Risk factors for polycystic ovary syndrome with nonalcoholic fatty liver disease / 临床肝胆病杂志

Polycystic ovary syndrome (PCOS) manifests as a series of disorders in reproductive system, endocrine, and metabolism, and there is a significant increase in the prevalence rate of nonalcoholic fatty liver disease (NAFLD) in the population with PCOS. At present, the risk factors for PCOS with NAFLD have not been fully clarified. This article introduces the research advances in PCOS with NAFLD from the aspects of hyperandrogenism, insulin resistance, obesity, dyslipidemia, chronic low-grade inflammation, and intestinal flora imbalance, so as to provide ideas and methods for improving the awareness and management of PCOS with NAFLD.

Risk factors for polycystic ovary syndrome with nonalcoholic fatty liver disease / 临床肝胆病杂志

Polycystic ovary syndrome (PCOS) manifests as a series of disorders in reproductive system, endocrine, and metabolism, and there is a significant increase in the prevalence rate of nonalcoholic fatty liver disease (NAFLD) in the population with PCOS. At present, the risk factors for PCOS with NAFLD have not been fully clarified. This article introduces the research advances in PCOS with NAFLD from the aspects of hyperandrogenism, insulin resistance, obesity, dyslipidemia, chronic low-grade inflammation, and intestinal flora imbalance, so as to provide ideas and methods for improving the awareness and management of PCOS with NAFLD.

Effect of indwelling drainage tube and extubation time on recessive hemorrhage and functional recovery after total hip arthroplasty / 中国骨伤

OBJECTIVE@#To study and compare the effect of indwelling drainage tube and extubation time on occult hemorrhage and functional recovery after total hip arthroplasty(THA).@*METHODS@#From July 2017 to June 2018, 123 patients who underwent THA in our hospital for the first time were selected as the subjects of study. According to whether the drainage tube was retained or not and the time of extubation, they were divided into three groups:in group A, 41 patients (24 males, 17 females, age 53 to 77 years) did not put drainage tube after THA;in group B, 41 patients were removed 24 hours after THA, 26 males and 15 females, aged 55 to 74 years;in group C, 41 patients were removed 48 hours after THA, 25 males and 16 females, aged 52 to 75 years. The VAS score of pain 72 hours after THA, the total and recessive blood loss, the time of starting functional exercise, and the incidence of postoperative limb swelling were recorded. All the patients were followed up for one year after discharge. Harris hip score was used to evaluate the degree of hip function recovery one year after operation.@*RESULTS@#The occult blood loss of group A, B and C were(513.6±25.3), (521.7±33.4), (519.3±29.8) ml, respectively, with no significant difference(>0.05). There was no significant difference in blood loss in operation among the three groups(>0.05). In group B and C, the postoperative apparent blood loss was more than that in group A (0.05). The time of getting out of bed in group A was shorter than that in group B and C (0.05). There was no significant difference in the incidence of complications among three groups (>0.05).@*CONCLUSION@#Whether the drainage tube is left or not and the time of extubation have no significant effect on the latent blood loss and functional recovery after THA, but without drainage tube after THA can reduce the apparent blood loss, patients can get out of bed at 6 hours after THA, which is more conducive to the recovery and nursing of patients.

Advances in vitamin D and microvascular complications of type 2 diabetes mellitus / 中国医师杂志

Increasing evidence suggests that vitamin D deficiency may play an important role in the pathogenesis of type 2 diabetes mellitus (T2DM).T2DM manifests as a result of insulin resistance,increased hepatic glucose production and β-cell failure.Vitamin D metabolites are thought to play an important role in increasing insulin sensitivity and facilitating insulin exocytosis which is mediated both by direct mechanism through the availability of vitamin D receptors in several tissues and indirect mechanism through the changes in calcium levels.Vitamin D has also been shown to decrease inflammatory cytokines which plays an important role in insulin resistance and β-cell apoptosis.Several studies have confirmed that vitamin D is closely related to the long-term complications of diabetes.Low levels of vitamin D can exacerbate diabetic peripheral neuropathy,nephropathy,and retinopathy.Although diabetic patients with vitamin D deficiency is widespread,the existence of vitamin D deficiency and diabetes complications is still controversial,this article will review the relationship between vitamin D and the microvascular complications of T2DM.

Performance Evaluation of the CLIA and ECLIA for Anti-TP Screening in Blood Donors / 中国实验血液学杂志

OBJECTIVE@#To evaluate the performance of the chemiluminescence immune assay (CLIA) and the electro-chemiluminescence immuneoassay(ECLIA) for Treponemapallidum antibody（anti-TP） screening in blood donors.@*METHODS@#The sero-panel samples from NCCL were tested with ELISA, CLIA and ECLIA assays synchronously to evaluate their performances respectively.@*RESULTS@#The sensitivity and the negative predictive value of the CLIA were 100%, which were the same as one kind of ELISA, and better than the other ELISA; The specificity of the CLIA was 88.46%, the accuracy rate was 97.02%, the positive predictive value was 96.13%, which were higher than both ELISA. Due to the significant interference of sample heat inactivation in ECLIA detection, the result can not demonstrate the true performance of ECLIA in this study. The preliminary result was as follows: the sensitivity was 98.93%, the negative predictive value was 96.75%, and the accuracy rate, specificity and positive predictive value of ECLIA were 97.02%, 91.54% and 97.10% respectively.@*CONCLUSION@#Compared with ELISA, the CLIA has higher sensitivity and specificity and can be used for Treponemal antibody screening in blood bank. Unfortunately, the data in this study cannot come to a conclusion for ECLIA and needs more testing.

Treatment of Pipkin type I and II femoral head fractures through modified Smith-Peterson approach and modified Hardinge approach-a case-control studies / 中国骨伤

<p><b>OBJECTIVE</b>To compare clinical results of treatment of Pipkin type I and II femoral head fractures through modified Smith-Peterson(S-P) approach and modified Hardinge approach.</p><p><b>METHODS</b>From July 2005 to July 2014, 42 patients with Pipkin type I and II femoral head fractures were treated with operation. A total of 23 patients in anterior group was treated with modified S-P approach including 17 males and 6 females with an average age of (29.3±9.4) years old, 5 cases of type I by excision of the fragement, 3 cases of type I and 15 cases of type II cases by fixation of the fragement. While a total of 19 patients in the lateral group was treated with modified Hardinge approach including 15 males and 4 females with an average age of (31.4±10.0) years old, 3 cases of type I by excision of the fragement, 4 cases of type I and 12 cases of type II by fixation of the fragement. Operative time, blood loss during operation and fracture healing time were observed and compared. The clinical and radiographic outcomes of the patients were measured using Thompson-Epstein scoring scale. The effect of hip reduction time of less than 6 h, 6 to12 h, and more than 12 h, the effect of surgery time within 24 h and more than 24 h after injury were compared.</p><p><b>RESULTS</b>All patients were followed up from 24 to 60 months with an average of(30.29±6.95) months. The operation time (61.96±12.22) min, blood loss (46.09±18.03) ml, and (74.74±10.06) min, blood loss (72.11±19.88) ml in lateral group in the anterior group were better than those of lateral group(<0.05). In anterior group, fracture healing time was(12.22±1.70) weeks, the results were excellent in 8 cases, good in 10 cases, fair in 4 cases and poor in 1 case, the excellent and good rate was 78.3%, the incidence of avascular necrosis of femoral head was 8.69%(2/23), and the incidence of heterotopic ossification was 13.04%(3/23). While in lateral group, the fracture healing time was(12.42±1.95) weeks, the results were excellent in 6 cases, good in 7 cases, fair in 3 cases and poor in 3 cases, the excellent and good rate was 68.4%, the incidence of avascular necrosis of femoral head was 10.53%(2/19), and the incidence of heterotopic ossification was 5.26%(1/19). There was no significant difference in fracture healing time, postoperative effect and postoperative complications between the anterior group and lateral group(<0.05). The effect of patients with reduction time of hip dislocation less than 12 h was significantly better than that of more than 12 h, there was no significant difference in the effect between reduction time within 6 h and 6 to 12 h. There was no significant difference in the outcome between surgical patients within 24 h and more than 24 h after injury.</p><p><b>CONCLUSIONS</b>Dislocated hip of Pipkin type I and II femoral head fractures should be closed reduction within 6 h. If conditions are limited, the reduction time can be accepted within 12 h. Both of modified S-P approach and modified Hardinge approach are effective in treating Pipkin type I and II femoral head fractures, and can obtain excellent outcomes. Moreover, modified S-P approach has advantage of less trauma, less blood loss, shorter operative time.</p>

Effects of Apheresis Platelets Treated with Vitamin BPhotochemical Technology on the Release of White Blood Cells- and Platelet-Derived Cytokines during Storage / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate whether vitamin Bphotochemical pathogen reduction technology(PRT) treatment may lead to increase white cell- and platelet- derived cytokines release from platelets during storage.</p><p><b>METHODS</b>Sixty milliliters of leukodepleted apheresis platelets were collected from 20 healthy donors, then were divided into 2 parts: one part (30 ml) remained untreated to serve as control, while the other part was treated with vitamin B-UVB photo-chemical technology as experimental group. During 7 d of storage under standard blood bank conditions, platelet coun-ting (PC), platelet distribution width (PDW), mean platelet volume (MPV), white cell-derived cytokines (IL-1β, IL-2, IL-6, IL-8, TNF-α and IFN-γ) and platelet-derived cytokines (CCL3, CCL5, TGF-β-1 and PF4), P-selectin and phosphatidyl serine (PS) were analyzed on day 1, 3, 5 and 7 of storage, respectively.</p><p><b>RESULTS</b>No signi-ficant differences were observed on PC, PDW and MPV between the experimental and control groups, respectively. The higher levels of platelet-derived cytokines were detected and reached a plateau after 5-7 days of storage, and the cyto-kines showed significant increase in experimental group compared with the control group. PS expression increased signi-ficantly in experimental group as compared with control group on day 3, 5 and 7 of storage, respectively. The accumula-tion of P-selectin was significant higher in experimental group than that in control group on day 5 and 7 of storage (P<0.05). The white cell-derived cytokines were not elevated by PRT treatment during 7 days of storage.</p><p><b>CONCLUSION</b>The PRT-treated platelets are the main source of released cytokines during storage of PRT treatment. The levels of platelet-derived cytokines reach a plateau after 5-7 days of storage, most likely due to accelerated platelet activation and apoptosis.</p>

Microwave ablation: results in ex vivo and in vivo porcine livers with 2450-MHz cooled-shaft antenna / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Imaging-guided thermal ablation using different energy sources continues to gain favor as a minimally invasive technique for the treatment of primary and metastatic hepatic malignant tumors. This study aimed to evaluate the performance of microwave ablation with 2450-MHz internally cooled-shaft antenna in ex vivo and in vivo porcine livers.</p><p><b>METHODS</b>All studies were animal care and ethics committee approved. Microwave ablation was performed using a noncooled or cooled-shaft antenna in 23 ex vivo (92 ablations) and eight in vivo (36 ablations) porcine livers. Diameters of the coagulation zone were observed on gross specimens. The coagulation diameters achieved in different microwave ablation parameter groups were compared. Curve estimation analysis was performed to characterize the relationship between applied power and treatment duration and coagulation diameter (including short-axis and long-axis diameter).</p><p><b>RESULTS</b>Coagulation zones were elliptical and an arrowed-shaped carbonization zone around the shaft was observed in all groups. But the antenna track was also coagulated in the noncooled-shaft antenna groups. In ex vivo livers, the short-axis diameter correlated with the power output in a quadratic curve fashion (R(2) = 0.95) by fixing ablation duration to 10 minutes, and correlated with the ablation duration in a logarithmic curve fashion (R(2) = 0.98) by fixing power output to 80 W. The short-axis reached a relative plateau within 25 minutes. In in vivo livers, short-axis diameter correlated with the coagulation duration in a sigmoidal curve fashion (60 W group R(2) = 0.76, 80 W group R(2) = 0.87), with a relative plateau achieved within 10 minutes for power settings of 60 W and 80 W.</p><p><b>CONCLUSIONS</b>The internally cooled microwave antenna may be advantageous to minimize collateral damage. The short-axis diameter enlargement has a plateau by fixing power output.</p>

Comprehensive sequential interventional therapy for hepatocellular carcinoma / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Since the 1980s, various approaches to interventional therapy have been developed, with the development and achievement of medical imaging technology. This study aimed to evaluate the effectiveness of comprehensive sequential interventional therapy especially personal therapeutic plan in 53 radical cure patients with hepatocellular carcinoma (HCC).</p><p><b>METHODS</b>From January 2003 to January 2005, a total of 203 patients with HCC received sequential interventional treatment in our hospital. Fifty-three patients achieved radical cure outcomes. Those patients were treated with transcatheter arterial chemoembolization (TACE), radiofrequency ablation (RFA), percutaneous ethanol injection (PEI), or high intensity focused ultrasound (HIFU), sequentially and in combination depending on their clinical and pathological features. PET-CT was used to evaluate, assess, and guide treatment.</p><p><b>RESULTS</b>Based on the imaging and serological data, all the patients had a personal therapeutic plan. The longest follow-up time was 24 months, the shortest was 6 months, and mean survival time was 16.5 months.</p><p><b>CONCLUSION</b>Comprehensive sequential interventional therapy especially personal therapeutic plan for HCC play roles in interventional treatment of HCC in middle or advanced stage.</p>

The crush syndrome patients combined with kidney failure after Wenchuan earthquake / 中华外科杂志

<p><b>OBJECTIVE</b>To retrospectively analysis the treatment characteristics of the systemic situation in patients with crush syndrome after Wenchuan earthquake happened in May 12th, 2008.</p><p><b>METHODS</b>Forty-nine patients with crush syndrome and subsequent acute renal failure (ARF) due to the earthquake were treated in West China Hospital. All of patients had been rescued from buildings that collapsed in Wenchuan earthquake. The major associated injuries were in the low extremities and upper extremities. 49 patients developed ARF with increased concentrations of serum creatinine (mean 64 022 U/L) had underwent haemodialysis. Hyperkalaemia was seen in 9 patients and four of them underwent haemodialysis. 49 patients were administered hemodialysis.</p><p><b>RESULTS</b>No patient died. All patients who suffered from the ARF were weaned from hemodialysis after admitted 7 to 35 days. Forty-five extremities underwent amputations and 52 extremities had fasciotomy.</p><p><b>CONCLUSIONS</b>Crush syndrome requires urgent recognition and prompt surgical treatment with simultaneous measures to control hyperkalemia and ARF. The authors believe that immediate intensive care therapy and multi-subjective coordination would have improved the survival rate.</p>

CT guided 125iodine seed implantation for portal vein tumor thrombus in primary hepatocellular carcinoma / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>This study evaluated the clinical application of CT guided 125iodine implantation in patients with portal vein tumor thrombus in primary hepatocellular carcinoma.</p><p><b>METHODS</b>The ten patients (9 males and 1 female, aged from 36 to 72 years) with portal vein tumor thrombus accompanying hepatocellular carcinoma had been treated with comprehensive therapy including surgery, transcatheter arterial chemoembolization, radiotherapy ablation, microwave ablation or percutaneous ethanol injection. The average diameter of each tumor thrombus was 21.5 mm x 30.5 mm. Seeds of 30 MBq 125I were implanted 5 mm apart within the portal vein tumor thrombus. The follow-up after 4 months included enhanced spiral CT.</p><p><b>RESULTS</b>CT screening of the tumours indicated that 4 out of 10 patients showed complete response to the therapy, 5 partial response and 1 stable disease. Adverse effects included aggravated abdominal dropsy and temporarily increased transaminase, which were controlled by medical management. Severe complications such as haemorrhage, biliary fistula, hepatic abscess, pancreatic fistula and hepatic function failure were not observed. Implanted seeds migrated to lung and left hepatic lobe in 1 case.</p><p><b>CONCLUSION</b>CT guided implantation of 125iodine seeds, can effectively treat portal vein tumor thrombus accompanying hepatocellular carcinoma with minimal damage and few complications.</p>

Sex hormones in female patients with systemic lupus erythematosus / 中南大学学报(医学版)

OBJECTIVE@#To explore the levels of sex hormones in female patients with systemic lupus erythematosus (SLE) and its role in the genesis of SLE.@*METHODS@#The serum levels of estradiol, estriol, testosterone, progesterone, and prolactin were determined by electro-chemiluminescence immunoassay in 98 female patients with SLE and compared with those of 38 healthy women.@*RESULTS@#The serum levels of estradiol, estriol, progesterone, and prolactin were significantly higher than those in the healthy women (P <0.05). The serum levels of estradiol, progesterone, and prolactin in patients with SLE in 25 to 34 year old group were higher than the other age groups and the control group (P < 0.05), and the serum levels of estradiol and prolactin in patients with active phase of SLE were significantly higher than those in patients with stable phase of SLE (P <0.05).@*CONCLUSION@#The levels of sex hormones have a close corretation with the genesis and development of SLE.

High intensity focused ultrasound for liver cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the effect of high intensity focused ultrasound (HIFU) for liver cancer.</p><p><b>METHODS</b>HIFU treatment was performed in 44 liver cancer patients under general anesthesia and ultrasound positioning. Before and after HIFU treatment, the clinical symptoms, liver functional tests, AFP and MRI were evaluated.</p><p><b>RESULTS</b>After HIFU treatment, the remission rate of clinical symptoms was 87.5% (28/32), with the scanty ascites in 3 patients disappeared. ALT (79.73 +/- 12.31 U/L) and AST (103.47 +/- 24.55 U/L) before HIFU were reduced to normal in 84.6% (22/26) and 73.5% (25/34) patients. AFP in 64.3% (18/28) patients decreased > or = 50% of the original value. After HIFU, MRI showed coagulative necrosis and blood supply reduction or disappearance of tumor in the target region.</p><p><b>CONCLUSION</b>HIFU treatment pocesses good effect on liver cancer, which will offer a considerable weight in noninvasive local treatment of hepatic tumor.</p>