices for the infertile patients with PCOS, such as LE or CC citrate ovulation induction, in vitro fertilization and embryo transplantation, ultrasound-guided immature follicle puncture, and in vitro maturation and fertilization of oocytes from unstimulated cycles. We can provide individualized treatment according to the medical treatment conditions, doctors′ professional capability and the patients′ situation.

Objective To study effect of drug treatment in polycystic ovary syndrome patients withhyperprolactinemia.Methods We retrospectively studied 63 women with polycystic ovary syndrome and hyperprolactinemia from the Reproductive Medicine Center,Provincial Hospital between January 2005 andMarch 2007.According to the beginning time of bromocriptine,all women were divided into two groups.Group Ⅰ was composed of 48 cases who received bromocriptine administration before induction of ovulation cycles,and the dose of bromocriptine was modulated depending on the level of serum prolactin.When serum prolactin was controlled at normal levels,we decreased the dosage of bromocriptine step by step(1.25 mgonce),and then continued the treatment at maintenance dosage for no less than 3 weeks.After a baselineultrasonographic examination on day 3,patients were treated with clomiphene citrate at a dosage of 100 mg (2 tablets/day)for 5 days of a normal cycle or progesterone-induced bleeding.On day 9,we monitored the growth conditions of follicles routinely with trans-vaginal uhrasound.If there was no dominant follicle,we added human menopausal hormone(hMG,75 U/d)to the protocol.Human chorionic gonadotropin(hCG,6000-10000 IU)was given intramuscularly when the mean diameter of a follicle reached at least 18 mm.At the same time we instructed the patients to have sexual intercourses or carried out artificial inseminationsbefore and after ovulation.Group Ⅱ were 15 cases in which induction of ovulations were commenced almostsimultaneously with beginning of bromocriptine.The same protocol was given to patients in group Ⅱ.The procedures of ovulation induction and the outcomes of treatment were analyzed and compared.Results Compared with groupⅡ.the days of using hMG in Group Ⅰ was shorter by instructing the time of sexualintercourse.The difference was significant(P=0.004).And there were similar results in the artificial insemination cycles(P=0.009).The rate of pregnancy in group Ⅰ(40%,19/48)was higher than that in groupⅡ(27%,4/15),but the difference was not obvious(P=0.525).Conclusion Bromocriptine administration before the stimulated ovulation therapy can decrease the total dosage and treatment course of ovulating drugs.Induction of ovulations simultaneously with start of bromocriptine therapy can shorten the treatment time of infertility.

Objective To dynamically monitor the base excess(BE) in traumatic brain injury(TBI) patients within 3 d after admission,and to assess the impact of the early BE on prognosis.Methods Blood BE was monitored for 3 d in 56 TBI patients.Patients were classified into mild group(15 patients),moderate group (22 patients) and severe group (19 patients) according to the scores of Glasgow coma scale(GCS).Patients were classified into survival group(42 patients) and dead group(14 patients) according to prognosis.Patients were classified into high BE group (35 patients,BE≥-8 mmol/L) and low BE group (21 patients,BE ＜-8 mmol/L).The relations among BE,degree of injury and prognosis were analyzed.Results The level of BE in mild group,moderate group and severe group was increased after treatment for 1,2,3 d than that before treatment.The level of BE was consistent with the degree of injury [mild group:(-3.02 ± 0.21)mmol/L; moderate group:(-8.49 ± 1.44) mmol/L;severe group:(-9.64 ± 1.19) mmol/L].The level of BE in mild group and severe group had significant difference than that in moderate group (P＜ 0.01).The level of BE in dead group before treatment and after treatment for 1,2,3 d was significantly lower than that in survival group [(-11.97 ±2.13) mmol/L vs.(-6.29 ± 1.16) mmol/L,(-9.84 ± 1.33) mmol/L vs.(-4.89 ± 1.78)mmol/L,(-8.78 ± 2.01) mmol/L vs.(-3.61 ± 1.43) mmol/L,(-7.84 ± 1.42) mmol/L vs.(-3.10 ±0.98)mmol/L] (P ＜0.01).The scores of APACHE Ⅱ before treatment and fatality rate in low BE group were significantly higher than those in high BE group [(24.84 ± 3.68) scores vs.(16.27 ± 2.21) scores,52.4％ (11/21) vs.8.6％(3/35)] (P ＜ 0.01).The scores of GCS before treatment in low BE group was significantly higher than that in high BE group [(7.56 ± 3.09) scores vs.(10.51 ± 2.43) scores](P ＜ 0.01).Conclusion The level of early BE is a good factor on evaluating the condition and prognosis in TBI patients.

Objective To explore the molecular mechanism of Atractylodes macrocephala in the treatment of Ulcerative colitis(UC)based on network pharmacology,and verify it with animal experiments.Methods The active components of Atractylodes macrocephala was screened from the TCMSP database,the TCM-ID database,and in combination with relevant references,and the corresponding targets were obtained through Swiss database.The relevant targets of UC were obtained from GeneCards database,construct the"drug-component-target-disease"network diagram and"pathway-active ingredient-target"network diagram and draw PPI network diagram;GO function enrichment analysis and KEGG signal pathway annotation analysis were carried out.Autodock software is used for molecular docking of active components and targets.Then,the experimental validation of the network pharmacology prediction was carried out.The mouse UC model was induced by dextran sodium sulfate(DSS).The pathological changes of the colon tissue,the number of goblet cells,and the positive expression of inflammatory factorswere detected by HE staining,AB-PAS staining and immunohistochemistry in colon tissue of UC mice.Results The results have shown 30 active ingredients including atractylolactone I,II and III were screened,and 591 corresponding targets were obtained,of which the key target was IL-1β、TNF-α and so on.Molecular docking show that the core components had good binding affinity with the key targets.And the results of animal experiments showed that the alcohol extract of Atractylodes macrocephala could significantly increase the colon length,reduce the DAI score,improve the pathological changes of colon tissue of UC mice,increase the number of goblet cells,and inhibit the expression of IL-1β,TNF-α in colon tissue.Conclusion This study indicated that Atractylodes macrocephala could regulate the release of inflammatory factors through multiple components,multi-target and multi-channel,which could inhibit inflammatory reaction and play a role in improving UC.