[Long-term mesh-related complications after total pelvic reconstruction surgery with tension-free transvaginal mesh]

Objective: To investigate the long-term mesh-related complications and treatment outcome of total pelvic reconstruction surgery with tension-free transvaginal mesh (PROSIMA^TM pelvic floor repair system). Methods: From July 2010 to June 2012, 48 patients with severe pelvic organ prolapse(POP)who underwent PROSIMA^TM were enrolled and treated in Peking Union Medical College Hospital. 29 patients (60.4%) were followed up periodically for at least 3 years to observe the occurrence of long-term mesh-related complications, and the clinical characteristics, classification of complications and treatment outcome of these cases were summarized. Results: The 29 cases with an average age of (65.1±5.2) years were followed up for an average of (71.6±21.2) months. The last follow-up was 36-105 months after treatment. The long-term success rate of the treatment was 79.3% (n=23). There were 18 cases of mesh exposure (18/48, 37.5%), of which 10 cases (55.6%) were new and persistent. 4 cases (4/18) had symptoms; the rest were found by pelvic examination. Ten patients (10/18) were positive for vaginal swab culture. As for treatment outcome, one case suffered from mesh erosion into the bladder. 4 patients (6.9%) complained of postoperative pain. Twenty-nine patients were divided into the exposure group (n=18) and the non-exposure group (n=11) according to mesh exposure occurrence. There was a significant difference in the proportion of positive swab culture results between the two groups (P=0.019), but no significant difference in the incidence of postoperative pain (P=0.566). Conclusion: The incidence of long-term mesh exposure in PROSIMA^TM is not low, and most of patients with which had no symptoms.

Profiling and identification of aqueous extract of Cordyceps sinensis by ultra-high performance liquid chromatography tandem quadrupole-orbitrap mass spectrometry

Characterization of aqueous extract in traditional Chinese medicine (TCM) is challenging due to the poor retention of the analytes on conventional C₁₈ columns. This study presents a systematic characterization method based on a rapid chromatographic separation (8 min) on a polar-modified C₁₈ (Waters Cortecs T3) column of aqueous extract of Cordyceps sinensis. UHPLC-HRMS method was used to profile components in both untargeted and targeted manners by full MS/PIL/dd-MS² acquisition approach. The components were identified or tentatively identified by reference standards comparison, fragmentation rules elucidation and available databases search. A total of 91 components, including 10 nucleobases, 20 nucleosides, 39 dipeptides, 18 amino acids and derivatives and 4 other components, were characterized from the aqueous extract of C. sinensis. And this was the first time to systematically report the presence of nucleosides and dipeptides in C. sinensis, especially for modified nucleosides. The chemical basis inquiry of this work would be beneficial to mechanism exploration and quality control of C. sinensis and related products. Meanwhile, this work also provided an effective solution for characterization of aqueous extract in TCM.