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.

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.

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.

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.

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 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 evaluate the effect of hydrogen-rich saline on neuropathic pain in rats.Methods One hundred and twenty male Sprague-Dawley rats,weighing 200-250 g,were randomly divided into 4 groups (n =30 each) using a random number table:sham operation group (S group); hydrogen-rich saline group (H group); chronic constrictive injury (CCI) group; CCI + hydrogen-rich saline group (CH group).Neuropathic pain was induced by CCI.The animals were anesthetized with intraperitoneal 10％ chloral hydrate 300 mg/kg.The left sciatic nerve was exposed and 4 ligatures were placed on the sciatic nerve at 1 mm intervals.In H and CH groups,hydrogen-rich saline 10 ml/kg was injected intraperitoneally twice a day for 3 consecutive days starting from 1 day after CCI.The paw withdrawal threshold to mechanical stimulation with yon Frey filament (PWT) and paw withdrawal latency to thermal stimulation (PWL) were measured on the day before CCI (T0) and on 3,5 and 7 days after CCI (T1-3).The rats were sacrificed after the last measurement of pain threshold at T4.The left lumbar segments (L4-6) of the spinal cord were removed for determination of the contents of tumor necrosis factor-alpha (TNF-α),interleukin-1β (IL-1β),interleukin-6(IL-6) and high-mobility group box-1 (HMGB1) (by ELISA),and malondialdehyde (MDA) content and superoxide dismutase (SOD) and catalase (CAT) activities (using visible spectrophotometer).Results Compared with S group,PWT was significantly decreased,PWL was shortened,the contents of TNF-α,IL-1β,IL-6,HMGB1 and MDA were increased,and the activities of SOD and CAT were decreased at each time point after CCI in CCI and CH groups.Compared with CCI group,PWT was significantly increased,PWL was prolonged,the contents of TNF-α,IL-1β,IL-6,HMGB1 and MDA were decreased,and the activities of SOD and CAT were increased at all the time points after CCI in group CH.Conclusion Hydrogen-rich saline can alleviate neuropathic pain in rats via reducing the inflammatory response and lipid peroxidation response.

Objective To investigate the serum concentrations of secreted protein acidic and rich in cysteine (SPARC) in patients with diabetic nephropathy and SPARC mRNA and protein expressions in renal tissue of db/db mice.Methods Serum SPARC levels in normal subjects and patients with type 2 diabetes mellitus (without diabetic nephropathy),chronic renal failure (without diabetes mellitus),and diabetic nephropathy were determined with enzyme-linked immunosorbent assay.RT-PCR,Western blot,and immunofluorescence were used to detect the mRNA and protein expressions of SPARC in renal tissue of db/db mice.Results The serum level of SPARC in diabetic nephropathy group was significantly higher than those in normal group,type 2 diabetes mellitus,and chronic renal failure group [(5.78 ± 1.41 vs 3.58 ±0.41,4.51 ± 1.08,and 3.81 ± 1.16) μg/L,P＜0.05 or P＜0.01].The SPARC level in the type 2 diabetes mellitus group was higher than that in normal group (P＜0.05),but there was no difference between normal group and chronic renal failure.SPARC mRNA and protein levels in renal tissue of db/db mice were higher compared with the littermates (P ＜ 0.05).Conclusions The long term hyperglycemic state in patients with diabetic nephropathy causes pathological change of renal tissue.Simultaneously,increased secretion of SPARC from renal tissue results in elevation of serum SPARC level and may play a role in pathological change of diabetic nephropathy.