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Introduction and hypothesis Extracellular matrix (ECM) synthesis and metabolism abnormalities may influence the pelvic supporting system and lead to the occurrence and development of pelvic organ prolapse (POP). Genetic polymorphisms of such related genes have been increasingly studied. This study aims to explore the association between the single-nucleotide polymorphisms (SNPs) of genes encoding ECM processing enzymes (a disintegrin and metalloproteinase with thrombospondin motifs [ADAMTSs]), ECM degrading enzymes (matrix metalloproteinases [MMPs]) and their tissue inhibitors of metalloproteinase (TIMPs), and POP. Methods We conducted an association study including 48 women with POP at stages III and IV and 48 women without prolapse in Chinese groups. SNPs were identified using the target region sequencing technique. We performed Fisher’s exact tests to assess the association between SNPs and POP in the unadjusted model and logistic regression analysis in the adjusted model, adjusting for delivery and pregnancy. Results There was a significant association between TIMP2 SNP rs2277698 (odds ratio [OR], 0.37; 95% confidence interval [CI], 0.16–0.82; P = 0.015), ADAMTS13 SNP rs149586801 (OR, 0.18; 95% CI, 0.05–0.69; P = 0.012), and ADAMTS1 SNPs rs370850 and rs422803 (OR, 3.71; 95% CI, 1.35–10.15; P = 0.011 for both), rs402007, rs428785, rs434857, and rs445784 (OR, 2.18; 95% CI, 1.05–4.56; P = 0.038 for the four), and POP in the adjusted model. Conclusion TIMP2, ADAMTS13, and ADAMTS1 might be candidate genes for POP. Our results provide preliminarily new evidence for future investigation of these genes in the pathophysiology of POP.

Introduction and hypothesis Pelvic organ prolapse (POP) is a common condition in older women that affects quality of life. Mechanical injury of the pelvic floor support system contributes to POP development. In our study, we aimed to examine the mechanical damage to human uterosacral ligament fibroblasts (hUSLFs) to preliminarily explore the mechanism of mechanical transduction in POP. Methods hUSLFs were derived from POP and non-POP patients. Mechanical stress was induced by the FX-5000 T-cell stress loading system. Student’s t-test was used for comparisons between different groups. Results We found that hUSLFs from POP patients were larger and longer than those from non-POP patients and exhibited cytoskeleton F-actin rearrangement. Collagen I and III expression levels were lower and matrix metalloproteinase 1 (MMP1) levels were higher in POP patients than in non-POP patients. Additionally, the apoptosis rate was significantly increased in POP patients compared to non-POP patients. After mechanical stretching, hUSLFs underwent a POP-like transformation. Cells became longer, and the cytoskeleton became thicker and rearranged. The extracellular matrix (ECM) was remodelled because of the upregulation of collagen I and III expression and downregulation of MMP1 expression. Mechanical stress also induced hUSLF apoptosis. Notably, we found that the p38 MAPK pathway was activated by mechanical stretching. Conclusions Mechanical stress induced morphological changes in ligament fibroblasts, leading to cytoskeleton and ECM remodelling and cell apoptosis. p38 MAPK might be involved in this process, providing novel insights into the mechanical biology of and possible therapies for this disease.

Objective: Pelvic organ prolapse (POP) is a common health issue that has a profound negative influence on women's quality of life. Genetic susceptibility to POP has been increasingly investigated. In this study, we assessed the single-nucleotide polymorphisms (SNPs) of six collagen-related genes (COL14A1, COL5A1, COL4A2, COL3A1, COL1A1, and COL18A1) and the genetic association with POP in Chinese women. Methods: We performed a candidate gene association study of case women (n = 48) with stage III and IV prolapse and control women (n = 48) without prolapse. A target region sequencing approach was used to identify the SNPs in collagen-related genes. The association between SNPs and POP was examined by Fisher exact tests for unadjusted model and logistic regression analysis adjusted for delivery and pregnancy. Results: There was a significant association between COL14A1 SNPs (rs4870723, rs2305600, and rs2305598; P = 0.013, 0.019, and 0.028, respectively), a COL5A1 SNP (rs3827852; P = 0.016), and COL4A2 SNPs (rs76425569, rs388222, and rs2281968; P = 0.049 for the three, and rs445348, P = 0.040) and POP, respectively. Although there was no significant association between the COL3A1 SNP and POP, there was a trend toward significance for COL14A1 SNP (rs2305603), COL4A2 SNP (rs74941798), two COL1A1 SNPs (rs2586488 and rs2249492) and three COL18A1 SNPs (rs1050351, rs56335679, and rs55690336), and POP. Conclusion: We are the first to evaluate the relationship between COL14A1, COL5A1, and COL4A2 polymorphisms and POP, besides COL3A1, COL1A1, and COL18A1, which have been reported previously. We found several candidate SNPs that were significantly associated with prolapse in Chinese women. Our results provide new evidence for further investigation of the involvement of these potential genes in the etiology of POP.

We aimed to evaluate the long-term effectiveness and safety of Burch colposuspension (BC) for stress urinary incontinence (SUI). In this prospective cohort study, 84 patients with SUI undergoing BC were enrolled from February 2004 to January 2010. Data on long-term subjective success and postoperative complications were collected at clinic visits and by telephone follow-up. During a mean follow-up period of 14.2 years, 68% (57/84) patients completed the follow-up. A total of 68.4% of patients (39/57) reported absence of SUI symptoms, 73.6% (42/57) were subjectively satisfied according to the Patient Global Impression of Improvement, and 68.4% (39/57) reported subjective success regarding urinary symptoms via the Urinary Distress Inventory Short Form. However, 28.1% (16/57) suffered at least one long-term postoperative complication and incident. Specifically, 1 in 25 (4.0%) sexually active patients reported dyspareunia, 3 patients (5.3%) had de novo overactive bladder, and 6 patients (10.5%) reported voiding dysfunction. Four patients (7.0%) reported new onset prolapse symptoms, and 3 patients (5.3%) underwent secondary urinary incontinence surgery. Our study indicated that Burch colposuspension is an effective procedure for SUI, and the cure effect was largely maintained for the 14-year follow-up period, with relatively low complication rates. BC should be considered a surgical option for SUI.

Introduction and hypothesis This study aimed to investigate the evaluation and management of complications after pelvic floor reconstructive surgery for pelvic organ prolapse in China. Methods Complications of pelvic floor reconstructive surgery for pelvic organ prolapses from 27 institutions were reported from November 2017 to October 2019. All complications were coded according to the category-time-site system proposed by the International Urogynecological Association (IUGA) and the International Continence Society (ICS). The severity of the complications was graded by the Clavien-Dindo grading system. Four scales were used to evaluate patient satisfaction and quality of life after management of the complications: the Patient Global Impression of Improvement (PGI-I), the Pelvic Floor Impact Questionnaire Short Form (PFIQ-7), the Pelvic Organ Prolapse Symptom Score (POP-SS), and a 5-point Likert-type scale that evaluated the patient’s choice of surgery. Results Totally, 256 cases were reported. The occurrence of complications related to transvaginal mesh (TVM) and laparoscopic sacrocolpopexy (LSC) had a significantly longer post-surgery delay than those of native tissue repair surgery (p p = 0.010, respectively). Both PFIQ-7 and POP-SS score were lower after management of complications (p Conclusions The occurrence of complications related to TVM surgery and LSC had a longer post-surgery delay than native tissue repair surgery. Long-term regular follow-up was vital in complication management. Patient satisfaction with the management of TVM complications was acceptable.

Pond smelt Hypomesus olidus is a small-sized economic species of freshwater fish with delicious meat and high output. In this study, the complete mitochondrial genome of H. olidus sequenced to be 16,786 bp in length, including 13 protein-coding genes, 2 ribosomal RNAs, 22 transfer RNAs and a control region. The overall base composition of H. olidus is 24.3% for A, 27.3% for T, 29.2% for C and 19.2% for G, with a slight A + T bias. The mitogenome sequence data may provide useful information to the population genetics analysis of H. olidus and the elucidation of evolutionary mechanisms in Hypomesus fish.

Objective: The objective of this study is to assess the consistency between the WeChat-based Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire short form (PISQ-12) in Chinese and the paper version and to determine the test–retest reliability of the WeChat questionnaire. Methods: A total of 120 women aged between 24 and 69 years were recruited from the outpatient clinic at Peking Union Medical College Hospital and randomly assigned to two groups. All participants completed the WeChat and paper questionnaires twice. Group A completed the paper questionnaire before the WeChat version; Group B completed the WeChat questionnaire before the paper version. Two weeks later, all participants completed the questionnaires in the opposite order. Then, the reliability and validity of the two versions were assessed using Pearson correlation coefficients, intraclass correlation coefficients, and Bland-Altman graphs. Results: No significant difference in completion time was found between the two versions of the Chinese PISQ-12 (P = 0.67). Half of the participants (60/120) preferred the WeChat questionnaire, 15% (18/120) preferred the paper form (P

Background: Pelvic organ prolapse (POP) is a major health problem in adult women that involves many factors. No proteomic analysis has been conducted exclusively in POP patients. This study aimed to identify the differential expression of proteins that may be involved in POP by proteomic analysis. Methods: Samples of the uterosacral ligament (USL) were collected from five POP patients and five non-POP patients matched according to age, parity, and menopausal status and analyzed using two-dimensional electrophoresis and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS). Quantitative real-time polymerase chain reaction (qRT-PCR) was used to verify the mRNA expression of proteins that showed differential expression in the proteomic analyses. Results: Proteins differentially expressed between POP and non-POP patients were detected. Eight proteins that were down-regulated in the POP group were identified by MALDI-TOF-MS. These proteins included electron transfer flavoprotein, apolipoprotein A-I, actin, transgelin, cofilin-1, cyclophilin A, myosin, and galectin-1, and their expression was verified by qRT-PCR. Conclusion: Using comparative proteomics, we identified eight differentially expressed proteins (including four cytoskeleton proteins and three proteins related to apoptosis) in the USL that may be involved in apoptosis associated with the tissue effects in POP pathophysiology.

Water transport, a component of integrated transport systems, is a key strategic resource for achieving sustainable economic and social development, particularly in the Yangtze River Economic Zone (YREZ). Unfortunately, systematic studies on water transport efficiency are not forthcoming. Using Data Envelope Envelopment Analysis (DEA) and the Malmquist index as a model framework, this paper measures water transport efficiency in YREZ, conducts spatial analysis to identify the leading factors influencing efficiency, and provides scientific evidence for a macroscopic grasp of water transport development and the optimization of YREZ. The results indicate that water transport technical efficiency (TE) in YREZ is low and in fluctuating decline. Therefore, it has seriously restricted performance and improvements in the service function. Additionally, the spatial pattern of TE has gradually changed from complexity and dispersion to clarity and contiguity with a larger inter-provincial gap. Water transport efficiency has slightly improved through technological change (TECHch), whereas deteriorating pure technical efficiency change (PEch) is the main cause of a TE decrease. According to our findings, decision-makers should consider strengthening intra-port competition and promoting water transport efficiency.

Megaregions are the new engines of global and regional economic growth, and they often are considered a principal urbanization platform in China. To understand megaregional processes’ responses to China’s regional policies, this study focused on two aspects of integration development in the Central Yangtze River megaregion between 2000 and 2014: The internal collaborative networks using enterprises’ headquarters-branch locations as a proxy measurement and the role of regional transportation in the integration networks. Based on a three-step network analysis, the Central Yangtze River megaregion was increasingly similar to a polycentric urban system with Wuhan, Changsha, and Nanchang as the dominant service cities, and there were some indications of a preliminary urban network formation. However, integration development remained a government-led administrative process with administrative boundaries that significantly influenced the network structure. A panel regression analysis further suggested that transportation accessibility to the three central cities was the key determinant of network participation for the peripheral cities compared to economic performance. This work contributes to the debate on the hierarchical-administrative properties of China’s megaregions and transportation implications of the economic integration process.

Background: Although repair augmented with mesh has been proved its priority in anatomical and functional recovery after anterior compartment reconstruction, the data about posterior compartment are scarce. The aim of this study was to compare bowel functional outcome of posterior vaginal compartment repair with and without mesh in patients with pelvic organ prolapse (POP). Methods: This was a prospective, double-blind, clinical pilot study of 22 postmenopausal women with symptomatic POP (overall POP-quantification [POP-Q] Stage III-IV) who underwent total pelvic floor reconstruction. Patients were grouped according to the use of mesh for posterior vaginal compartment repair: A mesh group and a nonmesh group. POP-Q stage, the pelvic floor impact questionnaire short form-7 (PFIQ-7) and anorectal manometry were evaluated before and 3 months after surgery. Anatomical success was defined as POP-Q Stage II or less. A t-test was used to compare preoperative with postoperative data in the two groups. Results: Totally, 17 (71%) were available for the follow-up. POP-Q measurements improved significantly compared to baseline (P < 0.05) in both groups. No recurrence was observed. Subjects in both groups reported improvement in pelvic floor symptoms, and there was no significant difference in the PFIQ-7 score between groups at follow-up (P > 0.05). Compared with baseline, the nonmesh group exhibited a statistically significant decrease in anal residual pressure, a significant increase in the anorectal pressure difference during bowel movement, and a reduced rate of dyssynergia defecation pattern (P < 0.05). Conclusions: Provided there is sufficient support for the anterior wall and apex of vagina with mesh, posterior compartment repair without mesh may be as effective as repair with mesh for anatomical recovery while providing better anorectal motor function.

To investigate the histological characteristics in uterine ligaments of stress urinary incontinence (SUI) and pelvic organ prolapse (POP); to detect the alteration of collagen ultrastructure in uterine ligaments that contribute to SUI and POP; to study the relationship between collagen alteration and SUI and POP.The cardinal ligament (Car lig.) and uterosacral ligaments (U-S lig.) samples were obtained from 73 subjects suffering from SUI, or normal controls who underwent hysterectomy. Collagen ultrastructure was examined with transmission electron microscopy (TEM).1) The smooth muscle fascicles in the patients with SUI and POP were thinner. Arrangement of smooth muscle fascicles was in disorder. 2) The collagen constituting the ligaments was active in metabolism. The mean collagen fibril diameters in the SUI and POP groups were about 25% larger than that in the control groups (por = 0.01). 3) Histological characteristics of the Car lig. and the U-S lig. were similar.1) The Car lig. and U-S lig. are homologous. Abnormalities in arrangement of smooth muscles and the collagen ultrastructure were obviously seen in SUI and POP 2) The collagen fibril diameter in the SUI and POP subgroups was significantly larger than that in the control groups. Those ligaments are probably less elastic and more likely to break. Predominance of collagen degradation during tissue repair may contribute to POP and SUI.