Vaginal cones: a conservative method of treating genuine stress incontinence

Summary. A set of weighted vaginal cones designed to exercise the pelvic floor muscles was used by a group of 39 premenopausal patients with genuine stress incontinence who were awaiting corrective surgery. The effectiveness of the exercises in reducing urinary loss was assessed with a standard urine pad test before and after 1 month of training. Of the 30 women who completed 1 month of the exercises 70% felt they were improved or cured and 90% found it an acceptable method of treatment. Of the 30 women only 11 (37%) opted for surgery after training. There was a highly significant correlation (P<0·001, r_s= -0·21) between decreased urine loss and increase in retained cone weight.     

针法微型外科解剖学基础

1针法微型外科对解剖学的要求 随着临床医学的发展，对解剖学从不同角度、不同形式提出了要求。解剖学指导和促进了医学的发展，同时又要求解剖学不断创新。早期的解剖学主要是服务于外科手术。随着外科手术的细致深入和发展，除常规的人体解剖和局部解剖外，又出现了显微外科解剖，人体皮瓣解剖，B超、CT和核磁共振等影像学解剖。     

Neuroprotective effect of estrogen after chronic spinal cord injury in ovariectomized rats

BACKGROUND: At present, there is still lack of effective drugs for chronic spinal cord injury, whereas it is found recently that estrogen has a neuroprotective effect on brain and spinal cord injuries. OBJECTIVE: To observe the effect of estrogen on the apoptosis of nerve cells after gradual chronic spinal cord injury in ovariectomized rats. DESIGN: A randomized controlled animal trial. SETTING: Institute of Orthopaedics, the Second Hospital of Lanzhou University. MATERIALS: Sixty-five female Wistar rats of common degree, weighing 220–250 g, were provided by the experimental animal center of Lanzhou University. The rats were randomly divided into sham-operated group (n =5), estrogen-treated group (n =30) and saline control group (n =30), and the latter two groups were observed at 1, 3, 7, 14, 28 and 60 days respectively, and 5 rats for each time point. METHODS: All the rats were treated with bilateral oophorectomy 2 weeks before the experiment. T10 vertebral lamina was revolved into using plastic screw. The spinal canal impingement was not induced initially. After that, the original incision was opened to expose the screw every 7–10 days. MAIN OUTCOME MEASURES: The apoptosis and Caspase-3 positive cells in the damaged spinal cord were detected using terminal deoxynucleotidal transferase-mediated dUTP-biotin nick end labeling (TUNEL) method and Caspase-3 immunohistochemical staining at 1, 3, 7, 14, 28 and 60 days after chronic spinal cord injury respectively. RESULTS: Totally 65 rats were used, and the deleted ones during the experiment were supplemented by others. Changes of Caspase-3 expression after spinal cord injury: In the sham-operated group, only a small amount of Caspase-3 proteins were observed in the rat spinal cord, mainly located in motor neurons of spinal cord anterior horn. In the estrogen-treated group and saline control group, positive cells expressed occasionally at 1 day postoperatively, began to increase obviously at 7 days after injury, strongly expressed at 14 and 28 days, but decreased at 60 days, mainly located in the neurons of spinal cord gray matter anterior horn, and they expressed fewer in the motor neurons and white matter of ventral horn, and there were obvious differences between the estrogen-treated group and saline control group at 7, 14, 28 and 60 days (P < 0.05). CONCLUSION: Estrogen can reduce the apoptosis of nerve cells and promote the recovery of neurological function following gradual chronic spinal cord injury.     

艾司洛尔控制开颅手术苏醒期脑过度灌注的效果

目的 通过监测脑血流速度、颈静脉球部血氧饱和度(SjvO2)、血压、心率(HR)和不良反应发生率等,综合评价艾司洛尔用于控制开颅手术苏醒期患者脑过度灌注的效果.方法 选择择期在全身麻醉下行开颅肿瘤切除术的患者,随机分为艾司洛尔组(E组,20例)和对照组(C组,20例).E组患者从拔管即刻起给予艾司洛尔0.6 mg·kg1·h-1静脉持续滴注15 min C组患者从拔管即刻起给予0.9%氯化钠溶液静脉持续滴注.分别监测两组患者术前、术后拔管即刻及拔管后15、30、45、60 min时的大脑中动脉平均血流速度(MCAVm)、SivO2平均动脉压(MAP)及HR,并记录不良反应发生例数.结果 E组术后15和30 min的MCA Vm、sjvO2及HR均显著低于C组(P值均<0.01),术后15 Min的MAP显著低于C组(P<0.05).无一例患者发生与艾司洛尔相关的药物不良反应.结论 艾司洛尔是控制术后脑过度灌注的理想药物.     

影响飞行员掩饰性心理家庭多因素分析

目的 探讨飞行员夫妻双方掩饰性与心理健康及婚姻质量的关系.方法 采用症状自评量表、艾森克个性问卷的掩饰分量表和Olson婚姻质量问卷对288名空军飞行员夫妻双方进行评定,采用SPSS 15.0进行相关分析、回归分析.结果 发现飞行员以及妻子的掩饰特质与自身的心理健康9个因子:躯体化、强迫症状、人际关系敏感、焦虑、抑郁、敌对、恐怖、偏执、精神病性具有显著负相关性,前者相关系数在-0.219～-0.306之间,后者在-0.127～-0.391之间.飞行员以及妻子的掩饰特质与自身婚姻质量的12因子中的6(相关系数0.151～0.232)、7(相关系数0.123～0.309)项有显著正相关性;飞行员以及妻子的掩饰特质与对方的婚姻质量各有4项存在显著相关性,前者相关系数在0.127～0.251之间,后者在0.129～0.203之间.多因素分析揭示,对丈夫掩饰特质贡献最大的因素依次为妻子的焦虑情绪、妻子的恐怖情绪、丈夫的敌对情绪、妻子的婚姻满意度、丈夫的角色平等性;对妻子掩饰特质贡献最大的因素依次为妻子的敌对情绪、经济安排、性格相客性,丈夫的性生活、与亲友关系等.结论 开展飞行员心理健康教育,进行婚姻家庭心理咨询时,提高夫妻双方的掩饰性是非常有必要的.     

Collaboration between nurse educators in Australia and New Zealand extends educational opportunities for nurses

This paper presents a case study style report of a collaborative endeavour between nursing faculty in two institutions, one in New Zealand and the other in Australia. Expertise developed and tested in New Zealand, in teaching through the distance education mode and in the subject area of nursing theory, was able to be applied to assist with establishing a new nursing education programme in Australia. What might have been treated simply as a consultancy situation had greater mutual benefit for all those concerned because of being approached within a collaborative framework. The purpose, process, pitfalls and rewards of the association are described with the hope that others may be stimulated to seek opportunities nationally, and internationally, for pooling resources in the interests of improving the quality and availability of advanced education in nursing.