Objective To investigate the influence of misoprostol and carboprost methylate for preoperative vaginal placement on the clinical index, the cervical dilatation degree and adverse reactions of patients with submucous myoma of uterus by hysteroscopic surgery.Methods150 patients with submucous myoma of uterus by hysteroscopic surgery were chosen in the period from August 2013 to August 2016 in Yiwu Maternal and Child Health Care Family Planning Service Center and divided into two groups including group A (75 patients) with misoprostol and group B (75 patients) with carboprost methylate for preoperative vaginal placement;and the operation time, the intraoperative blood loss, the recovery time of gastrointestinal function, the effects of cervical dilatation, the width of cervical dilatation and the adverse reactions incidence of both groups were compared.ResultsThe operation time and the intraoperative blood loss of B group were significantly better than A group(P<0.05).There was no significant difference in the recovery time of gastrointestinal function between the two groups.The effects of cervical dilatation in group B were significantly better than that in group A(P<0.05).The width of cervical dilatation in group B were significantly larger than that in group A(P<0.05).There was no significant difference in the adverse effects incidence between the two groups.ConclusionCompared with misoprostol, carboprost methylate for preoperative vaginal placement in the treatment of patients with submucous myoma of uterus by hysteroscopic surgery can efficiently shorten the operation time, reduce the operation bleeding, improve the effect of cervical dilatation and not increase the adverse reactions risk.

Objective To study the Mandarin long-term average speech spectrum (LTASS),the effects of gender,language and region material on LTASS were explored.This research would provide reference for clinical and academic use of Mandarin LTASS.Methods One hundred and sixty subjects from eight major dialectic regions of China,aging 16~30 (average 22.3±3.3),were asked to read two materials (storybook,newspaper)in Manda-rin at a steady speed and conversational level inside a standard soundproof booth.Ten males and ten females were in each dialectic region.A microphone (B&K 4192)was used to monitor each subject's speech which was analyzed with a real-time spectrum analyzer to obtain the long-term spectrum (B&K PULSE 3560C).Results Different Man-darin LTASS spectra were obtained based on gender,material and regions.The spectra were tested with profile a-nalysis.Language material had no significant effects on the Mandarin LTASS (F =2.52,P =0.11 ).There was, however,significant gender difference (F =116.39,P =0.00).Males had spoken with intensity levels higher than females at 100 Hz to 200 Hz.There was also a dialectic difference in the Mandarin LTASS (F =1.29,P =0.02). Speakers from Guangdong had the lowest intensity levels compared to those from other regions.Conclusion Genders and regions are factors that need to be considered when LTASS is used for clinical purpose and academic study.

Objective To observe the clinical curative effect of tripterygium polyglycoside combined with cozaar in elderly patients with IgA nephropathy (IgAN) and its influence on expressions of TGF-β1,PAI-1 and VEGF.Methods Eighty elderly patients with IgA nephropathy in Jiaxing Hospital of Armed Police Zhejiang Corps from April 2011 to January 2016 were selected and randomly divided into the control group and observation group,40 cases in each group.The two groups received the routine treatment of chronic basic diseases and took oral cozaar.On this basis the observation group took tripterygium polyglycoside for continuous 12 months.Urine protein,serum creatinine (Scr),blood urea nitrogen (BUN),plasma Alb,urine TGF-β1,PAI-1 and VEGF levels before treatment and at 3,6,12 months after treatment were compared between the two groups.The occurrence situation of adverse reactions was recorded.Results The 24 h urinary protein levels at 3,6,12 months after treatment in the two groups were decreased,moreover the 24 h urine protein level at each time point in the observation group was lower than that in the control group,the difference was statistically significant (P<0.05).The levels of Scr,BUN,urine TGF-β1,PAI-1 and VEGF after treatment in the two groups were decreased compared with before treatment,while the Alb level was increased compared with before treatment,moreover the levels of Scr,BUN,urine TGF-β1,PAI-1 and VEGF in the observation group were lower than those in the control group,while the Alb level was higher than that in the control group,the difference was statistically significant (P<0.05).The observation group appeared 2 cases of leukopenia,1 case of liver dysfunction and no serious adverse reactions occurred.Conclusion Tripterygium polyglycoside combined with cozaar has a significant therapeutic effect on elderly patients with IgAN,can significantly reduce urinary protein and protect renal function,moreover its clinical use is safer.Its efficacy may be related to reducing the expression levels of TGF-β1,PAI-1 and VEGF.

To observe the effects of ultrasound-guided stellate ganglion block (SGB) on cerebral oxygen metabolism and postoperative cognitive dysfunction (POCD) of elderly patients, we collected 80 elderly patients undergoing selective coronary artery bypass graft under cardiopulmonary bypass. The Mini Mental State Examination (MMSE) was applied to test the cognitive function. The SjvO2, Da-jvO2 and CEO2 were used for the analysis of the cerebral oxygen metabolism. We found that POCD was related to disequilibrium of cerebral oxygen metabolism. Ultrasound-guided SGB before surgery reduced the incidence of POCD because of the improvement of cerebral oxygen metabolism.
Aged ; Autonomic Nerve Block ; Cardiopulmonary Bypass ; Cognition Disorders ; prevention & control ; Coronary Artery Bypass ; Humans ; Neuropsychological Tests ; Oxygen Consumption ; Postoperative Complications ; Stellate Ganglion ; diagnostic imaging ; Ultrasonography

BACKGROUND:Cordyceps polysaccharide is a commonly used adjuvant drug for clinical treatment of nephrotic syndrome. As a classic model of nephrotic syndrome induced by adriamycin, the Sprague-Dawley rat model of nephrotic syndrome exhibits similar clinical manifestations and pathological changes to minimal-change nephropathy in humans. OBJECTIVE:To observe the effect of adipose-derived mesenchymal stem cel s (ADMSCs) transplantation combined with cordyceps polysaccharide on renal function and hypercoagulable state in rats with nephrotic syndrome. METHODS:ADMSCs suspension was made in vitro and labeled using PKH26. Fifty Sprague-Dawley rats were randomized into normal (no intervention), model, ADMSCs, cordyceps polysaccharide and combined treatment groups (n=10/group). Adriamycin administration was performed to make rat models of nephrotic syndrome in the latter three groups. After modeling, model rats were respectively given no treatment, ADMSCs intravenously for 3 days, cordyceps polysaccharide intragastrical y for 12 weeks, or their combined use. Then, 24-hour urinary protein, serum total cholesterol, triglyceride, total protein, albumin, high-density lipoprotein, low-density lipoprotein, creatinine, blood urea nitrogen levels and coagulation changes were detected at 12 weeks. Meanwhile, histopathological changes of renal tissues were observed under light microscope;survival and distribution of PKH26-labeled ADMSCs were observed by fluorescence microscopy;and expression of Hpa gene in renal tissue was detected by RT-PCR. RESULTS AND CONCLUSION:Compared with the model group, the 24-hour urinary protein, serum total cholesterol, triglyceride, low-density lipoprotein, creatinine, and blood urea nitrogen levels were significantly lower, while the serum total protein, albumin and high-density lipoprotein levels were significantly higher in the three treatment groups (P<0.05). These indicators showed significant differences between the combined group and ADMSCs and cordyceps polysaccharide groups (P<0.05). Both ADMSCs transplantation and cordyceps polysaccharide significantly relieved the hypercoagulable state of rats with nephrotic syndrome, and their combined effects were stronger (P<0.05). After treatment, the pathological improvement in the kidney tissues was found in the three treatment groups;moreover, it was better in the combined treatment group than the ADMSCs and cordyceps polysaccharide groups. Better improvement in the number of PKH26-labeled ADMSCs and the expression of Hpa mRNA was observed in the combined treatment group compared with the ADMSCs and cordyceps polysaccharide groups. In conclusion, the combination of ADMSCs transplantation and cordyceps polysaccharide can improve kidney function and hypercoagulable state in rats with nephrotic syndrome, reducing pathological damage to the kidney tissue.

Abstract Adolescent idiopathic scoliosis (AIS) is a relatively common spinal health problem in the adolescents, whose pathogenesis remains unclear. AIS substantially affects the mind, intellect and body shape in children and adolescents. From a neurophysiological perspective, this article discusses progress in domestic and international research on the anatomical morphology, physiological function and neuromodulation of muscle metabolism in the nervous system in AIS, and analyses the dynamic balance in regulatory mechanisms of the neuromuscular system affecting spinal movement, which argues that an imbalance between the synergistic control of the central nervous system and the spinal neuromuscular system results in a series of kinetic compensatory responses of the spine, thus leading to AIS generation and/or development. This article is aimed at providing theoretical guidance for educational intervention approaches to address adolescent spinal health problems.

Objective To explore treatment scheme and surgery for hypospadias with small glans.Methods Between January 2014 and January 2017,40 cases of hypospadias with small glans were enrolled in the study including 13 cases with penile hypospadias and 27 cases with penoscrotal hypospadias.The boys's average age was 1.5 years,aged from 1 to 5 years old.The boys whoes glans width less than 10 mm received the treatment of topical testosterone propionate smeared on penis once a day for 1 or 2 months.The patients received operation when their glans width reached 10 mm to 14 mm.Among of 27 cases of severe penile recurvation patients,17 cases received staging operation,one-stage was correction of penile recurvation and two-stage was Tubularized incised plate with pull-through procedure,10 cases received adopted modified Duplay combined with Duckett operation,then overturn split-skin graft for incision in the urethra located in glans penis.Among of 13 cases with mild and moderate recurvation,after penile correction,3 cases received Tubularized incised plate urethroplasty and 10 cases received Onlay island flap urethroplasty.All of the patients received modified plastic surgery for glans.Results All of patients were followed-up,from 3 months to 3 years.The surgical success rate was 70％ (28/40).12 cases got operative complications,including urinary fistula 6 cases and glans dehiscence 1 case,who were cured by reoperation,external orifice stricture 1 case and urethral stricture 4 cases who were healed by Urethra dilatation.All patients acquired good appearance glans and satisfied void stream.Conclusions Topical use testosterone propionate for hypospadias with small glans helps the growth of penis.Individualized diagnosis and treatment plan should be made for the particular case of hypospadias with small glans.The modified plastic surgery of glans is suitable for hypospadias with small glans,which could improve surgery success rate and reduce the postoperative complication.

Objective To explore the choice of handling methods for bilateral internal ring during the transumbilical single-site laparoscopic orchiopexy for cryptorchidism with bilateral processus vaginalis unclosed in children,and evaluate the clinical effect.Methods Retrospective analysis was conducted for the clinical data of 102 children with cryptorchidism and bilateral processus vaginalis unclosed who were hospitalized at Children's Hospital Affiliated to Capital Institute of Pediatrics from January 2011 to January 2016.They were divided into the observation group (55 cases) and the control group(47 cases).In the observation group,the internal rings of the affected side were destroyed and stitched with a needle between the edge of arcuate of musculus trasversus abdominis and fascia trans versalis of posterior peritoneum.If the diameter of opposite internal ring was less than 0.5 cm,only a circle was destroyed.Otherwise,a circle was destroyed and sutured with a needle.In the control group,the processing methods for orchiopexy and affected side internal ring were same as the observation group.Purse string suture was done for opposite internal rings of all cases in the control group.The parameters of operative duration,intraoperative blood loss,postoperative hospital stay,postoperative complications were compared between 2 groups.Results All operations were successful in both groups,spermatic cords were reserved and testicles were in scrotum of all cases.Operative duration was significantly shorter in the observation group than that in the control group [(42.02 ± 3.21) min vs.(48.43 ± 4.18) min,t =-8.739,P ＜ 0.01].The differences in intraoperative blood loss,postoperative hospital stay and postoperative complications between 2 groups were not statistically significant[(4.38 ± 1.42) mL vs.(4.80 ± 1.37) mL,t =-1.533,P ＞0.05;(2.87 ±0.64) dvs.(2.98 ±0.61) d,t =-0.853,P ＞0.05;1.8％ (1/55 cases) vs.2.1％(1/47 cases),x2 =0.013,P ＞ 0.05].During a mean follow-up of 30(12-72) months,there was no case of testicular ascent or atrophy,or hernia,or hydrocele.Conclusions The transumbilical single-site 3-port laparoscopic orchiopexy for cryptorchidism has stable efficacy.The improved method for bilateral internal ring is simple and has satisfactory effect,which is worthy of clinical promotion.

Objective To evaluate the clinical effect of treatment for high intra-abdominal cryptorchidism of children with transumbilical single-site and multichannel laparoscopic single stage Fowler-Stephens (F-S) orchiopexy.Methods The case records of the intra-abdominal cryptorchidism of children who had undergone transumbilical single-site laparoscopic single stage F-S orchiopexy were reviewed retrospectively in Children's Hospital Affiliated to Capital Institute of Pediatrics between January 2011 and January 2017,were assigned as the observation group,whose age ranged from 1 to 8 years and average age was 18 months,with 22 unilateral and 8 bilateral,38 testis in total.A total of 31 children with intra-abdominal cryptorchidism who had undergone laparoscopic two stage F-S orchiopexy were assigned as the control group,whose age was from 11 months to 9 years and average age was 20 months,with 23 unilateral and 8 bilateral,39 testis in total.Postoperative follow-ups were conducted with the evaluation index included the testical position,with or without atrophy.The procedure effect and postoperative complications were observed,and the difference between two operation methods was evaluated.Results Operations in all cases were successful in both groups without intraoperative complication.A total of 38 testis were operated with single stage F-S orchiopexy in the observation group,and 39 testis were operated with two stage F-S orchiopexy in the control group.Postoperative complications included scrotum wound infection one case and scrotum hematoma in one case in the observation group,and abdominal wall emphysema in one case,intestinal obstruction in one case as well as umbilicus infection 1 case in control group.Follow-ups ranged from 6 months to 6 years,median 24 months.All testicals were within the scrotum,and each group had 1 case of testical atrophy.The difference of postoperative complication and effect between two groups had no statistical significance(x2 =0.184,0.107,all P ＞ 0.05).Conclusions Outcomes between single stage and two stage F-S orchiopexy are similar.The transumbilical single-site laparoscopic F-S orchiopexy not only has the satisfactory effect,but also saves some patients from reoperation and secondary anaesthesia,but doctors must be aware of the indications and contraindications of this procedure should be brought to attention.

Objective:To compare the clinical and imaging outcomes of fascia lata autograft bridging repair reinforecd with an artificial ligament as the internal brace with the autograft bridging repair for the treatment of irreparable massive rotator cuff tears (IMRCTs).Methods:The data of 26 patients with IMRCT who underwent fascia lata autograft bridging repair augmented with artificial ligament as the internal brace (internal brace group) and of 24 patients with IMRCT who underwent bridging autograft repair alone (control group) were retrospectively evaluated preoperatively and at 2-year follow-up. Clinical outcomes were assessed using shoulder activity, the American Shoulder and Elbow Surgeons (ASES) Score, University of California Los Angeles (UCLA) Score, and visual analogue scale (VAS) for pain. Imaging outcomes were evaluated using acromiohumeral distance (AHD), Goutallier grade, and status of fascia lata grafts according to radiographs or magnetic resonance imaging results.Results:All 50 cases were followed up for 34.2±7.2 months (range 24-45 months). Compared to the control group, the internal brace group showed better ASES score (93.5±5.3 vs. 89.5±5.7, P<0.05), UCLA score (31.7±3.8 vs. 28.5±5.6, P<0.05), improvement in UCLA score (19.6±4.2 vs. 15.9±5.7, P<0.05), active elevation (167.3°±8.4° vs. 159.4°±13.6°, P<0.05), abduction strength (8.9±1.2 vs. 8.2±1.2, P<0.05), improvement in abduction strength (4.1±1.2 vs. 3.3± 1.0, P<0.05), AHD (7.0±1.4 mm vs. 5.9±1.0 mm, P<0.05), improvement in AHD (3.3±1.5 mm vs. 2.0±0.6 mm, P<0.05), and healing rate of fascia lata autografts (92% vs. 54%, P<0.05) at 2-year follow-up. Conclusion:Fascia lata autograft bridging repair reinforced with an artificial ligament as the internal brace improves healing rate of bridging graft and postoperatively short-term clinical outcomes of patients with IMRCT.