Objective To explore the clinical effect of pelvic floor muscle rehabilitation therapy to recover pelvic floor dysfunction.Methods 435 cases of 6-8 weeks postpartum urinary incontinence patients were chosen.The urinary incontinence questionnaire ( ICI-QSF) ,and Female Sexual Function Index questionnaire ( FSFI questionnaire) were used to detect maternal urinary incontinence (UI) investigation,pelvic organ prolapse (POP-Q) degree and quality of sexual life questionnaire.Ⅰ muscle,Ⅱ muscle strength and fatigue, vaginal and the change of dynamic pressure for pelvic floor functional change before and after Pelvic floor rehabilitation were compared.Pelvic floor mus-cle rehabilitation treatment included:imitation bioelectricity stimulus,biofeedback,scene reflection training and Kegel exercises.Results After pelvic floor muscle rehabilitation,pelvic floor function improved significantly,pelvic floor muscle strength increase, decrease fatigue, vaginal dynamic pressure rose significant difference:Electrical values (μV) before treatment (5.6 ±1.8),after treatment(15.1 ±4.6),t =3.6,P <0.05;Vaginal dynamic pressure (cmH2O) before treatment(48.7 ±11.0),after treatment (86.3 ±5.1)cmH2O(t=7.2,P<0.01);Fatigue obvi-ously improved,(P<0.01),the effect of Urinary incontinence treatment is very obvious (t=5.6,P<0.05)and pelvic organ prolapse improved significantly:Before treatment vaginal wall prolapse II degrees 63 people,after treat-ment 14 people,remission rate 82%,and Before treatment uterine prolapse 172 people,after treatment uterine pro-lapse 39 people,the response rate of 77.3% (P <0.01),sexual function improved significantly:before treatment score is (78.00 ±20.45) and after treatment scores is (100.00 ±25.36),t=8.6 (P<0.01).Conclusion Pelvic floor muscle rehabilitation effectively improve postpartum women pelvic floor function,can achieve the purpose of the treatment of urinary incontinence,improve pelvic organ prolapse and the quality of sex life.

To alleviate the shortage of excellent talents of traditional Chinese medicine (TCM), the State Administration of Traditional Chinese Medicine has decided to cultivate a group of talents with strong theoretical foundation, rich practical experience and exquisite skills who would like to devote themselves to TCM technology research. The national talent training program for inheritance of characteristic TCM technology is a major breakthrough in the history of new China in the cultivation of high-level TCM technology talents. A retrospective analysis was performed on the national talent training program for inheritance of characteristic TCM technology hold in training bases from Beijing, Shanghai, Guangdong Province, Jiangsu Province, Anhui Province, Xinjiang Uygur Autonomous Region, Inner Mongolia Autonomous Region, Heilongjiang Province, Yunnan Province, Sichuan Province, Shaanxi Province and Fujian Province. Based on the completion assessment work of 2014 and 2015 national talent training program for inheritance of characteristic TCM technology, and after knowledge exchange and discussion with the training subjects from 30 provinces and some teaching experts in the field of characteristic TCM technology, this paper summarizes the work of the national talent training program for inheritance of characteristic TCM technology. After trained in bases in China, training subjects' theoretical knowledge and practical skills as well as their comprehensive capacity have been greatly promoted. At the same time, there are also some problems and shortages. For example, characteristic TCM technology in some training bases is not prominent enough, some characteristic TCM technologies are not well inherited, and the affiliations of some training subjects do not pay enough attention to it. All of these problems should be solved and improved in future work.

Objective To explore the synergetic effect of HBX protein and M2 macrophages in inflammatory microenvironment on invasion and metastasis of hepatocellular carcinoma cells.Methods Hep3B cells were infected with recombinant lentivirus carrying HBx gene,following co-culture with THP-1 original M2 macrophages.The cells were divided into six groups:two infected groups (Hep3B +and Hep3B + + M2),four non-infected groups (Hep3B-,Hep3B-+ LV5,Hep3B-+ M2,Hep3B-+LV5 + M2).Western blot (WB) was used to assess the expression changes of E-cadherin and N-cadherin,markers of epithelial-mesenchymal transition (EMT).The cellular location of EMT markers was observed by immunofluorescence confocal microscopy.Transwell assay was used to evaluate the invasion ability of Hep3B cells.Results HBX protein overexpressed in Hep3B cells by lentivirus infection.After 72 h co-culture with M2 macrophages,WB results showed that E-cadherin descreased significantly in Hep3B+ (0.42 ±0.11) when compared with Hep3B-(1.00 ±0.18) (t =4.762,P ＜0.05),while N-cadherin was significantly higher in Hep3B + (2.85 ± 0.44) than in Hep3B-(1.00 ± 0.17) (t =4.762,P ＜ 0.05).M2macrophages decreased E-cadherin expression in Hep3 B + + M2 (0.1 ± 0.13) compared with Hep3 B + (t =3.255,P ＜0.05),while N-cadherin expression increased in Hep3B+ + M2 (4.18 ± 0.52) (t=10.009,P ＜ 0.05).Non-Infected groups didn't change the markers of E-cadherin and N-cadherin.It was suggested that invasion ability of Hep3B increased by HBx overexpression.Conclusions HBX protein and M2 macrophages synergetically mediated the invasion and metastasis of hepatocellular carcinoma cells by EMT.

Objective To evaluate the diagnostic value of virtual touch tissue quantification (VTQ) in the diagnosis of renal allograft fibrosis.Methods The renal allografts of 82 patients with biopsies or nephrectomy were assessed by virtual touch quantification.The renal allograft fibrosis was categorized according to the 2005 updated Banff criteria for a G0～G3 grade.All the results were compared among four groups.Results The mean SWV values in G0～G3 were (2.39 ± 0.31)m/s,(2.45 ± 0.34)m/s,(2.58 ± 0.18) m/s,(3.11 ± 0.40)m/s,respectively.There were no significant differences in the mean SWV value between G0 and G1 group,or between G1 and G2 group(P ＞0.05).There were significant differences in the mean SWV value between G0～G2 and G3 group,or between G0 and G2 group(P ＜0.05).Stiffness of renal allograft was significantly correlated to the mean SWV value (Spearman r =0.671,P ＜0.001).According to the area under the ROC curve,the sensitivity and specificity of SWV (area under ROC curve =0.847,cut-off=2.64 m/s) for grade ≥G2 was 78.9％ and 79.5％ respectively.Conclusions Stiffness measured by VTQ reflects the interstitial fibrosis in renal allograft.VTQ technique might be a new tool to identify patients with chronic allograft injury.

Objective To investigate the pathological manifestations of acute?stage radioactive myocardial damage and related mechanisms using an experimental animal model. Methods A total of 12 adult male Sprague?Dawley rats were randomly divided into control group and radiation group. In the radiation group, the model of radiation?induced myocardial damage was established by the irradiation of the anterior myocardial territory with 6?MV X?ray at a single dose of 20 Gy, and at 14 days after irradiation, HE staining was used to observe the morphological changes of cardiomyocytes and intercellular matrix, and Masson staining was used to observe the distribution of collagen fibers. The collagen volume fraction ( CVF) was used for semi?quantitative analysis. ELISA was used to measure the activity of total superoxide dismutase ( T?SOD) and the concentration of malondialdehyde ( MDA ) , and Western blot was used to measure the expression of the fibrosis marker protein collagen type I ( COL?1 ) and the endoplasmic reticulum stress?related proteins GRP78 and CHOP. The t?test, t ’?test, or nonparametric rank sum test was used for comparison between groups. Results At 14 days after local irradiation of the heart, the radiation group had disordered arrangement of cardiomyocytes, marked edema, rupture of some cardiomyocytes, mild karyopyknosis in cardiomyocytes, and infiltration of inflammatory cells in the myocardial interstitium, compared with the control group. Collagen fibers in the myocardial tissue were mainly distributed in the perivascular area and cardiomyocyte interstitium. The radiation group had a significantly higher CVF than the control group ( 11?35% vs. 5?23%, P=0?000 ) and a significant increase in the expression of COL?1 compared with the control group ( P=0?000) . The radiation group had significant increases in the activity of T?SOD and the concentration of MDA in the myocardial tissue compared with the control group ( T?SOD:156?61 U/mgprot vs. 137?06 U/mgprot, P= 0?042;MDA:2?36 nmol/mgprot vs. 1?31 U/mgprot, P=0?007) . Compared with the control group, the radiation group showed significant increases in the expression of endoplasmic reticulum stress?related proteins GRP 7 8 and CHOP ( P= 0?037 and 0?009 ) . Conclusions The pathological manifestations of acute?stage myocardial damage include degeneration of cardiomyocytes, inflammatory exudation in the interstitium, and deposition of collagen in the perivascular area and myocardial interstitium. Myocardial fibrosis can be observed in the acute stage of radiation?induced myocardial damage, and the mechanism may be related to oxidative stress and endoplasmic reticulum stress induced by radioactive rays.

Objective To investigate the local-regional recurrence in thoracic esophageal cancer after radical surgery including two-field lymph node dissection and provide evidence for postoperative radiotherapy. Methods We reviewed local-regional recurrence for 134 cases with esophageal squamous cell carcinoma after radical surgery from 2004 to 2009. Results In 134 cases, lymph node metastasis rate,anastomosis recurrence rate and tumor bed recurrence rate was 94. 0%, 9. 7% and 3.7%, respectively. As to the 126 cases with lymph node metastasis, significant difference was detected between mediastinal metastasis, supraclavicular metastasis and abdominal lymph node metastasis (80. 2%, 43.7% and 13.5%,respectively, χ2= 113. 15, P = 0. 000). Furthermore, the relative metastasis rate in upper mediastinum,middle mediastinum and the lower mediastinum was 73.8%, 39.7% and 1.6%, respectively, the difference was statistically significant ( χ2 = 139. 11, P = 0. 000 ). Significant difference was identified between right and left supraclavicular lymph node metastasis (31.7% vs 16. 7%, χ2= 7. 81, P = 0. 005 ).To confirm the analysis above,lymph node metastasis rate of left recurrent laryngeal nerve nodes, (including region 1L, 2L, 4L and 5) ,right recurrent laryngeal nerve nodes, azygos nodes, subcarinal nodes, and 2R region was 38.9%, 43.7%, 15.1%, 34.1% and 25.4%, respectively. Conclusions The main characteristics of local-regional recurrence may be lymph node metastasis for esophageal squamous cell carcinoma after radical surgery. On the contrary, tumor bed recurrence is rare. Dangerous regions include supraclavicular nodes, recurrent laryngeal nerve nodes, azygos nodes as well as subcarinal nodes.

ObjectiveTo evaluate correlation factors of cervical lymph nodes metastasis in thoracic esophageal carcinoma.MethodsLocal-regional metastasis of lymph node for 126 cases with esophageal squamous cell cancer after surgery from 2004 to 2009 were reviewed.Risk factors of cervical lymph nodes metastasis were examined by multiple Logistic regression analysis.ResultsIn 126 cases,supraclavicular lymph node metastasis rate was 43.7％ (55/126).By logistic regression,none of the primary site,T stage,N stage,histological grade,lymph node metastasis rate,lymph node metastasis degree and number of lymph nodes metastatic field was not the high risk of cervical lymph nodes metastasis.In addition,multivariate analysis found that lymph node metastasis in mediastinum region 1 was high risk factor for lymph node metastasis of region 1 ( x2 =12.14,9.27,P =0.000,0.002),lymph node metastasis in region Ⅲ and region 2 were high risk factors for lymph node metastasis of region Ⅱa ( x2 =14.56,8.27,8.02,3.93,P =0.000,0.004,0.005,0.047 ).ConclusionMediastinal para-recurrent nerve lymph node metastasis is a significant predictor for cervical lymph nodes metastasis.

Objective To evaluate the effect of GTV volume on response of esophageal carcinoma.Methods From Jan.2004 to Dec.2008,72 cases newly diagnosed N0 stage thoracic esophageal carcinomas were included in this retrospective study.All treatment plans were set up and designed by CT simulator and 3D TPS.They received dose 56-70 Gy/27-33F/6-7w with 6MV X-ray.The GTV,the tumor length and maximum diameters were measured on the treatment planning system with the X-ray.RECIST standard was applied to evaluate the radiotherapy response of esophageal carcinoma.The effectiveness of related prognostic factors on survival was evaluated by univariate analyses.Results The short-term response with CR were 79％ with length ＜ 5 cm,48％ with 5-7 cm and 26％ with length ＞7 cm(P =0.003).The 1-,2-,3-and 5-year survival rates were 93％,79％,69％,69％ ; 91％,61％,46％,46％ and 80％,46％,28％,22％ (P =0.037).The short-term response with CR were 56％ with maximum diameters ≤3 cm and 33％ with maximum diameters ＞ 3 cm(P =0.033).The 1-,2-,3-and 5-year survival rates were 91％,72％,55％,37％ and 80％,45％,30％,30％ (P =0.037).The short-term response with CR were 52％ with GTV volume≤40 cm3 and 30％ with GTV volume ＞40 cm3(P =0.059).The 1-,2-,3-and 5-year survival rates were 91％,67％,51％,41％ and 80％,43％,27％,27％ (P =0.047).In the multivariate analysis,the length of GTV was likely to be the most important factor for the short-term response(P =0.005,0.014).Conclusions GTV volume,the tumor length and maximum diameters are factors for short-term response of N0 stage esophageal carcinoma.The GTV length is independent prognostic factor.The GTV length is the worse the prognosis will be.

Objective To evaluate the value of quantitative analysis of contrast‐enhanced ultrasonography (CEUS) in differentiating acute rejection(AR) from acute tubular necrosis(ATN) of transplant kidney. Methods Total of 67 kidney recipients were examined with conventional US and CEUS. Biopsies were performed in 37 patients, 26 patients were with AR, 11 with ATN, 30 patients as control group. The hemodynamic parameters (PSV and RI) were measured on infrarenal artery with conventional US, while CEUS quantitative analysis was performed on the cortex, pyramid and interlobar artery by time‐intensity curve (TIC). TIC parameters including rise time (RT ), time to peak (TTP), mean transit time (mTT ) were compared among three groups. In addition, the reproducibility of TIC parameters was evaluated. Results The RI in AR group was significantly higher than that in control group, but there were no significant differences of RI between AR and ATN groups. TIC parameters including RT, TTP were with high reproducibility (ICC> 0 7.5). Compared to the other two groups, the RT and TTP of the pyramid, ΔRTm‐c, and ΔTTPm‐c were significantly longer in AR group, the receiver operating curves (ROC) analysis demonstrated that ΔRTm‐c had the highest accuracy and RI had the lowest accuracy for detecting AR(areas under the curve were 0 7.86, 0 7.56, 0 7.49, 0 7.36 and 0 4.98, respectively). High sensitivity and specificity(78 3.% and 73 5.%, respectively) were shown when using 4 6.2 s as a cutoff point of ΔRTm‐c to diagnose AR. Conclusions Quantitative analysis of CEUS could detected the changes of the microcirculation perfusion in kidney grafts with AR and ATN, which might be superior in the diagnosis of AR compared with conventional US.

Objective To evaluate the effect of TGF-β1 and IL-1β expression in serum on acute radiation-induced heart disease (RIHD) in patients with thoracic tumors.Methods Three-dimensional conformal radiotherapy (3D-CRT) or intensity modulated radiotherapy (IMRT) was delivered at 1.8-2.0 Gy,5 times per week to a total dose of 50-66 Gy to 44 patients with lung cancer and 10 patients with esophagus cancer.The target and organs at risk dose distribution were analyzed by 3-dimensiond treatment planning system.The expressions of TGF-β1 and IL-1β in serum were detected by enzyme linked immunosorbent assay before and at the end of the irradiation.The cardiac injury was evaluated by detecting the cmyocardium creatase,cardiac troponin I (cTnI),electrocardiogram and cardiac function before and at the end of the irradiation within 90 d.The acute RIHD was evaluated by the Common Terminology Criteria V 3.0 (NCI-CTCAE 3.0).The expressions of TGF-β1 and IL-1β in the serum of RIHD patients with thoracic tumors were analyzed.Results The expression of TGF-β1 in serum was (888.4 ± 41.1) μg/L before the irradiation and approached to (926.1 ± 23.1) μg/L at the end of the radiotherapy.The expression level of TGF-β1 in the serum of acute RIDH group was (900.6 ± 34.5) μg/L,higher than that of normal group [(865.7 ±47.0) μg/L,t =-2.646,P ＜0.05)].The acute RIDH was correlated with the expression level of TGF-β1 before irradiation and the difference before and at the end of irradiation (r =0.378,0.311,P ＜0.05).The IL-1β expression had no significant difference before and after irradiation.The expression of TGF-β1 in serum before and at the end of irradiation had positive correlation with the expression of IL-1β at the end of the irradiation (r =0.416,0.389,P ＜ 0.05).Conclusions The expression of TGF-β1 in the serum of patients with thoracic tumor increases after irradiation and correlated with the acute RIHD,but the expression of IL-1β in serum has no relationship with RIHD.TGF-β1 could induce the expression of IL-1β at the end of the irradiation.