Is polycystic ovary syndrome appropriately diagnosed by obstetricians and gynaecologists across China: a nationwide survey.

BACKGROUND: To describe the diagnostic criteria used and their application accuracy in the practice of polycystic ovary syndrome (PCOS) caring among obstetricians and gynaecologists across China. METHODS: This was an Online cross-sectional survey of Obstetricians and gynecologists involved in PCOS caring conducted via the largest continuing education platform of obstetrics and gynecology across China from September 2019 to November 2019. RESULTS: A total of 2,328 respondents were eligible for the final analysis. Of these, 94.5 % were general obstetricians and gynaecologists (Ge-ObGyn), and 5.5 % were reproductive endocrinologists (Re-ObGyn). Overall, the most frequently used criteria were the Androgen Excess and Polycystic Ovary Syndrome Society (AE-PCOS) criteria (48.2 %), followed by the Rotterdam criteria (35.7 %) and NIH criteria (12.1 %). Of the respondents, 31.3 % used their diagnostic criteria in their clinical practice. More respondents who chose the Rotterdam criteria could accurately apply the diagnostic criteria than those who chose the AE-PCOS criteria (41.2 % vs. 32.1 %, P < 0.001). Compared with Ge-ObGyn, Re-ObGyn were less likely to use the AE-PCOS criteria (adjusted odds ratio, 0.513; 95 % CI, 0.328-0.802; P < 0.05) and 1.492 times more likely to accurately use their criteria (95 % CI, 1.014-2.196; P < 0.05). CONCLUSIONS: Less than one-third of obstetricians and gynaecologists across China could accurately use the diagnostic criteria they choose to diagnose PCOS. There is an urgent need to train obstetricians and gynaecologists on PCOS diagnosis in an effort to improve the medical care quality of patients with PCOS.

Serum metabolomic profiling reveals potential biomarkers in assessing the management of women with polycystic ovary syndrome: a randomized controlled trial / 中华医学杂志(英文版)

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.

A rapid and accurate method for herpesviral gnome editing / 生物工程学报

To rapidly and accurately manipulate genome such as gene deletion, insertion and site mutation, the whole genome of a very virulent strain Md5 of Marek's disease virus (MDV) was inserted into bacterial artificial chromosome (BAC) through homogeneous recombination. The recombinant DNA was electroporated into DH10B competent cells and identified by PCR and restriction fragment length polymorphism analysis. An infectious clone of Md5BAC was obtained following transfection into chicken embryo fibroblast (CEF) cells. Furthermore, a lorf10 deletion mutant was constructed by two step Red-mediated homologous recombination. To confirm the specific role of gene deletion, the lorf10 was reinserted into the original site of MDV genome to make a revertant strain. All the constructs were rescued by transfection into CEF cells, respectively. The successful packaging of recombinant viruses was confirmed by indirect immunofluorescence assay. The results of growth kinetics assay and plaques area measurement showed that the lorf10 is dispensable for MDV propagation in vitro. Overall, this study successfully constructed an infectious BAC clone of MDV and demonstrated its application in genome manipulation; the knowledge gained from our study could be further applied to other hepesviruses.

A Randomized, Single-blind, Group sequential, Active-controlled Study to evaluate the clinical efficacy and safety of α-Lipoic acid for critically ill patients with coronavirus disease 2019(COVID-19)

ObjectTo evaluate the clinical efficacy and safety of -Lipoic acid (ALA) for critically ill patients with coronavirus disease 2019 (COVID-19). MethodsA randomized, single-blind, group sequential, active-controlled trial was performed at JinYinTan Hospital, Wuhan, China. Between February 2020 and March 2020, 17 patients with critically ill COVID-19 were enrolled in our study. Eligible patients were randomly assigned in a 1:1 ratio to receive either ALA (1200 mg/d, intravenous infusion) once daily plus standard care or standard care plus equal volume saline infusion (placebo) for 7 days. All patients were monitored within the 7 days therapy and followed up to day 30 after therapy. The primary outcome of this study was the Sequential Organ Failure Estimate (SOFA) score, and the secondary outcome was the all-cause mortality within 30 days. ResultNine patients were randomized to placebo group and 8 patients were randomized to ALA group. SOFA score was similar at baseline, increased from 4.3 to 6.0 in the placebo group and increased from 3.8 to 4.0 in the ALA group (P=0.36) after 7 days. The 30-day all-cause mortality tended to be lower in the ALA group (3/8, 37.5%) compared to that in the placebo group (7/9, 77.8%, P=0.09). ConclusionIn our study, ALA use is associated with lower SOFA score increase and lower 30-day all-cause mortality as compared with the placebo group. Although the mortality rate was two-folds higher in placebo group than in ALA group, only borderline statistical difference was evidenced due to the limited patient number. Future studies with larger patient cohort are warranted to validate the role of ALA in critically ill patients with COVID-19.

Ethnic discordance in serum anti-Müllerian hormone in healthy women: a population study from China and Europe.

RESEARCH QUESTION: Chinese women are known to have an earlier age of natural menopause than their European counterparts, but whether they also have a lower functional ovarian reserve is unknown. This study was designed to assess whether there are ethnic differences in anti-Müllerian hormone (AMH) concentrations in women of reproductive age. DESIGN: Women in China and Europe with regular menstrual cycles, not on hormonal contraception and with no medical history of note, were recruited to provide a day 2-5 early follicular phase sample. AMH concentration was determined using the Roche Elecsys assay. Decline in AMH was modelled with linear, quadratic and quadratic with interaction on age equations to assess the impact of ethnicity. RESULTS: A total of 887 European and 461 Chinese women participated in the study. Despite the Chinese population being slightly younger (34.1 ± 8.4 years) than their European counterparts (34.8±8.9 years), their median AMH was lower, at 1.87 ng/ml (interquartile range [IQR] 0.28-3.64) compared with 2.11 ng/ml (IQR 0.73-3.96), with evidence of increasing discordance from age 25 years. In all regression models of the age-related decline in AMH, there was evidence of a difference between Chinese and European women. Although AMH was 28.1% (95% confidence interval [CI] 18.2-36.7%) lower in the Chinese population at age 30, this decline increased to 79.4% (95% CI 75.4- 82.9%) at age 45. CONCLUSIONS: There were independent effects of age and ethnicity on serum AMH concentrations, with Chinese women having a substantially lower AMH in adult life than their European counterparts from age 25 onwards.

Understanding fetal-maternal hemorrhage: commonly overlooked aspects / 中华围产医学杂志

A consensus on the clinical management of fetal-maternal hemorrhage (FMH) has been reached. We review here other aspects of FMH which we believe should also be considered, including the diagnostic criteria of sinusoidal fetal heart rate pattern, mechanisms of assisted diagnostic methods such as Kleihauer-Betke test and flow cytometry test, differential diagnosis of fetal edema associated with FMH, the timing of intrauterine transfusions, the relationship between FMH and intra-placental choriocarcinoma, and risk of recurrent FMH in subsequent pregnancies, for a better understanding of this disease and its management.

Clinical study of hysteroscopy combined with laparoscopy in the diagnosis and treatment of unexplained infertility / 中华妇产科杂志

Objective:To explore the importance of the diagnosis and treatment value of laparoscopy and hysteroscopy in patients with unexplained infertility.Methods:A total of 519 cases diagnosed as unexplained infertility, received laparoscopy and hysteroscopy in Peking Union Medical College Hospital from May 2012 to December 2015. The causes of infertility were evaluated, and the subjects were followed up to observe the nature pregnancy rate.Results:Among 519 unexplained infertility patients, pelvic abnormalities had been explored in 466 (89.8%, 466/519) cases. Pelvic endometriosis combined with adhesions, pelvic adhesion alone, uterine leiomyoma and uterine cavity polyp were 72.4% (376/519), 12.3% (64/519), 3.7% (19/519) and 1.3% (7/519) respectively. The total natural pregnancy rate within the 3 years of follow up was 53.9% (208/386), and the natural pregnancy rate was 29.8% (31/104) in patients aged 35 years and over.Conclusions:The patients with clinical diagnosis of unexplained infertility should be examined by hysteroscopy and laparoscopy. Under the examination, the causes of infertility could be found more intuitively, and targeted treatment could be carried out to improve the pregnancy rate. The natural pregnancy rate of the elderly patients decrease obviously after operation, and the time of natural trying pregnancy should not be too long.

Clinical study of hysteroscopy combined with laparoscopy in the diagnosis and treatment of unexplained infertility / 中华妇产科杂志

Objective@#To explore the importance of the diagnosis and treatment value of laparoscopy and hysteroscopy in patients with unexplained infertility.@*Methods@#A total of 519 cases diagnosed as unexplained infertility, received laparoscopy and hysteroscopy in Peking Union Medical College Hospital from May 2012 to December 2015. The causes of infertility were evaluated, and the subjects were followed up to observe the nature pregnancy rate.@*Results@#Among 519 unexplained infertility patients, pelvic abnormalities had been explored in 466 (89.8%, 466/519) cases. Pelvic endometriosis combined with adhesions, pelvic adhesion alone, uterine leiomyoma and uterine cavity polyp were 72.4% (376/519), 12.3% (64/519), 3.7% (19/519) and 1.3% (7/519) respectively. The total natural pregnancy rate within the 3 years of follow up was 53.9% (208/386), and the natural pregnancy rate was 29.8% (31/104) in patients aged 35 years and over.@*Conclusions@#The patients with clinical diagnosis of unexplained infertility should be examined by hysteroscopy and laparoscopy. Under the examination, the causes of infertility could be found more intuitively, and targeted treatment could be carried out to improve the pregnancy rate. The natural pregnancy rate of the elderly patients decrease obviously after operation, and the time of natural trying pregnancy should not be too long.

Clinical safety of short-term antivirus intervention in 54 pregnant women with high viral load of hepatitis B e antigen and the effect of blocking mother-to-child transmission of hepatitis B virus / 中国医师进修杂志

Objective To investigate the effects and safety of short-term telbivudine intervention on blocking mother-to-child transmission (MTCT) of hepatitis B virus (HBV) in pregnant women with hepatitis B e antigens (HBeAg) positive during mid-gestation. Methods Fifty-four chronic HBV infection pregnant women with HBeAg positive from November 2016 to November 2017 in Dalian Sixth People′s Hospital Affiliated to Dalian Medical University were selected, and the serum HBV DNA (logarithmic transformation) of pregnant women was ≥1010 U/L. The pregnant women began oral telbivudine 600 mg at the 24th week of pregnancy, 1 time/d, and stopped at the day of delivery. The neonates were injected 10 μg hepatitis B vaccine and 100 U HBV immunoglobin 12 h after parturition, and they were injected 10 μg hepatitis B vaccine at 1 and 6 months of birth. The HBV DNA, creatine kinase (CK), alanine aminotransferase (ALT) and total bilirubin (TBIL) at 12th, 24th, 28th, 32th week of pregnancy and 1, 7 months after parturition were detected. The hepatitis B surface antibody (HBsAb) and hepatitis B surface antigen (HBsAg) of infants during 28 to 32 weeks of birth were detected. Results There were no statistical differences in CK, ALT and TBIL of 54 pregnant women (P＞0.05). The HBV DNA at 28th, 32th week of pregnancy and 1 month after parturition was significantly lower than that at 12th week of pregnancy (5.7 ± 2.2, 5.1 ± 2.3 and 8.3 ± 1.7 vs. 9.5 ± 1.0), and there was statistical difference (P＜0.05); there was no statistical difference between 7 months and 12th week of pregnancy after parturition (P＞0.05). During 28 to 30 weeks of birth, all the neonates showed serum HBsAb>109 U/L and HBsAg < 30 U/L. Conclusions Short-term intervention with telbivudine in mid-gestation for pregnant women infected with HBV could significantly reduce the level of serum HBV-DNA to the safety level or below. The adverse effects are not found during the telbivudine intervention period. Of note, after drug withdrawal, the HBV DNA level will rebound variously. The virus related detection conducted on the neonates indicates that short-term telbivudine intervention can realize complete MTCT blocking.

Epidemiological and clinical characteristics of imported malaria in Dalian from 2013 to 2018 / 中华地方病学杂志

Objective To understand the epidemiological and clinical characteristics of imported malaria cases admitted in Dalian and provide evidence for clinical diagnosis,treatment and control of the disease.Methods A retrospective analysis method was used to descriptively analyze the epidemiological data of 104 cases of imported malaria from 2013 to 2018 treated in Dalian Sixth People's Hospital.The clinical characteristics of 93 hospitalized patients (13 in the severe group and 80 in the non-severe group) were analyzed by t (t') test or Mann-Whitney U test.Results Among 104 cases of imported malaria,82 cases were falciparum malaria,5 cases were vivax malaria,4 cases were oval malaria,2 cases were quartan malaria,2 cases were mixed infections,and there were 9 cases without classification.The ratio of males to females was 16.33:1.00 (98:6).The age was (42.07 ± 11.07) years.There was no obvious seasonality in the onset time.We found 102 cases were come from Africa,and their main occupations were outbound workers or fishermen.After blood laboratory examination at admission between severe group and non-severe group,the differences of red blood cell (RBC),hematocrit (PCV),hemoglobin (Hb),serum creatinine (SCr),and blood urea nitrogen (BUN)were statistically significantly different (t =6.561,7.140,6.962;Z =-3.469,-3.739,P ＜ 0.05).Conclusions In Dalian the falciparum malaria is the main infectious species in imported malaria cases,and Africa is the main area of infection.Outbound workers should be trained in malaria prevention and treatment in Africa.Early admission indicators (RBC,PCV,Hb,SCr,BUN) help clinicians to diagnosis and treat severe cases early.

Clinical curative effect research status and analysis of acupuncture treatment for primary insomnia / 中国针灸

<p><b>OBJECTIVE</b>To grasp the clinical efficacy of acupuncture in the treatment of primary insomnia (PI), and analyze its future research directions.</p><p><b>METHODS</b>A total of 41 prospective randomized controlled trials (RCTs) were conducted in which the clinical efficacy of acupuncture for treatment of PI was compared with sedative and hypnotic drugs in recent six years by searching databases of CNKI, database, PubMed, and BioMed Central (BMC), the aspects of diagnostic criteria, efficacy standards, observation time, control drugs, characteristics of acupoint selection and regularity were used to review and analyse.</p><p><b>RESULTS</b>Acupuncture treatment for PI was mainly based on acupoints in the head, combined with selecting the points according to the different syndrome, showing short-term efficacy and safety advantages, but it was not well-established in many aspects such as diagnostic criteria, efficacy evaluation, observation time, and control drugs.</p><p><b>CONCLUSION</b>Current evidence shows that acupuncture treatment is effective, but it is necessary to add more stringent RCTs, and introduce objective monitoring indicators to strengthen the evidence and enhance the overall level of research.</p>

Effect of low-dose or standard-dose conjugated equine estrogen combined with different progesterone on bone density in menopause syndrome women / 中华妇产科杂志

Objective To explore the effect of low-dose or standard-dose conjugated equine estrogen (CEE)combined with natural progesterone or dydrogesterone on bone density in menopause syndrome women.Methods Totally 123 patients with menopause syndrome were recruited and randomly assigned to 3 treatment groups: group A(low-dose CEE+progesterone), group B(standard-dose CEE+progesterone), group C(standard-dose CEE+dydrogesterone). Using continuous sequential regimen, the duration of intervention was 12 cycles.The bone mineral density of lumbar 2-4 and neck of femur,the bone metabolic markers, the level of FSH and estradiol were examined just before the drug administration and 12 months after the beginning of experiment. Results There were 107 cases completed the one year trial.(1)Bone density:after 12 cycles of treatment,there was no significant change in bone density in group A(P>0.05);lumbar vertebrae of group B and C increased significantly,at 3.0% and 2.1%respectively(all P<0.05).The bone density of left femoral neck of group C significantly increased by 2.9%(P=0.029). There was no significant difference among the treatment groups at the beginning of experiment(P>0.05).(2)Bone metabolic markers: after 12 cycles of treatment, the levels of calcium, phosphorus, alkaline phosphatase, Ca/Cr decreased significantly,the difference were statistically significant(all P<0.05).There was no significant difference among the treatment groups at the beginning of experiment(P>0.05).(3)Levels of FSH and estradiol:after 12 cycles of treatment,the levels of FSH in three groups were decreased significantly(all P<0.01). The levels of estradiol in three groups were increased significantly(all P<0.01). There was no significant difference among the treatment groups at the beginning of experiment(P>0.05). Conclusions Both low-dose and standard-dose menopause hormone therapy(MHT)could elevate the level of estradiol, reduce bone turnover, prevent bone loss of postmenopausal women effectively. The standard dose of MHT could also increase the density of vertebrae and femoral neck,and generate more clinical benefits.

Research on Correlation between Traditional Chinese Medicine Clinical Research Progress and Quality Evaluation / 世界科学技术-中医药现代化

This paper was aimed to analyze the correlation between quality evaluation and whole complete quality assessment in traditional Chinese medicine (TCM) clinical research progress,in order to discuss key steps and strategies in the clinical research progress.In accordance with the quality control indexes,all projects of Prevention and Treatment of Chronic Disease of TCM were given a research progress evaluation and complete condition.The scores were described with radar map method.The influence of research progress to whole complete quality was analyzed with correlation methods.The results showed that there was a significant correlation between research progress (including included cases and completed cases) and the total score of quality control (P ＜ 0.05).It was concluded that research progress was a key step to influence the entire clinical research level.It is necessary to strengthen the supervision on research progress to guarantee the whole research level.

Investigator Compliance Quality Analysis on Clinical Research of TCM Prevention and Treatment for Chronic Diseases / 中国中医药信息杂志

Objective To explore ways and means to improve the investigator compliance through the evaluation and analysis of the investigator compliance of TCM clinical research projects of chronic diseases. Methods Totally 28 studies from the project Chinese medicine clinical study on prevention and treatment of chronic disease started in 2010 or 2011 and ended in 2015 were collected. The investigator compliance was analyzed by the evaluation form, which were drafted by quality control core team of TCM projects of chronic diseases, as research method performance, compliance of subjects inclusion and exclusion, integrity, accuracy and normalization of case report form in final quality evaluation for TCM clinical research on chronic diseases. Results There were 19 excellent studies according to investigator compliance, accounting for 67.9%, including 3 studies with ten score, accounting for 10.7%. There were 8 good studies according to investigator compliance, accounting for 28.6%. There was 1 study up to standard, accounting for 3.6%. 11 studies included unreasonable changes in the record during the process of implementation. 12 studies included missing in the filling of research records during the process of implementation. Conclusion In general, 28 studies of TCM linical research projects for chronic diseases show high investigator compliance. The existing problems are mainly found in the integrity and normalization of research records.

YANG's pricking-cupping therapy for knee osteoarthritis: a multi-center randomized controlled trial / 中国针灸

<p><b>OBJECTIVE</b>To evaluate the clinical efficacy of YANG's pricking-cupping therapy for knee osteoar thritis (KOA). Methods This was a multi-center randomized parallel controlled trial. One hundred and seventy one patients with KOA were randomly allocated to a pricking-cupping group (89 cases) and a conventional acu puncture group (82 cases). Neixiyan (EX-LE 4), Dubi (ST 35) and ashi points were selected in the two groups. Patients in the pricking-cupping group were treated with YANG's pricking-cupping therapy; the seven-star needles were used to perform pricking at acupoints, then cupping was used until slight bleeding was observed. Patients in the conventional acupuncture group were treated with semi-standardized filiform needle therapy. The treatment was given for 4 weeks (from a minimum of 5 times to a maximum of 10 times). The follow-up visit was 4 weeks. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the visual analogue scale (VAS) were adopted for the efficacy assessments.</p><p><b>RESULTS</b>The pain score, stiffness score, physical function score and total score of WOMAC were all reduced after 4-week treatment and during follow-up visit in the two groups (all P<0. 0001). Except that the difference of stiffness score between the two groups was not significant after 4-week treatment (P>0. 05), each score and total score of WOMAC in the pricking-cupping group were lower than those in the conventional acupuncture group after 4-week treatment and during follow-up visit (P<0. 0001, P<0. 01). After 2-week treatment, 4-week treatment and during follow-up visit, the VAS was all reduced compared with that before treatment (all P<0. 0001) ; with the increase of the treatment, the reducing trend of VAS was more significant (P<0. 0001). The scores of VAS in the pricking-cupping group were lower than those in the conventional acupuncture group after 4-week treatment and during follow-up visit (P < 0. 01, P <0. 0001). CONCLUSION The YANG's pricking-cupping and conventional acupuncture therapy can both significantly improve knee joint pain and function in patients with KOA, which are relatively safe. The pricking cupping therapy is superior to conventional acupuncture with the identical selection of acupoints.</p>

Change tendency during 30 years of infertility and endometriosis in Peking Union Medical College ;Hospital / 中华妇产科杂志

Objective To analyze the incidence of endometriosis in inpatients with infertility in Peking Union Medical College Hospital in 30 years. Methods The inpatients of Peking Union Medical College Hospital admitted between May 1983 and November 2013 was searched. The infertile patients receiving laparoscopy or laparotomy were included. The discharge diagnosis and the operation were summarized. The incidence of gynecologic diseases were demonstrated, such as endometriosis, pelvic adhesions, uterine fibroid, hydrosalpinx, ovarian benign tumor, and adenomyosis. The age was collected, and the change of age and the incidence of endometriosis was analyzed. Results The incidence of endometriosis in infertile female inpatients was 35.50%(95%CI:34.50%-36.49%). The incidence showed relatively stable increasing tendency after 2004 (with P<0.01). The age had increased significantly since 1996 (with P<0.01);the average age was (29.76±3.74) years old in 1996, and (32.85±4.49) years old in 2013 (P<0.01). The inpatients diagnosed with endometriosis had greater age, (32.67 ± 4.06) versus (32.04 ± 4.55) years old (P<0.01);the incidence of endometriosis differed in different age group, the older group had higher incidence (χ2=85.807, P<0.01). Conclusions Infertile female inpatients showed increasing incidence of endometriosis in recent years. Older infertile patients maybe have higher risk of endometriosis.

Immune maturation of human monocyte-derived dendritic cells induced by angiotensinⅡ / 中国病理生理杂志

AIM:To investigate the effects of angiotensin II ( Ang II) on the immune maturation and the oxi-dized low-density lipoprotein (Ox-LDL)-uptaking capacity of human monocyte-derived dendritic cells (DCs).METH-ODS:Human peripheral blood mononuclear cells were isolated by density gradient centrifugation , and the monocytes were purified by positive selection with anti-CD14 magnetic beads.After cultured with rhGM-CSF (100 μg/L) and rhIL-4 (50μg/L) for 5 d, the monocytes differentiated into immature DCs .On the 6th day of the culture, the cells were treated with various concentration levels of Ang II or pretreated with losartan .The immunophenotypic expression of HLA-DR and CD83 was analyzed by flow cytometry .The secretion levels of IL-12 and IFN-γin the culture supernatants were measured by ELISA.Furthermore, DCs were incubated with DiI-labelled Ox-LDL.The DiI-Ox-LDL-incorporated fraction was investiga-ted by flow cytometry .The mRNA expression of 3 scavenger receptors , scavenger receptor A ( SR-A) , CD36 and lectin-like oxidized low-density lipoprotein receptor 1 (LOX-1), was examined by real-time PCR.RESULTS: Ang II induced the maturation of human monocyte-derived DCs, stimulated the expression of CD83 and HLA-DR, and promoted the secre-tion of IL-12 and IFN-γ, which were suppressed by losartan .Furthermore, Ang II increased the Ox-LDL-uptaking capacity of DCs, which was partially reduced by losartan .The incubation of DCs with Ang II enhanced the mRNA expression of LOX-1 in a dose-dependent manner , which was reduced by losartan .However, the expression of SR-A and CD36 was not changed .CONCLUSION:Ang II promotes the immune maturation of human monocyte-derived DCs and increases the up-take of Ox-LDL probably through the up-regulation of LOX-1 expression.

Effects of the change of multipile electrocardiogram parameters on P-R interval in pregnant women / 中国综合临床

Objective To explore the change of multiple electrocardiogram(ECG) parameters and their impact on P-R interval in pregnant women.Methods Healthy women aged 20-40 years were enrolled and divided into 4 groups:control group (n =194),early-pregnant group (n =172),mediate-stage group (n =105)and late-phase group(111).The following data were collected for analysis:heart rate (HR),axis,rotation,P-R interval(on lead V3),and p wave duration(on lead Ⅱ).Between-group analysis and multiple liner regression analysis were conducted.Results Compared with the control group,we found no significant difference in the early-pregnant group,but HR significantly increased in the mediate-stage group and late-phase group((77.76 ± 14.75) beat/min vs.(78.12 ± 11.24) beat/min vs.(84.21 ± 11.91) beat/min vs.(88.15 ± 15.05) beat/min,P ＜ 0.05).BP increased with the duration of pregnancy.Axis and P wave duration decreased with the duration of pregnancy.We found no significant difference in the early-pregnant group,but significantly decreased axis and P wave duration in the mediate-stage group and late-phase group (axis:(61.11 ± 225.84) ° vs.(56.97 ±25.17)° vs.(50.11 ±21.78)° vs.(41.72 ±28.36)°,P ＜0.05;P wave duration:(0.100 ±0.015)s vs.(0.099 ± 0.012) s vs.(0.095 ± 0.013) s vs.(0.093 ± 0.013) s,P ＜ 0.05).P-R interval was significantly shorter in women at all the three stages of pregnancy than in the healthy controls ((0.145 ± 0.021)) svs.(0.138±0.019) s vs.(0.133 ±0.020) s vs.(0.131 ±0.019) s,P ＜0.05).There was no significant difference found in heart rotation proportion among the four groups.Multiple liner regression analysis indicated that only pregnancy factors (t =-4.607,P =0.000) and p wave duration (t =9.339,P =0.000) had significant influences on P-R interval.Conclusion P-R interval is negatively correlated to pregnancy stage and positively correlated to p wave duration,but irrelevant to HR and axis in pregnant women.

Clinical study on 48 cases with complete 17α-hydroxylase deficiency / 中华妇产科杂志

Objective To investigate efficient diagnosis and treatment of 17α-hydroxylase (17OHD) deficiency by summarizing clinical characteristics of those patients.Methods From January 1983 to January 2010,48 cases with 17OHD in Peking Union Medical College Hospital were studied retrospectively.Results Among 48 patients with 17OHD,karyotype analysis showed,12 cases with 46,XX and 36 cases with 46,XY.The 46,XX karyotype and 46,XY karyotype with complete 17OHD had typical clinical presentation of amenorrhea [ 12/12,100％ ( 36/36 ) ],no typical spontaneous puberty [ 12/12,13.9％ (5/36) ],Hypertension [ 11/12,100％ ( 36/36 ) ],hypokalemia [ K +:( 2.6 ± 0.7 ),( 2.8 ± 0.7 )mmol/L],hypergonadotropin [ follicle-stimulatinghormone ( FSH ):( 51 ± 35 ),( 79 ± 46 ) U/L,luteinizing hormone( LH ):( 27 ± 14 ),(49 ± 37 ) U/L ],impaired production of sex hormones [ testosterone(T):0.003,0.005 nmol/L; estradiol ( E2 ):26.86,10.64 pmol/L ],hyper-progesterone [ (P):( 32 ± 15 ),( 29 ± 23) nmol/L],impaired production of 17α-hydroxyprogesterone ( 17α-OHP ) [ ( 2.5 ± 1.1 ),( 2.4 ±1.7) nmol/L],ACTH hypersecreation (91.8,114.0 pmol/L).ACTH stimulating test did not elevated in 17α-OHP and cortisol.Conclusion When patients with elevated basal serum levels of progesterone higher than that of ovulation period in addition to clinical symptoms,examination about 17OHD should be warranted.

Relationship between endometriosis fertility index and pregnancies after laparoscopic surgery in endometriosis-associated infertility / 中华妇产科杂志

Objective To evaluate the relationship between endometriosis fertility index (EFI) and pregnancies after laparoscopic surgery in endometriosis-associated infertility.Methods From Jan.2005 to Jan.2010,medical documents of 350 infertile patients due to endometriosis undergoing laparoscopic surgery were studied retrospectively.Pregnancy outcomes were followed up by telephone.EFI was calculated by history factors,least function score and some aspects of the revised American Fertility Society (r-AFS) endometriosis stage.The cumulative pregnancy rate was calculated and compared by Kaplan-Meier survival analysis.Results Within 3 years after surgery,the cumulative pregnancy rates among patients with EFI score 8,9,10 were 62.5％,69.8％ and 81.1％,respectively.There was no significant difference in pregnancy rates among those three groups of patients ( P =0.24 ).The cumulative pregnancy rates among patients with EFI score 5,6,7 were 49.8％,43.9％ and 41.6％,respectively,which did not reach statistical difference ( P =0.83 ).The cumulative pregnancy rates of EFI score 8 - 10 was significantly higher than that of EFI score 5 -7 (71.8％ vs.44.4％,P =0.000).The patients with EFI score 0 -4 was quite small with only 33 cases,among which 15 cases were pregnant.Conclusions There is relationship between EFI and pregnancy in patients with endometriosis-associated infertility.EFI is meaningful to guide post surgical treatment.