生物反馈电刺激治疗产后盆底肌力减退的疗效评估

目的:探讨生物反馈联合电刺激对产后盆底肌力减退早期干预治疗方法的疗效。方法:在4家妇产科专科医院选取产后6周经筛查发现存在盆底肌力减退的产妇纳入对照组和生物反馈联合电刺激治疗组,治疗6周。在治疗结束时和治疗结束后的3个月、6个月进行阴道内指检并经PHENIX检测仪量化评定产妇盆底Ⅰ类肌和Ⅱ类肌的情况。结果:电刺激对于重度盆底肌力减退患者Ⅰ类肌均有效(P<0.001);Ⅱ类肌在治疗刚结束时无效,但在治疗结束6个月出现疗效并有后续持续增强肌力的效果(P<0.05)。电刺激对于轻度盆底肌力减退患者Ⅰ类肌和Ⅱ类肌均有效(P<0.001),但在治疗结束后的6个月内,无明显后续持续增强肌力的效果。结论:生物反馈联合电刺激对轻度和重度盆底肌力减退都有明显疗效。     

Hypo-activity induced skeletal muscle atrophy and potential nutritional interventions: A review

Periods of hypo-activity result in profound changes in skeletal muscle morphology and strength. This review primarily addresses the differential impact of de-training, bed-rest, limb immobilisation and unilateral lower limb suspension on muscle morphology, strength and fatigability. The degree of muscle atrophy differs depending on the hypo-activity model and the muscles in question, with the leg and postural muscles being the most susceptible to atrophy. Hypo-activity also results in the dramatic loss of strength that often surpasses the loss of muscle mass, and consequently, the nervous system and contractile properties adapt to adjust for this excessive loss of strength. In addition, the degree of muscle strength loss is different depending on the hypo-activity model, with immobilisation appearing to have a greater impact on strength than unloaded models. There is a step-wise difference in the magnitude of muscle loss so that, even after accounting for differential durations of interventions immobilisation ≥ unilateral lower limb suspension ≥ bed-rest ≥ de-training. Muscle fatigability varies between hypo-activity models but the results are equivocal and this may be due to task-specific adaptations. This review also addresses potential nutritional interventions for attenuating hypo-activity induced muscle atrophy and strength declines, in the absence of exercise. Essential amino acid supplementation stands as a strong candidate but other supplements are good contenders for attenuating hypo-activity induced atrophy and strength losses. Several potential nutritional supplements are highlighted that could be used to combat muscle atrophy but extensive research is needed to determine the most effective.     

中国成年人慢性病与肌肉重量、力量及质量的相关性分析

目的 探索我国成年人主要慢性病与肌肉重量、力量和质量的关系。方法 主要利用中国慢性病前瞻性研究项目的第二次重复调查,采用logistic回归分析主要慢性病种类、个数及患病年限与肌肉重量、力量和质量的相关性。结果 在24 242名研究对象中,糖尿病、冠心病、脑卒中和慢性阻塞性肺疾病（慢阻肺）的患病率分别为9.6%、5.8%、3.2%和26.8%,患以上任一慢性病者占38.8%。患上述任一慢性病与低手握力和低上肢肌肉质量（AMQ）呈正相关,且其患病年限越长,风险越高（线性趋势P值均<0.001）,患任一慢性病≥ 10年者低手握力和低AMQ的OR值（95%CI）分别为1.64（1.42~1.90）和1.83（1.60~2.10）;患1、2、≥ 3种慢性病者低手握力的OR值（95%CI）分别为1.26（1.17~1.37）、1.42（1.23~1.64）和2.27（1.55~3.32）,低AMQ的OR值（95%CI）分别为1.28（1.18~1.38）、1.67（1.46~1.92）和2.41（1.69~3.45）,且关联均存在线性趋势（线性趋势P值均<0.001）。糖尿病、冠心病和脑卒中均与低手握力和低AMQ呈正相关;慢阻肺患者低四肢肌肉重量指数（ASMI）、低全身肌肉重量指数（TSMI）和低手握力的风险高于非慢阻肺患者,且风险与患病年限呈正相关（线性趋势P值均<0.05）,患慢阻肺≥ 10年者低ASMI和低TSMI的OR值（95%CI）分别为2.39（1.36~4.20）和2.41（1.37~4.26）。结论 慢性病患者肌肉力量和质量更低,且随患慢性病个数及年限延长,低手握力、低AMQ的比例更高。     

Attitudinal and experiential correlates of anorgasmia

Twenty-four orgasmic and 10 anorgasmic women, ages 21–40, provided continuous self-report measures of sexual arousal while viewing explicit videotape segments depicting a variety of sexual activities. They also completed several questionnaires designed to assess sexual attitudes, knowledge, and guilt. As compared to the orgasmic women, the anorgasmic women reported (i) greater discomfort in communicating with a partner regarding only those sexual activities involving direct clitoral stimulation, (ii) more negative attitudes toward masturbation, (iii) greater endorsement of sex myths, and (iv) greater sex guilt. Contrary to expectations, the groups failed to differ significantly on either the frequency of use of any of the sexual activities depicted or on arousal to viewing these activities. The theoretical and clinical implications of these findings are explored.This research was supported in part by an NIH Biomedical Research Support Grant to the second author.     

中国成年人睡眠时长及失眠症状与肌肉重量、力量及质量的相关性分析

目的探索我国成年人睡眠时长及失眠症状与低肌肉重量、力量和质量的关系。方法主要利用中国慢性病前瞻性研究(CKB)项目的第二次重复调查, 采用logistic回归分析睡眠时长、有无失眠症状及其年限与低肌肉重量、力量和质量的相关性。结果研究人群每天睡眠时长为(7.4±1.5)h, 9.3%睡眠时间过短(<6 h), 17.4%睡眠时间过长(≥9 h), 29.9%自报有失眠症状。以睡眠时间7～h为参照组, 睡眠时间过长与低肌肉重量、力量和质量呈正相关, 低四肢肌肉重量指数(ASMI)、低全身肌肉重量指数(TSMI)、低手握力和低上肢肌肉质量(AMQ)的OR值(95%CI)分别为1.32(1.18～1.48)、1.26(1.13～1.41)、1.33(1.18～1.49)和1.16(1.03～1.30)。与无失眠症状者相比, 自报有失眠症状者低ASMI和低TSMI的危险性均增加, 且其失眠症状年限越长, 低ASMI和低TSMI的风险越高(线性趋势均P<0.001)。与睡眠时间7～h且无失眠症状者相比, 睡眠时间过短且有失眠症状者低ASMI和低TSMI的风险明显增加, OR值(95%...     

中老年女性盆腔器官脱垂盆底肌力特征分析

目的分析中老年女性盆腔器官脱垂(POP)患者盆底肌力、肌电值及疲劳度变化特征。方法选择2019年1-10月沈阳市妇婴医院收治的中老年POP患者70例作为观察组,另选同时期于我院就诊的其他无盆底功能障碍的妇科良性疾病患者70例作为对照组。比较两组患者的盆底肌力(收缩力和阴道横截面肌力)和电生理指标(Ⅰ类和Ⅱ类肌纤维的肌力、肌电值和疲劳度)。结果观察组盆底肌力和阴道横截面肌力均低于对照组,组间差异有统计学意义(P<0.05)。观察组Ⅰ类和Ⅱ类肌纤维肌力和肌电值均低于对照组,组间差异有统计学意义(P<0.05);观察组Ⅰ类和Ⅱ类肌纤维疲劳度均高于对照组,组间差异有统计学意义(P<0.05).结论中老年POP患者盆底支持力明显低于其他妇科良性疾病患者,这不仅表现在盆底肌力方面,即便在Ⅰ类和Ⅱ类肌纤维的电生理指标方面也有所体现。     

中国成年人体力活动与肌肉重量、力量及质量的相关性分析

目的探索我国成年人体力活动、休闲静坐时间与低肌肉重量、力量和质量的关系。方法利用中国慢性病前瞻性研究(CKB)项目的第二次重复调查, 采用logistic回归分析体力活动水平、休闲静坐时间与低四肢肌肉重量指数(ASMI)、低全身肌肉重量指数(TSMI)、低肌肉力量和低肌肉质量(AMQ)的相关性。结果研究纳入24 245名研究对象, 体力活动水平为(18.3±13.8)MET-h/d, 休闲静坐时间为(4.4±1.9)h。以体力活动最低组为参照组, 高水平的体力活动与较低的低ASMI、低TSMI、低手握力和低AMQ有关, 对应的OR值(95%CI)分别为0.68(0.60～0.77)、0.66(0.58～0.75)、0.82(0.72～0.94)和0.84(0.74～0.95)。工作、交通、家务和休闲相关体力活动亚型亦与上述指标呈现不同程度的负相关。与休闲静坐时间最短组相比, 静坐时间最长组低TSMI的危险性增加(OR=1.13, 95%CI:0.99～1.30)。结论体力活动与低肌肉重量、力量和质量呈负相关, 而休闲静坐时间与低肌肉重量呈正相关。     

Frequency of sexual problems and sexual dysfunction in middle-aged Danish men

The frequency of sexual dysfunction of a representative group of Danish middle-aged men was recorded, using a questionnaire and an interview that contained, respectively, 12 and 23 questions about sexual problems. The study sample consisted of 439 51-year-old men, all of whom received the questionnaire. Of these men, 100 were also interviewed. Interviewed men more frequently reported erectile dysfunction and previous contact with a therapist due to sexual problems at interview than in the questionnaire. Thus, 16 men (4% of the study population) who reported erectile dysfunction in the questionnaire constituted only a fraction of the true number. At interview nearly 40% of the men reported some kind of sexual dysfunction. There were, however, only 7% who found their problems abnormal for their age—and only 5% of the interviewed men intended to seek treatment for their problems.This project was supported by the Danish National Health Insurance Foundation (Journals H 11/118-86, H 11/80-87 and H 11/137-87) and utilized the statistical service of the Danish Medical Research Council.     

Aphasia and Sexuality

Changes in sexuality following stroke have attracted the interest of clinical researchers, but studies seldom include aphasic individuals, who comprise almost one third of the stroke population. Studies excluded those with moderate or severe aphasia because they cannot participate in interviews or complete questionnaires used in sexuality research. This pilot study investigated how stroke changed sexuality for aphasic people and their spouses. We sought their input as to when these issues should be addressed during the process of stroke recovery, and by whom. Interviews included a structured verbal questionnaire supported by gesture, written, and pictographic materials. Responses were qualitatively analyzed. We found that aphasia affects sexuality differently than for other stroke patients. They believe that improved communication skills would help their sex life. Aphasic individuals and their spouses are open to discussing sexuality with a physician and have specific medical, physical, and psychological issues they wish to address.     

危重症病人胃肠功能障碍与预后关系的临床研究

目的：探讨危重症病人胃肠功能障碍与预后的关系。方法：回顾性分析300危重症病人临床资料,将其分为胃肠功能障碍组（181例）和非胃肠功能障碍组（119例）。评价胃肠功能障碍与急性生理和慢性健康（APACHEⅡ）评分、多器官功能障碍综合征（MODS）及预后的关系。结果：综合性重症监护病房（GICU）内胃肠功能障碍的患病率为60．3％。胃肠功能障碍组病人APACHEⅡ评分、MODS发生率和病死率,均较非胃肠功能障碍组明显升高（P〈0．05）。结论：危重症病人胃肠功能障碍提示病情严重和预后不良。     

尿动力学仪的配置和临床应用

膀胱尿道功能障碍疾病是泌尿外科诊治的难点之一,该类疾病的诊断主要依据尿动力学的检查。尿动力学仪是尿动力学检查的关键设备,也是近２０年来泌尿外科设备中随着计算机的发展而发展最快的设备之一。该设备主要由尿动力学主机,计算机主机,压力传感器,肌电图仪,尿流率仪和数字影像系统组成。尿流率为尿动力学检查中最常用的设备,但尿流率的大小仅反映逼尿肌功能和尿道阻力的综合效果。尿动力学检查中最主要的检查为膀胱测压,