44Sacral extracorporeal magnetic stimulation is an effective treatment for pelvic floor dyssynergia; Comparative study with biofeedback therapy

Background: Recent development of extracorporeal magnetic stimulation (ECMS) which uses current‐changing magnetic fields allows the induction of electrical stimulation in the desired deep tissue. Recent study showed the sacral nerve stimulation reduces corticoanal excitability that may play a functional role in anal continence mechanisms. Preliminary study shows that ECMS of sacral nerve can modify pelvic floor function and expel rectal balloon in patients with pelvic floor dyssynergia (PFD). Aims: To evaluate the effect of ECMS compared with biofeedback therapy (BF) in patients with PFD. Methods and Materials: Thirty‐eight patients who fulfilled Rome II criteria for PFD by colon transit time and anorectal function tests, were randomly treated with 8 sessions of ECMS (2/weeks; n = 19) at prone position or BF (2/weeks; n = 19) at sitting position. Stimulation parameters were set at 50–80% of maximum intensity, 10 and 50 Hz frequency, 3 s burst length with 3 and 6 s off using arm‐typed stimulator (BioCom‐1000, Mcube Co., Korea). Symptom scores for constipation with/without anorectal function test were repeatedly measured after each treatment. Response was defined as 50% or more decreased symptom score after treatment (partial response: 30–50%, poor: <30%). Results: Fifteen patients (age 49.1 ± 13.4 years, mean ± SD; 4 men) completed 8 session of BF and 14 patients (54.5 ± 17.6 years, 3 men) completed 8 session of ECMS. Four patients of BF group discontinued treatment due to unsatisfactory therapeutic effect (n = 1) and withdrew consent (n = 3) and 5 patients of ECMS group discontinued treatment because of same reasons (n = 1, 4). Total symptom scores were significantly decreased after treatment of 8 session in both treatment groups (13.4 ± 6.6 vs. 4.3 ± 4.0 for BF, p = 0.009; 14.9 ± 5.6 vs. 3.4 ± 4.0 for ECMS, p < 0.001). Bowel movements per week were also significantly increased after treatment in both groups (median 2 vs. 7 for BF, p = 0.035; median 2 vs. 7 for ECMS, p = 0.008). Thirteen out of 15 patients showed response in BF group and 12 out of 14 showed good response in ECMS group. No adverse effects in both groups. Conclusions: ECMS is as effective as BF for the treatment of PFD. Long‐term effect of ECMS for the patients with pelvic floor dyssynergia need to be evaluated in the near future.     

薄层色谱溶剂系统的最优化方法——Ⅵ.均匀设计法的再探讨

就第Ⅱ报及第Ⅴ报提出的用于选取薄层色谱最佳溶剂系统的均匀设计法进行了进一步的改进及实验验证,使其更趋完善。结果表明,该法不仅适用于已知混合物,而且适用于未知混合物,是一种比较简捷、快速且行之有效的方法。     

The Arabidopsis PILZ group genes encode tubulin-folding cofactor orthologs required for cell division but not cell growth

Plant microtubules are organized into specific cell cycle-dependent arrays that have been implicated in diverse cellular processes, including cell division and organized cell expansion. Mutations in four Arabidopsis genes collectively called the PILZ group result in lethal embryos that consist of one or a few grossly enlarged cells. The mutant embryos lack microtubules but not actin filaments. Whereas the cytokinesis-specific syntaxin KNOLLE is not localized properly, trafficking of the putative auxin efflux carrier PIN1 to the plasma membrane is normal. The four PILZ group genes were isolated by map-based cloning and are shown to encode orthologs of mammalian tubulin-folding cofactors (TFCs) C, D, and E, and associated small G-protein Arl2 that mediate the formation of alpha/beta-tubulin heterodimers in vitro. The TFC C ortholog, PORCINO, was detected in cytosolic protein complexes and did not colocalize with microtubules. Another gene with a related, although weaker, embryo-lethal phenotype, KIESEL, was shown to encode a TFC A ortholog. Our genetic ablation of microtubules shows their requirement in cell division and vesicle trafficking during cytokinesis, whereas cell growth is mediated by microtubule-independent vesicle trafficking to the plasma membrane during interphase.     

Laparoscopic resection for a left adrenal black adenoma

Adrenal black adenoma (pigmented adenoma) is quite rare. Recently, we performed a laparoscopic resection for a functioning adrenal black adenoma. We report the case here.     

Liver-derived cytotoxic T cells in hepatitis A virus infection

An autologous in vitro model was developed to analyze the immunologic cause of liver tissue injury during hepatitis A virus (HAV) infection. Human T lymphocytes infiltrating the livers of two patients with acute HAV infection were isolated from liver biopsy cores, cloned, and expanded in vitro. Procedures using a cell culture system with HAV-infected autologous skin fibroblasts demonstrated that 42% and 53% of the liver-infiltrating CD8+ clones were HAV-specific and that they kill HAV-infected skin fibroblasts in a human leukocyte antigen-restricted manner. Data show virus-specific killing by liver-infiltrating T lymphocytes in man and support the hypothesis that liver cell injury in acute HAV infection is mediated by HAV-specific CD8+ T lymphocytes and is not caused by a cytopathic effect of the virus itself.     

Arabidopsis V-ATPase activity at the tonoplast is required for efficient nutrient storage but not for sodium accumulation

The productivity of higher plants as a major source of food and energy is linked to their ability to buffer changes in the concentrations of essential and toxic ions. Transport across the tonoplast is energized by two proton pumps, the vacuolar H⁺-ATPase (V-ATPase) and the vacuolar H⁺-pyrophosphatase (V-PPase); however, their functional relation and relative contributions to ion storage and detoxification are unclear. We have identified an Arabidopsis mutant in which energization of vacuolar transport solely relies on the activity of the V-PPase. The vha-a2 vha-a3 double mutant, which lacks the two tonoplast-localized isoforms of the membrane-integral V-ATPase subunit VHA-a, is viable but shows day-length-dependent growth retardation. Nitrate content is reduced whereas nitrate assimilation is increased in the vha-a2 vha-a3 mutant, indicating that vacuolar nitrate storage represents a major growth-limiting factor. Zinc is an essential micronutrient that is toxic at excess concentrations and is detoxified via a vacuolar Zn²⁺/H⁺-antiport system. Accordingly, the double mutant shows reduced zinc tolerance. In the same way the vacuolar Na⁺/H⁺-antiport system is assumed to be an important component of the system that removes sodium from the cytosol. Unexpectedly, salt tolerance and accumulation are not affected in the vha-a2 vha-a3 double mutant. In contrast, reduction of V-ATPase activity in the trans-Golgi network/early endosome (TGN/EE) leads to increased salt sensitivity. Taken together, our results show that during gametophyte and embryo development V-PPase activity at the tonoplast is sufficient whereas tonoplast V-ATPase activity is limiting for nutrient storage but not for sodium tolerance during vegetative and reproductive growth.     

小鼠脑缺血后的能量代谢改变和药物的作用

应用部分结扎小鼠颈总动脉(包括迷走神经)及小鼠断头法引起脑缺血后,脑组织的ATP和磷酸肌酸明显降低,乳酸明显升高。部分结扎颈动脉出现四肢无力、转圈及昏睡等症状,其严重程度与脑能量代谢改变相平行。皮下注射尼莫地平、硝苯吡啶、尼卡地平和三七皂甙对脑缺血有一定保护作用。苯巴比妥钠能改善正常和脑缺血小鼠的脑能量代谢,人参皂甙Rb₁可降低正常小鼠脑乳酸含量。     

外科术后康复护理中深化护理文化建设的探索与实践

目的 探讨在外科术后专科康复护理中深化护理文化建设的实践与效果。方法 选择符合诊断标准的乳腺癌改良根治术、脑卒中偏瘫及脊髓损伤、腰椎间盘突出患者随机分成实验组和对照组，实验组患者术后应用自制辅助卧位枕辅助维持康复体位及VCD光盘辅助指导功能锻炼，对照组采用传统方法辅助卧位及健康教育方法。结果 实验组患者疼痛减轻，舒适度及依从性优于对照组（P〈0．05）；特定知识的知晓率及功能锻炼正确率高于对照组（P〈0．05）。结论 自制系列辅助康复卧位枕及VCD光盘辅助指导功能锻炼的应用可让患者感到舒适、方便，实践了人性化护理与专科护理技术的有机结合，丰富了护理文化的内涵，值得推广。     

聚羟基丁酸己酸酯/聚碳酸亚丙酯共混材料作为血管组织工程支架的性能特征

目的：为改善生物材料聚羟基丁酸己酸酯（PHBHHx）的力学性能和聚碳酸亚丙酯（PPC）的可加工性,将两者共混,制备不同比例的共混材料,并对共混膜上血管平滑肌细胞的黏附和共混材料制成的管形支架的力学性能进行评价,以选出合适比例的共混材料作为血管组织工程支架。 方法：实验于2006-08/2007-04在清华大学生物科学与技术系生物膜与膜生物工程国家重点实验室完成。①制备5种不同比例（PHBHHx∶PPC分别为0∶10,3∶7,5∶5,7∶3,10∶0）的共混材料,利用CCK-8试剂测定兔主动脉平滑肌细胞在共混膜上培养24h后的黏附数量。②采用热致相分离和冷冻干燥法制备管形支架,通过反复浸渍和晾干,在多孔支架外层形成一层晾干的膜层。利用扫描电镜观察支架形貌、压汞仪测量孔隙率和孔径分布,利用自制装置以6.65kPa/s的加压速度测定管形支架的破裂强度,万能材料试验机测定支架的缝合强度,以羊颈动脉为对照。 结果：①兔主动脉平滑肌细胞在各种膜上培养24h后,在5∶5比例PHBHHXx/PPC共混膜和PPC膜上相对黏附量高于PHBHHXx膜（P〈0.05）。②PHBHHx和共混材料均可制备成管形支架,而单纯PPC支架在制备晾干层时溶化,无法维持原形。管形支架的孔径随PPC含量的增加而增大,孔隙率提高。③支架的破裂强度与羊颈动脉相似（P〉0.05）;缝合强度均强于羊颈动脉,以5∶5和3∶7PHBHHx/PPC共混材料制备的管形支架的缝合强度高于PHBHHx支架。 结论：①与PHBHHx相比,5∶5PHBHHx/PPC共混膜和PPC膜上兔主动脉平滑肌细胞的黏附更好。②共混材料均可以制备成管形支架,并且力学强度符合移植的要求,缝合强度以5∶5和3∶7的PHBHHx/PPC共混材料最佳。