Objective To investigate the effect of ginsenoside-Rgl on paraurethral fascia fibroblastsmultiplication and the expression of proliferation cell nuclear antigen (PCNA) of stress urinary incontinence(SUI) women in vitro. Methods Specimens of human paraurethral fascia were obtained from 4 SUI womenduring tension-free vaginal tape (TVT) or tension-free vaginal tape-obturator (TVT-O) procedure.Fibroblasts were isolated and cultured by outgrowth technique. After reaching confluency fibroblasts weresubcultured every 5 days and cells after passage number 3 to 5 were used for assessment. The paraurethralfascia fibroblasts were treated with ginsenoside-Rgl at different concentrations (5, 10, 20 μmol/L) andfibroblnsts without Rgl were used as controL The multiplication conditions of paraurethral fascia fibroblastswere respectively detected by methyl thiazolyl tetrazolium (MTr) assay and the expression of PCNA byhistochemistry. Results ( 1 ) Compared with the control group, the growth rate of cells treated with differentconcentrations of Rgl after 72h [ (29±5 )%, (40±5 )%, (26±4)% respectively ] was significantly higher(P<0.01). (2)Compared with the control group, the stimulatory effect of Rgl on fibroblast growth wassignificant at 24 h (P<0.01), and peaked at 72 hi (29±5)% ,(40±5)%, (26±4)% respectively, P<0.01]. (3)Compared with the control group(28.77% ), there was a significant increase of PCNA-positivecells (P<0.01) after 48 h treatment with different concentrations of Rgl (49.24%, 83.48%, 54.50%respectively). Conclusion The results indicate that, at least in vitro, fibroblasts from paraurethral fasciataken from women suffering from SUI are able to proliferate after

Objective To determine quantity of type Ⅰ collagen and mRNA expression of decorin and transforming growth factor (TGF)- β_1 in the upper portion of the anterior vagina in women with pelvic organ prolapse (POP). Methods Transvaginat biopsies were obtained from the anterior vaginal wall in 27 POP(POP group) and 21 non-poP(control group). The concentration of type Ⅰ collagen was determined by ELISA technique. RT-qPCR was used to verify the mRNA level of decorin and TGF- β_1. Results The mean concentration of type Ⅰ collagen in the premenopausal women in POP group [(47.94 ± 6.82) mg/g total protein (TP)]was significantly lower than that in control group [(62.33±6.57) mg/g TP],in the postmenopausal women in POP group, it was (41.82±5.96) mg/g TP, significantly lower than that in control group[(61.21 ± 4.84)mg/g TP](P< 0.01). The mRNA expression of decorin was 1.61 ± 0.10 in POP group, significantly lower than that in control group 2.77±0.60 ,while that of TGF-β_1 was higher in POP greup10.86 ± 0.23 than that in control group 9.87 ± 0.92 (P < 0.05). In the postmenopausal women in two groups, there were no significant difference in the mRNA expression of decorin and TGF-β_1 (P > 0.05). Conclusions A decrease in quantity of type Ⅰ coUagen in the connective tissue of anterior vagina may compromise the tensile strength and an increase susceptibihty to prolapse. Deeorin might be involved in the pathogenesis in premenopausal women with POP. The pathogenesis of POP is muhifactorial.

Objective To observe the relation between content of type Ⅲ collagen and expression of decorin in paraurethral connective tissue in patients with stress urinary incontinence(SUI). Methods Transvaginal biopsies were obtained from the paraurethral connective tissue in 43 SUI and non-SUI control women. The concentration of type Ⅲ collagen was determined by immunohistochemical technique, electrophoretic separation and quantification. RT-PCR was used to verify the mRNA level of decorin. Results The mean concentration of type Ⅲ collagen was significantly reduced in patients with SUI(23?4), compared to the control group(34?6, P

Objective To investigate the risk factors of hemorrhagic transformation (HT) after cerebral infarction. Methods The clinical and neuroimaging data of 100 patients (gender,age-matched)with cerebral infarction and hemorrhagic transformation from January 2005 to January 2010 were analyzed retrospectively. The following factors were listed for single factor analysis: the history of hypertension, diabetes mellitus,admission blood pressure,blood sugar,infarction size,alcohol,smoking,atrial fibrillation,hypercholesterolemia, combined anticoagulant and antiplatelet aggregation therapy. All the above factors were analyzed by chi-square test or t test, and Logistic regression analysis was used to screen out the related risk factors of HT from the potentially related factors. Results Atrial fibrillation (OR =5.483,95%CI:fibrillation,extensive cerebral infarction,blood sugar,high blood pressure at the beginning of the disease,combined anticoagulant and antiplatelet aggregation therapy are the major risk factors of HT. At the same time, the occurrence of HT is the result of the joint effect of multiple factors and multiple mechanisms.

60,≤60 year age groups and control group was 2.49?1.82,1.82?1.58,0.90?1.38, significantly decreased(P

Objective To investigate the prevalence of lower urinary tract symptoms in women in a community in Fuzhou. Methods We designed a patient-completed questionnaire according to Bristol Female Lower Urinary Tract Symptoms (BFLUTS) questionnaire.A few parts of the questionnaire were adjusted based on living habits and social backgrounds in our country.The health care workers distributed and collected the questionnaires and instructed the women to fill in them one by one. Results A total of 6066 questionnaires were distributed and 5587 were collected. Of the responders 4745 women were more than 18 years. The prevalence of stress incontinence, urgency incontinence,urgency,frequency and nocturia were 9.0% (425/4745),2.4% (113/4745),10.3% (489/4745),1.5% (72/4745) and 9.8% (446/4745),respectively.The prevalence of storage symptoms increased with age,showing a 20.5%(104/507) in 18~27 years’ group,19.1% (332/1740) in 28~37,22.5%(338/1503) in 38~47,32.2%(202/628) in 48~57,41.2%(61/148) in 58~64,58.0% (127/219) in ≥65 years’ group. The overall prevalence was 24.5%.The prevalence of delayed urinary,intermittent stream,increased abdominal urination, incomplete emptying and voiding pain were 7.0%(330 cases),4.1%(194),4.6% (217),4.9% (233) and 4.8%(229),respectively.The prevalence of general voiding dysfunction increased with age,showing a 13.0% (66/507) in 18~27 years’ group,9.3% (162/1740) in 28~37,10.7%(161/1503) in 38~47,13.2%(83/628) in 48~57,16.2% (24/148) in 58~64 and 26.9%(59/219) in ≥65 years’ group.The overall prevalence was 11.7%. Conclusions The prevalence of lower urinary tract symptoms are high in community-dwelling women,and the prevalence of storage symptoms are more common than that of voiding dysfunction in these women.

Objective To evaluate the effect and safety of a modified Prolift procedure, without preceding partial trachelectomy or hysterectomy for pelvic organ prolapse (POP) with coexistent cervical elongation. Methods Clinical data of 72 patients that underwent a modified Prolift procedure for POP with coexistent cervical elongation, between December 2008 and June 2012 in Fuzhou General Hospital of Nanjing Military Command was retrospectively analysed. A comparison was carried out between preoperative and postoperative parameters of pelvic organ prolapse quantitation system (POP-Q), and an objective evaluation was made according to the overall cure rate and recurrence rate. Pelvic floor distress inventory-short form 20 (PFDI-20) was used to investigate the subjective cure rate and improvement of symptoms. Results Patients were followed up at median 52 months (36-78 months). One bladder perforation and one rectum perforation occurred during the procedure. Four patients (6%, 4/72) had uterine prolapse at 9-19 months after the opertaion and had transvaginal hysterectomy laterly. The overall anatomical correction rate was 94%(68/72). Six patients (8%, 6/72) had mesh exposures at 3-9 months after the opertaion. Scores of PFDI-20 decreased sifnificantly after the procedure (118.2±25.2 vs 12.1±8.0 vs 12.5±9.5 vs 13.0±9.9, P<0.05). The patients′ satisfaction rate was 92% (66/72). Conclusion This modified Prolift procedure, without preceding partial trachelectomy or hysterectomy, could effectively and safely correct POP with coexistent cervical elongation.

0 05) While patients′ satisfactory rate was significantly higher in electrical stimulation group than in medical group( P

Objective To evaluate the safety and efficacy of modified Prolift pelvic floor reconstruction with improving the placement of Prolift-A in treatment of severe pelvic floor dysfunction and stress urinary incontinence (SUI).Methods From July 2008 to September 2010,170 cases with severe pelvic organ prolapse(POP) treated by modified Prolift pelvic floor reconstruction surgery in Fuzhou General Hospital were enrolled in this study.The Prolift-A was laid tension-free under the mid-urethra with the position of Prolift-A displaced from the neck of bladder to the mid-urethra.No concomitant tension-free urethra suspender via vagina was performed.Primary outcomes were assessed with POP quantitation ( POPQ) system to evaluate the postoperative anatomical replacement stage.Secondary outcome measure were:urogenital distress inventory 6 ( UDI-6),the incontinence impact questionnaire 7 ( IIQ-7 ) and the pelvic floor incontinence questionnaire 7 (PFIQ-7) to evaluate the impact on life quality at the follow-up of 1,6,12 months.Results At 6 and 12 months after surgery,168 cases and 163 cases were followed up.The anatomical cure rates were 98.8％ (166/168) at 6 months and 97.5％ (159/163) at 12 months,respectively.One case with bladder injury and 1 case with rectum injury were observed.Five cases with recurrence were observed,including 2 cases with anterior vagina prolapse,2 cases with uterine prolapse and 1 case with posterior vagina prolapse.Meanwhile,3 cases with hematoma and 7 cases with mesh erosion were observed.Quality of life of all patients were improved significantly by UDI-6,IIQ-7 and PFIQ-7 scoring system evaluation.Among 79 POP patients with SUI,the cure rate of SUI was 93.7％ (74/79).Of 5 cases with symptomatic SUI,2 cases were needed surgical intervention.Twenty-three cases were found with minimal SUI symptoms and subjective satisfaction without objective influence on quality of life.Seven patients presented dysuria after surgery,5 cases recovered urination with 10 days,1 case recovered with 1 months,and 1 case with 6 months by bladder drainage.Eleven cases with discomfort urination and 3 cases with slow urination were found.Conclusions The modified Prolift pelvic reconstructive surgery was safe and efficacy intervention in treatment of POP and prevention of SUI.

Objective To study risk factors with the occurrence of the mesh exposure after pelvic floor reconstruction.Methods From Mar.2007 to Mar.2011,a retrospective study was made on the clinical data of 353 patients undergoing vaginal mesh pelvic floor reconstruction.The related complications of the mesh were surveyed,and risk factors associated with the mesh's exposure were studied by single factor and multiple factors logistic regression.Results It was found that the exposure rate was 9.6％ (34/353) after 1 year postoperative follow-up.Single factor analysis showed that patients who were not less than 70 years old,patients who were on their menopause stage,the occurrence of not less than three parturition,history of pelvic surgery,diabetes and smoking had a significant correlation (all P ＜ 0.05) with the occurrence of the mesh exposure after pelvic floor reconstruction.Multiple factors logistic regression analysis showed that patients who were not less than 70 years of age (OR =2.389),the occurrence of not less than three parturition (OR =2.688),the history of diabetes (OR =3.545),the history of pelvic surgery (OR =5.385) were the independent risk factors,and the operation experience was the protection factors (OR =0.134).Conclusions Mesh exposure is a common complication after pelvic floor reconstruction.Old age,multiple delivery,history of diabetes and history of pelvic surgery are the risk factors of mesh exposure.Preoperative full assessment and the quality of training contribute to reduce the incidence.