To assess the effectiveness and safety ofinside-out (TVT-O) vs. outside-in transobturator-tape procedures (TOT) in the surgical management of female stress urinary incontinence (SUI).A total of 8 randomized controlled trials were retrieved from the literature and analyzed by metaanalysis with RevMan 5.0 software.Meta-analysis showed that no statistical differences existed in objective cure rate,objective failure,postoperative voiding dysfunction,groin/thigh pain and sling exposure in both procedures (P ＞ 0.05).These preliminary results suggest there is no evidence of significant differences in the efficacy and safety between TVT-O and TOT.

Objective To study the prevention,diagnosis and treatment of the pulmonary embolism after abdominal surgery.Methods The clinical data of patients with acute pulmonary embolism(PE) after abdominal surgery between July 2008 and June 2012 were analyzed retrospectively.The high-risk patients received D-dimer,deep venous ultrasound and pulmonary CT examination to confirm the diagnosis postoperatively.Anticoagulation,thrombolysis,inferior vena cava filter placement were carried out in these patients.The high-risk patients received low molecular weight heparin(LMWH) to prevent PE from January 2010.Results 5 patients with PE survived and 3 patients died.The incidence of venous thromboembolism event was 0.43％ (13/3012) before January 2010 and PE was 0.20％ (6/3012).The incidence of venous thromboembolism event was 0.15％ (7/4803) after taking preventive measures and PE was 0.04％ (2/4803).There was no PE within 1 week since using LMWH after 2010.Lower limb DVT was found in 7 patients including 2 patients with PE after LMWH discontinuance within 2-3 weeks postoperatively.Conclusions Early prevention,diagnosis and treatment of postoperative PE are important for high-risk patients.

Objective:To evaluatte the high risk factors of stent occlusion in patients with acute iliofemoral vein thrombosis and Cockett syndrome.Methods:The clinical data of 178 patients of Cockett syndrome and acute lower extremity deep vein thrombosis from Jan 2014 to Dec 2016 was analyzed retrospectively. All patients underwent catheter directed thrombolysis or percutaneous mechanical thrombectomy combined with stent placement. The patency rate of stent was followed up by color Doppler ultrasound. Patients were divided into study group (stent occlusion) and control group (stent patency).Results:The stent patency rate at 6 months was 83.7%, body mass index ( OR=1.245, 95% CI: 1.097-1.413), time of thrombosis more than 2 weeks ( OR=3.899, 95% CI: 1.147-13.257), low thrombus clearance ( OR=0.238, 95% CI: 0.117-0.486) was the high risk factor of short-term stent occlusion. Stent patency rate at 3 years was 75.3%, body mass index( OR=1.225, 95% CI: 1.076-1.394), thrombosis history more than 2 weeks( OR=11.777, 95% CI: 2.576-53.832), malignant tumor( OR=4.444, 95% CI: 1.153-17.127) , compression therapy( OR=0.332, 95% CI: 0.113-0.977), low thrombus clearance( OR=0.184, 95% CI: 0.089-0.381), long stents( OR=8.427, 95% CI: 2.329-30.488) was the high risk factor for mid-term stent occlusion. Conclusions:Obesity, the duration of thrombus longer than 2 weeks and low thrombus clearance are the high risk factors of early stent occlusion, while malignant tumor, irregular compression therapy and long stents may lead to lower medium and long term patency rate of the stent.

ObjectiveTo compare the therapeutic effects of a new surgical endoscopic technique, the transilluminated powered phlebectomy (TriVex System, Smith+Nephew) and pointed phlebectomy in the treatment of varicosis of the great saphenous vein of the lower limbs. Methods Thirty-nine patients (46 limbs) received TriVex operations under spinal, or epidural anesthesia. The powered vein resector and an irrigated illuminator device-a minimally invasive system was used for varicose vein surgery. During the same period, 41 patients (46 limbs) underwent pointed phlebectomy. Results The average postoperative hospital stay was 4.6 days in patients receiving TriVex, and 8.1 days for pointed phlebectomy. Compared with the pointed phlebectomy, the incision of TriVex procedure was shorter and the number less. Conclusion This new surgical device is easy to operate, minimally invasive, efficacious and time saving with satisfactory results.

Objective: To investigate the expression characteristics of the USP24 gene in the mouse testis and its role in spermatogenesis. METHODS: We examined the expression characteristics of USP24 in the testis tissues of wild-type mice at different postnatal weeks (PNW) and androgen receptor (AR)-knockout (ARKO) adult mice using real-time quantitative PCR and immunofluorescence, and detected the transcriptional activity of the USP24 promoter by dual-luciferase reporter gene assay. RESULTS: The expression of the USP24 gene was low in the testis tissue of the wild-type mice at PNW 1, increased dramatically at PNW 3 and stayed at a similar level till PNW 8. The USP24 protein was located mainly in the cytoplasm of Sertoli and spermatogenic cells. Compared with the wild-type, the adult ARKO mice showed a decreased expression of USP24 localized in the posterior head and mid-piece of the mature sperm in the testis. Dual-luciferase reporter gene assay showed that the transcriptional activity of the USP24 promoter was increased after testosterone stimulation. CONCLUSIONS The increased expression of the USP24 gene was associated with the initiation of sexual development, and the USP24 protein was expressed in the mature sperm of the mice. USP24 is an AR-target gene, which may be involved in the regulation of spermatogenesis in mice.
Animals ; Male ; Mice ; Mice, Knockout ; Promoter Regions, Genetic ; Receptors, Androgen ; genetics ; Sertoli Cells ; Spermatogenesis ; genetics ; Spermatozoa ; metabolism ; Testis ; metabolism ; Testosterone ; administration & dosage ; Transcription, Genetic ; Ubiquitin Thiolesterase ; genetics ; metabolism

Aim To explore the effect of tanshinone II A (Tan II A) on reverse cholesterol transport in atherosclerosis model mice and RAW264. 7 cells and the underlying mechanism. Methods Thirty-two male LDLR -/- mice were randomly divided into four groups. These mice were fed with normal diet or high fat diet for 12 weeks. The control group and model group were given normal saline. Tan II A group and atorvastatin group were given Tan II A solution and atorvastatin solution for 12 weeks. RAW264. 7 cells were induced with oxidized low-density lipoprotein (ox-LDL) 100 mg • L-

OBJECTIVETo evaluate the therapeutic effect of Danning Tablet (DNT) on patients with non-alcoholic fatty liver (NAFL) of damp-heat Syndrome type.

METHODSMulti-center randomized double-blinded positive medicine parallel controlled method was adopted. One hundred and two patients were treated with DNT and 33 patients treated with Ursodeoxycholic acid (UDCA) as control. Indexes including body mass index (MBI), principal symptom, liver function, blood lipids, iconographic parameters and comprehensive efficacy were measured before and after treatment in the two groups respectively.

RESULTSDNT and UDCA had the effect in improving BMI, distress in hepatic region, fatigue, anorexia, liver function, blood lipids and iconographic parameters, etc. DNT showed effects in improving BMI and distress in hepatic region better than those of UDCA. Histological examination also showed that DNT had good therapeutic effect.

CONCLUSIONDNT is an effective medicine for NAFL patients of damp-heat Syndrome type, and its efficacy is better than that of UDCA.

Adult ; Diagnosis, Differential ; Double-Blind Method ; Drugs, Chinese Herbal ; therapeutic use ; Fatty Liver ; classification ; drug therapy ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Phytotherapy ; Tablets ; Treatment Outcome

Objective:To explore the effects of gynecological traditional operation and laparoscopic surgery on iliofemoral deep vein thrombosis (DVT ) and vital pulmonary embolism (PE ) . Methods :The clinical data of in‐patients who underwent gynecological operations in Obstetrics and Gynecology Hospital , Fudan University from Jul 2003 to Jun 2014 were retrospectively analyzed .The effects of gynecological traditional operation and laparoscopic surgery on DVT and PE were compared .Results:Iliofemoral DVT with symptoms occurred in 19 patients ,of whom 11 patients(0 .32‰) were from the group of traditional operation and 8 patients(0 .12‰) were from the group of laparoscopic procedure .The difference between the two groups was statistically significant(P<0 .05) .There were 3 patients suffered from PE ,of whom 2 patients were in the group of traditional operation and 1 patient was in the group of laparoscopic procedure .One patient with PE died in group of traditional operation .Conclusions :The incidence of iliofemoral DVT gynecological patients who have undergone laparoscopic procedure is lower than that in the group of traditional operation .Vena cava filter may prevent fatal PE .

OBJECTIVETo observe the effects of hepatocyte growth factor (HGF) derived from tumor microenvironment and/or afatinib on the growth of human lung adenocarcinoma H1975 cells and explore the potential mechanisms by which HGF induces primary resistance to afatinib.

METHODSThe effects of HGF, TGF-α and afatinib on the growth of H1975 cells were evaluated by MTT assay. The HGF concentrations of normal human fetal lung fibroblasts MRC-5 cells and human lung adenocarcinoma H1975 cells co-cultured or separately cultured were determined by ELISA assay. Western blot was used to detect the expressions of EGFR and Met signal pathway-related proteins and epithelial-mesenchymal transition (EMT) markers in H1975 cells treated with HGF and/or afatinib.

RESULTSThe MTT assay showed that H1975 cells were hyposensitive to afatinib in the presence of HGF. The ELISA assay showed that HGF production by H1975 cells was less than 0.1 ng/2.0×10(6) cells, but HGF production by MRC-5 cells was (151.37 ± 2.07)ng/2.0×10(6) cells incubated for 48 h. When H1975 cells and MRC-5 cells were co-cultured for 72 h, the concentration of HGF in the culture supernatant was (61.13 ± 16.21)ng/ml. In the presence of HGF, the expression of p-Met, p-Akt and p-ERK proteins in the H1975 cells was markedly up-regulated. afatinib inhibited p-EGFR, but did not affect the expression of p-Met, p-Akt and p-ERK proteins. In the presence of afatinib, HGF up-regulated the expression of vimentin and down-regulated the expression of E-cadherin.

CONCLUSIONSHGF secreted by stromal cells in the tumor micro-environment may confer resistance to afatinib in H1975 cells by activation of the Met/PI3K/Akt and Met/MAPK/ERK signaling pathways, and is involved in the epithelial-mesenchymal transition process.

Adenocarcinoma ; metabolism ; pathology ; Antineoplastic Agents ; pharmacology ; Cadherins ; metabolism ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Cells, Cultured ; Coculture Techniques ; Drug Resistance, Neoplasm ; Epithelial-Mesenchymal Transition ; Fibroblasts ; cytology ; metabolism ; Hepatocyte Growth Factor ; pharmacology ; secretion ; Humans ; Lung ; cytology ; Lung Neoplasms ; metabolism ; pathology ; MAP Kinase Signaling System ; drug effects ; Phosphatidylinositol 3-Kinases ; metabolism ; Proto-Oncogene Proteins c-akt ; metabolism ; Proto-Oncogene Proteins c-met ; metabolism ; Quinazolines ; pharmacology ; Receptor, Epidermal Growth Factor ; metabolism ; Signal Transduction ; drug effects ; Transforming Growth Factor alpha ; pharmacology ; Tumor Microenvironment ; Vimentin ; metabolism

Aim To explore the protective effect of Yishen Huashi Granule (YSHS) on streptozotocin (STZ) - indueed diabetes nephropathy (DN) in mice and its possible mechanism. Methods The STZ induced DN mice model was established, which was randomly divided into model group, YSHS group and YAP inhibitor Vertepofin group, and the eontrol group was also established. The intervention was started eight weeks after the successful modeling with the course of four weeks. Urine protein concentration before and after intervention in each group as well as serum creatinine (Scr) and blood urea nitrogen (Bun) levels after intervention were measured. After the treatment, the mice were sacrificed, and the pathological changes of glomeruli were observed by light microscope HE staining. The protein expression of YAP, p-YAP S127 and CTGF were detected by Western blot, and the mRNA expressions of YAP, CTGF and podocyte functional proteins nephrin, podophyxin and WT1 were detected by RT-PCR. Results The biochemical indexes of YSHS group were better than those of model group, and HE staining showed that the pathological injury of glomeruli was improved. In the model group the protein expression of YAP, p-YAP (S127) and CTGF as well as the mRNA expression of YAP and CTGF increased, while the mRNA expression of nephrin, podocalyxin and WT1 decreased. After YSHS treatment, the protein expression of YAP, p-YAP S127, CTGF and the mRNA expression of YAP and CTGF decreased, while the mRNA expression of nephrin, podocalyxin and WT1 increased. Conclusions YSHS can reduce urinary protein, protect renal function and alleviate glomerular pathological injury in DN mice. Its possible mechanism may be related to the down-regulation of YAP in renal tissue, the reduction of CTGF expression level and the up-regulation of podocyte protein mRNA expression.