Objective:To detect the levels of sex hormones and insulin in follicular fluid(FF)and the expression level of phosphatase and tensin homolog deleted on chromosome ten(PTEN)in granulosa cells in the infertile patients with polycystic ovary syndrome(PCOS),and to preliminarily explain the correlations between the insulin level and the expression level of PTEN mRNA.Methods:Seventy infertile patients were selected as the subjects and divided into PCOS group and control group(tubal obstruction or infertility due to male factors)according to infertility factors.All patients received in vitro fertilization-embryo transfer(IVF-ET)treatment.FF and ovarian granulosa cells were collected on the day of ovulation.The expression levels of PTEN mRNA in ovarian granulosa cells of the patients in two groups were detected by real-time fluorescence quantitative PCR(RT-qPCR)method.The levels of sex hormone and insulin in FF were measured by electrochemiluminescence.The correlations of the PTEN mRNA expression level in ovarian granulosa cells and testosterone(T)in FF with the level of insulin in FF were analyzed by Spearman correlation analysis method.Results:There were no significant differences in age,infertility years,body mass index(BMI),basic sex hormone,total dose of gonadotropin(Gn)and days of ovulation induction in two groups(P＞0.05).Compared with control group,the anti-Mullerian hormone(AMH)and antral follicle counting(AFC)of the patients in PCOS group were significantly increased(P＜0.05).The RT-qPCR results showed that the PTEN mRNA expression level in ovarian granulosa cells of the patients in the PCOS group was higher than that in control group(P＜0.001).The electrochemiluminescence results showed that the levels of T and insulin in FF of the patients in PCOS group were higher than those in control group(P＜0.05),whereas the estrogen and progesterone levels were lower than those in control group(P＜0.05).The Spearman correlation analysis showed that that T level in FF was positively correlated with the insulin level of the patients in PCOS group(r=0.577,P＜0.001),and the PTEN mRNA expression level in ovarian granulosa cells was positively correlated with the insulin levels in FF(r=0.616,P＜0.001);in control group,there was no correlation between T level and insulin level in FF(r=0.266,P=0.123),and there was no correlation between the expression level of PTEN mRNA in granulosa cells and the insulin level in FF in control group(r=-0.214,P=0.216).Conclusion:The high expression of PTEN in granulosa cells of the infertile patients with PCOS may be related to the local hyperinsulin level in the ovary,and PTEN participates in the occurrence and development of PCOS.

Objective To study the effects of bundles of care on complications and unplanned extubation rate of neonatal in PICC .Methods 116 cases of neonatal which didn′t accept the bundles of care ware group A ,the other 93 cases of neonatal which accepted the bundles of care ware group B .Two groups were observed and compared on the incidence of complications and un-planned extubation rate and so on .Results The complications in A group treatment were 70 cases(60 .3% ) ,while there were 25 ca-ses in group B(26 .9% ) ,the group B was significantly lower than the group A (P<0 .05) .Mechanical phlebitis ,catheter occlusion , catheter ectopic and other aspects of ectopic group B were significantly lower than in group A (P<0 .05) .The rate of unplanned ex-tubation and catheter blockage in group B were significantly lower than A (P<0 .05) .The total rate of ectopic and right basilic vein ectopic rate in group B were all significantly lower in group A (P<0 .05) .Group B unplanned extubation rate and catheter blockage weresignificantlyloweringroupA(P<0.05).Gestationalagedidn′thaveimpactoncomplications(P>0.05),birthweightand catheter days had more impact on neonatal complications (P<0 .05) .Conclusion The cluster management can reduce the incidence of neonatal PICC complications ,reduce unplanned extubation rates ,better play the role of PICC ,try to arrange an experienced staff of medical operations for children of low birth weight newborns .