Objective To study the impact of vaginal mesh exposure on quality of life in patients undergoing transvaginal reconstructive pelvic surgery (RPS) with polypropylene mesh.Methods From May 2004 to March 2011,114 patients with severe pelvic organ prolapse(POP) undergoing transvaginal RPS with polypropylene mesh were enrolled in this study,which were divided into exposure and non-exposure group according to appearing vaginal mesh exposure at 2 months,6 months and 1 year after operation.At the same time,pelvic floor distress inventory short form 20 ( PFD1-20 ) and pelvic floor impact questionnaire short form 7 ( PFIQ-7 ) were completed in those patients.Results At 2 months after operation,96 patients were followed up,including 19 patients in exposure group and 77 patients in non-exposure group,and the rate of exposure was 19.8c (19/96); At 6 months after operation,85 patients were followed up,including 13 patients in exposure group and 72 patients in non-exposure group,and the rate of exposure was 15.3％( 13/85 ) ; At 1 vear after operation,77 patients were followed up,including 6 patients in exposure group and 71 patients in non-exposure group,and the rate of exposure was 7.8％ (6/77).Mean score of PFDI-20 and PFIQ-7 in exposure group before operation was 39.6 and 57.1,which was statistically improved to 8.3 and 9.5 at 2 months after operation,8.3 and 9.5 at 6 months after operation,2.1 and 0 in I year after operation (P ＜0.01 ). Mean score of PFDI-20 and PFIQ-7 of non-exposure group before operation was 54.2 and 66.7,which was improved to 8.3 and 4.8 at 2 months after operation,0 at 6 months and 1 vear after operation,but there was no significant difference in mean score of PFDI-20 and PFIQ-7 between the two groups (P ＞ 0.05 ).Conclusion Vaginal mesh exposure was common after transvaginal RPS with polypropylene mesh,however,most of them were moderate,and there was no significant impact on patients'qualifies of life.

Objective To investigate ventricular remodeling and glucose transporter 4(GLUT4) expression in rat with type 2 diabetes mellitus(DM) complicated with myocardial infarction (MI), as well as the effects of ramipril on ventricular remodeling and CLUT4 expression. Method Diabetic animal model (DM) was produced by cholesterol-diet and intraperitoneal injedtion of streptozotocin (STZ,30 mg/kg). The successful model was identified based on the blood gulcose value > 6.7 mmol/L. Left anterior descending coronary artery was ligated to produce the model of MI. 46 wistar rats were randomly(random number) divided into 5 groups: DM + MI + placebo group(placebo group, n = 9), DM + MI + ramipril group(ramipril group, n = 10), DM + sham-operation group (DM group, n = 10),non-DM group + MI (MI group, n = 9), and non-DM + sham-operation group (n = 8). After six weeks, echocardiographic studies was performed ; Left ventricular mass index (LVMI), myocardial infarct size and myocardial collagen volume fraction(CVF) of non-infarction area were also detected. GLUT4 mRNA in the myocardium away from infarction region was measured with real-time fluorescent quantitative RT-PCR and the expression of GLUT4 protein was measured with western blot. Analysis of variance was used to compare the groups. P -values< 0.05 were considered to indicate statistically significant differences. Results Compared with Ml group and DM group,EF[(32 ±3)% vs. (65 ±4)%, P <0.01 and (32 ±3)% vs. (38 ±4)%, P <0.05 respectively] significantly decreased,while E/A ratio (P < 0.01), LVMI (P < 0.05) and CVF (P < 0.05) obviously increased in placebo group. The expression of GLUT4 mRNA and protein were similar between placebo group and DM group, however, much lower than those in MI group(P<0.01).In rampiril group, E/A ratio (P < 0.01), LVMI(3.1±0.2 vs.4.2±0.4, P <0.01) and CVF(P < 0.05) significantly decreased compared with placebo group, while EF[(45±3)% vs.(32±3)%, P <0.01] and the expression of GLUT4 mRNA and protein (P < 0.05) increased. Conclusions Rampiril could improve left ventricular hypertrophy and systolic/di-astolic dysfunction, increase the expression of GLUT4 mRNA and protein in diabetic rats complicated with MI.

Objective To explore the feasibility of right ventricular outflow tract index in the evaluation on right ventricular systolic function and its relationship to other right ventricular functional indices generally accepted in clinical practice. Methods Sixty-one patients with heart failure were randomly selected and divided into elevated right side pressure group and normal right side pressure group by pressure gradient ≥35 mm Hg aquired from tricuspid regurgitation velocity. Twenty-four healthy adults were selected as control group. All the people experienced transthoracic echocardiography. Right ventricular longitudinal excursion(RVLX), right ventricular ejection fraction(RVEF), right ventricular outflow-tract fractional shortening(RVOTFS) and right ventricular ejection time(RVET) were measured, and their differences were compared between healthy adults and heart failure patients as well as between elevated right side pressure group and normal right side pressure group. Relationships of RVOTFS with other right ventricular functional indices were also analyzed. Results Compared with healthy adults, heart failure patients had lower RVOTFS((0.49)?(0.13) vs (0.22)?(0.09),P

Due to the good tumor-targeting and excellent biocompatibility, the drug-loading nanoparticles (NPs) has been widely applied in the diagnosis and treatment of cancer. However, after the NPs are recognized and internalized by cancer cells, the effects of NPs on cell migration behavior were unclear. In the present study, the self-assembly techniques (SAMs) was used to modify gold (Au) nanoparticles (Au NPs) with different chemical functional groups (CH3, OH, COOH and NH2) as model NPs. The dispersion of these groups in solution and the distribution in cells were studied by transmission electron microscope (TEM), respectively, and the proliferation was examined by MTT assay in vitro. The wound-healing and the Transwell assay were used to examine the effect of internalized Au-NPs on HepG2 cells migration. The results showed that different Au-NPs mainly distributed at the edge of the vesicle membrane and the gap between cells. The Au-NPs resulted in decreased cell viability in a concentration-depended manner. In addition, the results of wound-healing and Transwells assay indicated that the internalization of the NH2-NPs and OH-NPs would inhibit cell migration compared with those in the control group.
Carcinoma, Hepatocellular ; metabolism ; Cell Movement ; Cell Proliferation ; Cell Survival ; Gold ; Hep G2 Cells ; Humans ; Liver Neoplasms ; metabolism ; Metal Nanoparticles ; chemistry

To study the potential molecular mechanism of tumor angiogenesis in its microenvironment, we investigated the effects of HepG2 conditioned medium on the proliferation of vascular endothelial cell and vascular angiogenesis in our laboratory. Human umbilical vein endothelial EA. hy926 cells were co-cultured with HepG2 conditioned medium in vitro. The proliferation and the tubulogenesis of EA. hy926 cells were detected by teramethylazo salt azole (MTT) and tube formation assay, respectively. The results showed that the survival rate of the EA. hy926 cells was significantly increased under the co-culture condition. HepG2 conditioned medium also enhanced the angiogenesis ability of EA. hy926 cells. In addition, the expressions of intracellular VEGF and extracellular VEGFR (Flk-1) were regulated upward in a time-dependent manner. In conclusion, the proliferation of vascular endothelial cells and Vascula angiogenesis were improved under the condition of indirect co-culture.
Carcinoma, Hepatocellular ; pathology ; Cell Proliferation ; Coculture Techniques ; Culture Media, Conditioned ; Endothelial Cells ; cytology ; Hep G2 Cells ; Human Umbilical Vein Endothelial Cells ; Humans ; Liver Neoplasms ; pathology ; Neovascularization, Pathologic ; Tumor Microenvironment ; Vascular Endothelial Growth Factor A ; metabolism ; Vascular Endothelial Growth Factor Receptor-2 ; metabolism

OBJECTIVE:To improve community pharmaceutical care so as to promote the rational drug use of community resi-dent and improve the quality of life. METHODS:By analyzing the situation of community pharmaceutical care,the pharmaceutical care of community pharmacists was improved by changing pharmaceutical care mode,actively developing the propaganda of ratio-nal drug use,strengthening retraining of clinical pharmacists. RESULTS:With the help of Hongkou district quality control group, many hospitals of the district signed thepharmaceutical linkage assistance agreement. Through the efforts of Hongkou district quality control group and many hospitals,community pharmaceutical care was improved and the propaganda of rational drug use has achieved certain results. CONCLUSIONS:Through exploration and practice,the pharmaceutical care levels of community phar-macists have been improved and the rational drug use of community residents has been promoted.

Objective Analysis of myocardial microvascular perfusion in patients with chronic total coronary occlusion (CTO) who underwent a coronary artery bypass graft (CABG) use real-time myocardial contrast echocardiography (RTMCE),to provide an effective method of detecting viable myocardium and a reference for the choice of CABG indications.Methods Twenty-seven patients with CTO underwent RTMCE 1 week before CABG,they underwent follow-up echocardiography and coronary artery 256-slice multislice computed tomography aagiography 1 year after CABG.Myocardial viability was defined as a postoperative ultrasound wall motion significantly improved ≥ 1 point.Semi-quantitative analysis of contrast images,myocardial viability was defined as myocardial perfusion score ≤ 2 points.Viable myocardium by quantitative assessment of myocardial blood flow (MBF) was determined by analyses of receiver-operating characteristic (ROC) curves.Results Patients with LVEF increased significantly after CABG (P ＜ 0.01),Of 259 segments with wall motion abnormality,149 (58％) showed wall motion significantly improved ≥ 1 point after CABG,considered viable myocardium,110 (42％) were not observed in wall motion improved,considered to be non-viable.The viable myocardial segments were significantly greater than non-viable myocardial segments in A,β,A × β value (P ＜ 0.01).Compared with the semi-quantitative analysis,quantitative analysis of MBF increased the sensitivity and accuracy of RTMCE for detecting viable myocardium (P ＜ 0.05).Conclusion RTMCE could accurately assess myocardial viability and provide a strong reference for clinical decision making and judging prognosis.

Objective To study the efficacy of performing transvaginal Prosima mesh with high uterosacral ligament suspension (HUS) in treatment of severe pelvic organ prolapse (POP).Methods From July 2010 to February 2011,70 patients with severe POP underwent transvaginal prosima mesh with HUS in First Affiliated Hospital,General Hospital of People's Liberation Army.Clinical parameters of perioperation were collected.After 1 month and 2 - 3 months,perineal two-dimensional ultrasound examination was performed to measure mesh length in midsagittal plane.Validated prolapse quality of life questionnaires,pelvic floor distress inventsry short form 20 (PFDI-20) and pelvic floor impact questionnaire short form 7 (PFIQ-7) were used to evaluate the therapeutic effect.The mean results of pre-operative PFIQ-7 and PFDI-20 was 54 and 51,respectively.Results Median operation time was ( 195 ± 47 ) min and median blood loss was (160 ±64) ml.All the patients were followed for a mean time of 13 months (2 - 19 months).Seven cases were found with mesh exposure with less than 1 cm2.The objective cure rate was 100％.The mean score of post-operative PFIQ-7 and PFDI-20 were both 19,which were significantly lower than those of preoperation ( P ＜ 0.05 ).Anterior Prosima mesh was 3.5 cm at 1 month by ultrasound examination,and the second result of ultrasound scans was 2.8 cm at 2 - 3 month,which were both shortened 2.5 cm and 3.2 cm when compared with that of original size.Conclusions Transvaginal Prosima mesh placement with HUS is a safe and efficient surgery with less complication.Although mesh became shorter after 2 - 3 month,it did not affect surgery efficacy.

Objective To study the objective and subjective therapeutic effect of total and partial (LeFort) colpocleisis in treatment of severe pelvic organ prolapsed ( POP) in selected elderly patients.Methods From Oct 2005 to Feb.2010,63 severe POP patients[59-87 years,median age (75 ±6) years]with stage Ⅲ and Ⅳ by POP-Q system underwent total and partial colpocleisis.The mean age was (75 ±6)years (59-87 years).Fifty-eight patients(58/63,92% )present more than one kind of medical disease.There were 53 cases with uterus prolapse,1 case with cervix prolapse and 9 cases with vaginal vault prolapse.Seven patients were recurrent POP from previous surgery.Twenty-three patients(36% ) presentedvoiding difficulty.Seven patients (17%) presented obstructive bowel symptom.Three patients (5%) presented fecal incontinence,and 28 patients(44% )presented either had urinary incontinence or history of that Among 63 patients,48 patients (76% ) underwent total colpoclesis,and 15 (24% ) patients partial colpoclesis.Meanwhile,58 (92% ) patients underwent levator myorrhaphy plus perineorrhaphy and 20 (32% ) patients underwent anti-urinary incontinence procedure ( TVT-0 ),respectively.Patients were followed up to evaluate therapeutic effect at 2 months and 1 year after surgery.Objective evaluation included the POP-Q and the length of vagina,genital hiatus,perineal body.A nonvalidated Body Image and Satisfaction Questionnaire was completed for subjective evaluation.Results The mean operating time of 63 patients was (105 ±48) minutes,which was (128 ±58) in total and (82 ±26) minutes partial procedures,which exhibited significant difference(P<0.05).The mean blood loss was (187 ± 128) ml (50-600 ml),total and partial procedures caused (232 ± 159) and (101 ±54) ml,respectively,which also showed significant difference ( P < 0.05 ).No intraoperative injury or death occurred.The rate of postoperative complications was 5% (3/63).Mean follow-up time of 63 patients was 22.5 months (1-51 months).All patients had POP-Q staging score ≤Ⅰ.No recurrent patient was observed.At 1 year after operation,the mean preoperative total vaginal length (TVL) and genital hiatus (GH) of (7.7 ± 1.1) and (5.5 ± 1.5)cm were decreased to (3.4 ± 1'.l)and (2.3 ±0.5) cm (P<0.01) ;and perineal body (PB) measurements was increased from (2.6±0.9) to (3.4 ±0.9)cm(P <0.01).Three (5%,3/63) patients had mild urinary incontinence after the operation.Twenty-three patients with voiding difficulty presenting the mean postvoid residual volumes (110 ± 38) ml(50-235 ml) were decreased to 12 ml after the operation.Obstructive bowel symptom was improved in 6(54%,6/11) patients,and fecal incontinence improved in 2(2/3).One year after the operation,52 ( 82% ) patients completed the nonvalidated Body Image and Satisfaction Questionnaire.49 (94% ) patients said either 'very satisfied' or 'satisfied' with the outcome of their surgery,while 3 ( 6% ) reported unsatisfied or not at all satisfied.Conclusions The objective and subjective curative rates of colpocleisis in treatment of severe POP are high with lower morbidity and recurrence.Colpocleisis is a safe and effective management in selected elderly patients with severe POP,who no longer desire to maintain vaginal coital function.

Objective To study mental status of recovered two year after in shake area crowd of gansu wen-xian. Methods Fifty former disaster crowd were assessed with SCL-90, Coping Style Questionnaire and Social Support Questionnaire two year after their discharge, 50 healthy medical staffs of gan-su CTM Affiliated Hospital of logistics ensure center were assessed with same instruments as control. Results The former disaster crowd and 5 subscores of SCL-90 with higher average scores than Chinese norm and results of control, they were somatization( F =4. 31) , phobia ( F = 5. 25) , obtrude ( F =5. 91) , P＜0. 01, depression ( F = 3. 11) anxiety ( F = 3. 74) , P ＜ 0. 05; The former disaster crowd felt more objective support, used more rationalization, but were less capable in problem solving. In former disaster crowd, problem-solving, objective social support and utility of the support were negatively correlated with subscores of SCL-90 ( r = -0. 31～-0. 40, P ＜0. 05) ; while immature coping, such as fantasy, withdrawal and rationalization were positively correlated with subscores of SCL-90 ( r = 0. 40 ~ 0. 60, P ＜ 0. 05).Conclusion Former disaster crowd still have psychosomatic symptoms and need social and psychology intervene and support.