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.     

颅脑超声对高原新生儿缺氧缺血性脑病观察及探讨

本文对西宁地区新生儿缺氧缺血性脑病（ＨＩＥ）颅脑超声诊断分析脑缺氧缺血产生的原因、脑实质损伤程度及预后评估。提出对围产期窒息导致脑缺血性损害的预防措施。     

The effectiveness of sub-Tenon's infiltration of local anaesthesia for cataract surgery

Purpose: To determine if adequate anaesthesia and akinesia could be obtained using an inferonasal quadrant sub-Tenons anaesthesia for cataract surgery.
Methods: The sub-Tenons method of local anaesthesia was used in 50 patients undergoing extracapsular cataract extraction and lens implantation. The technique followed was that described by JD Stevens in his study of 50 patients. Posterior sub-Tenons space was approached through a conjunctival incision in the inferonasal quadrant and the anaesthetic solution delivered by an irrigating cannula. The patients were assessed for residual ocular movements just before surgery. Effectiveness of anaesthesia was assessed during surgery using a verbal pain rating score. Scoring was based on the concept of a visual analogue pain score chart.
Results: Total akinesia was obtained in 20% patients and total anaesthesia in 24% patients. The remainder of the patients had adequate akinesia and anaesthesia to proceed with and complete the surgery.
Conclusion: This method provides satisfactory anaesthesia for cataract surgery.     

p53基因在RA诱导SH-SY5Y细胞分化后低表达

全反式维甲酸(RA)的抑制肿瘤细胞生长和调控细胞分化的作用是一项重要的研究课题。而p53基因是一个重要的肿瘤抑制基因,在RA的作用中是否涉及到p53的作用尚有待阐明。本文用低浓度的RA(10 μmol/L)作用于SH-SY5Y细胞,每2d换一次液,在作用9 d后,用光学显微镜观察SH-SY5Y细胞的形态学变化,并提取细胞质总RNA进行RT-PCR反应半定量检测p53基因表达。结果显示,SH-SY5Y细胞经RA诱导后,细胞生出较长的突起,具有神经元的形态;而对照组保持成纤维细胞的形态、无明显的形态学变化。RT-PCR半定量显示,在细胞诱导后,p53基因表达明显下调。本文结果提示,RA的作用可能独立于p53基因途径,p53基因的表达变化可能是继发于RA的作用。     

探针浓度对压电传感器基因杂交效应的影响

目的 探讨探针浓度对压电传感器基因杂交效应的影响。方法 9种浓度的探针与同一浓度的靶序列在压电传感器阵列上进行杂交,计算机采集并分析传感器频率数据,比较各探针浓度下固定前后频率差,杂交达到平衡所需时间,杂交前后频率差,同时,根据较低浓度数据得出的杂交动力学参数。计算各浓度下的频率变化理论值。结果 随探针浓度增加,固定引起的频率变化值逐渐增加,杂交时间有缩短趋势,杂交前后的频率差值在探针浓度较低（1nmol/L-0.5μmol/L)时逐渐增大,而探;针浓度较高（1.0-3.5μmol/L)时反而减小,高浓度时杂交前后频率变化理论值与实际值存在明显差异。结论 在石英晶体传感器阵列上,基因杂交效率随探针浓度增加而增大,但探针浓度过高反而抑制杂交,其原因可能主要在于探针之间的空间构象关系和静电排斥。     

内毒素血症小鼠巨噬细胞膜脂改变对CD14表达及TNFα分泌的影响

目的 以小鼠内毒素血症为模型,研究小鼠腹腔巨噬细胞膜脂改变,及其对受体CD14表达及血浆TNFα产生的影响。方法 48只小鼠分为3组。①对照线（n=8）;②内毒素血症组：小鼠尾静脉注射LPS,200μg/只,分1、3、5、8 4个观察时相点,每个时相点8只动物;③脂质体预处理组（n=8）：小鼠腹腔注射卵磷脂脂质体1ml(1mg/ml),18h后尾静脉注射LPS,200μg/只,5h后观察巨噬细胞膜脂成分、膜流动性及CD14阳性率、血浆中TNFα含量的变化。结果 LPS刺激下,巨噬细胞主要膜脂成分降解,细胞膜荧光偏振度、微粘度和分子排列有序系数增加,膜流动性显著降低;CD14阳性率增加,5h达高峰,8h降至正常水平;TNFα含量显著升高,3h达高峰,8h降至正常水平。磷脂脂质体预处理后,膜损伤减轻,CD14阳性率及TNFα含量均明显降低。结论 内毒素血症小鼠腹腔巨噬细胞膜磷脂降解,细胞膜从相对比较流动变为相对固化,这可能是膜受体CD14阳性率增加,TNFα产生增多的重要原因。脂质体预处理能修复膜损伤,减少膜CD14表达,减轻炎症反应。     

长期饮酒对男性生殖系统功能影响

目的探讨饮酒对男性生殖系统的损害及其机理。方法选择45名男性饮酒者和9名慢性酒精中毒者为研究对象,以15名不吸烟不接触毒物的男性为对照组。结果长期大量饮酒和酒精中毒者血清中T和CS水平下降,而LH和FSH水平升高;精浆和精子中LDH,LDH-x和G-6PD活力下降,以LDH-x下降为敏感;精子数量和活动精子年均降低,精子畸形率及异常精液检出率均升高。上述各指标与对照组比较差异均有高度显著性（P＜0.01）。结论长期饮酒可损害男性生殖系统功能。     

Vitiligo in children and adolescents: association with thyroid dysfunction

Background The clinical characteristics of vitiligo in children and adolescents with an emphasis on thyroid dysfunction have only been reported in a few studies. Objective The purpose of this study was to examine the characteristics of children and adolescents with vitiligo and compare the incidence of thyroid dysfunction between them and controls without vitiligo at the same age. Methods A retrospective analysis of 324 Korean children and adolescents with vitiligo was performed. The results of thyroid function screening tests in them (n = 254) were compared with controls (n = 122). Results Of the total 324 children and adolescents with vitiligo, vitiligo vulgaris was the most common type (42.3%) and the most commonly involved site was the face (54.6%). A total of 15 of 254 (5.9%) patients screened for thyroid function were diagnosed with thyroid disease (four had Hashimoto’s thyroiditis; two, Graves’ disease; seven, subclinical hypothyroidism; and two, subclinical hyperthyroidism). None of the 50 patients with segmental vitiligo showed any thyroid dysfunction (P = 0.047). There was no significant difference in the incidence of thyroid disease between children and adolescents with vitiligo and the control group, in which seven of 122 (5.7%) showed thyroid dysfunction. Conclusion In this study, we demonstrated the characteristics of children and adolescents with vitiligo and also observed no significant difference in the incidence of thyroid disease between children and adolescents with vitiligo and the control group.