Ultralight type I transvaginal mesh: an alternative for recurrent severe posterior vaginal prolapse.

OBJECTIVE: This study aimed to analyze the medium-term outcomes of ultralight type I mesh for postmenopausal women with recurrent severe posterior vaginal prolapse (PVP). METHODS: All participants underwent transvaginal ultralight type I mesh repair between April 2016 and April 2021 and were followed until May 2022. Pelvic Organ Prolapse Quantification System (POP-Q) staging, mesh-related complications, Patient Global Impression of Improvement (PGI-I) scale and quality of life questionnaire responses were evaluated. The primary outcome was composite surgical success rate at the last follow-up, composite success being defined as no vaginal bulge symptoms, no POP-Q point at or beyond the hymen and no re-treatment for POP. Secondary outcomes included anatomic outcomes (POP-Q score), symptomatic relief and complications. RESULTS: The median follow-up was 37.3 months. At the last follow-up, the composite success rate was 75%, and POP-Q scores for the vault and posterior wall and quality of life questionnaire scores were significantly improved (p < 0.01). The subjective satisfaction (PGI-I ≤ 2) rate was 83.3%. There were no mesh-related complications. CONCLUSIONS: Ultralight mesh can achieve good clinical outcomes and substantially improve the quality of life of patients with severe recurrent PVP in the medium term, and may thus be a viable alternative for treating this condition.

Association between preconception paternal smoking and birth defects in offspring: evidence from the database of the National Free Preconception Health Examination Project in China.

OBJECTIVE: To clarify whether preconception paternal smoking has any adverse effects on the offspring. DESIGN: Prospective, population-based study. SETTING: Preconception registry data from the National Free Preconception Health Examination Project. POPULATION OR SAMPLE: Couples planning pregnancy, with complete information on preconception paternal smoking behaviour and pregnancy outcomes. METHODS: The effect of questionnaire-based paternal smoking behaviour during preconception and pregnancy was assessed via logistic regression. Additionally, we performed a 1:1 case-control (birth defects versus normal pregnancy) analysis, matched for maternal province, folic acid supplementation and paternal alcohol consumption. MAIN OUTCOME MEASURES: Risk of birth defects in offspring. RESULTS: In total, 566 439 couples with complete information on preconception paternal smoking behaviour and pregnancy outcomes were enrolled. The preconception paternal smoking rate was 28.7% (162 482) overall: 8.7% (49 303) stopped smoking, 13.3% (75 517) decreased their smoking, and 6.6% (37 662) continued smoking during early pregnancy. The risk of birth defects was higher in the continued-smoking (P < .000, odds ratio [OR] 1.87, 95% CI 1.36-2.56) and decreased-smoking groups (P = .007, OR 1.41, 95% CI 1.10-1.82). In the case-control analysis, infants whose fathers stopped (P = .003, OR 0.32, 95% CI 0.15-0.67) or decreased smoking (P = .000, OR 0.25, 95% CI 0.13-0.49) were at lower risk of congenital heart diseases, limb abnormalities, digestive tract anomalies and neural tube defects than those whose fathers continued smoking. CONCLUSION: Preconception paternal smoking may be associated with congenital heart diseases, limb abnormalities and neural tube defects in the offspring. Changes in smoking behaviour may reduce this risk. TWEETABLE ABSTRACT: This study suggests that preconception paternal smoking is associated with birth defects in offspring. Changes in smoking behaviour may reduce this risk.

Effect of Mg/Ca molar ratios on characteristics of anaerobic-anoxic denitrifying dephosphatation.

In this study, the effect of three Mg/Ca molar ratios (5.0, 3.8 and 1.7) on denitrifying phosphate removal performance, biomass morphology, and Extracellular Polymeric Substances (EPS) were examined. Results showed that when the influent Mg/Ca molar ratio was 3.8, the anaerobic-anoxic EBPR performed complete phosphate removal. The microbial bacterial population was a mixed culture comprised of 81±3% DPAO and 13±2% denitrifying glycogen accumulating organisms (DGAO). A higher influent Mg/Ca molar ratio (5.0) had a distinct impact on phosphate removal, biomass morphology, and EPS. This probably induced the deterioration of the anaerobic-anoxic Enhanced Biological Phosphorus Removal (EBPR). The results of this study may inform the proper operation of an anaerobic-anoxic EBPR, and contribute to its application in the real world.

Accumulibacter clades Type I and II performing kinetically different glycogen-accumulating organisms metabolisms for anaerobic substrate uptake.

The anaerobic acetate (HAc) uptake stoichiometry of phosphorus-accumulating organisms (PAO) in enhanced biological phosphorus removal (EBPR) systems has been an extensive subject of study due to the highly variable reported stoichiometric values (e.g. anaerobic P-release/HAc-uptake ratios ranging from 0.01 up to 0.93 P-mol/C-mol). Often, such differences have been explained by the different applied operating conditions (e.g. pH) or occurrence of glycogen-accumulating organisms (GAO). The present study investigated the ability of biomass highly enriched with specific PAO clades ('Candidatus Accumulibacter phosphatis' Clade I and II, hereafter PAO I and PAO II) to adopt a GAO metabolism. Based on long-term experiments, when Poly-P is not stoichiometrically limiting for the anaerobic VFA uptake, PAO I performed the typical PAO metabolism (with a P/HAc ratio of 0.64 P-mol/C-mol); whereas PAO II performed a mixed PAO-GAO metabolism (showing a P/HAc ratio of 0.22 P-mol/C-mol). In short-term batch tests, both PAO I and II gradually shifted their metabolism to a GAO metabolism when the Poly-P content decreased, but the HAc-uptake rate of PAO I was 4 times lower than that of PAO II, indicating that PAO II has a strong competitive advantage over PAO I when Poly-P is stoichiometrically limiting the VFA uptake. Thus, metabolic flexibility of PAO clades as well as their intrinsic differences are additional factors leading to the controversial anaerobic stoichiometry and kinetic rates observed in previous studies. From a practical perspective, the dominant type of PAO prevailing in full-scale EBPR systems may affect the P-release processes for biological or combined biological and chemical P-removal and recovery and consequently the process performance.

Rabbit model of primary hyperparathyroidism induced by high-phosphate diet.

The objective of this study is to establish a new rabbit model of primary hyperparathyroidism (PHPT) induced by high-phosphate diet. One hundred twenty rabbits were divided into two groups of 60 each. The treatment group was fed a high-phosphate diet (Ca:P = 1:7) and the control group was given a normal animal diet (Ca:P = 1:0.7) for 1 to 6 mo. Serologic examinations, including parathyroid hormone (PTH), calcium and phosphorus levels, blood urea nitrogen, creatinine, and uric acid, and the histologic examination, including parathyroid, kidney, and bones, were performed at the end of each month for 6 mo. Compared with the control, serum PTH levels in the treatment groups were elevated at all six time points, whereas serum calcium levels were reduced, and serum phosphorus levels remain unchanged over the course of the first 3 mo. Serum calcium levels were increased, whereas serum phosphorus levels were reduced at 4, 5, and 6 mo. Parathyroid histopathological examination showed no change during the first month, whereas 60% of the animals exhibited mild hyperplasia starting at 2 mo, and 90% of the animals in the treatment group exhibited mild-to-moderate hyperplasia with gland enlargement starting from 3 mo through the end of the study. Histopathological examination of the kidneys showed no change at 1 mo, but focal parenchymal inflammation with calcium deposition was observed in the treatment groups at 2 to 6 mo. Fibrous tissue of the bone extended toward the cortex, and fibrosis was evident at the third month. The fibrous cells were found to be concentrated mainly on the inner and outer membranes of the bone cortex, and the amount of fibrous tissue increased as the disease progressed. We conclude that a new rabbit animal model of PHPT can be successfully created by the administration of a high-phosphate diet. This animal model can be used in various future studies related to PHPT.

Effects of vitamin E supplementation in the extender on frozen-thawed bovine semen preservation.

The maturing sperm cells discard the majority of their cytoplasm during the final stages of spermatogenesis and lose some of their defense enzymes. The purpose of this study was to investigate the effects of vitamin E supplementation on standard semen quality parameters and antioxidant activities of frozen-thawed bovine sperm. Vitamin E was added at concentrations of 0.5, 1.0, 1.5 and 2.0 mg/ml to bovine semen cryoprotective medium. The results showed that the sperm motility and VSL, STR values in the extender supplemented with 1.0 and 1.5 mg/ml of vitamin E, were significantly higher than that of other concentrations (P < 0.05). The percentages of acrosome-intact and membrane-intact sperm were significantly improved (P < 0.05) by supplementing with 1.5 mg/ml of vitamin E. In biochemical assays, the extender supplemented with vitamin E did not exhibit significant improvement in SOD (superoxide dismutase) levels, compared with the control (P > 0.05). Compared with other groups, CAT (catalase) levels were demonstrated to be greater with the supplementation of vitamin E at 1.0 and 1.5 mg/ml (P < 0.05). The extender supplemented with 1.5 mg/ml of vitamin E caused the highest levels of glutathione peroxidase (GSH-Px), compared with other groups (P < 0.05). The glutathione (GSH) activity was significantly higher with the supplementation of 0.5, 1.0 and 1.5 mg/ml of vitamin E, compared with 2.0 mg/ml in the vitamin E group and control (P < 0.05). Moreover, increasing the doses of vitamin E decreased sperm antioxidant activities, the extender supplemented with 2.0 mg/ml of vitamin E, caused the lowest levels of GSH-Px and GSH activities, compared with other treatment groups (P < 0.05). In conclusion, the beneficial effects of vitamin E noted in this study can be attributed to the antioxidant characteristics. Vitamin E supplementation in the extender reduced the lipid peroxidation potential and improved semen quality during freezing-thawing. More researches are needed to evaluate and understand the precise physiological role of vitamin E in reproduction.

The cryoprotective effects of vitamin B12 supplementation on bovine semen quality.

The present study aimed to investigate the effects of vitamin B(12) supplementation on standard bovine semen quality parameters and anti-oxidative enzyme activities. Vitamin B(12) was supplemented at concentrations of 1.25, 2.5, 3.75 and 5.0 mg/ml to bovine semen cryoprotective medium. The results indicated that the motility and straight line velocity, curvilinear velocity, mean coefficient, velocity of the average path values of sperm supplemented with 2.50 mg/ml vitamin B(12) were significantly higher than that of other groups (p<0.05). No significant difference was observed for linearity index, lateral head displacement values and the percentage of grade A spermatozoa between the extenders containing 2.50 and 3.75 mg/ml vitamin B(12) (p>0.05). The percentages of acrosome-intact and plasma membrane-intact spermatozoa were significantly improved (p<0.05) by supplementing with 2.50 mg/ml vitamin B(12) . The results of biochemical assay revealed that vitamin B(12) supplementation did not cause significant changes in superoxide dismutase levels compared with control (p>0.05). However, the catalase levels were higher in the treatment supplemented with vitamin B(12) at 2.50 mg/ml, when compared with other groups (p<0.05). The extender supplemented with vitamin B(12) significantly decreased glutathione peroxidase activity compared with the control (p<0.05). The supplementation of 3.75 mg/ml vitamin B(12) caused the highest value of glutathione reductase activity, compared with other groups (p<0.05). In conclusion, the extender supplemented with vitamin B(12) could reduce the oxidative stress provoked by freezing-thawing and improve bovine semen quality. Further studies are required to obtain more concrete results on the determination of lipid peroxidation and antioxidant capacities of vitamin B(12) in cryopreserved bovine semen.

Green tea epigallocatechin gallate: a natural inhibitor of fatty-acid synthase.

We discover that epigallocatechin gallate (EGCG) from green tea is an inhibitor of fatty-acid synthase (FAS) from chicken liver. Its inhibition of FAS is composed of reversible fast-binding inhibition, through which 52 microM EGCG can inhibit 50% of the activity of FAS, and irreversible slow-binding inactivation following saturation kinetics with the dissociation constant of 0.352 mM and limiting rate constant of 0.0168 min(-1). The marked inhibition of ketoacyl reduction shows that the inhibition is related to beta-ketoacyl reductase of FAS. The observable protection of NADPH and competitive inhibition of NADPH for ketoacyl reduction indicate that EGCG may compete with NADPH for the same binding site. The synthetic inhibitor C75 does not show obvious fast-binding inhibition, but does exhibit irreversible slow-binding biphasic inactivation, which is demonstrated to be a second-order reaction. That the inactivation by C75 is protected by malonyl-CoA indicates C75 is similar to cerulenin in being a covalent inactivator of the beta-ketoacyl synthase.

Production of polyesters consisting of medium chain length 3-hydroxyalkanoic acids by Pseudomonas mendocina 0806 from various carbon sources.

Pseudomonas mendocina strain 0806 was isolated from oil-contaminated soil and found to produce polyesters consisting of medium chain length 3-hydroxyalkanoates (mclPHAs). The monomers of mclPHAs contained even numbers of carbon atoms, such as 3-hydroxyhexanoate (HHx or C6), 3-hydroxyoctanoate (HO or C8), and/or 3-hydroxydecanoate (HD or C10) as major components when grown on many carbon sources unrelated to their monomeric structures, such as glucose, citric acid, and carbon sources related to their monomeric structures, such as myristic acid, octanoate, or oleic acid. On the other hand, PHA containing both even and odd numbers of hydroxyalkanoates (HA) monomers was synthesized when the strain was grown on tridecanoic acid. The molar ratio of carbon to nitrogen (C/N) had a significant effect on PHA composition: the strain produced PHAs containing 97-99% of HD monomer when grown in a glucose ammonium sulfate medium of C/N<20, and 20% HO, and 80% of the HD monomer when growth was conducted in media containing C/N>40. It was demonstrated that the HO/HD ratio in the polymers remained constant in media with a constant C/N ratio, regardless of the glucose concentration. Up to 3.6 g/L cell dry weight containing 45% of PHAs was produced when the strain was grown for 48 h in a medium containing 20 g/L glucose with a C/N ratio of 40.

[An outline of spreading of Western mediciine into Yantai in modern age].

At the turn of the last century, side by side with the infiltration of religious culture from Western countries, western medicine spread into Yantai. The religious force, headed by American Presbyterian Mission, carried out charitable activities in the process of preaching and laid down the foundation for western medicine rooted in Yantai by establishing schools, education and training followers. They cultivated local physicians by first setting up clinics which had later transformed into hospitals. These are their major measures for building bases for spreading Christianity by foreigners. The Temple Hill Hospital set up by the American physician Oscar F. Hills in Yantai was a successful example of mutual promotion of missionary and medical activities which pushed forward the spreading and development of western medicine in Yantai.

A study of the immunofunction in patients of coronary heart disease with the fundamental deficiency and outward excess syndrome.

The fundamental deficiency and outward excess syndrome of coronary heart disease can be classified into Qi Yang deficiency with blood stasis (QYD) and Yin deficiency with blood stasis (YD). The patients showed disturbances in immunofunction manifested as marked increase of serum IgG, CIC, IC-IgG and IC-C3 levels and the percentage of B cells in the peripheral blood, while the percentages of OKT3+, OKT4+ and OKT8+ cells markedly decreased, especially the percentage of OKT8+ cells, resulting in an increase of the ratio of T4/8 and imbalance between TS and TH. The authors deem that the fundamental deficiency of coronary heart disease is related to the low cellular immunity, especially the imbalance between TS and TH cells, while outward excess of coronary heart disease is related to hyperactivity of humoral immunity.

Hybridization studies of chicken liver fatty acid synthetase. Evidence for the participation in palmitate synthesis of cysteine and phosphopantetheine sulfhydryl groups on adjacent subunits.

Enzymatically inactive variants of chicken liver fatty acid synthetase have been prepared by specific chemical modification of the active cysteine SH group with iodoacetamide, and the phosphopantetheine SH group with chloroacetyl-CoA. Hybridization of each of these variants with the unmodified enzyme yielded (modified)-(unmodified) hybrid dimers which possessed 50% synthetase activity. A 50% active (iodoacetamide-modified)-(chloroacetyl-CoA-modified) hybrid dimer was also demonstrated by recombination of these variants with each other. These results indicate that the two functional sites on the synthetase are independently active, and that each is comprised of a cysteine SH group from one subunit and a complementary phosphopantetheine SH group from the other subunit as depicted by the head-to-tail arrangement proposed by Wakil and co-workers (Wakil, S. J., Stoops, J. K., and Joshi, V.C.