Objective To observe the therapeutic effect of transvaginal repair of uterine diverticula after cesarean section.Methods The clinical data of 12 patients underwent transvaginal repair (group A) with uterine incision diverticulum treatment were retrospectively analyzed.13 cases underwent transabdominal repair of the uterine incision diverticulum were selected as group B.The operation time,intraoperative bleeding volume,postoperative exhaust time,hospital stay and the next days of menstrual period were compared between the two groups.Results In group A,the operation time was 48 min,the amount of bleeding was 30 ml,postoperative exhaust time was 9 h,the length of hospital stay was 4.5 d,the next time menstruation was 3-5 days,Those of group B were 120 min,120 ml,16 h,7.8 d and 3-5 d.The differences of operation time,bleeding volume,postoperative exhaust time,hospitalization days between the two groups were significant(P ＜ 0.05).There was no statistically significant difference between the two groups in the days of the next menstrual period (P ＞ 0.05).Conclusion The effect of transvaginal,transabdominal repair on uterine diverticula formation after cesarean section is clear,but the transvaginal operation can shorten the operation time,reduce intraoperative bleeding volume,shorten postoperative exhaust time and decrease the hospitalization days,thus reduce the cost of hospitalization.

ObjectiveTo investigate the efficacy and treatment options of precise electrophysiological diagnosis combined with percutaneous low-frequency electrical stimulation for penile scleroderma in high-altitude hypoxic areas. MethodsA total of 54 patients with electrophysiological diagnosis and treatment of corpora cavernosa were included in the retrospective analysis. Their age ranged from 20 to 70 years with a mean of 45.5±11.6 years and disease duration from 2 to 16 months. PDE5i， levocarnitine oral solution， and traditional Chinese medicine for invigorating blood circulation and eliminating stasis were administered orally before treatment. The visual precision electrophysiological diagnosis was performed after discontinuation of all oral drugs for 1 week before treatment. The electrophysiological diagnostic parameters were recorded and contrasted before and after the set-up treatment， and the corresponding parameters for precision electrophysiology were adjusted for percutaneous low-frequency electrical stimulation treatment， 2-3 hours each time， once daily， and 10 times per course. At the same time was administered assisted nasal cannula oxygen inhalation for 2 to 3 hours （4L/min）. Before and after electrophysiological diagnosis and treatment were evaluated by using the numeric assessment scale of pain extent， the international index of erectile function score （IIEF-5）， penile curvature measurement， color Doppler measurement of plaque areas and comparison of whole body and disease local infrared thermogram temperature changes. ResultsAll patients successfully completed 2-4 sessions of percutaneous low-frequency electrical stimulation （20 sessions to 40 sessions）. There was a significant statistical difference （P < 0.01） between the mean values before and after treatment for the degree of weakness / erection pain （7.1±1.6 vs 2.0±1.0）；（8.2±3.2 vs 16.0±5.1） before and after IIEF-5 treatment， respectively （P < 0.01），Pre- and post-treatment of PCDDU measured mean plaque size was 0.23（0.09~0.54）cm² vs 0.23（0.09~0.54）cm²，with no statistically different change in improvement value （P = 0.189）. Four cases had no penile camptodactyly， Before electrical stimulation， 50 （92.6%） patients had different degrees of penile curvature deformity， and there was no change in the improvement of the contrast bending angle before and after treatment （P >0.05）. The comparison of TMT images before and after treatment with visual precision electrophysiology diagnosis suggested that temperature change >1.5℃ in the whole body and penile and bilateral inguinal regions， etc. could be considered effective electrical stimulation treatment. There were no recurrences of induration， increased pain and penile curvature at 3~10 months follow-up， and no patient required subsequent surgery. ConclusionThe results of this study show that visualizing the electrophysiological diagnosis situation to set local and holistic combined treatment parameters， and treating PD by means of percutaneous low-frequency electrical stimulation at meridian and neuromuscular acupoints of traditional Chinese medicine could achieve good safety and efficacy， especially in the early stage，which has a clear effect on pain treatment， thus opening new avenues for PD treatment.

Objective To investigate the distribution characteristics of gallbladder diseases in children with hepatic alveolar echinococcosis, and to analyze the related factors for hepatic alveolar echinococcosis and gallbladder diseases. Methods The clinical data of hepatic alveolar echinococcosis patients under 18 years were collected in Qinghai Provincial People’s Hospital-from January 2012 to December 2017, and the gallbladder-related complications in the surgically treated patients with hepatic al-veolar echinococcosis were analyzed. Results The clinical data of 51 child patients with hepatic alveolar echinococcosis were collected and analyzed. According to the PNM classification criteria of WHO, P1, P2 and P3 in the 51 patients accounted for 37.25% (19/51), 41.18% (21/51) and 19.60% (10/51), respectively. According to the diagnostic criteria (WS 257–2006) of China for echinococcosis, the patients of infiltration type, calcification type and liquefaction cavitary type accounted for 66.67% (34/51), 21.57% (11/51) and 11.76% (6/51), respectively. Among the 51 patients, 78.43% (40/51) of the patients had clinical symptoms of biliary tract disease, and 58.82% (30/51) had gallbladder-related complications. The operations were performed on 40 patients, and 77.50% (31/40) of them had the postoperative complications. The results of binary multivariate logistic regression analysis showed that the clinical image classification, the liver segment distribution, size, location and number of lesions of hepatic alveolar echinococcosis were important correlative factors for the occurrence of gallbladder complications in hepatic alveolar echinococcosispatients. Conclusions The incidence of complications related to gallbladder diseases is higher in the children with hepatic alveolar echinococcosis in Qinghai Province, and it has great influence on the operation mode and the occurrence and prognosis of postoperative complications. The early diagnosis and treatment of alveolar echinococcosis in children is particularly important.

Objective To investigate the postoperative complications of ex vivo liver resection combined with autologous liver transplantation in the treatment of end-stage hepatic alveolar echinococcosis at high altitude and related prevention and treatment strategies. Methods Surgical data and follow-up data were collected from 11 patients with end-stage hepatic alveolar echinococcosis who underwent autologous liver transplantation in Qinghai People's Hospital from January 2013 to March 2019, and intraoperative and postoperative conditions were analyzed. Results All 11 patients underwent autologous liver transplantation successfully, without intraoperative death, among whom 2(18.18%) underwent hemi-extracorporeal hepatectomy and 9 (81.82%) underwent total extracorporeal hepatectomy. For the reconstruction of the retrohepatic inferior vena cava, 2 patients (18.18%) underwent reconstruction with the autologous great saphenous vein, 4 patients (36.36%) underwent reconstruction with artificial vessels, and the autologous retrohepatic inferior vena cava was preserved in 5 patients (45.45%). For biliary reconstruction, 8 patients (72.73%) underwent choledochoenterostomy and 3 (27.27%) underwent choledochocholedochostomy. The main postoperative complications of the 11 patients included bleeding in 2 patients (18.18%), bile leakage and abdominal infection in 4 patients (36.36%), bilioenteric anastomotic stenosis in 1 patient (9.09%), thrombus in 2 patients (18.18%), pulmonary infection and pleural effusion in 2 patients (18.18%), and echinococcosis recurrence in 1 patient (9.09%). Of all 11 patients, 2 (18.18%) died during the perioperative period, and the other 9 patients (81.82%) were improved and discharged. Conclusion Bleeding, biliary complications, and infection are the main causes of death in patients undergoing autologous liver transplantation at high altitude. An accurate understanding of surgical indication, careful multidisciplinary evaluation before surgery, superb operation during surgery, standardized surgical procedures, and fine perioperative management are the key to reducing perioperative mortality, avoiding and reducing postoperative complications, and achieving good long-term survival in patients undergoing autologous liver transplantation.

High throughput sequencing technology is also called Next Generation Sequencing (NGS), which can sequence hundreds and thousands sequences in different samples at the same time. In the present study, the culture-independent high throughput sequencing technology was applied to sequence the fungi metagenomic DNA of the fungal internal transcribed spacer 1(ITS 1) in the root of Sinopodophyllum hexandrum. Sequencing data suggested that after the quality control, 22 565 reads were remained. Cluster similarity analysis was done based on 97% sequence similarity, which obtained 517 OTUs for the three samples (LD1, LD2 and LD3). All the fungi which identified from all the reads of OTUs based on 0.8 classification thresholds using the software of RDP classifier were classified as 13 classes, 35 orders, 44 family, 55 genera. Among these genera, the genus of Tetracladium was the dominant genera in all samples(35.49%, 68.55% and 12.96%).The Shannon's diversity indices and the Simpson indices of the endophytic fungi in the samples ranged from 1.75-2.92, 0.11-0.32, respectively.This is the first time for applying high through put sequencing technol-ogyto analyze the community composition and diversity of endophytic fungi in the medicinal plant, and the results showed that there were hyper diver sity and high community composition complexity of endophytic fungi in the root of S. hexandrum. It is also proved that the high through put sequencing technology has great advantage for analyzing ecommunity composition and diversity of endophtye in the plant.

OBJECTIVE： To establish the qualitative and quantitative control method of Tibetan medicine Thlaspi semen. METHODS： TLC and HPLC method were used to identify and determine flavonoids isovitexin， swertisin and glucosinolates sinigrin from 15 batches of T. semen. The stationary phases identified by TLC of flavonoids and glucosinolates were polyamide film and high performance silica gel GF254. The developing agents were trichloromethane-methanol-glacial acetic acid （11 ∶ 1 ∶ 1，V/V/V） and ethyl acetate-methanol- triethylamine （4 ∶ 5 ∶ 0.5，V/V/V）. In chromatogram condition of content determination of isovitexin and swertisin， the separation was performed on CAPCELL PAK MGⅡ C18 column with mobile phase composed of acetonitrile-0.4％ glacial acetic acid solution （gradient elution） at the flow rate of 1.0 mL/min. The detection wavelength was set at 336 nm. In chromatogram condition of content determination of sinigrin， the separation was performed on CAPCELL PAK MGⅡ C18 column with mobile phase composed of acetonitrile-0.02 mol/L tetrabutylammonium hydrogen sulfate （15 ∶ 85，V/V，pH 6） at the flow rate of 1.0 mL/min. The detection wavelength was set at 227 nm. RESULTS： In TLC identification chromatogram， spots corresponding to isovitexin， swertisin and sinigrin control were detected in test samples. The linear ranges of isovitexin， swertisin and sinigrin were 1.26-79.00， 1.21-75.38， 12.80-640.00 μg/mL， respectively （all r≥0.999 5）. The limits of detection （LODs） were 0.09， 0.12， 0.15 μg/mL， and limits of quantitation （LOQs） were 0.39， 0.43， 0.54 μg/mL， respectively. RSDs of precision， stability （24 h） and reproducibility tests were all lower than 2.0％（n＝6）. The recoveries were 99.1％， 97.0％ and 98.1％， and RSDs were 1.9％， 1.8％， 1.8％（n＝6），respectively. The contents of isovitexin， swertisin and sinigrin in 15 batches of T. semen were 0.013-0.090， 0.020-0.130 and 18.92-40.75 mg/g， respectively. CONCLUSIONS： Established quality control method is simple， reproducible and stable， and can be used for the quality control of Tibetan medicine T. semen.

The hepatic echinococcosis is an anthropozoonosis and caused by the larva of Echinococcus. The main pathogenic type of Echinococcus in China is E. granulosus and E. multilocularis, which cause cystic echinococcosis and alveolar echinococcosis respectively. At present, the treatment of hepatic echinococcosis has made great progress, but there are still some difficulties in the treatment of complex echinococcosis, especially of the cases existing one or more complications, and the focus of infection encroaching the hepatic portal, important vessels and bile vessel. This paper based on the literature reports and clinical experiences in recent years, puts forward the surgical treatment strategy for complex hepatic echinococcosis.

Based on the results of previous data mining,the mechanism of high frequency use of Tibetan medicine in the treatment of high altitude polycythemia(HAPC) was analyzed in this study by network pharmacology. The author obtained the high frequency use data on Tibetan medicine Terminalia chebula,Aucklandia lappa,Crocus sativus and Myristica fragrans for the treatment of HAPC by data mining in the previous period. The first five main active ingredients of each high frequency Tibetan medicine were screened out by reviewing comprehensive literature and TCMSP database. The potential targets of each medicine were screened by PharmMapper and Drug Bank database,and then the targets were imported into MAS 3. 0 database to obtain the corresponding path information. The KEGG database was used for path annotation and GO function enrichment analysis. Finally,Cystoscope 3. 4. 0 software was used to construct " compound-target-path" network for four high-frequency Tibetan medicines. Among them,the target points of four herbs related to HAPC were 16(T. chebula),20(A. lappa),20(C. sativus),and 15(M. fragrans). The common target points included BHMT,F2,ADH5,AKR1 C2,GSK3 B,INSR and PDE4 B,involving pathways related to T. chebula(17),A. lappa(17),C. sativus(24) and M. fragrans(14),and the common pathway was metabolism of xenobiotics by cytochrome P450. The results showed that high-frequency Tibetan medicine had common pathways and targets in treating HAPC,such as T. chebula,A. lappa,C. sativus and M. fragrans.The medicines could reduce hemoglobin and enhance immunity by mediating cell proliferation and oxidative stress,exerting anti-inflammatory effects and participating in regulating blood vessels,showing therapeutic effects for HAPC. In this study,the multi-component,multi-target and multi-pathway mechanism of Tibetan medicine in preventing and treating HAPC was analyzed from the information level,providing a useful reference for further study of Tibetan medicine in preventing and treating plateau diseases from the multi-dimensional perspective.
Data Mining ; Glycogen Synthase Kinase 3 ; Humans ; Medicine, Chinese Traditional ; Medicine, Tibetan Traditional ; Polycythemia

AIMTo study the influence of acetylcholine (ACh) on nicotinic receptor(N receptor) beta-subunit of the gastric epithelia and the gastric adenocarcinoma cells, and the difference of both cells.

METHODSImmunohistochemistry method was used to examine the number, number density and surface density of N receptor beta-subunit in both cells cultured in vitro.

RESULTSThe number and number density of N receptor beta-subunit in the gastric adenocarcinoma cells were much more than that in the gastric epithelia (P < 0.05). But surface density of N receptor beta-subunit in the gastric adenocarcinoma cells were lower than that in the gastric epithelia (P < 0.05). ACh at 10(6) mol/L could increase the number, number density and surface density of N receptor beta-subunit in the gastric epithelia (P < 0.01). The increase effect could not be blocked by atropine. ACh had no effect on N receptor beta-subunit in the gastric adenocarcinoma cells.

CONCLUSIONACh at low concentration initiates N receptor desensitization in the gastric epithelia. ACh has no effect on sensitivity of N receptor beta-subunit in the gastric adenocarcinoma cells.

Acetylcholine ; pharmacology ; Adenocarcinoma ; metabolism ; Cells, Cultured ; Epithelial Cells ; drug effects ; Gastric Mucosa ; cytology ; Humans ; Receptors, Nicotinic ; metabolism ; Stomach Neoplasms ; metabolism ; Tumor Cells, Cultured