ABSTRACT
Objective:To investigate the clinical efficacy of modified vaginal hysterectomy in the treatment of uterine prolapse.Methods:A total of 60 patients with uterine prolapse who received treatment in Fengtai County People's Hospital from July 2017 to October 2021 were included in this study. They were divided into control and observation groups ( n = 30/group) according to different treatment methods. The patients in the control group were treated with traditional vaginal hysterectomy (vaginal hysterectomy + vaginal anterior and posterior wall repair). The patients in the observation group were treated with modified vaginal hysterectomy (vaginal hysterectomy + vaginal anterior and posterior wall repair + autologous ligament suspension). The changes in surgical indicators and treatment effectiveness were evaluated between the two groups. All patients were followed up at 3, 6, and 12 months. Vaginal fornix prolapse and quality of life score were compared between the two groups. Results:The average drainage volume, average anal exhaust time, the average time to get out of bed, and the average length of hospital stay in the observation group were (520.13 ± 52.14) mL, (36.47 ± 5.72) hours, (32.48 ± 7.12) hours, and (16.48 ± 2.67) hours, respectively, which were significantly less or shorter than those in the control group ( t = 19.35, 18.25, 17.56, 17.35, all P < 0.05). The total response rate in the observation group was 93.3% (28/30), which was significantly higher than 80.0% (24/30) in the control group ( χ2 = 6.32, P = 0.005). At 3, 6, and 12 months after surgery, vaginal fornix prolapse did not occur in any patient in the observation group, but it occurred in two, three, and seven patients in the control group at the corresponding time points. Treatment efficiency was superior in the observation group to that in the control group ( χ2 = 4.21, P = 0.001). At 3, 6, and 12 months after surgery, quality of life score in the observation group was significantly higher than that in the control group [3 months: (60.71 ± 7.58) points vs. (50.69 ± 2.89) points; 6 months: (76.42 ± 3.50) points vs. (63.31 ± 8.67) points; 12 months: (81.30 ± 2.64) points vs. (70.72 ± 6.51) points], and the differences were statistically significant ( t = 7.21, 7.10, 6.31, all P < 0.05). Conclusion:The modified vaginal hysterectomy for the treatment of uterine prolapse has an ideal effect. It can effectively reduce the amount of drainage, shorten the exhaust time and the length of hospital stay, improve quality of life, and thereby is worthy of clinical promotion.
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Autoimmune hepatitis (AIH) is a chronic progressive inflammatory disease of the liver caused by the attack of liver cells by the autoimmune system, with the features of positive serum autoantibodies, high IgG, and/or γ-globulinemia. Current studies on pregnancy in patients with AIH mainly focus on labor complications, and there is still a lack of systematic recommendations for the evaluation, treatment, and management of diseases in the progestational stage, during pregnancy, and after delivery. Although immunity is suppressed during pregnancy, poor disease control within one year before pregnancy and spontaneous drug withdrawal during pregnancy can significantly increase adverse pregnancy outcomes. Therefore, this article describes how to implement multidisciplinary collaboration and management of the whole cycle of pregnancy, so as to improve maternal and fetal safety.
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Activating metabolite glutamate receptor 8 (mGluR8) has anti-hyperpathia effect in central nervous system, however, studies of effects in gastrointestinal tract are rare. Visceral hypersensitivity is one of the pathogenesis factors of irritable bowel syndrome (IBS). Aims: To investigate the effect and potential mechanism of activating mGluR8 on visceral hypersensitivity in neonatal maternally separated (NMS) rats. Methods: Twenty-four male newborn SD rats were randomly divided into normal control (NC) group, NMS group and mGluR8 agonist (S)-3, 4-DCPG group (3, 10 mg/kg). Newborn rats were subjected to 3 hours daily maternal separation on postnatal day 2-14 to establish the NMS model; in (S)-3, 4-DCPG group, (S)-3, 4-DCPG (3 or 10 mg/kg) were administered 1 hour prior to the visceral sensitivity test in NMS rats. Abdominal withdrawal reflex (AWR) score and abdominal electromyography (EMG) activity were used to measure visceral sensitivity. mGluR8 mRNA and protein expressions in colon mucosa were measured by RT-PCR and Western blotting, respectively; TNF-α, IL-1β and IL-6 mRNA expressions in colon mucosa were measured by RT-PCR. The protein expression of myeloperoxidase (MPO) was measured by immunohistochemistry. Results: AWR score and EMG activity in NMS group were significantly higher than those in NC group under different colorectal distension (CRD) pressure. AWR score and EMG activity were significantly decreased in (S)-3, 4-DCPG group. mGluR8 mRNA and protein expressions in NMS group were significantly higher than those in NC group (P<0.05). Compared with NMS group, TNF-α mRNA expression was significantly decreased in 3 mg/kg (S)-3, 4-DCPG group (P<0.05), and MPO protein expression was significantly decreased in 10 mg/kg (S)-3, 4-DCPG group (P<0.05). Conclusions: Activating mGluR8 attenuates visceral hypersensitivity in NMS rats, the mechanism may be related to decrease of pro-inflammatory cytokine TNF-α.
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Objective To investigate the therapeutic effect of silencing fibrinogen-like protein 2 (FGL2) gene on acute necrotic pancreatitis (ANP) mice.Methods Eighteen C57/BL mice were randomly divided into SO (sham operation) group,ANP group and Ad-FGL2-siRNA group carrying FGL2 siRNA adenovirus,with 6 in each group.Sodium taurocholate was retrogradely injected into the biliopancreatic ducts of the mice to induce ANP mice model.The mice in Ad-FGL2-siRNA group were injected intravenously in the tail vein with Ad-FGL2-siRNA befor the model establishment.The mice were sacrificed 6 h later,and then the pancreatic tissue and blood were collected.TNF-α and IL-1β expression were measured with ELISA,pancreatic tissue was examined with routine pathological examination,FGL2 mRNA and protein expression were measured with reverse transcription-PCR,western blotting and immunohistochemical staining,and cell apoptosis was assessed by TUNEL method.Results The pathological score of the pancreatic tissue in SO group,ANP group and Ad-FGL2-miRNA group was(1.33 ±0.21),(9.17 ±0.98) and (6.26 ±0.52),respectively.The serum TNF-α level in SO group,ANP group and Ad-FGL2-miRNA group was(63.8 ± 4.2),(240.4 ± 18.6)and(123.0 ± 10.3)ng/L,respectively.The serum IL-1β level was (43.6 ±4.4),(186.6 ± 18.7)and (92 ±10.9)ng/L.The mRNA expressions of FGL2 was 1.20 ±0.22,4.40 ± 1.21 and 2.15 ± 0.56.The protein expressions of FGL2 was 0.33 ± 0.08,1.23 ± 0.24 and 0.68 ± 0.09.The rate of FGL2 positive cells was (2.56 ± 0.31) ％,(15.10 ± 3.23) ％ and (8.68 ± 1.81) ％.The number of apoptotic cells was (4.51 ±1.21),(35.81 ± 4.11) and (11.79 ± 3.02) / × 200HPF,which in the ANP group was higher than that in SO group,and in the Ad-FGL2-siRNA group was significantly lower than that in ANP group and higher than that in SO group.All the differences were statistically significant (all P values ＜ 0.05),except that on the FGL2 mRNA expression between Ad-FGL2-siRNA group and SO group.Conclusions Silencing FGL2 gene may alleviate pancreatic injury in ANP by reducing the release of inflammatory factors and inhibiting cell apoptosis.
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Objective To evaluate the combination use of transcatheter arterial chemoembolization (TACE), portal vein embolization (PVE) and high intensity focused ultrasound (HIFU) in treating portal vein tumor thrombus(PVTT). Methods A total of 85 patients with primary hepatocellular carcinoma complicated by PVTT, who were encountered during the period from Jan. 2011 to Feb. 2012 at authors’ hospital, were enrolled in this study. The patients were divided into the study group (n=47) and the control group (n=38). TACE, PVE and HIFU were performed in the patients of the study group, while only TACE and PVE were carried out in the patients of the control group. The therapeutic process was as follows: PVE was carried out 2 weeks after TACE was performed, and for the patients of the study group additional HIFU was conducted about 10 days after PVE procedure. Results The short-term effective rate in the study group and the control group was 89.4% (42/47) and 39.5% (15/38) respectively, and the difference between the two groups was statistically significant (P< 0.05). The 6-month, one-year, and two-year survival rate in the study group were 87.2%(41/47), 66.0%(31/47) and 27.7%(13/47) respectively; the median survival time was 15.4 months. In the control group, the 6-month, one-year, and two-year survival rate were 55.3% (21/38), 39.5% (15/38) and 10.5%(4/38) respectively;the median survival time was 10.3 months. The differences between the two groups were statistically significant (P< 0.05). Conclusion For the treatment of primary hepatocellular carcinoma associated with portal vein tumor thrombus, transcatheter arterial chemoembolization, portal vein embolization together with high intensity focused ultrasound is an safe and effective therapy as it can significantly improve the therapeutic effect and prolong the survival time.