An experiment control study on the ovarian reserve function after cisplatin intraperitoneal or intravenous chemotherapy in rats model / 中华妇产科杂志

Objective To compare the impact on the ovarian reserve function after cisplatin intraperitoneal or intravenous chemotherapy in rats model. Methods Thirty 8-weeks old female Sprague Dawley rats were randomly assigned to control group (group A, n=10), intraperitoneal chemotherapy group (group B, n=10) and intravenous chemotherapy group (group C, n=10). Cisplatin was diluted by normal saline (NS) into 4 mg/ml. On the first day of chemotherapy, 0.2 ml cisplatin dilution was injected into the abdomen of rats in group B, isodose cisplatin was injected into vein and 1.8 ml NS was injected into abdomen of rats in group C, 2.0 ml NS was injected into abdomen of rats in group A for control. Feed the three groups rats and test the anti-Mullerian hormone (AMH) in serum on day 0 (just before injection), day 10 and day 20 by ELISA, count the numble of follicle in bilateral ovaries on day 20. Results (1) The levels of serum AMH in the three groups before and after chemotherapy were compared: ① comparison between groups: On day 10 and day 20 , the AMH level in group B [(64.5 ± 2.9), (68.6 ± 3.4) ng/L] and group C [(76.1±4.9), (91.3±3.9) ng/L] was significantly lower than that in group A [(120.1±5.3), (121.7±4.6) ng/L;P<0.01], AMH level in group B was significantly also lower than that in group C (P=0.000). ② Comparison within groups:the AMH level on day 0 was significantly lower than that on day 10 and day 20 in group A (P<0.01), but there was no significant difference between day 10 and day 20 (P=0.427). The AMH level on day 0 was significantly higher than those on day 10 and day 20 in group B (P<0.01) and group C (P<0.01). There was no difference in AMH level between day 10 and day 20 (P=0.124) in group B, but the level was significant lower on day 10 than that on day 20 in group C (P=0.011). (2)Comparison of the number of follicles in ovaries of three groups 20 days after chemotherapy:the follicles number in group A(35±13)was greater than that in group B (16 ± 9,P=0.003) and similar with group C (31 ± 16,P=0.474) on day 20. The follicles number in group B was significantly less than that in group C (P=0.018). Conclusions In the present study, both intravenous and intraperitoneal chemotherapy have impacts on ovarian reserve function and the latter might be more serious. The level of AMH will rise again over time after chemotherapy and rats undergo intravenous chemotherapy would recover faster. The results suggest that the ovarian reserve function need more time to recover after intraperitoneal chemotherapy. For patients with ovarian cancer who want to preserve fertility function, intravenous chemotherapy might be more appropriate.

Application of virtual simulation technology to laboratory medicine / 中华检验医学杂志

Medical virtual simulation teaching environment is an advanced and complex combination of virtual simulation technology and medical technology training .As an advanced information technology , it has been attracting the attention of medical education researchers .Based on the characteristics of medical laboratory technology education , the virtual simulation experimental teaching center was established and a framework of the virtual simulation training environment was designed in the Department of Laboratory Medicine, Southern Medical University .Virtual simulation softwares and tool softwares were put into use widely in our experimental teaching .As it turns out, this simulated training environment has many merits such as risk-free safety , great efficiency , genuine learning experience and wide application potential , which partly overcomes the restriction of the teaching process brought by the condition of the practical operation and improves the teaching effect significantly .

Application of modified total pelvic reconstruction in the treatment of pelvic organ prolapse in elderly women / 中华老年医学杂志

Objective To evaluate the efficacy and safety of modified total pelvic reconstruction for pelvic organ prolapse in elderly women.Methods 105 patients required operation for treatment of pelvic organ prolapse were enrolled in this study.Patients were divided into experimental group (n =68,treated with the modified total pelvic reconstruction) and control group (n=37,receiving prolift procedure).Objective indexes including bleeding volume,operative time,residual urine volume,postoperative complications,medical expenses,hospitalization time were recorded.Clinical efficacy and follow-up results were recorded and compared between the two groups at 6 months after operation.Results Bleeding volume and hospitalization costs were lower in experimental group than in control group (both P＜0.05),while the operative time,residual urine volume,time out of bed,anal exhaust time,the maximum body temperature,mean postoperative hospital stay showed no significant differences between the two groups (all P＞0.05).Vaginal perforation was observed in 7 cases,with 4 cases in experimental group and 3 cases in control group.No serious complications such as bladder and rectum perforation were observed.According to pelvic organ prolapse quantitation (POP-Q) score,64 cases (94.1％) were cured and 4 cases (5.9％) were invalid in experimental group,while 36 cases (97.3％) were cured and 1 case (2.7％) was invalid in control group.The noninferiority test showed that clinical efficacy in experimental group was non-inferior to that in control group (u=2.252,P＜0.05).Conclusions Modified total pelvic reconstruction is an effective and safe minimally invasive surgery,which is similar to prolift surgical operation,but it is relatively inexpensive,which is easier to be accepted by Chinese patients,with a great perspective in clinical application.

An modified vaginal mesh procedure for the female persistent or recurrent stress urinary incontinence after initial synthetic mid-urethral slings operation / 中华泌尿外科杂志

Objective The aim of study is to evaluate the efficacy of a new complementary midurethral sling surgery in treating recurrent or persist female stress urinary incontinence (SUI) after primary Synthetic mid-urethral slings (MUSs).Methods The methods was used in 32 patients who had suffered recurrent or persist SUI patients after primary MUSs during June 2005 and July 2011.Their primary MUSs were:TVT 2 cases,IVS 4 cases,TVT-O 17 cases,TOT 3 cases,T-sling 1case,other MUSs 5 cases.9 cases complained SUI symptoms continued after primary surgery and had no improvement after 6 months following up.23 cases reported SUI symptoms recurrent and aggravated in 6 months after primary operation and had no improvement 1 year after operation.All these patients have been treated with surgery,a trans-vaginal mid-urethral sling on descending pubic ramus.In this study we followed up these patients for one year after this complementary operation and evaluated operating time,blood loss,efficacy and complications.Results In this study the operating time was 41.1±13.1 minutes,blood loss was 70.6±23.8 ml.30 patients kept urinary catheter 6 h after operation and 2 kept urinary catheter 48 h after operation.All patients could micturate after removed urinary catheter and average residual urine was 23.8 ± 21.4 ml (range 0-80 ml).The average in-patients duration was 4.8± 1.1days.SUI symptoms still persisted in two patients after second operation,subjective cure was achieved in 26 patients and the symptoms obviously improved in 4 patients when they left hospital.The efficient rate was 93.8％ (30/32) left hospital and after 3 months,93.3％ (28/30) after 6 months and 86.2％ (25/29) after 1 year.There were 2 cases of recurrence and 1 case of mesh erosion after 1 year,no other operative complications were reported.Conclusions Our study found that it is a efficient operation to treat SUI recur or persist after primary.

A comparative study on two surgical procedures in treatment of stress urinary incontinence in old women / 中华老年医学杂志

Objective To evaluate the safety and efficacy of two surgical procedures including retropubic space pathway and obturator foramen pathway in treatment of the old women with stress urinary incontinence (SUI). Methods Intravaginal Slingplasty (IVS) procedure by retropubic space pathway was performed in 52 cases with simple SUI from June 2003 to June 2005. And the modified Transobturator Vaginal Tape Inside-Out (TVT-O) procedure was carried out in 112 cases with simple SUI from October 2005 to October 2008, using self-tailed polypropylene mesh and helical needles. The comparative retrospective study was performed between these two groups. Results The cure rate was 80.8% (42/52) and the improvement rate was 13.5% (7/52) in IVS group. And the corresponding data were 84.8% (95/112) and 11.6% (13/112) in modified TVT-O group. The 3 (5.8%) cases failed in IVS procedure and 4 (3.6%) cases failed in modified TVT-O procedure at 1 month's follow-up. All of the 7 patients received the 'Tong's hammock procedure' and no cases failed at 6 and 12 month's follow-up. One case of vaginal erosion was found in each group although good effect of continence was observed. Meshes were removed in these two patients and then the 'Tong's hommock procedure' was performed which turned out to be good outcome. Bladder injuries were found in 3 cases when route cystoscopy was performed. No significant difference in efficacy was found between these two groups(P＞0. 05). In modified TVT-O group, operative duration, blood loss and medical cost were significantly reduced as compared with IVS group (P＜0. 01). Conclusions Both of the two surgical procedures of modified TVT-O versus IVS are simple, safe and mini-invasive procedures with high efficacy. However, the modified TVT-O procedure is more easy to be adopted by patients due to short operative time and lower medical cost.

IL-6 can upregulate porcine ovarian granulosa cells androgen receptor expression / 基础医学与临床

Objective To study the effect of intedeukin 6 (IL-6) on the expression of androgen receptor (AR) in porcine ovarian granulosa cells(GC) and to explore its role of in the polycystic ovary syndrome(PCOS) pathogenesis.Methods Different concentrations of IL-6 (10,100 and 1 000 ng/L) were treated with GC.Expression of androgen receptor (AR) mRNA and protein in GC were detected by real-time quantitative RT-PCR and Western blot.Results The mRNA and protein expressions of AR in GC were upregulated in groups with 100 and 1 000 ng/L IL-6 at 72 h.Conclusion IL-6 can improve androgen activity.This process may explain the function of chronic subclinical inflammation in PCOS pathogenesis.

The clinical effect and safety of human blood albumin for treating acute cerebral hemorrhage / 中国综合临床

Objective To assess the clinical effect and safety of human blood albumin in treatment of acute cerebral hemorrhage.Methods 88 patients with acute cerebral hemorrhage were randomly divided into 2 groups. Both group were given routine therapy and 45 cases in the treating group were given additional 10% human blood albumin 100 ml ivgtt once a day for 7 days.14 days served as a treatment course.Neurofunction was compared before and after treatment.Results Both the effective rate (P<0.05) and the neurofunction in the treating group were better than that of the control group (P<0.05).No advert effect happened.Conclusion Human blood albumin is an efiective and safe medicine for treatment of acute cerebral infarction.

Mechanical analyses on urethra wall after suburethral slings for female pig stress urinary incontinence / 第三军医大学学报

Objective To analyze the mechanical mechanism of suburethral slings by measuring the mechanical properties of female pig urethra wall and polypropylene mesh.Methods The uniaxial tension tests of 49 female pig urethra wall strips and 27 polypropylene mesh samples were performed to test the mechanical properties.Results The stress and strain of urethra wall displayed a parabola shape and its elastic modulus was proportional to the square root of stress as well as the strain.The maximum calculated elastic moduli of the urethra wall were 0.806 MPa and 0.818 MPa correspondingly calculated with stress and strain.The elastic modulus of polypropylene mesh was(6.977?1.095) MPa.The ultimate stress of polypropylene mesh was significantly higher than that of the urethra wall,and the ultimate strain of polypropylene mesh was significantly lesser than that of the urethra wall.The calculation results suggested that the suburethral slings treatment of poly-propylene mesh decreased the deformation to 1/3 of the untreated stress urinary incontinence.Conclusion Polypropylene mesh has special mechanical properties that suit suburethral slings and enhance the support to the urethra,and improve the continence.