A 14-year multi-institutional collaborative study of Chinese pelvic floor surgical procedures related to pelvic organ prolapse

Background:It has been a global trend that increasing complications related to pelvic floor surgeries have been reported over time.The current study aimed to outline the development of Chinese pelvic floor surgeries related to pelvic organ prolapse(POP)over the past 14 years and investigate the potential influence of enhanced monitoring conducted by the Chinese Association of Urogynecology since 2011.Methods:A total of 44,594 women with POP who underwent pelvic floor surgeries between October 1,2004 and September 30,2018 were included from 22 tertiary academic medical centers.The data were reported voluntarily and obtained from a database.We compared the proportion of each procedure in the 7 years before and 7 years after September 30,2011.The data were analyzed by performing Z test(one-sided).Results:The number of different procedures during October 1,2011-September 30,2018 was more than twice that during October 1,2004-September 30,2011.Regarding pelvic floor surgeries related to POP,the rate of synthetic mesh procedures increased from 38.1%(5298/13,906)during October 1,2004-September 30,2011 to 46.0%(14,107/30,688)during October 1,2011-September 30,2018,whereas the rate of non-mesh procedures decreased from 61.9%(8608/13,906)to 54.0%(16,581/30,688)(Z=15.53,P<0.001).Regarding synthetic mesh surgeries related to POP,the rates of transvaginal placement of surgical mesh(TVM)procedures decreased from 94.1%(4983/5298)to 82.2%(11,603/14,107)(Z=20.79,P<0.001),but the rate of laparoscopic sacrocolpopexy(LSC)procedures increased from 5.9%(315/5298)to 17.8%(2504/14,107).Conclusions:The rate of synthetic mesh procedures increased while that of non-mesh procedures decreased significantly.The rate of TVM procedures decreased while the rate of LSC procedures increased significantly.Trial registration number:NCT03620565,https://register.clinicaltrials.gov.

50 Gb/s PAM4 underwater wireless optical communication systems across the water–air–water interface [Invited]

A 50 Gb/s four-level pulse amplitude modulation(PAM4)underwater wireless optical communication(UWOC)system across the water-air-water interface is demonstrated in practice.In practical scenarios,laser beam misalignment due to oceanic turbulence degrades performance in UWOC systems.With the adoption of a reflective spatial light modulator(SLM)with an electrical controller,not only can the laser be arbitrarily adjusted to attain a water-air-water scenario,but oceanic engineering problems can also be resolved to establish a reliable UWOC link.Brilliant bit error rate performance and clear PAM4 eye diagrams are attained by adopting a Keplerian beam expander and a reflective SLM with an electrical controller.This proposed PAM4 UWOC system presents a feasible state that outperforms existing UWOC systems due to its feature providing a high-speed water-air-water link.