Objective To investigate the effect of Tianma Gouteng Decoction(TGD) on myocardial fibrosis in spontaneously hypertensive rats(SHR) and to explore its possible mechanism. Methods Twenty-four male SHR with 8 weeks old were equally randomized into three groups: TGD(20g/kg) group,captopril(100mg/kg)positive group and the model group.Eight Wistar Kyoto rats(WKY) with the same age served as the controls.The systolic blood pressure(SBP),left ventricular mass(LVM),left ventricular mass index(LVMI),myocardial collagen(MC) content in left ventricle of three groups were determined after treatment for 24 weeks.Meanwhile,the expression of myocardial insulin-like growth factor 1(IGF-1) was determined by reverse transcription-polymerase chain reaction(RT-PCR) assay.Results TGD had an effect on decreasing the SBP,LVM,LVMI,MC content and IGF-1 expression(P

Objective To investigate the changes of collagen types Ⅰ and Ⅲ, the effects of Oleum Curcumae Aromaticae oil injection on injuried rat arteries and collagen types Ⅰ and Ⅲ after balloon angioplasty Methods The left common carotid artery in rats was denuded with a balloon catheter The rats were killed 14 days after injury Cross sections stained with picrosirius red from the injuried segments were processed for distribution, arrangememt, amount, proportion of collagen type Ⅰ and type Ⅲ by polarizing microscope, and those stained with hematoxylin eosin for histological and morphological changes studied by computer assisted picture analysis system Results Fourteen days after balloon injury, collagen type Ⅰ and type Ⅲ of the model group were found mainly in adventitia, much more, thicker, brighter and more disordered than those of the sham operation group Compared with the model group, collagen type Ⅰ and type Ⅲ of the E Zhu You group were found mainly in adventitia, less, thinner, dimmer and more orderly Lumen area, EEL perimeter, IEL perimeter of the model group were decreased and the areas of collagen types Ⅰ and Ⅲ increased more significantly than those of the sham operation group Compared with the model group, maximal intimal thickness, neointima area, the areas of collagen type Ⅰ and Ⅲ of the E Zhu You group were decreased significantly which was not different from those of the sham operation group Lumen area, EEL perimeter and IEL perimeter were increased markedly up to those of the sham operation group The ratio of collagen subtypes Ⅰ/Ⅲ was not significantly different between the two of the three groups Conclusion The accumulation and derangement of collagen types Ⅰ and Ⅲ may be more important in restenosis than the ratio of collagen subtypes Ⅰ/Ⅲ We concluded that Oleum Curcumae Aromaticae oil injection inhibits neointimal formation and vascular remodeling after arterial injury by mechanisms involving collagen types Ⅰ and Ⅲ production and their arrangement

BACKGROUND: 5-azacytidine (5-Aza) has been frequently used to induce bone marrow mesenchymal stem cells (BMSCs)differentiation into cardiomyocyte.OBJECTIVE: To observe expression of cardiomyocyte-related receptors in cardiomyogenic differentiation of rat BMSCs.METHODS: BMSCs of passage three were assigned to four groups: group Ⅰ: L-DMEM solution alone was replaced; Ⅱ:L-DMEM solution was replaced after induction of 100 mg/L AST+5 μmol/L 5-Aza for 24 hours; group Ⅲ: L-DMEM solution wasreplaced after induction of 10 μmol/L 5-Aza for 24 hours; and group Ⅳ: L-DMEM solution was replaced after induction of 5 μmol/L5-Aza for 24 hours. Culture medium was replaced every 3 days in each group. Differentiated cells were identified after 30 days ofinduction.RESULTS AND CONCLUSION: Expression of cardiomyocyte specific proteins Nkx2.5, cTnT and Desmin was detected in groupsⅢ, Ⅳ and Ⅱ after induction compared with group Ⅰ , with significant differences (P < 0.01). The amount of cTnT and Desminexpression expression was significantly higher in groups Ⅱ and Ⅲ compared with group Ⅳ (P < 0.01). The level of Nkx2.5expression was significantly higher in groups Ⅱ (P < 0.01) and Ⅲ (P < 0.05) compared with group Ⅳ. No Nkx2.5, cTnT andDesmin espression was detected in group Ⅰ. After induction for 2 weeks, cells with spontaneous contractility were observed ingroups Ⅱ and Ⅲ, indicating differentiation towards cardiomyocyte after induction. Results demonstrated that induction effectswere similar between 100 mg/L AST+5 μmol/L 5-Aza and 10 μmol/L 5-Aza. This may contribute to cytoprotective effects of AST,which can promote vascular endothelial cell proliferation, enhance celss tolerance to 5-Aza-induced cytotoxicity and upregulatecardiac-specific protein expression.

Objective To investigate the clinical efficacy and improvement of patients' quality of life in tension-free vaginal tape(TVT)and tension-free vaginal tape obturator(TVT-O)for surgical treatment of severe female stress urinary incontinence.Methods This study was a randomized,singleblinded,controlled trial.Patients were randomized by a computer-generated randomization schedule with allocation to either TVT or TVT-O procedure.TVT procedure was performed in 35 cases and TVT-O in 34 cases.None had received surgery for urinary incontinence or was in pregnancy.Transvaginal hysterectomy and prolapse reparation were done simultaneously in some of the patients.All patients were requested to complete the Urinary Distress Inventory(UDI-6)and Incontinence Impact Questionnaire(ⅡQ-7)as part of their pre-and postoperative assessment.Results All patients were evaluable and the mean follow-up was 14.5 months.The mean operative time was(18±5)min in the TVT-O group,Significantly shorter than in the TVT group(27±5)min(P＜0.01).The two groups did not differ significantly in perioperative blood loss,postoperative complications(including tape erosion,pain in thigh or behind pubis),postvoid residual volume,hospital stays or expenses(all P＞ 0.05).Sixty patients were successfully treated for stress urinary incontinence(88.6%and 85.3%for TVT and TVT-O groups,respectively).There were significant improvements in postoperative scores for both the ⅡQ-7 and the UDI-6(P＜0.01),except in subscale measuring symptoms of voiding dysfunction(P＞0.05).Conclusions Both techniques appear to be equally effective in the surgical treatment of severe stress urinary incontinence in a short term review.Significant improvements could also be seen in patients' quality of life.However.TVT-O has a shorter operative time.No evidence of increasing risk of urethral obstruction after the operation could be found.Long term followups axe necessary to evaluate outcomes of different types of surgery for stress urinary incontinence.

The cytoplasmic and nuclear changes during the development of goat oocytes were studied with light and electron microscopy. The oocyte development may be divided into 8 stages in accordance with the number and distribution of follicle cells and the size of the follicle. The results indicated that the Golgi complex, mitochondria, smooth endoplasmic reticulum and cortical granules became well developed and they moved into the cortical region as the oocyte development proceeded. In the oocytes in the follicle of 1.5-3mm in diameter, all the mitochondria became hooded and the number and size of fibrillar centers in the nucleolus reached maximum, but the nucleolar compaction still not occured at this stage. By the time when the follicle reached 3.5-5mm in diameter, the follicular cell processes began to degenerate, the microvilli of the oocyte withdrew from the zona pellueida and the oocytes might be cultured to mature in vitro. In the mature oocytes, Golgi complex and rough endoplasmic reticulum disappeared, the cortical granules arranged themselves in one layer beneath the oolemma, the mitochondria dispersed in the central region of cytoplasm and the eggs were ready for fertilization.

Objective To observe the effects of Tianma Gouteng Yin (TGY) on the proliferation of myocardial fibroblasts of spontaneous hypertensive rat(SHR) stimulated by insulin. Methods The cardiac fibroblasts from one-day-old spontaneously hypertensive rat were primarily cultured and then sub-cultured to 3rd-6th generation,and were identified with light microscopy and immunohistochemical technique. The effect of serum containing TGY on the proliferation of cardiac fibroblasts of SHR treated with insulin was determined by MTT colorimetric assay and 3-H-TdR incorporation,and the cell cycle was analysised with flow cytometer. Results TGY inhibited the proliferation of cardiac fibroblasts induced by insulin. Insulin can stimulate the proliferation of fibroblasts by promoting the cell cycle transfer from G0/G1 period to S period and increasing the synthesis of cell DNA. Compared with the model group,the percentage of the cells at G0/G1 period was much higher,while the percentage of the cells at S period was much lower in TGY group. Conclusion TGY has the effect on inhibiting the proliferation of cardiac fibroblasts and inhibiting the cell cycle transfer from G0/G1 period to S period,which may be one of its therapeutic and protective mechanisms for hypertension and myocardial fibrosis in clinic.

Objective To evaluate clinical and sexual outcomes in women with severe uterine prolapsed at child-bearing period undergoing laparoscopic high uterosacral ligament suspension combined with cervical amputation.Methods From November 2007 to March 2010,34 patients (≤50 years old) with severe uterine prolapse (prolapse group) who had already given birth and underwent laparoscopic high uterosacral ligament suspension combined with cervical amputation in Peking Union Medical College Hospital were enrolled in this retrospective study.All patients were defined as Pelvic Organ Prolapse Quantification (POP-Q) stage Ⅲ.Follow-up was performed at 1,6,and 12 months,and then annually.Anatomic failure was defined as ≥ 1 pelvic compartment classified as POP-Q ≥ stage Ⅱ.Sexual outcomes were assessed at baseline and 3-year follow-up according to validated Short-Form Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12).Thirty one age-matched women who underwent health examinations during the same time period were selected as a healthy control group.Results Mean age of women at prolapse group were (39 ±5) years and average surgery time were (51 ±8) minutes.No severe intraoperative complications occurred,including urethral twist,bladder and rectum injury,pelvic hemotoma.All patients were followed up for more than 3 years,the mean following up period was 40 months (36-64 months).Based on stage Ⅱ of POP-Q as recurrence criteria,the anatomical success and patient satisfaction rates were both 100％ (34/34).POP-Q point C and D measurements were significantly higher after surgery then those at preoperative values [C:(-5.4±0.6) cm versus (2.2 ±0.7) cm,D:(-6.7 ±0.4) cm versus (-4.0 ±0.7) cm; P ＜0.01 for all].Three years postoperatively,33 patients were sexually active.Among the 94％ (31/33) patients who answered the PISQ-12 questionnaire,there was significant improvement in post-and preoperative total PISQ-12 scores (38 versus 26,P ＜ 0.01) and in all three subscale PISQ-12 domains (P ＜ 0.01 for all).The postoperative PISQ-12 score was similar to that of the control group (38 ± 6 versus 37 ± 3,P ＞ 0.05).Conclusion Laparoscopic high uterosacral ligament suspension combined with cervical amputation conferred satisfying long-term anatomic and sexual function outcomes in women at child-bearing age.

Objective To investigate clinical outcome of laparoendoscopic single-site compared with traditional three-port in treatment of ovarian cystectomy.Method From February 2012 to June 2013,54 patients with ovarian cyst were randomized to the single-site group (n =24) or the three-port group (n =30) in Peking Union Medical College Hospital.The outcome of laparoscopic single-site and three-port ovarian cystectomy were evaluated.Operation time,blood loss,surgical complications,postoperative pain score,postoperative analgesic requirements,length of hospital stay,cosmetic satisfaction score,postoperative recovery and total cost were compared between both groups.Results No difference was found in blood loss,length of hospital stay,complications and total cost between the two groups(P ＞ 0.05).Operation time was (31-± 10) minute in three-port group and (40 ± 19) minute in single-site group.Visual analogue pain score was 5.6 ± 1.7 in three-port group and 2.7 ± 1.4 in single-site group,cosmetic satisfaction score was 92.5 ± 2.5 in three-port group and 97.4 ± 1.5 in single-site group.Those clinical parameter reached statistical difference (all P ＜ 0.05).Conclusion Laparoendoscopic single site surgery approach is feasible and safe to treat benign ovarian cyst disease.And it offers decreased pain and offer improved cosmesis.

Objective To evaluate the safety and efficacy of ischiospinous ligament fixation in treatment of stage Ⅲ pelvic organ prolapse (POP).Methods Between March 2007 and December 2009,65 patients with stage Ⅲ POP who underwent ischiospinous ligament fixation in Peking Union Medical College Hospital were enrolled in this study.Among 21 cases complicated with stress urinary incontinence (SUI) underwent transobturator tension-free vaginal tape (TVT-O) concomitantly.Clinical parameter associated with perioperation,objective and subjective successful rate and complication were recorded.Results The mean operating time was (71 ±22) min and the mean blood loss was (93 ±40) ml.No intraoperative blood transfusion and viscera injury cases were observed.All patients were able to recover spontaneous micturition.Two cases experienced pelvic hematoma with diameter of 7 cm,after conservative treatment,they all recovered later.The objective success rate was 100％ at 6 weeks follow-up by POP-Q scoring.And 46.2％ (30/65) were followed up at range of 1 -3 years,recurrence rate were 10％ (3/30),and however,no operation were needed.At median of 20 months,all patients were followed up by telephone,the subjective successful rate was 95.4％ (62/65).At 6 weeks after operation,6.2％ (4/65) patients suffered from lower back pain and right thigh pain,visual analogue scale of pain was at range of 3 to 5,which relieved gradually after treatment and disappeared totally within 2 years.The rate of suture exposure was 10％ (3/30),the new urinary incontinence 4.6％ (3/65),and the new dyspareunia 12.5％ (3/24).Conclusions Ischiospinous ligament fixation is a safe and efficacious management.

Objective To investigate strategies of diagnosis and treatment of ureter endometriosis. Methods From 1983 to 2010, the cases registered in Peking Union Medical College Hospital and confirmed as ureter endometriosis by surgery were enrolled in this study. Clinical manifestatios, preoperative examinations, surgical categories and routes, surgical and pathological findings, post-operative medical treatment, relapse and relating factors were collected and studied. Results Totally 46 patieuts with ureter endometriosis underwent one or two surgeries. Forty-eight per cent (22/46) of patients were not be diagnosed with ureter endometriosis pre-operatively, and 46% (21/46) only presented dysmenorrhea or even no symptoms. Ureterolysis (72%, 33/46) and laparotomy (63%, 29/46 ) were the most common surgical category and surgical approach. There were 64% (25/39) of patients had left ureter involved and 80% (37/46) had extrinsic ureter endometriosis. Fifteen per cent (7/46) of patients had relapsed disease with median recurrent time of 24 months (13 -49 months), and they all received second surgeries. Logistic regression analysis showed that only gonadotropin releasing hormone analogue agents were related with recurrence when compared with those patients without medical treatment post-operatively significantly ( OR =23.2, 95% CI:2. 4 -221.7, P =0. 002). Conclusions Ureter endometriosis was related with reproductive tract endometriosis. It has insidious process resulting in difficulty for early diagnosis. It's important to treat pelvic deep infiltrating endometriosis and ovarian endometrioma to prevent ureter from further involvement. Post-operative treatment of pelvic endometriosis is the key point of preventing relapse of ureter endometriosis.