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.

AIM: To investigate the role of epigenetic modification in Pdx-1 gene transcription and expression, and to compare the differences between epigenetic modifications of Pdx-1 gene promoter in various cell types of mice. METHODS: The promoter DNA methylation and histone modification status of Pdx-1 and MLH1 genes in NIT-1 cells, NIH3T3 cells and mouse embryonic stem cells were measured by chromatin immunoprecipitation-real time PCR method. The expression levels of these genes in the three cell lines were measured by real time RT-PCR. The relation between epigenetic modifications and gene expression was analyzed. RESULTS: (1) Compared to mES cells, there was lower DNA methylation and higher H3K4m3 modification levels in the promoter of Pdx-1 gene in NIT-1 cells (P<0.05). DNA methylation, H3 acetylation, H3K4m3 and H3K9m3 modification levels in the promoter of Pdx-1 gene in NIH3T3 cells were distinctly increased (P<0.05). (2) Pdx-1 gene transcription expressed only in NIT-1 cells. The Spearman's rho between Pdx-1 gene expression and DNA methylation (r=-0.802,P<0.01) was observed. The Pearson correlation between Pdx-1 gene expression and H3K4m3 modification (r=0.997,P<0.01) was also found. The Spearman's rho between Pdx-1 gene expression and H3K9m3 modification (r=-0.879,P<0.01) was observed. (3) No correlation between housekeeper MLH1 gene expression and epigenetic modification was found. CONCLUSION: DNA methylation, H3K4m3 and H3K9m3 modification coordinated participate to regulate and control the expression of Pdx-1 gene. It is of great significance to the differentiation of β cells from ES cells.

AIM:To study the changes in lymphatic motion and histochemical stain of nitric oxide synthase(NOS) in the early phase of acute rat endotoxemia and explore their relationship. METHODS: After lipopolysaccharide (LPS) was injected into femoral vein, rats' mesenteric lymphatic were inspected within two hours. Paraffin section was stained by HE, frozen section by NADPH diaphorase histochemistry. RESULTS: In LPS group, the mesenteric lymphatic diameter was greater than that in the control and contractile frequency was decreased, the villi central lacteal and submucosal microlymphatics of small intestine was extremely dilated under microscope. In LPS and control group, NOS was positive in lymphatic endothelia and the nerve fibers in the vessels' wall. CONCLUSION: In the early stage of acute endotoxemia, the lymphatic vessles dilated and contractile activity diminished, NOS may play an important role in these changes.

This study was aimed to investigate the effects of resveratrol on plasma glucose and the oxidative stress ability in gestational diabetic rats. A total of 100 SD rats with gestation for 5 days were intraperitoneally injected with streptozotocin (STZ, 35 mg?kg-1) to prepare gestational diabetic rat model. Rats were randomly divided into 6 groups, which were the normal gestation group, gestational diabetic model group, resveratrol (30, 60, 120 and 240 mg?kg-1) treatment groups, with 20 rats in each group. A total of 20 rats with gestation for 5 days were selected as the normal gestation control group and another 20 rats with no gestation were selected as the normal control group. The levels of plasma glucose and insulin were determined on 0, 7, 14 days after experiment. Two weeks later, the contents of malondialdehyde (MDA) and the activities of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and catalase (CAT) in serum were determined. The results showed that compared with the normal control group, there were no significant difference on the levels of plasma glucose and insulin, the content of MDA, and the activities of SOD, GSH-Px and CAT of the normal gestation control group (P > 0.05). Compared with the gestational diabetic model group, the content of MDA in serum of the resveratrol (30, 60, 120 and 240 mg?kg-1) treatment groups were significantly decreased (P < 0.05,P < 0.01); the level of plasma glucose were significantly decreased and the level of insulin was significantly increased of the resveratrol (120 and 240 mg?kg-1) treatment groups (P < 0.05,P < 0.01); the activities of SOD, GSH-Px and CAT were also significantly increased (P < 0.05, P < 0.01). It was concluded that resveratrol had dose-dependent effect on reducing plasma glucose and improving antioxidant ability in gestational diabetic rats, which perhaps related to its effects on raising the level of insulin and improving the activity of antioxidant enzymes.

Objective To analyze the clinical features and risk factors of isolated calf deep vein thrombosis (ICDVT).Methods Age,gender,locations,clinical symptoms,and risk factors of the hospitalized patients who diagnosed with ICDVT in the Department of Vascular Surgery,the First Affiliated Hospital of Zhengzhou University in 2015 were retrospectively analyzed.Results 122 hospitalized ICDVT patients were enrolled,accounting for 25.7％ of the patients with lower extremity deep vein thrombosis.Among them,41 cases (33.6％) were male,81 cases(66.4％) were female.The average age was 56.41 ±13.87 years.49 cases (40.0％) had left lower limb ICDVT,39 cases (32.0％) had right lower limb ICDVT;34 cases (28.0％) had both two lower limbs involved.Muscular calf vein thrombosis accounted for 77.9％ (95 cases).76 cases (62.3％) were painful.91 cases (74.6％) had swelling.Common risk factors included age (≥ 45 years) (85.2％),deficiency of natural anticoagulants (83.0％),surgery (45.9％) and malignant tumors (28.7％).Conclusions Pain and swelling were the main clinical symptoms of ICDVT.Age ≥ 45 years,deficiency of natural anticoagulants,surgery,and malignancy were main risk factors of ICDVT.

Objective To analyze the risk factors of voiding dysfunction after mid-urethral sling surgery for stress urinary incontinence.Methods Clinical data of 573 consecutive patients undergoing midurethral sling surgery from January 2003 to December 2010 were collected and analyzed retrospectively.All relative risk factors were evaluated by univariate and multivariate Logistic analysis to identify risk factors of voiding dysfunction.Results Voiding dysfunction occurred in 28 patients,with an incidence of 4.9％ (28/573).Univariate analysis showed that age,previous pelvic surgery,pre-operative postvoid residuals,maximum flow rate,average urine flow rate,Valsalva leak point pressure,concomitant anterior pelvic repair and operator performing＜50 procedures were the relative risk factors (P＜0.05) for voiding dysfunction.Multivariate logistic regression analysis revealed that the maximum flow rate (Qmax) ≤ 15 ml/s (OR=3.782,P=0.003) was an independent risk factor for voiding dysfunction and surgery experience was its protection factors (OR=0.295,P=0.016).Conclusions Qmax ≤ 15 ml/s on preoperative urodynamic study is an independent risk factor for voiding dysfunction after mid-urethral sling procedure.Improving skill of surgery and strengthening technical training will help to reduce the incidence of this complication.

Objective Design short stature panel with gene curration strategy.Methods The gene curation process was introduced in detail.The strength of a gene-disease relationship was evaluated based on publicly available genetic and experimental evidence.This process in short stature panel design and its effect on gene selection was further demonstrated.Results After gene curation, the number of gene in list was effectively decreased from 1 276 to 705.The panel sequencing reached a diagnosis rate of 19.7% among a cohort of 371 nation-wide ascertained short stature patients.The gene curation process reduced the risk of false positive findings and decreased diagnostic cost and working hours without affecting the diagnosis rate.Conclusion Gene curation is an important step for NGS-based test and should be widely exercised.

Objective:To evaluate percutaneous mechanical thrombectomy (PMT) using Aspirex device for treating acute iliofemoral deep vein thrombosis (IFDVT).Methods:The clinical and follow-up data of 68 patients with IFDVT at our institution from Jan 2019 to Jun 2021 was retrospectively analyzed.Results:Twenty-six patients who had received PMT combined with auxiliary catheter directed thrombolysis (CDT) were included into group A, and 42 patients received CDT alone were into group B.The final thrombus clearance rates were more than 50%, and the clinical efficacy of thrombolysis was achieved. Group A associated a significant reduction in lysis duration and UK dosage and hospital days and degree of detumescence after 24 h compared with group B,and all aforementioned differences were statistically significant. Hospitalization costs in group A were more than group B. At one year follow-up, there were no significant differences between the two groups in the cumulative prevalence post-thrombotic syndrome (PTS) and the Villalta score and primary patency (92.0% vs. 90.0% , χ2=0.059, P=0.807). Conclusions:The application of PMT using the Aspirex device for acute IFDVT was safe and effective, which could accelerate the clearance of thrombus, and reduce UK dosage, lysis duration, hospital days. However, it increased the hospitalization costs.