Objective To evaluate status of female pelvic floor function and sexual life after total hysterectomy.Methods From March 2001 to January 2004,92 patients with undergoing hysterectomy due to benign gynecological diseases were enrolled in this study.They were followed up at outpatient department,including pelvic examination,filling in female sexual quality questionnaire,pelvic floor distress inventory short form 20 ( PFDI-20 ),pelvic floor distress impact questionnaire short form 7 ( PFIQ-7 ) and quality of sexual life of chinese women questionnaire.Results At 6 years after total hysterectomy,it was observed that 7 cases (7/92,7.6％ ) were pelvic organ prolapse and 62 cases (62/92,67.4％ ) were urinary incontinence.A median score of PFDI-20 were 4.67.A median score of PFIQ-7 were 0.Symptoms of pelvic floor dysfunction concentrated in lower urinary tract ( 58 cases with cough leak,32 cases with spot urine leakage,31 cases with frequent micturition,24 cases with urgent urination)and bowel symptoms (26 cases with constipation,24 cases with defecation urgency,21 cases without fully drained stool).In the 68 patients filling in female sexual quality questionnaire,an average score were (127 ± 20) points.Female sexual quality questionnaire score,sexual satisfaction,sexual communication and adjustment,sexual response and sexual body image were positively correlated with the patients' income ( r = 0.432,P = 0.007 ; r = 0.356,P =0.028;r=0.475,P=0.003;r=0.421,P=0.009;r=0.324,P=0.047).Conclusions Hysterectomy may have long-term effect on female pelvic floor function and sexual life.Quality of sexual life in those patients was positively correlated with income.

Objective To detect the expression of type Ⅰ collagen, type Ⅲ collagen, prolyl-4-hydroxylases (PH4) and matrix metalloproteinase 1 (MMP-1) in sacral ligament fibroblasts under stress, to understand the collagen synthesis and metabolism in stress situations change. Methods Eight patients who underwent abdominal hysterectomy for uterine benign disease were enrolled in this study. Primary sacral ligament fibroblasts were isolated by explant. After mechanical loading, gene expression of type Ⅰ , Ⅲ collagen, PH4 and MMP-1 were measured. Results Stress of 8% continuing for 24 hours, collagen Ⅰ (1. 13 ± 0.24), collagen Ⅲ (1.05 ± 0. 31) mRNA expression and PH4 expression (1.11 ± 0. 31) compared with static groups (1) showed increasing trends;when the stress were 4% and 12%, collagen Ⅰ (0. 86 ± 0. 26 and 0. 85 ± 0. 25), collagen Ⅲ showed increasing trends (0. 74 ± 0. 29 and 0. 83 ± 0. 38) mRNA expression were decreased. After removal of the stress, in the stress of 4% for 1 hour, collagen Ⅰ (0.79±0.40, 0.97±0.24 and 1.46 ±0.75), collagen Ⅲ (0.86±0.40, 0.99±0.60 and 1.59±0.82) and PH4 (1.11 ±0. 51, 1.17 ±0. 54 and 1.37 ±0. 39) mRNA expression increased gradually. In 8% stress group, collagen Ⅰ mRNA expression (1.16 ± 0. 62, 1.01 ± 0. 51 and 1.05 ± 0. 80) reached the peak in day 1, and collagen Ⅲ (0.99 ±0.69, 1.59 ±0.55 and 1.03 ±0.91) and PH4 (1.05 ±0.31, 1.07 ±0. 80 and 0. 85 ±0. 31) mRNA expression reached the peak in day 2, then decreased. 4% and 8% of the stress with time after the change, MMP-1 mRNA expression have peaked at day 1. Conclusions Moderate stress could contribute to pelvic floor collagen synthesis, too much or too little stress is not conducive to the synthesis of collagen. Collagen Ⅰ and collagen Ⅲ on the stress response may be different, the former have faster reaction than the latter. PH4 were involved in the synthesis of collagen, while MMP-1 may play a role in collagen degradation.

Objective To explore the effect of large group psychological intervention mode on coping style of patients with breast cancer.Methods 420 patients with breast cancer participated in the Rukang Salon, a large group psychological intervention, were investigated with the Simplified Coping Style Questionnaire and self-administrated questionnaire before and after intervention, respectively. Results The score of coping style of the patients significantly improved after the intervention (P<0.01). Conclusion It is effective in the large group psychological intervention on coping style of patients with breast cancer, more often in positive coping style and less in negative coping style.

Objective To investigate clinical value of pubococcygeal line (PCL) determined by dynamic magnetic resonance imaging (MRI) used in evaluating pelvic organ prolapse (POP), and investigate the relationship of pelvic organ prolapse quantitation (POP-Q) stage and pubococcygeal line (PCL) for the patient with POP. Methods Twenty patients with POP were evaluated by POP-Q stage and pelvic dynamic MRI examination simultaneously. Sagittal MRI images were acquired at rest and during maximal Valsalva using a fast gradient echo sequence two-dimensional fast low angle shot (FLASH) T1weighted image. The degree of prolapsed anterior vaginal wall, uterus and posterior vaginal wall were measured by PCL and compared with POP-Q system. Results There were 20 cases with cystocel diagnosed by POP-Q staging system, in which bladder neck or bladder base of 17 patients were under the PCL during maximum Valsalva. The concordance rate was 85% (17/20) between PCL and POP-Q stage. There were 19cases with rectocele diagnosed by POP-Q, in which the anorectal junction of 4 patients' PCL descent below more than 2. 5 cm. The concordance rate was 4/19 between PCL and POP-Q stage. There were 14 cases with uterine prolapse diagnosed by POP-Q staging system, in which uterine cervix of all descent below PCL. The concordance rate was 14/14 between PCL and POP-Q stage. However, it was noted that 5 cases did not reach POP-Q staging and their lowest uteri cervix were below or above PCL but less than 1 cm at maximal Valsalva. Conclusions Compared with POP-Q staging system, the reference line of PCL determined by dynamic MRI could diagnose uterine prolapse accurately and anterior vaginal wall with greater clinical value,however it was limited in diagnosing posterior vaginal wall prolapse effectively. Therefore, the clinical value of PCL should be further studied for evaluating POP.

Objective To analyze the sensitivity and specificity of several volume parameters regarding volume responsiveness.The studied volume parameters include pulmonary artery obstruc-tion pressure (PAOP),central venous pressure (CVP),right ventricular end-diastolic volume (RV-EDV)measured by Swan-Ganz pulmonary artery catheter and left ventricular end-diastolic area (LVEDA),inferior vena cava diameter (IVC)measured by transesophageal echocardiography (TEE). Methods Twelve patients with ASA Ⅱ or Ⅲ,scheduled for coronary artery bypass grafting were studied.After anesthesia induction,the TEE probe was put into the esophagus and Swan-Ganz cathe-ter was placed in right internal jugular venous.Measurements were made at the time before cutting the skin (T0 ),20 min after divorcing from cardiopulmonary bypass or finishing vascular anastomosis in off-pump surgery(T1 ),10 min after rapid infusion (T2 )and 30 min after rapid infusion (T3 ),re-spectively.Results The values of PAOP,IVC,LVEDA,COLVOT at time T2 increased significantly compared to those at time T1 (P <0.01).No obvious correlation (r=-0.298 5、r=-0.091 8、r=-0.243 6)was observed between △CVP、△PAOP、△RVEDV and △COLVOT (the difference between T2 and T1 );Meanwhile,△IVC and △LVEDA were well correlated to △COLVOT (r= 0.445 0、r=0.612 0).Using more than 1 5% change of COLVOT after volume expansion as definition of positive re-sponse,the areas under the receiver operating characteristic curves of CVP,PAOP,RVEDV,IVC and LVEDA were 0.389 (95% CI 0.035-0.743 ),0.458 (95% CI 0.109-0.807 ),0.333 (95% CI 0-0.671 ), 0.903 (95% CI 0.701-1.000 ) and 0.889 (95% CI 0.661-1.000 ), respectively. Conclusion PAOP,IVC,LVEDA,CO are more sensitive to the change of volume;while CVP and RVEDV have weak responses to volume changes.This indicates that IVC and RVEDA have more ad-vantage to estimate cardiac output increase and guide volume therapy.

Objective To evaluate the changes in the right ventricular systolic and diastolic function during the early period after cardiopulmonary bypass (CPB) in patients undergoing coronary artery bypass grafting (CABG).Methods Eighteen ASA physical status Ⅱ or Ⅲ patients of both sexes,with coronary heart disease (NYHA Ⅱ or Ⅲ),aged 50-80 yr,weighing 51-96 kg,with left ventricular ejection fraction≥50％,scheduled for elective CABG under CPB,were enrolled in this study.Before splitting of sternum and at 5 min after termination of CPB,the parameters of hemodynamics,cardiac output (CO)and variables of right ventricular function (using transesophageal echocardiography) including tricuspid annular plane systolic excursion (TAPSE),right ventricular fractional area change (RVFAC),tricuspid annular peak velocity during isovolumic contraction (IVV),peak velocity during ejection phases (St),early diastolic peak velocity (Et),late diastolic peak velocity (At),E/Et ratio and Et/At ratio were recorded.Results Compared with the baseline value before splitting of sternum,TAPSE,IVV,St,RVFAC,CO,E,Et and At were significantly increased,and no significant change was found in the parameters of hemodynamics and E/Et and Et/At ratios at 5 min after termination of CPB.Conclusion For the patients undergoing CABG,the right ventricular systolic function is significantly enhanced,and there is no obvious improvement in the right ventricular diastolic function during the early period after CPB.

Objective To evaluate the effect of sevoflurane preconditioning on the left ventricular function in patients undergoing coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB).Methods Thirty ASA physical status Ⅱ or Ⅲ patients,aged 42-70 yr,with body height 152-181 cm,weighing 43-78 kg,scheduled for elective CABG under CPB,were randomly divided into 2 groups (n =15 each) using a random number table:control group (group C) and sevoflurane preconditioning group (group SP).Group SP inhaled sevoflurane with the end-tidal concentration corresponding to 1 MAC for 30 min after endotracheal intubation.Before sevoflurane preconditioning (T0) and at 60 min after termination of CPB (T1),mean arterial pressure (MAP),stroke volume index (SVI),pulmonary artery obstruction pressure and the TEE variables including left ventricular ejection fraction (LVEF),peak E wave velocity (E),systolic wave velocity (S),and diastolic wave velocity (D),and low propagation velocity (Vp) were recorded.S/D ratio and E/Vp ratio were calculated.Extubation time and duration of ICU stay were also recorded.Results Compared with the baseline value at T0,HR was significantly increased at T1 (P ＜ 0.05 or 0.01),and no significant change was found in the other parameters of the left ventricle function in the two groups (P ＞ 0.05).There was no significant difference in the parameters of the left ventricle function,extubation time and duration of ICU stay between SP group and C group (P ＞ 0.05).Conclusion Preconditioning with inhalation of sevoflurane with the end-tidal concentration corresponding to 1 MAC before CPB does not produce myocardial protection in terms of the left ventricular function or exerts little effect on the short-term outcomes.

Objective To evaluate the changes in early left ventricular myocardial diastolic function after cardiopulmonary bypass (CPB) in the patients undergoing mitral valve replacement.Methods Twenty patients of both sexes,aged 40-70 yr,of ASA physical status Ⅱ or Ⅲ (NYHA Ⅱ or Ⅲ),with left ventricular ejection fraction (LVEF) ≥ 45 ％,scheduled for elective mitral valve replacement with CPB,were enrolled in the study.Global and regional left ventricular diastolic function was measured by using TEE.After splitting of sternum and at 30 and 90 min after termination of CPB,HR,mean arterial pressure,central venous pressure,cardiac index,LVEF,early diastolic transmitral velocity (E),early diastolic tissue velocity (Ea),right ventricular early myocardial velocity (Em) and right ventricular late myocardial velocity (Am).E/Ea and Em/Am ratios were calculated.Results There was no significant difference in the parameters of hemodynamics and left ventricular diastolic function at each time point before and after CPB.LVEF was greater than 50％ and E/Ea ratio was greater than 20 at each time point in the patients.Conclusion There is no further damage to the early left ventricular myocardial diastolic function after CPB in the patients undergoing mitral valve replacement.

Objective To explore the therapeutic effects of the folic acid,vitaminB12on Helicobacter pylori(Hp)-negative patients with chronic atrophic gastritis(CAG).Methods we enrolled 67 patients who were diagnosed as CAG of Hp-negative from the First Affiliated Hospital of Xi′an Medical University.The patients were divided into control group and treatment group. Control group were given routine treatment(pepsin tablets), treatment group were given routine treatment and folic acid,vitaminB12. Then respective compared the folic acid, vitaminB12,clinical symptoms scores,gastroscopic scores and histopathological scores in the two groups before treatment and after treatment of 12 weeks and 24 weeks.Results After treatment of 12 weeks,there were signifi-cant differences in the gastroscopic scores and histopathological scores(activity),folic acid,vitaminB12status (P<0.05);no significant difference existed in clinical symptoms scores,histopathological scores(chronic inflam-mation,atrophic,intestinal metaplasia)between the two groups(P > 0.05). After treatment of 24 weeks,the differences of clinical symptoms scores,gastroscopic scores,histopathological scores(chronic inflammation, activity,atrophic,intestinal metaplasia)and folic acid,vitaminB12status were significant(P < 0.05);no significant difference existed in histopathological scores(intestinal metaplasia)between the two groups(P >0.05). Conclusion Folic acid and vitaminB12can improve the clinical symptoms and histological situation of the Hp-negative patients with CAG,worthy of further popularizing in clinic.

Objective:To study the inhibitory effect and anti-cancer mechanisms of adenovirus-mediated ING4 gene on the MG-63 osteosarcoma xenografts in nude mice.Methods:Ad-ING4 was transfected into QBI-293 cells and harvested.15 nude mice of the subcutaneous tumor models were established with MG-63 osteosarcoma cells and were randomly divided into PBS,Ad-GFP and Ad-ING4 groups.Then PBS(100 μl),Ad-GFP(100 μl,10~9pfu/ml) and Ad-ING4 (100 μl,10~9pfu/ml) for each one were given respectively QOD for 5 times,with intratumor injections.Tumor volume changes were monitored;and the 15 mice were sacrificed 2 weeks after treatment,the tumors were removed,weighed and ratios of tumor-suppression were calculated.The morphological changes of apoptotic tumor cells were observed under microscope.Bcl-2,Bax,Caspase-3,VEGF,CD34 expression was tested by immumohistochemistry.Results:High titer(10~9pfu/ml)adenoviral vector of ING4 gene were obtained.In nude mice bearing MG-63 osteosarcoma xenografts,the growth of MG-63 tumors treated by intratumoral injecting of Ad-ING4 was significantly suppressed,compared with PBS group and Ad-GFP group.The ratios of tumor weight-suppression of Ad-ING4 group was 59.3%(P＜0.05).Immumohistochemistry displayed that the expression of Bax,Caspase-3 was up-regulated and the expression of Bcl-2,VEGF,CD34 was down-regulated by Ad-ING4.Conclusion:Ad-ING4 can inhibit the growth of MG-63 osteosarcoma xenografts in nude mice,which may be via activating the apoptosis pathway and inhibiting tumor angiogenesis.