Objective To discuss the clinical efficacy and complication of using polypropylene net in pelvic floor reconstruction to treat pelvic floor organ prolapsus. Method From October 2007 to May 2008,15 cases of organ prolapsus of many region defect in pelvic cavity were operated pelvic floor reconstruction, 14 cases had three regional defects,and 1 case had two regional defects. Results All the cases were punctured smoothly without hematoma and injury of blood vessel and organs. The time of operation for 15 cases ranged from 60 to 150 minutes,averaged (85.0±4.3) minutes. The amount of bleeding in operations ranged from 150 to 400 ml,averaged (200.0±0.1) ml. Fifteen cases recovered well after operation without infection.The days in hospital were 5-9 days,averaged (6.0±0.7) days. Following up 1-12 months,pelvic floor structure of all patients were normal,and interrelated symptom disappeared or improved. One case was discovered the net was eroded after 5 weeks. Conclusions Pelvic floor suspension by vagina is a micro operation to treat complicated pelvic floor organ prolapsus. It can accomplish pelvic floor reconstruction and reserve uterus simultaneously, healing efficacy is stable in short-term,but need further observation.

Objective To investigate the clinical effect of magnesium sulfate combined with nifedipine in the treatment of patients with pregnancy induced hypertension( HDCP) .Methods Retrospective study was used in this study and 116 patients with HDCP from January 2013 to July 2015 in department of obstetrics and gynecology from our hospital were divided into two groups, including routine group of 62 patients who received routine treatment +magnesium sulfate) and combination group of 54 patients who received routine treatment +magnesium sulphate +nifedipine.The clinical effect was analyzed after five days’ continuous treatment.Results The systolic blood pressure, diastolic blood pressure,24h urinary protein, random urine protein /creatinine,serum homocysteine (Hcy) and CRP values in combination group were lower than routine group (P<0.05).There were no statistical difference in maternal uterine inertia, neonatal asphyxia, fetal distress, postpartum hemorrhage rate between the two groups after the treatment.But the rate of cesarean section in the combination group(50.00%)was significantly lower than that in the routine group(68.25%)(P <0.05).Conclusion Magnesium sulfate combined with nifedipine in the treatment of patients with HDCP had better antihypertensive effect, and would not increase fetal adverse birth outcomes incidence and significantly reduce the rate of cesarean section.

Objective To investigate the expression of IFN-? and IL-18 in patients with progressive psoriasis and its clinical significance. Methods Twenty cases of psoriasis vulgaris, 19 cases of erythroder-mic psoriasis and 10 oases of pustular psoriasis were studied. Sandwich ELISA was used to detect the plasma level of IFN-? and IL-18, or supernatant level of IFN-? and IL-18 in PBMC culture under the stimula-tion of staphylococcal enterotoxin B (SEB). Results The plasma level of IFN-? in patients with psoriasis vulgaris, erythrodermic psoriasis and pustular psoriasis was higher than that in healthy control. The plasma level of IL-18 in progressive psoriasis vulgaris was higher than that in healthy control. The supernatant level of IFN-? and IL-18 in PBMC culture in progressive psoriasis vulgaris were higher than that in normal control, with a positive correlation between IFN-? level and IL-18 level (r = 0.55, P

OBJECTIVE To study and find reasonable methods of nursing care of incision through analyzing the risk factors in liver transplant patients.METHODS A total of 416 liver transplantation operations in our hospital from Sep 2004 to May 2006 were evaluated.The risk factors that resulted in the incision infection were considered.RESULTS The incision infection rate was decreased from 13.9% to 4.3% after improvement.CONCLUSIONS Nursing care is of great significance in preventing the incision infection in liver transplant patients.

Objective To study the value of the diameters of fetal umbilical artery and umbilical vein in early prenatal screening program for thalassemia by ultrasound.Methods A total of 120 cases of singleton pregnant with thalassemia at 12- 28 gestational weeks were detected by ultrasound,328 cases of normal singleton pregnant at 12 - 28 gestational weeks were selected as controls.The diameters of fetal umbilical artery and umbilical vein were tested and compared between the two groups.The diagnostic values were evaluated by ROC curve.Results At 12 - 15+6 gestational weeks,the diameters of umbilical artery and umbilical vein of thalassemia group were larger than those of control group(P ＜0.05).At 16 - 19+6 gestational weeks, the diameter of umbilical vein of thalassemia group was larger than that of control group,the differences were significant (P ＜0.05).The cutoff threshold of the diameter of fetal umbilical artery was 1.80 mm,the diameter of fetal umbilical vein was 2.95 mm at 12 - 15+6 gestational weeks,the diameter of fetal umbilical vein was 3.80 mm at 16- 19+6 gestational weeks,which were obtained by ROC analysis.The sensitivity of this cutoff threshold to identify thalassemia were 83.3％, 83.3％, 47.8％,respectively, while the specificity were 90.5 ％, 95.2 ％, 85.4％, respectively.Conclusions The diameters of fetal umbilical artery and umbilical vein detected by ultrasound have great value on early prenatal screening of thalassemia, these indexes can be used as an important factors in early prenatal screening of thalassemia.

Objective To estimate the indications, operative technique, perioperative treatment, postoperative complications and the outcome of lung transplantation (LTx) for end-stage pulmonary diseases. Methods The clinical data of 100 patients with end-stage lung diseases receiving LTx in our hospital were retrospectively analyzed. The main indications for LTx were as follows:idiopatic pulmonary fibrosis (IPF, 47/100), chronic obstructive pulmonary disease (COPD, 33/100),silicosis (5/100 ), bronchiectasis ( 5/100 ), Eisenmenger syndrome (4/100 ), secondary lung tuberculosis (2/100), idiopathic pulmonary hypertension ( 2/100 ), lung lymphangioleiomyomatosis ( 1/100), primary alveolar cell carcicoma (1/100). There were 72 patients receiving single LTx and 28 patients receiving bilateral LTx. Sixty-one patients received lTx under circulation support, including 5 cases of cardiopulmonary bypass (CPB) support and 56 cases of extracorporeal membrane oxygenation (ECMO) support. All the patients were followed up when they discharged from our hospital. The issues including postoperative complications and prognosis were observed. Results The perioperative survival rate was 82. 0 % (82/100). There were 18 deaths in early stage (30 days) after LTx: 10 due to pulmonary infection, 6 due to primary graft dysfunction (PGD), 1 due to acute rejection (AR) and 1 due to pulmonary infarction. The common complications included lung infection (11 cases), PGD (10 cases), AR (3 cases), tracheostenosis (10 cases), stoma fistula (3 cases),hemorrhage (3 cases), pulmonary embolism (3 cases), pulmonary artery stenosis (one case) and thrombus in the deep veins of lower limb (one case). During long-term follow-up period, 15 patients developed obliterative bronchiolitis, and one patient suffered from lung cancer in his contralateral native lung. The 1-, 2-, 3- and 5-year survival rate after LTx was 73.3 %, 61.6 %, 53.5 % and 40. 7 % respectively. Conclusion LTx is an effective therapy for various end-stage pulmonary diseases. Perioperative mortality is especially high in patients undergoing LTx. Consummate perioperative management is the key to increase survival rate.

ObjectiveTo observethe clinical efficacy of surround needling plus high-energy red light in treating herpes zoster. MethodSixty patients with herpes zoster were randomized into a medication group, a control group and a united group. The medication group was intervened by oral administration of medication, the control group was by surround needling plus electroacupuncture in addition to the medication, and the united group was by the medication, surround needling plus electroacupuncture, and the high-energy red light radiation. The effect on pain and the comprehensive therapeutic efficacy were evaluated on treatment day 5 and day 10.ResultThe efficacies in releasing pain in the control group and united group were significantly superior to that in the medication group on treatment day 5 (P<0.05), while the difference between the control group and united group was statistically insignificant (P>0.05); on treatment day 10, the effects on releasing pain in the control group and united group were more significant than that in the medication group (P<0.01), and the effect in the united group was more significant than that in the control group (P<0.05). The comprehensive therapeutic efficacy in the united group was superior to that in the medication group on treatment day 5 (P<0.01); the difference between the control group and medication group was statistically insignificant (P>0.05); on treatment day 10, the efficacies in the control group and united group were significantly better than that in the medication group (P<0.01), and the efficacy in the united group was superior to that in the control group (P<0.05). ConclusionSurround needling plus high-energy red light can effectively reduce the neuralgia caused by herpes zoster, shorten the pain duration, improve the symptoms, andthus this combination is an effective and safe method.

OBJECTIVE: To explore the genetic basis for a fetus with hydrocephalus. METHODS: The fetus was found to have hydrocephalus upon ultrasonography duringthe second trimester. Following induced abortion, fetal tissue was collected for the extraction of DNA and whole exome sequencing.Sanger sequencing was used to verify the suspected variants in the family. RESULTS: The fetus was found to harbor a hemizygous c.620A>G (p.Tyr207Cys) variant of the L1CAM gene (OMIM 308840),for which his mother and sister were heterozygous carriers. The same variant was not found in his father, uncle and grandparents.Based on the standards and guidelines of the American College of Medical Genetics and Genomics, the variant was predicted to be likely pathogenic (PM1+PM2+PP3+PP4). CONCLUSION The hemizygous c.620A>G (p.Tyr207Cys) variant of the L1CAM gene probably underlay the hydrocephalus in this fetus.
Adult ; Female ; Heterozygote ; Humans ; Hydrocephalus/genetics* ; Male ; Mutation ; Neural Cell Adhesion Molecule L1/genetics* ; Pedigree ; Pregnancy ; Whole Exome Sequencing

Objective: To observe ascitic interleukin-7 expression level in cirrhotic patients complicated with spontaneous bacterial peritonitis, and to detect the effect of recombinant human IL-7 on CD4⁺ and CD8⁺T lymphocyte function. Methods: A total of 84 patients with liver cirrhosis who were hospitalized from August 2017 to April 2018 were selected. Among them, 51 cases were complicated with cirrhosis and untainted ascites, and 33 cases were cirrhosis complicated with spontaneous bacterial peritonitis. Peripheral blood and ascites were collected routinely. The levels of IL-7 in peripheral blood and ascites were measured by enzyme-linked immunosorbent assay. CD4⁺T cells and CD8⁺T cells were purified from ascites, and were stimulated with recombinant IL-7. Cellular proliferation, key transcription factors for mRNA, and cytokines production by CD4⁺T cells in response to IL-7 stimulation was measured. mRNA expression corresponding to perforin, granzyme B, and granulysin as well as cytokines production by CD8⁺T cells was also measured in response to IL-7 stimulation. Cytolytic and non-cytolytic activity of CD8⁺T cells in response to IL-7 stimulation was also investigated in both direct and indirect contact co-culture system. Measurement data of the normal distribution were compared between the two groups by Student’s t-test and the data before and after stimulation were compared by paired t-test. Measurements that did not conform to normal distribution were compared between the two groups using Mann-Whitney U test, and data before and after stimulation were compared using Wilcoxon paired test. Results: There was no significant statistical difference in serum IL-7 levels between the two groups [(5 001 ± 1 458) pg/ml vs. (4 768 ± 1 128) pg/ml, P = 0.41]. The level of ascitic IL-7 in cirrhotic patients complicated with SBP was significantly lower than cirrhosis patients with untainted ascites [(966.4 + 155.8) pg/ml vs. (792.1 + 126.4) pg/ml, P < 0.01]. Recombinant IL-7 stimulation promoted the proliferation of CD4⁺ and CD8⁺T cells from ascites in patients with liver cirrhosis complicated by SBP. T-bet mRNA relative expression and IFN-γ secretion in CD4⁺T cells was also elevated in response to IL-7 stimulation in vitro. Moreover, IL-7 stimulation also increased the mRNA expressions of perforin, granzyme B, and granulysin as well as productions of IFN-γ and TNF-α by CD8⁺T cells. Recombinant IL-7 stimulation elevated cytolytic and non-cytolytic activity of CD8⁺T cells from ascites in patients with liver cirrohosis complicated by SBP, which manifested as increased target cell death and IFN-γ production in both direct and indirect contact co-culture system. Conclusion Ascitic IL-7 promotes T lymphocyte function in patients with liver cirrhosis complicated with SBP.

OBJECTIVETo compare the efficacy between acupuncture with smoothing liver and regulatingand lactulose for post-stroke slow transit constipation(STC) and to explore the mechanism.

METHODSSixty patients were randomized into an acupuncture group and a medication group,30 cases in each one. Based on the comprehensive stroke unit care,acupuncture with smoothing liver and regulatingwas used at Danzhong(CV 17),Qihai(CV 6),Tianshu(ST 25),Neiguan(PC 6),Gongsun(SP 4) and Taichong(LR 3) in the acupuncture group,once a day. Lactulose oral liquid was taken at a draught in the morning in the medication group,20 to 30 mL a time,once a day. The study period was 11 weeks,including 1-week baseline evaluation,6-week treatment and 4-week follow-up. We recorded the time of the first independent defecation,constipation symptom score,and gastrointestinal hormone level,including somatostatin(SS),motilin(MTL),P substance(SP) and vasoactive intestinal peptide(VIP). Also,the side effects were recorded at any time.

RESULTSThe time of the first independent defecation was (30.18±16.14) h in the acupuncture group,which was significantly different from (43.22±28.42) h in the medication group(<0.05). The constipation scores after 6-week treatment and at follow-up were lower than those before treatment in the two groups (all<0.05),with better results in the acupuncture group(both<0.05). MTL and SP increased,as well as SS and VIP decreased after treatment in the two groups(all<0.05). The changes were better in the acupuncture group(all<0.05). The side effect was not observed in the two groups.

CONCLUSIONSAcupuncture with smoothing liver and regulatingachieves better effect than lactulose for post-stroke STC in terms of efficacy onset,extent,and long term. The mechanism may relate to increasing excitatory regulatory peptide and reducing inhibitory regulatory peptide.