Objective To evaluate the short-term efficacy of Perigee system in the treatment of anterior pelvic organ prolapse. Methods From October 2012 to September 2014, 59 patients with pelvic organ prolapse, pelvic organ prolapse quantitation system (POP-Q) were diagnosed as anterior pelvic organ prolapse Ⅲ degree and above were performed Perigee anterior pelvic floor reconstruction, while some patients combined with sacrospinous ligament suspension, posterior wall repair or posterior pelvic reconstruction surgery for pelvic prolapses. Pelvic floor distress inventory-short form 20 (PFDI-20), pelvic organ prolapse-urinary incontinence sexual questionnaire-12 (PISQ-12) were evaluated, and postoperative POP-Q were used to analyze the changes of the indexes and postoperative complications. Results In 59 patients, the average operation time was (99±29) minutes, the average intraoperative blood loss was (119± 92) ml. The median postoperative follow-up time of 59 cases was 17.5 months (range:8-30 months), median follow-up time of subjuctive symptoms was 21.2 months (range:11-34 months), the total score of PFDI-20 was compared with the preoperative, and the difference was statistically significant (5.6 versus 27.8, P<0.01). It was statistically significant of PISQ-12 score before and after surgery (34±3 versus 36±4, P<0.05). Short-term anatomical cure rate was 98%(58/59), 1 cases (2%, 1/59) in recurrence, 2 cases (3%, 2/59) of erosion. Conclusion This results show that the Perigee system is effective and reliable in the treatment of anterior pelvic organ prolapse.

In the current study, nine flavonoids were isolated and purified from 75% ethanol extract of Selaginella uncinata (Desv.) Spring by column chromatographic techniques over macroporous resin, polyamide, silica gel, Sephadex LH-20 and pre-HPLC. On the basis of their physico-chemical properties and spectroscopic data analyses, these compounds were elucidated as cirsimarin (1), nepitrin (2), apigenin-6-C-α-L-arabinopyranosyl-8-C-β-D-glucopyranoside (3), apigenin-6-C-β-D-glucopyranosyl-8-C-α-L-arabinopyranoside (4), apigenin-7-O-β-D-glucopyranoside (5), 2,3-dihydroamentoflavone (6), 4'-O-methylamentoflavone (7), 2,3-dihydro-4'-O-methyl-amentoflavone (8), and 2,3,2",3"-tetrahydron-4'-O-methyl-robustaflavone (9). Compounds 1-5 belong to flavonoid glycosides and were isolated from the genus Selaginella for the first time.
Flavonoids ; analysis ; Selaginellaceae ; chemistry

This paper designed an index for the differences in medical service prices and this index therein named the Hospital Price Difference Index ( HPDI) which is used as a quantitative tool for evaluation. During evalua-tion, the paper measured the levels of prices and the factors of influence in 18 public hospitals listed in the Sichuan Province. The results showed that the effect of regulating the levels of prices was reasonable and effective, but was sig-nificantly affected by the internal and external factors. The internal factors have been found to be the medical and clini-cal technologies, and the grade and scale acted as external ones. This paper suggested that the price department should pay more attention on the levels of prices, and hence made a reasonable reform project for the prices by taking the scale of adjustment of prices into account.

Objective To explore the effect of carvedilol on ACE2 gene and protein expression in chronic heart failure rats after myocardial infarction.Methods The heart failure model was induced by acute myocardial infarc- tion (AMI) through ligating the left anterior descending coronary artery.One month after operation,rats were randomized to receive placebo or carvedilol 2 mg/(kg?d),by gavage.Sham-operated rats were used as the control group.Hemodynamies,body mass and left ventrieular mass index,plasma and myocardial level of angiotensin Ⅱ were determined.ACE2 gene and protein expression was assessed by using RT-PCR and Western Blot.Results The mortality of placebo and Carvedilol groups were 20%,compared with 0% in sham operated rats.Carvedilol significantly improved LVEDP,LVSP,+dp/dt_(max) and-dp/dt_(min) in CHF rats but all the hemodynamics data were still inferior than that of controls.Plasma and myocardial angiotensin Ⅱ level were increased significantly in CHF placebo rats than those of control rats (plasma Ang Ⅱ:CHF:194?19 vs controls:132?15 ng/L,myocardium Ang Ⅱ:CHF:6.7?0.4 vs control:3.8?0.3 ng/g,P

SMART-RACE was performed after isolating the total RNA of Armillariella tabescens to amplify the full-length cDNA of arabinosidase (GenBank Accession No. AJ620046). Bioinformatics analysis was used to analyze the code frame of arabinosidase, to predict its structure and function. Recombinant plasmid pPIC9-AF was constructed and then electroporated into methylotrophic yeast Pichia pastoris GS115. The secreted 6 ? His fusion protein was purified to analyze its enzymology property. This arabinosidase had high activity at 30-35℃ under acid condition, and was stable within wide range of pH and temperature. It maintained about 80% activity at the range of pH4. 0-8.0 and 20-40℃,wider than many other cloned arabinosidase. So it was worthy to go step further to study this enzyme, and recombinant expression provided a chance of highly expressing arabinosidase.

Background and objectives: Radiation treatment in nasopharyngeal carcinoma (NPC) is known to be associated with increased prevalence of carotid stenosis. The objectives of the study was to determine the prevalence of radiation-induced extracranial carotid stenosis, plaque, carotid intima thickness (CIMT) in NPC patients; to explore whether the stenosis is due to direct effect of radiation rather than general tendency to atherosclerosis. Methods: This was a cross-sectional study conducted in the University Malaya Medical Centre from July 2011 to February 2012. The study subjects consisted of 47 NPC patients who were treated with radiation, and 47 healthy control. The patients and control had carotid duplex ultrasound and transcranial Doppler (TCD). Results: The mean age of the patients was 55.1 years, the time lapse from radiation was 76.7 ± 95.3 months. Internal carotid artery (ICA) and common carotid artery (CCA) stenosis of ≥50% was seen in 17.0% of patients vs 2.1 % of controls (p = 0.031), with 61.7% of patients and 19.1% of controls having plaque in ICA and CCA (p=0.004). CIMT was increased in 70.2% of patients and 44.7% of controls (p =0.022). Both the patient group and control had similar rate of intracranial stenosis of 12.8% in TCD. Conclusion: Extracranial internal carotid artery is the most common site of stenosis following radiotherapy in NPC. This suggests that local trauma from irradiation is the most important factor in predisposition to atherosclerosis following radiation therapy.

Primary angiitis of the central nervous system (PACNS) is a rare vasculitis restricted to the central nervous system without systemic involvement. Delay in diagnosis and treatment is common due to its non-specific symptoms and lack of non-invasive diagnostic tests. Myelopathy can occur in PACNS, during the clinical course of the illness, with or without cerebral symptoms. We describe here a 51 year-old ethnic Chinese woman who presented initially with paraparesis without cerebral symptoms. The diagnosis of PACNS was eventually made from brain biopsy when she subsequently developed cerebral involvement. Despite aggressive treatment, the patient developed progressive neurological deterioration and died. This patient demonstrates the rare occurrence of myelopathy as the sole initial presentation of PACNS.
Central Nervous System ; Spinal Cord Diseases

Objective To understand the infection of Salmonella (S.) in patients with diarrhea and outbreaks caused by Salmonella to identify the serotypes, resistance to antibiotics and PFGE types of the strains from the surveillance program in Guangdong province. Methods S. strains from patients with diarrhea were detected, and all the positive strains collected in routine and outbreak surveillance programs, were tested by serum agglutination, antibiotic susceptibility and PFGE.Results 71 S. strains were isolated from 1922 stool samples in 2008, with positive rate as 3.7%.85 S. strains were isolated from 2110 stool samples in 2009, with positive rate as 4.0%. All the 156 strains were divided into 37 serotypes, with S. serotype typhimurium and enteritidis as the most common serotypes. 10 incidents of food poisoning were detected, of which 4 were caused by enteritidis and 3 by typhimurium. A suspected outbreak by enteritidis was discovered and under epidemiological investigation. The findings indicated that 2 of the 4 patients from this outbreak were infected with identical enteritidis isolates. 80% of the 229 isolates were found susceptible to cephalosporins and quinoione and 59.3% of them were muitiresistant to the antibiotics. Conclusion S. enteritidis and S. typhimurium were the most common serotypes that caused infectious diarrhoea and food poisoning in Guangdong province.

Objective To understand the distribution,molecular characteristics and virulence genes of the O1 and O139 Vibrio cholerae isolates from the Pearl River Estuary water.Methods Vibrio cholerae isolates collected from the Pearl River estuary waters from January 2009 to December 2010,were tested by PCR for eight virulence-related genes,including cholera toxin(ctxA),zonula occludens toxin(zot),accessory cholera enterotoxin(ace),hemolysin(hlyA),toxin-coregulated pilus (tcpA),outer membrane protein(ompU),and the regulatory protein genes(tcpⅠ,toxR).Genetic relation was assessed by pulsed-field gel electrophoresis(PFGE)and the patterns were clustered by BioNumerics.Results From 1152 aquatic samples,69 isolates were identified,including 41 Inaba,18 Ogawa and 10 O139.All the isolates showed ctxA negative,while the hlyA and toxR genes were positive in all the isolates.34.15％(14/41)of the Inaba strains were hlyA + toxR + ompU + ace + zot + tcpI+,while 66.67％(12/18)belonged to Ogawa strains and 70％(7/10)of the O139 strains were hlyA + toxR+.Through PFGE analysis,the O1 isolates formed three clusters in this study.The patterns of O1 isolates differed widely,with the similarity as 72.8％-100.0％,while the patterns of O139 isolates having the similarity of 69.9％-95.5％.Conclusion The non-toxigenic O1 and O139 V.cholerae had a wide distribution in the environment of Pearl River estuary water during the nonepidemic period of cholera.All the aquatic isolates presented diversities on the related virulent genes.

INTRODUCTIONOtorrhoea is a common complaint in Ear, Nose and Throat clinics. This study aimed to establish the pathogens involved in cases of otorrhoea in Singapore, their sensitivity patterns and the effectiveness of empirical management.

METHODSA retrospective chart review was conducted on 91 patients with otorrhoea who had undergone swab cultures between July 2010 and February 2011.

RESULTSOf the 91 cases, 53% were diagnosed empirically as bacterial otitis externa and 25% as otomycosis. Aerobic bacteria accounted for 35.8% of the microorganisms cultured, while 34.7% were fungi and 29.5% were anaerobic bacteria. Pseudomonas (P.) aeruginosa and Staphylococcus (S.) aureus made up 31.6% and 21.0% of the microorganisms, respectively. 20% of S. aureus grown was methicillin-resistant. Aspergillus was the most common fungus and 19% of cultures were polymicrobial. 38% of patients had their treatment changed on the basis of culture results, as no improvement was observed on follow-up. P. aeruginosa was sensitive to ciprofloxacin and gentamicin in 81.8% and 76.0% of patients, respectively, while S. aureus was sensitive to cloxacillin in 93.8% and clindamycin in 87.5% of patients.

CONCLUSIONThe common microorganisms involved in otorrhoea in Singapore are P. aeruginosa, Aspergillus and S. aureus. Resistant strains of Pseudomonas spp. are now present. Methicillin-resistant S. aureus is increasingly prevalent and highly sensitive to vancomycin. Aminoglycoside and fluoroquinolone-containing eardrops are suitable first-line topical antimicrobials. Cloxacillin may be started should a concomitant oral antimicrobial be warranted empirically or for S. aureus infections. Otomycosis should be considered in patients who show no improvement with antibiotics.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anti-Infective Agents ; therapeutic use ; Child ; Child, Preschool ; Drug Resistance, Bacterial ; Ear Diseases ; drug therapy ; microbiology ; Female ; Humans ; Male ; Medical Audit ; Middle Aged ; Retrospective Studies ; Singapore ; Young Adult