Assessing the Effects of Geniculate Artery Embolization in a Nonsurgical Animal Model of Osteoarthritis

PurposeTo create a nonsurgical animal model of osteoarthritis (OA) to evaluate the effects of embolotherapy during geniculate artery embolization (GAE).Materials and MethodsFluoroscopy-guided injections of 700 mg of sodium monoiodoacetate were performed into the left stifle in 6 rams. Kinematic data were collected before and after induction. At 10 weeks after induction, Subjects 1 and 4–6 underwent magnetic resonance (MR) imaging with dynamic contrast enhancement (DCE) and Subjects 1, 3, and 4–6 underwent angiography with angiographic scoring to identify regions with greatest disease severity for superselective embolization (75–250-μm microspheres). Target vessel size was measured. At 24 weeks after angiography, DCE-MR imaging, angiography, and euthanasia were performed, and bilateral stifles were harvested. Medial/lateral tibial and femoral condylar, patellar, and synovial samples were cut, preserved, decalcified, and scored using the Osteoarthritis Research Society International criteria. The stifle and synovium Whole-Organ Magnetic Resonance Imaging Score and Multicenter Osteoarthritis Study score were determined. The volume transfer constant (K_trans) and extracellular volume fraction (v_e) were calculated from DCE-MR imaging along the lateral synovial regions of interest.ResultsThe mean gross and microscopic pathological scores were elevated at 38 and 61, respectively. Mean synovitis score was elevated at 9.2. Mean pre-embolization and postembolization angiographic scores were 5 and 3.8, respectively. Mean superior, transverse, and inferior geniculate artery diameters were 3.1 mm ± 1.21, 2.0 mm ± 0.50, and 1.6 mm ± 0.41 mm, respectively. Mean pre-embolization and postembolization cartilage and synovitis scores were elevated at 35.13 and 73.3 and 5.5 and 9.2, respectively. The K_trans/v_e values of Subjects 4, 5, and 6 were elevated at 0.049/0.38, 0.074/0.53, and 0.065/0.51, respectively. Altered gait of the hind limb was observed in all subjects after induction, with reduced joint mobility. No skin necrosis or osteonecrosis was observed.ConclusionsA nonsurgical ovine animal knee OA model was created, which allowed the collection of angiographic, histopathological, MR imaging, and kinematic data to study the effects of GAE.     

阴道顺产与剖宫产对初产妇产后早期盆底功能的影响比较

目的研究阴道顺产与剖宫产对初产妇产后早期盆底功能的影响。方法选择2020年1月至12月在阳春市人民医院产科中心分娩的120例初产妇展开研究,按照分娩方式的不同分为对照组与观察组,每组各60例。对照组为阴道顺产,观察组采用剖宫产,两组均在产后第6周进行早期盆底功能检查,并进行盆底康复治疗,比较两组的治疗效果。结果观察组的尿失禁、阴道脱垂、子宫脱垂发生率低于对照组,差异有统计学意义(P<0.05);观察组治疗后的盆底肌力分级情况优于对照组,差异有统计学意义(P<0.05);观察组治疗后的膀胱颈与耻骨联合下缘水平线间的垂直距离(BSD)高于对照组,膀胱尿道后角(RA)、膀胱颈移动度(BND)低于对照组,差异均有统计学意义(P<0.05)。结论阴道顺产对于盆底功能及盆腔结构的不良影响大于剖宫产,盆底功能障碍性疾病发生率更高,而康复治疗可有效改善阴道顺产、剖宫产初产妇的盆底功能,剖宫产初产妇的盆底功能恢复更好。     

小剂量克赛联合百令胶囊对微小病变型NS的疗效

目的 探讨小剂量克赛联合百令胶囊对微小病变型肾病综合征（NS）患者高凝血状态和免疫功能的影响。 方法 选取2017年4月～2020年5月于本院就诊的90例微小病变型NS患者，按随机数表法分为观察组（45例）和对照组（45例）。对照组服用百令胶囊，观察组同时应用小剂量克赛。观察两组患者临床疗效、肾功能指标变化、凝血指标变化、血液流变学指标变化、T淋巴细胞亚群及药物不良反应。 结果 治疗后，观察组治疗总有效率高于对照组（P＜0.05）；观察组肾功能损伤指标及24 h尿蛋白水平均低于对照组（P＜0.05）；观察组凝血相关时间指标水平高于对照组，凝血相关因子水平低于对照组（P＜0.05）；观察组血液流变学指标水平低于对照组（P＜0.05）；观察组外周T淋巴细胞亚群检测结果显示CD3+、CD4+、CD4+/CD8+水平高于对照组，CD8+水平低于对照组（均P＜0.05）；两组不良反应发生率比较，差异无统计学意义（P＞0.05）。 结论 小剂量克赛联合百令胶囊对微小病变型肾病综合征患者疗效确切，可减少患者肾功能损伤，调节血液高凝状态，降低血液粘稠度，提升人体免疫功能，且安全性较好。     

Good clinical research practice (GCRP) in pharmacodynamic studies of neuromuscular blocking agents III: The 2023 Geneva revision

The set of guidelines for good clinical research practice in pharmacodynamic studies of neuromuscular blocking agents was developed following an international consensus conference in Copenhagen in 1996 (Viby-Mogensen et al., Acta Anaesthesiol Scand 1996, 40 , 59–74); the guidelines were later revised and updated following the second consensus conference in Stockholm in 2005 (Fuchs-Buder et al., Acta Anaesthesiol Scand 2007, 51 , 789–808). In view of new devices and further development of monitoring technologies that emerged since then, (e.g., electromyography, three-dimensional acceleromyography, kinemyography) as well as novel compounds (e.g., sugammadex) a review and update of these recommendations became necessary. The intent of these revised guidelines is to continue to help clinical researchers to conduct high-quality work and advance the field by enhancing the standards, consistency, and comparability of clinical studies. There is growing awareness of the importance of consensus-based reporting standards in clinical trials and observational studies. Such global initiatives are necessary in order to minimize heterogeneous and inadequate data reporting and to improve clarity and comparability between different studies and study cohorts. Variations in definitions of endpoints or outcome variables can introduce confusion and difficulties in interpretation of data, but more importantly, it may preclude building of an adequate body of evidence to achieve reliable conclusions and recommendations. Clinical research in neuromuscular pharmacology and physiology is no exception.     

女性生育力评估

随着人口老龄化和生育力的下降,我国放开了三孩政策,对有生育要求的夫妇进行生育力评估显得非常必要。女性生育力与年龄关系密切,还依赖于卵巢、输卵管、子宫等生殖器官。本文就影响女性生育力的因素进行介绍。