Table of Content

05 October 2016, Volume 31 Issue 10

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A number of measures to eliminate the infection source of tuberculosis

Xiao Heping，Fang Yong

2016, 31(10):  1045-1047.  doi:10.3969/j.issn.1004-583X.2016.10.001

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The infection source is the root cause of the tuberculosis epidemic， which is still severe at present. More worse， drugresistant tuberculosis is prevalent all over the world. Eliminating the infection source is the key to tuberculosis control. A number of measures including the implementation of the national TB control programs， the legislation for TB infection source control， early detection of the infection source， standardizing the chemical treatment of tuberculosis， improving selfprotection of medical workers are important weapons of eliminating the infection source of TB.

Research advances of tuberculous pleurisy

Wu Shucai，Zhang Ling， Zhang Xin， Xi Suya，Liu Wei

2016, 31(10):  1048-1053,1057.  doi:10.3969/j.issn.1004-583X.2016.10.002

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On a global scale， tuberculous pleurisy remains one of the most frequent causes of pleural effusion， and with the development of the basic and clinical research， the understanding of tuberculous pleurisy has been updated. This article reviews the recent progress of  tuberculous pleurisy in etiology， diagnosis and management.

Diagnosis of smearnegative pulmonary  tuberculosis

Chen Suli，Liu Rui

2016, 31(10):  1054-1057.  doi:10.3969/j.issn.1004-583X.2016.10.003

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Smearnegative tuberculosis has been a difficulty in the diagnostic process of pulmonary tuberculosis (TB). Diagnosis of TB mainly relies on the clinical features， chest imaging manifestations and laboratory tests. Although sputum culture is the gold standard in diagnosis of TB， it has a very poor sensitivity and takes a relatively long period of time to get. Considering the limitations of conventional methods to test TB， new molecular methods and cellular immunological examinations are getting more and more attention in TB clinical diagnosis.

Diagnosis and treatment of bronchial tuberculosis

Xie Lanpin，Dong Yakun

2016, 31(10):  1058-1062.  doi:10.3969/j.issn.1004-583X.2016.10.004

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The tuberculosis morbidity of China is very high. As the bronchoscope diagnosis technology is widely developing， the diagnosis of tracheobronchial tuberculosis increases year by year. As the clinical feature and imageological examination of tracheobronchial tuberculosis are not specific，so it is easy to be missed.Early diagnosis and treatment can avoid  many complications，such as bronchial stenosis，bronchial occlusion，atelectasis，respiratory failure and so on.On the basis of standardization systemic antituberculosis treatment，selecting the appropriate interventional method can benefit the patients.

Progress in molecular pathology diagnostic techniques of Mycobacterium tuberculosis

Yang Yonghui，Zhu Guiyun，Chen Ning

2016, 31(10):  1063-1066.  doi:10.3969/j.issn.1004-583X.2016.10.005

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Diagnosis of tuberculosis is the key to timely treatment of patients.For a long time， the tuberculosis diagnosis method  mainly relies on bacteriological smear and culture. In recent years， the rapid development of molecular biology  technique  provides a new way for the diagnosis and treatment of tuberculosis. This paper discussed the molecular pathology technologies in diagnosis of tuberculosis， and objectively analyzed the feasibility of these technologies.

Progress in imaging diagnosis of pulmonary tuberculosis

Lv Yan， Zhou Xinhua

2016, 31(10):  1067-1071.  doi:10.3969/j.issn.1004-583X.2016.10.006

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Based on basic imaging characteristics of pulmonary tuberculosis， more attention should be paid in diagnosis and differential diagnosis of atypical pulmonary tuberculosis， drugresistant tuberculosis， tuberculosis in poor immunity patients， and coexisting tuberculosis of other diseases. Furthermore， it is important to take a reasonable application and evaluation of new technology in imaging diagnosis. Thus， it is still an important method to confirm the diagnosis of pulmonary tuberculosis by using the combination of imaging features with clinical comprehensive analysis.

Interpretation of 2016 EULAR rheumatoid arthritis treatment recommendation

Li Zhanguo

2016, 31(10):  1072-1074.  doi:10.3969/j.issn.1004-583X.2016.10.007

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In recent years，the treatment of rheumatoid arthritis(RA)  concepts are updated continuously accompanied by an increase in clinical studies. However， the remission rate is still relatively low in clinical practice， and medication and concept of RA needs to be further understood and improved. In 2016 EUALR Congress， a new version of RA treatment recommendation has come up with many update and supplement comparing to 2013 version. Thus， the article provides  an introduction and interpretation of the new version of RA treatment recommendation according to the domestic treatment status. The aim is to offer some references for RA treatment in clinic practice.

Influence factors analysis on clinical outcomes of  elderly patients of hemodialysis with congestive heart failure

Sun Yana，Sun Boa， Yan Guoqianga， Li Shenga， Tian Hongxiaa， Zhang Xua， Wang Yanb

2016, 31(10):  1075-1079.  doi:10.3969/j.issn.1004-583X.2016.10.008

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ObjectiveTo discuss the  risk factors of the survival time for the elderly maintenance hemodialysis（MHD）  patients with congestive heart failure. MethodsFrom the period of January 1， 2008 to December 31， 2015， a total of 46 elderly patients hospitalized for the reason of maintenance hemodialysis with congestive heart failure(CHF) and rehospitalized or dead for the reason of CHF were selected， and 32 patients of maintenance hemodialysis without CHF or presented CHF for only one time were selected as control. The clinical information from outpatient service was colleted and the followup was terminated on December 31， 2015 or rehospitalization because of CHF or allcause mortality (termination of survival time). The risk factors affecting survival time for the patients were analyzed using KaplanMeier survival curve and Cox proportional hazard regression model. ResultsThe KaplanMeier survival curve showed that age， left cardiomegaly， infection， left ventricular ejection fraction (LVEF) and dialysis interphase weight gain had distinct effects on the survival time for the elderly paitents of maintenance hemodialysis with CHF（P＜0.05）.The Cox proportional hazard regression model showed that age，left cardiomegaly， LVEF value and dialysis interphase weight gain were independent risk factors affecting  the survival time for the elderly patients of the maintenance hemodialysis with CHF（P＜0.05）.ConclusionAge stratification， left cardiomegaly， dialysis interphase weight gain and LVEF reduction are the independent risk factors affecting  the survival time for the elderly patients of the maintenance hemodialysis with CHF.

Relationship between cystatin C and severe coronary artery disease  in patients with acute ST elevation myocardial infarction

Li Heng， Han Congcong， Ren Taojun， Guo Xingmei， Xu Yanmin

2016, 31(10):  1080-1083,1087.  doi:10.3969/j.issn.1004-583X.2016.10.009

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ObjectiveTo explore the value of cystatin C in prediction of severe coronary artery disease and its clinical application in patients with acute ST elevation myocardial infarction (STEMI). MethodsA total of 321 patients with STEMI were divided into three groups according to levels of cystatin C. The   study included clinical data， laboratory examination indicators， the results of coronary angiography and adverse events during hospitalization. The relationship between cystatin C and Gensini score， Syntax score and other indicators were analyzed. At the same time， the patients were divided into mild to moderate stenosis group and severe disease group according to Gensini score. Logistic regression analysis model， ROC curve analysis of cystatin C and STEMI risk factors on the severity of coronary artery disease were analyzed. ResultsThe Gensini score of high level of cystatin C group (Group C3) was significantly increased than that of the other two groups (P<0.01). Cystatin C was positively associated with a higher Gensini and Syntax scores (r=0.256; 0.353，P<0.01). In addition， the value of Cystatin C on predicting the severe STEMI vascular lesions was equal to troponin. ConclusionSerum cystatin C level significantly increased in STEMI patients and it has positively relationship and good predictive value with the severity of coronary artery lesions.

Comparison of stenosis degree of mural coronary artery between 128slice and 256slice spiral  CT

Wang Yujun1， Liu Haixia2， Feng Changchao3

2016, 31(10):  1084-1087.  doi:10.3969/j.issn.1004-583X.2016.10.010

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ObjectiveTo compare the stenosis degree of mural coronary artery and myocardial bridge thickness of 128slice spiral coronary CTA with those of 256slice spiral coronary CTA，and to evaluate the difference of 128slice spiral CT and 256slice spiral CT.MethodsThe study collected 279 myocardial bridges at multicenter，totally 256 patients with the perfect form myocardial bridges，149 of them were male，115 of them were female， age from 27 to 87 years old. The analysis was made in the image of curved planar reformation(CPR）， multiplanar reformation (MPR)， maximum intensity projection(MIP)， the thickness and length of myocardial bridge， the pipe diameter of front and below and after the bridge section were measured，the degree of coronary artery stenosis was calculated. The stenosis degree of mural coronary artery and the thickness of myocardial bridge were calculated and measured. 128 and 256 slice spiral coronary were evaluated in the difference between the above indexes. ResultsThere was significant difference （P<0.01）  between the total myocardial bridge thickness with 128slice CT and 256slice CT， but in the thickness of myocardial bridge ≥3.2  mm，the two methods showed no significant difference（P>0.05）；There was no significant difference between the myocardial bridge length with 128slice CT and 256slice CT (P>0.05). There was significant difference between the stenosis degree of mural coronary artery between the two methods （P<0.01），but in the stenosis degree of mural coronary artery ≥13%， there was no significant difference between the two methods（P>0.05）. ConclusionWhen the thickness of myocardial bridge ≥3.2  mm or the stenosis degree of mural coronary artery ≥13%， 256slice CT is similar to  128slice CT， so 128silce CT can completely meet the clinical necessity.

Prevalence of hyperuricemia and factors in elderly in Hebei Renqiu

Xu Lihua1，Yan Yinglin1，Ji Ruijun2，Yu Kai1，Yang Hongna1，Li Fang1，Gao Suying1

2016, 31(10):  1088-1091.  doi:10.3969/j.issn.1004-583X.2016.10.011

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ObjectiveTo investigate the prevalence of hyperuricemia(HUA) in Renqiu elderly residents in urban and rural areas，and to analyze the related factors. MethodsA cluster random sampling method was used for study， the sample involved the age 60 to 70 years of  Renqiu permanent residents including 5 010  cases screened object. Using face to face health questionnaires， anthropometric measurements， and laboratory test were performed.  HUA and risk factors were analyzed using spearman correlation，multiple regression methods. ResultsThe prevalence of HUA in the elderly in Renqiu was 6.1%， 9.8% in males，3.2% in females， and there was significant difference between males and females(P＜0.05). The multiple factors regression analysis showed that the uric acid level was positively correlated with waist circumference， TG， INS， diastolic blood pressure(P＜0.05)，but negatively correlated with TC， HDLC，FPG， systolic blood pressure and heart rate(P＜0.05).ConclusionThe prevalence of HUA in the elderly is lower in Hebei Renqiu than in other areas in China， HUA was associated with the variety of cardiovascular disease risk factors. Waist circumference， TG， INS and diastolic blood pressure are the risk factors for HUA， while TC， HDLC， FPG， systolic blood pressure and heart rate are associated with the decreased SUA level.

Effect of berberine hydrochloride on neurological function and serum malondialdehyde  in patients with acute ischemic stroke

Chai Meijing1，Wang Pei2

2016, 31(10):  1092-1095.  doi:10.3969/j.issn.1004-583X.2016.10.012

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ObjectiveTo explore the effect of berberine hydrochloride on neuralogical function and serum malondialdehyde (MDA) in patients with acute ischemic stroke. MethodsA total of 102 patients with acute ischemic stroke were randomly divided into two groups， including berberine group 52 cases and control group 50 cases. The control group received routine treatment while berberine group was given berberine hydrochloride 0.5 g three times a day on the basis of routine treatment for 14 days.Blood was collected from both groups before treatment and after treatment of 7 days and 14 days， then the serum MDA was determined with enzymelinked immunosorbent assay. Before treatment and after treatment of 7 days and 14 days， the neural function defect scale was scored by the US National Institutes of Health Stroke Scale (NIHSS). ResultsAfter treatment， the NIHSS score and MDA  declined in both groups， and was significantly lower in berberine group than in control group (P<0.05). ConclusionBerberine hydrochloride significantly reduced MDA level in patients with acute ischemic stroke，the drug can improve the degree of neurological function deficit.

Clinical research of endoscopic ligation in upper gastrointestinal submcosal  tumor under endoscopic ultrasonography

Zhang Yan， Ma Shiyang， Lu Xiaolan， Dong Lei， Wang Jinhai， Song Yahua

2016, 31(10):  1096-1099.  doi:10.3969/j.issn.1004-583X.2016.10.013

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ObjectiveTo evaluate the indications， safety and efficiency of  elastic band ligation on upper gastrointestinal submucosal tumor(SMT) guided by endoscopic ultrasonography (EUS). MethodsThe study enrolled 69 patients with a total of 71 lesions， which were diagnosed as upper gastrointestinal SMT by EUS. The endoscopic elastic band ligation was performed on each of the patients. Then， all patients received proton pump inhibitor  treatment for two weeks and they were followed up with endoscopy after 24 weeks. ResultsOf  69 patients， the diameters of lesions ranged 0.51.5 cm, 32 cases(45.1%) located in esophagus， 23 cases(32.4%) in stomach， 16 cases(22.5%) in duodenal; 28 cases(39.4%) in deep mucosal， 20 cases(28.2%) in submucosal， 23 cases(32.4%) in muscularis propria， 56 cases(78.9%) with wide base， 15 cases(21.1%) with rebagliati， respectively; 63 cases(88.7%)  of them were sloughed successfully. Statistics showed that the decisive factors for successful treatment were the size， layer of invasion and elasticity. All patients had no bleeding， perforation， severe  guidance  dysphagia or other complications. ConclusionEUS is important for endoscopic elastic band ligation of upper gastrointestinal SMT. The tumor size， layer of invasion and elasticity can be evaluated by EUS precisely.

Expression and clinical significance of Six1 and FOXC2 in colon cancer

Wang Jingmiao1， Jia Xihua1， Zheng Shujun1， Wang Youjun2

2016, 31(10):  1100-1103.  doi:10.3969/j.issn.1004-583X.2016.10.014

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ObjectiveTo investigate the expression of Six1 and FOXC2 in colon cancer and the relationship between their expression and  the occurrence， development and metastasis of colon cancer. MethodsThe immunohistochemical method was used to determine the expression of Six1 and FOXC2 in 70 cases of colon cancer and 30 cases of adjacent normal tissues. The correlation between the two proteins and colon cancer process and the pathological features of colon cancer were explored. ResultsThe expression of Six1 and FOXC2 in colon cancer were significantly higher than those in adjacent normal tissues (82.9% vs 16.7% and  74.3% vs  20.0%，respectively，P<0.05）. Both proteins were positively correlated with colon adenocarcinoma（r=-0.426，P<0.01）. The expression of the two kinds of proteins were related with the TNM staging of tumor， depth of invasion and lymph node metastasis（P<0.05），no association was observed with patients' age， gender， tumor size and histological grading (P>0.05). ConclusionSix1 and FOXC2 were overexpressed in colon cancer. They may play important roles in carcinogenesis and progression of colon cancer and a positive correlation was shown between them， suggesting that the expression of  two proteins may be closely associated with poor prognosis in colon cancer.

 

Correlation analysis between Helicobacter pylori infection and gastric mucosal atrophy and intestinal metaplasia

Tang Yanfeng1， Shao Jun2， Yu Qingxian1，Wang Jianping3

2016, 31(10):  1104-1106,1110.  doi:10.3969/j.issn.1004-583X.2016.10.015

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ObjectiveTo investigate the correlation  between Helicobacter pylori (Hp) infection and gastric mucosal atrophy and intestinal metaplasia. MethodsThe study enrolled 114 cases with gastric mucosal atrophy and intestinal metaplasia. Hp infection was detected by rapid urease test and pathological result. ResultsThere were more female than male patients in gastric mucosa with intestinal metaplasia. The Hp positive rate in the patients with gastric mucosal atrophy and intestinal metaplasia was 44.74%， but there was no significant difference in Hp between the severity of intestinal epithelial metaplasia and intestinal epithelial atrophy (P>0.05). ConclusionHp infection was significantly associated with the occurrence and development of chronic atrophic gastritis and intestinal metaplasia. But the effect of Hp  infection severity of intestinal metaplasia and gastric mucosal atrophy was not obviovs，which may be more related to the age and coures of disease. It needs to anti Hp therapy and strengthen the monitoring and regular followup for  the patients  with chronic atrophic gastric mucosa and intestinal epithelial metaplasia， expecially in those with Hp infection positive.

Correlation of serum omentin1 and gestational diabetes mellitus

Pan Baolong1， Wu Ling2， Ma Runmei1

2016, 31(10):  1107-1110.  doi:10.3969/j.issn.1004-583X.2016.10.016

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ObjectiveTo investigate the relationship of serum omentin1 and gestational diabetes mellitus (GDM). MethodsSerum omentin1， fasting plasma glucose (FPG) and fasting insulin (FINS) were tested in 85 cases of GDM with prepregnancy obesity， 85 cases of GDM with normal pregnancy and 85 cases of NGT. The resistance of insulin (HOMA IR) was calculated and statistically analyzed. Results① The FPG， FINS and HOMAIR in GDM group were significantly higher than NGT group， and the last two appeared: obesity GDM > nonobese GDM>NGT group (P<0.05); ② Serum omentin1 in  GDM group was obviously lower than NGT group， obesity GDM<non obese GDM<NGT group (P<0.05); ③ Correlation analysis: serum omentin1 was significantly negative correlation with BMI， FPG， FINS and HOMAIR; ④ The multiple regression analysis, pregnancy obesity GDM group: omentin1=484.1265.015BMI7.016FPG13.224FINS; GDM with normal pregnancy group: omentin1=497.0084.092BMI6.079FPG11.258FINS.ConclusionSerum omentin1 is associated with GDM closely，which can reflect degrees of sugar， lipid metabolic disorder and insulin resistance in pregnant women， may be involved in the occurrence and development of GDM.

Dyslipidemia epidemiological survey and risk factors analysis in Gansu Dingxi

Zhang Shulan1，Liu Jing2，Ma Qiming1，Xian Zhanqi3

2016, 31(10):  1111-1113,117.  doi:10.3969/j.issn.1004-583X.2016.10.017

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ObjectiveTo investigate the prevalence of dyslipidemia in population aged 20 to 74 years in Dingxi，and analyze the risk factors in a basis for clinical intervention. MethodsA total of 1 702 participants 20 to 74 years old living in the local residence for at least 5 years were selected using a stratified cluster and random sampling design. All subjects completed a questionnaires survey，immediately following a physical examination and laboratory test. The prevalence of dyslipidemia was assessed according to diagnostic criteria，namely Chinese adult dyslipidemia prevention guideline，and the risk factors were analyzed. ResultsThe overall prevalence of dyslipidemia in Dingxi was 37.0%，the prevalence in men was higher than that in women(44.1% vs 30.8%，χ2=27.86，P=0.00). The prevalence of elevated triglycerides，elevated total cholesterol，elevated lowdensity lipoprotein  and low highdensity lipoprotein cholesterol were 23.0%，4.0%，16.5% and 4.5%， respectively. Gender and obesity were the risk factors for dyslipidemia. ConclusionThe prevalence of dyslipidemia in Dingxi is high，especially in men.  Gender and obesity are the main risk factors for dyslipidemia.

Helicobacter pylori effects on glucolipid metabolism of type 2 diabetes mellitus

Zhu Chunyinga， Zhang Yingfub， Yang Qiana， Li Yanga，Li Zhihonga， Guo Shuqina

2016, 31(10):  1114-1117.  doi:10.3969/j.issn.1004-583X.2016.10.018

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ObjectiveThrough the analysis of type 2 diabetes mellitus(T2DM) patients with helicobacter pylori (Hp) infection status， to investigate the correlation between Hp and glucolipid metabolism in T2DM. MethodsThe study enrolled 195 cases of patients with T2DM who enderwent by gastroscope gastric mucosa biopsy or 13C urea breath test to determine Hp infection rate，and detections were performed in the common clinical indicators such as HbA1c，FBG，TG，TC，HDLC，LDLC， ALB， C peptide， insulin， 24hour urine protein，admission blood pressure， BMI and HOMRIR. ResultsHp infection rate  in diabetes group was 48.2%（94/195）， but that in control group  37.6%（88/234） (P＜0.05). In diabetic patients with Hp positive group，FBG，TG，ALB， 24 hours urinary protein， serum insulin， HOMR  IR were higher than in Hp negative group， serum cpeptide was lower than in Hp negative group (all P＜0.05).  ConclusionHp  infection rate in diabetic patients is higher， Hp infection may increase diabetes glucolipid metabolic disorders and insulin resistance. Eradicating Hp can improve the glucolipid metabolism in diabetic patients， reduce urinary protein， to a certain extent， can prevent and delay the occurrence  and development of diabetes complications.

Changes of lipid metabolism， C reactive protein， interleukin-6(IL-6) and IL-10  in macrosomia of gestational diabetic mothers

Han Lei， Ren Xueyun， Wang Yu， Niu Fenhai， Cai Wenxian

2016, 31(10):  1118-1120.  doi:10.3969/j.issn.1004-583X.2016.10.019

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ObjectiveTo explore changes of lipid metabolism， C reactive protein(CRP)， interleukin6(IL6) and IL10 in macrosomia of gestational diabetic mothers， in order to provide theoretical basis for reducing the risk of longterm cardiovascular disease in the offspring of GDM.MethodsFifty macrosomia born by mothers with gestational diabetes mellitus were selected as observing group， and 50 normal fullmonth neonatus born by mothers without pregnancy complication served as normal control. Levels of total cholesterol(TC)， triglyceride(TG)， low density lipoprotein cholesterol(LDLC），high density lipoprotein cholesterol(HDLC）， CRP， IL6 and IL10 were measured within 24 hours after birth. ResultsThe levels of TC， TG and LDLC in observing group were significantly higher than those in control group (P<0.01). HDLC showed no significant difference between observing group and control group (P>0.05). Levels of CRP， IL6 and IL10 showed no significant difference between observing group and control group (P>0.05). ConclusionMacrosomia of gestational diabetic mothers tended to develop lipid metabolism disorder， and levels of CRP， IL6 and IL10 had no obvious change.

Surveillance of pathogen distribution and antimicrobial resistance of bacilli from  cerebrospinal fluid among children with central nervous system infection

He Ping， Xu Jun，Feng Tao，Wang Yunzhong， Tao Yunzhen， Fang Ruiying， Shao Xuejun，Zhu Hong

2016, 31(10):  1121-1124.  doi:10.3969/j.issn.1004-583X.2016.10.020

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ObjectiveTo analyze pathogen distribution and antimicrobial resistance of  bacilli from cerebrospinal fluid among children with central nervous system infection. MethodsThe VITEK32 was used for bacteria identification.The bacterial susceptibility testing was done by KirbyBauer method. The antimicrobial susceptibility was determined according to CLSI standard. Results1990 cerebrospinal fluid of children with central nervous system infection were detected. 181 strains were isolated，and the detection rate was 9.1% （181/1990）．The isolated rate of bacteria was 95.0%（172/181）  and fungus rate was  5.0%（9/181）.The rate of Streptococcus pneumonia， Staphylococcus epidermidis and Escherichia coli were 19.3% （35/181），18.8%（34/181），17.1%（31/181），respectively. The isolated rate of ESBLs of Escherichia coli and Klebsiella pneumoniae were 41.9%（13/31）  and  50.0% (3/6). The isolated rate of  tripredominant bacteria were the highest in pediatric patients with one year of age. The drug of resistant rates of  fundamental gramnegative bacteria including Escherichia coli and Klebsiella pneumoniae to ertapenem and imipenem were 0. The resistance to vancomycin of grampositive bacteria was not detected. ConclusionIt is important to apply clinical antibiotics for increasing antibiotics susceptibility on the basis of cultivation results and antimicrobial resistance of bacilli from cerebrospinal fluid among children with central nervous system infection.

Analysis of blood uric acid and blood lipid in Uygur patients with hypertension in Xinjiang

Dai Jianxia， Zhao Min

2016, 31(10):  1125-1127.  doi:10.3969/j.issn.1004-583X.2016.10.021

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ObjectiveTo investigate the relationship between blood uric acid blood，blood lipid and hypertension in Uygur patients. MethodsThe blood uric acid and blood lipid in 2 400  Uygur hypertension patients and 1800 normal controls were detected by automatic biochemistry analyzer. The association between blood uric acid， blood lipid and hypertension in Uygur patients was analyzed by SPSS 13.0. ResultsThe blood uric acid and blood lipid in Uygur hypertension patients were significantly different from those in normal controls (P<0.05). Blood pressure levels were positively correlated with the levels of UA， TG， TC and LDLC， and negatively correlated with the level of HDLC. ConclusionThe blood uric acid and blood lipid may be associated with hypertension in Uygur patients in Xinjiang.

Combination treatment with metformin and spironolactone in patients with polycystic ovary syndrome

Zhao Ruofei1， Li Yajuan1， Dai Qiang1， Li Hong1，Shi Bimin2

2016, 31(10):  1128-1130,1136.  doi:10.3969/j.issn.1004-583X.2016.10.022

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ObjectiveTo investigate the effect of combination therapy with metformin and spironolactone in patients with polycystic ovary syndrome， including metabolism， endocrinerelated impacts， and subsequent ovulation rates.  MethodsA total of 60 patients with polycystic ovary syndrome were included in this study. All patients were randomly divided into A and B groups (30 cases each). Group A was treated with metformin 1 000 mg  everyday while group B was treated with metformin 1 000 mg combined with spironolactone 40 mg for 3 months. Then related indices were compared before and after treatment  between two groups. ResultsAfter 3 months of treatment， body mass and BMI were decreased in both groups and were significantly lower than those before treatment （P<0.05）; The waisthip ratio（WHR）  and FerrimanGallwey score were significantly lower after treatment in group B than in group A （P<0.05）.  After treatment， the levels of LH and T were decreased and were significantly lower than those before treatment （P<0.05）， however， the level of FSH was slightly changed （P>0.05）. After treatment， the level of insulin was significantly decreased in group A （P<0.05）， however， the level of glucose was no obvious difference（P>0.05）; in group B， the levels of insulin and glucose were significantly decreased (P<0.01 and P<0.05， respectively). After treatment， the levels of TG and LDLC were significantly decreased in group A （P<0.05）  and the levels of TG， LDLC and TC were significantly decreased in group B （P<0.05，P<0.01 and P<0.05， respectively）.ConclusionIn comparison with metformin alone， the combination therapy may be more effective for PCOS patients.

Weight gain and postmenopausal breast cancer risk: a doseresponse metaanalysis

Pan Bin， Ma Xiufen， Mao Hongyan

2016, 31(10):  1131-1136.  doi:10.3969/j.issn.1004-583X.2016.10.023

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ObjectiveTo assess the association between adult weight gain（AWG）and postmenopausal breast cancer risk. MethodsPubMed， EMbase， Web of science， CBM， CNKI， VIP and Wanfang databases were searched. Two reviewers extracted data independently according to methods of  Cochrane Collaboration. Statistical analysis was performed using Stata 11.0 software. ResultsA total of 15 prospective observational trials with 445 453 participants （17 285 cases） were included in the metaanalysis. The metaanalysis showed that  the highest AWG group had an increase in the risk of postmenopausal breast cancer  when compared with control group（RR=1.42，95%CI=1.331.51，P<0.05）. Significant nonlinear doseresponse  association was identified between AWG and breast cancer risk in postmenopausal wom (P<0.05). Individuals with AWG >12 kg yielded the increased postmenopausal breast cancer risk（P<0.05）.ConclusionThis metaanalysis highlighted that AWG contributed to increased breast cancer risk in a nonlinear doseresponse manner in postmenopausal women. The association between AWG and postmenopausal breast cancer risk is statistically significant for more than 12 kg in AWG.

Magnesium sulfate and montelukast for  treatment of asthma in adult: a metaanalysis

Ma Kang1，Zhao Yu2

2016, 31(10):  1137-1142.  doi:10.3969/j.issn.1004-583X.2016.10.024

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ObjectiveTo systemically review the efficacy and safety of magnesium sulfate for asthma. MethodsSuch databases as Pubmed， Cochrane Library， CNKI， VIP from inception to January 2016 for randomized controlled trials (RCTs) concerning magnesium sulfate and montelukast for adult asthma. Two reviewers screened literature according to the inclusion and exclusion criteria， extracted  data， and assessed methodological quality of included studies. Then metaanalysis was performed using RevMan 5.3 software. ResultsA total of 12 RCTs involving 1 992  patients were included. The results of metaanalysis showed that  magnesium sulfate and montelukast had higher remission rate of clinical signs compared with control group(OR=5.50， 95%CI=3.738.11，P<0.01). And magnesium sulfate and montelukast could significantly reduce the relief time of cough (SMD=-1.66， 95%CI= -1.92-1.40，P<0.01)， gasp (SMD=-1.42， 95%CI=-1.68-1.16，P<0.01)， chest congestion (SMD=-1.54， 95%CI=-1.73-1.34，P<0.01). Compared with control group， magnesium sulfate and montelukast could obviously reduce the recurrence rate of asthma (OR=0.26， 95% CI=0.150.43，P<0.01). And magnesium sulfate and montelukast could significantly improve lung function index: PEF (SMD=0.85， 95%CI=0.111.59，P<0.01)， FEV1% (SMD=7.65， 95%CI=2.6012.71，P<0.01)， FEV1/FVC% (SMD=6.31， 95%CI=5.477.14，P<0.01). Magnesium sulfate and montelukast could cause more adverse drug reactions (OR=4.43， 95%CI=1.8710.49，P=0.0007). Funnel plot of the remission rate of clinical signs is asymmetric that indicates publication bias. ConclusionMagnesium sulfate and montelukast can obviously improve the clinical signs， pulmonary function of patients with asthma， and reduce the recurrence rate, but increase adverse drug reactions. Due to limited quantity and quality of the included studies， the above conclusion should be further verified by conducting more high quality， large scale， multicentre RCTs.