Objective The aim of study is to evaluate the efficacy of a new complementary midurethral sling surgery in treating recurrent or persist female stress urinary incontinence (SUI) after primary Synthetic mid-urethral slings (MUSs).Methods The methods was used in 32 patients who had suffered recurrent or persist SUI patients after primary MUSs during June 2005 and July 2011.Their primary MUSs were:TVT 2 cases,IVS 4 cases,TVT-O 17 cases,TOT 3 cases,T-sling 1case,other MUSs 5 cases.9 cases complained SUI symptoms continued after primary surgery and had no improvement after 6 months following up.23 cases reported SUI symptoms recurrent and aggravated in 6 months after primary operation and had no improvement 1 year after operation.All these patients have been treated with surgery,a trans-vaginal mid-urethral sling on descending pubic ramus.In this study we followed up these patients for one year after this complementary operation and evaluated operating time,blood loss,efficacy and complications.Results In this study the operating time was 41.1±13.1 minutes,blood loss was 70.6±23.8 ml.30 patients kept urinary catheter 6 h after operation and 2 kept urinary catheter 48 h after operation.All patients could micturate after removed urinary catheter and average residual urine was 23.8 ± 21.4 ml (range 0-80 ml).The average in-patients duration was 4.8± 1.1days.SUI symptoms still persisted in two patients after second operation,subjective cure was achieved in 26 patients and the symptoms obviously improved in 4 patients when they left hospital.The efficient rate was 93.8％ (30/32) left hospital and after 3 months,93.3％ (28/30) after 6 months and 86.2％ (25/29) after 1 year.There were 2 cases of recurrence and 1 case of mesh erosion after 1 year,no other operative complications were reported.Conclusions Our study found that it is a efficient operation to treat SUI recur or persist after primary.

Objective To compare the impact on the ovarian reserve function after cisplatin intraperitoneal or intravenous chemotherapy in rats model. Methods Thirty 8-weeks old female Sprague Dawley rats were randomly assigned to control group (group A, n=10), intraperitoneal chemotherapy group (group B, n=10) and intravenous chemotherapy group (group C, n=10). Cisplatin was diluted by normal saline (NS) into 4 mg/ml. On the first day of chemotherapy, 0.2 ml cisplatin dilution was injected into the abdomen of rats in group B, isodose cisplatin was injected into vein and 1.8 ml NS was injected into abdomen of rats in group C, 2.0 ml NS was injected into abdomen of rats in group A for control. Feed the three groups rats and test the anti-Mullerian hormone (AMH) in serum on day 0 (just before injection), day 10 and day 20 by ELISA, count the numble of follicle in bilateral ovaries on day 20. Results (1) The levels of serum AMH in the three groups before and after chemotherapy were compared: ① comparison between groups: On day 10 and day 20 , the AMH level in group B [(64.5 ± 2.9), (68.6 ± 3.4) ng/L] and group C [(76.1±4.9), (91.3±3.9) ng/L] was significantly lower than that in group A [(120.1±5.3), (121.7±4.6) ng/L;P<0.01], AMH level in group B was significantly also lower than that in group C (P=0.000). ② Comparison within groups:the AMH level on day 0 was significantly lower than that on day 10 and day 20 in group A (P<0.01), but there was no significant difference between day 10 and day 20 (P=0.427). The AMH level on day 0 was significantly higher than those on day 10 and day 20 in group B (P<0.01) and group C (P<0.01). There was no difference in AMH level between day 10 and day 20 (P=0.124) in group B, but the level was significant lower on day 10 than that on day 20 in group C (P=0.011). (2)Comparison of the number of follicles in ovaries of three groups 20 days after chemotherapy:the follicles number in group A(35±13)was greater than that in group B (16 ± 9,P=0.003) and similar with group C (31 ± 16,P=0.474) on day 20. The follicles number in group B was significantly less than that in group C (P=0.018). Conclusions In the present study, both intravenous and intraperitoneal chemotherapy have impacts on ovarian reserve function and the latter might be more serious. The level of AMH will rise again over time after chemotherapy and rats undergo intravenous chemotherapy would recover faster. The results suggest that the ovarian reserve function need more time to recover after intraperitoneal chemotherapy. For patients with ovarian cancer who want to preserve fertility function, intravenous chemotherapy might be more appropriate.

Objective:To observe the effect of Buzhongyiqi Decoction on the expression of transforming growth factor β-3(TGFβ-3)and microRNA-30d(miR-30d)in uterosacral ligament tissues in a rat model of pelvic organ prolapse.Methods:According to the number lottery, 16 rats in the blank control group were divided into 2 groups: the A1 group(feeding 4 weeks, n=8)and the A2 group(undergoing the ovariotomy with normal saline gavage for 8 weeks, n=8). The 64 rat models of pelvic organ prolapse were randomly divided into 8 groups(8 rats in each group): the B1 group(feeding 4 weeks), the B2 group(given normal saline via gavage for 8 weeks), the C1 and C2 groups(given Buzhongyiqi Decoction via gavage, 3.5 ml·kg -1·d -1, for 4 and 8 weeks, respectively), the D1 and D2 group(given Buzhongyiqi Decoction via gavage, 7.0 ml·kg -1·d -1, for 4 and 8 weeks, respectively), the E1 and E2 group(given Buzhongyiqi Decoction via gavage, 14.0 ml·kg -1·d -1, for 4 and 8 weeks, respectively). Reverse transcription-polymerase chain reaction(RT-PCR)was used to detect the expression of collagen COL1A1, COL3A1, TGF β-3 and miR-30d in uterosacral ligament tissues. Results:Compared with A1 group, the B1 group showed that the expression of COL1A1 and COL3A1 was decreased and the expression of TGFβ-3 and miR-30d was increased( P<0.01). After 4 weeks treament of Buzhongyiqi Decoction, the expression of COL1A1 was higher in E1 group than in C1 group ( P<0.01), The expression of COL3A1 in group D1 was singificantly higher than that in group C1, The expression of COL3A1 in group E1 was also singificantly higher than that in group D1 .The expression of TGF β-3 was higher in the D1 and E1 groups than in the C1 group( P<0.01). The expression of miR-30d was lower in the D1 and E1 groups than in the C1 group( P<0.01). After 8 weeks of Buzhongyiqi Decoction treatment, the expression of COL1A1 was higher in the D2 group than in the C2 group( P<0.01), while was lower in the E2 group than in the D2 group( P<0.01). The expression of COL3A1 and TGFβ-3 was higher in the D2 group than in the C2 group( P<0.01)and the expression of TGFβ-3 was lower in the E2 group than in the D2 group( P<0.01). The expression of miR-30d was lower in the D2 group than in the C2 group( P<0.01)and was higher in the E2 group than in the D2 group( P<0.01). Compared with the B1 group, the expression of COL1A1, COL3A1 and TGF β-3 was increased in the D1 and E1 groups( P<0.01), the expression of miR-30d was decreased in the C1, D1 and E1 groups( P<0.01). Compared with the B2 group, the expression of COL1A1 and COL3A1 was increased in the D2 and E2 groups, the expression of TGF β-3 was increased and the expression of miR-30d was decreased in the C2, D2 and E2 groups( P<0.01). Conclusions:Buzhongyiqi Decoction can increase the synthesis of collagen COL1A1 and COL3A1 in uterosacral ligament tissues of rats with pelvic organ prolapse, which may be related to the up-regulation of TGF β-3 expression and the down-regulation of miR-30d expression in rat uterosacral ligament tissues.