PCOS is a highly prevalent disease in modern women of gestational age, characterized by infertility. Prevention before onset has been a key focus of national efforts in recent years. This article explored the prevention and treatment plan for polycystic ovary syndrome based on the three-level prevention theory of Academician Wang Qi. Primary prevention: control pathogenic risk factors; secondary prevention: precise screening and life intervention to prevent the formation of dangerous constitution; third level prevention: differentiation of body-differentiation of disease-differentiation of syndrome to achieve the goal of three-level prevention. In the prevention and treatment of PCOS, pre-disease prevention, post disease prevention and cure are tried to achieve, which could provide a truly effective, easy to operate, and applicable three-level prevention and treatment plan for a large population in clinical response to PCOS.

Bronchial asthma(asthma)is a common clinical respiratory disease mediated by multiple cells and components,and neutrophils,as one of the classic innate immune cells,play an important role in the pathogenesis of asthma.In the inflammatory state,neutrophils release neutrophils extracellular trap(NET)into the periphery through the NETosis procedure.Although NET is a beneficial antibacterial defense structure,its excessive accumulation can trigger different response mechanisms that can also adversely affect the lungs and exacerbate asthma.Based on the basic principles of traditional Chinese medicine constitution,exploring the important role of NET in the pathogenesis of asthma,it holds that the life process theory body-spirit composition theory,endowment inheritance theory,and environmental constraint theory are related to the gradual formation of NET and different stimuli affect the heterogeneity of NET,thereby mediating different biological effects during the onset of asthma.Targeting NET and/or its components may become a new treatment strategy on asthma.

AIM:To study the effect of hepatitis B combined with hepatic fibrosis on endogenous and exogenous metabolism of liver and the effect of glycyrrhizic acid combined with tenofovir(TFV)es-ter on anti-HBV efficacy.METHODS:Hepatitis B mouse was induced by chronic CCI4 to form a mod-el of hepatitis B with hepatic fibrosis.H&E staining,Sirius Red Staining,α-SMA immunohistochemistry were used to detect pathological changes in liver tissue.The changes of liver endogenous metabo-lism in mice with hepatitis B and hepatic fibrosis were detected by metabolomics.LC-MS/MS was used to investigate the plasma and liver concentra-tions of TFV and its active metabolite(TFV-DP),for investigating the changes of exogenous metabo-lism.RESULTS:HBV+CCl4 mice showed fibrosis symptoms such as liver injury and collagen deposi-tion.Hepatitis B combined with hepatic fibrosis af-fected nucleotide metabolism,amino acid metabo-lism,tricarboxylic acid cycle,pentose phosphate pathway and other endogenous metabolism,low-ered the hepatic level of TFV-DP,and decreased the antiviral efficacy.By combining with glycyrrhizic acid or forming a self-assembled preparation,the hepatic level of TFV-DP was improved,and the anti-viral efficacy was enhanced.CONCLUSIONS:Hepati-tis B combined with hepatic fibrosis affected both endogenous and exogenous metabolism of liver.Different forms of combination of glycyrrhizic acid and TFV could elevate the level of TFV-DP in liver and improve the antiviral efficacy in HBV+CCI4 mice.

OBJECTIVE To investigate the eff ects of different habitat processing methods on the quality of Cyperus rotundus ， such as sun-drying after steaming ，sun-drying after boiling and direct sun-drying ，and to investigate the optimal habitat processing method of C. rotundus from the perspective of chemical component. METHODS The fingerprint of C. rotundus was established by high performance liquid chromatography （HPLC）combined with the Similarity Evaluation System for Chromatographic Fingerprint of TCM （2012 edition）. The similarity evaluation was conducted to determine the common peak. Cluster analysis （CA）combined with principal component analysis （PCA）and partial least squares-discriminant analysis （PLS-DA）was used to differentiate and compare C. rotundus treated by different habitat processing methods. And the contents of cyperrenone ，α-cyperone，luteolin and ferulic acid in C. rotundus were determined by HPLC. RESULTS There were 22 common peaks in the HPLC fingerprints of C. rotundus reated by different habitat processing methods ；their similarities were higher than 0.9；common peak 16 and common peak 20 were cyperrenone and α-cyperone. CA results showed that C. rotundus boiled for 4，8 and 12 min were clustered into one category，the rest of the samples clustered into one category. PCA results showed that comprehensive score of C. rotundus steamed for 10 and 15 min and boiled for 2 min were the highest. The steaming treatment had small effect on comprehensive score of samples，while the boiling treatment had a great effect on the quality of the samples ；the overall score of samples decreased sharply after boiling for 2 min. Results of PLS-DA showed that variable importance projection （VIP）of peak 20（α-cyperone），peak 16 （cyperrenone），peak 22，peak 17 and peak 22 in HPLC fingerprints were all higher than 1. The results of content determination showed that there was significant difference in the contents of α-cyperone，cyperrenone and luteolin in samples treated by different habitat processing methods.With the increase of steaming and boiling time ，the contents of α-cyperone，cyperrenone and luteolin showed a significant downward trend ，and boiling had a great impact on them. CONCLUSIONS Too long boiling treatment greatly；2019 destroys the chemical composition of C. rotundus ， andsteaming for 10，15 min or boiling for 2 min is the optimal processing method.

[Abstract] Objective: To investigate the effects of exosome originated from bone marrow mesenchymal stem cell (BMSCs) on proliferation, migration and invasion of prostate cancer PC-3 cell and its mechanism. Methods: qPCR was used to detect the expression level of miR-21-5p in prostate cancer cell lines. The morphology of exosomes isolated from BMSCs was observed with an electron microscope. Western blotting was used to detect the expressions of exosome surface markers and the epithelial-mesenchymal transition (EMT)-related proteins (E-cadherin, N-cadherin and Vimentin). Dual luciferase reporter gene experiment was used to detect the targeted regulation relationship between miR-21-5p and PH domain leucine-rich repeat protein phosphatase 2 (PHLPP2). PC-3 cells were co-cultured with 10 μl BMSCs exosomes suspension (Exo group), transfected with sh-PHLPP2 or antagomiR, then CCK-8 and Transwell experiments were used to detect changesinproliferation,migrationandinvasionofPC-3cell.Results: miR-21-5p was highly expressed in prostate cancer PC-3 cell line. The exosomes in the supernatant of BMSCs culture fluid were successfully isolated, and the typical vesicle-like structures of exosomes were observed under transmission electron microscope. Exosomes expressed specific proteins such as CD9, CD63 and CD81. In the Exo group, the proliferation, invasion, migration, as well as the expressions of N-cadherin, Vimentin and miR-21-5p in PC-3 cells were significantly higher than those in the control group (all P<0.05). PHLPP2 is a target gene of miR-21-5p. Compared with the control group, the expression of PHLPP2 in PC-3 cells of Exo group and sh-PHLPP2 group was significantly reduced (0.66±0.09, 0.42±0.05 vs 1.09±0.08, all P<0.01); cell viability, invasion and migration were significantly improved (all P<0.01); and E-cadherin expression level was significantly reduced while N-cadherin and Vimentin expressions were significantly increased (both P<0.05). Conclusion: miR-21-5p is highly expressed in prostate cancer PC-3 cell line. BMSC exosome miR-21-5p can increase the proliferation, migration and invasion ability of PC-3 cells through targeted down-regulation of PHLPP2.

Objective To compare two operative approaches for treatment of distal hypospadias. Methods One hundred and seven patients were recruited into the study. Group1(n=51) underwent OUPF and group2(n= 56) underwent TIPU repair. The results were analyzed with Chi-square and two Sided test. Results Operative times for OUPF and TIPU repair were (103±29) min and (92±21)min respectively (P>0.05). Fistula occurred rates were 7.8% (4/51)and 14.2% (8/56) (P>0.05). Satisfied rates for the appearance of the penis post-operation were 84.8% (39/46)and 87.8%(36/41) respectively (P>0.05). 87 patients were followed up. With mean follow-ups of 15 months (range 6 to 47) , the overall complication rates were 15.7% (8/51) and 32.1 % (18/56)(P<0. 05) for OUPF and TIPU repair. Only 4 of 51 patients (7.8%) undergoing OUPF underwent re-operations, compared to 15 of 56 patients (26.8%) undergoing TIPU repair (P<0.001). A plateau uroflow curve (vs normal bell curve)was observed in 33.3% (13/39)and 67.6(25/37) ,respectively(P<0. 001). The average flow rate was 9. 4 ml per second (range 3. 2 to 17. 1) in patients undergoing OUPF repair, compared to 6. 8 ml per second (3. 3 to 15, P<0. 05) for those undergoing TIPU repair. Mean peak flow rates were12.2 ml per second (range 3.9 to 22.9) and 8. 3 mi per second (range 3.7 to 18. 1, P<0.01) for OUPF and TIPU procedures. Conclusion OUPF is superior to TIPU in the surgical treatment of distal hypospadias.

Objective To evaluate the features of pelvic lymph node metastasis and the significance of lymph node dissection in bladder cancer patients treated with radical cystcetomy. Methods The data of 77 bladder cancer patients(58 males and 19 females with mean age of 57 yrs)treated with radical eystectomy and pelvic lymph node dissection from Jan. 1990 to Dec.2008 were analyzed retrospectively.Preoperative TNM staging showed stage T1 tumor of 9 cases,stage T2 of 24 cases,stage T3 of 39 eases and stage T4 of 5 cases.The pelvic lymph nodes were divided into 5 groups according to the anatomic sites.The metastatic rate and dissected lymph node positive rate in these patients were compared. Results The metastatic rate and dissected lymph node positive rate were 27.3%(21/77)and 14.8%(233/1576),respectively.The metastatic rate in these patients from higher to lower were as follows:obturator group 19.5%(15/77),internal iliac group 19.3%(11/57),external iliac group 13.7%(10/73),common iliac group 5.3%(3/57)and presacral group 3.8%(1/26),with a significant difference in those groups,P<0.01.The dissected lymph node positive rates from higher to lower were as follows:external iliac group 23.0%(83/361),obturator group 22.1% (103/467),common iliac group 9.5%(17/179),internal iliac group 6.8%(28/411)and presacral group 1.3 % (2/158), with a significant difference in those groups, P<0.01. There was no metastasis in 9 eases with stage T, tumor. Conclusions In the radical cystectomy for the treatment of bladder cancer, it is suggested that the regional lymph nodes with higher metastatic rate should he resected accordingly, and the group with a higher metastatic rate should be dissected completely. The operation extent may be adjusted according to the result of sentinel lymph node biopsy in the obturator or presacral groups. The pelvic lymphadenectomy is not suggested in the cases of stage T1 tumor.

Objective To describe the retroperitoneal laparoscopy-assisted Anderson-Hynes dismembered pyeloplasty with small incision for the treatment of ureteropelvic junction obstruction (UPJO) and to evaluate its clinical effect. Methods Twelve cases of UPJO (8 men and 4 women;age range,5-48 years) underwent retroperitoneal laparoscopy-assisted, small incision,dismembered pyeloplasty.Of them,4 cases had severe hydronephrosis;6,intermediate;and 2,mild by B-ultrasound and urography.Nine cases had good IVU imaging and 3 had poor IVU imaging. Results All the procedures were successful.The operative time was 100-180 min (mean,127 min);the blood loss was 30-100 ml(mean,70 ml) and the postoperative hospitalization was 5-8 d (mean,5.6 d).No perioperative complication occurred.Follow-up of 3-12 months by intravenous urography and B-ultrasound showed no stricture at UPJ,and hydronephrosis was remitted and renal functions were improved. Conclusions Retroperitoneal laparoscopy-assisted Anderson-Hynes dismembered pyeloplasty with small incision is a feasible,minimally invasive and effective way to treat UPJO with less morbidity and shorter convalescence.

Objective To evaluate the feasibility of laparoscopically assisted dismembered pyeloplasty without the V-flap reconstruction.Methods A total of 13 cases of ureteropelvic junction obstruction(UPJO) underwent laparoscopically assisted dismembered pyelopasty via a small incision through the retroperitoneal approach without the V-flap pyeloplasty technique.After exposing the proximal ureter and renal pelvis to identify the UPJ obstruction,the UPJ area is then excised and the apex of the ureter is then anastomosed to the most inferior aspect of the renal pelvis. Results All the operations had been successfully completed.The operating time was 100~180 min(mean,121 min),and the intraoperative blood loss,30~100 ml(mean,70 ml).Follow-up for 3~20 months(mean,12.3 months) in 12 cases revealed a full recovery of renal functions and disappearance of hydronephrosis.Conclusions Laparoscopically assisted dismembered pyeloplasty without the V-flap reconstruction is feasible in the treatment of UPJO.

Objective To summarize the complication of clinical characteristics, factors causing misdiagnosis, and diagnosis of large intestine tuberculosis (LIT). Methods The data of twenty cases of LIT misdiagnosed preoperatively in our hospital were analyzed retrospectively. The difficulties of LIT diagnosis and management were studied and analyzed. Results Abdominal pain, mass, and the alteration of stool habit were the most common symptoms. LIT was most commonly confused with malignant tumor, Crohn's disease, and periappendicular abscess. Ten of 17 patients, who were performed exploratory laparotomy, were misdiagnosed as tumor or Crohn's disease. Most of our cases were not definitively diagnosed until the histopathologic examination after surgery. Three cases were diagnosed by other methods. Gastrointestinal X ray series, colonoscopy, endoscopic fine needle aspiration cytology(FNAC) and laparoscopic exploration may improve the diagnosis. Exploratory laparotomy with biopsy was the final procedure for diagnosis. Final diagnosis mainly depends on histology. Conclusions LIT lacks special clinical manifestations and has a high misdiagnosis rate. But if correct diagnosis is established, most patients can be cured and unnecessary exploratory laparotomy can be avoided. Six months antituberculosis treatment is effective for LIT whether the lesion is excised or not.