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Objective:To investigate the differences in understanding and diagnosis of polycystic ovary syn-drome(PCOS)among obstetricians and gynecologists with different clinical experiences,in order to promote com-munication and improve medical quality.Methods:This was a multi-center cross-sectional survey.Information on participants'basic information and their knowledge of PCOS comorbidities and treatment management was col-lected online.Physicians were divided into two groups according to their experience:experienced(>200 consulta-tions/year)and inexperienced(≤200 consultations/year).The differences in the diagnosis and treatment of PCOS among different groups were compared.Logistic regression analysis was used to explore other factors that might influence the diagnosis and treatment of PCOS.Results:1689 questionnaires were finally included,among which 95 were experienced and 1594 were inexperienced.①In the comparison of basic conditions,the proportion of experienced persons in tertiary hospitals and reproductive endocrinology specialties was higher than that of in-experienced persons(P<0.05);The percentage of experienced persons who predicted patients with comorbid insulin resistance(proportion>30%)and predicted comorbid overweight/obesity(proportion 30%-50%)was higher than that of less experienced persons(P<0.05).②There was no significant difference in the evaluation of PCOS and its complications among different groups(P>0.05).Logistic regression suggested that different expe-riencers did not significantly affect the assessment of androgens,OGTT and lipid testing(P>0.05).③There was no statistical significance in the choice of treatment for those with no fertility need(P>0.05).For those with fertili-ty needs,metformin and letrozole were more actively selected by experienced group than inexperience(P<0.05).In terms of weight loss,experienced participants were more active in using metformin(P<0.05)and were more likely to choose1.0 or1.5 g/d(P<0.05)than those with inexperience.Conclusions:There was no signifi-cant difference in PCOS assessment among participants with different experience,but in treatment,experienced participants were better able to take into account the multi-system abnormalities brought by PCOS,and at the same time,they give more comprehensive and accurate treatment opinions on patients with or without fertility needs.
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BACKGROUND@#As one of the most common endocrinal disorders for women at childbearing age, the diagnostic criteria of polycystic ovary syndrome (PCOS) have been defined differently among different international health organizations. Phenotypic heterogeneity of PCOS also brings about difficulties for its diagnosis and management assessment. Therefore, more efficient biomarkers representing the progression of PCOS are expected to be integrated into the monitoring of management process using metabolomic approaches.@*METHODS@#In this prospective randomized controlled trial, 117 PCOS patients were enrolled from December 2016 to September 2017. Classical diagnostic parameters, blood glucose, and metabolome were measured in these patients before and at 2 months and 3 months of different medical interventions. The receiver operating characteristic (ROC) curves were built based on multivariate statistical analysis using data at baseline and 3 months' management, and combinational biomarkers with appreciable sensitivity and specificity were selected, which then validated with data collected at 2 months.@*RESULTS@#A set of metabolites including glutamic acid, aspartic acid, 1-methylnicotinamide, acetylcarnitine, glycerophosphocholine, and oleamide were filtered out with high performance in representing the improvement through 3-month management of PCOS with high sensitivity and specificity in ROC analysis and validation with other two groups showed an appreciable area under the curve over 0.96.@*CONCLUSIONS@#The six metabolites were representative of the remission of PCOS through medical intervention, making them a set of potential biomarkers for assessing the outcome of PCOS management.@*TRIAL REGISTRATION@#ClinicalTrials.gov, NCT03264638.
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Female , Humans , Biomarkers , Metabolomics , Polycystic Ovary Syndrome/diagnosis , Prospective Studies , ROC CurveABSTRACT
Objective To explore the surgical methods and clinical applications of single operation hole for thorascopic surgery in treatment of encapsulated effusion with atelectasis after thoracic injury.Methods From October 2011 to October 2013,using single operation hole for thorascopic surgery treating encapsulated effusion with atelectasis in 56 cases after thoracic injury,35 males and 21 females,aged 21-68,mean 34 years old.The left encapsulated effusion with atelectasis in 31 cases,the right of encapsulated effusion with atelectasis in 25 cases,atelectasis in 43 cases,partial atelectasis in 9 cases,total atelectasis in 4 cases.Before thorascopic surgery,routine thoracentesis or (and) closed thoracic drainage were performed,but ineffective.Surgical approach for anesthesia with the thorascopic surgery encapsulated effusion dissection + suction drum lung surgery.Thorascopic surgery were completed in single operation hole,postoperative chest tube into the hole from observation.Results The operation time was 55-120 min,average 75 min; blood loss was 25-150 ml,average 65 ml.All patients underwent in single operation hole.The postoperative hospital stay was 7-19 d,average 11.2 d.There were no perioperative mortality and major complications.Conclusions The single operation hole for thorascopic surgery in treatment of encapsulated effusion with atelectasis after thoracic injury is exactly effective and simple.It can be used as an effective treatment.
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Objective:To study the expression of CD44V6 and Ezrin in human non-small cell lung cancer(NSCLC). Methods:CD44V6 and Ezrin were detected by two-step immunohistochemical staining technique in tumor tissues from 65 lung cancer cases and in normal lung tissues from 15 patients with benign disease and analyzed by the lung cancer clinicopathologic characteristics. Results:The positive rate of CD44V6 expression in NSCLC was 69.23%,and no difference was detected in the normal lung tissues.The up regulated of CD44V6 expression was significantly correlated with lymph node metastasis and distant metastasis,but not correlated with pathological type, the degree of differentiation of tissue and clinical stage.The positive incidence of Ezrin expression (72.3%)was significantly lower in lung cancer tissues than that in normal tissues (100%)(P