Mid-term efficacy of laparoscopic sacral colpopexy of combined transabdominal-transvaginal approach in the treatment of stageⅣpelvic organ prolapse / 中华妇产科杂志

Objective To evaluate the clinical effect after laparoscopic sacral colpopexy (LSC) of combined transabdominal-transvaginal approach on stage Ⅳpelvic organs prolapse (POP). Methods The clinical data of 65 patients undergoing LSC of combined transabdominal-transvaginal approach from January 1st, 2010 to July 30th, 2017 due to POP stage Ⅳ in First Affiliated Hospital of Guangzhou Medical University were retrospectively analyzed. Objective outcome was assessed by comparing preoperative and postoperative pelvic organ prolapse quantification (POP-Q) systems. Subjective effects were assessed by comparing pelvic floor distress inventory-short form 20 (PFDI-20), pelvic floor impact questionnaire short form (PFIQ-7), pelvic organ prolapse/urinary incontinence sexual questionnaire-12 (PISQ-12) and patient global impression of improvement (PGI-I). Results All 65 patients were successfully performed without any intraoperative complications. Fifty-three patients were followed in the clinic department and 12 were followed up by telephone. The follow-up duration was 6.1-80.3 months and the median follow-up duration was 24.5 months. The bleeding loss was 20-250 ml. Postoperative urethral catheter residence day was (2.5± 1.1) days, length of postoperative stay was (6.2±1.7) days. The postoperative POP-Q scores were compared with preoperative scores which had significantly improved except pb (all P<0.01). The objective cure rates of vaginal anterior wall, apical and posterior wall prolapse stageⅣwere 90% (47/52), 100% (23/23) and 95% (20/21).About PGI-I, except for 1 patient who chose"improvement", the other 64 patients (98%, 64/65) all chose"significant improvement". Furthermore, preoperative and postoperative PFDI-20, PFIQ-7, and PISQ-12 scores were all statistically significant (all P<0.01). Subjective efficacy was significant. Three cases (5%, 3/65) of postoperative fever occurred. Two cases (4%, 2/53) had mesh exposure. Six patients (11%, 6/53) had recurrence of postoperative prolapse. Five cases had recurrence of vaginal anterior wall prolapse and no reoperation was performed; 1 case was recurrence of posterior vaginal wall prolapse who diagnosed as vaginal posterior wall prolapse stage Ⅲ; no recurrence of apical prolapse. The rate of reoperation (including exposed-mesh removal and pelvic floor reconstruction surgery) was 5% (3/65). Conclusions The LSC of combined transabdominal-transvaginal approach has a high subjective efficacy rate. The objective cure rate in the case of apical prolapse stage Ⅳ is one hundred percent.The LSC of combined transabdominal-transvaginal approach has low mesh exposure, low postoperative infection and the reoperation rate, which is one of optional pelvic floor reconstruction surgery. However, there is still a risk of recurrence in patients with POP stageⅣwith severe bladder bulging.

Structural modeling of selectivity filter in transient receptor pontential melastatin 8 ion channel / 浙江大学学报·医学版

OBJECTIVE@#To construct a three-dimensional structural model for the selectivity filter in the transient receptor pontential melastatin 8 (TRPM8) ion channel.@*METHODS@#In the Rosetta computational structural biology suite, multiple rounds of modeling with the kinematic loop closure algorithm were performed.@*RESULTS@#After nine rounds of computational modeling, we obtained the models of the selectivity filter within the TRPM8 channel with the lowest energy and high convergence. The model showed that the sidechain of D918 points were away from the central ion permeation pathway, while the sidechains of Q914, D920 and T923 pointed towards it. The glycosylation site N934 was located outside the pore region and its side chain directed to the extracellular water environment.@*CONCLUSIONS@#A three-dimensional structural model for the selectivity filter in the TRPM8 ion channel was constructed, which provides reliable structural information for exploring the mechanism of ion selectivity.

Study on the preoperative clinical criteria for nerve-sparing radical prostatectomy / 肿瘤研究与临床

Objective@#To investigate the preoperative clinical criteria for nerve-sparing radical prostatectomy.@*Methods@#A retrospective analysis of 79 patients undergoing radical prostatectomy with complete clinical and pathological data in Jinhua Hospital of Zhejiang University from January 2012 to December 2016 was performed. The distance between the edge of the prostate tumor and the neurovascular bundle (NVB) was measured. When the distance between the edge of the tumor and the ipsilateral NVB was >2 mm, NVB retention surgery can be performed; when it was ≤2 mm, NVB retention surgery cannot be performed. The influencing factors of the distance between the tumor edge and NVB were analyzed by χ 2 test and logistic regression analysis.@*Results@#Univariate analysis showed that side-specific positive biopsy core ≥1/3, side-specific maximum tumor length in biopsy core ≥5 mm, side-specific tumor involvement rate in biopsy core ≥1/2 and extraprostatic cancer extension by preoperative magnetic resonance imaging (MRI) examination were associated with the distance between the tumor edge and NVB (all P < 0.01). Multivariate analysis showed that extraprostatic cancer extension by preoperative MRI examination (OR = 3.66, P = 0.006) and side-specific positive biopsy core ≥1/3 (OR = 3.39, P = 0.008) were the independent influence factors.@*Conclusion@#The clinical criteria for a nerve-sparing radical prostatectomy are side-specific positive biopsy core <1/3 and no extraprostatic extension by preoperative MRI examination.

Application of modified Veil nerve-sparing technique in laparoscopic radical prostatectomy / 中国医师进修杂志

Objective To explore the application and early efficacy of modified Veil nerve-sparing technique during laparoscopic radical prostatectomy(LRP).Methods Fifty-seven modified Veil nerve-sparing during LRP procedures were performed in patients with clinically localized prostate cancer between 2012 and 2016 by the same surgeon.Preoperative PSA level was 10.9 μg/ml,and Gleason score was 6.06(5-8).TNM clinical stage showed cT1 in 39 cases and cT2in 18 cases.All patients underwent transrectal ultrasonography before operation. Prostate volume was 40.2 (26- 99) ml. ECT bone scan excluded bone metastasis.MRI or CT examination showed no obvious prostate invasion and lymph node metastasis. The key technology was anatomical separation of detrusor apron, dorsal vascular complex (DVC) and the level between the prostate capsule, and a complete reservation was accomplished. Measurements: the rates and location of positive surgical margins (PSM) and tumor biochemical recurrence rate as well as functional outcomes were presented.Questionnaires were used to assess urine function and IIEF-5 score was used to estimate sexual function.Results Fifty-seven cases were followed up,and the average follow-up of 27.3(6-65)months.Five cases showed biochemical recurrence after 23 months.Five patients had a PSM(2 patients in apical margins,1 patient in left side,1 patient in right side and 1 patient in the bottom).At catheter removal,49 of 57 patients(86%)were dry(0 pads),and 8 of 57 patients(14%)needed one security pad.After 3 months and 6 months,42%(24 of 57 patients)and 60%(34 of 57 patients)presented an International Index of Erectile Function score>15(with or without phospho-diesterasetype-5inhibitors). Conclusions The modified Veil nerve-sparing technique during LRP can retain the fascia around the prostate more completely and restore postoperative urine and erectile function early.For selective cases, it will not increase the positive rate of surgical margins and biochemical recurrence rate.

Effect of the modified nerve-sparing technique in open antegrade radical prostatectomy for 30 patients with prostate cancer / 肿瘤研究与临床

Objective To evaluate the clinical value of the modified nerve-sparing open antegrade retropubic radical prostatectomy (MNS-ORP).Methods MNS-ORPs were performed in 30 patients with clinically localized prostate cancer.The modified technique included: endopelvic fascia was not incised, the prostate capsule was freed laterally from surrounding fasciae and dorsally;using the method of separating the peripheral fascia of the prostate, the Veil technique was applied to the open operation, that is, the modified Veil perserving nerve technology;pelvic lymph node dissections (9 regions and 5 groups) were extended;bladder neck preservation was completed;deep dorsal vein complex was bunched;jumper intussusception technology was applied for bladder and urethral anastomosis.Functional outcomes of continence and sexual function (IIEF-score) were followed-up.Results Median age of patients was 62 years old, and the level of PSA was 11.9 ng/ml.Median operating time was 150 minutes (75-240 minutes), blood loss was 350 ml (100-1 600 ml), preoperative IIEF-score was 21 scores (15-25 scores).Pathologic stage included pT1 (8 cases), pT2a (15 cases), pT2b (4 cases) and pT3a (3 cases).By Gleason score, there were 2 cases of 5 scores, 7 cases of 6 scores, 20 cases of 7 scores and 1 case of 8 scores.4 cases had positive margins including 2 cases (10.5 ％) of pT2 and 2 cases (67 ％) of pT3.There were no postoperative complications.Mean follow-up was 19 months (6-48 months).At the 1st month, 27 patients (90 ％) got full continence, and at the 3rd month, all of the patients had full continence.At the 3rd month and the 6th month, median IIEF-scores were 13 and 19 scores, respectively with baseline of IIEF-score reaching by 40 ％ (at the 3rd month) and 70 ％ (at the 6th month) of preoperative level.Conclusions MNS-ORP follows rationales of radical prostatectomy and might be considered for selected patients.Preserving all periprostatic fasciae/nerves can recover early continence and maintains potency without affecting outcomes.

Two new phenolic glycosides from the stems of Clematis parviloba / 药学学报

To study the chemical constituents of the stems of Clematis parviloba, six compounds were isolated from a 95% ethanol extract by using a combination of various chromatographic techniques including column chromatography over silica gel, ODS, Sephadex LH-20, and semi-preparative HPLC. Two new phenolic glycosides, 2-((E)-3-carboxybut-2-en-yl)-4-hydroxy-3-methyl-phenyl-O-beta-D-glucopyranoside (1) and 4'-hydroxy-phenol-beta-D-[6-O-(4"-hydroxy-3", 5"-dimethoxy-benzoate)] glucopyranoside (2) were isolated, together with a known phenolic glycoside, 4'-hydroxy-3'-methoxy-phenol-beta-D-[6-O-(4"-hydroxy-3", 5"-dimethoxy-benzoate)] glucopyranoside (3) as well as three known megastigmane glycosides, linarionoside A (4), linarionoside C (5), and staphylionoside K (6). Their structures were determined on the basis of spectroscopic analysis and chemical evidence. Among them, compounds 1 and 2 were named as clemaparvilosides A (1) and B (2), respectively, and compounds 3-6 were obtained from Clematis genus for the first time.

The clinical investigation of ischemic tolerance of brain / 中国医师进修杂志

Objective To explore whether ischemic tolerance exists in patients of cerebral infarction following transient ischemic attacks (TIA). Methods Thirty-eight patients with cerebral infarction following TIA(with TIA group) and 98 patients with cerebral infarction without TIA (without TIA group)were studied. The positive expression rate of CD62P in platelet and the size of cerebral infarction on admission was measured. The scores of activities of daily living were evaluated on admission and after a month. Results The positive expression rate of CD62P in platelet was lower in with TIA group than that in without TIA group [ (4.21 ± 0.43 )% vs (6.01 ± 0.03)%,P< 0.05 ]. The area of cerebral infarction and the scores of activities of daily living were lower in with TIA group than those in without TIA group(P< 0.05 ). Conclusion Cerebral infarction following TIA has ischemic tolerance.

Studies on chemical constituents of Uvaria tonkinensis var. subglabra / 中国中药杂志

<p><b>OBJECTIVE</b>To isolate and identify chemical constituents of Uvaria tonkinensis var. subglabra.</p><p><b>METHOD</b>The column chromatographic techniques were applied to isolate constituents, and their structures were elucidated by means of spectral data analysis including 1D and 2D NMR, IR and MS techniques.</p><p><b>RESULT</b>Seven compounds were isolated and identified as subglain C (1), beta-senepoxide (2) , 2, 4-dioxohexahydro-1, 3-diazepin (3), kaempferol-3, 7-di-O-alpha-L-rhamnoside (4), anolobine (5), (-)-lyoniresinol (6) and schizandriside (7).</p><p><b>CONCLUSION</b>Compound 1 was the new natural product; compounds 2-7 were isolated for the first time from U. tonkinensis var. subglabra.</p>

Studies on chemical constituents from leaves of Cassia alata / 中国中药杂志

<p><b>OBJECTIVE</b>To isolate and identify chemical constituents of Cassia alata.</p><p><b>METHOD</b>Compounds were separated and purified by column chromatography with silica gel and Sephadex LH-20, elucidated by spectroscopic methods including 1D and 2D NMR, IR and MS techniques.</p><p><b>RESULT</b>Twelve compounds were isolated from C. alata, which were identified as chrysoeriol (1), kaempferol (2), quercetin (3), 5,7,4'-trihydroflavanone (4), kaempferol-3-O-beta-D-glucopyranoside (5), kaempferol-3-O-beta-D-glucopyranosyl-(1-->6)-beta-D-glucopyranoside (6), 17-hydrotetratriacontane (7), n-dotriacontanol (8), n-triacontanol (9), palmitic acid ceryl ester (10), stearic acid (11), palmitic acid (12).</p><p><b>CONCLUSION</b>Compounds 3-12 were isolated from C. alata for the first time.</p>

A new glycoside from Alpinia officinarum / 药学学报

Aim To investigate the glycosidic constituents in the rhizomes of Alpinia officinarum Hance. Methods The isolation and purification of glycosides were done with column chromatography on macro porous resin, polyamides and Sephadex LH-20, whilst the structure elucidation was done by HRCI-MS and NMR (1D and 2D ) methods. Results A glycosidic ester identified as 4'-hydroxy-2'-methoxyphenol-β-D-{ 6-O-[ 4"-hydroxy-3", 5"-dimethoxy ( benzoate ) ] }-glucopyranoside ( I), along with a known compound n-butyl-β-D-fructopyranoside (II) , were isolated and characterized. Conclusion Ⅰ was found to be a new compound, named as alpinoside A, whilst Ⅱ was isolated from the genus Alpinia for the first time.

Study of the mechanism of brain injury caused by thrombin and the intervention effect of hirudin and nimodipine / 临床神经病学杂志

Objective To investigate the mechanism of brain injury caused by thrombin and the intervention effect of hirudin and nimodipine.Methods Different doses of thrombin or/and hirudin were injected into nucleus caudatus of SD rats,nimodipine was given intraperitoneally.Dry-wet-weighing technique,immunohistochemical method and TUNEL were used to examine brain edema,the changes of cytoskeleton,neuron apoptosis and histological changes.Results(1) High dose of thrombin resulted in severe cerebral edema as early as 4 h after injection and the maximum edema occurred at 24~48 h.The edema gradually decreased and got close to normal within 3~7 d.Cytoskeleton changes were observed at early stage(4h),reversible or irreversible injuries presented at 24~48 h,and neuron necrosis occurred within 3~7 d.Neuron apoptosis started at 4h and peaked at 24~48 h.In contrast,low dose of thrombin and normal saline did not show these effects.(2) The effects of thrombin could be inhibited by hirudin and nimodipine(a calcium-ion antagonist) could relieve or delay cell injury.Conclusions High dose of thrombin may result in severe brain edema,neuron irreversible injury and apoptosis,which all peak at 24~48 h.Early treatments could greatly reduce brain damage and improve prognosis of intracerebral hemorrhage.

Whether Fetus Would be Ominous in Blood Group Incompatibility If IgG Antibody's Efficiency More than 1∶512 / 中华围产医学杂志

Objective To investigate the fetal haemolytic status when IgG antibody's efficiency of pregnant women was ≥1∶512 in blood group incompatibility. Methods We retrospectively analyzed the data of 6 pregnant women whose IgG antibody's efficiency were more than 1∶512 in blood group incompatibility. The levels of bilirubin, IgG antibody's efficiency and blood type in amniotic fluid from amniocentesis were examined. Umbilical blood bilirubin, blood type analysis and Coombs test of newborns were performed. Results Serum IgG antibody's efficiency of pregnant women did not correlate with the severity of haemolytic disease of newborn. Conclusions Fetal haemolytic disease can not be diagnosed only by serum IgG antibody's efficiency of pregnant women.

Chemical constituents of Securidaca inappendiculata Ⅱ / 中草药

Object To investigate the chemical constituents of Securidaca inappendiculata Hassk Methods Compounds of 95% alcohol extract from the stem of S inappendiculata were isolated by column chromatography and Medium Pressure Liquid Chromatography, respectively The structures of the compounds were elucidated by chemical and spectral (UV, IR, MS, 1HNMR adn 13 CNMR) analyses Results Six compounds were isolated and identified as: 4, 4′ dimethyl 1, 7 heptanedioic acid (Ⅰ), inositol (Ⅱ), stigmasterol (Ⅲ), vittadinoside (Ⅳ), rhamnose (Ⅴ), sucrose (Ⅵ) Conclusion For the first time, compound Ⅰ was obtained from the plant and other compounds were isolated from Securidaca Mill

Association between Air Pollutants Exposure during Pregnancy and Preterm Delivery in Taiyuan / 环境与健康杂志

Objective To investigate the relationship between air pollutant exposure and preterm delivery (PTD) by Logistic regression model, as the effect of air pollutant exposure to PTD made great concern today. Methods The present study consisted of 31 145 qualified birth cases, 80.09% of the total amount, from 1 Nov, 2005 to 1 Aug, 2007. The covariant items included maternal age, nation, education, residence, income, occupation, occupation exposure, parent-drinking, father-smoking, heating-type, folic acid supplement, season of pregnancy, prenatal health care, etc. The Logistic regression analysis was employed to control the confounding factors mentioned above, then the pollutant was introduced step by step to build the single, double and triple pollutant Logistic regression model to examine the association between three pollutants (SO2, NO2, and PM10) and PTD during the first and third trimesters of pregnancy. The air monitoring data (daily average of SO2, NO2, and PM10) were collected from Taiyuan Environmental Monitoring Station. Results In the first trimester, a quartile increase of NO2 exposure caused the risk for PTD increased by 22.7%. As for the effect of PM10, no significant differences were seen. In the third trimester, a quartile increase of NO2 exposure caused the risk for PTD increased by 19.1%. Conclusion The NO2 exposure during the pregnancy can increase the risk of PTD. The susceptible exposure-window choice is critical for the further study in this field.

HPLC fingerprint of Ramulus cinnamomi / 中成药

AIM: To establish HPLC fingerprint of Ramulus cinnamomi.This fingerprint was expected to be standards of quality control and identification of the Chinese crude drug. METHODS: The HPLC method was used,chromatography condition were Kromasil C_(18)(250 mm?4.6 mm,5?m) column with gradual mobile phase of acetonitrile-0.5% acetic acid,UV detection wavelength at 280 nm and column temperature at 25(?C) with the flow rate of 1 ml?min~(-1). RESULTS: The retention time of Cinnamaldehyder,Cinnamic acid,o-Methoxycinnamic acid and Coumarin in Ramulus cinnamomi were determined.The fingerprint showed high similitude in samples from different regions. CONCLUSION: The HPLC fingerprint of Ramulus cinnamomi.can be used as a standard of quality control and identification of the Chinese crude drug.