Objective To discuss the clinical efficacy and complication of using polypropylene net in pelvic floor reconstruction to treat pelvic floor organ prolapsus. Method From October 2007 to May 2008,15 cases of organ prolapsus of many region defect in pelvic cavity were operated pelvic floor reconstruction, 14 cases had three regional defects,and 1 case had two regional defects. Results All the cases were punctured smoothly without hematoma and injury of blood vessel and organs. The time of operation for 15 cases ranged from 60 to 150 minutes,averaged (85.0±4.3) minutes. The amount of bleeding in operations ranged from 150 to 400 ml,averaged (200.0±0.1) ml. Fifteen cases recovered well after operation without infection.The days in hospital were 5-9 days,averaged (6.0±0.7) days. Following up 1-12 months,pelvic floor structure of all patients were normal,and interrelated symptom disappeared or improved. One case was discovered the net was eroded after 5 weeks. Conclusions Pelvic floor suspension by vagina is a micro operation to treat complicated pelvic floor organ prolapsus. It can accomplish pelvic floor reconstruction and reserve uterus simultaneously, healing efficacy is stable in short-term,but need further observation.

Objective To compare the five different methods of extration process of Curcuma Long. Methods With the content of curcumin and yield of extract as evaluation index, the best extraction process of Curcuma long L. was optimized. Results The content of curcumin extracted in 80 ℃ ethanol immersion was higher, that was the optimum condition. Conclusion The extractive content of curcumin is higher by this process. It is easy to operate and proved to be stable and feasible.

Objective To study the effects of hypotensive resuscitation on microvascular perfusion in a clinically relevant model of uncontrolled hemorrhagic shock in pregnancy. Methods Thirty New Zealand white rabbits at 15 -25 days, pregnanal age were randomly divided into three groups; Group normal saline traditional aggressive resuscitation ( NS), traditional aggressive resuscitation in the prehospital phase with a large quantity of normal saline and Ringer's solution to maintain mean arterial pressure (MAP) at the approximately 80 mm Hg ( 1 mm Hg = 0.133 kPa) level: Group normal saline hypotensive resuscitation (NH) and group hypertonic hyperosmotic hypotension resuscitation (HHH), hypotensive resuscitation in the prehospital phase with a bolus dose of 4 ml/kg normal saline or hypertonic hydroxyl ethyl starch (10% hydroxyl ethyl starch + 7.5% NaCl), followed by Ringer's solution to maintain MAP at 60 mm Hg.Production pregnant rabbit model with hemorrhagic shock. The experiment consisted of four phases:basic phase (0 miniutes), shock phase (0- 30 miniutes), prehospital phase (30- 90 miniutes) and hospital phase (90- 180 miniutes). Measurements: (1) arteriole and venule diameter were continuously monitored by microcirculatory detecting instrument; (2) functional capillary density (FCD) of each phase was expressed by the percentage of opening capillaries segments relative to basic phase; (3) blood pH, BE PCO2, PO2 in pregnant rabbits were determined with a Medica Easy Blood Gas Analyzer. Results ( 1 )There were no significant differences among three groups in arteriole and venule diameter at baseline ( P ＞0.05 ). After hemorrhagic shock arteriole diameter were NS ( 50.8 ± 5.6) μm, NH (47.6 ± 3.7 ) μm, HHH (51.3 ±2.4)μm, respectively, with no significant differences between groups(P ＞0.05). At the end of prehospital resuscitation phase and hospital resuscitation phase, significant differences were found in arteriole diameter in group NS(52.8 ± 4.9, 56.0 ± 3.8 )μm, NH (61.3 ± 2.9, 65.4 ± 3.2 )μm and HHH group (67.0 ± 4.1,74.1 ± 4.8 )μm ( P ＜ 0.05 ); after hemorrhagic shock venule diameter were NS(79.6 ± 7.0)μm, NH (75.3 ±5.3)μm and HHH(76.2 ±5.8)μm, respectively, with no significant differences between groups(P ＞0.05 ). At the end of prehospital resuscitation phase and hospital resuscitation phase,venule diameter were NS(81.1 ± 6.7, 84.4 ±6.0)μm, NH(82.8 ± 3.3, 85.4 ±4.3) μm and HHH (86.9 ± 5.8, 89.4 ± 6.8)μm, respectively, with no significant differences between groups ( P ＞ 0.05 ). (2) The values of FCD in every groups were all 100%. After hemorrhagic shock FCD were NS(39.8 ±6.8)%, NH (43.9 ±4.0)%, HHH(44.0 ± 4.8)%, respectively, with no significant differences between groups(P ＞0.05); at the end of prehospital resuscitation phase and hospital resuscitation phase, FCD were NS(54.5 ±7.3,59.7 ±4.8)%,NH(63.1 ±5.8,70.3 ±5.6)% and HHH (80.5 ±6.9, 91.7 ±4.7)%,respectively, with significant differences between groups( P ＜ 0.05 ). (3) Blood gas parameter: the values of blood pH, BE, PO2, PCO2 in pregnant rabbits in all groups were within normal bounds at basic phase. Shock phase induced typical hyperventilation in all groups, with increase of arterial PO2 and decrease of PCO2; at the end of hospital resuscitation phase, there were no significant difference among the three groups in the values of blood PCO2 ( P ＞ 0.05 ); the values of blood PO2 at the hospital resuscitation phase were significantly lower in NS groups than corresponding values in the other groups (P ＜ 0.05 ). After hemorrhagic shock there was significant metabolic acidosis as shown by decrease of pH, BE; at prehospital resucitation phase, pH, BE values tended to increase in all the groups but not reach to base period. At the end of hospital resucitation phase. The pH, BE value was significantly higher in NS group than those in the other two groups( P ＜ 0.05 ) . (4) Median survival time in NS (2.1 ± 0.2) days group was significantly shorter than NH(3.0 ±0.3) days and HHH(3.6 ± 0.3) days group( P ＜ 0.05). FCD at the end of the hospital resuscitation were significantly related with survival time ( r = 0.655, P = 0.000 ). Conclusion Compared with traditional aggressive fluid resuscitation, hypotensive resuscitation reduce constriction of arterial and venule diameter, increase FCD, alleviate metabolic acidosis and improve long-term survival Hypertonic hydroxyl ethyl starch resuscitation ameliorate microcirculation without improving survival rate.

Objective To analyze the clinical data of recipients over 15 years after renal transplantation,and to find the factors that affect the long-term survival of recipients after renal transplantation.Method Before June 30,2000,326 renal transplant recipients in our hospital were collected retrospectively.The risk factors which affect the survival of kidney transplant recipients and kidney were analyzed from four dimensions.A Cox model was established to analyze these multi factors.Result Cox hazard model indicated that advanced age (P=0.010,RR =1.052),AMR (P＜0.001,RR =18.311),nonadherence (P =0.001,RR =2.854),smoking (P =0.025,RR =2.097)were the risk factors for recipients' survival.Using immunosuppressive regimen FK506 + MMF+ Pred (P =0.019,RR =0.433),or CsA + MMF + Pred (P =0.019,RR =0.413) was the protective factor for recipients' survival.Nonadherence (P＜0.001,RR =5.645),and diabetes (P＜0.001,RR =3.310) were the risk factors of grafts' survival.Using immunosuppressive regimen FK506 + MMF + Pred (P＜0.001,RR =0.236),or CsA + MMF + Pred (P =0.002,RR =0.317) was the protective factor of grafts' survival.Conclusion To enhance the long-term outcome of recipients and grafts,the individualization of immunosuppressive regiments and controlling of the chronic diseases progress by changing the unhealthy life style are cutting on edge.

Diabetic foot infection may hamper wound healing and lead to non-traumatic amputation in diabetes patients and early diagnosis and proper treatment can improve prognosis.In this review,the progress in classification,influencing factors,diagnostic methods and local treatment of diabetic foot infection is introduced.

Objective To explore the long-term efficacy of botulinum toxin type A injections on facial beauty and its long-term safety.Methods A total of 33 beauty-seekers with botulinum toxin type A treatment for more than five years were reviewed as observation group,using digital muscle palpation meter (Myoton PRO) for the determination of the orbicularis oculi muscle and masseter muscle tension (F),the muscle characteristic parameters,such as muscle hardness (S) using a homemade facial questionnaire test for satisfactory rate of beauty from both beauty-seekers and physicians.At sametime,33 normal adults that never accepted botulinum toxin injection with matched age and gender were collected as control group.The same-sex indicators were dtermined and compared with using statistic analysis t test.Results The pairwised parameters of the same sex and site were comparied between the two groups;average F and S values in the observation group were lower than those of the control group,but no statistically significant difference were observed between the two groups (P＞0.05);in the observation group,average appearance age was 7.3 years younger than the control group,and the facial shape improved significantly.Conclusions Long-term and repeated application of botulinum toxin A is able to remove crow's feet and decrease the masseter and so the injection is safe with high satisfaction to beauty-seekers.

Objective To explore the relationship among job stressors,sleep quality and psychological health of nurses.Methods 708 female nurses in a 3-A-grade general hospitals of Guangxi were chosen and asked to fill out the Nurse Job Stressors Questionnaire-Revised (NJSQ-R),Pittsburgh Sleep Quality Index (PSQI) and Symptom Checklist 90 (SCL-90).Results ① The total mean score of NJSQ-R (1.50± 0.62) and the five job stressors,including the job environment and characters (1.60±0.65),personal relation ship(1.21±0.73),the attitude of patient and their relatives(1.63±0.74),professional skill(1.38±0.71) and social status and career development(1.97±0.72) were positively related with the total mean score of SCL-90 (1.64±0.69) (r=0.32-0.50,P＜0.01)and the total score of PSQI(8.11±3.52) (r=0.28-0.35,P＜0.01).There was a positive relationship between SCL-90 and PSQI(r=0.46,P＜0.01)).② SCL-90(β=0.387,P＜ 0.01)and the job stressor of the social status and career development(β=0.120,P＜0.05)were directly sig nificantly associated with PSQI.The job stressor of job environment and characters(β=0.235,P＜0.01) and professional skill(β=0.117,P＜0.05)were indirectly associated with PSQI mediated by SCL-90.③ PSQI was directly significantly associated with SCL-90(β=0.344,＜0.01).The job stressor of the social status and career development was indirectly significantly associated with SCL-90 mediated by PSQI(β=0.113,P＜0.05).And the job stressor of job environment and characters was directly (β=0.172,P＜0.01)and indirectly (β=0.184,P＜0.01) associated with PSQI mediated by SCL-90.Conclusion The higher the job stress,the more the mental health problem,and the poor the sleep quality among nurses.Job stressors have direct or in direct influence on psychological health and sleep quality,depending on the nature of job stressors.In addition,the result suggests that a bidirectional relationship exists between sleep quality and psychological health.

The perivascular space is formed by the pia mater around the blood vessels and participates in the fluid exchange and waste clearance in the brain. The enlarged perivascular space (EPVS) indicates the disorder of brain clearance mechanism, which is closely related to the occurrence and development of a variety of clinical diseases. In recent years, there are a lot of studies on the pathogenesis and influencing factors of EPVS. This article reviews its anatomy, neuroimaging, pathogenesis, and risk factors.

A large number of studies have shown that the elevated lipoprotein (a) is a risk factor for ischemic stroke, but the specific mechanism is still unclear. Therefore, this article reviews the role of elevated lipoprotein (a) in ischemic stroke, its mechanism, and intervention measures.

Post-stroke cognitive impairment (PSCI) directly affects the outcome of patients with stroke. Enlarged perivascular spaces (EPVS) suggest the impairment of brain clearance mechanism and may affect cognitive function. More and more studies have confirmed that the presence of EPVS will aggravate PSCI. This article reviews the relationship between EPVS and PSCI.