Objective To evaluate the long-term outcomes,complications and urodynamic parameters of using tension-free vaginal tape-obturator(TVT-O)in the treatment of patients with stress urinary incontinence.Methods Preoperative and postoperative evaluations including urodynamic data and quality of life were performed for 24 patients with stress urinary incontinence who were enrolled and treated with TVT-O between May 2007 and June 2011.Results Patients completed long-term postoperative follow-up from 12 to 60 months after surgery.Twenty-one(87.5％)patients achieved long-term subjective success and 22(91.7％)achieved objective success.Surgical satisfaction and quality of life was high.Long-term postoperative abdominal leak point pressure of 23 patient was greater than 100 cm H2O,and the remaining parameters preoperative and postoperative showed no significant differences.Voiding difficulty and external reflection voding desire were the main long-term complications.Conclusions TVT-O is with few complications and high patient satisfaction.It is a simple,safe and effective procedure for treatment of patients with stress urinary incontinence.Long follow-up period is important for the comprehensive evaluation of TVT-O.Postoperative urodynamic study has significance in complications,diagnosis and evaluation.

The full name of the polycystic liver disease is autosomald ominant polycystic liver disease.Surgical treatment is the main method to deal with it at present.With the deep study of the polycystic liver disease into the molecular genetic level,it is possible for molecular diagnostics to achieve presymptomatic and prenatal diagnosis.The article mainly introduce the research progress of the polycystic liver disease's etiology,pathogenesis,diagnosis,treatment,and so on.

BACKGROUND:With the improvement of cervical posterior surgical techniques, lateral mass screw fixation technology has been widely used in the reconstruction surgery of the cervical spine for stability. However, currently, the finite element study on the lateral mass screw fixation reconstruction of the cervical spine is rare. OBJECTIVE:To establish a fine normal lower cervical spine (C3-C7 ) three-dimensional finite element model and a reconstructed finite element model with three-segment laminectomy with lateral mass screw fixation. Then, to do an initial biomechanical analysis of the lateral mass screw fixation reconstructed lower cervical finite element model. METHODS:We col ected a normal female volunteer aged 30 years old to do CT scan for the whole cervical spine. The Dicom data were obtained. Then, the CT scanning images were dealt with software Mimics 10.01, Geomagic Studio 12.0, Solidworks2012, HyperMesh 10.1 and Abaqus 6.12 software to build the normal lower cervical spine (C 3-C7 ) finite element model, the laminectomy finite element model and the rebuilt finite element model. At last, we analyzed the stress changes of reconstructed models under the state of flexion, extension, lateral bending and rotational motion. RESULTS AND CONCLUSION:The lower cervical spine finite element model contained 503 911 elements and 93 390 nodes with a fine realistic appearance. It successful y passed the validation. The surgical procedure was completed in the software, and the lateral mass screw fixation reconstruction finite element model has been established. Lateral mass screw fixation system provides good stability for the postoperative finite element model. The activity of rebuilt finite element model is much lower than the normal finite element model. In the extension condition, the stress of lateral mass screw fixation system becomes strong.

AIM: To compare the measurement of anterior chamber depth(ACD) inclusive of corneal thickness using intrao-cular lens(IOL) master and ultrasound biomicroscopy (UBM) and evaluate the repeatability of each method.METHODS: Two consecutive measurements of ACD were prospectively performed using IOL master and UBM in 60 eyes in 60 individuals. Mean values were compared using the paired t test. For each individual, ACD measure-ments was performed 5 times to estimate the repeatability of each method by a coefficient of variation(CV).RESULTS: The mean ACD was 2.95±0.25mm with the IOL master and 2.96±0.22mm with the UBM. This diffe-rence was not statistically significant (P=0.631).The coefficient of variation (CV) was 0.56%±0.26% and 0.65%± 0.36% in IOL master and UBM, respectively.CONCLUSION: The mean ACD of IOL master was the same as UBM. The repeatability of IOL master is better than UBM.

Objective To investigate the effects of peroral catheter balloon dilatation on patients with dysphagia caused by cricopharyngeal achalasia after stroke.Methods Thirty-two stroke survivors with cricopharyngeal achalasia were randomly divided into a control group and a treatment group,each of 16.Both groups were given routine dysphagia rehabilitation training,but the treatment group was additionally given peroral balloon dilatation therapy six times a week for 2 weeks.Both groups were given swallowing function evaluations and videofluoroscopic swallowing examinations (VFSS) before and after the treatment.Results After the treatment,14 of the 16 patients in the treatment group demonstrated improved swallowing,significantly better than the control group,where only 9 patients had improved.The VFSS showed dysphagia to have been relieved in both groups,but significantly more in the treatment group.Transit duration in the pharnx was significantly shortened from 0.28 s to 0.16 s in the treatment group,but no significant difference was tound in the control group.Conclusion Peroral catheter balloon dilatation is effective for relieving cricopharyngeal achalasia after stroke.

Objective:To explore the early evaluation value of calprotectin (S100A8/A9) and ischemia modified albumin (IMA) for adult acute appendicitis (AA) and adult non-simple acute appendicitis.Methods:The data of 62 patients with histologically confirmed appendicitis and 57 healthy controls in the physical examination center of our hospital during the same period from May 2018 to October 2019 were collected. According to postoperative pathological data, patients with appendicitis were divided into the simple appendicitis group and the non-simple appendicitis group . The measurement data conforming to normal distribution were expressed as mean ± standard deviation (Mean±SD), and Student's t test was used for comparison between groups. S100A8/A9, IMA, C-reactive protein (CRP), procalcitonin (PCT), and blood routine parameters were compared after grouping.The area under the ROC curve (AUC) was used to evaluate the early efficacy of S100A8/A9 and IMA for acute appendicitis and non-simple acute appendicitis. Results:There were no significant differences in sex, age, platelet count (PLT), and red blood cell count (RBC) between the appendicitis group and healthy control (all P>0.05), while white blood cell count (WBC), CRP, PCT, neutrophils to lymphocytes ratio (NLR), S100A8/A9, and IMA levels in the appendicitis group were higher than those in healthy control (all P<0.05). The AUC of S100A8/A9 (≥366.9 μg/L), IMA (≥0.29), and S100A8/A9 combined with IMA in predicting acute appendicitis were 0.735, 0.891, and 0.913, respectively. There was no significant difference in WBC between the non-simple appendicitis group (21 cases) and the simple appendicitis group (41 cases) ( P>0.05).The levels of CRP, PCT, NLR, S100A8/A9 and IMA in the non-simple appendicitis group were significantly higher than those in the simple appendicitis group ( P<0.05). The AUC of S100A8/A9 (≥532.9 μg /L), IMA (≥0.41) and S100A8/A9 combined with IMA in predicting non-simple acute appendicitis were 0.866, 0.873 and 0.936, respectively. Conclusions:S100A8/A9 and IMA could be used as biomarkers for the diagnosis of AA, which have certain clinical value for the assessment of acute appendicitis and non-simple acute appendicitis.

Objective To observe serum secreted protein acidic and rich in cysteine (SPARC) levels in normal subjects,obese subjects,patients with type 2 diabetes mellitus (T2DM),and obese patients with T2DM,as well as the difference of SPARC expression in mesenteric adipose tissue of subjects with and without T2DM.Methods Serum SPARC level was measured with the ELISA.RT-PCR,Western blot,and immunofluorescence were used to examine SPARC mRNA and protein expressions in mesenteric adipose tissue.Results (1) SPARC levels were higher in obesity,T2DM,and T2DM with obesity groups compared with normal group [(1 191.6 ± 718.91,1 223.81 ± 645.96,1 538.01 ± 757.95 vs 851.07 ± 280.21) ng/L,P＜0.05].(2) Pearson correlation analysis showed that SPARC level was positively correlated with homeostasis model assessment for insulin resistance index (r =0.205,P＜ 0.05).(3) The expression levels of SPARC mRNA and protein in mesenteric adipose tissue of T2DM patients were higher than those of control subjects (P ＜ 0.05).Conclusion SPARC is closely related to the development of obesity,insulin resistance,and type 2 diabetes mellitus.

AIM: To study the expression profile of QKI m RNA and protein in rat heart during pathological cardiac hypertrophy. ME THODS: A rat cardiac hypertrophy model was established using continuous norepinephrine (NE) perfusion. Real-time PCR and Western blotting were applied t o examine QKI mRNA and protein expression respectively in rat heart. RES ULTS: Both mRNA and protein of three QKI isoforms were detected in adult rat heart. QKI-5 mRNA and total QKI protein were remarkably decreased in NE-ind uced hypertrophic heart compared with those in control group (P

Objective To assess the protective effect of the proteasome inhibitor bortezomib on rat liver subjected to bile duct obstruction. Methods Thirty rats were divided randomly into three groups, which were sham-operation group (SO group), bile duct ligation control group (Con group) and bortezomib group (Bor group). All rats in the Con group underwent ligation of the common bile duct, and rats in the Bor group were given bortezomib intrabominally at-1 d, 4 d post-ligation of the common bile duct. All the rats were sacrificed at 7 d post-surgery. ALT, TB and TBA levels were determined. The expression of NF-κB p65 was assessed using immunohistological staining. RT-PCR was employed to detect TNF-α mRNA levels in liver samples. Results There was no significance in the levels of TB and TBA between Con and Bor groups. The ALT revel in the Bor group [(92.4±21.4)μmol/L]was significantly lower than that in the Con group [(145.7 ±33.5) μmol/L], P＜0.05. The positive staining rate of NF-κB p65 subunit in the Bor group showed significant lower value (11.6% ±2.7 % ) compared to that in the Con group (15.5 %±4.3 % ), P＜0.05. The expression ratio of TNF-α mRNA in the Bor group was 1.0± 0. 2, which also significantly lower than that in the Con group (1.3±0.4), P＜0. 05. Conclusion These data suggest that the proteasome inhibitor bortezomib reduces rat hepatocyte injury in the bile duct ligation by mechanisms associated with the inhibition of NF-κB as well as the attenuation of inflammation.

Objective To investigate the effect of multidisciplinary physician/nurse collaboration care mode in diagnosis and treatment of elderly patients with intertrochanteric fracture.Methods Clinical data of 433 elderly patients with intertrochanteric fracture treated from August 2011 to September 2013 were studied retrospectively.Among them,136 were diagnosed and treated using conventional methods (control group) and 297 using the multidisciplinary physician/nurse collaboration approach (collaboration group).Hospital stay,surgery rate,time from hospitalization and operation,and complications were compared between the two groups.Results Length of hospital stay [(14.8 ± 5.9) d] in collaboration group was not statistically different from that in control group [(16.0 ± 4.7) d,t =0.433,P ＞ 0.05],but surgery rate was improved (72.8％ vs 83.9％,x2 =7.212,P ＜ 0.05),time from hospitalization and operation shortened [(5.6 ± 2.9) d vs (6.9 ± 3.4) d,t =3.096,P ＜ 0.05],and perioperative complication rate reduced in collaboration group compared to control group (all P ＜ 0.05).Conclusion Multidisciplinary physician/nurse collaboration mode is a novel method for diagnosis and treatment of intertrochanteric fracture in the elderly and is associated with improved surgery rate,reduced perioperative complications and early functional recovery.