Objective To evaluate efficacy and safety of porcine small intestine submucosa (SIS) for the repair of severe vaginal relaxation (stage Ⅳ) in women.Methods Biological repair meshes were fixed in 18 patients with stage Ⅵ vaginal relaxation,among which anterior walls were fixed in 12 cases,posterior walls in 5 cases,and both walls in 1 patient.Patients with POP underwent vaginal vault suspension first,then patient with SUI underwent transvaginal urinary incontinence surgery.Extravesicle fascia was transversely folded and sutured with 2-0 Mousse.The pelvic arch ligament together with vesicle fascia,SIS mesh and vaginal submucosa were sutured 3 stitches per side with 1-0 Mousse.Scar tissue at posterior vaginal wall was rhombically excised followed by transverse folding constriction of the rectovaginal fascia with 2-0 Mousse.A 1-0 Mousse was then used for colpoperineoplasty by suturing ruptured superficial anal sphincter,superficial transverse perineal muscle,and bulbocavernosus muscle.Patients were followed at 2,6,and 12 months post-operatively.Unsuccessful outcome was defined as diameter of outer 1/3 of vagina greater than 3.5 cm,or vagina prolapsed beyond hymen.Results The median follow-up was 13 months.Pelvic Organ Prolapse/Urinary Incontinence/Sexual Function Short Form Questionnaire (PISQ-12) was obtained in 13 patients and the score increased was noted (P＜0.01).Pelvic floor distress inventory-short form for scoring the quality of life (PFIQ) was collected from 18 patients and the score decreased was noted (P＜0.01).Pelvic floor impact questionnaire (PFIQ-7) was gathered in 18 patients and the score decreased was noted (P＜ 0.01).One unsuccessful case with stage Ⅱ anterior vaginal wall prolapse who underwent posterior vaginal wall fixed with patch ended with a diameter of outer 1/3 of vagina greater than 4.0 cm post-operation.Severe complications like infection,rosion,rejection or SUI were not noticed in any case.Conclusions The anatomical repair of pelvic floor is the most effective modality for vaginal rejuvenation.Adjunct SIS can enhance vaginal elasticity,reduce scar formation and recurrence,particularly.

Nucleos(t)ide analogues (NAs) have been widely used in clinical practice as first-line antiviral drugs.In recent years, many clinical studies have found that some patients cannot reach a satisfactory therapeutic outcome.This article introduces the antiviral indications and follow-up of chronic hepatitis B and summarizes the influence of baseline characteristics, HBV genotype, HBV mutation and drug resistance, patients'' medication compliance, presence or absence of other diseases or viral infection, and serum vitamin D level on the antiviral effect of NAs.It is pointed out that appropriate timing for antiviral therapy, patient education before treatment, regular follow-up during treatment, and timely identification of comorbidities and drug resistance help to improve the antiviral effect of NAs and delay the progression of liver diseases.

Objective To discuss the relationship between bone mineral salt metabolism index change and bone density in different stage of chronic kidney disease (CKD).Methods Three hundred and forty-five non-dialysis patients with CKD were enrolled in this study.According to the serum creatinine (SCr),glomerular filtration rate (GFR),they were divided into stage 1-5.CKD 1 had 75 cases,CKD 2 had 65 cases,CKD 3 had 65 cases,CKD 4 had 65 casès,CKD 5 had 75 cases.The level of blood calcium (Ca),phosphorus (P) and SCr were detected by ion selective electrode method.The level of urea nitrogen (BUN) was detected by picric acid method.The level of intact parathyroid hormone (iPTH) and 1,25 (OH)2VitD3 were detected by chemiluminescence.Results With the decline of renal function,the level of iPTH and blood P increased gradually,especially in stage CKD 4 and CKD 5,and compared with stage CKD 1,there were significantly differences [(289.6578 + 187.7945),(482.0667 + 232.2065) μ g/L vs.(77.8431 + 52.9760) μ g/L and (1.6938 + 0.1960),(2.6034 ± 0.5986) mmol/L vs.(1.3833 ± 0.4068) mmol/L,P ＜ 0.05].The level of blood Ca and 1,25 (OH)2VitD3 decreased gradually,especially in stage CKD 4 and CKD 5,and compared with stage CKD 1,there were significantly differences [(1.9185 +0.4633),(1.8293 ± 0.3075) mmol/L vs.(2.0893 + 0.2245) mmoi/L and (10.0892 + 0.2638),(7.6058 +0.4356) ng/L vs.(18.0036 + 0.3218) ng/L,P ＜ 0.05].With the decline of renal function,the proportion of osteoporosis also gradually increased,especially in stage CKDS,and compared with stage CKD 1 and CKD 2,there was significantly difference [60.00％ (45/75) vs.20.00％ (15/75),23.08％ (15/65),P ＜ 0.05].Conclusion With the decline of renal function,the level of blood P and iPTH increase,and blood Ca,1,25(OH)2VitD3,bone density decrease,especially in stage CKD 4 and CKD 5 patients.

Objective To study the expression of dihydrodiol dehydrogenase (DD) in prostate cancer and its significance. Methods With reference to expression of ?-actin gene,the expression level of a human dihydrodiol dehydrogenase isoform (DD2) mRNA was examined in prostate cancer tissues (11 cases) and normal prostate tissues (10 cases) by reverse transcriptive-polymerase chain reaction(RT-PCR). Quantitative determination of relevant band densities was performed using densitometry-scanning techniques. Results Strong expression of DD2 mRNA was detected in prostate cancer tissures with absorbance in the range of 0.550 to 1.018 (median,0.726),and low expression of DD2 mRNA in normal prostate tissues with absorbance in the range of 0.248 to 0.420 (median,0.333). The difference of the expression of DD2 mRNA between cancer and normal prostate was significant ( P

Objective To investigate the effect of clusterin on the cytobiological features of bladder cancer EJ cells. Methods EJ cells were transfected using lipofectine-induced antisense oligonucleotide of clusterin,and their expression was blocked.The biological behaviors of EJ cells,such as proliferation,apoptosis and necrosis,were observed. Results Compared with the sense group which were transfected by sense oligonucleotide of clusterin,the antisense group which were transfected by antisense oligonucleotide of clusterin exprerienced increase in apoptosis of EJ cells,reaching the peak on day 5 with apoptosis rate of 80%.The difference between the 2 groups was statistically significant ( P

Objective To study the mechanism of novel antiapoptosis factor clusterin in EJ cell. Methods MMC was used to induce apoptosis of EJ cells and the ratio of apoptosis was studied by flowcytometry after the use of clusterin. Results Clusterin in low dose can inhibit the apoptosis induced by MMC. Conclusions Clusterin can influence the development of bladder cancer by antiapoptosis.The expression of clusterin may have some relationship with the drug resistance or recurrence of bladder cancer.The study of clusterin is helpful to elucidate the biological mechanism of the bladder cancer and direct the therapy of bladder cancer using the antibody of clusterin.

Objective To investigate the role of GYLZ-RCC18 in the generation and development of renal cell carcinoma (RCC). Methods By using SMART RACE and RT-PCR the full length of GYLZ-RCC18 was cloned and its expression was detected in RCC of different grade and stage by amplification of a special fragment sequence in the first reading frame about 504 bp. Results The full length of GYLZ-RCC18 about 3.5 kb expressed in RCC in higher level than in normal kidney tissue.GYLZ-RCC18 overexpressed in high grade and high stage RCC being 1-9 folds higher than that in low grade and low stage ones. Conclusions GYLZ-RCC18 is a new gene especially related to RCC and is closely related to the generation and development of RCC.Study of the gene will be helpful in the understanding of the molecular mechanism of the generation and development of RCC and may direct the diagnosis and treatment of RCC.

Objective To study clusterin expression in bladder cancer cell line EJ and its antiapoptosis mechanism. Methods The expression of clusterin in EJ cells was detected by means of immunocytochemical staining and its effect on apoptosis studied by 3′TUNEL method. Results Clusterin expressed clearly in EJ cells.Likewise,when a small dose of clusterin was added,clusterin was stained strongly in the cytoplasm of the EJ cells and MMC induced apoptosis of the EJ cells was markedly inhibited. Conclusions Clusterin can penetrate the cell membrane getting into the cell cytoplasm and there in the cytoplasm the antiapoptosis effect is evoked.By detecting the clusterin expression,recurrence and multidrug resistance of a bladder cancer may be evaluated.It is hopeful that the use of clusterin antibody in the treatment of bladder cancer might be feasible.

Objective To study the expression and significance of antiapoptosis facter-clusterin in prostate neoplasm. Methods Reverse transcriptive polymerase chain reaction(RT PCR) was used to examine the expression level of clusterin in prostate cancer tissues(3 cases),prostate cancer cell line PC3M and normal prostate tissues(3 cases). Results Compared with the internal marker gene ? actin , the expression level of clusterin in prostate cancer is much higher than that of normal prostate. Conclusions The high expression level of clusterin in prostate cancer indicates that clusterin may play an important role in the biological characteristics of prostate cancer through the antiapoptosis pathway.

Objective To study the application of ESWL for ureteral stones in acute colic and with impairment of renal function. Methods From Mar.1987 to Sep.2000,emergent ESWL was performed for 168 cases of ureteral stone in acute colic and with impaired renal function on IVU (nonvisualization on IVU). Results All the patients got well after ESWL.104 patients less than 60 with a history of renal colic within 1 month have been followed up for 1 year.The renal function has reco vered and the urinary tract became visualized on IVU. Conclusions Ureteral stone may induce acute injury to the kidney but the harm is temporary and reversible when the ureteral stone is cured by ESWL on time.