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In recent years,due to the coming of aging society,pelvic floor dysfunction(PFD)has gradually become one of the research hotspots in the field of obstetrics and gynecology worldwide.At present,surgery is the preferred treatment for moderate to severe PFD patients. With the development of minimally invasive surgery technology and the renewal of minimally invasive concept,PFD treatment options have been improved continuously. Natural orifice transluminal endoscopic surgery has been applied to gynecological surgery because of its fast recovery,slight pain and being without abdominal incision. Although the development of minimally invasive surgery provides more surgical options,different surgical methods have their advantages and disadvantages,and they should be controlled.Therefore,the age,symptoms,signs,medical history and general condition of the patients should be comprehensively evaluated to achieve the best therapeutic effect.
RESUMO
OBJECTIVE: To study the efficacy of transvaginal natural orifice transluminal endoscopic surgery(vNOTES)sacrocolpopexy in the treatment of pelvic organ prolapse(POP).METHODS: From June 2017 to September 2018,33 POP patients who underwent vNOTES sacrocolpopexy in the Third Affiliated Hospital of Guangzhou Medical University were collected.The operative time,blood loss and postoperative complications were recorded to evaluate the safety of the operation.After regular follow-up,POP-Q was used to objectively evaluate the effect of surgery,and PFIQ-7 was used to evaluate the recovery effect.RESULTS: In this group,3 of 33 cases were converted to transumbilical laparoscopy,and in the remaining 30 cases the surgery was successfully completed.The operation time was(184.97±41.91)min,and mean estimated blood loss was(28.33±18.77)mL.No complications such as exposure or infection of mesh were found after operation.The POP-Q indicators were significantly improved in 1,3,6 months after surgery(P<0.05),and the quality of life was better after operation than before(P<0.05).CONCLUSION: vNOTES is a feasible and safe approach for sacrocolpopexy with positive short-term efficacy in the treatment of POP.
RESUMO
Dirigent and dirigent-like family proteins contain a number of proteins involved in lignification or in the response to pathogen infection and abiotic stress in plants. In the present study, a full-length cDNA sequence of a dirigent-like gene designated ScDir (GenBank Accession Number JQ622282) was obtained from sugarcane based on the stem full-length cDNA library. The ScDir gene was 819-bp long, including a 564-bp ORF encoding 187 amino acid residues. The protein N-terminus contained signal peptides at amino acid residues of 1-25 and transmembrane regions at 7-26 aa. A his-tagged ScDir protein with an estimated molecular mass of 27.4 kDa was expressed in Escherichia coli system. The expressed ScDir protein had increased the host cell's tolerance to PEG and NaCl. When an endogenous GAPDH gene was used as internal control, results from real-time qPCR demonstrated that the ScDir mRNA amount in sugarcane stems was significantly higher than that in the roots, leaves and buds by 18.64 ± 0.48, 25,635.16 ± 2,966.03 and 721.50 ± 8.17-fold, respectively. The ScDir transcript levels in sugarcane seedling increased under H(2)O(2), PEG or NaCl stress. The expression level of ScDir was significantly upregulated under PEG stress, and the highest level was observed at 12 h after stress. Thus, both the ScDir-hosted cell performance and the enhanced expressions in sugarcane imply that the ScDir gene is involved in the response to abiotic stresses of drought, salts and oxidation. The transcription of the ScDir gene is highly stem-specific, as revealed by real-time qPCR. Key message A novel sugarcane Sc-Dir gene, DIRd subfamily, which is highly stalk-specific expression and involved in the response to artificial stresses of drought, salts, and oxidatives.
