Objective To analyze incidence,pathogenesis and treatment of the complications of transvaginal hysterectomy(TVH)collected during past six years,and to discuss the possible methods of prevention.Methods The patients involved in present study were admitted and underwent the transvaginal hysterectomy in the General Hospital of PLA from Jan.2000 to Jun.2006.The data of complications occurred at intra-or post-operation were retrospectively analyzed.Results Among all of the 1990 cases with TVH,complications occurred in 75 cases,the incidence of complication was 3.77%,including 21 cases of bladder injury(1.06%),5 cases of ureter trauma(0.25%),6 cases of rectal injury(0.3%),30 cases of vaginal stump inflammation(1.51%),8 cases of vaginal stump haematoma(0.4%),2 cases of intra-abdominal hemorrhage(0.1%),2 cases of vaginal narrowness(0.1%)and 1 case of intestinal obstruction(0.05%).The bladder injury and vaginal stump inflammation almost toke the two third of total cases.Some complications were got correction by surgery appropriately during or after the operation when injuries were found.Some cases were managed by conservative treatment.All of the patients with complications were healed without any sequelae.The organ injuries occurred more easily in the cases with pelvic adhesion or less movable large uteri,such as the cases with the history of pelvic operation,the endometriosis or the lower segment myoma.Conclusions The organs adjoined to uterus were easily damaged by TVH during the performance of operation,and the corresponding complications are common after the operations.The operator should familiar with the pelvic anatomy,master the skilled surgical techniques and suitably control the indications of the TVH.With the improvement of techniques in TVH and the research of new instrument applied in this procedure,the incidence of complications in TVH would be further reduced.

Objective To detect the expression of lysyl oxidase (LOX) in pelvic floor tissues and the serum copper ions level of the women with stress urinary incontinence (SUI) for exploring the role of LOX in SUI pathogenesis. Methods The sera of 25 patients with SUI were collected before the operation. The content of serum copper was measured by the technique of atomic absorption spectrum. Meanwhile, 25 patients with similar age but suffering from benign gynecological diseases and undergone total hysterectomy were enrolled as control. Biopsy specimens were obtained from the uterine cardinal sacral ligament of the patients with and without SUI during the operation. The histological structure of pelvic collagen fiber was examined with routine HE staining and Van Gieson (VG) staining. Immunohistochemistry was used to determine the location of LOX. Protein expression of the LOX in pelvic floor tissue was analyzed by Western blotting. Results There was no statistical difference in serum copper content between SUI group and the control group. In the HE and VG staining sections, collagen fiber density of pelvic tissue in SUI group was decreased and fibers were arranged disorderly. Immunohistochemistry showed that LOX was mainly expressed in the cytoplasm of fibroblast. The number of positive cells in pelvic tissues of the patients with SUI was smaller than that in the control group, and the positive signal in SUI group was weaker than that in the control group. The gray degree values of SUI group was obviously lower than that of the control group (P

ObjectiveTo observe the outcomes of psychological nursing for earthquake patients in recovery stage. Methods90 earthquake patients were divided into 4 groups by age and accepted psychological nursing. They were evaluated for post-traumatic stress disorder (PTSD) a year after earthquake. ResultsNone PTSD had been found. ConclusionPsychological nursing can improve self-care ability and confidence of the earthquake patients.

Objective To establish a tree shrew mode of breast tumor.Method Forty-five 3 to 4 month-old female tree shrews were orally gavaged with 20 mg 7,12-dimethylbenz(a)anthracene (DMBA) or peanut oil per animal for three times.Following that, fifteen DMBA administrated tree shrews were implanted 90 day-release medroxyprogesterone acetate ( MPA) pellets.The tree shrews were palpated once weekly to detect mammary tumors for 45 weeks after first DMBA administration.Results DMBA were able to induce breast tumors (12.5%) in tree shrews, and MPA increased the tumor incidence (50%) while no breast tumors were observed in the control group.Three induced breast tumors were intraductal papillary carcinomas and one was IDC by H&E stain.Conclusion All induced tumors are similar with spontaneous tumors in structure and molecular markers.

Objective To compare the effect of anterior and superior reconstruction plate internal fixation in treatment of middle clavicular fractures in the old patients.Methods Thirty-nine old patients with middle clavicular fractures received anterior and superior reconstruction plate internal fixation treatment,respectively.There were 19 males and 20 females at average age of 66.7 years.The operation time,intraoperative blood loss and healing time were observed and compared in two groups.According to the Constant scoring system,shoulder functional evaluation was made at half a year after operation and the latest follow-up.Results All the patients were followed up for 10-32 months (average 18.7 months).Of the two groups,there was no statistical significance in aspects of healing time and Constant score at half a year after operation and the latest follow-up ( P ＞0.05 ).The complication of superior reconstruction plate internal fixation group was significant higher than that of anterior reconstruction plate internal fixation group,while the anterior reconstruction plate internal fixation group had shorter operation time and less intraoperative blood loss in comparison with the superior reconstruction plate internal fixation group ( P ＜ 0.05).Conclusion As for the middle clavicular fractures in the old patients,both anterior and superior reconstruction plate internal fixation can obtain satisfactory curative effect.With shorter operation time,less intraoperative bleeding and less complications,anterior reconstruction plate internal fixation is a much reliable treatment for middle clavicle fractures in the old patients and deserves wider application.

Objective To investigate the therapeutic effects of nano-hydroxyapatite/polyamide 66/platelet-rich plasma com-pound(n-HA/PA66/PRP)on the recovery of rabbit femur bone defect.Methods 40 New Zealand rabbits were artificially made to be bone defect by resecting the 1 cm substantia ossea with periosteum of femur,and were divided into two groups averagely depen-ding on implanted materials:experimental group(n-HA/PA66/PRP),control group (n-HA/PA66).Every five rabbits were sacri-ficed on week 2,4,8,12,and the femur healing status was observed by X ray,histology,and immunohistochemistry.Results No rabbit was infected or died,no implantation objects dropped.Gross observation,X-ray result and histology results demonstrated that the experimental group began to have a new bone tissue at 2 weeks after the operation,with the extension of time,the experimental group new bone growth speed and the quantity was better than the control group.The Lane-Sandhu method X-ray score showed that the experimental group (6.80±2.05)points and the control group(4.20±1.30)points at 12 weeks after the operation,and there were significant differences between two groups(P <0.05).Immunohistochemistry indicated that expression intensity of Vas-cular endothelial growth factor at 2 weeks and 4 weeks were significant differences between two groups(P <0.05),but there was no significant difference at 8 weeks and 12 weeks (P >0.05).Conclusion PRP combined with n-HA/PA66 artificial bone could accel-erate the healing of bone defect,and the effect of repair of bone defect is better than that of n-HA/PA66 artificial bone in the early.

Objective:To construct a specific small hairpin RNA (shRNA) expressing vectors against human receptor for advanced glycation end product (RAGE) gene and study its inhibitory effect on the proliferation of androgen-independent prostate cancer cells DU145. Methods:Four RAGE specific oligonucleotides were designed and synthesized. These oligonucleotides were annealed to forill double strand DNA fragments and this fragment was cloned into psi-U6 plasmid. The recombinants were transfected into RAGE-overexpressing sub DU145-2C1 cells. Cellular morphology and transfection efficiency were observed under fluorescence microscope. The inhibitory effect of RAGE shRNA construct on RAGE mRNA and protein expression was examined with semi-quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) and Western blotting, respectively. The cellular proliferation was detected with cell counting kit-8 (CCK-8). Scratch test was used to observe the migration of DU145 cells.Results:RAGE shRNA expression plasmids were successfully constructed and transfected into sub DU145-2C1 cells. It can effectively inhibit the expression of RAGE mRNA (P<0.05). The inhibitory effects of shRNA RAGE-1 (R1) was the most stronger. The RAGE mRNA expression was inhibited by 84% and RAGE protein expression was inhibited by 27%. Compared with negative control, the proliferation potential was significantly decreased in shRNA RAGE-transfected cells. The cell migration capability had no significant changes. Conclusion:RAGE shRNA effectively inhibited the expression of RAGE mRNA and protein and suppressed the proliferation of DU145 cells in vitro.

Neurogenesis is a process in which the neuronal stem cells differentiate into functional neurons including the cell proliferation,differentiation and migration.Previously,it was believed that neurogenesis is a prenatal process and the adult ependymal cells are incapable of regeneration.Now it is clear that mammalian brain retains the ability to generate new ceils in specific regions.One of the regions is subventricular zone of the lateral ventricles,new generated neurons and glial cells later migrate to olfactory and repair dysosmia through the RMS road.Here we will review the advances in adult neurogenesis in mammal subventficular zone.

Blood glucose levels of 220 days were recorded in 85 type 2 diabetic patients for monitoring glycemia for 48-72 h each one by the continuous glucose monitoring system (CGMS). Frequencies of nocturnal hypoglycemia (blood glucose≤2. 8mmol/L) were estimated when bedtime blood glucose levels were≤4.4mmol/ L,≤5.0mmol/L,≤5. 6mmol/L,≤6.1mmol/L,≤6. 7mmol/L, or≤7. 2mmol/L respectively. Nocturnal hypoglycemia occurred in 39 nights of 220 days (17.7%) of 26 patients and their bedtime blood glucose level was (4.4?2.6)mmol/L with a range from 2. 2 to 12. 6 mmol/L. Using a cut-off of bedtime blood glucose at≤6. 7 mmol/L, area under the ROC curve was reached maximal value (0. 359?0. 046). The positive predictive value was 25% and the negative predictive value was 91. 7%. CCMS is a useful tool to detect unaware nocturnal hypoglycemia.

Objective To compare the clinical outcomes of transforaminal lumbar interbody fusion (TLIF) through Wiltse approach and posterior midline approach in the treatment of degenerative lumbar spondylolisthesis.Methods A total of 37 patients with degenerative lumbar spondylolisthesis were treated between March 2008 and March 2010,including 23 patients managed by TLIF via posterior midline approach ( posterior midline approach group) and 14 by TLIF via Wiltse approach ( Wiltse approach group).The Japanese Orthopaedic Association (JOA) score and visual ltanalogue scale (VAS) before and after operation,and the interbody fusion condition in both the Wiltse approach group and posterior midline approach group were reviewed and the clinical outcomes of both groups were compared.Results The follow-up lasted for 6-26 months ( mean,15.7 months),during which both groups had obvious relief in clinical symptoms like pain of waist and legs.X-ray photographs showed good spondylolisthesis reduction and interbody fusion,with no loosening or breakage of the internal fixators.The fusion rate of Wiltse approach group and posterior midline approach group at the last follow-up were 86％ and 87％,respectively.The operation time of Wiltse approach group and posterior midline approach group was ( 117.8 +25.6) minutes and ( 128.5 ± 38.7 ) minutes respectively ( P ＞ 0.05 ).The intra-operative blood loss of Wiltse approach group and posterior midline approach group was (203.5 ± 16.4) ml and (284.4 ±27.6) ml respectively (P ＜0.05).Both groups presented significant decrease of JOA score post-opera-tively (P ＜ 0.05).Also,the two groups sbowed significant difference concerning the VAS score in low back pain one week post-operatively (P ＜ 0.05),but no significant difference in terms of VAS score in leg pain at one week after operation (P＜0.05) and VAS score in pain of low back and legs at the final follow-up ( P ＞0.05).Conclusions In the management of lumbar spondylolisthesis,TLIF via Wiltse approach and via posterior midline approach can both achieve satisfactory interbody fusion rate and clinical outcomes,but the Wiltse approach results in relatively less intra-operative blood loss and faster postoperative recovery.