Objective To compare the effects of transabdominal hysterectomy(TAH),transvaginal hysterectomy(TVH),and laparoscopic total hysterectomy(LTH)on sexual function and psychological health.Methods A total of 100 patients undergoing TAH,100 patients undergoing TVH,and 40 patients undergoing LTH were followed up for 1 year.All the patients were aged between 45 and 54 years.The Results of the questionnaire on sexual function and psychological health were analyzed and compared with those from 100 control subjects undergoing hysteromyomectomy.Results In pateints under 50 years of age,no significant difference in the sexual function and psychological health was found between control group and any one of TAH,TVH,and LTH goups.In patients aged 50 yeare and older.ESFI score decreased from control group to TVH group to LTH group to TAH group;CHQ-12 score increased from control group to TVH group to LTH group to TAH group;and there was significant difference in the FSFI and CHQ-12 scores both between TAH and control groups and between TAH and TVH groups(P＜0.05).Conclusion There is no obvious effect of these 3 surgical approches to hysterectomy on the sexual function and psychological health in patients under 50 years of age,and there is no significant difference in the sexual function and psychological health among these 3 surgcial approaches.In patients aged 50 yean;and older,TAH has a negative impact on the psychological health and sexual function.

Objective To investigate the relationship between expression of eofilin-1 and in vivo implantation capacity of eutopic endometrium of endometriosis.Methods Eutopic endometrium of 20 cases with stage Ⅲ or Ⅳ endometriosis were obtained by laparoscopic or laparotomy surgery (endometriosis group) matched with 20 cases of eutopic endometrium from patients with cervical cancer in situ (control group) in Department of Obstetrics and Gynecology,ShengJing Hospital.All cases' eutopic endometrium were collected and injected into abdominal cavity of nude mice to establish endometriosis animal model, then the successful rate of animal model and volume of endometriosis lesion were calculated.The expression and positive rate of eofilin-1 protein were measured by western blot and immunohistochemistry staining.Results The mean volume of endometriosis lesions (2.38 ± 0.22)mm~3 in endometriosis group was significantly bigger than (0.36 ± 0.08) mm~3 in control group (P < 0.05).The successful rate of establishing endometriosis model was 95% (19/20) in endometriosis group and 5% (1/20)in control group, which reached statistical difference(P <0.05).The expression and positive rate of cofilin-1 protein in eutopic endometrium and the expression of cofilin-1 protein in endometriosis lesion of animal model were 0.82±0.06, 90% (18/20), 0.85 ± 0.03 and 0.21 ± 0.03, 20% (4/20), 0.22 ± 0.02 in control group, which reached statistical difference(P <0.05).The successful rate of establishing endometriosis model with positive cofilin-1 in endometrium 86% (19/22) was significantly higher than 6% (1/16) of model's endometrium with negative cofilin-1 expression(P <0.05).Conclusions Implanting capacity and cofilin-1 expression level of eutopic endometrium of endometriosis were more intensive than that of normal endometrium.High cofilin-1 expression was probably related with implanting capacity of eutopic endometrium of endometriosis.

Objective To evaluate the clinical value of laparotomy,transvaginal surgery,and lapaioscopic surgery in treating benign ovarian cyst.Methods We retrospectively analyzed 227 patients with benign ovarian cyst who underwent laparotomy,transvaginal surgery,or laparoscopic surgery.The duration of the operation,amount of blood loss,hospitalization time,anal exhaust time,temperature recovery time.outof-bed time,usage of analgesics,postoperative morbidity,and hospitalization cost were analyzed.Results There were significant differences in above indicators between the patients undergoing transvaginal surgery or laparoscopic surgery and those undergoing laparotomy.Conclusion Transvaginal surgery and laparoscopic surgery are minimally invasive and safe in treating benign ovarian cyst.These 3 surgical approaches have distinct advantages and disadvantages.The clinicians should choose the appropriate surgical approach for benign ovarian cyst according to the patient's condition.

Objective To investigate epigenetic inactivation of SPOCK2 gene in the malignant transformation of ovarian endometriosis ( EM ) by comparing the methylation status and protein expression of SPOCK2 gene in the malignant tissues,ectopic endometria and the eutopic endometria of endometriosis.Methods From Jan.2005 to Jan.2011,22 paraffin-embedded specimens diagnosed as malignant transformation of ovarian endometriosis ( EAOC ) including 11 cases with ovarian endometrioid carcinoma,8 cases with clear cell carcinoma,2 cases with serous cystadenocarcinoma and 1 case with mucous cystoadenocarcinoma matched with 22 cases with ovarian endometriosis and 16 cases with normal endometrium form cervical intraepithelial neoplasia(CIN) patients as controls in Department of Obstetrics and Gynecology of Shengjing Hospital.Twenty-two malignant tissues,15 ectopic endometria and 10 eutopic endometria were captured by microdissection in EAOC group; 22 eetopic endometria and 17 eutopic endometria were captured in EM group; 22 endometrium were captured in the NE group.The methylation statue of SPOCK2 was determined by combined bisulfite restriction analysis,and the protein expression of SPOCK2 was evaluated by immunohistochemistry.Results ( 1 ) Methylation of SPOCK2:in the EAOC group,the frequency of SPOCK2 hypermethylation in malignant tissue was 45％ (10/22),which was significantly higher than 1/15 in the ectopic endometrium (P＜0.05).There was no statistical difference of the frequency of SPOCK2 hypermethylation in ectopic endometrium in the EAOC group(1/15) and EM group (5％,1/22) (P＞0.05).(2) SPOCK2 protein:the loss rate of SPOCK2 was 44％ (11/22) in malignant tissue in EAOC group,which were significantly higher than 2/15 of in ectopic endometrium of EAOC (P ＜ 0.05).However,there was no remarkable difference in loss rate of SPOCK2 protein between ectopic endeometrium of EAOC and endometrium of EM [ 2/15 vs.5％ ( 1/22 ),P ＞ 0.05 ].No significantly difference in loss rate of SPOCK2 in eutopic endometrium was observed among three groups ( P ＞ 0.05 ).(3) The abnormal methylation of SPOCK2 could lead to loss expression of protein ( P ＜ 0.05 ).Conclusion Epigenetic inactivation of SPOCK2 gene is involved in the malignant transformation of ovarian endometriosis.

Objective To study the feasibility of transperitoneal laparoscopic radical prostatectomy. Methods Laparoscopic radical prostatectomy was performed according to Montsouris technique. Results All the operations were successfully completed. The operating time was 330~540 min (mean, 433 min) and the estimated blood loss was 100~550 ml (mean, 274 ml). No patients required a blood transfusion. Bladder injury was found in 1 patient and was sutured promptly during the operation. The postoperative hospital stay was 15~23 days (mean, 17 days). The catheterization time was 14~23 days (mean, 16 days). In 2 patients presenting with urinary leakage, the catheter was removed at 20 and 23 days after surgery respectively, while in the remaining 8 patients, at 2 weeks after operation. Mild urinary incontinence occurred in 3 patients and disappeared after 4 weeks of supportive treatment. Pathological examinations revealed stage pT_ 1c) in 3 patients, stage pT_2 in 6, and stage pT_3 in 1. A follow-up for 3~21 months (mean, 7.5 months) was carried out. The postoperative prostate-specific antigen (PSA) level was 0~2.70 ?g/L(mean,0.05 ?g/L). Two patients returned a normal sexual function. Conclusions Strict following surgical indications, adequate preoperative preparation, improvement of surgical techniques, and proper application of surgical instruments and devices make transperitoneal laparoscopic radical prostatectomy feasible.

Ovarian cancer is one of the common gynecological malignant tumors. In China, there are more than 50 000 new cases diagnosed as ovarian cancer each year, and more than 30 000 death cases every year. In recent years, with the rapid development of gene detection technology, the establishment of ideal surgery concept, the specification of chemotherapy, the attention of recurrent ovarian cancer, and the application of targeted drugs, the diagnosis and treatment system of ovarian cancer is gradually standardized and improved. This article reviews the current status of ovarian cancer treatment and the latest research progress.

Objective To compare the clinical features and results between transperitoneal laparoscopic radical prostatectomy and extraperitoneal laparoscopic radical prostatectomy.Methods Thirty-three prostate cancer patients treated with laparoscopic radical prostatectomy. Among them,21 cases had been done transperitoneally and 12 cases had been done extroperitoneally. The two different approaches were evaluated and compared in respects of operating time, estimated blood loss, complications during surgery, postoperative complications, intestinal function recovery time, catheterization time and length of hospital stay.Results All the surgeries had completed successfully without conversion to open surgery. For transperitoneal approach and extraperitoneal approach, the operating time was (299±46)min and (309±64)min, blood loss was (618±448)ml and (677±469)ml. There were 3 cases with severe blood loss, 2 cases with bladder injuries and 1 case with ureteral injury in transperitoneal approach group. There were 1 case with severe blood loss, 1 case with obturator never injury, 1 case with cysto-ureteral injury and 1 case with peritoneum injury in extraperitoneal approach group. For transperitoneal approach and extraperitoneal approach,the catheterization time was(14.6±3.8)d and (12.3±2.9)d, intestinal function recovery time was (2.7±0.7)d and (2.1±0.5)d, length of hospital stay was (17.0±3.6)d and (11.2±3.5)d, respectively.Conclusions Laparoscopic radical prostatectomy is feasible and safe in clinical practice. Extraperitoneal approach has better vision, less impact on abdominal organs, faster recovery and shorter hospital stay comparing to transperitoneal approach.

Functional diarrhea is a common disease of the digestive tract system. Traditional Chinese medicine (TCM) mainly included herbal formulea, acupuncture and moxibustion to treat the functional diarrhea, according to the principles of strengthening spleen and moistening, nourishing spleen and kidney, and soothing liver. In recent years, many studies have been conducted on the effective mechanism of TCM treatment of functional diarrhea. However, further researches needed to be done on the micro-mechanism of TCM syndrome differentiation for functional diarrhea.

OBJECTIVETo investigate the therapeutic effects of the conditioning regimen with busulfan plus cyclophosphamide (BU+CY) or total body irradiation plus cyclophosphamide (TBI+CY) on haploidentical stem cell transplantation (HSCT) in hematologic malignancy.

METHODSThe clinical outcomes of 77 HSCT recipients with hematologic malignancy from January 2001 to December 2010, including 21 AML, 33 ALL, 19 CML and 4 MDS were retrospectively evaluated. Among them, 65 patients obtained complete remission (CR) and 12 non-remission (NR) before transplantation; 39 patients received conditioning regimen with BU+CY, and 38 with TBI+CY.

RESULTSThere were no statistically significant differences in hematopoietic reconstitution, disease free survival (DFS), and transplant- related mortality (TRM) between two groups. The estimated 3- years overall survival (OS) was 56.4% for BU+CY and 31.6% for TBI + CY (P=0.0283). The overall relapse rate was similar between two groups (15.4% vs 34.2%; P=0.1538). However, the accumulative probability of relapse at 1-year was significantly lower in BU+CY than that in TBI+CY group (2.56% vs 26.67%; P=0.0116). The incidence of grade II-IV graft-versus-host disease (GVHD) was similar between two regimens (20.5% in BU+CY group and 18.4% in TBI+CY group; P=0.8168). The incidence of chronic GVHD (cGVHD) was higher in the TBI+CY group than that of BU+CY group (84.6% vs 41.1%; P=0.0007). The extensive GVHD obtained the similar outcome (30.8% vs 10.5%; P=0.0416).

CONCLUSIONPatients using BU+CY as conditioning regimen before transplant could obtain a better 3 year OS and lower short-term relapse rate. The TBI+CY conditioning regimen could significantly increase the incidence of cGVHD without increasing the acute GVHD. BU+CY conditioning regimen could be used for HSCT, but the attention should be paid to prevent the related hemorrhagic cystitis.

Adolescent ; Adult ; Busulfan ; administration & dosage ; Child ; Child, Preschool ; Cyclophosphamide ; administration & dosage ; Female ; Hematologic Neoplasms ; therapy ; Hematopoietic Stem Cell Transplantation ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Transplantation Conditioning ; methods ; Whole-Body Irradiation ; Young Adult