Objective To analyze postoperative effect of a new rectopexy technique with Douglas pouch elevation for complete rectal prolapse (CRP) in adults.Methods From January 2010 to May 2011, 52 CRP cases were treated by rectopexy with Douglas pouch elevation.In terms of different surgical techniques, patients were divided into two groups : Group A (n =28) received laparoscopic rectopexy with Douglas pouch elevation;and Group B (n =24) received laparoscopic rectopexy with Douglas pouch elevation combined with procedure for prolapse and hemorrhoids (PPH).Rectal prolapse, constipation, and fecal incontinence in the two groups were assessed respectively before surgery, and on the 6th, 12th, and 24th month after surgery, postoperative complications were evaluated with severe grading of surgical complications.Results Symptoms of rectal prolapse disappeared at half a year after surgery in all patients, and relapsed to different extent afterwards.However, two years after operation, the status of rectal prolapse in Group B tended to be stable.The trend of constipation after surgery was consistent with that of rectal prolapse.In addition, fecal continence improved gradually on half a year after surgery in the two groups and recovered to the optimal status in the first postoperative year.However, in the second year, the results of fecal incontinence reduced slightly in Groups A, and Group B became stable.Two years after surgery, four cases in Groups A relapsed while there was no recurrence in Group B.Difference of Grade I to Grade Ⅲ complications among the two groups was statistically insignificant (x2 =0.05, P ＞ 0.05).Conclusions The clinical effect of laparoscopic rectopexy with Douglas pouch elevation associated with the procedure for prolapse and hemorrhoids (PPH) is better than that without PPH for female and male CRP patients with severe symptoms.

Objective To investigate changes in plasma levels of D-dimer in patients with prostate hyperplasia(BPH)complicat-ed with acute urinary retention(AUR),and to explore its clinical significance.Methods 102 cases of patients with prostate hyper-plasia complicated with acute urinary retention,treated in this hospital from July 2013 to December 2014,were selected and divided into the simple BPH group(56 cases)and BPH complicated with AUR(BPH+AUR)group.The plasma levels of D-dimer of these patients were detected and comparatively analysed.Results Compared with the simple BPH group,the plasma levels of D-dimer of patients in the BPH+AUR group was increased,had statistically significant difference.(P <0.01).Conclusion The plasma levels of D-dimer in patients with BPH complicated with AUR increase significantly,which indicates that patients are with secondary in-creased fibrinolytic activity.Measures should be taken to relieve urinary retention as soon as possible,so as to protect the vascular endothelial function of patients and reduce the incidence of complications.

Background Pupil atresia increases the difficulty of cataract surgery.The improper enlarging pupil will lead to many complications.The appropriate method of pupil dilation is very important to improve the postoperative effect.Objective This study was to evaluate the pupillary function after manually enlarged pupil to different sizes for pupil atresia complicated cataract.Methods A retrospective case-controlled study was designed.Thirty-eight eyes of 30 cases suffered from pupil atresia complicated cataract induced by chronic uveitis were enrolled in Shandong Eye Institute from May 2006 to May 2012.The eyes underwent pupil forming and phacoemulsification and assigned to the pupil enlarged to ≥6.0 mm group (15 eyes) and 4.5-5.5 mm group (23 eyes).The fibrosis membrane at pupil zone was removed,and the fibrosis strip at pupil collar was cut evenly by 23G intraocular microscissors as zigzag shape.Then the pupil was enlarged in multipoint by a pair of left and right iris hook from the main and lateral incisions.The pupils of 15 eyes in the pupil enlarged to ≥6.0 mm group were dilated above 6.0 mm and 23 pupils in the 4.5-5.5 mm group were dilated to 4.5-5.5 mm and followed by routine phacoemulsification and foldable intraocular lens implantation.Topical and systemic corticosteroids and nonsteroidal anti-inflammatory drugs combined topical mydriatic were applied before and after operation.The pupil diameter,light reflex and photophobia symptom in postoperation were compared between the two groups.The visual acuity before and after operation and intra-and post-operative complications were recorded.This study was approved by Ethic Committee of Shandong Eye Hospital,and written informed consent was obtined from each patient before operation.Results The pupil diameter in the pupil enlarged to ≥6.0 mm group was dilated to (6.9±0.4) mm and that of the 4.5-5.5 mm was dilated to (5.1 ±0.3) mm intraoperatively,with a statistical significance between them (t =16.100,P =0.000).Three months later,the pupil diameter in the pupil enlarged to ≥ 6.0 mm group was (4.9 ±0.4)mm,with different degrees of lacerated pupillary margins,and that in the pupil enlarged to 4.5-5.5 mm group was (3.5 ±0.5) mm,with rare lacerated pupillary margins,showing a statistically significant difference (t =9.820,P =0.000).The unresponsive or obtuse light reflex in the pupil enlarged to ≥6.0 mm group was significantly higher than in the pupil enlarged to 4.5-5.5 mm group(11 eyes vs.6 eyes) (x2 =8.200,P =0.005).The subjective photophobia symptom of 2-3 grades in the pupil enlarged to ≥6.0 mm group was in 12 eyes,which was higher than that in the pupil enlarged to 4.5-5.5 mm group (2 eyes) (H=19.840,P=0.000).The iris haemorrhage were seen in 3 eyes in the pupil enlarged to 4.5-5.5 mm group and 7 eyes in the pupil enlarged to ≥6.0 mm group (x2 =5.290,P=0.030).The visual acuities of the operated eyes in the two groups improved at different degrees.Conclusions Approximate physiological pupil and good visual quality can been obtained by manual releasing and enlarging pupil to less than 5.5 mm evenly during the surgery for pupil atresia complicated cataract induced by chronic uveitis.

Background Eyes with filamentary keratitis present with serious clinical symptoms.This disease is easy to relapse and the treatment is tricky.At present,its pathogenesis is still unclear,and few works were done on filamentous composition.Objective This study was to analyze the composition of corneal filament by imageological and histopathological method,and discuss the formation mechanism of filamentary keratitis.Methods Eighty-eight eyes of 82 cases who suffered from filamentary keratitis were collected in Shandong Eye Hospital between January 2008 and January 2011.The etiologies of the patients were classified and the clinical data were recorded.Firstly,the corneal filiform strip was detected by laser scanning confocal microscopy (LSCM),and the corneal structure was examined by high-definition optical coherence tomography (HD-OCT).Then the composition of filamentary strip was analyzed by Giemsa and Masson trichrome staining of stretched preparation of filiform strip.Results Etiological study showed that filamentary keratitis occurred after penetrating keratoplasty in 40 eyes,after cataract surgery and photorefractive keratectomy (PRK) in 18 eyes,dry eye and neural dystrophic corneal disease in 14 eyes,acute conjunctivitis in 10 eyes.HD-OCT revealed that filament lesion developed to Bowman layer.Filament was composed of epithelial cells,inflammatory cells,mucus and the high reflective strip core with spiral arrangement under the LSCM,and epithelial cells,inflammatory cells and fibrous tissue were seen in the strip core.Giemsa staining exhibited that filament contained corneal epithelial cells,inflammatory cells,mucus and dark blued strip core with helical arrangement.Masson trichrome discovered that the strip core was red fibrous tissue surrounding by blue mucus.Conclusions Epithelial cells,inflammatory cells,mucus and the high reflective strip core with spiral arrangement are the main elements of filament in filamentary keratitis.The lesion can reach Bowman layer.The results contribute to reveal the formation mechanism of corneal filament and assist treatment.

Chronic osteomyelitis is one of the most common disorder in clinic. In recent years due to diabetes, peripheral vascular disease and trauma induced disease increased, the prevalence rate increased. With the development of magnetic resonance imaging and CT imaging technology, it greatly improved the accuracy of clinical diagnosis of chronic osteomyclitis and ability to describe the infection characteristics, and provide a reliable basis for clinical treatment. The current research on chronic osteomyelitis mainly concentrated on the aspects of imaging applications and ways of using antibiotic optimization control inflammation, defect restoration and reconstruction of blood supply and treatment. But the best time to the antibiotic therapy and the use of program is still uncertain, for after debridement, bone grafting time and defect repair function of fast recovery still need further research.
Anti-Bacterial Agents ; therapeutic use ; Chronic Disease ; Humans ; Osteomyelitis ; diagnosis ; therapy

Objective To evaluate the development of fetal cerebellar vermis using 3D transabdominal ultrasound,and provide evidence for prenatal screening fetal cerebellar vermis anomalies.Methods Totally 387 normal fetuses at 20～36 gestation weeks were examined by three-dimensional extended imaging(3DXI) to observe the fetal cerebellar vermis.The width,anteroposterior diameter,craniocaudal diameter of the cerebellar vermis,the angle between brain stem and vermis,a ratio between the area of anterior vermis and posterior vermis were measured,and the relationship between the gestational age and parameters mentioned above were analyzed.Results The multi slice view of 3DXI and 3D reconstructed sagittal section well evaluated the integrity of vermis morphous and vermis size,identified characteristic signs of vermis:the fourth ventricle apex and vermis crack.In normal fetus,brain stem and vermis were almost parallel,the angle between them was 3.97°±1.65°.There was no significant correlation between the angle and the gestational age.The area of the anterior vermis was smaller than that of posterior vermis,with a ratio of 0.76±0.06,which was also not related to gestational age.The width,anteroposte rior diameter and craniocaudal diameter of the cerebellar vermis were positively correlated with gestational age.Conclusions The multi slice view of 3DXI and 3D reconstructed sagittal section should help evaluate the development of the cerebellar vermis,accurately show the cerebellar vermis and its surrounding strutures,and provide a new way to evaluate the fetal cerebellar vermis.

Objective To investigate the expression of adaptin-2(AP-2) in different stages of mouse coch‐lea and its probable role in the auditory generation and formation .Methods Mice were divided into 4 experimental groups by age (7 days old ,15 days old ,35 days old ,16 months old) ,which respectively represented the newborn mice ,developmental mice ,mature mice and old mice .Auditory brainstem response (ABR) ,laser scanning confocal microscopy (LSCM) ,immune-fluroscence histochemistry and qRT - PCR were used in this study .Results For the 15 days old ,35 days old ,16 months old groups ,ABR average threshold was 18 .67 ± 1 .21 dB nHL ,13 .83 ± 1 .47 dB nHL ,37 .83 ± 7 .68 dB nHL ,respectively ,for the 7 days old groups no responses were observed .The AP-2 im‐munoreactivity was found in all the stages of mice cochlea inner hair cell (IHC) cytoplasm ,especially in IHC basal part ,nearby the ribbon synapse .For the 7 days old ,15 days old ,35 days old ,16 months old groups ,immune-flu‐roscence histochemistry IMV(intensity mean value)were 190 .91 ± 17 .27 ,494 .06 ± 27 .63 ,838 .41 ± 38 .23 ,682 .65 ± 72 .22 ,respectively .For the 7 days old ,15 days old ,35 days old ,16 months old groups ,mRNA RQ(relative quantity)were 0 .53 ± 0 .09 ,1 .03 ± 0 .02 ,1 .00 ± 0 .09 ,1 .03 ± 0 .06 ,respectively .Developmental mice expressed significantly higher than those of the newborn in the AP -2 protein expression level which was measured by immuno -fluores‐cence histochemistry and qRT PCR(P<0 .01) .There was no significant difference between old and mature mice in the AP-2 protein expression level measured by qRT PCR (P> 0 .05) ,but mature mice had significant advantages by immuno-fluorescence histochemistry .Conclusion AP-2 protein expression level may closely related to the au‐ditory formation and maintenance because its expression gradually increases with age in mice .

Objective To investigate the role of transcriptional-coactivator with PDZ-binding motif( TAZ) in genistein-induced osteoblastogenic differentiation of mouse bone marrow-derived mesenchymal stem cells ( BMSCs) .Methods Mouse BMSCs were cultured in phenol red-freeα-MEM containing osteogenic supplements for inducing osteogenic differentiation.BMSCs were transfected with siRNA-TAZ and treated with genistein.The temporal sequence of osteoblastic differentiation in BMSCs cultures was assayed by measuring alkaline phosphatase activity (ALP) and calcium deposition.The mRNA expression of bone sialoprotein ( BSP) and osteocalcin ( OC) were detected by reverse transcription-polymerase chain reaction(RT-PCR).The binding interaction between TAZ and cbfa1 was identified by co-immunoprecipitation.Results TAZ expression was detected during the induction of osteogenic differentiation, the ALP activity and calcium deposition were significantly decreased in BMSCs which were transfected with siRNA-TAZ.Genistein(0.01-1 μmol/L) exhibited a dose-dependent effect on TAZ expression in mouse BMSCs cultures.Treatment with genistein ( 1 μmol/L ) resulted in increased ALP avtivity and calcium deposition of BMSC cultures as function of time.Genistein(1μmol/L) also promoted the nuclear localization of TAZ and augmented the interaction between TAZ and cbfa1, and by which upregulated cbfa1-mediated gene expression such as BSP and OC.However, the ALP avtivity and calcium deposition, as well as the expression of BSP and OC were not promoted by genistein in BMSCs transfected with siRNA-TAZ.Conclusion These data suggest that the TAZ plays an important role in genistein-induced osteoblastic differentiation of mouse BMSCs cultures.

Objective: To explore the mechanism of acupuncture in regulating cognitive deficits in insomnia rats by observing the effect of acupuncture on microglia in thalamic reticular nucleus (TRN). Methods: Thirty rats were randomly divided into a control group, a model group and an acupuncture group, with 10 rats in each group. The insomnia model was established by intraperitoneal injection of para-chlorophenylalanine (PCPA) once a day for 2 d. Rats in the control group were intraperitoneally injected with the same amount of normal saline. Rats in the acupuncture group received acupuncture at Neiguan (PC 6) and Zusanli (ST 36) for 5 consecutive days. The CLOCKLAB 2 data acquisition system was used to dynamically observe the sleep of the rats throughout the experiment. The cognition of rats was evaluated by event-related potentials (ERPs). After intervention, brain tissue was extracted. Immunofluorescence was used to test the fluorescence expression in TRN region. The concentrations of interleukin (IL)-1β and tumor necrosis factor (TNF)-α were detected by enzyme-linked immunosorbent assay. Results: After intraperitoneal injection of PCPA suspension, the spontaneous activity in light period of rats in the model group and acupuncture group increased significantly compared with the control group (both P<0.01). After acupuncture treatment, the rats in the acupuncture group had much less spontaneous activity during the light period than those in the model group (P<0.01), and the results indicated that acupuncture could effectively improve the sleep quality of insomnia rats. Compared with the control group, rats in the model group showed that the P3 latency, the average optical density of microglia, and the concentrations of IL-1β and TNF-α increased significantly (all P<0.05), and the P3 amplitude decreased significantly (P<0.01). Compared with the model group, rats in the acupuncture group presented that the P3 latency, the average optical density of microglia, and the concentrations of IL-1β and TNF-α were significantly decreased (all P<0.05), and the amplitude of P3 was significantly increased (P<0.05). Conclusion: Acupuncture possesses an ability to improve the cognitive state in insomnia rats. The mechanism may be related to inhibiting the microglial activation, diminishing the levels of pro-inflammatory mediators like IL-1β and TNF-α, and promoting the recovery of central nervous system function.

OBJECTIVE: To investigate the expression of Myosin VI and Disabled-2 (Dab2) in the cochlea of mice at different ages. METHOD: Forty KM mice were divided into four groups according to age, named as postnatal 2 week (P2w), P5w, P9w, P16month. The localization of protein in the basilar membrane of mice cochlea was detected by immunofluorescence staining and laser scanning confocal microscope (LSCM). The mRNA expression level of protein in cochlear at different ages was evaluated by real-time fluorescent quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR). Statistical analysis was performed by the SPSS18.0 software. RESULT: Myosin VI and Disabled-2 protein mainly expressed at the apical cytoplasm of hair cells. As for the inner hair cell, Dab2 labeling was abundant especially at the cuticular plate and nearby. Comparing four immunofluorescence staining images of Myosin VI, we found the fluorescence intensity of P2w and P16m were weaker than that of P5w and P9w. After setting P9w as the control group, qRT-PCR revealed that the mRNA expression of MyosinVI and Dab2 in P2w was less than that in the control group (P < 0.01), while no significant difference was found between P5w and the control group, nor between P16m and the control group (P > 0.05). CONCLUSION Myosin VI and Dab2, two proteins which regulated the clathrin-mediated endocytosis, expressed at hair cells of mice cochlea. In the inner hair cell, this process of endocytosis may be more efficient at the cuticular plate and nearby. The expression level of protein may change in different ages, and this probably leads to a difference of CME, it also may cause a defect of inner hair cells function.
Adaptor Proteins, Vesicular Transport ; metabolism ; Aging ; Animals ; Cochlea ; metabolism ; Endocytosis ; Hair Cells, Auditory ; metabolism ; Hair Cells, Auditory, Inner ; metabolism ; Mice ; Microscopy, Confocal ; Myosin Heavy Chains ; metabolism