Objective:To exlplore the association between the baseline luteinizing hormone/follicle stimulating hormone (LH/FSH) ratio of polycystic ovary syndrome (PCOS) and in vitro fertilisation-embryo transfer outcomes.Methods:This was a retrospective cohort study. A total of 2 868 PCOS patients were enrolled, all of the participants were patients in The First Affiliated Hospital of Anhui Medical University Hospital from October 2015 to October 2021. Propensity score matching (1∶2.5) was conducted to regulate the non-random allocation of patients. Data were extracted from the hospital′s medical records. Patients with baseline LH/FSH ratio>2 were deemed as study group, patients with baseline LH/FSH ratio≤2 were deemed as control group. Single factor analysis was applied to compare the differences of pregnancy outcomes between two groups.Results:After propensity score matching (1∶2.5), there were no statistically significant differences in baseline data between the two groups (all P>0.05), indicating that the data were comparable. In the study group, the total dose of gonadotropin (Gn) and duration of Gn were lower than those of the control group ( t=4.989, P<0.001; t=3.267, P=0.001), the rate of in vitro maturation was higher than that of the control group ( χ2=4.938, P=0.026), the number of retrieved oocytes and cleavage were higher than those of the control group ( t=-2.305, P=0.021; t=-2.816, P=0.005), but there were no differences in the number and rate of high-quality embryos between the two groups ( t=-1.636, P=0.102; t=-0.123, P=0.902). The incidence of moderate to severe ovarian hyperstimulation syndrome in the study group was significantly higher than that in the control group ( χ2=17.277, P<0.001). Regardless of fresh embryo transfer or frozen-thawed embryo transfer cycles, the incidences of gestational diabetes mellitus in the study group were higher than those in the control group ( χ2=9.174, P=0.002; χ2=4.204, P=0.040) of singleton pregnancy. In the fresh embryo transfer cycle, the clinical pregnancy rate [30.30% (20/66) vs 47.75% (53/111)] and delivery rate [30.30% (20/66) vs 46.85% (52/111)] in the study group were lower than those in the control group ( χ2=5.198, P=0.023; χ2=4.695, P=0.030). In the frozen-thawed embryo transfer cycle, the delivery rate in the study group was higer than that in the control group [59.41% (423/712) vs 55.04% (1 053/1 913); χ2=7.526, P=0.023]. The clinical pregnancy rate and delivery rate of fresh embryo transfer cycle in the study group were significantly lower than those of frozen-thawed embryo transfer cycle ( χ2=21.308, P<0.001; χ2=20.871, P<0.001), but there were no significant differences in the control group (all P>0.05). Conclusions:PCOS patients with a higher basal LH/FSH ratio are more likely to develop moderate to severe ovarian hyperstimulation syndrome after controlled ovarian stimulation and have a higher incidence of gestational diabetes mellitus. Better pregnancy outcome could be obtained by frozen-thawed embryo transfer.

Objective:To investigate the relationship between sarcopenia and the maximum diaphragm excursion(Dmax)observed on ultrasound in the elderly.Methods:Elderly volunteers(age≥60 years)were recruited from family members of patients at Guangdong Provincial People's Hospital.Their Dmax during forced inhalation was measured via ultrasound.The parameters for the diagnosis of sarcopenia included the appendicular skeletal muscle mass index(ASMI), handgrip strength and usual gait speed.We compared the differences in physical characteristics, pulmonary ventilation, physical performance and Dmax between patients with and without sarcopenia, and evaluated the relationship between sarcopenia and DEmax in the elderly via linear regression.Results:A total of 145 elderly volunteers[age(69.47±5.15)years]were included, and 28(19.31%)were diagnosed with sarcopenia.Body weight, ASMI, maximum inspiratory pressure(Pinmax), maximal power output(Wmax)and Dmax of patients with sarcopenia were significantly lower than those of patients without sarcopenia(all P<0.05).Dmax in the elderly was correlated with sex, height, ASMI, handgrip strength, usual gait speed, Pinmax and Wmax( r=0.181, 0.130, 0.322, 0.373, 0.401, 0.134, and 0.388, P=0.012, 0.037, 0.009, 0.002, 0.022, 0.009, and 0.002, respectively).After adjusting for sex, age, height and forced vital capacity(FVC), there was still a negative correlation between sarcopenia and Dmax in the elderly( β=-0.310, P=0.021). Conclusions:Dmax is related to Pinmax and physical performance in the elderly, and sarcopenia increases the risk of decline in the maximum diaphragm excursion in the elderly as observed on ultrasound.

Objective:To investigate clinical efficacy and safety of dupilumab in the treatment of atopic dermatitis (AD) .Methods:An ambispective study was conducted on 123 AD patients treated with dupilumab in Department of Dermatology, the Second Xiangya Hospital of Central South University from July 2020 to March 2022, clinical data were collected, and efficacy and safety of dupilumab were evaluated. Primary outcomes included scores of eczema area and severity index (EASI) , patient-oriented eczema measure (POEM) , peak pruritus numerical rating scale (NRS) and dermatology life quality index (DLQI) before and after 4-, 8-, 12- and 16-week treatment, and adverse reactions and events were recorded. Comparison of scores before and after treatment was performed using paired t test or repeated measures analysis of variance, Mann-Whitney U test was used for the comparison of efficacy among patients with different types of skin lesions or different IgE levels, and multiple regression model based on robust standard errors was used to analyze factors influencing the efficacy. Results:Among the 123 AD patients, 107 were enolled into the efficacy analysis, and 85 (79.44%) completed at least 4 weeks of treatment, including 6 (7.06%) achieving EASI75 and 23 (27.06%) achieving EASI50, and the EASI, NRS, POEM, DLQI scores (10.41 ± 6.72, 4.12 ± 1.74, 8.60 ± 4.29, 7.81 ± 4.38, respectively) significantly decreased compared with those before treatment (18.08 ± 10.69, 7.21 ± 2.01, 16.88 ± 5.74, 12.95 ± 5.95, respectively; all P < 0.001) in the 85 patients. Among the 107 patients, 47 (43.93%) completed at least 16 weeks of treatment. Among the 47 patients, 23 (82.14%) of 28 adults and 17 (89.47%) of 19 adolescents and children achieved 75% or greater improvement in EASI score; the EASI, NRS, POEM and DLQI scores before the treatment all significantly differred from those 4, 8, 12, 16 weeks after the treatment (all P < 0.001) , and all the scores were significantly lower at weeks 4, 8, 12 and 16 than at the previous adjacent time points (all P < 0.05) . At week 4 during the treatment, the EASI improvement rate was significantly lower in the AD patients with prurigo nodularis than in those without ( U = 151.00, P = 0.006) , while there was no significant difference in the EASI improvement rate between the AD patients with xeroderma and those without ( P > 0.05) ; at week 16 during the treatment, there was no significant difference in the EASI improvement rate between patients with prurigo nodularis or xeroderma and those without (both P > 0.05) . Multiple regression analysis based on robust standard errors at week 16 showed that the improvement degree in the EASI score was not correlated with the type of skin lesions ( β = 3.20, P = 0.075) , but correlated with age ( β = -0.22, P = 0.030) , whether patients were in adulthood ( β = 9.54, P = 0.049) , immediate family history ( β = 7.46, P = 0.017) ; the improvement degree in the NRS score was correlated with the type of skin lesions ( β = 0.55, P = 0.032) , age ( β = -0.04, P = 0.033) , weight ( β = -0.05, P = 0.020) , whether patients were in adulthood ( β = 2.06, P = 0.003) and whether patients received combined treatment with antihistamines ( β = -1.91, P = 0.001) . Adverse reactions: among the 123 patients, 6 (4.88%) developed conjunctivitis, and 2 (1.63%) developed facial erythema. Adverse events: vitiligo-like changes occurred on the right forehead of 1 patient, and 3 patients discontinued the treatment with dupilumab due to Henoch-Sch?nlein purpura, distal axonal damage in peripheral nerves in both upper limbs, and epilepsy, respectively. The causal relationship between these adverse events and dupilumab was unclear. Conclusion:Dupilumab is effective in the treatment of AD with high overall safety, and can serve as a new treatment option for AD patients with an unsatisfactory response to traditional treatment.

Objective:To investigate the clinical features of drug-induced hypersensitivity syndrome (DiHS) and enhance the recognition of its diagnosis and treatment.Methods:Drug-induced hypersensitivity syndrome diagnosed in the Second Xiangya Hospital of Central South University in recent 6 years were retrospectively analyzed and summarized.Results:Of 35 cases of drug-induced hypersensitivity syndrome there were ten types of suspected drugs. Antibiotics were the most common allergy-inducing drug, followed by allopurinol, antiepileptics, and non-steroidal anti-inflammatory drugs. The expected clinical findings of DiHS were characterized by skin rash, fever, enlarged lymph nodes, which may be accompanied by eosinophilia, liver function damaged. The lesions of DiHS were variable and the majority of cases 65.71%(23/35) were characterized by eruptive papules.The main therapeutic approach of DiHS was systemic application of glucocorticoids and intravenous immunoglobulin (IVIG). When necessary its combination with immunosuppressant or hemoperfusion (HP).Conclusions:DiHS should be on the high alert when a patient with medication history, rash, high fever and lymph nodes large, accompanied by eosinophilia, liver function damaged. Predictors of good prognosis are early diagnosis and treatment.

Objective Bushen-Qingxin decoction combined conjugated estrogen tablets of modulation perimenopausal women osteoporosis patients, explore the impact of bone mineral density and bone metabolic markers. Methods A total of 160 female patients were recruited in our hospital by the random number table method, and were divided into the control group 80 cases and the observation group 80 cases. The control group was treated with standard dose of conjugated estrogen tablets, while the observation group was treated with Bushen Qingxin decoction on the basis of the control group. Both groups were treated 3 period with 28 days per period. The enzyme-linked immunity analyzer was used to detect serum bone-specific alkaline phosphatase (BALP), C-terminal cross linked peptide (CTX-Ⅰ), tartrate resistant acid phosphatase -5b (TRACP-5b) level, and the dual-energy X-ray absorptiometry measurement method was used to detect bone mineral density values. The clinical curative effect was compared between two groups. Results The total effective rate of the observation group was 91.3%, while the control group was 78.8%, which showed the difference was statistically significant (χ 2=3.971, P=3.971). After treatment, the serum BALP levels (88.55 ± 10.33 U/L vs. 80.47 ± 8.67 U/L, t=5.399) of the observation group were significantly higher than this of the control group (P<0.01). After treatment, the serum TRACP-5b (501.31 ± 35.77 pg/L vs. 538.51 ± 37.69 pg/L, t=6.498), CTX- (130.09 ±Ⅰ17.55 ng/ml vs. 164.71 ± 19.45 ng/ml, t=11.928) of the observation group were significantly lower than those of the control group (P<0.01). After treatment, the bone mineral density of the observation group rose up from the baseline (t=3.396, P=0.010). Conclusions The Bushen-Qingxin decoction combined conjugated estrogen tablets can increase on women in the menopausal transition of osteoporosis in patients with bone mineral density values and serum BALP levels, reduce serum TRACP-5b, CTX-Ⅰ level.

Objective To investigate the expression of FAM19A4 gene promotor methylation in different cervical lesions and its diagnostic value. Methods 31 cervical cancers cases ,22 HSILs and 23 normal cervical tissues of formalin-fixed and parrffin-embedded specimen diagnosed by pathology were selected. Taqman probe-based quantitative PCR(qPCR)was used to detect the differences of FAM19A4 methylation in different cervical lesions, and then corresponding analyses were made. Results Statistical differences of FAM19A4 methylationrates were observed in cervical caner ,HSIL and normalcervix,respectively96.8%(30/31),72.7%(16/22)and 8.7%(2/23) (P < 0.05 ).FAM19A4 methylation rates increased with severity of cervical lesion (P < 0.05).The methylation rates of FAM19A4 were not statistically different in different clinicopathological characteristics of cervical cancer (P>0.05). Conclusions FAM19A4 gene promoter methylation is probably a specific biomarker of cervical cancer,andmay play a role in the development and progress of cervical cancer,but may not participate in the invasion and metastasis.

Objective To study the expression and clinical correlation of miR-141 in peripheral blood and tumor tissue in elderly patients with rectal cancer.Methods Rectal tumor tissue and tumor-adjacent normal tissues were taken in 75 cases of rectal cancer.The expression levels of miR-141 in peripheral blood and tumor tissue as well as tumor-adjacent normal tissues were determined by real-time polymerase chain reaction method.The correlation of miR-141 expression between peripheral blood and tumor tissue,and the correlation of peripheral blood miR-141 with clinicopathologic features and clinical prognosis were analyzed.Results (1) Compared with peripheral blood in the subjects undergoing normal physical examination or tumor-adjacent normal tissue in the patients with rectal cancer,the miR-141 expression level in peripheral blood and tumor tissue in the patients with rectal cancer was decreased significantly (P<0.01).(2) The cancer tissue miR-141 level in the patients with lymph node metastasis was positively correlated with peripheral blood miR-141 level (r=0.694,P<0.01),and cancer tissue miR-141 level in the patients without lymph node metastasis was positively correlated with peripheral blood miR-141 level (r=0.725,P<0.01).(3) The differences between peripheral blood miR-141 level with tumor stage,tumor differentiation degree and lymphatic metastasis had statistical significance (P<0.01).(4)The postoperative 6-month follow up displayed that among 75 cases,13 cases(17.33%) appeared replase/ metastasis,and peripheral blood miR-141 level was (2.64±0.34),which was significantly lower than that in the patents without replase/metastasis (P<0.01).Conclusion Expression variation trend of miR-141 in peripheral blood is similar to that in tumor tissue,which can reflect the clinicopathologic feature in the patients with rectal patients.

Objective To observe the therapeutic effect of Shenluo'an Decoction(SD) for the treatment of obese patients with early diabetic nephropathy and to explore the possible mechanism.Methods A total of 68 obese patients with early diabetic nephropathy were randomly assigned into control group and treatment group,34 cases in each group.Both groups were given conventional western medicine treatment including lifestyle regulation,dietary control,and medicine for lowering blood pressure,blood glucose and blood lipids.Additionally,the control group was given oral use of Irbesartan,and the treatment group was given oral use of SD combined with Irbesartan.Before and after treatment,we observed the traditional Chinese medical syndrome scores,body mass index(BMI),blood levels of cystatin C (Cys C),β2-microglobumin(β2-MG),homocysteine (Hcy) and fasting blood glucose (FBG),and urine parameters of urinary monocyte chemoattractant protein-1 / urinary creatinine (UMCP-1/UCR),urinary factor of regulated on activation in normal T cell expressed and secreted / urinary creatinine (URANTES/UCR),urinary albumin-to-creatinine ratio (UACR) and urinary albumin excretion ratio (UAER) before treatment and after treatment for 16 weeks.After treatment,the clinical efficacy and safety were also evaluated.Results (1) During the treatment,5 cases were dropped out,and a total of 63 cases (32 from the treatment group and 31 from the control group) completed the experiment.(2) The total effective rate of the treatment group(90.6％) was significantly higher than that of the control group(67.7％),the difference being significant(P ＜ 0.05).(3)BMI of the two groups after treatment was significantly lower than that before treatment (P ＜ 0.05).(4) After treatment,the traditional Chinese medical syndrome scores,blood parameters (Cys C,β2-MG,Hcy,FBG) and urine parameters (UMCP-1/UCR,URANTES/UCR,UACR,UAER) in the treatment group were decreased as compared with those before treatment and those in the control group after treatment(P ＜0.05).(5) A positive correlation was present among the parameters of UMCP-1/UCR,URANTES/UCR,UACR and UAER.(6) No abnormal changes took place in the blood and stool routine examination,hepatic function,or electrocardiography of the 63 cases.Conclusion SD combined with western medicine exerts certain therapeutic effect for obese patients with early diabetic nephropathy,and is effective on relieving clinical symptoms anddecreasing BMI,Cys C,β2-MG,UACR,UAER,UMCP-1 and URANTES.Its mechanism is probably related with the inhibition of chronic renal inflammation.

Objective To investigate the change of CNP (C-natriuretic peptides) in patients with PCOS (polycystic ovary syndrome) undergoing in vitro fertilization-embryo transfer (IVF-ET) with GnRH-α longprotocol for controll ovarian hyper-stimulation(COH).Methods From March 2012 to September 2014,22cases patients with PCOS undergoing IVF-ET in the Reproductive Medical Center of the Center Hospital of JiangMen were selected as study group(Group 1),and 32 cases patients with normal ovarian reserve,the age younger than 35,and the number of oocytes retrieved more than 6 at the same period were selected as control group(Group 2).The level of serum CNP and estradiol(E2) on the day of human chorionic gonadotropin (HCG) and retrieving oocytes,the level of CNP and E2 in follicular fluid were analyzed.In additional,the levels of CNP and E2 in follicular fluid of different fertility and embryo quality were compared.Results (1) CNP and E2 on the day of HCG were significantly higher than that on the day of retrieving oocytes (CNPof Group 1:(107.21±78.55) μg/L vs.(73.01±55.99) μg/L,CNP of Group 2:(69.16±32.39) μg/L vs.(44.11±27.23) μg/L;E2 of group 1:(5231.38±1489.00) ng/L vs.(1985.52±662.54) ng/L,E2 of Group 2:(3678.45±969.57) ng/L vs.(1567.71±493.93) ng/L;t =2.968,2.752,8.147,14.567;P＜0.05).CNP and E2 on the day of retrieving oocytes and E2 on the day of HCG of Group 1 were higher than that of Group 2(t=2.866,2.227,2.173;P＜0.05).CNP in follicular fluid in Group 1 was higher than that in Group 2,but E2 of in follicular fluid in Group 1 was lower than that in Group 2 (t =2.244,-2.650;P＜0.05).(2) In Group 1,CNP and E2 in follicular fluid of normal fertility were lower than that of unnormal fertility,and E2 in follicular fluid of unnormal fertility were higher than that of no-fertility,and there were significant differences(t =-6.117,-2.374,2.760;P＜0.05).(3) In Group 2,only E2 in follicular fluid of unnormal fertility were higher than that of no-fertility,and there was significant difference(t=2.658,P＜0.05).(4) In 2 groups,CNP in follicular fluid of high-quality embryo were lower than that of non-high-quality embryo,and there was significant difference (t =-2.910,-2.029;P＜0.05).CNP in follicular fluid of non-high-quality embryo in Group 1 were higher than that in Group 2,but E2 in follicular fluid of non-high-quality embryo in Group 2 were higher than that in Group 1,and there were significant differences (t =2.141,-2.009;P ＜ 0.05).Conclusion There are differences in the change of CNP in the patients with PCOS and non-PCOS,and there are some deficiencies of the first meiosis in the patients with PCOS.