A 14-year multi-institutional collaborative study of Chinese pelvic floor surgical procedures related to pelvic organ prolapse / 中华医学杂志(英文版)

BACKGROUND@#It has been a global trend that increasing complications related to pelvic floor surgeries have been reported over time. The current study aimed to outline the development of Chinese pelvic floor surgeries related to pelvic organ prolapse (POP) over the past 14 years and investigate the potential influence of enhanced monitoring conducted by the Chinese Association of Urogynecology since 2011.@*METHODS@#A total of 44,594 women with POP who underwent pelvic floor surgeries between October 1, 2004 and September 30, 2018 were included from 22 tertiary academic medical centers. The data were reported voluntarily and obtained from a database. We compared the proportion of each procedure in the 7 years before and 7 years after September 30, 2011. The data were analyzed by performing Z test (one-sided).@*RESULTS@#The number of different procedures during October 1, 2011-September 30, 2018 was more than twice that during October 1, 2004-September 30, 2011. Regarding pelvic floor surgeries related to POP, the rate of synthetic mesh procedures increased from 38.1% (5298/13,906) during October 1, 2004-September 30, 2011 to 46.0% (14,107/30,688) during October 1, 2011-September 30, 2018, whereas the rate of non-mesh procedures decreased from 61.9% (8608/13,906) to 54.0% (16,581/30,688) (Z = 15.53, P < 0.001). Regarding synthetic mesh surgeries related to POP, the rates of transvaginal placement of surgical mesh (TVM) procedures decreased from 94.1% (4983/5298) to 82.2% (11,603/14,107) (Z = 20.79, P < 0.001), but the rate of laparoscopic sacrocolpopexy (LSC) procedures increased from 5.9% (315/5298) to 17.8% (2504/14,107).@*CONCLUSIONS@#The rate of synthetic mesh procedures increased while that of non-mesh procedures decreased significantly. The rate of TVM procedures decreased while the rate of LSC procedures increased significantly.@*TRIAL REGISTRATION NUMBER@#NCT03620565, https://register.clinicaltrials.gov.

Instillation of diesel exhaust particles on the posterior wall of pharynx on reproductive function in female mice / 中华预防医学杂志

<p><b>OBJECTIVE</b>The present work aims to investigate the effects of subacute exposure to diesel exhaust particles (DEP) on reproductive function in female mice.</p><p><b>METHODS</b>A total of 168 ICR (Institute of Cancer Research) mice were randomly divided into four groups by numeration table method, including the low (B), middle (C), high (D) dose DEP exposure groups and the control group (A). Each group consisted of 42 mice. Mice were inoculated with 30 µl DEP suspension at 0.8 (B), 3.0 (C), 12.0 (D) µg/µl, respectively, or the same volume of phosphate-buffered saline (A) on pharynx posterior wall per triduum for 4 times. The body weight and ovary weight were tested and ovary weight/body weight ratios were calculated. Rates of survival, germinal vesicle breakdown, extrusion of the first polar body, in-vitro fertilization and quantity of mitochondrial DNA for the oocytes were investigated. Ultrastructural changes of the oocytes were observed.</p><p><b>RESULTS</b>The ovary weight/body weight ratios were (15.4 ± 7.3) × 10(-5), (14.1 ± 6.8) × 10(-5), (8.2 ± 0.7) × 10(-5) and (7.2 ± 2.5) × 10(-5) in groups A, B, C and D (F = 3.841, P < 0.05). In groups A, B, C and D at 48 h post-insemination, rates of oocyte survival were 64.3%, 56.8%, 39.5% and 32.9% (χ(2) = 21.575, P < 0.05), rates of extrusion of the first polar body were 75.5%, 65.3%, 37.0% and 27.1% (χ(2) = 52.772, P < 0.05), rates of 2-cell embryos were 27.9%, 39.1%, 17.6% and 12.5% (χ(2) = 20.148, P < 0.05), and rates of embryos over 2 cells were 45.3%, 32.2%, 12.5% and 13.9% (χ(2) = 32.135, P < 0.05), respectively, and were significantly lower in groups C and D compared with group A (P < 0.05). Logarithmic values of mitochondrial DNA copy numbers were 6.54 ± 0.13, 6.48 ± 0.09, 5.57 ± 0.15 and 5.41 ± 0.07 in groups A, B, C and D, respectively, and were significantly lower in groups C and D compared with group A or B (F = 89.241, P < 0.05). A number of mitochondria of the oocytes exhibited tremendous tumescence and vacuolization in groups C and D, which was contrast to a roughly normal appearance in groups A and B.</p><p><b>CONCLUSIONS</b>DEP is noxious to murine female reproduction. Subacute exposure to DEP injures the ovary and oocyte resulting in compromised ovarian function and fertilizability of the oocyte.</p>

Observation of the tape after TVT-O surgery using two and three dimensional ultrasonography in the patients with stress urinary incontinence / 中华医学超声杂志（电子版）

Objective To observe the position and mobility of the tape after tension-free vaginal tape-obturator(TVT-O) surgery using transperineal two and three dimensional ultrasonography in patients with stress urinary incontinence.Methods A total of 32 patients with stress urinary incontinence who had TVT-O surgery and cured were enrolled.Transperineal two and three dimensional ultrasonography were performed after operation 3 months later.Both the position,morphology and mobility of the tape at rest and during Valsalva menuaver were observed.Results The tapes were mainly located in the 1/3 connection of the middle and distal urethra.The length of the urethra and the length of the urethra between the bladder neck and the proximal tape at valsalva menuaver were longer than those at rest.The tapes moved front-down at valsalva manuaver according to the mean distance between the tape and the symphysis pubis.The angles of the tapes were smaller at valsalva manuaver without significant difference.Conclusion It is useful to observe the position,morphology and mobility of the tape using transperineal two and three dimensional ultrasonography.The changes of the position and morphology of the tapes at valsalva menuaver were not significant.But the tapes can strengthen the urine control in the middle of urethra.

Effect of Reduced Glutathione on Expression of Malondialdehyde,Glutathione Peroxidase and Superoxide Dismutase after Focal Cerebral Infarction in Rats / 中国康复理论与实践

@#ObjectiveTo observe the effect of reduced glutathione(GSH) on expression of malondialdehyde(MDA),glutathione peroxidase(GSH-PX) and superoxide dismutase(SOD) after focal cerebral infarction in rats.MethodsRat models of middle cerebral artery occlusion(MCAO) were estabilished with thread after 2-hour ischemia and 6-hour reperfusion.Rats were divided at random into three groups,i.e.,sham-operated,control and treatment group(with GSH 1200 mg/kg) respectively.After the rats model was performed,neurology deficit score,the size of brain infarct region and the change of brain tissue pathologic were evaluated.Contents of MDA and activity of SOD and GSH-PX were detected with spectrophotometer.ResultsCompared with the control group,GSH can ameliorate neurological deficit score and decrease infarct volume induced by MCAO.GSH may reduce contents of MDA and improve activity of SOD and GSH-PX in brain tissue.ConclusionGSH may reduce contents of MDA and improve activity of SOD and GSH-PX so as to enhance capability of eliminating oxygen free radical,and play a neuroprotective effect after cerebral focal ischemia reperfusion.

Prevalence and risk factors of urinary incontinence in Fuzhou Chinese women / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>We randomly sampled a healthy community to evaluate the prevalence and associated risk factors of urinary incontinence.</p><p><b>METHODS</b>The survey was performed in Fuzhou, China. Of women over twenty years of age in the city, 3.0% were randomly selected and 4684 evaluated by Bristol Female Urinary Tract Symptoms Questionnaire.</p><p><b>RESULTS</b>Of the women in Fuzhou, 19.0% had urinary incontinence. The prevalence of stress incontinence, urge incontinence and mixed incontinence was 16.6% (n = 777), 10.0% (n = 468), 7.7% (n = 360) respectively. The prevalence of the three types of urinary incontinence increased significantly with age (P < 0.01). In multiple logistic models, age (OR, 1.3, 95% CI, 1.1-1.4), vaginal delivery (3.0, 1.9-4.7), parity > 2 (2.1, 1.5-2.9), hypertension (2.7, 1.4-5.6), constipation (2.6, 1.8-3.8), alcohol consumption (4.7, 1.1-20.2), episiotomy (1.7, 1.4-2.0), higher body mass index (BMI, 1.8, 1.5-2.2) and unskilled worker (0.7, 0.5-0.8) were potential risk factors for stress incontinence. Urge incontinence was associated with age (OR, 1.3, 95% CI, 0.9-1.3), menopause (1.6, 1.1-2.4), Caesarean delivery (0.2, 0.1-0.5), parity > 2 (2.6, 1.8-3.8), constipation (2.3, 1.4-3.7), foetal birthweight (1.7, 1.1-2.4), episiotomy (1.4, 1.1-1.8), higher BMI (1.5, 1.2-2.0) and unskilled worker (0.7, 0.5-0.9).</p><p><b>CONCLUSIONS</b>The prevalence of urinary incontinence and its subtypes in Chinese women is lower than that of occidental women. In China, age, vaginal delivery, parity, hypertension, constipation, alcohol consumption, episiotomy, higher BMI are potential risk factors for stress incontinence. Urge incontinence is associated with age, menopause, Caesarean delivery, parity, constipation, foetal birthweight, episiotomy, higher body mass index.</p>