A diffractometer using a lateral effect photodiode for the rapid determination of sarcomere length changes in cross-striated muscle

A simple method is devised to record rapid sarcomere length changes of muscle fibres using a lateral effect diode. In the standard position the diffractometer records length changes between 1.65 and 3.8 m, the output being linear 1 V/m with a frequency response of –3 dB at 1.2 kHz. The absolute error is<0.05 m between 1.65 and 2.80 m and <0.1 m between 2.81 and 3.30 m. The resolution of length changes is<0.005 m over the whole range. By varying the detector position the length range can be extended to either side, and spatial resolution can be improved at the expense of length range.     

子宫背带式缝合治疗剖宫产术中宫缩乏力出血疗效分析

目的探讨子宮背带式缝合治疗剖宫产术中宫缩乏力出血的临床效果。方法回顾性分析2012年6月—2014年1月间来我院接受剖宫产并且术中出现宫缩乏力出血的孕妇87例的临床资料,分析患者术中宫缩乏力出血时采取给中治疗手段的效果。结果 87例术中缩宫乏力出血患者中有37例使用了按摩压迫子宫以及药物治疗止血,其中有13例起效,未起效的患者与其他患者采用子宮背带式缝合治疗,均成功止血,37例常规止血患者平均出血量为（950±30.4）mL,50例子宮背带式缝合患者出血量为（540±21.4）mL。结论与其他止血方式相比,子宮背带式缝合治疗剖宫产术中宫缩乏力出血具有明显优势,用于临床取得了显著效果,因此适合临床推广使用。     

Spontaneous transient inward currents and rhythmicity in canine and guinea-pig tracheal smooth muscle cells

Spontaneous transient inward currents (STICs) were recorded in canine and guinea-pig tracheal myocytes held at negative membrane potentials. STICs were Cl^– selective since their reversal potential was dependent on the Cl^– gradient and they were blocked by the Cl^– channel blocker niflumic acid. STICs were insensitive to Cs⁺, charybdotoxin, and nifedipine. Ca²⁺-activated K⁺ currents often preceded STICs, suggesting that the STICs are Ca²⁺ dependent. In support of this suggestion, we found the Cl^– currents were: (1) abolished by depleting intracellular Ca²⁺ stores using caffeine, acetylcholine, histamine, or substance P; (2) enhanced by increasing external concentrations of Ca²⁺; (3) evoked by voltage-dependent Ca²⁺ influx. The channels responsible for this Cl^– current are of small unitary conductance (<20 pS). Decay of the STICs was described by a single exponential with a time constant of 94±9 ms at –70 mV; the time constant increased considerably at more positive potentials. Using Ca²⁺-dependent Cl^– currents and contractions as indices of internal levels of Ca²⁺, we found that isolated tracheal cells are capable of exhibiting rhythmic behaviour: bursts of currents and contractions with a periodicity of less than 0.1 Hz and which continued for more than 20 min. These rhythmic events were recorded at negative membrane potentials, suggesting that cyclical release of internally sequestered Ca²⁺ is responsible. We conclude that spontaneous release of Ca²⁺ from intracellular stores in tracheal muscle cells leads to transient currents in some cases accompanied by rhythmic contractions. Our studies provide evidence for a cellular mechanism that could underly myogenic oscillations of membrane potential in smooth muscle.     

射频消融治疗高血压人群中室性早搏的中长期随访

目的:了解射频消融治疗高血压人群中室性早搏患者的临床疗效及手术对患者生活质量的影响。方法:在进行高血压规范化治疗并达标的基础上,对27例高血压人群中频发室性早搏患者,采用起搏标测法/激动标测法或两者结合进行标测消融,并让患者在术前和术后分别检查动态心电图、心脏超声、手术前后测定心肌钙蛋白I(cTnI),以及在手术前、手术后3月、12月分别填写SF-36调查表,量表采用标准分法进行评分、统计分析。结果:即刻成功率89%(24/27),总成功率96.3%,1例患者早搏次数较术前有明显好转,但次数仍大于3000次/d。cTnI在手术后稍升高[手术前后分别为(0.15±0.19)和(1.09±0.40)μg/L,P<0.01],但仍在正常范围内;患者左心室舒张末期内径(LVEDd)[手术前后分别为(44.40±5.07)mm(42.44±5.60)mm,P<0.01]、左心室收缩末期内径(LVESd)[分别为(33.07±2.30)mm和(31.66±2.20)mm,P<0.01]在手术后有所缩小,可以提高左室射血分数(LVEF)[分别为(56.07±1.59)%和(59.92±1.49)%,P<0.01]。患者群整体的生活质量各项指标在术后均有明显提高(P<0.01)。射频消融治疗能降低患者就医次数、医药费用(P<0.01),随访中无并发症。结论:射频消融治疗高血压人群中室早患者安全、有效,能进一步改善心功能;可显著提高患者生活质量。     

Involvement of prostaglandin F2α in the adverse effect of PCB 77 on the force of contractions of bovine myometrium

Polychlorinated biphenyls (PCBs) stimulate in vitro both the force of myometrial contractions and endometrial secretion of PGF2α in cattle. Therefore, the goal of this study was to investigate the participation of PGF2α in the effect of PCBs on uterine contractility. For this aim, the myometrial strips were incubated (48 h) with PCB 77 at the dose of 1, 10 and 100 ng/ml (i.e., 0.0034, 0.034 and 0.34 nmol/ml) separately or jointly with indomethacin (INDO, 10⁻⁴ M), which blocks the PGF2α synthesis. Next, the force of myometrial strips contractions was measured. Further, the influence of PCB 77 (0.1, 1 and 10 ng/ml) on the PGF2α secretion from myometrial cells after 6, 24, and 48 h and PCB 77 (1 and 10 ng/ml) on the mRNA expression of cyclooxygenase 2 (COX-2) and PGF2α synthase (PGFS) in myometrial cells after 6 and 24 h, was investigated. The increase (P < 0.05–0.001) of the contractions force of myometrial strips evoked by each dose of PCB 77, was markedly reduced (P < 0.05–001) by INDO. There was an increase (P < 0.05–0.001) of both PGF2α secretion after all studied periods of cell incubation and mRNA expression for COX-2 and PGFS after 6 h treatment of myometrial cells with PCB 77. It can be concluded that myometrial synthesis of PGF2α and its further secretion is a part of the mechanism by means of which PCB 77 may affect the force of myometrial contractions in cattle.     

Mother-father relationship,object relations and premature contractions

Mother-father relationship during pregnancy and its influence on obstetric complications, such as premature contractions, has been little investigated, but seems to be far more important than has been acknowledged so far. From a psychoanalytic and psychodynamic perspective three case studies are used to illustrate the ongoing dynamics. First the fetus is identified with an object Of the past and/or the present. To ward off threatening object representations the pregnant woman needs a third person, the father. If he is unavailable for her she is in danger Of rejecting the child. Results are discussed also in relation to the medical support system.     

参松养心胶囊联合胺碘酮治疗室性早搏的临床观察

目的：观察参松养心胶囊联合胺碘酮片治疗室性早搏的临床疗效。方法：将98例室性早搏患者随机分成3组,对照组33例,口服胺碘酮片,每日200mg,每日3次,1周后按病情调整剂量;单药组31例,口服参松养心胶囊4粒,每日3次;联合用药组34例,同时服用参松养心胶囊和胺碘酮片,剂量同前,3组均以4周为1疗程,比较3组病人在治疗前后的临床症状、室性早搏的次数及不良反应情况。结果：联合用药组、单药组、对照组控制室性早搏的总有效率分别为91.2％、64．6％和72．7％;症状改善率分别为97．1％、71．0％、75．7％。联合用药组控制室性早搏的总有效率及症状改善率均优于单药组及对照组（P〈0．05）,单药组与对照组控制室早的总有效率及症状改善率均无显著性差异（P〉0．05）。结论：参松养心胶囊联合胺碘酮治疗室性早搏疗效优于两药单独使用。     

Assessment of pelvic floor muscles in sportswomen: Quality of life and related factors

ObjectivesTo evaluate Maximum Voluntary Contraction (MVC) of the Pelvic Floor Muscles (PFM) in sportswomen, to observe the urinary symptoms and their impact on the Quality of Life (QoL).DesignObservational cross-sectional study.SettingGyms and teams in the North of Portugal.ParticipantsSportswomen (n = 197).Main outcome measuresThe measurement was performed using a manometer. The sportswomen were instructed to perform 3 MVC of the perineum, held for 3 s. The Kings Health Questionnaire (KHQ) was used to evaluate urinary symptoms and the QoL of the sportswomen.ResultsAge significantly influenced (p < 0.05) the QoL in all domains. An increase in BMI was also significantly associated with a decrease in the QoL. MVC values had a highly significant effect on the overall QoL and all domains, including a reduction in urinary symptoms. The weekly time of physical activity was associated with a better QoL in symptomatology. The practice of high-impact activities decreased the QoL (compared to low-impact activities). The vaginal resting pressure values ranged from 1.60 to 59.80 (24.34 ± 11.00).ConclusionsAge, BMI and high-impact sports appear to be the leading factors that promote the onset of SUI, which in turn decrease the QoL in sportswomen. There was a positive association between MVC and weekly time of physical activity in the QoL.     

Apport de la transdisciplinarité sans perdre sa spécificité de kinésithérapeute dans la rééducation d’un enfant polyhandicapé : étude de cas

This paper presents the case study of Julie, a 5-year-old child presenting a cerebral palsy. Her motor function level is rated V on the Gross Motor Function Classification System for cerebral palsy (GMFCS) and her manual ability is rated V on the Manual Ability Classification Scale (MACS). Her communication level is rated IV on the Système de classification des fonction de communication (SCFC). Our work focuses on the major hypertonia observed with this child and which massively alter her voluntary motor skills. The analysis was led through an interdisciplinary re-education team and enabled us to consider the different roots for these contractions. Not only is the neuromotor function altered by the brain injury leading to an inflated basal state of contraction, but the sensory, psychological and emotional dimensions were also taken into account to understand Julie's behavior in relation to her exaggerated contractions. Based on this multidimensional diagnosis, a collective process led to a physiological and educative therapy in order to allow this young girl with multiple disabilities to achieve a certain level of control over her contractions. The installations, the organization of her environment and an adapted educational framework were the three areas chosen to answer the three identified dimensions of pathological contraction. Regulating her state of contraction appears as a necessary step towards optimizing her expression and accessing an improved state of relaxation and comfort – a key element to support her general development.