Clinical efficacy of integral theory-guided laparoscopic integral pelvic floor/ligament repair in the treatment of internal rectal prolapse in females.

BACKGROUND: Internal rectal prolapse (IRP) is one of the most common causes of obstructive constipation. The incidence of IRP in women is approximately three times that in men. IRP is mainly treated by surgery, which can be divided into two categories: Abdominal procedures and perineal procedures. This study offers a better procedure for the treatment of IRP. AIM: To compare the clinical efficacy of laparoscopic integral pelvic floor/ligament repair (IPFLR) combined with a procedure for prolapse and hemorrhoids (PPH) and the laparoscopic IPFLR alone in the treatment of IRP in women. METHODS: This study collected the clinical data of 130 female patients with IRP who underwent surgery from January 2012 to October 2014. The patients were divided into groups A and B. Group A had 63 patients who underwent laparoscopic IPFLR alone, and group B had 67 patients who underwent the laparoscopic IPFLR combined with PPH. The degree of internal rectal prolapse (DIRP), Wexner constipation scale (WCS) score, Wexner incontinence scale (WIS) score, and Gastrointestinal Quality of Life Index (GIQLI) score were compared between groups and within groups before surgery and 6 mo and 2 years after surgery. RESULTS: All laparoscopic surgeries were successful. The general information, number of bowel movements before surgery, DIRP, GIQLI score, WIS score, and WCS score before surgery were not significantly different between the two groups (all P > 0.05). The WCS score, WIS score, GIQLI score, and DIRP in each group 6 mo, and 2 years after surgery were significantly better than before surgery (P < 0.001). In group A, the DIRP and WCS score gradually improved from 6 mo to 2 years after surgery (P < 0.001), and the GIQLI score progressively improved from 6 mo to 2 years after surgery (P < 0.05). In group B, the DIRP, WCS score and WIS score significantly improved from 6 mo to 2 years after surgery (P < 0.05), and the GIQLI score 2 years after surgery was significantly higher than that 6 mo after surgery (P < 0.05). The WCS score, WIS score, GIQLI score, and DIRP of group B were significantly better than those of group A 6 mo and 2 years after surgery (all P < 0.001, Bonferroni) except DIRP at 2 years after surgery. There was a significant difference in the recurrence rate of IRP between the two groups 6 mo after surgery (P = 0.011). There was no significant difference in postoperative grade I-III complications between the two groups (P = 0.822). CONCLUSION: Integral theory-guided laparoscopic IPFLR combined with PPH has a higher cure rate and a better clinical efficacy than laparoscopic IPFLR alone.

Peniciketals A-C, new spiroketals from saline soil derived Penicillium raistrichii.

Peniciketals A-C (1-3), three new spiroketals with a benzo-fused 2,8-dioxabicyclo[3.3.1]nonane moiety, were isolated from the saline soil derived fungus Penicillium raistrichii. Their structures including absolute configurations were established by NMR, X-ray diffraction, and ECD calculations. Their cytotoxicities were tested against A549, HL-60, and K562 cell lines, and 1-3 showed the selective effects on HL-60 cells with IC50 values of 3.2, 6.7, and 4.5 µM, respectively.

Acute stress and chronic stress change brain-derived neurotrophic factor (BDNF) and tyrosine kinase-coupled receptor (TrkB) expression in both young and aged rat hippocampus.

PURPOSE: The purpose of this study is to explore the dynamic change of brainderived neurotrophic factor (BDNF) mRNA, protein, and tyrosine kinase-coupled receptor (TrkB) mRNA of the rat hippocampus under different stress conditions and to explore the influence of senescence on the productions expression. MATERIALS AND METHODS: By using forced-swimming in 4 degrees C cold ice water and 25 degrees C warm water, young and aged male rats were randomly divided into acute stress (AS) and chronic mild repeated stress (CMRS) subgroups, respectively. BDNF productions and TrkB mRNA in the hippocampus were detected by using Western-blotting and reverse transcription-polymerase chain reaction (RT-PCR), separately, at 15, 30, 60, 180, and 720 min after the last stress session. RESULTS: The short AS induced a significant increase in BDNF mRNA and protein in both age groups, but the changes in the young group were substantially greater than those of the aged group (p < 0.005). The CMRS resulted in a decrease in BDNF mRNA and protein, but a significant increase in TrkB mRNA in both young and age groups. The expression of BDNF mRNA and protein in the AS groups were higher than in the CMRS groups at 15, 30, and 60 min after stress. CONCLUSION: The results indicated that the up/down-regulation of BDNF and TrkB were affected by aging and the stimulus paradigm, which might reflect important mechanisms by which the hippocampus copes with stressful stimuli.

Aging effects on the BDNF mRNA and TrkB mRNA expression of the hippocampus in different durations of stress.

Brain-derived neurotrophins factor (BDNF) belongs to the neurotrophins family which acts on neuronal survival and growth and has been associated with cognition process. TrkB is the primary signal transduction receptor for BDNF. In the present study, hippocampal BDNF and TrkB mRNA were detected by RT-PCR in 2- and 22-month rats, respectively, which were exposed to different durations of mild stress protocol of 8-day, 21-day and 28-day chronic unpredictable mild stress (CUMS). Observation of exploratory behavior in an open field (OF) test indicated stress levels and changes of spontaneous activity. We demonstrated that CUMS induced decrease of BDNF mRNA in two aged groups, but the increase change of TrkB mRNA compared with those of the control groups. Moreover, the changes of BDNF mRNA and TrkB mRNA measured in both the 21-day and 28-day stress groups represent obvious decrease than those of the 8-day stress groups, and the expression examined in young groups appeared to be higher than those of the aged group, especially in the 28-day stress groups. Results of OF test showed that explicit behaviors in two age groups decreased gradually with the process of stress revealing a depressive state under the stress condition. Meanwhile, the behaviors of young rats seemed to be more active than those of the aged rats, exhibiting weak adaptation to the stress. The study suggested that stress paradigm and aging certainly had effect on the regulation of BDNF mRNA and TrkB mRNA which might be related to damage and protection function of the hippocampus.

Psychiatric state of college students with a history of childhood sexual abuse.

BACKGROUND: Childhood sexual abuse (CSA) seriously influences children's psychological status. This study aimed to investigate the relationship between CSA and the psychiatric disorders. METHODS: An anonymous and retrospective questionnaire survey was carried out in 1307 college students (aged 18-25 years; 701 females, 606 males) to investigate the participants' CSA experience by means of a complete random sampling method. The Symptom Check-List-90 (SCL-90) test was used to study the victims' psychiatric aspects. RESULTS: 22.11% (155/701) of the female students and 14.69% (89/606) of the male students experienced physical and/or non-physical contact CSA before age 18, with a significant difference between female and male (P<0.05). And 11.43% (80/701) of the female students and 7.26% (44/606) of the male students experienced physical contact CSA (P<0.05). Most abusers were male and young people, and only a few of them used violence. 78.7% of the females experienced non-physical contact CSA from strangers, while 71.3% experienced physical contact CSA from acquaintances. 89.9% of the male victims knew the abusers before. Females were more likely than males to experience physical contact CSA from members of the family circles. The CSA incidence increased with age in females, while 54.7% of the male victims experienced CSA from 12 to 16 years. The students who experienced CSA had higher SCL-90 scores than those who did not in somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism. The more serious the CSA experience was, the higher SCL-90 scores of the psychiatric disorders would be. CONCLUSIONS: CSA is not uncommon in adolescents. Girls are more likely to experience CSA than boys. About half of the abusers are the victims' close relatives, neighbors and teachers; most abusers were male. Personal experience of CSA may seriously affect the victims' psychological health.