Objective: To compare the effects of metformin, rosiglitazone, and their combination in obese polycystic ovary syndrome (PCOS) patients with insulin resistance. Design: Prospective randomized controlled trail. Setting: Tertiary teaching hospital. Patient(s): Obese Chinese women (body mass index [BMI] R25 kg/m 2 ) with insulin resistance who fulfilled the Rotterdam criteria of PCOS. Intervention(s): In group 1, 68 patients administered metformin (1,500 mg/day); in group 2, 67 patients administered rosiglitazone (4 mg/day); in group 3, 69 patients administered metformin (1,000 mg/day) and rosiglitazone (4 mg/day) for 6 months, all with the same diet and regular exercise lifestyle recommendation. Main Outcome Measure(s): Average menstrual interval, anthropometric measurements, androgen-related parameters, and metabolic features of insulin, carbohydrates, and lipids, with intention-to-treat analysis. Result(s): The baseline parameters showed no statistically significant differences. After the 6-month treatment, most participants showed an improved menstrual pattern. There were statistically significant decreases in acne scores, weight, BMI, waist circumference, waist-to-hip ratio, and serum testosterone. The metabolic indexes of insulin, carbohydrates, and lipids were improved obviously compared with the baseline in each group. Among the three groups, the patients administered 1,500 mg/day metformin experienced greater reductions in weight. However, the rosiglitazone users (alone or combined with metformin) showed a more notable decline in total cholesterol and triglyceride levels. Conclusion(s):Considering the benefits of metformin on weight loss, high-dose metformin (1,500 mg/day) along with lifestyle modification should be recommended for obese, insulin-resistant women with PCOS. Rosiglitazone alone or combined with lowdosage metformin plus lifestyle modification should be considered for the women with abnormal lipid profiles.

Two at once: Xanthones with different functional groups were obtained with CO (balloon) in the presence of a simple catalytic system that consists of Pd(OAc)2, K2S2O8, and trifluoroacetic acid (see scheme). Preliminary mechanism studies reveal that the second CH functionalization might be the rate‐determining step.

P-Chem may reduce the risk of progression to GTN in women with CMs who are at a high risk of malignant transformation; however, current evidence in favour of P-Chem is limited by the poor methodological quality and small size of the included studies. As P-Chem may increase drug resistance, delays treatment of GTN and may expose women toxic side effects, this practice cannot currently be recommended.

Although advances in wireless technologies such as miniature and wearable electronics have improved the quality of our lives, the ubiquitous use of electronics comes at the expense of increased exposure to electromagnetic (EM) radiation. Up to date, extensive efforts have been made to develop high-performance EM absorbers based on synthetic materials. However, the design of an EM absorber with both exceptional EM dissipation ability and good environmental adaptability remains a substantial challenge. Here, we report the design of a class of carbon heterostructures via hierarchical assembly of graphitized lignocellulose derived from bamboo. Specifically, the assemblies of nanofibers and nanosheets behave as a nanometer-sized antenna, which results in an enhancement of the conductive loss. In addition, we show that the composition of cellulose and lignin in the precursor significantly influences the shape of the assembly and the formation of covalent bonds, which affect the dielectric response-ability and the surface hydrophobicity (the apparent contact angle of water can reach 135°). Finally, we demonstrate that the obtained carbon heterostructure maintains its wideband EM absorption with an effective absorption frequency ranging from 12.5 to 16.7 GHz under conditions that simulate the real-world environment, including exposure to rainwater with slightly acidic/alkaline pH values. Overall, the advances reported in this work provide new design principles for the synthesis of high-performance EM absorbers that can find practical applications in real-world environments.

No abstract

BackgroundEndometriosis affects fertility negatively. The study aims to evaluate whether laparoscopic surgery combined with oral contraceptive or herbs were more effective than laparoscopic alone in improving fecundity and pelvic pain in women with minimal/mild endometriosis.MethodsA randomized controlled trial (RCT) was conducted in 156 infertile women with minimal/mild endometriosis. After laparoscopic surgery, patients were randomized to three groups: in Group A (n = 52) oral contraceptive (OC) was administered one pill a day, continuous for 63 days without intervals, in Group B (n = 52) OC was administered as above and then Dan’e mixture was added 30 g/day for the latter 30 days, and in control Group C (n = 52) patients tried to get pregnant after surgery without complementary treatment. The follow-up periods were 12 months in Group C and 14 months in complementary medical treatment Group A and B. The pregnant women were further followed up, and labor and pregnancy outcomes were assessed. Primary outcome was pregnancy rate (PR) and live birth rate (LBR). Secondary outcomes included changes of pelvic pain visual analog scale scores and side effects. Analyses were done as intention-to-treat.ResultsThe PR was 46.80% (73/156), and the LBR was 69.86% (51/73). Of the 73 pregnancies, 60 occurred within 12 months of follow-up and 7 of the remaining 13 patients underwent assisted reproductive technology for >1 year. No significant difference was observed in PR and LBR among the three groups. Patients given medical treatment (OCs or OCs plus herbal medicine) had significantly decreased pain scores compared with the laparoscopy alone group.ConclusionsCombination of laparoscopy with OCs or OCs and herbal medicine does not have more advantages than laparoscopy alone in improving fertility of women with minimal/mild endometriosis.Trial registrationChiCTR-TRC-11001820

To compare the therapeutic efficacy of clomiphene citrate (CC) and letrozole (LE) on ovulation, pregnancy, and live birth in women with polycystic ovary syndrome (PCOS); and to ensure if LE can replace CC as the first-line therapy for ovulation induction in these women. This is a prospectively, randomized, controlled trial in the tertiary hospital. Two-hundred and sixty-eight anovulatory PCOS patients were treated by CC or CC plus metformin and LE or LE plus metformin for three continuous cycles or conception; their ovulation rates, pregnancy rates, and live birth rates were calculated and compared. No significant difference was noted among the four groups regarding to the baseline data of clinical manifestations, serum sex hormone levels, and serum insulin levels. A total of 240 patients completed the therapies. The ovulation rate was significantly higher in the group LE than the group CC; however, no significant difference was noted between the groups LE and CC, CC, and CC + MET, or LE and LE + MET in the pregnancy rate, abortion rate, and live birth rate. No birth defect was found in the total of 63 newborns. CC regimen was still recommended to be the first-line therapy of ovulation induction for PCOS.

The objective of this study is to measure serum chemerin levels in women with polycystic ovary syndrome (PCOS) and assess their relationship with clinical, metabolic, and hormonal parameters. One hundred eighteen PCOS women and 114 healthy women were recruited in this study. Their blood pressure, body mass index (BMI), waist circumference and waist-to-hip ratio (WHR), fasting insulin (FIN), fasting plasma glucose (FPG), blood serum sex hormone, and blood lipid were measured. Serum chemerin, leptin, and adiponectin were measured by ELISA. Serum chemerin was significantly higher in the obese PCOS group (47.62 ± 11.27 ng/mL) compared with non-obese PCOS (37.10 ± 9.55 ng/mL) and the obese (33.71 ± 6.17 ng/mL) and non-obese (25.78 ± 6.93 ng/mL) control groups (p < 0.05). Serum chemerin was positively related to BMI, waist circumference, WHR, testosterone (T), FPG, FIN, homeostasis model assessment of insulin resistance (HOMA-IR), total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL-C), LDL-C/high-density lipoprotein(HDL-C), TC/HDL-C and serum leptin, while negatively related to glucose-to-insulin ratio (G/I), HDL-C, and adiponectin levels. Multiple linear regression analysis revealed HOMA-IR, leptin, and TC were the significant influencing factors of chemerin levels (p < 0.05). Increased serum chemerin in PCOS woman with or without obesity suggested that chemerin may be involved in the development of the pathogenesis of PCOS.