Comparison of long-term clinical outcomes between transvaginal mesh and pelvic floor reconstruction with native tissue repair in the treatment of advanced pelvic organ prolapse / 中华妇产科杂志

Objective:To study the long-term clinical effect of transvaginal mesh (TVM) and pelvic floor reconstruction with native tissue repair (NTR) in the treatment of advanced pelvic organ prolapse (POP).Methods:Totally 207 patients with advanced POP who were treated in Hunan Provincial Maternal and Child Health Care Hospital from Jan. 2016 to Sep. 2019 were enrolled. The patient′s pelvic organ prolapse quantification were all at degree Ⅲ or above, and they all complained for different degree of symptoms. They were divided into two groups according to the different surgical methods, TVM group and NTR group. In TVM group, the mesh was implanted through the vagina for pelvic floor reconstruction, while in NTR group, the traditional transvaginal hysterectomy combined with uterosacral ligament suspension and anterior and posterior wall repair, as well as perineal body repair were performed. The median follow-up time was 60 months, during the follow up time, 164 cases (79.2%, 164/207) had completed follow-up, including 76 cases in TVM group and 88 cases in NTR group. The perioperative data and complication rates of the two groups were compared, and the subjective and objective outcomes of the two groups at 1, 3 and 5 years were observed, respectively. The objective efficacy was evaluated by three composite criteria, namely: (1) the distance from the farthest end of the prolapse of the anterior and posterior wall of the vagina to the hymen is ≤0 cm, and the descending distance of the top is ≤1/2 of the total length of the vagina; (2) determine the disappearance of relevant POP symptoms according to “Do you often see or feel vaginal mass prolapse？”; (3) no further operation or pessary treatment was performed due to prolapse. If the above three criteria were met at the same time, the operation is successful; otherwise, it was recurrence. The subjective efficacy was evaluated by the pelvic floor distress inventory-short form 20 (PFDI-20) and pelvic floor impact questionnaire-short form 7 (PFIQ-7).Results:The median follow-up time of the two groups was 60 months (range: 41-82 months). Five years after the operation, the subjective and objective cure rates of TVM group were 89.5% (68/76) and 94.7% (72/76), respectively. The subjective and objective cure rates in NTR group were 80.7% (71/88) and 85.2% (75/88), respectively. There were significant differences in the subjective and objective cure rates between the two groups ( χ2=9.869, P=0.002; χ2=3.969, P=0.046). The recurrence rate of TVM group was 5.3% (4/76), and that of NTR group was 14.8% (13/88). There was a significant difference between the two groups ( P=0.046). The postoperative PFDI-20 and PFIQ-7 scores of the two groups were significantly lower than those before surgery, and there were significant differences of the two groups before and after surgery (all P<0.05). Postoperative mesh exposure in TVM group was 1.3% (1/76). Conclusions:The long-term outcomes between the two groups show that the subjective and objective outcomes of pelvic floor reconstruction in TVM group are significantly higher than those in NTR group, and the recurrence rate is significantly lower than that in NTR group. TVM has certain advantages in the treatment of advanced POP.

Research progress of rapid surgery for hip fracture in elderly patients / 中国修复重建外科杂志

OBJECTIVE@#To review the research progress of rapid surgery for hip fracture in elderly patients.@*METHODS@#The published studies, expert consensus, and guidelines at home and abroad were systematically summarized from the aspects of the characteristics of aging population, the benefits of rapid surgery, the disadvantages of delayed surgery, and the recommendations of current guidelines, so as to further guide clinical practice.@*RESULTS@#Hip fracture is a common fracture type in the elderly population. As elderly patients generally have poor physique and often have a variety of underlying diseases, such as hypostatic pneumonia, bedsore, lower limb vein thrombosis, and other complications in conservative treatment, its disability rate and mortality are high, so surgical treatment is the first choice. At present, most relevant studies and expert consensus and guidelines at home and abroad support rapid surgery, that is, preoperative examination should be started immediately after admission, and adverse factors such as taking anticoagulant drugs, serious cardiovascular diseases, and severe anemia should be clearly and actively corrected, and surgery should be completed within 48 hours after admission as far as possible. Rapid surgery can not only significantly reduce the mortality of patients, but also reduce the length of hospital stay and the incidence of perioperative cognitive impairment, which is conducive to the recovery of patients with pain during hospitalization and postoperative function, and improve the prognosis of patients.@*CONCLUSION@#In order to avoid many problems caused by delayed surgery, the elderly patients with hip fracture should be operated as soon as possible under the condition of actively correcting the adverse factors. Comprehensive evaluation and preparation, the development of an individualized surgical plan, and the formation of a multidisciplinary medical team can reduce surgical risks and improve effectiveness.

Chinese expert consensus on diagnosis, treatment and prevention of venous thrombus embolism associated with chest trauma (2022 version) / 中华创伤杂志

Chest trauma is one of the most common injuries. Venous thromboembolism (VTE) as a common complication of chest trauma seriously affects the quality of patients′ life and even leads to death. Although there are some consensus and guidelines on the prevention and treatment of VTE at home and abroad, the current literatures lack specificity considering the diagnosis, treatment and prevention of VTE in patients with chest trauma have their own characteristics, especially for those with blunt trauma. Accordingly, China Chest Injury Research Society and editorial board of Chinese Journal of Traumatology organized relevant domestic experts to jointly formulate the Chinese expert consensus on the diagnosis, treatment and prevention of chest trauma venous thromboembolism associated with chest trauma (2022 version). This consensus provides expert recommendations of different levels as academic guidance in terms of the characteristics, clinical manifestations, risk assessment, diagnosis, treatment, and prevention of chest trauma-related VTE, so as to offer a reference for clinical application.

Application and progress of non-invasive neuromodulation techniques in chronic refractory pain / 中华神经科杂志

Chronic refractory pain is an excruciating pain caused by various reasons, which is easily recurrent and barely responded to multiple drugs. It affects more than 10% of the global population and thus causes a huge burden on the society and the economy. With the development of neuroscience, neuromodulation technologies have been well concerned, which guide a novel direction in the treatment of chronic refractory pain. This review summarizes the research progresses on repetitive transcranial magnetic stimulation, transcranial direct current stimulation, transcranial focused ultrasound stimulation, optogenetics and other non-invasive neuromodulations in the treatment of chronic refractory pain.

Clinical discipline-oriented teaching reform on laboratory diagnostics and its effect evaluation / 中华医学教育探索杂志

Objective:To explore a clinical discipline-oriented teaching model for laboratory diagnostics and evaluate its effect in medical education.Methods:changed the arrangement of traditional teaching content, re-edited the content of the teaching materials under the guidance of clinical subjects, compiled innovative textbooks and introduced new teaching methods such as CBL and PBL. The procedure could be briefly described below. 78 students from two natural classes in batch 2015 were selected as the observation group, and 77 students from other two natural classes were selected as the control group. The new teaching model and traditional teaching model were applied respectively in the students to compare the teaching effect in the way of formative evaluation.Results:The total score of theoretical exams in the observation group was significantly higher than that of control group ( P<0.01). It was found that the scores of the observation group were significantly higher than of the control group in terms of practical techniques, clinical application type and the selection and evaluation of test items ( P<0.01). However, there was no significant difference in terms of the scores of basic knowledge and theory between the observation group and the control group ( P=0.470). Conclusion:The clinical discipline-oriented teaching method of laboratory diagnostics can promote the students in the assessment of applied and improved knowledge as well as the selection and evaluation of clinical disease examination items, which is helpful to cultivate students' clinical thinking ability, and the ability to reasonably select the test items and analyze the test results scientifically.

Nuclear Envelope Protein MAN1 Regulates the Drosophila Circadian Clock via Period / 神经科学通报·英文版

Almost all organisms exhibit ~24-h rhythms, or circadian rhythms, in a plentitude of biological processes. These rhythms are driven by endogenous molecular clocks consisting of a series of transcriptional and translational feedback loops. Previously, we have shown that the inner nuclear membrane protein MAN1 regulates this clock and thus the locomotor rhythm in flies, but the mechanism remains unclear. Here, we further confirmed the previous findings and found that knocking down MAN1 in the pacemaker neurons of adult flies is sufficient to lengthen the period of the locomotor rhythm. Molecular analysis revealed that knocking down MAN1 led to reduced mRNA and protein levels of the core clock gene period (per), likely by reducing its transcription. Over-expressing per rescued the long period phenotype caused by MAN1 deficiency whereas per mutation had an epistatic effect on MAN1, indicating that MAN1 sets the pace of the clock by targeting per.

Experience of chest wall tumor resection and chest wall defect reconstruction / 中华胸心血管外科杂志

Objective To investigate the resection of chest wall tumor and the reconstruction of it.Methods Retrospectively summarize the diagnosis and treatment of 91 cases of chest wall tumors in our hospital from January 2008 to November 2017.There are 55 males and 36 females and the ages ranged from 7 to 78 years,with a median age of 43 years.82 cases were operated for the first time,and 9 cases were reoperated.The postoperative pathology showed that the benign were 52 cases and malignant were 39 cases.The largest benign tumor was 15 cm × 10 cm × 3 cm and the largest malignant tumor was 30 cm × 20 cm × 15 cm.Local excision was performed in 66 cases and extended resection in 25 cases.After the resection,ilium,titanium mesh,Dacron mesh and Matrix reconstruction system were selected for reconstruction of chest wall respectivly.Results All the operation was successful and without death.Local resection was performed in all of benign tumor and in 15 cases of malignant tumor,extended resection was performed in the other 24 malignant tumor cases.After the local resection,the soft tissue was sutured directly to reconstruct the chest wall.The enlarged resection of the bone was performed by reconstructing the bony chest with different materials.In the soft tissue reconstruction,1 cases were treated with myocutaneous flap,and the other 23 cases were sutured directly.Postoperative chest wall integrity is stable,no chest wall floating and abnormal breathing.1 patients received ventilator supportion,and 2 patients had wound infection.The chest wall defect caused by benign tumor has good quality of life,no recurrence.After resection of the malignant tumor of the chest wall,2 died,and the rest were still alive.Conclusion Local resection is the main therapeutic method of benign chest wall tumor,and malignant chest wall tumor is mostly enlarged excision.Bone remodeling after extended resection plays an important role in the reconstruction of chest wall.It is necessary to select appropriate materials for reconstruction.Matrix titanium sternal or rib reconstruction system fixed reliably and the follow-up in a short term were also satisfactory.

Review of high-resolution peripheral quantitative computed tomography for the assessment of bone microstructure and strength / 生物医学工程学杂志

Trabecular microstructure is an important factor in determining bone strength and physiological function. Normal X-ray and computed tomography (CT) cannot accurately reflect the microstructure of trabecular bone. High-resolution peripheral quantitative computed tomography (HR-pQCT) is a new imaging technique in recent years. It can qualitatively and quantitatively measure the three-dimensional microstructure and volume bone mineral density of trabecular bone . It has high precision and relative low dose of radiation. This new imaging tool is helpful for us to understand the trabecular microstructure more deeply. The finite element analysis of HR-pQCT data can be used to predict the bone strength accurately. We can assess the risk of osteoporosis and fracture with three-dimensional reconstructed images and trabecular microstructure parameters. In this review, we summarize the technical flow, data parameters and clinical application of HR-pQCT in order to provide some reference for the popularization and extensive application of HR-pQCT.

Biomechanical comparison of Gamma3 and InterTan nails for stable and unstable intertrochanteric fractures / 中华创伤骨科杂志

Objective To compare the biomechanical properties of Gamma3 and InterTan nails in the fixation of femoral intertrochanteric fractures. Methods Twelve synthetic femora of 4th generation were randomized into 4 equal groups ( n=3 ) for assessment of the 2 constructs of fracture fixation ( Gamma3 versus InterTan nails ) . Groups A and B were made into models of stable femoral intertrochanteric fracture (AO/OTA type 31-A1. 1) and groups C and D into unstable ones(AO/OTA type 31-A2. 3) . The biomechanical properties of Gamma3 and InterTan nails in the 4 models were tested and compared. Results For stable fracture models, the fracture gap movement increased with the increasing axial load and the torque increased with the increasing torsion angle. There were significant differences between groups A and B in fracture gap movement and torque ( P 0. 05 ) . For unstable fracture models, there were no significant differences between groups C and D in fracture gap movement when the axial loads were 500 N, 600 N or 700 N ( P > 0. 05 ) , but there was a significant difference between the 2 groups when the axial load was larger than 800 N ( P <0. 05 ) . With the increasing torsion angle, the torque increased in groups C and D. There was a significant difference between the 2 groups in the torque at the same torsion angle ( P <0. 05 ) . There were a significant difference between groups C and D in failure load ( 2, 781. 5 ± 600. 6 N versus 3, 150. 5 ± 633. 8 N ) ( P=0. 007 ) . Conclusions For stable femoral intertrochanteric fractures, InterTan and Gamma3 nails may exhibit similar biomechanical properties. For unstable femoral intertrochanteric fractures, InterTan nails may provide obviously better biomechanical stability than Gamma3 nails.

The latest research on the pathogenesis of osteonecrosis of the femoral head / 中国组织工程研究

BACKGROUND: Theories concerning the pathogenesis of osteonecrosis of the femoral head (ONFH) are various, such as blood supply dysfunction, lipid metabolism disorder, increased intraosseous pressure, osteocyte apoptosis, gene polymorphism and immunity, but the underlying mechanisms remain unclear.OBJECTIVE: To review the pathogenesis of ONFH, thus providing clues for the study on ONFH.METHODS: Search strategy femoral head necrosis OR osteonecrosis of femoral head AND pathogenesis OR mechanism was used to search articles published between 1985 to 2017 in PubMed, Embase, and Medline databases.Meanwhile, CNKI, WanFang and VIP databases were searched with Chinese keywords of femoral head necrosis,pathogenesis from 1985 to 2017. Finally, 39 articles were included for retrospective analysis.RESULTS AND CONCLUSION: ONFH is a complex disease caused by a variety of factors, among which, biomechanics plays an important role in its occurrence and development. The internal mechanic strength of the femoral head is reduced or the imbalance between external stress and inner structures of femoral head caused by various risk factors leads to micro-fractures of the trabeculae, stress concentration and repeated destruction and repair. When the destruction rate exceeds the repair speed, the femoral heads eventually collapse. Most of ONFH cases are sporadic, but its familial aggregation has been reported; therefore, it may be related with genetic factor.

Determination of perchlorate in food by ultra performance liquid chromatography-tandem mass spectrometry / 中国食品卫生杂志

Objective To establish a method for the determination of perchlorate in food by ultra performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS).Methods The perchlorate residue in spices and condiments was extracted with water,that in vegetables and fruits was extracted with acetonitrile-water (1∶ 1,V/V),and that in meat,poultry,eggs,milk and aquatic products was extracted with acetonitrile-water (2∶ 1,V/V).The supernatant was cleaned up with C18 SPE (3 ml,200 mg),and the detection was carried out by UPLC-MS/MS with internal standardmethod for quantification.Results The calibration curve was linear in the concentration range of 0.3-20.0 pg/L (R2 ≥0.999),the recovery was in the range of 82.6％-108.6％,the relative standard deviation (RSD) was in the range of 1.0％-9.9％,and the limit of detection was 2.0 μg/kg for milk,and 10.0 μg/kg for other food.Conclusion The method was simple,accurate and highly sensitive,and suitable for the determination of perchlorate in food.

In vitro evaluation of the antibacterial activities of different irrigants against Enterococcus faecalis / 实用口腔医学杂志

90 extracted single rooted human teeth were inoculated with E.faecalis.The cannals of the teeth were irrigated with MTAD, 5.25% NaClO,compound chlorhexidine gargle,tinidazole mouthwash,distilled H2 O(infection control)and autoclave followed by distilled H2 O(autoclaving control),respectively(n =1 5).Then E.faecalis infection of the samples were examined.The results showed that MTAD had significantly greater antibacterial effects than 5.25% NaClO,tinidazole mouthwashes,compound chlorhexidine gargle and tinidazole mouthwash(P <0.05).There was no significant difference between each 2 of the other 3 irrigants.

Clinical effect of diode laser on treatment of moderate to severe acne / 中华医学美学美容杂志

Objective To evaluate the efficacy and safety of 650 nm,810 nm diode laser on the treatment of moderate to severe acne.Methods A total of 87 patients with moderate to severe acne were divided into diode laser group (group A) and medication group (group B).In group A,the patients were irradiated with 650,810 nm diode laser at the fluence of 400-450 mW distance of 2-3 cm.In group B,the patients were treated with roxithromycin combined with vitamin B6 and gel lincomycini.Clinical follow-up was performed every week for 4 months.All the adverse effects were recorded.Results There was no significantly statistical difference in the cure rate between the two groups (group A versus group B at 2 weeks:65.0 ％ versus 42.6 ％,P＞0.05; at 4 weeks:92.5 ％ versus 76.5 ％,P＞0.05).However,the recurrence rate of group A was much lower than that of group B (30.0 ％ versus 61.7 ％,P＜0.01).There were no severe adverse effects in both groups during the period of the follow-up.Conclusions Compared to the medication,650,810 nm diode laser appears to be associated with lower recurrence rate in the treatment of moderate to severe acne.

Role of spinal cord opioid receptors in antinoclceptive effect of propofol in rats / 中华麻醉学杂志

Objective To investigate the role of spinal cord opioid receptors in the antinocieeptive effect of propefol in rats. Methods Male SD rats weighing 220-280 g were anesthetized with intraperitoneal chloral hydrate 300 mg/kg. Intratbecal (IT) catheter was placed at L5～6 interspace. Correct placement was confirmed by lower extremity motor block after injection of 2% lidocaine 15 μl via the iv catheter. Animals which were lame or paralyzed were excluded. Ninety SD rats in which IT catheters were successfully placed were randomly divided into 9 groups (n = 10 each): group Ⅰ propofol 10μg IT (P);group Ⅱ dimethyl suipbexide (DMSO-solvent for propofol) 5 μl IT (D);group Ⅲ artificial cerebral spinal fluid (ACSF) 5 μl IT;group Ⅳ propoful 10 μl + naloxone 15 μg IT (PN);group Ⅴ DMSO 5 μl IT + naloxone 15 μg IT (DN);group Ⅳ propofol 10μg IT + CTOP Ⅰμg IT (PC);group Ⅶ DMSO 5 μl IT + CTOP 1μg IT (DC);group Ⅷ propofol 10 μg IT + ICI 174, 864 1 μg IT (PI) and group ⅨDMSO 5 μl 1T + ICI 174, 864 1 μg IT (DI). In group Ⅳ-Ⅸ naloxone or CTOP (μ-receptor antagonist) or ICI 174, 864 (δ-receptor antagonist) was injected 5 min after propofol/DMSO. Pain threshold was measured before the first drug administration (T0) and at 10 min (T1), 20 min (T2) and 40 min (T3) after the first drug administration using hot water tail-withdrawal test. The latency for withdrawal of the tail from hot water was recorded. Results The pain threshold was significantly higher in group P, PN, PC and PI than in group D, DN, DC and DI respectively. The pain threshold was significantly increased at T1.2 compared with the baseline value at T0 in group P, PN, PC and PI. The pain threshold was significantly lower at T3 than at T1 and T2 in group P, PN, PC and PI. The pain threshold was significantly lower after drug administration in group PN and PI than in group P and PC. Conclusion Spinal cord δ-oploid receptors are involved in the anfinocicepfive effect of propofol.

Effects of Digoxin on Cardioventricular Function in Rats after Simulated Weightlessness / 航天医学与医学工程

Objective To investigate the protective effects of Digoxin on cardioventricular function in rats after simulated weightlessness.Methods Eighty rats were divided randomly into 5 groups:control(Con)group,tail-suspended+sham feeding(TS+SF)group,tail-suspended+Digoxin 2 wk(TS+D2)group and tail-suspended+Digoxin 3 wk(TS+D3)group.The TS+SF group was given the distilled water.At the end of tail-suspended for 3 weeks,the heart function of 10 rats in each group was examined with echocardiography.The level of atrial natriuretic polypeptide(ANP)in serum was measured with immunoradiometric assay in other 6 rats.Results Compared with TS+SF group,the contractile function of LV improved in TS+D2 and TS+D3 groups(P0.05).Conclusion Digoxin can improve muscle contractile and blood ejection of LV and retard the tendency of atrophy in simulated weightlessness.

The Cross-talk Between p27~(kip1) and Its Interacting Molecules in Breast Cancer Cells / 生物化学与生物物理进展

p27kip1 is an important negatively regulator of cell cycle progression and plays a central role in the pathogenesis of a member of tumors including breast cancer. In breast cancer cells, the level of p27kip1 expression usually decreases during tumor development and progression, in addition, cytoplasm mislocalization of p27kip1 has been reported, but less is known about the exact molecular mechanisms. Studies have indicated that phosphorylation is the key regulation way, several signal transduction pathways are involved in the regulation of the expression and distribution of p27kip1. To further understand the mechanism, the disparity of the interacting protein profiling between tumor cells and normal cells must be identified first. Including cyclins, cyclin-depend kinases, CRM1, jab1, SKP2, p27kip1 has various interacting molecules. There are also several interacting molecules especially for breast cancer cells. It seems that different protein profiling cause the different expression and intracellular distribution in different cell cycle phase. So, disparity of the p27kip1 protein profiling may be the main mechanism of its down-expression and mislocalization in breast cancer cells.

Clinical significance of p27~(Kip1) expression in breast cancer at clinical stage Ⅰ and Ⅱ / 医学研究生学报

Objective:Tumor size,lymphnode metastasis,hormone level and so on have been the prognosis predictors of breast cancer,but they are not ideal. This study is to investigate the influence of the expression of p27Kip1 in early breast cancer prognosis and its relationship with clinical feature. Methods:Archival early breast carcinomas (n=106),were analyzed for p27Kip1 expression by immunohistochemistry EnVision system using specific mono-clonal antibody. Results:The p27Kip1 protein nucleus expression was low in 61 (57.55%) of the 106 cases in early breast carcinomas,which has statistic difference from the high expression in survival rate (P0.05),but correlated with lymph-node metastasis and histological grade (P

Effect of postoperative analgesia with epidural morphine after cesarean section on prolactin and coiostrum / 中华麻醉学杂志

In order to observe the effect of postoperative analgesia with epidural morphine on the prolactin and colostrum after cesarean section. Method: Forty healthy full-term parturients undergoing elective cesarean section under epidural anesthesia, were randomly divided into two groups: the analgesic group (group A, n=20)and the controlled group (group C, n=20). Postoperative follow-up time was 48 hours. The plasma prolactin level was determined with radioimmunoassay. Result: The VAS of group A was significantly lower than that of group C (P

THE DISTRIBUTION OF THE SUBSTANCE K-LIKE IMMUNOREACTIVITY IN HUMAN SPINAL CORD / 解剖学报

thoracic, but the density of SKLI in the enlargement of the cervical segments is much higher than any other cervical segments. No SKLI was found in the ventral horn. It was also discussed that substance k may act as a neurotransmitter in nervous system.

MORPHOLOGICAL CHARACTERISTICS OF NORMAL CARDIAC MYOCYTE GROWTH / 解剖学报

The cell volume, length, cross-section area, surface area, width and thickness of isolated cardiac myocytes were measured by using of a new computer system of coulter channelyzer and avias eye imaging analysis system. The rats, 3 weeks to 24 weeks in age after birth, were performed thoracic operation the morphological growth characteristics of isolated cardiac myocytes were observed.1. Physiological growth of normal cardiac myocytes was due to increase in cell volume, i. e. the cell length and cross-section area were enlarged. In the mean time, the changes in cross-section shape of myocytes happened when the myocytes growing.2. The major axis of cross-section area of myocytes was enlarged but the minor cross-section diameter did not show any more changes. So that, the growth lead to the cardiac myocytes be flattened in shape. The flattened growing pattern was one of the characteristics of normal growing myocytes. It might be very significant for the clinicians to eliminate the factors which would stimulate myocytes to be enlarged in cell width, and to treat and to prevent the heart disease.