Background Whether negative suction during excimer laser in situ keratomileusis(LASIK) affect the structure and function of retina or not is in controversy,but it seems that temporary hypertention induced by negative suction is a key factor of impairment of retina in LASIK.ObjectiveThis study attempts to study the influence of transient high intraocular pressure (IOP) during LASIK on the contents of retinal amino acid.MethodsThe both eyes of 45 New Zealand white rabbits were suctioned for different periods (20s,45s,3min) with negative pressure generator during the LASIK to make the instantaneous high IOP models,and LASIK without negative suction was performed in the both eyes of 15 rabbits in the control group.The changes of the contents of retinal amino acids were evaluated with High Performance Liquid Chromatography(HPLC) at 0,7,10,14 and 28 days postoperatively and compared with those of control group.ResultsThere were no statistically significant differences in the contents of retinal amino acids among different time points after operation in negative suction for 20s group and 45s group,respectively(P＞0.05).At negative suction for 3minuts,the content of glutamic acid in retina was significantly increased in comparison with control group in 7,10,14 and 28 days (P＜0.05),and no statistically significant difference was seen in the contents of glutamic acid at postoperative instant group compared with control group(P＞0.05).A statistically significant difference in the contents of glutamine,tryptophan,phenylalanine was revealed among postoperative 10 days,14 days and 28 days groups comparison with control group (P＜0.05).ConclusionThe acute IOP elevation caused by negative suction during LASIK results in the reversible increase of retinal amino acids.The duration of negative suction time influent the reconstruction of retinal structure.

Objective To study the efficacy of performing transvaginal Prosima mesh with high uterosacral ligament suspension (HUS) in treatment of severe pelvic organ prolapse (POP).Methods From July 2010 to February 2011,70 patients with severe POP underwent transvaginal prosima mesh with HUS in First Affiliated Hospital,General Hospital of People's Liberation Army.Clinical parameters of perioperation were collected.After 1 month and 2 - 3 months,perineal two-dimensional ultrasound examination was performed to measure mesh length in midsagittal plane.Validated prolapse quality of life questionnaires,pelvic floor distress inventsry short form 20 (PFDI-20) and pelvic floor impact questionnaire short form 7 (PFIQ-7) were used to evaluate the therapeutic effect.The mean results of pre-operative PFIQ-7 and PFDI-20 was 54 and 51,respectively.Results Median operation time was ( 195 ± 47 ) min and median blood loss was (160 ±64) ml.All the patients were followed for a mean time of 13 months (2 - 19 months).Seven cases were found with mesh exposure with less than 1 cm2.The objective cure rate was 100％.The mean score of post-operative PFIQ-7 and PFDI-20 were both 19,which were significantly lower than those of preoperation ( P ＜ 0.05 ).Anterior Prosima mesh was 3.5 cm at 1 month by ultrasound examination,and the second result of ultrasound scans was 2.8 cm at 2 - 3 month,which were both shortened 2.5 cm and 3.2 cm when compared with that of original size.Conclusions Transvaginal Prosima mesh placement with HUS is a safe and efficient surgery with less complication.Although mesh became shorter after 2 - 3 month,it did not affect surgery efficacy.

Objective To assess the long-term effectiveness of the transvaginal high uterosacral ligament suspension (HUS) in women suffering from advanced pelvic organ prolapse (POP).Methods A retrospective review of records identified 118 women who underwent transvaginal HUS with or without additional concomitant anterior and (or) posterior repairs from June 2003 to August 2009 in the First Affiliated Hospital,General Hospital of People's Liberation Army.Of 118 women,104 women completed the follow-up during study period;these 104 women were analysed.Follow-up visits were performed 2,6 and 12 months after surgery and then annually.Anatomic results of POP was established by pelvic examination using pelvic organ prolapse quantitation system (POP-Q) staging.Funtional results were obtained by patient global impression of improvement (PGI-I),pelvic floor distress inventory-short form 20 (PFDI-20) and pelvic floor impact questionnaire short form (PFIQ-7).Surgical success required the fulfillment of all 3 criteria:(1) prolapse leading edge of 0 cm or less and apex of 1/2 total vaginal length or less;(2) the absence of pelvic organ prolapse symptoms as reported on the PFDI-20 question No.3 (Do you usually have a bulge or something falling out that you can see or feel in your vaginal area?);and (3) no prolapse reoperations or pessary use during the study period.Results The mean follow-up time was (9.1 ± 1.5) years.The overall surgery success rate was 91.3％ (95/104) according to above all 3 criteria.Prolapse recurrence rates were isolated anterior 6.7％ (7/104),isolated apical 0,isolated posterior 2.9％ (3/104) and multiple compartments 1.0％ (1/104).Five women (4.8％,5/104) developed bothersome vaginal bulge symptoms.None of recurrent women underwent retreatment,including either surgery or use of a pessary at last follow-up.The subjective satisfaction rate was 90.4％ (94/104).PFDI-20 and PFIQ-7 scores showed a statistically significant improvement from preoperative 72 and 65 points to postoperative 17 and 9 points respectively (all P＜0.01).There was a 2.9％ (3/104) rate of intraoperative ureteral kinking and 3.8％ (4/104) rate of postoperative morbidity.Conclusions The transvaginal HUS for vault prolapse offers good long-term anatomical results with excellent vault suspension.With additional concomitant anterior and (or) posterior repairs,it will be a reconstructive surgery for the majority of advanced POP.It is minimal traumatic and appropriate for different type of POP,especially for the eldly patients.It is worthy of being popularized for clinical application.

Objective To investigate the impact of colpocleisis on body image in women with severe pelvic organ prolapse (POP). Methods From Oct. 2005 to Feb. 2010,60 POP patients with stage Ⅲ and Ⅳ by POP quantitation system underwent total or partial colpocleisis. Patients received body image evaluation before and 1 year after operation. Results One year after operation, 52 (87% , 52/60) patients completed body image evaluation. Before and 1 year after operation, the ratio of answer Not at all of questions such as Have you felt less physically attractive as a result of your vaginal prolapse? , Have you been feeling less feminine as a result of your vaginal prolapse? , Did you find it difficult to look at yourself naked? , Have you been feeling less sexually attractive as a result of your vaginal prolapse?, Have you felt dissatisfied with your body? were 25% and 96% ( P ＜ 0. 01 ) , 21% and 96% ( P ＜ 0. 01) , 37% and 67% (P = 0.018), 29% and 96% (P＜0.01), 12% and 83% (P＜0.01), respectively, indicating significant improvement on body image after operation for patients treated by colpocleisis. Conclusion Women underwent colpocleisis for severe POP could not decrease their body image as a result of the disability of vaginal intercourse.

Objective: To explore the clinical characteristics, treatment strategy and prognosis of adenoid cystic carcinoma of the head and neck (ACCHN). Methods: A retrospective analysis of the clinical and follow-up treatment of 79 patients with ACCHN from June 2008 to July 2017 was conducted in the Cancer Hospital of Zhengzhou University. Results: A total of 79 ACCHN cases, including 31 males and 48 females. The age ranged from 19 to 77 (median, 52). The clinical manifestations of ACC were related to the locations of primary tumor.The mean size of the tumor was 2.6 cm (range from 1.5 to 7.7 cm). 50 of 79 patients with a definitive pathological diagnosis received surgical resection. 59 cases received chemotherapy and 62 cases received radiotherapy. With a median follow-up of 55 months, the 5-year, 10-year survival rate of these patients were 69.6% and 54.4%, respectively. Conclusions ACCHN is an uncommon neoplasm with the characteristics of epithelial nerve growth, being inclined to distant metastasis, and high early misdiagnosis rate. The clinical manifestation, imaging and pathological result are need to be combined together to diagnose ACCHN.

Objective: To analyze the clinical efficacy of thalidomide combined with TP regimen (taxol+cisplatin) in treatment of advanced gastric cancer. Methods: A total of 60 patients with advanced gastric cancer in the Affiliated Cancer Hospital of Zhengzhou University from February 2016 to March 2018 were enrolled. The patients were divided into two groups by using random number table method: the observation group (32 cases) taking thalidomide, oral administration 100 mg based on TP regimen before going to bed; the control group (28 cases) taking TP regimen chemotherapy only. Both groups received 75 mg/m² doses of cisplatin, intravenous infusion, 25 mg/m² per day, for 3 d. Paclitaxel dose was 150 mg/m², intravenous infusion for 1 day, 3-week was one course, and the efficacy was evaluated after at least 2 course of treatment. Results: The incidence of gastrointestinal adverse reactions including nausea and vomiting was 21.8% (7/32) in the observation group, and was 64.3% (18/28) in the control group, and the difference was statistically significant (χ ² = 11.051, P = 0.001), but there were no statistically significant differences in the incidence of morning faint, constipation, bone marrow suppression, liver and kidney injury and other adverse reactions between the two groups (all P > 0.05). The effective rates in the observation group and the control group were 43.8% (14/32) and 39.3% (11/28), respectively, and the disease control rates in the observation group and the control group were 84.4% (27/32) and 78.6% (22/28), respectively. There were no significant differences in the effective rates and the disease control rates between the two groups (χ ² = 0.122, P = 0.726; χ² = 0.336, P = 0.562). The improvement and significant improvement rate of sleeping quality, pain, Eastern Cooperative Oncology Group (ECOG) score was 71.9% (23/32), 53.1% (17/32), 56.2% (18/32), respectively in the observation group, and 17.9% (5/28), 14.3% (4/28), 21.4% (6/28), respectively in the control group, and the difference between the two groups was statistically significant (all P < 0.05). Conclusions Thalidomide combined with TP regimen in treatment of advanced gastric cancer patients can improve the efficacy of chemotherapy and the quality of life. It also has a good tolerance to side effects.

Objective:To evaluate the indications, surgical skills and clinic outcomes of abdominal minimal incision sacrocolpopexy (AMISC) for treatment of advanced pelvic organ prolapse (POP).Methods:The retrospective study analyzed 30 women with advanced POP who underwent AMISC between June 2016 and October 2019, including 9 cases of recurrent prolapse and 10 cases of vault prolapse. AMISC was especially applicable to: (1) patients with several medical complications who was unable to tolerate general anesthesia or laparoscopic surgery, but able to tolerate combined spinal-epidural anesthesia and open surgery; (2) other abdominal procedures were indicated to perform with AMISC simultaneously, such as myomectomy, subtotal hysterectomy etc, the specimens were easy to get out of the abdominal cavity and morcellation was avoided; (3) surgeons preferring open surgery to laparoscopic surgery or skilled in open surgery; (4) patients with prior pelvic operations, presenting severe abdominal and pelvic adhesions. Objective outcomes were assessed by pelvic organ prolapse quantification (POP-Q) system. Subjective outcome were assessed by pelvic floor distress inventory-short form 20 (PFDI-20), pelvic floor impact questionnaire-short form (PFIQ-7) and patient global impression of improvement (PGI-I).Results:All patients with 1-3 medical complications were successfully performed with AMISC without stopping procedure, enlarging the incision or changing to other procedure, the operation duration was (110±19) minutes. The mean time of follow-up was (33.5±12.4) months (range: 8-49 months). The postoperative points of Aa, Ba, C, Ap, Bp reduced significantly and point C improved from (2.33±2.50) cm to (-7.54±1.18) cm after AMISC ( P<0.01). The objective cure rates were both 100% (30/30) in apex and posterior compartment, while 97% (29/30) in anterior compartment. Postoperative scores of PFDI-20 and PFIQ-7 were all significant decreased (all P<0.01). About PGI-I, 29 patients chose “significant improvement”, subjective satisfaction was 97% (29/30). Anterior sacral plexus hemorrhage occurred in 2 cases (7%, 2/30). There was no intestinal obstruction or injury of bladder, bowel and ureter intra- and postoperation. Two cases (7%, 2/30) had mesh exposure. Conclusion:AMISC is a safety, convenient, minimal traumatic and durable procedure for apical prolapse with short learning curve in the most of cases.

As a collective noun of incense and medicine, fragrant medicine has long been integrated into Chinese culture. It is not only a symbol of the cultural exchange between China and foreign countries in the middle ancient times, but also plays a very important role in medicine and other fields. Among them, Borneol can not only be used for medicinal purposes, but also for incense and fumigation, as well as food, tea, wine and other applications. This paper intends to sort out the medicinal properties, effects and other applications of Borneol recorded in ancient books of traditional Chinese herbs in the past dynasties, focusing on summarizing its medicinal properties, meridians, effects, compatibility and application characteristics. In addition, modern pharmacological action was included as a supplement, in order to provide reference for the clinical use of Borneol in medicinal aspects.

Objective To evaluate the indications and clinic outcomes of vaginal high uterosacral ligament suspension (HUS) for treatment of recurrent advanced pelvic organ prolapse (POP). Methods This retrospective study analyzed 42 women with recurrent advanced POP who were referred to Fourth Medical Center of PLA General Hospital and underwent transvaginal HUS between November 2005 and January 2018. Primary surgeries included 30 vaginal colporrhaphy, 5 Manchester operation, 5 transvaginal mesh repair,2 sacrospinous ligament fixation.The median time for recurrence from primary pelvic floor repair surgery was 9 months, including 14 cases (33%, 14/42)≤3 months (median time was 2 months) and 25 cases (67%, 28/42) longer than 3 months (median time was 18 months).The rate of recurrent prolapse in stageⅢorⅣ was 79% (33 cases), 45% (19 cases) and 17%(7 cases) in anterior, apical and posterior compartment respectively. Results Transvaginal high bilateral uterosacral ligaments were identified and used for successful vaginal vault suspension after vaginal hysterectomy and residual cervical resection in all 42 consecutive patients. The cases of transvaginal mesh used in anterior wall and posterior wall were 25 (60%, 25/42) and 3 (7%, 3/42) respectively. There was no major intra-and postoperative complications,such as ureter and other pelvic organ injury. The median time of follow-up was 5.3 years after transvaginal HUS. The points of pelvic organ prolapse quantification system reduced significantly and point C improved from+0.3 cm to-8.2 cm after reoperation (P<0.01). The objective cure rate were 100% (42/42) both in apex and posterior compartment,while 93% (39/42) in anterior compartment. None had reoperation or pessary usage for recurrence of prolapse. Conclusion Transvaginal HUS with vaginal wall repair could be as a safety, cost-effective, minimal traumatic and durable procedure for recurrent POP in the most of cases.

Objective To assess the five?year effect of the transvaginal high uterosacral ligament suspension (HUS) with or without additional concomitant native?tissue anterior and (or) posterior repair in women suffering from middle compartment defect. Methods A retrospective review of records identified 79 women who underwent transvaginal HUS with or without additional concomitant native?tissue anterior and (or) posterior repair from January 2007 to January 2018 in Fourth Medical Center, General Hospital of People′s Liberation Army. The middle compartment defects were predominant in these patients with point C no less than point Ba or Bp if accompanied with anterior or posterior vaginal wall prolapse. Follow?up visits were performed 2,6 and 12 months after surgery and then annually. Anatomic results of pelvic organ prolapse (POP) was established by pelvic examination using pelvic organ prolapse quantitation system (POP?Q) staging. Funtional results were obtained by patient global impression of improvement (PGI?I) scale in POP, pelvic floor distress inventory?short form 20 (PFDI?20) and pelvic floor impact questionnaire short form (PFIQ?7). Surgical success required the fulfillment of all 3 criteria: (1) anterior or posterior vaginal wall prolapsed leading edge of 0 cm or less and apex of 1/2 total vaginal length or less; (2) the absence of POP symptoms as reported on the PFDI?20 question No.3 ("Do you usually have a bulge or something falling out that you can see or feel in your vaginal area?"); and (3) no prolapse reoperations or pessary use during the study period. Results Of 79 women, 51(65%, 51/79) women completed the five?year follow?up during the study period. The median follow?up time was 5.2 years (2.8-8.3 years). The overall surgery success rate was 86% (44/51) according to above all 3 criteria. Prolapse recurrence rates were isolated anterior 8% (4/51), isolated apical 0, isolated posterior 2% (1/51) and multiple compartments 4% (2/51). Seven women (14%,7/51) developed anterior or posterior prolapse beyond the hymen with the leading edge≤1 cm. No apical prolapsed occurred. None of recurrent women underwent retreatment,including either surgery or pessary usage at last follow?up. The subjective satisfaction rate was 90% (46/51). There was a 1% (1/79) rate of intraoperative ureteral kinking and 3% (2/79) rate of postoperative morbidity. Conclusions The transvaginal HUS for middle compartment defect offers good long?term anatomical results with excellent vault suspension. With additional concomitant native?tissue anterior and (or) posterior repair, it will be a reconstructive surgery for the majority of moderate?to?severe POP. It is minimal traumatic and worthy of being popularized for clinical application.