Application value of pelvic floor ultrasound in screening early postpartum stress urinary incontinence / 中国基层医药

Objective:To investigate the application value of pelvic floor ultrasound in screening early postpartum stress urinary incontinence (SUI).Methods:A total of 220 postpartum women, who were admitted by the Department of Gynecology and Obstetrics of The People's Hospital of Hechi from January 2018 to June 2019, were selected for this study. These women were divided into SUI ( n = 52) and no SUI ( n = 168) groups according to whether SUI occurred within 42 days after delivery. Pelvic floor ultrasound parameters and clinical data were compared between the two groups. The effects of each ultrasound parameter on postpartum SUI were assessed. The receiver operating characteristic (ROC) curve was plotted for each parameter. The area under the ROC was calculated. The risk factors for postpartum SUI were investigated using the logistic regression analysis. Results:The number of deliveries (≥ 2 times), the proportion of women subjected to vaginal delivery, and neonatal weight in the SUI group were significantly higher than those in the no SUI group [ χ2 = 4.13, 3.30, t = 4.43, all P < 0.05]. There were significant differences in the bladder neck position and levator hiatus area in the resting state between the two groups ( t = 2.29, 3.09, both P < 0.05). There were significant differences in the bladder neck position, levator hiatus area, urethral rotation angle, and bladder neck mobility during the Valsalva movement between the two groups ( t = 13.14, 4.27, 15.64, 8.54, all P < 0.05). The areas under the ROC of bladder neck position and levator hiatus area in the resting state and the areas under the ROC of bladder neck position, levator hiatus area, urethral rotation angle, and bladder neck mobility during the Valsalva movement were 0.707, 0.725, 0.730, 0.771, 0.813, and 0.836, respectively. The area under the ROC of parameters used in combination was 0.849. Logistic regression analysis results revealed that the number of deliveries (≥ 2 times), bladder neck position (> 27.286 mm) and levator ani hiatus area in resting state (> 16.663 cm 2), and bladder neck position (< -2.774 mm), levator hiatus area (> 21.915 cm 2), urethral rotation angle (> 80.445°), and bladder neck mobility (> 30.501°) during the Valsalva movement were the risk factors for postpartum SUI. Conclusion:Combined use of pelvic floor ultrasound parameters is valuable for the diagnosis of postpartum SUI. Abnormal changes in the bladder neck position, levator ani hiatus area, urethral rotation angle, and bladder neck mobility are closely related to the occurrence of postpartum SUI. Therefore, combined use of pelvic floor ultrasound parameters can be preferred to screen early postpartum SUI.

Definition and clinical progress of critical shoulder angle / 中华骨科杂志

Rotator cuff disease and degenerative osteoarthritis are caused by many factors. Several studies had shown that rotator cuff disease was related to lateral extension of the acromion and glenoid inclination. A new parameter, critical shoulder angle (CSA), which is defined as the angle between a line connecting the superior to the inferior margins of the glenoid and a line connecting the inferior margin of the glenoid to the inferolateral edge of the acromion measured on anteroposterior (AP) shoulder radiographs, is proposed to comprehensively reflect the relationship between abnormal anatomical structure and rotator cuff injury. There is a close relationship between CSA and the injury of rotator cuff and the osteoarthritis of glenohumeral joint: the injury of rotator cuff is often accompanied by a larger CSA (> 35 °), and a smaller CSA (< 30 °) is closely related to the occurrence of glenohumeral arthritis. Therefore, CSA is helpful for the diagnosis of rotator cuff injury and glenohumeral osteoarthritis. Correction of abnormal CSA by arthroscopic lateral acromial osteotomy also provides a new idea for the treatment of shoulder diseases. In this paper, we reviewed the research progress of the angle from five aspects: definition, measurement, biomechanical significance, treatment and ethnic differences.

Definition and clinical progress of critical shoulder angle / 中华骨科杂志

Rotator cuff disease and degenerative osteoarthritis are caused by many factors.Several studies had shown that rotator cuff disease was related to lateral extension of the acromion and glenoid inclination.A new parameter,critical shoulder angle (CSA),which is defined as the angle between a line connecting the superior to the inferior margins of the glenoid and a line connecting the inferior margin of the glenoid to the inferolateral edge of the acromion measured on anteroposterior (AP) shoulder radiographs,is proposed to comprehensively reflect the relationship between abnormal anatomical structure and rotator cuff injury.There is a close relationship between CSA and the injury of rotator cuff and the osteoarthritis of glenohumeral joint:the injury of rotator cuff is often accompanied by a larger CSA (＞ 35 °),and a smaller CSA (＜ 30 °) is closely related to the occurrence of glenohumeral arthritis.Therefore,CSA is helpful for the diagnosis of rotator cuff injury and glenohumeral osteoarthritis.Correction of abnormal CSA by arthroscopic lateral acromial osteotomy also provides a new idea for the treatment of shoulder diseases.In this paper,we reviewed the research progress of the angle from five aspects:definition,measurement,biomechanical significance,treatment and ethnic differences.

Application of holistic integrative medicine in gynecology clinical practice teaching / 中华医学教育探索杂志

With regard to teaching of gynecology, the integrated medical pattern should be built up and applied, which could help culturing students' ability of active thinking, analyzing and solving clinical problems. To set up the concept of individual-based treatment, we applied the concept of holistic integrated medicine in clinical teaching of gynecology, combing the aspects of teaching, clinic and resources. A reform in teaching content design and teaching mode had been carried out. The results showed that the students are highly satisfied with teaching process, their enthusiasm of learning has been effectively boosted, their clini-cal thinking has been initially cultivated. In a word, this teaching reform has achieved good results in practice.

Expression of CXC chemokine receptor 5 in skin lesions of bullous pemphigoid and its significance / 中华皮肤科杂志

Objective To study the role of CXC chemokine receptor 5 (CXCR5) in the pathogenesis of bullous pemphigoid (BP) by detecting the expression of CXCR5 on follicular helper T (Tfh) cells in skin lesions of BP.Methods An immunohistochemical procedure was used to detect CXCR5 expression in biopsy specimens from skin lesions of 16 patients with BP and normal skin of 10 healthy individuals.Results CXCR5 was mainly expressed in the cytoplasm and membrane of Tfh cells in the basal cell layer of normal skin as well as in both basal cell layer and prickle cell layer of BP lesions.The number of CXCR5-positive ceils per high power field (× 400) was 11.16 ± 4.47 in normal skin specimens,significantly lower than that in lesional skin specimens (35.70 ± 12.20,t =6.07,P ＜ 0.01).Conclusion CXCR5 may be involved in the pathogenesis of BP.