BACKGROUND:In recent years, prolift mesh pelvic materials have been widely used in the pelvic floor reconstruction. Scholars have been exploring the advantages and disadvantages of the prolift mesh pelvic reconstruction and the traditional hysterectomy for pelvic floor reconstruction. ＜br> OBJECTIVE:To systemical y assess prolift mesh pelvic reconstruction versus traditional hysterectomy for pelvic floor reconstruction. ＜br> METHODS:Wanfang, VIP, PubMed, Medline databases were searched for randomized control trials (RCTs) related to the clinical effectiveness of prolift mesh pelvic reconstruction versus traditional hysterectomy for pelvic floor reconstruction published from 1996 to 2014. Meta analysis of acquired data was performed through the use of RevMan5.2 software. ＜br> RESULTS AND CONCLUSION:Nine RCTs involving 780 patients were included. Of the 780 patients, 398 received prolift mesh pelvic reconstruction and 382 underwent traditional hysterectomy. Compared with, prolift mesh pelvic reconstruction was superior to the traditional hysterectomy group in terms of operative time, intraoperative bleeding, hospitalization duration, evacuation time, postoperative body temperature, and cure rate of 18 months (P＜0.05). However, there were no significant differences in the post-void residual volume, recurrence rate, the cure rate of 6 months and 12 months, quality of sexual life after 1 year postoperatively (P>0.05). These results reveal that the prolift mesh pelvic reconstruction exhibits better short-term effects on the pelvic floor dysfunction, but its long-term effects need to be further verified.

Acquired factor XIII deficiency disease is rare.One case with gum bleeding as the first symptom caused by acquired factor XIII de-ficiency disease was encountered.The case was analyzed and relevant literatures were reviewed.

Objective To investigate the status of glycemic control in a group of type 2 diabetes mellitus patients combined with pe-ripheral arterial disease before and after operation .Methods Patients with lower extremity arterial occlusive disease who were in charge in vascular surgery of Peking Union Medical College Hospital from 2002 to 2012 were involved .Type2 DM out patient without lower extremity arterial occlusive disease were involved as control .We measured blood pressure ,blood glucose and blood lipid .Fasting,2hPG and average plasma glucose of two groups patients were Compared ,at the same time we observed the difference of plasma glucose before and after operation.The Student′s t test and ANOVA analysis were used to compare the difference of before and after operation and between groups . Results Total of sixty DM patients with lower extremity arterial occlusive disease were involved ,and sixty five patients were involved in control group.There was no difference in age between two groups (65.8 ±8.9 vs 63.0 ±10.0years).The DM patients with lower extremity arterial occlusive disease had longer duration of DM (12.2 ±7.1 vs 7.7 ±5.9years).PAD group had higher fasting plasma glucose (8.3 ± 2.7 vs 7.7 ±2.3mmol/L),post breakfast and lunch plasma glucose (10.7 ±2.9 vs 9.0 ±2.4mmol/L,10.6 ±3.1 vs 8.9 ±4.1mmol/L) than control group .There was no significant difference in post dinner plasma glucose of two groups .Patients with PAD obtained a good plas-ma glucose after they made an operation but insulin Volume had no change ,which was as fasting plasma glucose (7.7 ±2.1 vs 6.8 ± 2.8mmol/L),breakfast (10.5 ±2.5 vs 8.5 ±3.4mmol/L),lunch(10.5 ±3.1 vs 8.7 ±3.8mmol/L)and average plasma glucose (9.6 ± 1.8 vs 8.2 ±2.9mmol/L).Post dinner plasma glucose had no difference in two groups .Conclusion Type 2 DM patients combined with lower extremity arterial occlusive disease had a longer duration of diabetes and higher plasma glucose .At the same,therapy and operation can improve blood glucose control .If a DM patient has a poor plasma glucose ,we should find its reason ,and deal with complication ,then plasma glucose can be controlled better .

Objective To investigate clinical significance of serum retinol -binding protein(RBP)in chron-ic hepatitis B(CHB)and liver cirrhosis after hepatitis B infection(LC).Methods 109 hospitalized patients were involved in this study.They were 51 patients with CHB,58 patients with LC.56 healthy individuals were selected as the the health controls(HC).RBP,ALT,AST,GGT,LDH,TBIL,PA and ALB were analyzed by automatic biochemical analyzer.Results Decreased serum RBP was observed in patients with CHB and LC(CHB vs.HC:t =8.06,P <0.01;LC vs.HC:t =10.26,P <0.01).In addition,the concentration of serum RBP in group of LC was lower than that in CHB(t =3.41,P <0.01).RBP was positively correlated with PA in patients with CHB and LC(CHB:r =0.856,P <0.01;LC:r =0.737,P <0.01),and RBP was positively correlated with ALB in patients with CHB and LC (CHB:r =0.571,P <0.01;LC:r =0.328,P <0.05).ROC analysis showed that area under the receiver operator characteristic curve(AUC)in CHB and LC were 0.874 and 0.942,respectively.Conclusion Serum RBP decreases significantly in patients with CHB and LC.Serum level of RBP is associated with severity of liver diseases and maybe a potential prognostic index for liver disease.

Objective To assess the detection of intestinal lesions by capsule endoscopies in Chinese patients. Methods To review the history and outcomes of 53 patients underwent 55 times ol capsule endoscopies from April 2002 to January 2003. Results Fifty-three patients received 55 times of capsule endoscopies , only one patient failed due to weak gastric peristalsis. Complication never happened. The capsule remained in the stomach and small intestine for an average of 44 minutes (range 6 - 135 minutes) and 334 minutes (range 90 -433 minutes) respectively. Three patients did not discard the capsule properly due to the stricture of small intestine. The diseases detected were small intestinal cancer, lymphoma, polyps, leio-myoma, xanthoma, Crohns disease, intestinal erosion and congestion, ascariasis, triehuriasis, foreign body and angiodysplasia. Conclusion This study demonstrates that the manipulation of capsule endoscopy is simple and safe, and provides excellent visualization of small intestine. Capsule endoscopy is superior to radiography or angiography in detecting lesions of small intestine, but it cannot afford enough information on orien-tation and histology.

Objective To evaluate the value of fractionated stereotatic radiation therapy (FSRT)(X knife) as a boost for recurrent or residual nasopharyngeal carcinoma (NPC) at the primary focus. Methods From Sept.20, 1995 to Dec.30,1998, 50 such patients were treated by FSRT with 6 MV photons. The total FSRT dose was 24～30?Gy prescribed at 1～4 centers on the 60%～90% isodose curves normalized to isocenter by multifractions of fraction size 6～8?Gy, 12,15?Gy, with interfraction duration of 4～6 days. Results CR 38/50 (76%), PR 9/50 (18%) and in evaluated 3/50 (6%). Total survivals(Kaplan meier):1 yr 83.6%, 2 yr 65.0% and 3 yr 59.6% . Conclusion Fractionated stereotatic radiotherapy (FSRT) is strongly indicated for recurrent or residual NPC at the primary focus.

Objective To study the effect of MRI on the enhancement of normal prostate, benign prostatic hyperplasia and prostate cancer by pharmacokinetic model. Methods A total of 80 patients with prostate cancer diagnosed by pathological examination in Lishui Central Hospital from February 2015 to August 2016 were selected as the subjects in this study. 1.5T superconducting magnetic resonance imaging was used, the serial needle was FMPSPGR for enhanced scan of the prostate of the patient, interlayer was 2 mm and the thickness was 7 mm, continuous scanning was performed 35 times, after the elbow vein indwelling catheter, the Gd-DTPA was injected rapidly at the beginning of the scan according to the 0.1 mmol/kg dose. By scanning data, inspection data transfer and workstation for patients with scanning results were analyzed using two room pharmacokinetic model calculation of ROI, the patients of normal prostate peripheral zone, benign prostatic hyperplasia and prostate cancer index, maximum enhancement of contrast agent distribution index, exchange rate, contrast absorption amplitude. Results After a series of calculation and analysis, the maximum enhancement index of prostate cancer, the distribution index of contrast agent, the contrast agent exchange rate and the contrast agent absorption index of prostate cancer were the highest. The maximum enhancement index, contrast agent distribution index, contrast agent exchange rate and contrast agent absorption index were significantly lower than those of prostate cancer, The difference was statistically significant (P<0.05). The indexes of normal prostate were significantly lower than those of benign prostatic hyperplasia (BPH) and prostate cancer (P<0.05). Conclusion The application of drug evaluation pharmacokinetic model of prostate MRI in different tissues to enhancing effect on patients with prostate tumor and non tumor tissue blood supply characteristics more accurately describe and differentiate, to improve the accuracy of identification and diagnosis of prostate in clinical treatment in a certain extent, with further clinical promotion and application significance.

Objective To investigate the effect of Ulinstatin(UTI) on oxygenation and gastric intramucosal pH in dogs with sepsis. Methods Sepsis was induced by intravenous infusion of lipopolysaccharide of E.coli.055:B5 to dogs,and the twenty dogs were divided into control group and ulinastatin group.Ulinastatin was administered in the ulinastatin group.The oxygen delivery(DO2),oxygen consumption(VO2), oxygen extraction(O2ER), plasma lactate levels and gastric intramucosal pH(pHi) were monitored. Results In early sepsis dogs,DO2,VO2,O2ER and plasma lactate levels increased significantly. Gastric intramucosal pH(pHi) decreased significantly. After the treatment with ulinastatin,DO2,VO2,O2ER and plasma lactate levels decreasd(P

Objective To study the time-and dose-effect of mitochondrial DNA (mtDNA) 4934 bp and 4977 bp deletions in the human peripheral blood irradiated by137 Cs γ-rays,and to evaluate its implication in biological dosimetry.Methods The peripheral blood from five healthy adults was collected and irradiated with γ-rays.The peripheral blood of one healthy adult was irradiated with 5 Gy and cultured for 2,24,48 and 72 h after irradiation.The peripheral blood from the other four healthy adults was cultured for 2 h after 0,0.5,1,2,5 and 10 Gy irradiation.The peripheral blood mtDNA 4934 bp and 4977 bp deletions were detected by real-time polymerase chain reaction and gel electrophoresis.The doseeffect curves were fitted using Curve Expert 1.4 Software.Results mtDNA 4934 bp and 4977 bp deletions were induced at 2 h post-irradiation and the mtDNA 4934 bp deletion had relative high levels at 2 h and 48h after radiation (t =10.782 and 8.966,P ＜ 0.05),and mtDNA 4977 bp deletion reached the highest level at 48 h after radiation (t =7.433,P ＜0.05).mtDNA 4934 bp (t =2.895-8.105,P ＜0.05) and 4977 bp deletion (t =3.006-7.715,P ＜0.05) irradiated at 0.5-10 Gy increased with a dosedependent manner.The incidence of mtDNA 4977 bp deletion was higher than that of 4934 bp deletion for those samples exposed with same dose of irradiation,especially at 10 Gy (t =2.919,P ＜ 0.05),which suggested that 4977 bp deletion might be more sensitive than 4934 bp deletion at high dose.But larger individual differences were found in 4977 bp deletion compared with 4934 bp deletion.The dose-effect equations for 4934 bp deletion and 4977 bp deletion were Y1 =1.178 + 0.1219D (R2 =0.9269) and Y2 =1.2578 +0.1933D (R2 =0.9016),respectively.Conclusions The induction of mtDNA deletion was correlated with radiation dose,and thus it may be a available method for biological dose estimation and prognostic evaluation.

Objective To explore the effect and safety of rituximab (RTX) in children with frequently relapsed nephrotic syndrome.Methods Twelve children (8 male and 4 female) with frequently relapse nephrotic syndrome were treated with RTX.They all showed resistance to various immunosuppressive agents and relapsed when steroid was reduced at 1.5-2.0 mg/kg.All immunosuppressive agents were stopped.Steroid was prescribed at doses of 2 mg/(kg · d),followed by alternate-day dosing (2 mg/kg) after proteinuria was negative for 5 days,and then tapered by 5 mg every 2 weeks until to low dose (＜ 0.5 mg/kg on alternate day) or discontinued.RTX was administered at a dose of 375 mg/m2 once every week for 3 weeks.Results The patients were followed up for 4-19 months [median (7.79 ± 3.00) months].Proteinuria turned negative on 1-14 d after first RTX treatment.Mean steroid dosages were significantly reduced than before treatment [alternate-day dosing (1.83 ± 1.02) mg/kg vs alternate-day dosing (0.34 ± 0.16) mg/kg,t =3.78,P =0.002].Gingival hyperplasia and Cushing appearance were significantly improved and steroid-induced glaucoma disappeared.The height was significantly increased compared with before treatment [(2.21 ± 1.40) cm/year vs (8.27 ±2.10) cm/year].Six cases had no relapse during follow-up.Another 6 cases relapsed in 5.5-19.0 months.All patients showed CD19 + B lymphocytes depletion after RTX treatment.However,CD19 + recovery could be seen in 5.5-12.0 months.Serum immunoglobulin did not significantly change.None of the patients was found with adverse events.Conclusions RTX can significantly reduce the dosage of steroid or even stop medication in children free of immunosuppressive agents,maintain remission for (7.79 ± 3.00) months,significantly improve the adverse reaction induced by steroid and immune-suppression.Thus,for children with frequently relapsed nephritic syndrome/steroid-dependent nephrotic syndrome who show resistance to immunosuppressive therapies,RTX treatment may be considered.