妇科泌尿学与盆底重建外科发展

盆腔器官脱垂（pelvic organ prolapse，POP）是盆底支持结构缺陷、损伤与功能障碍造成的主要后果，它与压力性尿失禁（stress urinary incontinence，SUI）也有密切关系。对POP的诊治是妇科泌尿学与盆底重建外科（urogynecology and reconstructive pelvic surgery，URPS）的基本内容。     

不同持续时间的周期性压力对构建组织工程软骨的影响

Objective To determine the best duration for exerting the cyclic pressure under which the tissue-engineered cartilage is constructed. Methods Free chondrocytes isolated from rabbit articular cartilage were seeded into polylactic acid-co-glycolic acid(PLGA) scaffolds after expansion in vitro, and ran-domized into 4 groups. In Groups 1 to 3, chondrocytes were cultured under daily cyclic pressure (0 ～ 200 kPa, 0.1Hz) for 4 hours, 8 hours, 12 hours respectively; Group 4 was a control in which no pressure was exerted. In each group, after 2 weeks of culture, the tissue engineered cartilages were observed in vitro and assessed by his-tological staining of liE. Next, the content of DNA and the secretion of type Ⅱ collagen and GAG in cartilages were detected quantitatively. Results Under the daily cyclic pressure (0 ～200 kPa, 0.1 Hz), the scaf-fold-chondrocytes complex in the group of 8 hours got the largest volume, smooth, lucidus, and elastic surface, the most queuing chondrocytes, and the highest content of type Ⅱ collagen and GAG (P < 0.01). Conclusions Since chondrecytes are baro-senstive, the metabolism of chondrocytes can be affected by the time of cyclic pressure. Under the effect of 0 ～200 kPa, 0.1Hz, the daily cyclic pressure of 8 hours may be optimal for chondrocytes to multiply and synthesize extracellular matrixes such as type Ⅱ collagen and GAG.     

无张力阴道吊带术治疗女性压力性尿失禁(附20例报告)

目的 评价无张力阴道吊带术(tension-free vaginal tape，TVT)治疗女性压力性尿失禁的疗效。方法 总结采用TVT术治疗女性压力性尿失禁20例的临床资料。结果 平均手术时间26.5min。拔除尿管后，19例病人控尿满意，1例仍有轻微尿失禁。术后平均随访12(3-24)个月，20例病人均无尿失禁。合并症有1例膀胱穿孔，1例术后轻度排尿不畅，2例尿频尿急。结论 TVT术操作简便快捷，创伤小，合并症少，术后康复快，是一种治疗女性压力性尿失禁的理想方法。     

我们如何应对职场压力

你的工作节奏太快；工作量太重；工作时间太长；责任太大；几乎不给朋友打电话；不去参加同学聚会；没有时间真正地放松；很少与家人一起共享天伦之乐，甚至连性生活都成了一种责任而非享受……[编者按]     

子宫脱垂病人合并压力性尿失禁的超声研究

目的研究子宫脱垂病人为什么易合并压力性尿失禁(SUI),如何预测无SUI病人在作矫治子宫脱垂手术后,可能发生压力性尿失禁.方法采用经前庭B超观察了子宫脱垂47人,对照组88人的尿道膀胱.47名子宫脱垂病人中,28人合并不同程度的压力性尿失禁(female stress urinary incontinence,SUI).检查指标是压力期尿道膀胱连接位UVJ-M(Mobility of Urethrovesical Junction),静止期近端尿道长度PUL-r(Proximal Urethra Length at rest).结果子宫脱垂妇女的UVJ-M和PUL-r与对照组有极显著差异,P＜0.001.将UVJ-M＞1.0cm,PUL-r≤2.0cm作为诊断SUI的临界值,子宫脱垂妇女发生SUI的可能性高达85.1%(40/47)其中显性的SUI占59.6%,潜在性的占25.5%.在子宫脱垂无SUI表现的19人中,潜在性的SUI占63.2%(12/19).结论用经前庭B超检查尿道膀胱是术前评估子宫脱垂妇女是否需作尿失禁矫治术最理想的方法,并有利于选择手术方式.     

改变看待处境方式有助减压

如何才能化压力于无形?专家针对这一现象提出了"职业压力管理"的概念,如果无法彻底消除这种压力,那么不妨缓解或分散压力。方     

试论医院数字化学习中心的意义和建设途径

医院数字化学习已为医院全面实现现代化的一项重要改革举措,其核心是信息技术和课程的结合,以数字化网络为学习平台,将信息作为学习的认知工具,突破了传统学习方式的时空限制.数字化学习中心的建设主要方式有:①建有局域网,配有充足的计算机终端;②更新观念,培养学习者终身学习的态度和能力;③建立数字化学习管理组织.     

不同层次护生在校期间感受压力及程度的分析

通过对在校学习期间不同层次护生心理压力的调查,从中找出主要的压力源及所产生压力的程度,为教师及教学管理者因材施教,提供科学依据.对本科、大专、中专三个层次118名学生进行问卷调查,得出三组学生前10位压力源排序及压力水平均值.结果,三组护生首位压力源均为"毕业分配情况",其中大专组压力水平显著低于中专组和本科组(P<0.05):"社会对护理专业的看法"对三个层次的护生均是较大的压力源,压力均值无显著性差异(P>0.05);本科组学生面临的经济压力显著高于大专、中专组(P<0.05);而大专组的课时压力显著高于其他两组(P<0.01).     

持续压力超负荷对兔左心室细胞凋亡的影响

OBJECTIVE: To study the effect of chronic pressure overload on the apoptosis of the left ventricle myocytes in rabbits. METHODS: Rabbit models of chronic pressure overload-induced heart failure were prepared in which dynamic changes of apoptotic myocytes in the left ventricle were observed by way of terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL) assay. RESULTS: Only a few apoptotic cells was observed in the sham-operated group, while in the experimental group, the apoptotic left ventricle myocytes significantly increased after operation, presenting a peak level between day 3 and day 7. Seven days after the operation, the apoptotic myocytes began to decrease and till day 14, the apoptotic cell number had been smaller than that measured on day 1. When signs of heart failure set in, the apoptotic myocytes were again increased (P<0.001). CONCLUSION: During chronic pressure overload, myocyte apoptosis in the left ventricle is elevated at the early stages and undulates subsequently, with the peak occurring before hypertrophy is obvious.     

无创正压通气不同压力支持水平对正常人呼吸做功的影响

目的 :观察无创正压通气 (NIPPV)不同压力水平对正常人呼吸做功的影响 ,为临床合理地应用NIPPV提供理论依据。方法 :选择 9例正常人行NIPPV并寻找出“最舒适”的吸气压力水平 (IPAP) ,在此压力基础上增加或减少 2 5 %的压力 ,构成低IPAP、最舒适IPAP和高IPAP三个压力水平 ,每一IPAP水平通气 15min以上 ,比较不同压力水平呼吸做功改变。结果 :受试者认为“最舒适”的IPAP为 (11.33± 3.2 0 )cmH2 O ,EPAP为 (4 .5 6± 0 .88)cmH2 O[相当于PSV水平为 (6 .77± 3.2 0 )cmH2 O]。与自主呼吸相比 ,NIPPV增加VE的同时 ,总的呼吸做功(Wtot)明显增加 (P <0 .0 5 ) ,而受试者吸气肌做功占总的吸气做功的百分比 (Wi,p/Wi)明显减少 (P <0 .0 5 )。在最舒适IPAP时 ,Wi,p/Wi降低到基础值的 14 %± 9%。这种变化趋势与IPAP的水平相关。结论 :NIPPV可以显著降低吸气肌肉做功。吸气肌做功减少的比例与IPAP的水平相关。研究的结果为NIPPV时PSV的参数设定提供了生理学的依据。