Intraoperative intensive blood pressure management strategy and the outcome of patients who had an acute ischaemic stroke undergoing endovascular treatment under general anaesthesia: study protocol for a prospective randomised controlled trial.

BackgroundEndovascular thrombectomy is the recommended treatment for acute ischaemic stroke, but the optimal blood pressure management strategy during the procedure under general anaesthesia remains controversial. In this study protocol, we propose an intraoperative intensive blood pressure range (110-140 mm Hg systolic blood pressure) based on a retrospective analysis and extensive literature review. By comparing the outcomes of patients who had an acute ischaemic stroke undergoing mechanical thrombectomy under general anaesthesia with standard blood pressure management (140-180 mm Hg systolic blood pressure) versus intensive blood pressure management, we aim to determine the impact of intraoperative intensive blood pressure management strategy on patient prognosis. METHODS AND ANALYSIS: The study is a double-blinded, randomised, controlled study, with patients randomised into either the standard blood pressure management group or the intensive blood pressure management group. The primary endpoint of the study will be the sequential analysis of modified Rankin Scale scores at 90 days after mechanical thrombectomy. ETHICS AND DISSEMINATION: The study has been approved by the ethics committee of Shanghai Changhai Hospital with an approval number CHEC2023-015. The results of the study will be published in peer-reviewed international journals. TRIAL REGISTRATION NUMBER: ChiCTR2300070764.

Effects of Desmodium caudatum on Gastrointestinal Hormones and Intestinal Flora in Rats with Gastritis.

In order to preliminarily explore the effects of Desmodium caudatum on gastritis and intestinal flora in rats, a chronic gastritis rat model was established using the classic sodium salicylate method. Eighteen SPF rats were divided into three groups: the control group (Group C), the model group (Group M), and the treatment group (Group T). Pathological sections of the gastric wall were taken from rats in each group. Furthermore, the concentrations of gastrin and malondialdehyde in the serum of rats in each group were determined by ELISA. Additionally, the effects of D. caudatum on the intestinal flora of rats with gastritis were explored through a detailed comparison of gut bacterial communities in the three groups, employing Illumina-based 16S rRNA gene sequencing. The results indicated that D. caudatum decoction could reduce the malondialdehyde content and increase the gastrin content. Moreover, D. caudatum decoction was found to enhance the diversity and abundance of intestinal flora, exerting a positive impact on the treatment of gastritis by regulating and restoring the intestinal flora.

New Dawn for Atherosclerosis: Vascular Endothelial Cell Senescence and Death.

Endothelial cells (ECs) form the inner linings of blood vessels, and are directly exposed to endogenous hazard signals and metabolites in the circulatory system. The senescence and death of ECs are not only adverse outcomes, but also causal contributors to endothelial dysfunction, an early risk marker of atherosclerosis. The pathophysiological process of EC senescence involves both structural and functional changes and has been linked to various factors, including oxidative stress, dysregulated cell cycle, hyperuricemia, vascular inflammation, and aberrant metabolite sensing and signaling. Multiple forms of EC death have been documented in atherosclerosis, including autophagic cell death, apoptosis, pyroptosis, NETosis, necroptosis, and ferroptosis. Despite this, the molecular mechanisms underlying EC senescence or death in atherogenesis are not fully understood. To provide a comprehensive update on the subject, this review examines the historic and latest findings on the molecular mechanisms and functional alterations associated with EC senescence and death in different stages of atherosclerosis.

Effects of Atractylodes lancea extracts on intestinal flora and serum metabolites in mice with intestinal dysbacteriosis.

OBJECTIVE: This study aims to explore the effect of an extract of Atractylodes lancea (A. lancea) on antibiotics-induced intestinal tract disorder and the probable therapeutic mechanisms employed by this extract to ameliorate these disorders. METHODS: Three days after acclimatization, nine male and nine female specific-pathogen-free (SPF) mice were randomly assigned into three groups: Group C (normal saline), Group M (antibiotic: cefradine + gentamicin), and Group T (antibiotic + A. lancea extract). Each mouse in Groups M and T received intragastric (i.g.) gavage antibiotics containing cefradine and gentamicin sulfate (0.02 ml/g-1/D-1) for 7 days. A. lancea extract (0.02 ml/g-1/D-1) was administered by i.g. gavage to Group T mice for 7 days following the cessation of antibiotic therapy. Group M received an equivalent volume of normal saline for 7 days, while Group C received an equivalent volume of normal saline for 14 days. Afterwards, we collected mouse feces to assess changes in intestinal microbiota by 16S ribosomal ribonucleic acid (rRNA) sequencing and metabolomics. In addition, serum samples were gathered and analyzed using liquid chromatography-mass spectrometry (LS-MS). Finally, we performed a correlation analysis between intestinal microbiota and metabolites. RESULTS: After treatment with antibiotic, the richness and diversity of the flora, numbers of wall-breaking bacteria and Bacteroidetes, and the numbers of beneficial bacteria decreased, while the numbers of harmful bacteria increased. After i.g. administration of A. lancea extract, the imbalance of microbial flora began to recover. Antibiotics primarily influence the metabolism of lipids, steroids, peptides, organic acids, and carbohydrates, with lipid compounds ranking first. Arachidonic acid (AA), arginine, and proline have relatively strong effects on the metabolisms of antibiotic-stressed mice. Our findings revealed that A. lancea extract might restore the metabolism of AA and L-methionine. The content of differential metabolites detected in the serum of Group T mice was comparable to that in the serum of Group C mice, but significantly different from that of Group M mice. Compared to putative biomarkers in the Kyoto Encyclopedia of Genes and Genomes (KEGG) database, it was found that altered metabolites, such as amino acids, glycerol, and phospholipids, were primarily associated with the metabolism. CONCLUSIONS: The effective mechanisms of A. lancea extract in regulating the disorder of intestinal flora in mice are related to the mechanisms of A. lancea. It could relate to lipid metabolism, bile acid metabolism, and amino acid metabolism. These results will provide a basis for further explaining the mechanism by which A. lancea regulats intestinal flora.

Research progress of circular RNA in drug resistance of liver cancer / 中国药理学通报

Circular RNAs are novel non-coding RNAs with multiple biological functions, which can participate in biological processes such as the occurrence, development, invasion, and metastasis of liver cancer, as well as drug resistance of liver cancer. This article reviews the roles and mechanisms of circR-NAs in chemotherapy resistance, targeted therapy resistance and immunotherapy resistance in liver cancer, in order to provide new ideas for solving liver cancer resistance.

Ectopic Ureter—A Retrospective Analysis, Symptom and Treatment

Background: The objective of our study was to share the experience of the ectopic ureter and to characterize associated clinical features, medical images, and management. Methods: A retrospective analysis was performed on 13 cases of ectopic ureter confirmed by surgery. The gender, age, abnormal urinary leakage, the site of the ectopic ureter, renal dysplasia, and surgical methods of the patients were compared and analyzed. Results: Eleven females and 2 males with ectopic ureters were analyzed. Eight cases had the clinical symptom of persistent or intermittent urine leakage since birth. One case was with complete persistent urine leakage, and 4 cases with no urine leakage.The site of the ectopic ureters was mostly unilateral. Ectopic ureters were located in the vagina in 6 cases, urethra in 4 cases,prostate in 1, and uncertain in 2 cases. There were 3 cases with ectopic kidney and renal atrophy, 3 cases had “Y” ureter, and 8 cases had repeated ureters with duplex kidneys. Twelve cases were treated with surgery, and 1 case underwent bilateral ureteral stent implantation. Three cases were complicated with ureteral stump syndrome after surgery. Conclusions: The classic symptom of the ectopic ureter is continuous wetting with intermittent normal micturition in most young girl patients. Ectopic ureter is often associated with duplex kidneys, ectopic kidneys and atrophic kidneys. The surgical approach should be personalized. The aim of the surgery is to make the patient without urine leakage and preserve kidney function. (AU)

Corrigendum: Comparative effectiveness of electroacupuncture VS neuromuscular electrical stimulation in the treatment of chronic low back pain in active-duty personals: A single-center, randomized control study.

[This corrects the article DOI: 10.3389/fneur.2022.945210.].

Comparative effectiveness of electroacupuncture VS neuromuscular electrical stimulation in the treatment of chronic low back pain in active-duty personals: A single-center, randomized control study.

Introduction: Low back pain (LBP) is the most prevalent form of chronic pain in active-duty military personnel worldwide. Electroacupuncture (EA) and neuromuscular electrical stimulation (NMES) are the two most widely used treatment methods in the military, while evidence for their benefits is lacking. The aim of this randomized clinical trial is to investigate the effectiveness of EA vs. NMES in reducing pain intensity among active-duty navy personals with chronic LBP. Methods: The study is designed as a single-center, randomized controlled trial. The primary outcome is a positive categorical response for treatment success in the first-time follow-up, which is predesignated as a two-point or greater decrease in the NRS score and combined with a score > 3 on the treatment satisfaction scale. The secondary outcomes include pain intensity, rate of treatment success, and Oswestry Disability Index (ODI) fear-avoidance beliefs questionnaire (FABQ) score along with muscular performance. The first follow-up starts on the first day after completing the last treatment session, and then the 4-weeks and 12-weeks follow-up are applied via telephone visit. Results: Eighty-five subjects complete the treatment diagram and are included in the analysis. For the primary outcome, no difference has been found between EA and NMES, with 65.1% (28 in 43) individuals reporting a positive response to EA treatment, while 53.5% (23 in 43) in NMES. However, for longer follow-ups, superiority in positive response of EA has been found in 4-weeks (26 in 39, 66.7% vs. 16 in 40, 40%; P = 0.018) and 12-weeks (24 in 36, 66.7% vs. 12 in 36, 33.3%; P = 0.005) follow-up. In the regression analysis, baseline pain intensity and FABQ score are identified to be highly associated with positive treatment outcomes. Finally, the subgroup analysis suggests that EA treatment is associated with better long-term outcomes in patients with LBP with a severe pain score (NRS score >4, Figure 4B) and stronger fear-avoidance beliefs. Conclusion: Both the EA and NMES are associated with a positive response in treating military LBP, and the former offers lasting benefits in the later follow-ups. Thus, electroacupuncture is a more recommended treatment for military LBP. A lot of research is needed to verify an efficient and standardized treatment session, with more information and evidence about indications for these treatments. Trial registration: ChiCTR, (ChiCTR2100043726); registered February 27, 2021.

Adnexal masses: Diagnostic performance of contrast-enhanced ultrasound using the simple rules from the International Ovarian Tumor Analysis group.

OBJECTIVE: To evaluate the role of the Simple Rules (SR) from the International Ovarian Tumor Analysis group in contrast-enhanced ultrasound (CEUS) of for the differential diagnosis of benign and malignant adnexal tumors. METHODS: A total of 180 patients with suspected malignant adnexal masses admitted to Lanzhou University Second Hospital were included, all of whom received conventional ultrasound (US) and CEUS examination before surgery. All masses were assessed using SR in US and SR in CEUS. To compare the diagnostic performance, the sensitivity, specificity, negative and positive predictive values, Youden index, and area under the curves values of SR in US and SR in CEUS were obtained. RESULTS: Sensitivity, negative predictive values, Youden index, and area under the curves were better for SR in CEUS than SR in US. The specificity and negative predictive value of SR in CEUS were lower than that of SR in US. Compared with SR in US, SR in CEUS significantly reduced the number of uncertain masses (21, 36.7% vs. 66, 11.7%). CONCLUSION: We concluded that SR in CEUS performed well in the diagnosis of malignant adnexal masses. SR in CEUS is a supplement to SR in US.

Ectopic Ureter-A Retrospective Analysis, Symptom and Treatment.

BACKGROUND: The objective of our study was to share the experience of the ectopic ureter and to characterize associated clinical features, medical images, and management. METHODS: A retrospective analysis was performed on 13 cases of ectopic ureter confirmed by surgery. The gender, age, abnormal urinary leakage, the site of the ectopic ureter, renal dysplasia, and surgical methods of the patients were compared and analyzed. RESULTS: Eleven females and 2 males with ectopic ureters were analyzed. Eight cases had the clinical symptom of persistent or intermittent urine leakage since birth. One case was with complete persistent urine leakage, and 4 cases with no urine leakage. The site of the ectopic ureters was mostly unilateral. Ectopic ureters were located in the vagina in 6 cases, urethra in 4 cases, prostate in 1, and uncertain in 2 cases. There were 3 cases with ectopic kidney and renal atrophy, 3 cases had "Y" ureter, and 8 cases had repeated ureters with duplex kidneys. Twelve cases were treated with surgery, and 1 case underwent bilateral ureteral stent implantation. Three cases were complicated with ureteral stump syndrome after surgery. CONCLUSIONS: The classic symptom of the ectopic ureter is continuous wetting with intermittent normal micturition in most young girl patients. Ectopic ureter is often associated with duplex kidneys, ectopic kidneys and atrophic kidneys. The surgical approach should be personalized. The aim of the surgery is to make the patient without urine leakage and preserve kidney function.

Curcumin Acetylsalicylate Extends the Lifespan of Caenorhabditis elegans.

Aspirin and curcumin have been reported to be beneficial to anti-aging in a variety of biological models. Here, we synthesized a novel compound, curcumin acetylsalicylate (CA), by combining aspirin and curcumin. We characterized how CA affects the lifespan of Caenorhabditis elegans (C. elegans) worms. Our results demonstrated that CA extended the lifespan of worms in a dose-dependent manner and reached its highest anti-aging effect at the concentration of 20 µM. In addition, CA reduced the deposition of lipofuscin or "age pigment" without affecting the reproductivity of worms. CA also caused a rightward shift of C. elegans lifespan curves in the presence of paraquat-induced (5 mM) oxidative stress or 37 °C acute heat shock. Additionally, CA treatment decreased the reactive oxygen species (ROS) level in C. elegans and increased the expression of downstream genes superoxide dismutase (sod)-3, glutathione S-transferase (gst)-4, heat shock protein (hsp)-16.2, and catalase-1 (ctl-1). Notably, CA treatment resulted in nuclear translocation of the DAF-16 transcription factor, which is known to stimulate the expression of SOD-3, GST-4, HSP-16, and CTL-1. CA did not produce a longevity effect in daf-16 mutants. In sum, our data indicate that CA delayed the aging of C. elegans without affecting reproductivity, and this effect may be mediated by its activation of DAF-16 and subsequent expression of antioxidative genes, such as sod-3 and gst-4. Our study suggests that novel anti-aging drugs may be developed by combining two individual drugs.

Discovery of bletillain, an unusual benzyl polymer with significant autophagy-inducing effects in A549 lung cancer cells through the Akt/GSK-3ß/ß-catenin signaling pathway.

Lung cancer is one of the most malignant tumors with the highest mortality and morbidity. The tubers of Bletilla striata are known as "an excellent medicine for lung diseases" in traditional Chinese medicine. This study performed a targeted study to explore compounds with anti-lung cancer activity and the molecular mechanisms using A549 cells. Eighteen bibenzyl derivatives, including four new compounds (13, 14, 16, and 18), were isolated from the tubers of B. striata. Analysis of the structure-activity relationship indicated that the cytotoxicity of the bibenzyls against A549 cells increased gradually as the number of the benzyl groups in the structures increased. Bletillain (18), an unusual benzyl polymer, was found to be the most active compound. Further flow cytometric analysis, dual-luciferase assays, real-time PCR assays, and western blot assays revealed that bletillain induced autophagy in A549 cells by regulating the Akt/GSK-3ß/ß-catenin signaling pathway. Beclin 1, LC3, and p62 are downstream autophagy factors of Akt, and Beclin 1 was the key autophagy factor. These results suggested that bibenzyls of B. striata play important roles in the treatment of lung cancer and provided scientific evidence illustrating why the tubers of B. striata are a suitable medicine for the treatment of lung cancer in traditional Chinese medicine.

Bisabolane-type sesquiterpenoids: Structural diversity and biological activity.

Bisabolane-type sesquiterpenoids, a class of monocyclic sesquiterpenoids, are widely distributed in nature and have a variety of biological activities. To provide a reference for the further research and development of these compounds, the phytochemical and biological properties of natural bisabolane-type sesquiterpenoids (356 compounds in total) isolated between 1985 and 2020 from 24 families, primarily Compositae, Zingiberaceae, Aspergillaceae, Halichondriidae, and Aplysiidae were reviewed. In vitro and in vivo studies have indicated that antibacterial, anti-inflammatory, and cytotoxic effects are the most commonly reported pharmacological properties of bisabolane-type sesquiterpenoids. Owing to their extensive significant effects, a lot of traditional medicines containing this type of compounds have been used for a long history. Thus, bisabolane-type sesquiterpenoids are a rich source of important natural products, which show great potential for the development of new drugs.

Traditional Chinese medicine formulas, extracts, and compounds promote angiogenesis.

Ischemic diseases, such as ischemic heart diseases and ischemic stroke, are the leading cause of death worldwide. Angiogenic therapy is a wide-ranging approach to fighting ischemic diseases. However, compared with anti-angiogenesis therapy for tumors, less attention has been paid to therapeutic angiogenesis. Recently, Traditional Chinese medicine (TCM) has garnered increasing interest for its definite curative effect and low toxicity. A growing number of studies have reported that TCM formulas, extracts, and compounds from herbal medicines exert pro-angiogenic activity, which has been confirmed in a few clinical trials. For comprehensive analysis of relevant literature, global and local databases including PubMed, Web of Science, and China National Knowledge Infrastructure were searched using keywords such as "angiogenesis," "neovascularization," "traditional Chinese medicine," "formula," "extract," and "compound." Articles were chosen that are closely and directly related to pro-angiogenesis. This review summarizes the pro-angiogenic activity and the mechanism of TCM formulas, extracts, and compounds; it delivers an in-depth understanding of the relationship between TCM and pro-angiogenesis and will provide new ideas for clinical practice.

Correlation of the type and degree of cystocele with stress urinary incontinence by transperineal ultrasound.

PURPOSE: To assess the correlation between the type and degree of cystocele and stress urinary incontinence (SUI) by transperineal ultrasound. METHODS: A retrospective study evaluated 207 women who were diagnosed with cystocele by transperineal ultrasound. One hundred and six women who were diagnosed with SUI by a full urodynamic study were enrolled in the SUI group, 101 women without SUI were enrolled in the prolapse group, and 100 normal women with neither SUI nor POP were enrolled as the control group. In the transperineal ultrasound study, the bladder neck, the lowest point of the bladder wall, bladder neck funneling, the retrovesical angle, and the urethra inclination angle were observed at rest and Valsalva. RESULTS: It was found that 87.7% of patients in the SUI group were diagnosed with cystourethrocele, which was significantly higher than the 47.5% in the prolapse group. In addition, 93.4% of patients in the SUI group were diagnosed with Grade I or II cystocele and 6.6% were Grade III, which was significantly higher than that in the prolapse group. Bladder neck funneling on ultrasonography had a sensitivity of 59.4% and a specificity of 64.1% for the detection of SUI. It was significantly higher in cystourethrocele than isolated cystocele (P < 0.05). CONCLUSION: The type and degree of cystocele can be diagnosed by transperineal ultrasound. Cystourethrocele and bladder neck funneling are highly correlated with SUI. Bladder neck funneling may be an important symptom of SUI.

Tim4 regulates NALP3 inflammasome expression and activity during monocyte/macrophage dysfunction in septic shock patients.

Sepsis is the leading cause of death in burn patients. Monocytes/macrophages rapidly exhibit impaired production of proinflammatory cytokines and an elevated generation of anti-inflammatory cytokines in septic patients with immunosuppression. However, the expression patterns of Tim4 and Nod-like receptor protein 3 (NALP3) inflammasome and their roles during immunosuppression in septic shock patients are not well understood. Tim4 and NALP3 inflammasome expression in monocytes were downregulated in immunosuppressive patients with sepsis compared with healthy volunteers. Meanwhile, NALP3 inflammasome expression was upregulated by Tim4 overexpression in murine bone marrow-derived macrophages (BMDMs) and J774A.1 macrophages. Tim4 overexpression improved the ability of BMDMs and J774A.1 macrophages to produce proinflammatory cytokines and increased the expression of cleaved-caspase-1 (p10) after LPS/ATP stimulation. In addition, overexpression of Tim4 enhanced phagocytosis of apoptotic polymorphonuclear neutrophils (PMNs) by BMDMs and J774A.1 macrophages, while depletion of NALP3 in Tim4 overexpressing BMDMs and J774A.1 macrophages decreased phagocytosis of apoptotic PMNs. In summary, the expression of Tim4 and NALP3 inflammasome in monocytes/macrophages was downregulated in septic shock patients, and diminished expression of Tim4 and NALP3 inflammasome in monocytes/macrophages might play a critical role in sepsis-elicited immunosuppression.

A Case Report of Primary Neonatal Hypocholinesterase Caused by Homozygous Frameshift Mutation of the utyrylcholinesterase (BCHE) Gene and Review of Literature.

BACKGROUND: Primary neonatal hypocholinesterase is rare; its genetic pattern and mutation still need to be further studied. METHODS: The patient and his parents are studied using next-generation sequencing technology. RESULTS: A boy one day after birth is admitted to the Neonatal Intensive Care Unit at our hospital after experiencing intermittent vomiting for 12 hours. The patient's serum cholinesterase level (113 - 283 U/L) is lower than normal value (4,000 - 12,600 U/L). Many factors of low serum cholinesterase are excluded. We highly suspect that it may be related to congenital factors. Molecular genetic test results show that the patient carried the BCHE gene (NM_000055.2) and has homozygous frameshift mutations at exon 2 c.401dupA (p.Asn134fs) of chromosome 3q26. It is a pathogenicity mutation. This locus mutation belongs to a novel pathogenic mutation. As a result of this mutation, the 134th amino acid Asn began to frameshift and the translation is terminated early. It can cause the Encoding of protein to truncate and lose its normal function. His parents' serum cholinesterase levels (father: 5,135 U/L; mother: 4,367 U/L) are in the normal value range, but his parents carried a heterozygous BCHE gene. CONCLUSIONS: This study suggests that gene sequence detection should be carried out early in hypocholinesterase of nknown cause in neonates. This study can not only improve understanding of the etiology and pathological mechanism of hypocholinesterase, but also it can enlarge the hypocholinesterase gene mutation spectrum.

Resolving neuroinflammation, the therapeutic potential of the anti-malaria drug family of artemisinin.

Artemisinin (Qinghaosu) and its semi-synthetic derivatives have been demonstrated to alleviate neuroinflammatory response in the central nerve system (CNS). In this review, we summarized that artemisinins are capable to treat neuroinflammtion-related CNS diseases in both direct (via regulating inflammatory process in the CNS, exerting anti-oxidative stress and neuroprotective effect, and preventing Aß accumulation) and indirect (via maintaining BBB integrity, suppressing systemic inflammation and alleviating intestinal inflammtion) manner. However, the precise mechanism of their anti-neuroinflammatory effects and potential neurotoxicity, which hindered further progress in these aspects, remains unclear. We suggest that further understanding of the PK/PD properties and structure-action relationship of atemisinin and its derivatives will facilitate the development of new therapeutics with better curative effects and safety.

Gene silencing of Rac1 with RNA interference mediated by ultrasound and microbubbles in human LoVo cells: evaluation of cell invasion inhibition and metastatic.

OBJECTIVE: The objective of this study was to assess the change of cytoskeleton and cell cycle in LoVo (human colorectal cancer) cell via gene silencing of Rac1 with RNA interference mediated by microbubble (SonoVue) and ultrasound (US). METHODS: The compound of plasmid Rac1-shRNA, LoVo cells, and SonoVue was exposed to US (1 MHz, 2 W/cm(2), 5 min). The expression of Rac1 mRNA and Rac1 protein was detected by RT-PCR and Western blot. Cytoskeleton was taken by confocal microscope in a random fashion. Cell invasion was assayed using modified Boyden chambers, and cell cycle and apoptosis were analyzed by flow cytometry in LoVo cells. RESULTS: Rac1 gene is overexpressed in human colorectal cancer cells, gene silencing of Rac1 with RNA interference mediated by microbubble and US strongly inhibited lamellipodia formation, cell invasion, and delayed cell cycle, as well as enhanced cell apoptosis of LoVo cells in vitro. CONCLUSION: Silencing Rac1 gene mediated by microbubble and US may become a new treatment option for the inhibition of the invasion and metastasis of colorectal cancer cells.

[Study on gasless-laparoscopic vaginoplasty using sigmoid colon segment].

OBJECTIVE: To study the clinical effect of gasless-laparoscopic vaginoplasty using sigmoid colon segment. METHODS: Clinical data of 119 cases undergoing laparoscopic or gasless-laparoscopic vaginoplasty using a vascularized pedicled sigmoid colon segment in Beijing Anzhen Hospital from January 2007 to December 2010 were reviewed retrospectively. Those patients were classified into 57 cases with laparoscopic sigmoid colon vaginoplasty and 62 cases with gasless-laparoscopic sigmoid colon vaginoplasty. The operation time, blood loss in operating, bowel movement after operation, postoperation hospital duration, side effect, and artificial vagina were compared between laparoscopic and gasless-laparoscopic group. RESULTS: The vaginoplasty were preformed successfully in 119 cases. The mean operation time of were (159 ± 18) min in laparoscopic group and (146 ± 17) min in gasless-laparoscopic group, respectively, which reached statistical difference (P < 0.01). The blood loss in operating were (83 ± 14) ml and (86 ± 13) ml, bowel movement after operation were (68 ± 8) hours and (68 ± 11) hours, and postoperation hospital duration were (11.1 ± 1.3) days and (11.4 ± 1.9) days respectively in laparoscopic group and gasless-laparoscopic group. No significant difference were found in the blood loss in operating, bowel movement after operation, and postoperation hospital duration between two groups (P > 0.05) .No intraoperative complication occurred. There were two cases with incomplete adhesive intestinal obstruction at 15-20 days postoperatively, which one was in laparoscopic group and one was in gas-less laparoscopic group. At 6-50 months of following up (median time 12 months), all artificial vaginas had a capacity of over two fingers in wideness and 12-15 cm in length. Vaginal discharges resembled a milky white water or mucus without odour. Eighty-five patients with sexual intercourse reported satisfactory feeling. One patients complained vaginal stenosis in laparoscopic group. CONCLUSION: Gasless-laparoscopic vaginoplasty using sigmoid colon segment is an alternative feasible and practical treatment.