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Objective:To investigate the effects of letrozole combined with human menopausal gonadotropin (HMG) on pregnancy rate and prognosis in patients with refractory polycystic ovary syndrome (PCOS).Methods:A total of 102 patients with refractory PCOS who received treatment in Jinhua Hongyue Women's and Children's Hospital between May 2019 and May 2020 were included in this study. They were randomly assigned to observation and control groups ( n = 51/group). All patients received the same treatment in the early period. During later ovulation induction period, patients in the control group were administered HMG and those in the observation group were given letrozole combined with HMG. Before treatment and 3 months after treatment, sex hormones [follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E 2), testosterone (T)], arterial hemodynamic indicators around the follicle [end diastolic velocity (EDV), peak systolic velocity (PSV), pulsation index (PI)], endometrial thickness and classification were compared between the two groups. The ovulation rate and pregnancy rate as well as pregnancy outcomes at 6 months of follow-up were recorded in each group. Results:After 3 months of treatment, FSH, LH, E 2 and T levels in each group were significantly decreased compared with those before treatment (all P < 0.05). FSH, LH, E 2 and T levels in the observation group were (1.85 ± 0.45) U/L, (9.86 ± 1.47) U/L, (81.25 ± 10.47) pmol/L, (1.75 ± 0.26) nmol/L, respectively, which were significantly lower than those in the control group [(3.12 ± 1.47) U/L, (12.58 ± 2.14) U/L, (109.25 ± 27.14) pmol/L, (3.58 ± 0.76) nmol/L, t = 5.90, 7.48, 6.87, 16.27, all P < 0.05). EDV in each group was significantly decreased after 3 months of treatment compared with that before treatment (both P < 0.05). After treatment, EDV in the observation group was significantly lower than that in the control group [(3.12 ± 1.42) cm/s vs. (5.14 ± 1.89) cm/s, t = 21.14, P < 0.001]. PSV in each group was significantly increased after treatment compared with that before treatment (both P < 0.05). After treatment, PSV in the observation group was significantly higher than that in the control group [(13.36 ± 2.01) cm/s vs. (10.24 ± 2.47) cm/s, t = 4.21, P < 0.001]. In each group, PI measured after treatment was not significantly different from that measured before treatment (both P > 0.05). After treatment, endometrial thickness in the observation group was significantly higher than that in the control group [(9.09 ± 1.58) mm vs. (8.41 ± 1.42) mm, t = 2.28, P < 0.05]. Ovulation rate in the observation group was significantly higher than that in the control group [88.24% (45/51) vs. 70.59% (36/51), χ2 = 4.85, P < 0.05]. There were no significant differences in endometrial type, biochemical pregnancy, clinical pregnancy rate, abortion rate, and premature delivery rate between the two groups (all P > 0.05). Conclusion:Letrozole combined with HMG has an ideal effect on refractory PCOS. It can improve the levels of sex hormones, restore the hemodynamic status in ovarian stroma and increase ovulation rate.
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Objective@#To investigate the relationship between apolipoprotein E (APOE) gene polymorphism and cerebral infraction (CI) in Chinese type 2 diabetes mellitus (T2DM) patients.@*Methods@#This study included 245 samples of T2DM patients without cerebral infraction (CON group) (Male/Female, 128/117) and 270 samples of T2DM patients with cerebral infraction (CI group)(Male/Female, 145/125) from the department of endocrinology and neurology utilizing real-time fluorescence quantitative PCR technique. The t test and χ2 test were used to compare the differences between the two groups.@*Results@#Patients with a history of hypertension in the CI group (84.12%) were significantly higher than those in the CON group (70.42%) (χ2=15.91, P<0.05).The systolic blood pressure (142.78±20.52)mmHg of the CI group was significantly higher than that of the CON group (133.89±18.58)mmHg (t=-5.16, P<0.05).Compared with CON group, the frequency of genotypes of ε2/ε3 and ε3/ε4 in CI group was significantly higher, while the frequency of ε3/ε3 genotype was significantly lower (χ2=11.48, P<0.05); the allele frequency of APOE ε4 was higher while ε3 was lower in CI group than that in CON group (χ2=7.00, P<0.05). Logistic regression analysis showed that hypertension history (OR=1.95, P<0.05), high systolic blood pressure (OR=1.02, P<0.05), APOE genotypes of ε2/ε3 (OR=2.08, P<0.05) and ε3/ε4 (OR=1.85, P<0.05) were independent risk factors for cerebral infarction in T2DM patients.@*Conclusion@#The polymorphism of APOE gene may be related to cerebral infraction in Chinese T2DM patients.
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Objective:To investigate the relationship between apolipoprotein E (APOE) gene polymorphism and cerebral infraction (CI) in Chinese type 2 diabetes mellitus (T2DM) patients.Methods:This study included 245 samples of T2DM patients without cerebral infraction (CON group) (Male/Female, 128/117) and 270 samples of T2DM patients with cerebral infraction (CI group)(Male/Female, 145/125) from the department of endocrinology and neurology utilizing real-time fluorescence quantitative PCR technique. The t test and χ 2 test were used to compare the differences between the two groups. Results:Patients with a history of hypertension in the CI group (84.12%) were significantly higher than those in the CON group (70.42%) (χ 2=15.91, P<0.05).The systolic blood pressure (142.78±20.52)mmHg of the CI group was significantly higher than that of the CON group (133.89±18.58)mmHg ( t=-5.16, P<0.05).Compared with CON group, the frequency of genotypes of ε2/ε3 and ε3/ε4 in CI group was significantly higher, while the frequency of ε3/ε3 genotype was significantly lower (χ 2=11.48, P<0.05); the allele frequency of APOE ε4 was higher while ε3 was lower in CI group than that in CON group (χ 2=7.00, P<0.05). Logistic regression analysis showed that hypertension history ( OR=1.95, P<0.05), high systolic blood pressure ( OR=1.02, P<0.05), APOE genotypes of ε2/ε3 ( OR=2.08, P<0.05) and ε3/ε4 ( OR=1.85, P<0.05) were independent risk factors for cerebral infarction in T2DM patients. Conclusion:The polymorphism of APOE gene may be related to cerebral infraction in Chinese T2DM patients.
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Objective@#To explore the effect of individualized nutrition intervention mode based on dysphagia screening in postoperative patients with cerebellopontine angle occupying lesion.@*Methods@#By developing nurses training, selecting special screening and evaluation tools, developing screening methods and individualized nutrition intervention measures and meal spectrum, making screening and intervention flow chart, and starting to be implemented in postoperative patients with cerebellopontine angle occupying lesion in July 2017. Forty-six patients with cerebellopontine angle occupying lesion in the previous year were reviewed as the control group, who were given routine treatment and nursing; One year after implementation, Another 48 patients were set as the experimental group, and were given individualized nutritional care based on screening of dysphagia.@*Results@#The incidence rate of dominant aspiration(0), pneumonia (4.17%, 2/48) and diarrhea (2.08%,1/48) in the experimental group was lower than 4.35% (2/46), 21.74% (10/46), 19.57% (9/46) in the control group, especially the difference of incidence rate of pneumonia and diarrhea was statistically significant (pneumonia: χ2=0.010, P=0.013; diarrhea: χ2=0.006, P=0.007). The retention rate of gastric tube in the experimental group (31.30%, 18/48) was lower than that in the control group (58.70%, 27/46), the difference was statistically significant (χ2=7.158, P=0.007). Average retention time of gastric tube in the experimental group (4.47±1.13) d was less than that in the control group (5.11±0.70) d, the difference was statistically significant (t=2.296, P=0,027). The hospitalization time in the experimental group (8.69±1.36) d were less than those in the control group (12.57±2.95) d, the difference was statistically significant (t=8.248, P=0,000). The nutritional status of 7 days after operation of the experimental group was better than that of the control group, the differenc e was statistically significant (albumin: t=4.888, P<0.01; prealbumin: t=5.188, P<0.01; hemoglobin: t=4.039, P<0.01). The knowledge and skills of swallowing of general nurses improved significantly after the work, in particular, the accuracy of screening tests for Wa Tian drinking water increased from 5/8 to 20/20. The difference was statistically significant (χ2=8.148, P=0.017).@*Conclusions@#Individualized nutrition intervention based on screening for dysphagia can improve the clinical outcome of patients, improve the comprehensive ability of nurses and achieve a win-win situation of nurse - patient.
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Objective To explore the effect of individualized nutrition intervention mode based on dysphagia screening in postoperative patients with cerebellopontine angle occupying lesion. Methods By developing nurses training, selecting special screening and evaluation tools, developing screening methods and individualized nutrition intervention measures and meal spectrum, making screening and intervention flow chart, and starting to be implemented in postoperative patients with cerebellopontine angle occupying lesion in July 2017. Forty-six patients with cerebellopontine angle occupying lesion in the previous year were reviewed as the control group, who were given routine treatment and nursing; One year after implementation, Another 48 patients were set as the experimental group, and were given individualized nutritional care based on screening of dysphagia. Results The incidence rate of dominant aspiration(0), pneumonia (4.17% , 2/48) and diarrhea (2.08% ,1/48) in the experimental group was lower than 4.35% (2/46), 21.74% (10/46), 19.57% (9/46) in the control group, especially the difference of incidence rate of pneumonia and diarrhea was statistically significant (pneumonia: χ2=0.010, P=0.013; diarrhea: χ2=0.006, P=0.007). The retention rate of gastric tube in the experimental group (31.30%, 18/48) was lower than that in the control group (58.70%, 27/46), the difference was statistically significant (χ2=7.158, P=0.007). Average retention time of gastric tube in the experimental group (4.47± 1.13) d was less than that in the control group (5.11±0.70) d, the difference was statistically significant (t=2.296, P=0,027). The hospitalization time in the experimental group (8.69±1.36) d were less than those in the control group (12.57 ± 2.95) d, the difference was statistically significant (t=8.248, P=0,000). The nutritional status of 7 days after operation of the experimental group was better than that of the control group, the differenc e was statistically significant (albumin: t=4.888, P<0.01; prealbumin: t=5.188, P<0.01; hemoglobin: t=4.039, P<0.01). The knowledge and skills of swallowing of general nurses improved significantly after the work, in particular, the accuracy of screening tests for Wa Tian drinking water increased from 5/8 to 20/20. The difference was statistically significant (χ2=8.148, P=0.017). Conclusions Individualized nutrition intervention based on screening for dysphagia can improve the clinical outcome of patients, improve the comprehensive ability of nurses and achieve a win-win situation of nurse-patient.
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Objective To investigate the effects of oxycodone hydrochloride combined with propofol on hemodynamics and related indicators in painless fiberoptic bronchoscopy.Methods Ninety patients receiving fiberoptic bronchoscopic examination from January 2016 to May 2017 were selected and divided into the sufentanil+propofol group(group A) and oxycodone hydrochloride+propofol group(group B) according to the random number table method 45 cases in each group.The hemodynamic indicators,intraoperative propofol dosage and incidence rate of adverse reactions in both groups were observed.Results The respiratory rate(RR) in the bronchoscope reaching the glottis(T2) in the group A was significantly higher than that in the group B (P＜ 0.05);mean arterial pressure(MAP),heart rate(HR),blood oxygen saturation(SpO2) and RR at the bronchoscope passing trachea carina(T3) and examination completing(T4) in the group A were significantly higher than those in the group B(P＜0.05).RR at 10 min after the examination completing(T5) in the group A was significantly higher than that in the group B,the difference was statistically significant(P＜0.05).The propofol dosage in the group A was significantlyhigher than that in the group B(P＜0.05);the incidence rate of adverse reactions in the group A was 31.11％,which was significantly higher than 6.67％ in the group B,the difference was statistically significant(P＜0.05).Conclusion Oxycodone hydrochloride combined with propofol can more stabilizes the change of hemodynamic parameters during the bronchofibroscopic examination process compared with sufentanil combined with propofol and can reduce the propofol dosage and incidence rate of adverse reactions.
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Objective To observe the effect of FOCUS-PDCA on the unplanned extubation (UEX) in ICU patients. Methods About 237 ICU patients during Jan. to Dec. 2014 were assigned as the control group, where the FOCUS-PDCA program was not used. Another 235 patients during Jan. to Dec. 2015 were assigned as the study group, where the the FOCUS-PDCA program was used. The two groups were compared in view of unplanned extubation rate and nurse's comprehensive ability. Result Compared with the control group, hospitalization time was comprehensively shortened in the observation group and the nurses comprehensive abibity increased (all P<0.05). Conclusion The FOCUS-PDCA program can prevent UEX in ICU patients, reduce the rate of UEX, improve the comprehensive ability of nurses and the quality of nursing.
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Objective To establish the determination method of the polysaccharide in Verdihong paint .Methods The anhy-drous dextrose was used as the control , 0.2%anthrone-sulfuric acid as the stain , the content of polysaccharide was determined by ul-traviolet spectrophotometer at the wavelength of 620 nm.Results The polysaccharide curve was linear within a range of 1.9~34.2μg/ml, linear equation was Y=0.033 X-0.006 7 (r=0.999 9), the average recovery was 98.6% with RSD of 1.06%(n=6). Conclusion This method was convenient , stable and coud be used to assay content of the polysaccharide in Verdihong paint .
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ObjectiveTo investigate the clinical significance of peripheral blood lymphocyte subsets in patients with idiopathic inflammatory myopathy (ⅡM).MethodsPeripheral blood lymphocyte subsets was determined by flow cytometry in 89 patients with polymyositis(PM ) or dermatomyositis ( DM ).The association between clinical features and peripheral blood lymphocyte subsets was analyzed by F test,t test and x2 test.ResultsPatients with active DM showed significant decreases in counts of CD3+ cell,CD3+CD4+ cell and CD3+CD8+ cell[(8±4),(5.4±2.8) and (2.6±1.6) ×108/L respectively],compared with those in inactive DM [(16±6), (10.4±5.6) and (5.6±3.8) ×108/L respectively] and healthy controls [(14±4), (8.3±2.8) and (4.6±1.7) ×108/Lrespectively](F=12.901,8.257,7.084; P＜0.05).Logistic regression analysis indicated that myositis disease activity could influence the counts of peripheral blood CD3+ cell,CD3+CD4+ cell and CD3+ CD8+ cell (b=0.211,0.344,0.289; P＜0.05 ).ILD in ⅡM could influence the counts of CD3+ cell and the ratio of CD3+CD4+cell (b=0.928,1.974; P＜0.05 ).Logistic regression analysis indicated that the count of CD3+CD8+ cell was risk factor for death,and the relative risk was 0.989(b=-0.011 ; P＜0.05).ConclusionPeripheral blood lymphocyte subsets may be regarded as useful laboratory parameters for monitoring RA disease activity.Decreased CD8+ T cell may predict a poor outcome of patients with IIM.
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Objective To investigate the aging features of pure leukoaraiosis (LA) in nondemented outpatients. Methods The outpatients with age older than 40 years, without taking cholesterol lowering and B vitamin medications and with mini-mental state examination more than 24 scores were selected from July 2008 to December. 2009 in Beijing Tiantan Hospital. LA was defined with MRI. Patients were classified into two groups i. e. LA group consisting of 138 patients with leukoaraiosis but without lacunar lesions and cortical infarcts and a control group consisting of 124 patients without any lesion in brain. Age and other vascular risk factors were also investigated. Results Age of the patients in the LA group was significantly higher than that in the control group (P< 0.001). Multivariable logistic regression analysis showed that age was independently associated with pure LA ( OR 1.080, 95% CI 1.042-1.120), after adjusting sex, vascular risk factors and presence of atherosclerosis in cervical arteries. If age-stratification was further considered, logistic regression analysis showed that OR (95% CI) for LA was 2.693 (95% CI 1.103-6.575) in a 60-69 year group and 13. 527(95%CI 3.319-55.131) in a≥70 year group as compared with a 40-49 year group. Conclusion Age is a determining risk factor for pure LA and patients with age older than 60 years are at high risk of LA.
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Objective: To investigate the effects of ω-3 fish oil fat emulsion on nutritional status and humoral immunity in postoperative patients suffering from gastrointestinal malignancy. Methods: Thirty patients of gastrointestinal malignancy were randomly divided into study group (n = 15) and control group (n = 15). All the patients were assigned to receive total parenteral nutrition with the equal nitrogen and calory,and those in study group received fish oil fat emulsion additionally. Liver and renal function, blood lipid, haemoglobin, albumin, transferrin, total lymphocyte count (TLC) , B lymphocyte subsets (B1, B2), immunoglobin(IgG, IgM, IgA) and complement(C3, C4) were determined preoperatively and 1, 6d postoperatively. Results: There were no significant differences in liver and renal function and blood lipid on postoperative day 6 versus preoperation in all the two groups. TLC, IgG, IgM, C3 on postoperative day 6 were siginificantly higher in the study group(P < 0. 05). Haemoglobin, albumin, transferrin and B lymphocyte subsets were not significantly different between the two groups. Conclusion: Fish oil fat emulsion treatment was safe and tolerated, and could improve the humoral immunity in patients.
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@#Objective To investigate the related factors of hemichorea.Methods 15 patients with hemichorea were analyzed retrospectively,including their clinical features,characteristics of neuroimaging and treatment.They were followed up for 0.5～4 years.Results The serum glucose increase in 11 cases.The lacunar cerebral infarctions in the area of basal ganglion were found in 5 patients,and the microvessel lesions in the area of basal ganglion resulted from diabetes mellitus in 10 patients.13 patients accepted medicine treatment,11 cases improved,1 case was ineffective,1 case deteriorated.Conclusion The hemichorea mainly related with cerebrovascular disease.The hemichorea due to diabetes mellitus may related with the ischemic or hemorrhagic microvessel lesions.
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<p><b>OBJECTIVE</b>To evaluate the value of the clinical use of CT perfusion imaging (CTPI) and CT subtraction angiography (CTSA) for diagnosing acute ischemic cerebrovascular disease (AICVD).</p><p><b>METHODS</b>Twenty-four patients with AICVD onset within 24 hours were examined with regular CT, CTPI, and CTSA. Some cases received CTPI, magnetic resonance imaging (MRI), magnetic resonance angiography (MRA), digital subtraction angiography (DSA) or single photon emission computer tomography (SPECT) during follow-up examinations.</p><p><b>RESULTS</b>Of the 24 cases, 11 had negative results from regular CT scans 3 - 6 hours after onset of stroke in 6 cases, 6 - 12 hours in 3 cases, and 12 - 24 hours in 2 cases. Ten of these cases were then confirmed by CTPI as having ischemic lesions, 2 with middle cerebral artery occlusion (MCAO), and 1 case with transient ischemic attack (TIA) with CTPI negative. Of the 24 cases, 13 had positive results from regular CT, 9 were diagnosed with ischemic lesions larger by using CTPI than regular CT, 1 case had MCAO and 1 had internal carotid artery occlusion (ICAO). There were 4 cases with ischemic lesions observed with regular CT having nearly the same range as that of lacunar infarctions using CTPI. Another 4 cases had more than 2 lesion areas. The peak time (PT), mean transit time (MTT) and relative flow (RF) of 24 cases were markedly different. The sides of ischemic lesions compared to each other and the core of the lesion compared to peripheral zones were also altered significantly (P < 0.01).</p><p><b>CONCLUSIONS</b>Combined CTPI with CTSA can detect acute ischemic lesions at early and hyper-early stages and could distinguish between TIA, lacunar infarction and a larger area of infarction. Using semiquantitative blood perfusion analysis status, CTPI with CTSA could define position, area and range of the ischemic lesion and penumbra. These scans can also analyze the brain blood perfusion status. It is important to early diagnose the occlusion of the entire division of the internal carotid artery or middle cerebral artery and it is meaningful to assess prognosis and assignment of therapy.</p>