Objective To analyze re-treatments of recurrence after the pelvic floor repair surgery.Methods The protocol and the effect of re-treatments were investigated by reviewing and analyzing the clinical data of 81 recurrent patients (grade Ⅱ and above),who had received the pelvic floor repair surgery from January 2011 to January 2016.Pelvic organ prolapse quantitation system (POP-Q) and two questionnaires about quality of life [pelvic floor distress inventory-short form 20 (PFDI-20) and pelvic floor impact questionnaire short form (PFIQ-7)] were used to evaluate objective and subjective efficacy,respectively.Results Among 81 recurrent patients who were followed up for a median of 35 months (10-69 months),78 cases (with prolapse up to grade Ⅲ or Ⅳ) were treated by surgical operation with both objective cure rate and subjective satisfaction being 100％ (78/78);3 cases (with grade Ⅱ prolapse) were treated by pelvic floor electrical stimulation biofeedback,and 1 case among the three cases had the vaginal foreign body sensation,the subjective satisfaction was 2/3.The methods of surgical operation for the 78 recurrent patients included:total pelvic floor reconstructive surgery (55 cases;3 of which involve trachelectomy),anterior pelvic reconstructive surgery (2 cases),posterior pelvic reconstructive surgery (3 cases),Y-mesh sacral colpopexy (2 cases),colpocleisis (11 cases),vaginal hysterectomy combined posterior fornix forming (3 cases),and vaginal hysterectomy combined posterior pelvic reconstructive surgery (2 cases).Conclusion The extent of recurrence,the recurrent site and complications must be carefully considered and evaluated for re-treatments of recurrence after pelvic floor repair surgery,and then an appropriately individualized re-treatment protocol could be designed for each of the patients.

Objective To calculate the biological reference of plasma amino acid on L-8900 amino acid analyzer and to provide reference for clinical diagnosis with domestic reagents replacing original reagent .Methods By testing the original standards and the same batch of plasma (50 cases) ,we compared original reagents with domestic reagents for their performance (including resolution , repeatability ,accuracy ) .We tested the plasma free amino acids of 400 cases of healthy people using the domestic reagents to estab-lish biological reference interval of plasma amino acid ,and do correlation analysis between the amino acids level and liver function . Results (1)Domestic reagents showed high accuracy in the results of 5 consecutive detection of amino acids were high peak separa-tion and high peak retention time and high peak area .(2)Statistics derived biological reference interval of 19 amino acids and 10 kinds of amino acids had significant differences .(3)Correlation analysis showed that ALT and liver function were negatively corre-lated with threonine(P<0 .05) .GLU and valine ,isoleucine ,leucine were positively correlated(P<0 .05) .CHO and negatively cor-related with isoleucine(P<0 .05) .Conclusion Domestic agents can replace the original reagents ,on the basis ,the biological refer-ence intervals of plasma amino acids have great importance to clinical diagnosis and prognosis .

Objective To compare the incorporation method of 3H-TdR and 125Ⅰ-UdR on determining the proliferation effect of lymphocytes. Methods The proliferation effects of lymphocyte and Daudi lymphoma cells were estimated by 3H-TdR and 125Ⅰ-UdR incorporation. Results The incorporating fraction of 3H-TdR and 125Ⅰ-UdR into lymphocyte was 20.95% ± 1.06% and 1.00% ±0.04%,respectively, and the incorporating fraction for the lymphoma cells was 29. 94% ± 4. 10% and 6. 02% ±0. 73% ,respectively. The incorporation fractions of 3H-TdR into lymphocyte and lymphoma cells were much higher than those of 125Ⅰ-UdR, but the incorporating fractions of 3H-TdR or 125Ⅰ-UdR into the lymphoma cells were much higher than those of lymphocytes. Conclusions For lymphocytes, 125Ⅰ-UdR cannot substitute 3H-TdR as a tracer agent. But for lymphoma cells, whether 125Ⅰ-UdR could be replace 3H-TdR or not needs further research.

Objective To explore the nursing problems and application value of intrauterine instruments positioning in assistance of tubal interventional treatment. Methods Uterine probe or expanding-uterus stick was used in 66 cases who had abortde with routine methods for rectifying the position of uterus or adhesion re-lease, then the selected catheter was inserted to the targeted fallopian tube for interventional aim. Nurses paid at-tention to the nursing cooperation and summarized the nursing points during the whole processes. Results With this technique, the achievement ratio of selected insertion to fallopian tube was 100% and that of recanaliza-tion was 92.68%. The major adverse effects were hypogastralgia and little vaginal bleeding. Pneumogastric nervereactions were found in 3.03% cases. Conchusions The assistant-immanent could elevate the achievement ra-tio of selected insertion to the targeted fallopian tubes, but the nursing problems shouldn't be neglected.

Objective To further investigate the impact of impaired microvasculature of spinal cord and its physiological compensation on postoperative morbidity after intramedullary microsurgery.Methods In 120 cats, the segmental anterior longitudinal spinal arteries (ALSA), the posterior longitudinal spinal arteries (PLSA), and the unilateral radiculomedullary arteries (RMA) were selectively coagulated in different patterns. Hydrogen electrode technique was used to detect the changes of regional blood flow of the spinal cord at different segments. Benzidine dihydrochloride (BDHC) staining was used to observe the microvascular pattern of the spinal cord, tetrazolium chloride (TTC) staining was applied to morphometric analysis of the ischemic area, and hematoxylin-eosin staining was applied to histologic examination.Results When the segmental ALSA was injured, the blood flow of the gray matter and white matter decreased greatly. Since the central arteries were the terminal blood supply arteries, no compensation occurred after the injury. The blood flow of the segment below the impaired segment hardly changed, indicating that the direction of the blood flow in ALSA altered to adapt the changes of the microvasculature. Injury to the unilateral PLSA and RMA at both cervical and lumbar area only caused a minor decrease in the regional blood flow, unless the perimedullary arterial system was considerably injured. In the thoracic medullary segment, the sparse microvasculature was the main cause for the segment vulnerable to ischemia and infarction. This was caused by not only the rarity of RMA as an anatomic factor, but also the small number and low activity of the neurons at this area. After microsurgery, the impairment and decompensation of the microvasculature were closely related to the ischemic volume of and pathological changes in the spinal cord. Conclusion The impairment and decompensation of microvasculature after microsurgery are the rudimentary causes of spinal cord ischemia. During operation, one should protect the terminal arteries to decrease the severity of injury to the perimedullary system, and do the best to avoid disturbance of microvasculature to accelerate the recovery of postoperative ischemia and neurological dysfunction of the spinal cord.

Objective To investigate the morphological abnormalities of the brain cortex in schizophrenic patients and their parents. Methods We recruited 33 schizophrenic patients, 63 their unaffected biological parents. Thirty well matched healthy controls served as control group 1 (for patients), and 28 well matched healthy controls as control group 2 (for parents). The high-resolution magnetic resonance imaging (MRI) and Freesurfer software were used to measure the gray matter volume, cortical thickness, cortical surface area, curvature and volume of subcortical regions on all the sub-jects. Results The patients demonstrated significant reduction of cortical thickness in the left middle-anterior cingulate, middle occipital gyrus, inferior circular sulcus of the insula, lateral occipito-temporal sulcus, the right lateral occipito-temporal gyrus, middle temporal gyrus, superior circular sulcus of the insula, inferior temporal sulcus, the bilateral poste-rior-dorsalcingulated gyrus and superior temporal sulcus (P<6.0×10-4,corrected by Bonferroni method). Compared with control group 2, the unaffected parents exhibited slight reduction of cortical in the left subcentral, triangular part of the in-ferior frontal gyrus, middle frontal gyrus, superior circular sulcus of the insula, occipital pole, inferior frontal sulcus, mid-dle occipital sulcus and lunatus sulcus, lateral orbital sulcus, the right middle occipital gyrus, lingual gyrus, posterior lat- eral sulcus and inferior precentral sulcus, but the reduction was not significant after correction for multiple comparisons. Conclusions Our results indicate that cortical thickness can specifically reflect the brain morphological abnormalities of schizophrenia and the reduction of cortical thicknes may be a heritable phenotype of schizophrenia.

Objective:To investigate the possible pathological mechanisms of tardive dyskinesia (TD) by analyzing brain cortex morphological changes and it's correlation to abnormal involuntary movement in schizophrenic patients with TD.Methods:Thirty-two schizophrenia patients with TD (TD group),31 schizophrenia patients without TD (non-TD group) and 21 healthy volunteers (control group) were recruited.Combined TD and non TD group into schizophrenia group.The psychopathological symptoms and abnormal involuntary movement were assessed with the Positive and Negative Syndrome Scale (PANSS) and Abnormal Involuntary Movement Scale (AIMS).The brain magnetic resonance imaging (MRI) data and Freesurfer software were used to measure the gray matter volume,cortical thickness,cortical surface area and volume of sub-conical regions among the three groups.Results:Schizophrenia group had significantly smaller gray matter volume in right nucleus accumbens,bilateral hippocampus,left superior frontal gyrus,left precentral sulcus superior part,and cortical surface area in left precentral sulcus superior part than the controls.The TD group had significantly smaller gray matter volume in right nucleus accumbens,larger gyrus gray matter volume and conical surface area in left precentral sulcus superior part than non-TD group (Ps ＜ 0.05).To test the difference between TD and non-TD group further,the chlorpromazine equivalent dose and PANSS negative scores Was controlled,the TD group still had significantly larger gray matter volume and surface area in left precentral sulcus superior part than the non-TD group [(2.03 ±0.07) × 103mm3 vs.(1.68-± 0.07) × 103 mm3,(1.01 ± 0.03) × 103 mm2 vs.(0.84 ± 0.03) × 103 mm2;Ps ＜ 0.05].Correlation analyses showed in schizophrenia group the cortical thickness in right inferior frontal gyrus correlated negatively with PANSS positive and general scores,positively with total scores;cortical volume in left occipital temporal sulcus correlated negatively with PANSS general and total scores,right inferior frontal gyrus correlated positively with PANSS positive scores,right intraparietal sulcus correlated positively with PANSS positive scores.In TD group,the cortical volume in left precentral sulcus superior part correlated positively with AIMS scores (r =0.46,P ＜0.01).Conclusions:The schizophrenia patients with TD had significantly increased gray matter volume and cortical surface area in left precentral sulcus superior part,which suggested there were motion compensation in the left precentral sulcus superior part in the pathogenesis of TD.

OBJECTIVE:To improve the quality standard for Qiwei maqianzi pills.METHODS:TLC was used for the qualitative identification of Chebulae Fmctus and Aucklandiae Radix in the preparation.HPLC method was used for the content determination of hydroxy safflor yellow A,brucine and strychnine in preparation.The determination was performed on Phenomenex Prodigy C18 column with mobile phase consisted of methanol-acetonitrile-0.7％ phosphoric acid soulution(26 ∶ 2 ∶ 72,V/V/V,for hydroxy safflor yellow A),acetonitrile-0.01 mol/L sodium heptanesulfonate mixed with same quantity of 0.02 mol/L potassium dihydrogen phosphate (pH adjusted to 2.8 using 10％ phosphoric acid,21 ∶ 79,V/V,for brucine and strychnine) at the flow rate of 1.0 mL/min.The detection wavelengths were 403 nm (for hydroxy safflor yellow A) and 260 nm (for brucine and strychnine).The column temperature was 25 ℃C,and the injection volume was 10 μL.RESULTS:TLC spots of Chebulae Fructus and Aucklandiae Radix were clear and well-separated without interference from negative control.The linear range was 6.29-62.94 μg/mL for hydroxy safflor yellow A(r=0.999 3),1.83-18.30 μg/mL for brucine(r=0.999 4) and 2.11-21.11 μg/mL for strychnine (r=0.999 6).RSDs of precision,stability and reproducibility tests were lower than 2.0％.The recoveries were 101.66％-104.91％(RSD=1.14％,n=6),99.58％-104.55％ (RSD=1.75％,n=6) and 101.22％-104.04％ (RSD=0.99％,n=6),respectively.CONCLUSIONS:Improved standard can be better used for quality control of Qiwei maqianzi pills.

Objective To observe the influence of different tilt positions for laparoscopic hysterectomy on intraocular pressure and patients’ postoperative comfort.Methods Totals of 80 patients with laparoscopic surgery with grade-I anesthesia ( American Society of Anesthesiologists, ASA) were chosen and divided into group A(15°T) and group B (30°T) by using the random table methods, with 40 cases in each.Intraocular pressure of patients at baseline ( T0 ) , 30 minutes ( T1 ) and 60 minutes ( T2 ) of pneumoperitoneum and after changing the position, and 10 minutes after pneumoperitoneum were monitored.The follow-up of the patients was within 24 hours asking the comfort of them.Results The intraocular pressure of patients at T1 and T2 in group A were (18.16 ±2.16) and (19.60 ±2.18) mmHg, which were significantly lower than group B [(19.21 ± 2.17) and (20.87 ±2.17) mmHg] (t =2.168 9, 2.611 3, respectively;P <0.05).The incidences of postoperative ocular discomfort and back pain in group A were 2.5% and 7.5%, respectively, which were significantly lower than group B (20.0%, 25.0%) (χ2 =4.507 5, 4.500 6, respectively;P<0.05).The incidences of nausea, vomiting, and leg pain had no significant differences (χ2 =0.238 1, 0.000 0, respectively;P>0.05).Conclusions 15°head-down position laparoscopic surgery has less effect on the patient’ s intraocular pressure than 30°head-down position laparoscopic surgery, besides, patients have more comfort.

Objective To investigate the clinical significance of the expression of antioxidant 1 copper chaperone protein(ATOX1)in hepatocellular carcinoma(HCC)and its relationship with tumor proliferation,migration and invasion.Methods The expression of ATOX1 mRNA in HCC cancer tissue and normal liver tissue was analyzed using the Human Genome Atlas database.Immunohistochemical experiment was used to detect the expression of ATOX1 in 15 cases of HCC cancer tissue and adjacent tissue.Human HCC cell lines Hep3B and HepG2 were divided into the control group(NC),the ATOX1 knockdown group 1(si-ATOX1#1)and the ATOX1 knockdown group 2(si-ATOX1#2).The effects of ATOX1 knockdown on the malignant biological behavior of HCC cells were observed through CCK-8 cell proliferation experiment,scratch experiment and Transwell invasion experiments.A nude mouse xenograft tumor model was constructed to analyze the effect of ATOX1 knockdown on the quality and volume of transplanted tumors.Western blot assay was used to detect the relationship between ATOX1 and JAK2/STAT3 pathway protein expression.Results Bioinformatics analysis showed that expression of ATOX1 mRNA in HCC cancer tissue was higher than that in adjacent normal tissue(P＜0.05).The immunohistochemical staining results showed that the positive rate of ATOX1 protein was higher in HCC cancer tissue than that in adjacent tissue(93.33%vs.13.33%,P＜0.01).In vitro experimental results showed that siRNA knockdown of ATOX1 protein expression in Hep3B and HepG2 cells significantly reduced the proliferation,migration and invasion abilities of cancer cells(P＜0.05).In vivo experiments in mice showed that the volume and weight of subcutaneous xenograft tumors were significantly smaller in the sh-ATOX1 group than those in the sh-con group(P＜0.05).The expression levels of JAK2/STAT3 pathway-related proteins p-JAK2,p-STAT3,CyclinD1 and MMP2 were significantly lower in the subcutaneous transplanted tumor tissue of the sh-ATOX1 group than that of the sh-con group(P＜0.05).Conclusion ATOX1 can promote the proliferation,migration and invasion of HCC through JAK2/STAT3 pathway,which can potentially become a potential tumor marker and therapeutic target.