Objective To evaluate the complications after trans-vaginal mesh-augmented pelvic floor reconstruction in treatment of pelvic organ prolapse (POP).MethodsFrom February 2007 to October 2009,vaginal mesh procedures were performed on 91 women with POP stage Ⅲ-Ⅳ in Pekiug University Third Hospital.The operative complications were studied.Results Ninety patients underwent successful surgery among 91 patients.Follow-up rate was 94％ (85/90) at a median follow-up of 28.4 ( 15 -44) months.One patient underwent intraoperative organ injuries,and 10 patients had postoperation mesh-related complications.The rate of mesh-related complications was 2％ ( 2/85 ),2％ ( 2/85 ),4％ ( 3/85 ),4％ ( 3/85 ) on 6,6 - 12,12 -24 and more than 24 months following up,respectively.Seven patients underwent conservative treatment and the symptoms were improved.Three patients underwent the second surgery,and the symptoms were cured or relieved.Conclusion The incidence of mesh-related complications was low,and interventions were effective in vaginal mesh procedure.

Objective To evaluate the effects of silicone pessary treatment on relieving the symptoms and improving the life quality of the pelvic organ prolapse patients.Methods From November 2005 to March 2009,33 pelvic organ prolapse (POP-Q stage Ⅲ～Ⅳ) patients received silicone pessary coneervative treatment were followed up and required to complete the Pelvic Floor Distress Inventory-20 (PFDI-20) before and after initiating pessary treatment.Results 31 of 33(93.94%) patients finished the follow-up completely.23 of 31(74.19%) patients continually used the pessary.The follow up time was 3 to 17 (10.04±2.57) months.27 patients completed the PFDI-20 questionnaires.Before silicone pessary treatment, PFDI20 total score,POPDI6 (Pelvic organ prolapse distress inventory),CARDI8 (colorectal anal distress inventory 8) and UDI6 (urinary distress inventory 6) scores were (54.16±36.12),(27.78±17.30),(0.61±1.01) and (25.77± 24.10),respectively.After the treatment of pessary,the scores decreased to (20.20±25.98), (4.48±5.88), (0.45±0.84) and (15.28± 21.53),respectively.Except for CARDI8,the PFDI scores decreased significantly after the pessary treatment (P＜0.05).Conclusion Silicone pessary is a viable noninvasive treatment for pelvic organ prolapse.It could relieve the symptoms and improve the life quality of protrusion and voiding dysfunction patients.

Objective To explore the polysomnography(PSG) characteristice of obstructive sleep apnea hypopnea syndrome(OS-AHS) and primary snoring(PS) in children and clinical value of PSG in children with sleep disorders. Methods We analyzed 74 children with OSAHS and 62 with PS, every patient being monitored with PSG for 7 hours at night for 16 parameters, including apnea hypopnea index(AHI), periodic leg movement index(PLMI),and the lowest oxygen saturation(LSaQ2) etc. The parameters of the 2 groups were comparaed. Results Comparaed with PS group, there was statistically significant difference in parameters such as PLMI, AHI,LSaQ2,the moderate oxygen saturation(MSaO2).AHI in non- rapid eye movement (NREM)(P

Objective To assess the influence of concentrations of sucrose on Streptococcus tautens (S. mutans) gbpC expression. Methods Total RNA was extracted from S. mutans after cultured in 0.5%, 1.0%, 5.0% sucrose and then reversely transcripted to cDNA. By TaqMan RT-RCR technique, we checked gbpC expression. Results Compared with 0.5% sucrose, 1.0% sucrose significantly upregulated gbpC expression(P<0.05); gbpC expression of more-adherent S. mutans strains was higher than that of less-adherent strains, Conclusion The upregulation of gbpC expression by sucrose may be one of the mechanisms underlying the increased adherence; There might be some correlation between gbpC expression andS. mutans adherence.

Objective To provide references for building the medical rehabilitation system in China by learning the progress and compliance of rehabilitation departments construction at tertiary hospitals. Methods Comparative and quantitative methods were used for dynamic analysis qualitative interview to learn the index compliance of the hospitals in question in 201 1-2012.Results Compared with 201 1, average days of stay of the rehabilitation departments declined in general,yet with insufficient therapists;introduction of early rehabilitation intervention was but 57.1%,and the functional assessment rate of rehabilitation service was less than satisfactory.Conclusion Lack of manpower,varying levels of medical rehabilitation services,and neglect for functional assessment were found to be the main problems in construction of medical rehabilitation departments for the time being.

Human proximal tubule epithelial cell line,HK-2 cells,were cultured with various concentrations of insulin for 48 h.Human urate transporter (hUAT) mRNA was detected by realtime quantitative PCR.hUAT mRNA levels were down-regulated by insulin (5,25,125,500 μIU/ml)in a dose-dependent manner (relative expression median were 0.95,0.40,0.24,and 0.23).In vitro,the expression of hUAT mRNA in HK-2 cells is associated with the concentration of insulin.

Objective To investigate the effect of different cryopreservation time on energy metabolism and reperfusion injury in rat to rat liver transplantation and the mechanism of liver function recovery in early period after operation.Methods The cryopreservation time of donor livers from 90 Wistar rats were 30 min,6 or 12 h in 4 ℃ UW solution.Then orthotopic liver transplantation were performed in another 90 Wistar rats.Another 6 rats served as normal controls.At 12 h,24 h,3 d,5 d,7 d after portal vein reperfusion,blood and liver tissue were obtained to determine the levels of ALT,AST,SOD,ATPase and ATP,and the pathologic changes of liver tissue were observed.Results At 12 h after operation,the levels of ALT and AST were significantly higher(P

Objective:To analyze the correlation factors between peripapillary duodenal diverticulum (PDD) and choledochectasia by CT scan.Methods:The clinical data of 220 patients with duodenal diverticulum detected by multi-slice spiral CT scan and confirmed by gastrointestinal angiography or endoscopic retrograde cholangiopancreatography (ERCP) in Dahua Hospital, Xuhui District of Shanghai City were retrospectively analyzed. The correlation of the PDD, the contact of common bile duct (CBD), length of contact and exudation with choledochectasia in patients with PDD were analyzed.Results:A total of 236 duodenal diverticulum were found in 220 patients. Among them, there were 152 PDD, 41 diverticulum located superior to the duodenal papilla, 28 diverticulum located inferior to the duodenal papilla, 3 diverticulum located lateral to the duodenal papilla, and 12 diverticulumlocated in the horizontal portion. The incidence of choledochectasia in patients with PDD contacted with CBD was significantly higher than that in patients with PDD not contacted with CBD: 59.35% (73/123) vs. 37.93% (11/29), and there was statistical difference ( P<0.05); the incidence of choledochectasia in patients with contact length of PDD and CBD ≥1.5 cm was significantly higher than that in patients without contact of PDD and CBD and patients with contact length of PDD and CBD <1.5 cm: 82.43% (61/74) vs. 24.49% (12/49) and 37.93% (11/29), and there was statistical difference ( P<0.05); the incidence of choledochectasia in PDD patients with exudation was significantly higher than that in PDD patients without exudation: 10/11 vs. 52.48% (74/141), and there was statistical difference ( P<0.05). Conclusions:The patients with contact length of PDD and CBD ≥1.5 cm and patients with PDD combined with exudation could be prone to choledochectasia.

Objective To investigate the CT features and different risk CT findings of intestinal stromal tumor. Methods The CT imaging data of 25 cases of intestinal stromal tumor confirmed by pathology and compared with operative and pathologic findings were retrospectively studied. Analyzing the CT features based on Histopathologieal classification of the different risk groups and using chi-square test to compare the differences. Results There were 9 cases which tumors originated from the jejunum, and 13 cases from ileum, only 3 cases from duodenum. Among them, 2 cases were submucosal type, 13 cases were intramural type, and 10 cases were subserous type. The pathologic patterns of different risk which included high-risk, intermediated-risk, low-risk, and very low-risk were 12 cases, 7 cases, 5 cases and 1 cases respectively. A typical CT manifestations of intestinal stromal tumors were a outward growth of irregular or round soft tissue mass originated in small intestine which had clear boundary and the non-homogeneous density, which corresponding to necrosis, cystic change, mucoid degeneration and sinus or cavity. Mesenteric fat invaded by tumor showed high-density lines or points shape. The Enhancement of lesion was obvious and not homogeneous which showed little change in peak of enhancement between arterial phase and venous phase. Intestinal stromal tumors took 5 cm as the boundary which including different size, shape, density, and appearance vessel-like artery shadow at arterial phase between different risk groups(low, very low-risk group and intermediated, high-risk group) were statistically different (P ＜0.05), while enhanced degree without significant difference (P ＞ 0.05). Conclusion CT findings of small intestine stromal tumor have characteristics and CT features have significant difference between different risk groups. These features of more than 5 cm in diameter, non-homogeneous density, irregular shape and chaos appearance like vascular enhancement are showed in intermediated-high-risk group.

Objective To investigate the value of contrast enhanced ultrasonography (CEUS) in the treatment of small hepatic malignancies with radiofrequency ablation(RFA). Methods Seventy patients with 104 pathologically proved malignant liver lesions treated by RFA (size 0.7 -2.7 cm) were divided into 2 groups including CEUS group and control group. In CEUS group,39 patients(54 lesions) were treated with RFA guided by CEUS, while in control group 31 patients (50 lesions) were guided by conventional ultrasonography. There was no significant difference between clinical data of the two groups. Results Seventeen tumors(among them,12 lesions were less than 1.5 cm in diameter) in 13 patients showed more clearly on CEUS image than on conventional ultrasonography image (31.5% ) in CEUS group. The tumor necrosis rate at one month after RFA was 100% in CEUS group,and 92% in control group ( P = 0. 034).The number of RFA sessions per tumor was 1.00± 0.00 in CEUS group,and 1.08 ± 0.27 in control group (P = 0.000). Local tumor progression rate was 0 in CEUS group and 4% in control group ( P = 0. 138)during the period of 8 - 52 months follow-up (average 21 months). Conclusions CEUS can not only improve the display of small hepatic malignancies but also provide precise guidance in contrast with conventional ultrasonography. Compared with control group, RFA of small hepatic malignancies guided by CEUS lower the number of RFA sessions, enhance the tumor necrosis rate, decrease post-RFA local progression and therefore it has extensive clinical value.