Résumé
Objective To explore the change of serum Apelin level and its relationship with insulin resistance (IR) in infertility patients with polycystic ovarian syndrome (PCOS). Methods Ninety-eight infertility patients with PCOS (PCOS group) and 72 infertility patients without PCOS (non-PCOS group) visiting our hospital for the first time from January 2011 to June 2012 were selected. The BMI , serum Apelin level (detected by ELISA), fasting blood glucose (FPG, detected by glucose oxidase method), fasting insulin (Fins, detected by chemiluminescence), and homeostasis model assessment of insulin resistance index (HOMA-IR) of the two groups were detected. Results The serum Apelin level and HOMA-IR in PCOS patients were higher than those in non-PCOS patients (3.28 ± 1.24 vs. 1.94 ± 0.78, P < 0.05; 3.84 ± 1.23 vs. 2.14 ± 0.77,P < 0.05). Pearson correlation analysis showed that serum Apelin level was positively correlated with HOMA-IR in PCOS patients (r=0.65, P<0.01). Conclusions The serum Apelin level in infertility patients with PCOS increased evidently, and was positively correlated with HOMA-IR; which indicated that Apelin may involve in the development of IR in infertility patients with PCOS.
Résumé
Objective To study the cause and management of difficult laparoscopic appendectomy.Method A retrospective analysis of 102 difficult laparoscopic appendectomies was performed. Results The associating factors leading to operative difficulty were as follows:adhesion of peri-appendix in 44 cases,gangrene at root of appendix in 21 cases,special location of appendix in 17 cases,abdominal adhesion in 12 cases,obesity and inflatable intestine in 8 cases. Laparoscopic appendectomy was successfully performed in 96 cases(94.1%,96/102) ,and no intestinal leakage or massive hemorrahge occurred. Conclusions Adhesion of peri-appendix is the most common cause in difficult laparoscopic appendectomy,and gangrene at root of appendix is the most difficult one. Reasonable management for appendix stump contributes to successful operation.