ObjectiveTo evaluate the safety and efficacy of total pelvic reconstruction surgery with Prosima in treatment of pelvic organ prolapse (POP) stage Ⅲ.Methods From July 2010 to December 2011,31 patients with POP stage Ⅲ undergoing total pelvic reconstruction surgery with Prosima were enrolled in this prospective study.Among two cases complicated with stress urinary incontinence underwent transobturator tension-freevaginaltapeconcomitantlywithtotalpelvicreconstructionsurgerywith Prosima.Clinical parameters during peri-operation were recorded and compared.Pelvic organ prolapse quantitative examiuation(POP-Q)andanatomicimprovementinthesepatientsafter surgery were analyzed.Comparisons of pelvic floor impact questionnaire-short form 7 ( PFIQ-7 ) and pelvic organ prolapse-urinary incontinence sexual questionnaire-short form 12 (PISQ-12) in these patients before and after surgery were used to evaluate quality of life and quality of sexual life.ResultsThe mean operating time was (55 ± 13) minutes,mean blood loss was (66 ± 25 ) ml.No severe intraoperative complications were observed.All patients were able to recover spontaneous mieturation within 5 days.Two cases experienced pelvic hematoma with diameters less than 7 cm,and resolved later.Another case was urinary tract infection.At the median follow-up 6 months ( 1 - 15 months),the rate of anatomic success defined as the leading vaginal edge above the hymen was 94％ (29/31).There were significant improvements in Aa,Ba,Ap,Bp,and C (P ＜0.01 ) by POP-Q.Two patients showed recurrent prolapse at 3 months and 1 year after surgery,without the need of further operation.The median score of post-operative PFIQ-7 was 0 point at 6 months and 0 point at 12 months after operation,respectively,which were significantly lower than that of 50 points pre-operation ( P ＜ 0.01 ).And there was no significant difference in the average score of PISQ-12 before and after surgery [ ( 30 ± 6) points versus (31 ± 4) points ] ( P ＞ 0.05 ).The rate of mesh exposure was 16％ ( 5/31 ),all the 5 cases occurred within 6 months and was cut in clinic.There was no case of de novo urinary incontinence and de novo dyspareunia.Conclusions Pelvic rcconstruction surgery with Prosima is safe and efficacy in treatment of POP stage Ⅲ.It could improve quality of life remarkably without influence on sexual quality of life.

PurposeIt is well known hypobaric hypoxia occurs with acute exposure to high altitude, with commonly associated change of cerebral blood flow (CBF). In this work, three-dimensional arterial spin-labeling (3D ASL) was used to monitor the change of CBF to further extend our understanding of hypobaric hypoxia.Materials and Methods Six healthy subjects were recruited for this study, they were asked to stay at high altitude areas for 5 days, and then returned to the plain. All subjects received MRI examination in both plain and high altitude areas using exactly the same 3.0T MR scanner. A total of 8 MR scans were performed, and all the parameters were kept the same, the changes of cerebral blood flow were observed.ResultsCBF increased obviously and reached its peak after acute exposure to high altitude, at the first day at high altitude, CBF measurements in global brain, grey matter and white matter increased signiifcantly compared to the plain, the difference was statistically significant (P<0.05); after that, the CBF measurements started to gradually decrease in the second day and a small climb on the third day at high altitude, then the CBF continued to drop after returning to sea level, even below that at sea level prior to departure. After 1 week back to the plain area, CBF measurements in global brain, grey matter and white matter were still lower than those before departure for high altitude areas, with a statistically signiifcant difference (P<0.05).ConclusionCBF measurements had obvious increase upon initial arrival at high altitude, and then the CBF continued to drop even below that at sea level prior to departure.

Objective:To investigate the protective effect of chrysin on the newborn rats with ischemic hypoxic brain damage and its related mechanism.Methods:The rats were randomly divided into sham-operated group, model group, low and high-dosage group of chrysin with 12 rats in each group. Except sham-operated group, the rats in other three groups were used as hypoxic-ischemic encephalopathy model. After the modeling, the rats in the low and high dosage groups were intraperitoneally injected with 30 mg/kg and 60 mg/kg chrysinimmediately, while the rats in the sham-operated group and the model group were intraperitoneally injected with equal volume of normal saline for 4 days. The HE staining was used to observe the protective effect of drugs on brain. The superoxide dismutase (SOD), catalase (CAT), malondialdehyde (MDA) levels in cells were measured by biochemical method. Western blot was used to detect the expression of heme oxygenase-1 (HO-1) and transcription factor NF-E2-related factor 2 (Nrf2).Results:The neurons in the cortex of rats in sham-operated group were arranged orderly with round nuclei and obvious nucleoli; the brain tissue of rats in model group showed edema and the arrangement of neurons was loose, the degeneration and necrosis of neurons in low and high dosage of chrysin groups were less than those in model group. Compared to the model group, the SOD activity (55.74 ± 5.14 U/mg, 69.84 ± 5.05 U/mg vs. 37.64 ± 6.41 U/mg) and CAT activity (2.44 ± 0.22 U/mg, 2.59 ± 0.42 U/mg vs. 2.08 ± 0.37 U/mg) in the brain tissue of rats in the low and high dose group were significantly increased ( P<0.05). The MDA level (3.74 ± 0.05 mmol/mg, 2.60 ± 0.18 mmol/mg vs. 4.35 ± 0.24 mmol/mg) in rat brain tissue of low and high dose group was significantly decreased ( P<0.05). The expressions of HO-1 (0.43 ± 0.08, 1.02 ± 0.15 vs. 0.14 ± 0.07) and Nrf2 (0.48 ± 0.07, 0.79 ± 0.09 vs. 0.26 ± 0.08) protein in rat brain tissue of low and high dose group were significantly decreased ( P<0.05). Conclusions:The chrysin could alleviate nerve injury in rats with hypoxic-ischemic encephalopathy, and its mechanism may be related to the up-regulated HO-1 and Nrf2 protein expression.