OBJECTIVE: To explore clinical effectiveness of modified laparoscopic sacrocolpopexy by using double-mesh in the treatment of pelvic organ prolapse.METHODS: A retrospective analysis was conducted in 61 patients with pelvic organ prolapse who received LSC from September 1,2012 to September 30,2017.Among 61 patients,32 cases received modified LSC(modified group)and 29 cases received traditional Y-mesh LSC(traditional group).The intraoperative and postoperative parameters were compared between the two groups and the improvement in subjective symptoms was evaluated by using the simple questionnaire(PFIQ-7)and subjective cure rate was assessed.RESULTS: The difference was of statistical significance in operation time[(127.34+7.88)min vs.(143.28+15.38)min]between the modified group and the traditional group(P<0.05).There was no significant difference in the blood loss,catheter indwelling time or hospital stay between the two groups(P>0.05).The median follow-up time of 61 patients was 28 months.In the modified group and traditional group,the objective cure rates were 96.86% and 89.65%,respectively.After operation each indicator point was recovered anatomically according to POP-Q,and there was statistical difference compared with before operation.The score of postoperative PFIQ-7 was obviously reduced compared to the preoperative parameter.The subjective cure rates of the modified group and traditional group were 100% and 94.74%,respectively.There was no new complications occurring in the modified group.There were 3 cases of postoperative mesh exposure in the traditional group.The symptoms of urinary incontinence disappeared after TVT-O in both groups.Two new cases of urinary incontinence occured in both groups after surgery.CONCLUSION: Both of the two operations for pelvic organ prolapse are safe and effective.The modified LSC is an alternative surgical option for ptatients with pelvic organ prolapse because of its advantages,such as simpler operation,shorter operation time,and fewer longterm complications.

Objective: The present study was designed to evaluate the protective effects of oligomeric proanthocyanidins (OPC) in mice exposed to paraquat (PQ) , and to explore the molecular mechanism. Methods: Four experimental groups were designed. Control group: 10 BALB/c mice were intraperitoneally injected with normal saline) . PQ group: 10 BALB/c mice were intraperitoneally injected with PQ (100 mg/kg) . PQ+OPC group: 10 BALB/c mice were administered with OPC (100 mg/kg) for 1 h before PQ (100 mg/kg) expo-sure. OPC group: 10 BALB/c mice were intraperitoneally injected with OPC (100 mg/kg) . The peripheral blood samples or lung tissue samples were collected at the designed time points for measuring the levels of oxi-dative stress indicators, the related protein levels of nuclear factor-kappa B (NF-κB) pathway and nuclear fac-tor erythroid related factor-2 (Nrf2) pathway. Results: Compared with the control group, the level of reactive oxygen species (ROS) , the content of malondialdehyde (MDA) in the PQ group were significantly induced, and the activity of superoxide dismutase (SOD) in the PQ group was decreased in the peripheral blood. As com-pared with the PQ group, the level of ROS and the content of MDA in the PQ+OPC group were significantly re-duced, the activity SOD in the PQ+OPC group was increased in the peripheral blood; the level of ROS and the content of MDA were also reduced in lung tissues in the PQ+OPC group. Moreover, compared with the con-trol group, the phosphorylation of IκBα and the expression of NF-κB p65 were increased in lung tissues in the PQ group. The phosphorylation of IκBα and the expression of NF-κB p65 were decreased in lung tissues in the PQ+OPC group as compared with the PQ group. In addition, compared with the control group, the expressions of HO-1 and Nrf2 were increased in lung tissues in OPC group, and these were decreased in lung tissues in PQ groups. Furthermore, the expressions of HO-1 and Nrf2 were also increased in lung tissues in PQ+OPC as com-pared with the PQ group. Conclusion OPC could alleviate PQ-induced systemic toxicity in mice by regulating oxidative stress via NF-κB and Nrf2 pathway.

OBJECTIVE To observe the clinical therapeutic effects of the formula capable of resolving turbidity, removing toxin, activating blood circulation and dredging collectrals in improving patients with vascular cognitive impairment of none dementia(VCIND) after stroke.MEHTODS 128 cases with VCIND after stroke were randomly divided into treatment group and control group, with 64 cases in each group.Patients in the treatment group were given compound Changpu Yizhi Decociton warmly both early in the morning and late in the afternoon, one bag per day.While those in the control group were treated with nimodipine, 30mg at a time, three times per day.Both groups received three-month treatment.TCM syndromes, cognitive ability, activity of daily living before and after treatment were evaluated and the levels of homocysteine and acetylcholinesterase were tested to detect the safety index and side effects.RESULTS There experienced an evident improvement of the treatment group in TCM syndrome curative effects and scores, together with obvious increases in the scores of mini-mental state examination(MMSE) and Activity of Daily Living (ADL), decreased scores in ADAS-cog and declined levels in homocysteine and acetylcholinesterase when compared to the control group.The difference was statistically significant(P<0.05).Neither evident abnormalities nor side effects were detected before and after treatment in the test.CONCLUSION Compound Changpu Yizhi Decoction can efficiently improve the TCM syndromes, cognitive function and daily living activity and reduce the levels of homocysteine and acetylcholinesterase of patients with VCIND after stroke.

OBJECTIVETo investigate the vaginal flora in patients with recurrent vulvovaginal candidiasis (RVVC).

METHODSVaginal swabs were collected at different time points from 6 RVVC patients and 5 healthy women of child-bearing age. The dynamic changes, microbiota composition, alpha diversity and beta diversity in the two groups were assessed by analyzing the 16S rRNA V4 hypervariable region amplified from the total genomic DNA from the swabs.

RESULTSLactobacillus was the predominant species in healthy women with similar proportions of L.iners and L.crispatus; small proportions of Gardnerella, Prevotella and other genus were also detected. In some healthy women, the vaginal flora showed a high relative abundance of anaerobic bacteria such as Gardnerella, Prevotella, Atopobium, Sneathia. Compared with the healthy women, patients with RVVC showed a significantly reduced diversity of vaginal flora, where L.iners was the predominant species and the content of L.crispatus decreased significantly. In healthy women, the vaginal flora fluctuated with the menstrual cycle, and the fluctuation was the most prominent during menstruation; the dominant species either alternated regularly or maintain an absolute superiority in the menstrual cycle. The vaginal flora showed attenuated fluctuation in women with RVVC, were highly conserved within the menstrual cycle, and maintained a similar composition in the episodes and intermittent periods.

CONCLUSIONThe vaginal flora of RVVC patients do not undergo regular variations with the menstrual cycle and shows a similar composition between the episodes and intermittent periods. Promoting the production of L.iners or inhibiting the colonization of L.crispatus to restore the composition of the vaginal flora may help in the treatment of RVVC.

Candidiasis, Vulvovaginal ; microbiology ; Case-Control Studies ; Female ; Humans ; Lactobacillus ; classification ; isolation & purification ; Longitudinal Studies ; Menstrual Cycle ; Microbiota ; RNA, Ribosomal, 16S ; isolation & purification ; Vagina ; microbiology

OBJECTIVETo report the first case of laparoendoscopic single-site surgery (LESS) for gynecologic malignancy in China and discuss the application of LESS in minimally invasive gynecologic surgery.

METHODSA 57-year-old postmenopausal woman presented with vaginal bleeding for 5 years and diagnostic curettage revealed endometrial cancer. Staged LESS for endometrial cancer was performed using a single multiple-channel port (Tri-port) inserted through a solitary 2.5 cm upper umbilicus incision.

RESULTSThe operation was completed successfully. The total operative time was 4.5 h, the duration of the LESS procedure was 4.0 h, and the establishment of the operative access took 1.0 h. No other port incision or transfer to open procedure was needed. The intraoperative blood loss was 100 ml. Bowel peristalsis and micturition recovered 2 days after the operation, and the peritoneal drainage tube was removed 4 days after the operation without vaginal bleeding. No obvious scar was left on the surface of umbilicus.

CONCLUSIONLESS can be a promising minimally invasive approach to effective management of benign and malignant gynecological diseases.

China ; Endometrial Neoplasms ; surgery ; Female ; Humans ; Laparoscopy ; methods ; Middle Aged ; Uterine Neoplasms ; surgery

Objective To estimate the prevalence and related risk factors of post-stroke depression (PSD) in ischemic stroke survivors from community-based medical centers in urban areas of Beijing.Methods Five community-based medical centers in urban areas of Beijing were selected.Patients with first-ever or recurrent ischemic stroke were evaluated from January 2003 to December 2006. The prevalence of PSD was evaluated by Self-Rating Depression Scale (SDS), and the information on the onset of stroke, vascular risk factors and living style was also collected.Results Totally 1089 stroke patients were registered, 1074 cases among which had complete information and met inclusion criteria. The mean age of the patients was (65.0 ± 8.9) years with a median stroke course of 13.0 months. The overall prevalence of PSD was 49.9% (536/1074), and the proportions of mild, moderate and major PSD were 52.2%, 36.0% and 11.8%, respectively. There were no significant differences in prevalence of PSD among different stages of stroke and the prevalence of PSD was 51.3% within 6 months after stroke onset, 47. 1% during 6-18 months and 53.2% after 18months. Low education, activities of Daily Living (ADL) dependence, cognition impairment and recurrence of stroke were independent risk factors for PSD.Conclusions The prevalence of PSD among ischemic stroke patients is higher in community-based medical centers, but most of PSD patients are mild or moderate. More effective early intervention should be adopted to decrease PSD,promote the recovery of neural function and improve their quality of life.

OBJECTIVETo report the first case of transumbilical laparoendoscopic single-site surgery-assisted vaginal hysterectomy in South China, and discuss its feasibility and safety.

METHODSA 42-year-old woman with multiple myoma of the uterus underwent laparoendoscopic single-site surgery-assisted vaginal hysterectomy performed using a single multiple-channel port inserted through a solitary 2 cm upper umbilicus incision.

RESULTSThe total operative time was 3 h, and duration of the laparoendoscopic procedure was 2 h. The surgery was completed uneventfully without an additional port incision or transfer to open surgery. The intraoperative blood loss was 100 ml. Bowel peristalsis was recovered 3 days after the operation. The vaginal stump and abdominal incision healed smoothly without occurrence of vaginal bleeding.

CONCLUSIONWith the development of surgical instruments and improvement of the surgeons' skills, laparoendoscopic single-site surgery, due to its invasiveness, can be a promising approach to the management of gynecological disease including gynecological malignant tumors.

Adult ; Female ; Humans ; Hysterectomy, Vaginal ; methods ; Laparoscopy ; methods ; Leiomyoma ; surgery ; Uterine Neoplasms ; surgery

OBJECTIVETo investigate the effect of small interference RNA (siRNA) targeting nuclear factor-kappaB (NF-kappaB) on endometriosis.

METHODThe eutopic endometrium of women with endometriosis were transplanted into the nonvascular region of 8-day-old chicken embryo chorioallantocic membrane (CAM), and the effects of NF-kappaB p65 siRNA on the vascularization and endometriotic lesion formation were tested with proper controls.

RESULTSTransplantation of the endometrium onto the CAM resulted in a strong angiogenic response in the chicken tissue. The angiogenesis was significantly reduced and endometriotic lesion formation significantly suppressed with siRNA targeting NF-kappaB in comparison with the control group.

CONCLUSIONSThe NF-kappaB pathway is involved in the development of endometriotic lesions in vitro, and NF-kappaB gene silencing reduces endometriotic angiogenesis and promotes cell apoptosis in the endometriotic lesions, suggesting that NF-kappaB might be a good target for endometriosis treatment.

Animals ; Chick Embryo ; Chorioallantoic Membrane ; blood supply ; metabolism ; Endometriosis ; genetics ; physiopathology ; Female ; Humans ; NF-kappa B ; deficiency ; genetics ; Neovascularization, Pathologic ; genetics ; RNA Interference ; RNA, Small Interfering ; genetics

Objective To investigate the possible role of abnormal signal transduction in smooth muscle cell in the pathogenesis of diabetic gastroparesis. Methods Healthy male SD rats were randomly divided into 2 groups: normal,model group,diabetes was induced by Ⅳ of alloxan,50mg/kg. Gastric emptying was measured by method of nutritious semisolid paste. The level of cAMP in gastric smooth muscle cell was measured by radioimmunoassay. Gsαand GiαmRNA positive cells were quantitatively measured by in situ hybridization and computer image analysis system respectively. Results ( 1 ) Gastric emptying rate of the normal was significantly higher than that of model group (P < 0.05 ) ; (2)the level of cAMP of the normal was significantly lower than that of model group( P < 0.05 ) ; (3)the expression of GsαmRNA in the model group was significantly higher than that of the normal groups( P < 0.05 ) ; (4) there was no marked difference in the expression of GiαmRNA between 2 groups( P > 0.05). Conclusion Altered expression of GSαmRNA may play a key role in the pathogenesis of diabetic gastroparesis.

OBJECTIVETo construct the recombinant adenovirus vector expressing human endostatin.

METHODSHuman endostatin gene extracted from pGEM-T Easy vector containing the target gene fragment was successfully amplified using PCR and cloned into pShuttle2 vector. The target gene was subcloned into an adenovirus vector and the resulted recombinant adenovirus (Ad-hEndo) was linearized before transfected into HEK 293 packaging cells. The Ad-hEndo recombinant adenovirus was efficiently amplified in 293T cells and purified by CsCl density centrifugation, and the titer of the virus was determined.

RESULTSThe amplified hEndostatin cDNA was verified by PCR and sequencing, and the resulted virus titer reached 5.2 x 10(9) pfu/ml.

CONCLUSIONThe recombinant adenovirus containing human endostatin gene has been successfully constructed, which may provide important basis for gene therapy research for angiogenesis-dependent diseases.

Adenoviridae ; genetics ; Cell Line ; Cloning, Molecular ; DNA, Recombinant ; genetics ; Endostatins ; biosynthesis ; genetics ; Genetic Vectors ; genetics ; Humans ; Recombinant Proteins ; biosynthesis ; genetics ; Transfection