Objective To systematically review the efficacy and safety of prolapse surgery versus combined prolapse and midurethral sling surgery in women with pelvic organ prolapse and stress urinary incontinence.Methods Databases including PubMed,EMbase,the Cochrane Library(Issue 7,2016),Web of Knowledge,CNKI,CBM,WanFang Data and VIP were searched from inception to July 31th 2016,to collect randomized controlled trial(RCT) of combined prolapse and midurethral sling surgery versus prolapse surgery for pelvic organ prolapse and stress urinary incontinence.Two reviewers independently screened literature,extracted data and assessed the risk of bias of included studies.Then,meta-analysis was performed using RevMan 5.3 software.Results A total of 4 RCT involving 446 patients were included.The results of meta-analysis showed that,for postoperative outcomes,compared with prolapse surgery,the incidence of urinary incontinence,stress urinary incontinence,urgency urinary incontinence,any treatment for SUI,surgery for stress urinary incontinence[RR=0.57,95%CI(0.46~0.70),P<0.000;RR=0.24,95%CI(0.10~0.60),P=0.002;RR=0.58,95%CI(0.39~0.85,P=0.006;RR=0.20,95%CI(0.06~0.67),P=0.009;RR=0.07,95%CI(0.01~0.56),P=0.010]were lower in combined prolapse and midurethral sling surgery.For complications,the incidence of bladder perforation or injury,urinary tract infection,incomplete bladder emptying at 1 week[RR=9.72,95%CI(1.78~53.01),P=0.009;RR=1.77,95%CI(1.23~2.54),P=0.002;RR=1.39,95%CI(1.06~1.81),P=0.020]were higher in combined prolapse and midurethral sling surgery,while there were no statistical differences between the two groups in the incidence of voiding dysfunction,vaginal tape erosion,major bleeding or vascular complication.Conclusion For women with pelvic organ prolapse and stress urinary incontinence,compared to prolapse surgery,the incidence of urinary incontinence and treatment of urinary incontinence is lower in combined prolapse and midurethral sling surgery,the incidence of partial complications is higher in combined prolapse and midurethral sling surgery.Due to the limited quality and quantity of the included studies,more high quality studies are needed to verify the above conclusion.

In order to help students understand and master the ultrastructure of the tissue and cells and provide teachers with rich picture resources and teaching materials, Department of Pathology of Jilin University collected and organized pictures of cell and tissue ultrastructure, and then selected typical ultra-structure pictures to carry on the classified annotation in accordance with organ systems to build the ultra structure electronic picture library. The electronic picture library can be used in biological electron micro-scope technique course, online courses establishment and students' autonomous learning.

The training of professional postgraduates is one mode of medical postgraduate training,which more emphasizes the cultivation of clinical practice and ability.The problems existing in the training of professional degree postgraduates in dermatology are analyzed in this article,such as weak foundation of scientific research foundation,lack of supervision and evaluation,and the challenges from dermatology characteristics.The solutions including the training objectives,project design,the optimization of teaching process and evaluation,the training of comprehensive ability will be discussed in this article.The purpose is to improve the quality of training,to give some advice for providing high quality professional degree postgraduates.

Stem cells refer to undifferentiated or inad equately differentiated cells that have the ability to become a variety of tissues,regenerate organs,and self expand.There is strong evidence that stem cells have abilities of self renewal differentiation,immune regulation,and a potential for targeted therapy,which all together support development of stem cell transplantation.Stem cell transplantation thera py has become a hot topic in recent years,and the basic theory and clinical application have made great progress.The a bilities of stem cells make their transplantation ideal to pro mote liver regeneration,inhibit liver fibrosis,and provide treatment for many diseases.This article will review the cur rent status and outlook of stem cell transplantation.

Objective To investigate the manifestation and the prevention means of video display terminal (VDT) visual fatigue in old people. Methods Conventional eye inspection were performed for 45 patients, including optical muscle movement, position of eye, confluence function and presbyopia. Results We found that the average difference between middle distance correcting lens and 33 cm reading distance from presbyopia correcting lens was about 0.52 DS( P

Objective To investigate the clinical value of the precision liver surgery in the liver graft procurement for pediatric living donor liver transplantation.Methods The clinical data of 58 living donors of left hepatic lobe graft who were admitted to the Renji Hospital of Shanghai Jiaotong University from December 2012 to January 2014 were retrospectively analyzed retrospectively from December 2012 to January 2014.All the donors donated voluntarily and gratuitously and were approved by the ethics committee of the hospital.All the donors received computed tomography (CT),and the two dimensional data were converted to three dimensional images for evaluating the intrahepatic bile ducts and blood vessles,and the typs of the left hepatic arteries and veins were determined.The donor's liver graft volume was assessed by CT before operation.The standard liver volume of the donors and the recipients,and the volume of liver to be reseeted and the total liver volume were measured.A virtual surgery was conducted for designing the actual surgery.The liver graft was resected with the precision liver surgery technique.Patients were followed up by the out-patient examination and phone call till April 2014.Results The results of CT angiography confirmed that 28 donors were with type Ⅰ left hepatic artery,10 with type Ⅱ left hepatic artery and 20 with type Ⅲ left hepatic artery; 35 patients were with type Ⅰ left hepatic vein and 23 with type Ⅱ left hepatic vein.The left-lobe volume estimated by CT was (243 ± 65) mL.Liver graft procurement was successfully carried out on the 58 donors,including 7 left hemihepatectomy and 51 left lateral lobectomy.Two donors received cholecystectomy concomitantly.The actual volume of liver resected was (255 ±59) mL,and the error rate of the liver volume to be resected was 4.94％.The weight of the liver graft to the body weight of the recipient was 3.3％ ± 1.0％.The operation time and the volume of blood loss were (260 ± 89) minutes and (181 ± 35)mL,respectively.One donor received red blood cell infusion of 2 U.The time for gastrointestinal function recovery was (2.0 ± 1.1) days,and the time of drainage tube pull-off was (3.0 ± 1.2) days.The duration of postoperative stay was (7 ± 3) days.The white blood cells,hemoglobin,alanine transaminase,aspartate transaminase,total bilirubin,direct bilirubin and albumin were at the normal levels at the discharge.Two donors were complicated by incisional bleeding and fat liquefaction,and they were cured by symptomatic treatment.All the donors were followed up for a median time of 8.7 months.The donors were recovered well without complications during the follow-up.Conclusions Liver graft procurement guided by precision liver surgery has the advantages of high accurate rate,little injury to the liver of the donors,few postoperative complications and quick recovery of the donors.

Objective To analyze the plasty of the tip framework and the nasal tip in insufficient-lining cases with auricular and septal cartilage.Methods The tip framework was formed by using septal extension graft (SEG) and columellar strut (CS) to construct the main framework of nasal tip,and then according to the size of the graft the next processes were chosen for supporting structure.When the graft size met the tip position,the caudal margin of the framework could be beyond the maximum stretch position of the lower lateral cartilage and reached or was close to the expected tip position.When the graft size was insufficient,auricular cartilage was used to hold the caudal margin of the framework to extend or to heighten the framework further.Refined plasty of nasal tip was as follows:when the end of framework was higher than or equal to the dome above 3 mm,auricular cartilage strip was used to reconstruct the dome;when less than 3 mm,multilayer onlay grafts were used to heighten the dome.Results From May 2013 to May 2015,42 cases were followed up from 6 months to 18 months.18 cases belonged to the type 1,including 13 cases using ear cartilage to reconstruct dome,5 cases using onlay graft;24 cases belonged to the type 2,including 14 cases using onlay graft and 10 cases using ear cartilage to reconstruct the dome.They all got good results.Conclusions To the insufficient lining cases,the appropriate method can be chosen to form stable tip framework according to the preoperative design and the graft size.Then onlay grafts or dome reconstruction technique is used to form the tip.Most of the insufficient-lining cases can get satisfactory results.

Objective: To establish the quality standards for Zhichuang capsules. Methods: Rhubarb, Mahonia, Angelica and Borneol in the formula were identified by TLC, the content of emodin and chrysophanol from Rhubarb in Zhichuang capsules were deter-mined by HPLC. Results: The qualitative identification was easy to operate with good specificity. The linearity was good ( r =0. 999 9) within the range of 25.8-516.0ng and the average recovery was 97.31%(RSD=0.69%,n=6)for emodin, the linearity was good (r=1.000 0) within the range of 51.1-1 022.0ng and the average recovery was 97.63%(RSD=0.72%,n=6)for Chry-sophanol. Conclusion:The method is reliable and accurate, which can be applied as a quality control method of Zhichuang capsules.

Objective To explore for the methede and effect of endoscopic treatment on biliary leakage and biliary duct damage. Methods All patients with biliary damage such as biliary leakage and biliary duct stricture were treated by endoscopic sphincoterotomy and endoscopic nasobiliary drainage (ENBD) during abdominal cavity drainage ENBD was removd when biliary leakage healed and abdominal cavity drainage ceased for 1～2 weeks were confirmed. Plastic stents were implanted to distend the biliary duct stricture for 2-3 months. Results Twenty-six patients with biliary leakage were cured 3-4 weeks after ENBD. Fourteen out of 17 patients implanted with plastic stent were recovered uneventfully after stent removed, and 4 patients also recovered after installation of double-stents for 3 months, while another case with calculus and stricture of left hepatic duct in spite of implantation of simple-stent suffered repeatedly from biliary tract infection and one case developed hepatic abscess after repeatedly infection for one year before he had the hepatic lobectomy. Conclution Endoscopic therapy is the first choice in treating biliary leakage or secondary duct stricture.