Objective To evaluate the diagnostic value of translabial two-dimensional (2D) ultrasound for female anterior pelvic floor dysfunction,and to discuss the ultrasound appearance of anterior pelvic floor dysfunction.Methods Translabial 2D ultrasound was performed on 63 patients who were diagnosed or suspected with anterior pelvic floor dysfunction using pelvic organ prolapse quantitation system,the position and mobility of bladder neck,the retrovesical angle and urethral rotation were measured during maximum Valsalva maneuver.Different types of anterior pelvic floor dysfunction diseases were diagnosed according to the ultrasound findings.Results Translabial 2D ultrasound diagnose different types of anterior pelvic floor dysfunction diseases based on the position and mobility of bladder neck,retrovesical angle and urethral rotation,including 15 cases bladder neck hypermobility,9 cases funneling of the bladder neck and 37 cases cystocele.Conclusions Translabial 2D ultrasound could provide useful information of anterior pelvic floor and is of great value in the diagnosis of female anterior pelvic floor dysfunction.

Objective To dynamically observe and evaluate the position and movement of pelvic floor organs in vaginal delivery primipara with translabial two-dimensional(2D) ultrasound,and to provide the imaging basis for the effects of pregnancy and vaginal delivery on the pelvic floor support structures.Methods Translabial 2D ultrasound was performed on 52 vaginal delivery postpartum women (postpartum group) and 43 normal women as control group to observe the position and movement of pelvic floor organs at rest,on pelvic muscle contraction and during maximum Valsalva maneuver.Results The location of urethrovesical junction and cervix were significantly lower in postpartum group compared with the control group at three stages.The movement of urethrovesical junction and cervix in vertical direction was greater in postpartum group than control group during maximum Valsalva maneuver,while was smaller on pelvic floor contraction.Conclusions Translabial 2D ultrasound could dynamically observe and evaluate the position and movement of pelvic floor organs.Pregnancy and vaginal delivery produce certain effect on pelvic floor support structures,which manifest as weak,defective and dysfunction.The impact was more obvious in anterior and middle compartments.

ObjectiveTo observe the morphology and structure of the urogenital hiatus in late pregnancy women using transperineal three-dimensional (3D) pelvic floor ultrasonography.Methods Twenty five nulliparas and fifty late pregnancy women were examined by transperineal 3D pelvic floor ultrasonography.The images of urogenital hiatus were obtained and compared to study their differences between nulliparas and late pregnancy women.Results Compared to nulliparas,urogenital hiatus in late pregnancy women tended to be circular and with an offset position.The puborectalis were bended and could be avulsed.Pelvic floor connective tissue could be loose.The morphology of vaginal might be abnormal and pelvic organ might prolapsed slightly.ConclusionsThe morphology and structure of urogenital hiatus in late pregnancy women are different to those in nulliparas,the hiatus tend to be slackness.3D pelvic floor ultrasonography is an effective imaging method to observe the morphology and structure of urogenital hiatus in pregnancy women.

Chemotherapy, Adjuvant ; Gastrectomy ; Humans ; Microsatellite Repeats ; Neoadjuvant Therapy ; Stomach Neoplasms/pathology*

Objective To evaluate the relationship between positive thyroid autoantibody and risk of preterm birth.Methods Literature search was done in PubMed,Embase,China Academic Journal Network Publishing Database,Wanfang Medical Database and China Biology Medicine disc databases from January 1st,1989 to January 26th,2012.Criteria for inclusion included:(1) Prospective cohort study; (2) The exposure was positive thyroid autoantibody and outcome was preterm birth; (3) The enrolled subjects were pregnant women without cardiovascular or rheumatic disease; (4) Relative risk (RR) and its 95％ confidence interval (95％CI) of preterm birth were provided in the study.Meta-analysis was performed by Stata 12.0.The relationship between positive thyroid autoantibody and risk of preterm birth was evaluated by RR and 95％ CI.Results Ten cohort studies were enrolled.One thousand six hundred and fifty seven cases of preterm birth occurred among 25 081 pregnant women.Heterogeneity among the 10 studies was found in meta-analysis (I2 =79.2％,P＜0.01).The risk of preterm birth in pregnant women with positive thyroid autoantibody was higher than those in control group by random effects analysis (RR=1.61,95％CI:1.18-2.20,P＜0.05).Subgroup analysis was further performed.In five studies,the cases of control group were pregnant women with normal thyroid function; heterogeneity was not found in these five studies (I2=39.1％,P=0.160); and RR of the risk of preterm birth was 2.55 in pregnant women with positive thyroid autoantibody (95 ％ CI:2.04 3.19,P＜0.01).In the other five studies,the cases of controlgroup were pregnant women who had not been ruled out the possibility of thyroid dysfunction;heterogeneity was not found in these five studies either (I2 =0.0％,P =0.970); and RR was 1.18(95 ％ CI:1.01-1.37,P＜0.05).After excluding two low-quality studies,RR of the risk of preterm birth was 1.72 in pregnant women with positive thyroid autoantibody (95％CI:1.18 2.53,P＜0.05).The funnel plots presented symmetrical graphics,indicating that there was no publication bias.Conclusions Positive thyroid autoantibody in pregnant women is a risk factor of preterm birth.

Objective To analyze the efficacy,late complications and prognostic factors of post-op-erative radiotherapy for cervical cancer. Methods From Nov. 1999 to Feb. 2005,114 patients with cervi-cal cancer received adjuvant pelvic radiotherapy after radical hysterectomy and pelvic lymphadenectomy. The median age was 42.5 (24 to 72) years old. According to the FIGO staging system,6,51,18,26 and 13 pa-tients had stage ⅠA, Ⅰb1, Ⅰb2, ⅡA and ⅡBdisease. The pathological type was squamous cell carcinoma,ade-nocarcinoma, squamous-adenocarcinoma and undifferentiated carcinoma in 92,19,2 and 1 patients, respec-tively. The whole-pelvic external beam irradiation of 50 Gy (40 to 60 Gy) was given with 6 MV or 15 MV X-ray beams using four-field box technique. Eighty-one patients received intravaginal brachytherapy of 16 Gy (4 -30 Gy in 1 -6 fractions) 4 weeks after the beginning of radiotherapy, with the referrence point being at 0.5 cm under the vaginal mucosa. Eighty-seven patients received preoperative and/or concurrent chemother-apy. The survival and independent prognostic factors were analyzed by Log-rank method and Cox model. Results The median follow-up time was 26.0 (5 - 75) months. The overall survival rate, disease-free sur-rival rate and local control rate were 93.1%, 88.1% and 94.6% at 2-year, and 75.7%, 62.3% and 85.6% at 5-year,respectively. The independent prognostic factors were lymph node metastasis and positive surgical margin for overall survival, positive surgical margin for local control, and stage, uterine body invasion and positive surgical margin for disease-free survival. Sixteen patients ( 14% ) had distant metastasis, and the most common sites were the lung,inguinal region,bone,liver and brain. According to RTOG grading sys-tem, the incidence of late gastrointestinal side effects of grade 1,2 and 3 was 11.4%, 11.4% and 3.5%. The corresponding genitourinary side effects were 14.0% ,6.1% and 0.9%, respectively. The incidence of leg lymphedema was 7 % . Conclusions Post - operative radiotherapy can achieve good local control in cervical cancer with acceptable late side effects. Distant metastasis is the main cause of death.

Objective To control the nosocomial infection and avoid the second pollution of thereclaimed medical apparatus to the washing area of supply room. Methods Count, classification and place of the reclaimed medical apparatus went along at the same self-designed categorizing pedestal of the muhi-function apparatus.No absorbing cloth was needed on the table-board, the dirty water flew into the outfall of the sewer directly and automatically, the discreteness could be unpicked, washed and lis-terized after work. Results It avoided the collision of the apparatuses, shortened the time of counting effectively and reduced the chance of pollution.It also avoided the waste of the manpower, the material resources, the time and the second environmental pollution. The effects of the two table-boards after disinfection had statistical difference (P＜0.01). Conclusions The categorizing pedestal of the mul-ti-function apparatus makes the reclaim and handling of the polluted apparatus more standard and to re-move the pollution more thoroughly.

Gas Chromatography-Mass Spectrometry ; methods ; Hexanones ; urine ; Humans ; Sensitivity and Specificity

OBJECTIVETo explore the therapeutic effects of internal fixation with Herbert screws for the treatment of Pipkin type I and type II femoral head fractures.

METHODSFrom January 2008 to December 2012, 23 patients with Pipkin type I and type II femoral head fractures were treated with open reduction and internal fixation by Herbert screws through Kocher-Langenbeck approach. Twenty-three patients (aged 18 to 52 years with a mean of 35.5 years, including 18 males and 5 females patients, 8 left hips and 15 right hips) with femoral head fractures and posterior hip dislocation. The fracture was classified according to Pipkin classification based on the radiographic findings, 5 patients had type I and 18 had type II fractures. The duration time from admission to the operation ranged from 6 to 72 h (averaged 32 h). The clinical and radiographic outcomes of the patients were measured using Thompson-Epstein scoring scale. The Harris hip score(HHS) was used to evaluate and compare hip functions at the latest follow-up between affected and healthy sides.

RESULTSAll the patients were followed up, and the duration ranged from 20 to 48 months (averaged 30 months). According to Thompson-Epstein system, 12 patients got an excellent result, 6 good, 4 fair and 1 poor. The average HHS at the finial follow-up was 87.80 ± 8.46 (ranged from 66 to 95), which is similar to that in the healthy side 90.10 ± 6.35 (ranged from 72 to 98) (t = 1.044, P = 0.302). The complications such as deep infection, and deep vein thrombosis were not found. At the 3rd year during follow-up,4 patients had avascular necrosis of femoral head. At the 1st year of follow-up, 1 patient had hip pain after walking,screws loosening and shift after trauma,and serious complications of traumatic arthritis. All the 5 patients were treated with total hip arthroplasties.

CONCLUSIONThe treatment of internal fixation with Herbert screws through the Kocher-Langenbeck approach is effective for Pipkin type I and type II femoral head fracture. The method is reliable and valuable for recommendation. However, such fracture may have avascular necrosis of femoral head and complication of traumatic arthritis, which should be observed carefully in clinic with preparation of the prevention and treatment measures.

Adolescent ; Adult ; Bone Screws ; Female ; Femoral Neck Fractures ; surgery ; Fracture Fixation, Internal ; adverse effects ; methods ; Humans ; Male ; Middle Aged

Objective To evaluate the changes of levator ani muscle contractility in different postpartum periods by observing the contractility of postpartum women's levator ani muscle.Methods Forty-six postpartum women and 43 nulliparous women were included in the object.All of those went through translabial pelvic floor ultrasound examinations.Images of their levator hiatus would be recorded at the conditions of rest and contraction.The hiatal length (L)and the area (A)of levator hiatus were measured,then the differences were obtained between rest and contraction conditions,recording as ΔL andΔA.Relevant data were analyzed.Results There was no obvious statistical difference of L and A between the groups (P >0.05).The ΔL and ΔA of the 6-8 weeks were the minimum in this objective(P <0.05). However,there was no statistical difference between nulliparous women and the postpartum 6-8 month's women(P >0.05).Conclusions After delivery,the contractility of levator ani muscle became weaker,but could recovery effectively after about half a year.