Objective:To evaluate the feasibility of pelvic floor muscle reconstruction for women with vaginal laxity accompanied by stress urinary incontinence (SUI).Methods:A prospective cohort clinical study was conducted to collect clinical data from patients with vaginal laxity and SUI admitted to the Urogenital Reconstructive and Gender-affirming Department at the Plastic Surgery Hospital, Chinese Academy of Medical Sciences, and the Department of Urology, Third Medical Center, Chinese PLA General Hospital, from January 2019 to September 2022. Patients underwent surgical treatment for pelvic floor muscle reconstruction. The cough provocation test and the patient global impression of improvement (PGI-I) scale were utilized as objective and subjective indicators of treatment effecacy, respectively. The urinary incontinence quality of life scale (I-QOL) and the pelvic organ prolapse and urinary incontinence sexual function questionnaire 12(PISQ-12) were used to evaluate the changes in quality of life and sexual funtion. The changes in pelvic floor anatomical structure were evaluated by pelvic floor ultrasound. Data analysis was performed using SPSS version 23.0. The I-QOL and PISQ-12 scores, posterior vesicourethral angle, urethral rotation angle, and bladder neck motion before and after surgery were analyzed using paired t-test, with P<0.05 was considered statistically significant. Results:A total of 36 female patients were included, with an average age of 41.7 years (ranged 24-51 years) and an average body mass index of 23.8 kg/m 2. The average operation time was 76.2 minutes, and the average blood loss was 84.5 milliliters. After 12-27 months of postoperative follow-up, the objective and subjective cure rates were 86.1% (31/36) and 88.9% (32/36), respectively. The sexual function and quality of life of the patients were significantly improved compared with the preoperative results, and postoperative pelvic floor ultrasound results showed significant improvement. The I-QOL and PISQ-12 scores 12 months after surgery were statistically significant compared with those before surgery ( P<0.01). Postoperative pelvic floor ultrasonography revealed statistically significant differences in posterior vesicourethral angle, urethral rotation angle, and bladder neck motion during maximum Valsalva maneuver compared to preoperative data ( P<0.01). Conclusion:Pelvic floor muscle reconstruction is a safe and effective surgical method for patients with vaginal laxity combined with SUI. This procedure can significantly improve sexual quality of life and alleviates SUI symptoms, restores anatomical structure in the female pelvic floor, and enhances overall quality of life.

Objective:To evaluate the feasibility of pelvic floor muscle reconstruction for women with vaginal laxity accompanied by stress urinary incontinence (SUI).Methods:A prospective cohort clinical study was conducted to collect clinical data from patients with vaginal laxity and SUI admitted to the Urogenital Reconstructive and Gender-affirming Department at the Plastic Surgery Hospital, Chinese Academy of Medical Sciences, and the Department of Urology, Third Medical Center, Chinese PLA General Hospital, from January 2019 to September 2022. Patients underwent surgical treatment for pelvic floor muscle reconstruction. The cough provocation test and the patient global impression of improvement (PGI-I) scale were utilized as objective and subjective indicators of treatment effecacy, respectively. The urinary incontinence quality of life scale (I-QOL) and the pelvic organ prolapse and urinary incontinence sexual function questionnaire 12(PISQ-12) were used to evaluate the changes in quality of life and sexual funtion. The changes in pelvic floor anatomical structure were evaluated by pelvic floor ultrasound. Data analysis was performed using SPSS version 23.0. The I-QOL and PISQ-12 scores, posterior vesicourethral angle, urethral rotation angle, and bladder neck motion before and after surgery were analyzed using paired t-test, with P<0.05 was considered statistically significant. Results:A total of 36 female patients were included, with an average age of 41.7 years (ranged 24-51 years) and an average body mass index of 23.8 kg/m 2. The average operation time was 76.2 minutes, and the average blood loss was 84.5 milliliters. After 12-27 months of postoperative follow-up, the objective and subjective cure rates were 86.1% (31/36) and 88.9% (32/36), respectively. The sexual function and quality of life of the patients were significantly improved compared with the preoperative results, and postoperative pelvic floor ultrasound results showed significant improvement. The I-QOL and PISQ-12 scores 12 months after surgery were statistically significant compared with those before surgery ( P<0.01). Postoperative pelvic floor ultrasonography revealed statistically significant differences in posterior vesicourethral angle, urethral rotation angle, and bladder neck motion during maximum Valsalva maneuver compared to preoperative data ( P<0.01). Conclusion:Pelvic floor muscle reconstruction is a safe and effective surgical method for patients with vaginal laxity combined with SUI. This procedure can significantly improve sexual quality of life and alleviates SUI symptoms, restores anatomical structure in the female pelvic floor, and enhances overall quality of life.

新冠病毒感染疫情严重威胁着世界各国人民的生命健康。目前，对病毒感染的防治研究主要集中在抑制病毒与分子受体的结合上。AXL作为新发现的严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）受体，在协助病毒感染人体呼吸系统中发挥着重要作用，是未来临床干预的潜在靶点。本研究对已发表的单细胞测序数据进行整理和分析，发现AXL在年轻人肺细胞中的表达水平明显高于老年人。人胚肺二倍体成纤维细胞（2BS）是衰老研究的公认细胞株。本文采用2BS细胞构建复制性细胞衰老模型，发现年轻细胞中AXL的蛋白水平明显高于衰老细胞，据此推测年轻人感染的风险可能更高，需要注意防护。我们发现一种羊栖菜褐藻多糖硫酸酯组分（SFW-3）可显著下调年轻2BS细胞中AXL的表达水平，表明SFW-3具有一定的抗SARS-CoV-2感染的研究价值，同时表明2BS细胞株也可作为潜在的SARS-CoV-2体外感染模型。
Humans ; SARS-CoV-2 ; Sargassum/metabolism* ; Diploidy ; Sulfates/metabolism* ; COVID-19 ; Polysaccharides/pharmacology* ; Lung

The Wnt signaling pathway and its key component β-catenin have critical roles in the development of diseases such as tumors in mammals. However, little has been reported about involvement of the Wnt/β-catenin signaling pathway in canine mammary tumors (CMTs). The present study detected expression of 30 Wnt signaling pathway-related genes in CMTs; the results are potentially useful for molecular-based diagnosis of CMTs and the development of new targeted therapies. Significant upregulations of dickkopf-1 protein, secreted frizzled-related sequence protein 1 (SFRP1), frizzled 3, β-catenin, and lymphoid enhancer-binding factor 1 (LEF1) were detected in highly malignant CMTs compared to levels in normal mammary gland tissues; moreover, highly significant upregulation of WNT5A was observed in low malignancy CMTs. Downregulation was only detected for SFRP4 in malignant CMT samples. The subcellular location of β-catenin and cyclin D1 in 100 CMT samples was investigated via immunohistochemical analysis, and significantly increased expressions of β-catenin in cytoplasm and cyclin D1 in nuclei were revealed. Western blotting analysis revealed that the expression of β-catenin and LEF1 increased in in the majority of CMT samples. Taken together, the results provide important evidence of the activation status of the Wnt pathway in CMTs and valuable clues to identifying biomarkers for molecular-based diagnosis of CMT.
beta Catenin ; Biomarkers ; Blotting, Western ; Cyclin D1 ; Cytoplasm ; Diagnosis ; Down-Regulation ; Immunochemistry* ; Lymphoid Enhancer-Binding Factor 1 ; Mammals ; Mammary Glands, Human ; Polymerase Chain Reaction* ; Up-Regulation ; Wnt Signaling Pathway

Background:Resistance of Helicobacter pylori(Hp)to antibiotics is the primary reason for failure of Hp eradication therapies. It has been reported that there are regional differences in the resistance rate of Hp to commonly used antibiotics. Monitoring the regional Hp resistance status is helpful for improving the eradication rate in local area. Aims:To investigate the resistant spectrum of clinical Hp strains to commonly used antibiotics in Jiaxing Area,Zhejiang Province. Methods:A total of 17 402 patients who underwent gastroscopy from Jan. 2009 to Dec. 2013 at Jiaxing First Hospital were recruited for Hp culturing by using gastric antral biopsies. Then a drug sensitive test was performed for the Hp strains obtained from the culturing. Sensitivity of these Hp strains to metronidazole,amoxicillin,gentamicin,furazolidone,clarithromycin and levofloxacin was determined. Results:Among the 17 402 cases of gastric antral biopsies,5 898(33. 9% )were positive for Hp culturing. Drug sensitive test revealed that the resistance rate of metronidazole was extremely high in all year and age groups;the resistance rates of clarithromycin and levofloxacin were increasing by years;and the resistance rates of furazolidone,amoxicillin and gentamicin were considerably low in all year and age groups. When two antibiotics were combined,amoxicillin and gentamicin accounted for the lowest resistance rate,and the next were amoxicillin and furazolidone,and gentamicin and furazolidone,respectively. Conclusions:The clinical Hp strains isolated from all age groups in Jiaxing Area,Zhejiang Province are highly resistant to metronidazole,therefore it is not recommended to be used in first line eradication regimen. Amoxicillin combined with gentamicin/ furazolidone is an ideal antibiotic combination for patients with Hp infection in all age groups;and combination of gentamicin and furazolidone is recommended to patients who are allergic to penicillin.

Background The simplex congenital blepharoptosis is the common blepharon motor dysfunction disease.Some researches have shown that congenital blepharoptosis is related to the hypoplasia of levator.Objective This study was to investigate the thickness and pathological features of levator palpebrae superioris aponeurosis in congenital blepharoptosis patients.Methods A prospective cohort study was carried out in Anyang Eye Hospital from March 2012 to April 2014.Eighty-five eyes of 56 patients with congenital blepharoptosis were divided into mild (15 eyes), moderate (25 eyes) and severe blepharoptosis (19 eyes) groups, and the fellow eyes of monocular blepharoptosis was used as fellow eye group (26 eyes).Twenty-six eyes of 13 normal subjects were recruited for the normal control group.The thickness of levator aponeurosis was measured by ultrasound biomicroscope (UBM) , and the shifting range of levator aponeurosis was detected by using measuring scale.Levator aponeurosis specimens were collected during the levator palpebrae superioris shortening surgery for the pathological examination.The study was approved by the medical ethics committee of Anyang Eye Hospital, and the patients or their guardian signed the informed consent.Results The thickness of levator aponeurosis was (0.331±0.018), (0.373±0.026), (0.539± 0.023) , (0.557 ± 0.024) and (0.547 ± 0.028) mm in the severe blepharoptosis group, moderate blepharoptosis group,mild blepharoptosis group, normal control group and fellow eye group, respectively, showing a significant difference among them (F =1.681, P =0.043).The thickness values of levator aponeurosis were considerably lower in the severe blepharoptosis group and moderate blepharoptosis group than those in the mild blepharoptosis group,fellow eye group and normal control group (all at P＜0.05) , and the thickness value of levator aponeurosis was significantly reduced in the severe blepharoptosis group compared with the moderate blepharoptosis group (P＜0.05).Pathological examination showed arranging disorder of muscle fibers,hyaline-like degeneration, connective tissue hyperplasia and interruption of endomysium.The number of eyes with severe hyaline-like degeneration and connective tissue hyperplasia was significantly increased in the severe blepharoptosis group than that in the moderate blepharoptosis group or the mild blepharoptosis group, as well as in the moderate blepharoptosis group than that in the mild blepharoptosis group(all at P＜0.01).The adipose cells in muscle in the mild blepharoptosis group, moderate blepharoptosis group and severe blepharoptosis group were (12.35±4.62), (17.58±7.46) and (26.19±10.81)/field,and adipose cells in the severe blepharoptosis group were significantly more than those in the mild and moderate blepharoptosis groups (t =5.60, P =0.00;t =2.71, P =0.01).A significant increase in the adipose cells also was seen in the moderate blepharoptosis group compared with the mild blepharoptosis group (t =2.44, P =0.02).Conclusions UBM can offer accurate thickness data of levator aponeurosis.The combination of thickness data and shifting range measurement of levator aponeurosis is helpful for the evaluation of muscle strength.The development of levator aponeurosis appears to be abnormal in congenital blepharoptosis patients.The histopathological change parallels to the severity of the disease.

Objective To study the expression of carbonic anhydrase 9(CA9) in clear cell renal carcinoma(ccRCC), and the relationship between the expression and recurrence .Methods Paraffin-embedded tissues from 53 ccRCC cases were collected during the past 3 years,and immunohistochemistry was used to detect the expression of CA 9.Fifty-three cases were followed up to evaluate the disease-free survival ( DFS) and recurrence .Association of CA9 expression with recurrence was then analyzed .Results Localized RCC recurred in eleven cases , the median DFS was 10 months, the integral optical density ( IOD) of the recurrent cases was 230 879 .84 ±64 878 .72 while the IOD of the thirteen nonrecurrent cases was much higher,444 993.31 ±146 946.27(P<0.01).Conclusion There might be a positive correlation between the low expression of CA9 and the recurrence of ccRCC .CA9 may help predict the ccRCC patients ’ prognosis.

BACKGROUND: Low back pain and low limb disability are classical symptoms of patients with degenerative lumbar spondylolisthesis who are often treated with operative internal fixation.OBJECTIVE: To observe the improvement of low-back pain and low-limbs disability of patients with degenerative lumbar spondylolisthesis following the treatment with general spine system(GSS).DESIGN: Self control clinical study with patients as subjects.SETTING: Department of Orthopaedics, Peking Union Medical College Hospital.PARTICIPANTS: Sixteen patients with degenerative lumbar spondylolisthesis combined with lumbar stenosis, including 10 males and 6 females with the average age of 58.5 years(ranged from 42 to 72 years) received treatment in our hospital between September 2001 and December 2001. Patients with low back pain were found in 16 cases and low-limb claudication in 15cases; preoperative spondylolisthesis of grade I was observed in 10 cases and grade Ⅱ in 6 cases.METHODS: After receiving lumbar canal decompression by spinal process and GSS for restoring spondylolisthetic vertebra, as well as internalfixation and lumbar fusion operation, patients were followed up at postoperative week 2 and month 1,3,6,12,18,24 for assessing the low-back pain and low-limb disability and meanwhile preoperative spondylolisthesis and postoperative restroration were also assessed with X-ray.RESULTS: Totally 16 patients were followed up for an average of21.2appeared in 15 out of 16 patients, and intermittent claudication resumed to time of follow-up revealed that all spondylolisthetic vertebra were restored with restoring rate of 100% (16/16).CONCLUSION: GSS was proved of satisfactory therapeutic effect in patients with spondylolisthesis by obviously improving their low-back pain and intermittent claudication.

OBJECTIVETo introduce a new spinal internal fixation system, Texas Scottish Rite Hospital (TSRH), and to investigate its early clinical outcomes.

METHODSThe preliminary clinical outcomes of 15 patients with thoracolumbar or lumbar scoliosis treated by anterior spinal fusion with TSRH instrumentation were studied retrospectively. Fourteen patients were diagnosed as idiopathic scoliosis and 1 as neuromuscular scoliosis.

RESULTSPreoperatively, the Cobb's angle on the coronal plane was 55.8 degrees (range 35 degrees to approximately 78 degrees), and 14 degrees postoperatively, with an average correction of 74.8%. The average unfused thoracical curve was 35.9 degrees preoperatively (range 26 degrees to approximately 51 degrees) and 21.8 degrees (10 degrees to approximately 42 degrees) postoperatively, with 40% correction. The sagittal curve of lumbar was kept physiologically, preoperative 27.9 degrees and postoperative 25.7 degrees respectively. The trunk shift was 13.4 mm (5 to approximately 28 mm) preoperatively and 3.5 mm (0 to approximately 7 mm) postoperatively. The averaged apic vertebra derivation was 47.8 mm (21 to approximately 69 mm) before operation and 10.8 mm (3 to approximately 20 mm) after operation. The distance of C7 to center sacrum vertical line (CSVL) was 19.5 mm (16 to approximately 42) preoperatively and 11.3 mm (0 to approximately 32 mm) postoperatively. The apical vertebra rotation was 3 degree in 15 patients preoperatively, and were improved to normal in 10 patients, 1 degree in 4 patients, and 2 degree in 1 patients postoperatively. None had neurological injury and infection. Only 1 patient complained a cool feeling in the low extremity of concave side, and the symptom vanished at 3-month followed up.

CONCLUSIONIf used appropriately, TSRH anterior spinal system is a good teatment for low thoracic or thoracic lumbar scoliosis.

Adolescent ; Adult ; Bone Screws ; Child ; Female ; Follow-Up Studies ; Humans ; Internal Fixators ; Lumbar Vertebrae ; diagnostic imaging ; surgery ; Male ; Radiography ; Retrospective Studies ; Scoliosis ; diagnostic imaging ; surgery ; Spinal Fusion ; instrumentation ; Thoracic Vertebrae ; diagnostic imaging ; surgery ; Treatment Outcome

OBJECTIVESTo investigate the diagnosis and treatment cervical disc calcification in children.

METHODS13 children with cervical disc calcification were analysed retrospectively. Cervical pain was observed after influenza in 5 children, suddenly cervical pain in 3, sudden wryneck in 3 cases. Two children with this disease were accidentally found after injury.

RESULTS14 calcifications of cervical disks were found in 13 children. Clinical symptoms disappeared after symptomatic management. Calcification disappeared in 5 months.

CONCLUSIONSCervical disc calcification in children is a kind of benign self-limited disease. Correst understanding of pathophysiologic course of this disease helps to avoid unnecessary surgery.

Adolescent ; Calcinosis ; diagnosis ; therapy ; Cervical Vertebrae ; pathology ; Child ; Child Health Services ; Female ; Humans ; Male