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Objective:To analyze and compare rehabilitation research funded by China′s National Natural Science Foundation (NSFC) with that funded by America′s National Institutes of Health (NIH) so as to provide references for future funding.Methods:Articles reporting rehabilitation research funded by the NSFC and the NIH were retrieved from the NSFC′s Science Output Service website and the NIH′s Project Report website and analyzed.Results:From 2009 to 2018 the NSFC funded 421 rehabilitation studies which resulted in a published report while the NIH funded 312. In 2018, the NSFC budget (US$3.89 million) was 8.46 times that of 2009 (US$460, 000), while the NIH′s grant budget (US$36.08 million) was 2.17 times that of 2009 (US$16.62 million). The number of published papers resulting from the Chinese and American studies was 1111 and 2571 respectively. Their impact factors mainly ranged between 0 and 3 points. Among the journals with an impact factor of 6 or more, published papers from the United States (297) were much more numerous than those from China (18). The number of SCI papers per million US dollars increased by 2.25 times in China and 0.05 times in the US.Conclusions:Both China and the United States have been investing more in rehabilitation medicine research, and that has resulted in more published papers. There is still a gap in funding and output between the two countries.
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Objective:To evaluate the indications, surgical skills and clinic outcomes of abdominal minimal incision sacrocolpopexy (AMISC) for treatment of advanced pelvic organ prolapse (POP).Methods:The retrospective study analyzed 30 women with advanced POP who underwent AMISC between June 2016 and October 2019, including 9 cases of recurrent prolapse and 10 cases of vault prolapse. AMISC was especially applicable to: (1) patients with several medical complications who was unable to tolerate general anesthesia or laparoscopic surgery, but able to tolerate combined spinal-epidural anesthesia and open surgery; (2) other abdominal procedures were indicated to perform with AMISC simultaneously, such as myomectomy, subtotal hysterectomy etc, the specimens were easy to get out of the abdominal cavity and morcellation was avoided; (3) surgeons preferring open surgery to laparoscopic surgery or skilled in open surgery; (4) patients with prior pelvic operations, presenting severe abdominal and pelvic adhesions. Objective outcomes were assessed by pelvic organ prolapse quantification (POP-Q) system. Subjective outcome were assessed by pelvic floor distress inventory-short form 20 (PFDI-20), pelvic floor impact questionnaire-short form (PFIQ-7) and patient global impression of improvement (PGI-I).Results:All patients with 1-3 medical complications were successfully performed with AMISC without stopping procedure, enlarging the incision or changing to other procedure, the operation duration was (110±19) minutes. The mean time of follow-up was (33.5±12.4) months (range: 8-49 months). The postoperative points of Aa, Ba, C, Ap, Bp reduced significantly and point C improved from (2.33±2.50) cm to (-7.54±1.18) cm after AMISC ( P<0.01). The objective cure rates were both 100% (30/30) in apex and posterior compartment, while 97% (29/30) in anterior compartment. Postoperative scores of PFDI-20 and PFIQ-7 were all significant decreased (all P<0.01). About PGI-I, 29 patients chose “significant improvement”, subjective satisfaction was 97% (29/30). Anterior sacral plexus hemorrhage occurred in 2 cases (7%, 2/30). There was no intestinal obstruction or injury of bladder, bowel and ureter intra- and postoperation. Two cases (7%, 2/30) had mesh exposure. Conclusion:AMISC is a safety, convenient, minimal traumatic and durable procedure for apical prolapse with short learning curve in the most of cases.
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Objective:To observe the clinical effects of intraperitoneal perfusion of bevacizumab combined with albumin paclitaxel and carboplatin in the treatment of malignant peritoneal adhesion caused by ovarian cancer.Methods:From January 2016 to December 2020, 54 patients treated in our hospital with malignant peritoneal adhesions caused by ovarian cancer were enrolled in this study. They were randomly divided into experimental group ( n=27) and control group ( n=27) according to the random number table method. The treatment regimen of the experimental group was intravenous infusion of albumin paclitaxel plus intraperitoneal infusion of carboplatin and bevacizumab. The treatment regimen of the control group was intra-venous infusion of albumin paclitaxel plus intraperitoneal infusion of carboplatin. The treatment was repeated every 21 days, and the therapeutic effect was evaluated every two cycles. The treatment lasted for six cycles. The efficacy and incidence of adverse reactions were compared between the two groups. Results:The remission rate of incomplete malignant bowel obstruction of the experimental group was higher than that of the control group [85.19% (23/27) vs. 59.26% (16/27)], the total effective rate of the experimental group was higher than that of the control group [74.07% (20/27) vs. 44.44% (12/27)], and there were statistically significant differences ( χ2=4.523, P=0.033; χ2=4.909, P=0.027). After treatment, the levels of vascular endothelial growth factor (VEGF) in ascites of the experimental group and the control group were significantly lower than those before treatment [(80.33±1.41) pg/ml vs. (310.45±3.35) pg/ml, t=449.884, P<0.001; (135.68±1.60) pg/ml vs. (310.46±3.09) pg/ml, t=499.281, P<0.001], and after treatment, the VEGF level in the experimental group decreased more significantly than that in the control group ( t=-134.907, P<0.001). Patients in the experimental group and the control group tolerated the treatment well, and there were no significant differences in the incidences of adverse reactions such as hypertension (11.11% vs. 3.70%, χ2=0.270, P=0.603), neutropenia (14.81% vs. 11.11%, χ2<0.001, P>0.999), peripheral neuropathy (3.70% vs. 0, χ2<0.001, P>0.999), diarrhea (7.41% vs. 3.70%, χ2<0.001, P>0.999), nausea (3.70% vs. 0, χ2<0.001, P>0.999), epistaxis (7.41% vs. 0, χ2=0.519, P=0.471) or albuminuria (3.70% vs. 0, χ2<0.001, P>0.999) between the two groups. Conclusion:Intraperitoneal perfusion of bevacizumab combined with chemotherapy is superior to simple chemotherapy in the treatment of malignant peritoneal adhesion caused by ovarian cancer.
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Objective:To investigate research into medical rehabilitation supported by China′s Natural Science Foundation (NSFC) between 2009 and 2018.Methods:Medical rehabilitation research projects supported by the NSFC between 2009 and 2018 were compiled. The project leaders, funding, awardee organization, research area and results were collected and analyzed.Results:There were 348 researchers who were supported in 421 projects during the period studied. They received ￥168.541 million and made 1395 achievements between 2009 and 2018. Neurological rehabilitation was the most popular research area, followed by musculoskeletal rehabilitation, while cardiopulmonary and pain rehabilitation were rarely covered.Conclusions:Rehabilitation medicine has been developed actively, but NSFC support has still been insufficient.
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Objective To assess the five?year effect of the transvaginal high uterosacral ligament suspension (HUS) with or without additional concomitant native?tissue anterior and (or) posterior repair in women suffering from middle compartment defect. Methods A retrospective review of records identified 79 women who underwent transvaginal HUS with or without additional concomitant native?tissue anterior and (or) posterior repair from January 2007 to January 2018 in Fourth Medical Center, General Hospital of People′s Liberation Army. The middle compartment defects were predominant in these patients with point C no less than point Ba or Bp if accompanied with anterior or posterior vaginal wall prolapse. Follow?up visits were performed 2,6 and 12 months after surgery and then annually. Anatomic results of pelvic organ prolapse (POP) was established by pelvic examination using pelvic organ prolapse quantitation system (POP?Q) staging. Funtional results were obtained by patient global impression of improvement (PGI?I) scale in POP, pelvic floor distress inventory?short form 20 (PFDI?20) and pelvic floor impact questionnaire short form (PFIQ?7). Surgical success required the fulfillment of all 3 criteria: (1) anterior or posterior vaginal wall prolapsed leading edge of 0 cm or less and apex of 1/2 total vaginal length or less; (2) the absence of POP symptoms as reported on the PFDI?20 question No.3 ("Do you usually have a bulge or something falling out that you can see or feel in your vaginal area?"); and (3) no prolapse reoperations or pessary use during the study period. Results Of 79 women, 51(65%, 51/79) women completed the five?year follow?up during the study period. The median follow?up time was 5.2 years (2.8-8.3 years). The overall surgery success rate was 86% (44/51) according to above all 3 criteria. Prolapse recurrence rates were isolated anterior 8% (4/51), isolated apical 0, isolated posterior 2% (1/51) and multiple compartments 4% (2/51). Seven women (14%,7/51) developed anterior or posterior prolapse beyond the hymen with the leading edge≤1 cm. No apical prolapsed occurred. None of recurrent women underwent retreatment,including either surgery or pessary usage at last follow?up. The subjective satisfaction rate was 90% (46/51). There was a 1% (1/79) rate of intraoperative ureteral kinking and 3% (2/79) rate of postoperative morbidity. Conclusions The transvaginal HUS for middle compartment defect offers good long?term anatomical results with excellent vault suspension. With additional concomitant native?tissue anterior and (or) posterior repair, it will be a reconstructive surgery for the majority of moderate?to?severe POP. It is minimal traumatic and worthy of being popularized for clinical application.
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Objective To evaluate the indications and clinic outcomes of vaginal high uterosacral ligament suspension (HUS) for treatment of recurrent advanced pelvic organ prolapse (POP). Methods This retrospective study analyzed 42 women with recurrent advanced POP who were referred to Fourth Medical Center of PLA General Hospital and underwent transvaginal HUS between November 2005 and January 2018. Primary surgeries included 30 vaginal colporrhaphy, 5 Manchester operation, 5 transvaginal mesh repair,2 sacrospinous ligament fixation.The median time for recurrence from primary pelvic floor repair surgery was 9 months, including 14 cases (33%, 14/42)≤3 months (median time was 2 months) and 25 cases (67%, 28/42) longer than 3 months (median time was 18 months).The rate of recurrent prolapse in stageⅢorⅣ was 79% (33 cases), 45% (19 cases) and 17%(7 cases) in anterior, apical and posterior compartment respectively. Results Transvaginal high bilateral uterosacral ligaments were identified and used for successful vaginal vault suspension after vaginal hysterectomy and residual cervical resection in all 42 consecutive patients. The cases of transvaginal mesh used in anterior wall and posterior wall were 25 (60%, 25/42) and 3 (7%, 3/42) respectively. There was no major intra-and postoperative complications,such as ureter and other pelvic organ injury. The median time of follow-up was 5.3 years after transvaginal HUS. The points of pelvic organ prolapse quantification system reduced significantly and point C improved from+0.3 cm to-8.2 cm after reoperation (P<0.01). The objective cure rate were 100% (42/42) both in apex and posterior compartment,while 93% (39/42) in anterior compartment. None had reoperation or pessary usage for recurrence of prolapse. Conclusion Transvaginal HUS with vaginal wall repair could be as a safety, cost-effective, minimal traumatic and durable procedure for recurrent POP in the most of cases.
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Objective To explore the clinical management and outcomes of polypropylene mesh and sling exposure after reconstructive pelvic surgery(RPS). Methods A total of 110 cases of mesh and sling exposure after RPS were analyzed, who admitted between Jan. 2002 and Oct. 2017 in First Affiliated Hospital of PLA General Hospital, in which 3 cases were referred from other hospitals. Mesh and sling exposures were identified in the outpatient clinic and categorized and managed according to International Continence Society and International Urogynecology Association(ICS-IUGA)classification about category, time and site(CTS)of mesh complication. Outpatient management included observation, topical estrogen use and mesh removal. Management in hospital included surgical removal of exposed mesh and repair of the resulting defects under the anesthesia. Seventy-four cases were managed in the outpatient setting, and 36 cases required inpatient management. Follow-up was consecutively performed from 1 month to 10 years. Objective outcome included the surgeon′s assessment of the healing state of the vaginal mucosa. Subjective outcome was evaluated with patient global impression of improvement questionnaire(PGI-I). Results One hundred and ten patients with mesh exposure were classified according to the different RPS underwent. There were 95 cases from transvaginal mesh surgery, 5 cases from anti-stress urinary incontinence sling surgery, and 10 cases from sacrocolpopxy. The outpatient group healed at an average of(3.0 ± 1.8)months. Of the 36 patients who required inpatient management, 21 cases healed completely at an average of 7 days after one surgery. The remaining 8 cases required either two or three times surgeries or conservative management. In the outpatient group, the PGI-I scale very much better was found in 65 cases(87.8％)and much better in 9 cases(12.2％). In the inpatient surgery group, the scale was very much better in 30 cases (83.3％), and much better in 6 cases(16.7％). Conclusions Among patients with mesh exposure after mesh-augmented RPS, 2/3 of patients with a CTS classification 1-3 could be managed in the office,and remaining 1/3 with CTS classification 4-6 need operation under anesthesia in hospital. If the mesh and sling exposure could be scientifically classified, according to the size, site and accompany symptoms, as well as pain, most of the mesh complications after explosure could be resolved. Using the pelvic floor repair and polypropylene mesh sling, the majority of the patients could get a better outcome, without affecting the effect of the original operation.
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Objective To assess the long-term effectiveness of the transvaginal high uterosacral ligament suspension (HUS) in women suffering from advanced pelvic organ prolapse (POP).Methods A retrospective review of records identified 118 women who underwent transvaginal HUS with or without additional concomitant anterior and (or) posterior repairs from June 2003 to August 2009 in the First Affiliated Hospital,General Hospital of People's Liberation Army.Of 118 women,104 women completed the follow-up during study period;these 104 women were analysed.Follow-up visits were performed 2,6 and 12 months after surgery and then annually.Anatomic results of POP was established by pelvic examination using pelvic organ prolapse quantitation system (POP-Q) staging.Funtional results were obtained by patient global impression of improvement (PGI-I),pelvic floor distress inventory-short form 20 (PFDI-20) and pelvic floor impact questionnaire short form (PFIQ-7).Surgical success required the fulfillment of all 3 criteria:(1) prolapse leading edge of 0 cm or less and apex of 1/2 total vaginal length or less;(2) the absence of pelvic organ prolapse symptoms as reported on the PFDI-20 question No.3 (Do you usually have a bulge or something falling out that you can see or feel in your vaginal area?);and (3) no prolapse reoperations or pessary use during the study period.Results The mean follow-up time was (9.1 ± 1.5) years.The overall surgery success rate was 91.3％ (95/104) according to above all 3 criteria.Prolapse recurrence rates were isolated anterior 6.7％ (7/104),isolated apical 0,isolated posterior 2.9％ (3/104) and multiple compartments 1.0％ (1/104).Five women (4.8％,5/104) developed bothersome vaginal bulge symptoms.None of recurrent women underwent retreatment,including either surgery or use of a pessary at last follow-up.The subjective satisfaction rate was 90.4％ (94/104).PFDI-20 and PFIQ-7 scores showed a statistically significant improvement from preoperative 72 and 65 points to postoperative 17 and 9 points respectively (all P＜0.01).There was a 2.9％ (3/104) rate of intraoperative ureteral kinking and 3.8％ (4/104) rate of postoperative morbidity.Conclusions The transvaginal HUS for vault prolapse offers good long-term anatomical results with excellent vault suspension.With additional concomitant anterior and (or) posterior repairs,it will be a reconstructive surgery for the majority of advanced POP.It is minimal traumatic and appropriate for different type of POP,especially for the eldly patients.It is worthy of being popularized for clinical application.
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Objective To estimate the efficiency of the single incision adjustable mini sling, Ajust, in the treatment of stress urinary incontinence (SUI) concomitant with advanced pelvic organ prolapse (POP) in eldly women. Methods From Dec. 2013 to Jul. 2014, 58 patients who had been diagnosed as SUI combined with advanced POP underwent both single incision adjustable mini sling and reductive surgery for advanced POP in the First Affiliated Hospital, General Hospital of People′s Liberation Army. Fifty-eight patients were assessed to evaluate the safety and efficiency at 2, 6, 12 months postoperatively. The primary outcomes include objective and subjective cure rate, Ajust sling related complications, ralues of urinary distress inventory (UDI-6), incontinence impact questionnaire short form (IIQ-7) and patient global impression of change (PGI-C). Results There was no case of leakage tested by cough test, so the objective cure rate for anti-incontinence had been achived to 100% (58/58) at a mean 12 months follow-up. There were 91% (53/58) of the patients′ PGI-C score reached 5, and 9% (5/58) of the patients′ PGI-C score reached 4. No case underwent the reoperation. There was no case of hematoma, bladder perforation, urethral injury, groin pain, as well as pain in the puncture point during the perioperative period of time. The values of UDI-6 and IIQ-7 declined significantly postoperatively (P<0.01). Conclusions The single incision mini sling, Ajust, presents satisfactory objective and subjective cure rate in the treatment of mild and moderate SUI combined with severe POP in the eldly womem. The advantages of this mini sling includes mini-invasiveness, simple to use, rare complications and less urinary retention rate. It is a procedure worth recommending in the clinical treatment of mild to moderate SUI.
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Objective To study the impact of vaginal mesh exposure on quality of life in patients undergoing transvaginal reconstructive pelvic surgery (RPS) with polypropylene mesh.Methods From May 2004 to March 2011,114 patients with severe pelvic organ prolapse(POP) undergoing transvaginal RPS with polypropylene mesh were enrolled in this study,which were divided into exposure and non-exposure group according to appearing vaginal mesh exposure at 2 months,6 months and 1 year after operation.At the same time,pelvic floor distress inventory short form 20 ( PFD1-20 ) and pelvic floor impact questionnaire short form 7 ( PFIQ-7 ) were completed in those patients.Results At 2 months after operation,96 patients were followed up,including 19 patients in exposure group and 77 patients in non-exposure group,and the rate of exposure was 19.8c (19/96); At 6 months after operation,85 patients were followed up,including 13 patients in exposure group and 72 patients in non-exposure group,and the rate of exposure was 15.3％( 13/85 ) ; At 1 vear after operation,77 patients were followed up,including 6 patients in exposure group and 71 patients in non-exposure group,and the rate of exposure was 7.8％ (6/77).Mean score of PFDI-20 and PFIQ-7 in exposure group before operation was 39.6 and 57.1,which was statistically improved to 8.3 and 9.5 at 2 months after operation,8.3 and 9.5 at 6 months after operation,2.1 and 0 in I year after operation (P ＜0.01 ). Mean score of PFDI-20 and PFIQ-7 of non-exposure group before operation was 54.2 and 66.7,which was improved to 8.3 and 4.8 at 2 months after operation,0 at 6 months and 1 vear after operation,but there was no significant difference in mean score of PFDI-20 and PFIQ-7 between the two groups (P ＞ 0.05 ).Conclusion Vaginal mesh exposure was common after transvaginal RPS with polypropylene mesh,however,most of them were moderate,and there was no significant impact on patients'qualifies of life.
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Objective To study the efficacy of performing transvaginal Prosima mesh with high uterosacral ligament suspension (HUS) in treatment of severe pelvic organ prolapse (POP).Methods From July 2010 to February 2011,70 patients with severe POP underwent transvaginal prosima mesh with HUS in First Affiliated Hospital,General Hospital of People's Liberation Army.Clinical parameters of perioperation were collected.After 1 month and 2 - 3 months,perineal two-dimensional ultrasound examination was performed to measure mesh length in midsagittal plane.Validated prolapse quality of life questionnaires,pelvic floor distress inventsry short form 20 (PFDI-20) and pelvic floor impact questionnaire short form 7 (PFIQ-7) were used to evaluate the therapeutic effect.The mean results of pre-operative PFIQ-7 and PFDI-20 was 54 and 51,respectively.Results Median operation time was ( 195 ± 47 ) min and median blood loss was (160 ±64) ml.All the patients were followed for a mean time of 13 months (2 - 19 months).Seven cases were found with mesh exposure with less than 1 cm2.The objective cure rate was 100％.The mean score of post-operative PFIQ-7 and PFDI-20 were both 19,which were significantly lower than those of preoperation ( P ＜ 0.05 ).Anterior Prosima mesh was 3.5 cm at 1 month by ultrasound examination,and the second result of ultrasound scans was 2.8 cm at 2 - 3 month,which were both shortened 2.5 cm and 3.2 cm when compared with that of original size.Conclusions Transvaginal Prosima mesh placement with HUS is a safe and efficient surgery with less complication.Although mesh became shorter after 2 - 3 month,it did not affect surgery efficacy.
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Objective To investigate the impact of colpocleisis on body image in women with severe pelvic organ prolapse (POP). Methods From Oct. 2005 to Feb. 2010,60 POP patients with stage Ⅲ and Ⅳ by POP quantitation system underwent total or partial colpocleisis. Patients received body image evaluation before and 1 year after operation. Results One year after operation, 52 (87% , 52/60) patients completed body image evaluation. Before and 1 year after operation, the ratio of answer Not at all of questions such as Have you felt less physically attractive as a result of your vaginal prolapse? , Have you been feeling less feminine as a result of your vaginal prolapse? , Did you find it difficult to look at yourself naked? , Have you been feeling less sexually attractive as a result of your vaginal prolapse?, Have you felt dissatisfied with your body? were 25% and 96% ( P ＜ 0. 01 ) , 21% and 96% ( P ＜ 0. 01) , 37% and 67% (P = 0.018), 29% and 96% (P＜0.01), 12% and 83% (P＜0.01), respectively, indicating significant improvement on body image after operation for patients treated by colpocleisis. Conclusion Women underwent colpocleisis for severe POP could not decrease their body image as a result of the disability of vaginal intercourse.
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Objective To investigate the prevalence of fecal incontinence (FI) among adult women in Beijing area, and to analysis risk factors associated with FI. Methods A stratified multiple-cluster systemic method was used to recruit women ≥ 20 years old in 6 districts of Beijing. A self-administrated questionnaire was used to collect information about Fl and possible risk factors. Results There were three thousand and 58 women participated in the survey, the average age was (48 ± 16 ) years (range 20 -79 years). The prevalence of FI was 1.28% ( 39/3058 ), which was related to age. There were five factors entered the logistic regress model, which were included age ≥40 years old ( OR = 3.3, 95% CI: 1.7 -6. 8), urinary incontinence ( OR = 3.0, 95% CI: 1.5 - 6. 1 ), vaginal delivery ( OR = 2.4, 95% CI:1.2 -4. 9), household per capita income ≤2000 RMB per month ( OR = 3. 3, 95 % CI: 1.6 - 6. 5 ), and feeling fatigue ( OR = 3.0, 95% CI: 1.5 - 5.8). Conclusion Prevalence of FI is low among adult women in Beijing area, while risk factors associated with Fl are complicated and further studies are necessary to be conducted.
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Objective To study the objective and subjective therapeutic effect of total and partial (LeFort) colpocleisis in treatment of severe pelvic organ prolapsed ( POP) in selected elderly patients.Methods From Oct 2005 to Feb.2010,63 severe POP patients[59-87 years,median age (75 ±6) years]with stage Ⅲ and Ⅳ by POP-Q system underwent total and partial colpocleisis.The mean age was (75 ±6)years (59-87 years).Fifty-eight patients(58/63,92% )present more than one kind of medical disease.There were 53 cases with uterus prolapse,1 case with cervix prolapse and 9 cases with vaginal vault prolapse.Seven patients were recurrent POP from previous surgery.Twenty-three patients(36% ) presentedvoiding difficulty.Seven patients (17%) presented obstructive bowel symptom.Three patients (5%) presented fecal incontinence,and 28 patients(44% )presented either had urinary incontinence or history of that Among 63 patients,48 patients (76% ) underwent total colpoclesis,and 15 (24% ) patients partial colpoclesis.Meanwhile,58 (92% ) patients underwent levator myorrhaphy plus perineorrhaphy and 20 (32% ) patients underwent anti-urinary incontinence procedure ( TVT-0 ),respectively.Patients were followed up to evaluate therapeutic effect at 2 months and 1 year after surgery.Objective evaluation included the POP-Q and the length of vagina,genital hiatus,perineal body.A nonvalidated Body Image and Satisfaction Questionnaire was completed for subjective evaluation.Results The mean operating time of 63 patients was (105 ±48) minutes,which was (128 ±58) in total and (82 ±26) minutes partial procedures,which exhibited significant difference(P<0.05).The mean blood loss was (187 ± 128) ml (50-600 ml),total and partial procedures caused (232 ± 159) and (101 ±54) ml,respectively,which also showed significant difference ( P < 0.05 ).No intraoperative injury or death occurred.The rate of postoperative complications was 5% (3/63).Mean follow-up time of 63 patients was 22.5 months (1-51 months).All patients had POP-Q staging score ≤Ⅰ.No recurrent patient was observed.At 1 year after operation,the mean preoperative total vaginal length (TVL) and genital hiatus (GH) of (7.7 ± 1.1) and (5.5 ± 1.5)cm were decreased to (3.4 ± 1'.l)and (2.3 ±0.5) cm (P<0.01) ;and perineal body (PB) measurements was increased from (2.6±0.9) to (3.4 ±0.9)cm(P <0.01).Three (5%,3/63) patients had mild urinary incontinence after the operation.Twenty-three patients with voiding difficulty presenting the mean postvoid residual volumes (110 ± 38) ml(50-235 ml) were decreased to 12 ml after the operation.Obstructive bowel symptom was improved in 6(54%,6/11) patients,and fecal incontinence improved in 2(2/3).One year after the operation,52 ( 82% ) patients completed the nonvalidated Body Image and Satisfaction Questionnaire.49 (94% ) patients said either 'very satisfied' or 'satisfied' with the outcome of their surgery,while 3 ( 6% ) reported unsatisfied or not at all satisfied.Conclusions The objective and subjective curative rates of colpocleisis in treatment of severe POP are high with lower morbidity and recurrence.Colpocleisis is a safe and effective management in selected elderly patients with severe POP,who no longer desire to maintain vaginal coital function.
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Objective To perfect gene profile expressed in pre-implantation embryos. Methods Using nested RT-PCR to investigate the expression of seven imprinted genes: P57~ KIP2, LIT1, TSSC3, GRB10, PEG3, ARHI, and ZAC1 in human oocytes and pre-implantation embryos. Results Transcripts of P57~ KIP2 and ZAC1 were detected in human oocytes and at all stages of pre-implantation; LIT1 was expressed only in stages of 8-cell and blastocyst; transcripts of TSSC3 could not be detected; GRB10 mRNA could be detected in oocytes and pre-implantation embryos except for 2-cell embryo; ARHI was expressed in oocytes and 2,8-cell embryos and blastocyst; Peg3 mRNA existed in 4,8-cell embryos and blastocyst. Conclusion Except for TSSC3, transcripts of the other six imprinted genes are detected in human pre-implantation development, which are helpful for pre-implantation diagnosis of imprinted diseases, and provide the theoretical basis for understanding the correlation among assisted reproductive technology, genetic imprinted diseases and tumor.
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Objective To study the expression of ARHI mRNA,an imprinted suppressor gene,in ovarian serous carcinoma and the methylation status of its three CpG islands,and to determine the possible role of aberrant methylation of ARHI gene in pathogenesis of ovarian serous carcinoma.Methods Twenty normal ovarian specimens and 20 ovarian serous carcinoma specimens were analyzed.Total RNA was extracted and semi-quantitative RT-PCR was employed to detect the mRNA expression of ARHI gene.Methylation status of three CpG islands were examined by DNA bisulfite treatment,PCR amplification and methylation specific restriction enzymes,TagI for CpG I and III,BstUI for CpG II.Results The average of ARHI/G3PDH was 0.73?0.09 in normal ovarian specimens,and it was 0.43?0.37 in ovarian carcinoma specimens(P