Objective To evaluate the complications after trans-vaginal mesh-augmented pelvic floor reconstruction in treatment of pelvic organ prolapse (POP).MethodsFrom February 2007 to October 2009,vaginal mesh procedures were performed on 91 women with POP stage Ⅲ-Ⅳ in Pekiug University Third Hospital.The operative complications were studied.Results Ninety patients underwent successful surgery among 91 patients.Follow-up rate was 94％ (85/90) at a median follow-up of 28.4 ( 15 -44) months.One patient underwent intraoperative organ injuries,and 10 patients had postoperation mesh-related complications.The rate of mesh-related complications was 2％ ( 2/85 ),2％ ( 2/85 ),4％ ( 3/85 ),4％ ( 3/85 ) on 6,6 - 12,12 -24 and more than 24 months following up,respectively.Seven patients underwent conservative treatment and the symptoms were improved.Three patients underwent the second surgery,and the symptoms were cured or relieved.Conclusion The incidence of mesh-related complications was low,and interventions were effective in vaginal mesh procedure.

Objective To study the expression and interactions of DNA methyltransferase 1 (DNMT1),enhancer of zeste homolog 2 (EZH2) and histone deacetylase 1 (HDAC1) in gastric cancer cell lines and tissue specimens.Methods The expression of DNMT1,EZH2 and HDAC1 was detected at mRNA and protein level in gastric cancer lines MKN28,SGC7901,BGC823,AGS,normal gastric epithelium cell line GES-1 and 10 pairs of fresh gastric cancer tissues and corresponding normal gastric tissues by real-time polymerase chain reaction and Western blot.Whether DNMT1,EZH2 and HDAC1 forming complex or not was detected by co-immunoprecipitation (Co-IP) in well-differentiated gastric cancer cell line MKN28,medium-differentiated gastric cancer cell line SGC7901,lowdifferentiated gastric cancer cell line BCG823,normal gastric epithelium cell line GES-1,mediumdifferentiated,medium to low-differentiated,low-differentiated gastric cancer tissues and corresponding normal gastric tissues.Results Compared with that of normal gastric epithelium cell and gastric tissue,the expression of DNMT1,EZH2 and HDAC1 in gastric cancer cell lines and gastric tissue was higher.The results of Co-IP indicated that DNMT1,EZH2 and HDAC1 formed complex in the high,medium,and poor differentiated gastric cancer cells and the medium,mediumlow,poor differentiated gastric cancer tissues,but not in normal gastric epithelium cell and tissue.Conclusion DNMT1,EZH2 and HDAC1 highly expressed in gastric cancer and there was interaction effects among them,which might be an important mechanism in the correlation between DNA methylation and histone modifications in gastric cancer.

Objective To investigate the value of combined therapy for hand post-burn scars.Methods We retrospectively analyzed 78 hands post-burn scars in 46 cases from 2007 to 2011.A mong them,scar contracture releasing,scar excision,free skin grafting and fixation with Kirschner's pins were performed in 38 hands,scar excision and regional flat transfer were performed in 18 hands,scar excision and skin grafting were performed in 18 hands,abdominal expanded flap transplantation and scar excision were performed in 4 hands.All patients received elastic sleeve pressure therapy,sili cone gel for external application and function training.Within six months after the operation,52 hands received drug delivery by wax therapy,16 hands incision with scar proliferation received drug injection into scar.We followed up all patients from half a year to three years after the treatment to observe the recovery of the appearance and function of the hands.Results We mainly chose surgery,elastic sleeve pressure therapy,silicone gel for external application,drug injection into scar,wax therapy,function training and so on treating the hand post-burn scars and found that the joins deformities caused by scar contracture were largely or totally corrected.The function and appearance were satisfying.Conclusions It is a good method to treat hand scars by surgery and post-surgery combined physical rehabilitation therapy,which deserves to popularization.

Objective To evaluate the effects of silicone pessary treatment on relieving the symptoms and improving the life quality of the pelvic organ prolapse patients.Methods From November 2005 to March 2009,33 pelvic organ prolapse (POP-Q stage Ⅲ～Ⅳ) patients received silicone pessary coneervative treatment were followed up and required to complete the Pelvic Floor Distress Inventory-20 (PFDI-20) before and after initiating pessary treatment.Results 31 of 33(93.94%) patients finished the follow-up completely.23 of 31(74.19%) patients continually used the pessary.The follow up time was 3 to 17 (10.04±2.57) months.27 patients completed the PFDI-20 questionnaires.Before silicone pessary treatment, PFDI20 total score,POPDI6 (Pelvic organ prolapse distress inventory),CARDI8 (colorectal anal distress inventory 8) and UDI6 (urinary distress inventory 6) scores were (54.16±36.12),(27.78±17.30),(0.61±1.01) and (25.77± 24.10),respectively.After the treatment of pessary,the scores decreased to (20.20±25.98), (4.48±5.88), (0.45±0.84) and (15.28± 21.53),respectively.Except for CARDI8,the PFDI scores decreased significantly after the pessary treatment (P＜0.05).Conclusion Silicone pessary is a viable noninvasive treatment for pelvic organ prolapse.It could relieve the symptoms and improve the life quality of protrusion and voiding dysfunction patients.

Objective To evaluate the therapeutic effect and influence factors of silicone pessary in treatment of pelvic organ prolapse ( POP).Methods From October 2005 to October 2010,132 with symptomatic POP managed by pessary were enrolled in this retrospective study.Validated prolapse quality of life questionnaire (pelvic floor distress inventory short form 20,PFDI-20),pelvic floor impact questionnaire short form 7 (PFIQ-7) and the patients' satisfaction degree were used to evaluate the therapeutic effect.Clinical characteristic of the patients with successful using for more than 6 months ( successful fitting group),giving up within 6 months (giving up group),unsuccessful fitting (unsuccessful fitting group)were compared.Factors influencing satisfaction degree and causing discontinuation were investigated.Results One hundred and six among 132 ( 106/132,80.3％ ) patients were in successful fitting group,26 (26/132,19.7％ ) patients were in the unsuccessful fitting group.In the successful fitting group,86.8％ (92/106) patients were followed up,the median follow-up time was 12.5 months.And 78.3％ ( 72/92 ) patients continued to use pessary with the wearing time ranged 3 -69 months; 21.7％ (20/92) patients discontinued with the wearing time ranged 1 -38 month,14 patients (14/20) gave up in the initial 6 months.The median scores of PFDI-20 and PFIQ-7 questionnaires before pessary use were 50.0 and 47.6,which decreased to 8.9 and 0.0 after pessary use (P＜0.05).And 87.1％ (61/70) patients were satisfied.There was no significantly difference among 3 groups on clinical characteristics,such as age,body mass index ( BMI ),pelvic surgery and so on (P ＞ 0.05 ).The main factor influencing satisfaction degree and causing discontinuation was difficulties in placing and removing.Conclusions Silicone pessary is effective for patients with POP.It could relieve discomfort symptoms and improve quality of life.The main factorinfluencing pessary use is difficulties in placing and removing.Thus,More suggestions are needed for patients in the initial 6 months.

Objective To evaluate clinical outcome and complications of mesh-augmented vaginal reconstructive surgery in treatment of pelvic organ prolapse. Methods From Feb 2007 to Jan 2009, meshaugmented vaginal reconstructive surgery were performed on 66 women with pelvic organ prolapse stage Ⅲ-Ⅳ. Pre and postoperative symptoms, pelvic organ prolapse quantitation (POP-Q) stage and pelvic floor distress inventory-short form 20 (PFDI-20) measurements were studied to assess anatomic and quality-of-life outcome. Operative complications were also analyzed. Results Totally 65 patients underwent successful surgeries. The rate of follow-up was 97% (63/65) with a median follow-up of 17. 2 months. Subjective cure rate and objective cure rate were both 97% (61/63) at 6 and 12 months after surgeries, 51 women completed PFDI-20 measurements and scores were 102 ± 50 before surgery, 16 ± 21 at 6 months and 15 ± 20 at 12 months. It reached statistical difference when scores were compared before and after surgeries ( P ＜0. 05). Among 66 patients, 2 patients underwent organ injuries, 2 had recurrent prolapse, 4 had meshrelated complications and 1 had severe de novo stress urinary incontinence. Six patients underwent second surgery. Conclusions Mesh-augmented vaginal reconstructive surgery in treatment of pelvic organ prolapsed brought satisfied clinical outcome. The incidence of mesh-related complications was low and secondary operative interventions were effective.

Objective To evaluate the efficacy of percutaneouse trans-hepatic Cyanoacrylate (TH glue) embolization for gastric varices. Methods TH glue was injected into the gastric varices and its feeder veins in 30 patients. The endoscopy was performed at 1 week and every 3 months after the procedure, while the CT and portal vein angiography were performed at 3 months and every 6 months after the procedure to e-valuate the oblitazation results. Results The effective rate of treatment was 100%. A total of 21 patients were followed up in a mean period of 27.9 months (11-33 months) with a recurrence rate of varices at 14. 29% (3/21). Portal hypertensive gastropathy was observed in 17 patients (80. 95%), and to-bleeding occurred in 2 patients (9. 52%) due to portal hypertensive gastropathy. CT and portal vein angiography dis-played TH glue in fundic peripheral veins, perforating veins in the gastric wall and other feeding veins with-out re-ciroulation or new branches after embolization. Conclusion Peroutaneous trans-hepatic TH glue is a-ble to embolize the gastric varices and its feeding veins, which is feasible and effective in treatment of gastric varices.

Objective To investigate the relevance between expectations before treatment, new symptoms and satisfaction after treatment of the pelvic organ prolapse (POP) patients. Methods Made a collection of 75 cases of POP patients at Peking University Third Hospital, who were affected by the POP symptoms and came to our clinic for treatment from January to December in 2013. Prospectively investigate the patients′expectations before treatment, which were the most troubling symptoms to be solved. According to treatment we divided the patients into surgery and pessary groups. Two groups were followed up with the degree to achieve the desired goals using patient global impression of improvement (PGI-I), new symptoms and satisfaction after treatment, try to find the relevance between expectations before treatment, new symptoms and satisfaction after treatment. Results There were 47 (63%, 47/75) patients in the surgical group and 28 (37%, 28/75) patients in the pessary group. The top three problems for patients were friction when walking (25%, 19/75), dysuria (23%, 17/75) and the feeling of vaginal prolapse (19%, 14/75). The follow-up rate was of 93% (70/75), follow-up time was (5 ± 4) months. Satisfaction score after treatment of surgical group was higher than that of pessary group [(4.9±0.4) versus (4.0±1.3) scores, P<0.01]. There was no statistically significant difference between two groups of PGI-I score [(6.7±0.6) versus (6.6±0.9) scores, P=0.886]. The top three new symptoms after treatment were increased secretion, urinary incontinence and dysuria. PGI-I and satisfaction scores was relevant (P=0.021). The availability of new symptoms and satisfaction scores was relevant (P=0.001). Conclusion When achieving higher expectations to the treatment and no more new symptoms, the satisfaction score after treatment is higher.

Objective To explore the clinical value of MRI in diagnosing and treating cesarean scar pregnancy (CSP).Methods A retrospective analysis was conducted on the clinical manifestations of 54 patients diagnosed with CSP between January 2009 to January 2013 in Peking University Third Hospital.Based on the patients' MRI image and other clinical datas,we did transvaginal operation on patients with CSP1,and transvaginal combined with abdominal operations on patients with CSP2.The intraoperative blood loss,operation time,postoperative hospital stay,and the length of time required for of serum hCG dropping to normal of the patients were analyzed.Results The average age of the 54 patients was (34±5) years and the average duration of gestation was (56± 16) days,all patients' vital sign were stable,the hCG level was 23-142 962 U/L before treatment.Twelve patients were diagnosed with CSP1 by MRI,and 5 of them had focus of 1-2 cm in diameter,the 5 patients' serum hCG level was 436-1 159 U/L and 23-32 days after drug administration,their hCG level returned to normal; the other 7 patients had focus of 2.0-4.4 cm in diameter,and their hCG level was 2 218-63 446 U/L,lesion resection was done on the 7 patients by hysteroscope or under B-uhrasound monitor.Forty-two patients were diagnosed with CSP2,and their focus were 1.0-7.1 cm in diameter,and serum hCG level were 23-142 962 U/L.We did bilateral uterine artery occlusion by laparoscope or laparotomy during operation for 22 patients or bilateral uterine artery embolization (UAE) before operation for 20 patients,then we did lesion resections.The blood loss during operation of CSP1 or CSP 2 was 50.1,267.2 ml; operation time was 30,128 minutes; postoperative hospital stay was 4.6,6.7 days;their serum hCG returned to normal 13-30 days after the surgery.All the 54 patients' uterus were preserved,and the patients undergoing operations were all cured without the second operation.Conclusion MRI is an effective method to conduct clinical treatment in CSP.

Objective To investigate the factors influencing therapy decision of surgery or pessary in patients with severe pelvic organ prolapse (POP). Methods Totally 419 cases ofⅢtoⅣdegree POP patients were studied retrospectively. Patients were divided into surgery and pessary groups according to their own choice. Clinical characters were compared such as age, body mass index (BMI), age of onset and disease duration, POP stage, complications. Results 67.5%(283/419) patients were in the surgical group and 32.5%(136/419) patients in the pessary group. Patients in surgical group had higher BMI [(25.1 ± 3.5) versus (23.8±2.6) kg/m2], elder age of onset [(62±12) versus (57±11) years old], longer disease duration [(5± 8) versus (11±11) years] and higher POP staging of middle compartment and less cardiac disease [20.1%(57/283) versus 30.9% (42/136)] than those in pessary group, all had significant difference (P<0.05). Logistic regression analysis on the above factors showed a statistically significant difference between two groups, BMI, disease duration and POP staging of middle compartment were independent factors (OR=1.141, 0.932, 1.389;all P<0.01). Conclusions Patients with higher BMI, higher POP staging of middle compartment and less cardiac disease tended to choose surgery. Patients with younger age of onset and longer disease duration tended to choose pessary. Factors as age, POP staging of anterior and posterior compartment, history of POP surgery, complicated with hypertension and diabetes, showed no influence on treatment choice.