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ObjectiveTo perform a visualized analysis on the relevant literature about rehabilitation in pelvic floor dysfunction (PFD) domestic and abroad, and summarize the current hot spots and frontiers in this field. MethodsThe literature related to PFD rehabilitation from January, 2012 to June, 2022 was searched and screened from the databases of CNKI and Web of Science, and the CiteSpace software was used to analyze the trends of publications, authors, institutions and key words. ResultsA total of 2 448 articles were included. Relatively few high-quality domestic researches were published. In terms of research hotspots, both domestic and international researches focused on causes, mechanisms, rehabilitation techniques and evaluation indicators of PFD, but domestic researches had not paid enough attention to evaluation indicators and prevention of PFD. The key words constantly appeared in 2022 were mechanisms of PFD due to pregnancy, treatment of postoperative complications in prostate cancer patients, the role of pelvic floor muscle training, and quality of life studies in women. ConclusionResearch related to the field of PFD rehabilitation is increasing. There is still a large gap for future development in China.
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Objective:To investigate the effect of SCN1A gene polymorphism (SCN1A-rs3812718) on the alterations of spontaneous brain activity using amplitude of low-frequency fluctuations (ALFF) of MR in patients with temporal lobe epilepsy (TLE).Methods:A total of 37 TLE patients (TLE group) admitted to the Epilepsy Center of the 900th Hospital of Joint Logistic Team from March 2018 to August 2019 were retrospectively analyzed, and another 28 healthy volunteers matched for gender, age, and years of education with the TLE group were selected as the healthy control group (HC group). Sixty-five subjects were divided into four groups by genotype and diagnosis: 34 cases in AA/AG-TLE subgroup, 3 cases in GG-TLE subgroup, 20 cases in AA/AG-HC subgroup and 8 cases in GG-HC subgroup. All subjects underwent sagittal 3D-T 1WI and resting-state functional MRI using a Siemens 3.0 T Trio Tim MR scanner. Then ALFF values of the four groups were calculated using DPABI by the MATLAB 2010 platform. The ALFF values between two groups were compared by independent samples t-test. The ALFF values of different genotypes at rs3812718 locus in TLE and HC group were analyzed by multivariate analysis of variance to find out the corresponding brain regions with interaction, and then post hoc simple effect analysis was performed. Results:The ALFF values in TLE group significantly increased in left marginal lobe, left parahippocampal gyrus, left fusiform gyrus, left hippocampus, right insular lobe and right inferior temporal gyrus (Alphasim corrected P<0.001) and decreased in the left superior frontal gyrus, left middle frontal gyrus, left inferior frontal gyrus, right middle frontal gyrus, right precuneus, left precuneus, bilateral cingulate gyrus and right angular gyrus (Alphasim correction P<0.05) compared with HC group. Subjects carrying the non-risk G allele had higher ALFF values in the right inferior temporal gyrus, right fusiform gyrus, and right cerebellum than subjects carrying the risk A allele ( t=3.30, Alphasim corrected P=0.002). There was a significant interaction effect on posterior cerebellar lobe, left anterior cerebellar lobe, left inferior temporal gyrus, left superior parietal lobule and right precuneus of TLE patients with SCN1A-rs3812718 genotype. Post-hoc simple effect analysis showed that ALFF significantly increased in the left posterior cerebellar lobe, left anterior cerebellar lobe, left inferior temporal gyrus and left fusiform gyrus in GG-TLE subgroup ( t=5.97, P<0.001), but significantly decreased in the right superior parietal lobule, right precuneus, right posterior cerebellar lobe in AA/AG-TLE subgroup compared to the HC group. Compared with GG-TLE subgroup, ALFF in left posterior cerebellar lobe, left fusiform gyrus and left inferior temporal gyrus decreased in AA/AG-TLE subgroup. Conclusion:SCN1A gene polymorphism in the rs3812718 locus affects spontaneous neural activity in resting state, which may be one of the pathophysiological mechanisms of TLE.
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Objective To evaluate the clinical efficacy and analyze relevant prognostic factors of simultaneous integrated boost intensity-modulated radiation therapy ( SIB-IMRT ) for esophageal squamous cell carcinoma. Methods A total of 101 patients diagnosed with esophageal squamous cell carcinoma received SIB-IMRT from 2009 to 2015. The prescribed dose of PTV was 5040 cGy/28 times ( 180 cGy/time) and the dose for planning gross tumor volume (PGTV) was 6020 cGy/28 times (215 cGy/time) or 6160 cGy/28 times ( 220 cGy/time) simultaneously. The total treatment time was 5. 5 weeks ( once a day, 5 times a week).The adverse events, mode of treatment failure,l-,3-and 5-year local control (LC) and overall survival ( OS) rates were observed. Results The quantity of patients who completed the 1-,3-and 5-year follow-up was 101, 84 and 45, respectively. The 1-,3-and 5-year LC rates were 81. 6％,70. 4％ and 68. 4％, respectively. The 1-, 3-and 5-year OS rates were 72. 3％, 49. 4％ and 45. 2％, respectively. The median survival time was 36 months. Univariate and multivariate analyses showed that clinical staging ( stageⅠ/Ⅱ/Ⅲ) and tumor response ( complete remission/ partial remission/no remission ) were the prognostic factors of OS (P=0. 016,0. 000,0. 005,0. 000).There were no significant differences in the LC and OS between the two groups of 215 cGy and 220 cGy (P=0. 283,0. 951).The incidence rates of grade 1,2,3 acute pneumonitis were 10. 9％(11/101),2. 0％(2/101) and 2. 0％(2/101), respectively. The incidence rates of grade 1, 2, 3 acute esophagitis were 63. 4％( 64/101 ) , 10. 9％( 11/101 ) and 4. 0％( 4/101 ) , respectively. No acute esophageal perforation or hemorrhage occurred. Five patients experienced late pneumonitis ( two died) . One case developed late lemostenosis, two cases developed esophageal perforation and hemorrhage, and two patients experienced esophageal hemorrhage. The patients treated with a fractionated dose of 220 cGy had a higher incidence rate of acute pneumonitis and upper gastrointestinal adverse reactions than those receiving 215 cGy ( P= 0. 062, 0. 024 ) . The local failure and recurrence accounted for 62. 5％ of all treatment-related failures. Conclusions SIB-IMRT yields high long-term clinical efficacy and tolerable adverse events in the treatment of esophageal squamous cell carcinoma. Compared with the dose of 215 cGy, the fractionated dose of 220 cGy fails to improve LC and OS rates, whereas enhances the risk of adverse events. The clinical staging and short-term clinical efficacy are the prognostic factors of survival rate.
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Objective To analyze and compare the outcomes of esophageal carcinoma treated with simultaneous integrated boost intensity-modulated radiation therapy (SIB-IMRT) and late course boost intensity-modulated radiation therapy (LCB-IMRT).Methods We retrospectively analyzed 128 patients with esophageal squamous cell carcinoma who were treated with SIB-IMRT or LCB-IMRT at the fifth department of radiation oncology in our hospital,from January 2009 to August 2015.Propensity score matching analysis was used to balance the variables differences in the two groups.Survival,failure patterns and toxicities were observed and compared between the two groups.Results one hundred and eleven patients were finally included after propensity scores matching.The 1-,3-and 5-year local control rates and survival rates were 83.6％ vs.81.7％,70.8％ vs.46.3％ and 66.0％ vs.38.2％ in the whole group,respectively.The 1-,3-and 5-year local control rates of SIB-IMRT and LCB-IMRT group were 81.6％ vs.88.0％,72.3％ vs.67.6％ and68.5％ vs.60.8％,respectively (P＞0.05).The 1-,3-and 5-year survival rates of SIB-IMRT and LCB-IMRT group were 81.3％ vs.82.4％,51.7％ vs.36.7％ and 45.8％ vs.26.7％,respectively (P ＞ 0.05).There was no statistical difference between the two group in ≥ grade 3 toxicities (P ＞ 0.05).There were 40 (36.0％) patients result in treatment failure in all.The treatment failure rates in SIB-IMRT and LCB-IMRT group were 33.8％ (26/77) vs.41.2％ (14/34),respectively (P ＞ 0.05).The local failure accounted for 65.0％ (26/40) of all treatment-related failures.Conclusions The toxicities of esophageal squamous cell carcinoma treated with SIB-IMRT and LCB-IMRT have no significant differences and were well tolerated.There were no significant differences in local control rates and survival rates between the two groups.However,SIB-IMRT had better trend than LCB-IMRT.Given SIB-IMRT's convenient manipulation,it could be a better choice in the treatment of advanced esophageal carcinoma.
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Objective To investigate the factors influencing the image quality of prostate magnetic resonance spectroscopy (MRS),and to put forward quality control measures to improve MRS in success ratio and image quality.Methods Totally 1 255 patients with prostate diseases confirmed pathologically from October 2009 to December 2015 had their MRS data analyzed retrospectively.MRS was executed with multi-voxel 3D chemical shift imaging technique,and special-purpose software was involved in for post processing.Re-scanning would be performed in case of baseline clutter,low SNR and etc.Results There were 1 218 patients had MRS executed well in preparedness,positioning,parameters setup,post processing,baseline and chemical shift,one patient underwent unsuccessful MRS due to incorrect bed mode,9 ones due to unstable baseline resulting from unsatisfactory preparedness,26 ones due to unstable baseline resulting from bad shimming and 1 case due to non-standard post processing.Conclusion Prostate SRS depends on patient preparedness,positioning,parameters setup,shimming and post processing.
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Objective To evaluate the diagnostic value of the SPM-based interhemispheric asymmetry analysis (SIAA) of 18F-FDG PET brain imaging in localization of temporal lobe epileptic foci.Methods A total of 73 patients (42 males,31 females,average age: (27.10±9.78) years) diagnosed as temporal lobe epilepsy (TLE) and 30 healthy volunteers (17 males,13 females,average age: (33.79±5.46) years) from March 2012 to July 2015 were enrolled in this retrospective study.18F-FDG PET brain imaging was performed on all subjects to localize temporal lobe epileptic foci.The results of 18F-FDG-PET were analyzed by SIAA,visual analysis and asymmetry index (AI) analysis.The accuracy of the three methods was evaluated according to the postoperative pathological results and curative effect.χ2 test and partition of χ2 test were used to analyze the data.Results The accuracies of localization with SIAA,visual analysis and AI analysis were 87.67％(64/73),75.34％(55/73) and 69.86％(51/73),respectively (χ2=6.993,P0.017).Conclusion The SIAA of 18F-FDG PET brain imaging may be a more objective and accurate method in localization of TLE foci.
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Objective To explore early aberrant change of the function and grey matter volume within default-mode network in patients with type 2 diabetes mellitus (T2DM) by Independent component analysis and voxel-based morphometry.Methods Twenty-nine T2DM patients and thirty-three healthy control subjects were recruited in this study between May 2014 and January 2015,and the demographic and clinical data (fasting plasma glucose and HbA1c level) were obtained.General cognition was assessed by MMSE and MoCA in all subjects.Resting-state fMRI and T1-weighted imaging were performed in all subjects.Then the z-maps of default-mode network were obtained from Resting-state fMRI by independent component analysis,and the grey matter volumes were extracted by VBM.Finally,two-sample t-test was performed in the function and grey matter volume of DMN between two groups,and pearson correlation coefficients among zFC values extracted from significantly different brain regions,grey matter volumes and durations of T2DM patients were calculated.Results Patients with T2DM showed decreased Z value around the right anterior cingulated cortex and the right medial pre-frontal cortex(cluster=121,t=-3.81,P＜ 0.05).There was no significant difference in grey matter volume between the two groups,and no correlation between Z value or duration and grey matter volume was found.Conclusions It suggests the abnormality of connectivity of default-mode network may precede the abnormality of grey matter volume in type 2 diabetes mellitus patients.The DMN might be a new potential tool in monitoring the change of cognition in patients with type 2 diabetes mellitus.
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The impact factors were explored to determine the horizontal positional relationship between the umbilicus and the 2nd lumbar spinal process in adults and to verify the accuracy of the localization of Shenshu (BL 23) via the umbilicus. The position of the umbilicus and the 2nd lumbar spinal process was measured in 100 participants and the data were analyzed through SPSS 20.0 software. It was found that the umbilicus and the 2nd lumbar process were not positioned horizontally. The positional relationship of these two sites was not apparently correlated with gender, age, body weight, body height, BMI, waistline and discomfort of lumbar region. The umbilicus was commonly and posteriorly projected on the site between the 4th and 5th lumbar vertebra. It is explained that the localization of Shenshu (BL23) via the umbilicus is not accurate.
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Adolescent , Adulte , Femelle , Humains , Mâle , Adulte d'âge moyen , Jeune adulte , Points d'acupuncture , Région lombosacrale , Méridiens , OmbilicRésumé
Large vascular lesions have become one of the main causes in the death and disability of type 2 diabetes mellitus (T2DM). The article systematically and in-depthly studied the mechanism of large vascular lesions in T2DM, in order to seek effective drug prevention and treatment. It was of vital importance in the improvement of prognosis of T2DM patients. In traditional Chinese medicine (TCM), the basic pathogenesis of T2DM large vascular lesions was deficiency in origin and excess in superficiality, in whichqi-yin deficiency was the origin and the obstruction of collaterals was the superficiality. In western medicine, the body endothelial dysfunction, oxidative stress reaction and abnormal gene expression and so on could cause T2DM large vascular lesions. This article summarized related research literatures on both TCM and western medicine in recent years. It discussed studies on mechanism of T2DM large vascular lesions.
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Objective To investigate the effects ofLiuwei-Dihuang Pills combined with Ginkgo Biloba Leaves Extract Tablets on diabetic complications in patients with type 2 diabetes mellitus (T2DM). Methods Seventy-eight patients with T2DM were randomized into a TCM treatment group and a conventional treatment group by random number table method, 39 in each group. The patients in the conventional treatment group were regularly using antihyperglycemic drugs or insulin. On the basis of conventional treatment group, the patients in the TCM treatment group were additionally treated withLiuwei-Dihuang Pills and Ginkgo Biloba Leaves Extract Tablets. Intima-media thickness (IMT) of internal carotid artery, vibration perception threshold (VPT) and diabetic retinopathy in both groups were detected before the treatment, 12 and 36 months after the treatment.Results The VPT in the left foot 12 months after the treatment in the TCM treatment group were significantly lower than that in the conventional treatment group (13.98 ±4.38 Vvs. 18.70 ±2.43 V;t=2.764, P=0.008). IMT of internal carotid artery (left: 0.81 ± 0.16 mmvs.0.70 ± 0.10 mm,t=3.120,P=0.003; right: 0.81 ± 0.17 mmvs. 0.73 ± 0.12 mm,t=2.286,P=0.026), VPT (left foot: 14.82 ± 6.45 Vvs. 20.63 ± 9.75 V,t=2.714, P=0.009; right foot: 16.73 ± 7.10 Vvs. 20.73 ± 10.35 V,t=2.001,P=0.048) and incidence of diabetic retinopathy (35.9%vs. 53.8%;χ2=5.804,P=0.016) 36 months after the treatment in the TCM treatment group were significantly lower than those in the conventional treatment group.ConclusionsLiuwei-Dihuang Pills combined with Ginkgo Biloba Leaves Extract Tablets can effectively reduce the progression of diabetic complications in patients with T2DM.
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Objective To investigate integrated status of community inpatients with type 2 diabetes mellitus.Methods 240 cases of type 2 diabetic patients in the Zhangjiagang Aoyang Hospital were included in the study from May 1,2007 to Dec 31,2008.A uniform questionnaire was applicated.Gender,disease duration,age,academic qualifications,occupation,education,height,weight,waist circumference,hip,relevant medical history and so on were collected.Results The onset age of inpatients with type 2 diabetes was (48.91 ± 12.38),onset age of male was(46.32 ±12.08),which was significantly lower than female (52.42 ± 11.97) (P ＜ 0.01).The onset age female and male proportion also had significant differences,age onset of male was in advance.The average body mass index was (24 ±3.47)kg/m2,most of the inpatients were workers and farmers,the level of education was primary and secondary.Multiple regression analysis hints,risk factor of onset age is the family history of diabetes,the history of hypertension,male,low academic qualifications.Percentage of newly diagnosed patients was 28.3％,about one-third in patients were with the metabolic syndrome,hyperlipidemia,high blood pressure,fatty liver.Conclusions Education level of the inpatients was lowe in the community,so strengthening diabetes education was required.The persons in the commuities who were male,or with the family history of diabetes,with high blood pressure history were of the communities require for early screening of diabetes mellitus,so the occurrence and development of diabetes woule be controlled.
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Objective To investigate the effects of ribs in high intensity focused ultrasound (HIFU)beam path on formation of coagulative necrosis in cattle liver in vitro in the same acoustic power. Methods The HIFU ablation was carried out in the manner of a single dot in the liver in vitro. The liver was ablated by HIFU in free field,then the ribs were placed between the focal plane and transducer,directing the beam axis through the intercostals space, lied at the rib edge and on the centre of middle rib. For each of these axial arrangements,the plane of the front surface of ribs was placed 3 cm,6 cm or 9 cm in front of the focus. After HIFU exposure,the tissue necrosis rate(TNR),the maximum length,width,depth and position of the coagulated necrosis in the liver were measured. Results ①The TNR was 100% in the free field. When the ribs were placed 3 cm in front of the focal plane,directing the beam axis through the intercostals space, the TNR was 100%. When directing the beam axis lied at the rib edge and on the centre of middle rib,the TNR decreased sharply. When the ribs were placed 6cm and 9cm in front of the focal plane, the TNR was more than 50%. ②When the ribs were placed in HIFU beam path, the volume of necrosis decreased compared with those in free field. The relationship between the ribs and beam axis, the location of ribs placed away from the focal plane different,the volume,length,width and position of the coagulated necrosis different. ③ When the ribs were close to the focal plane,unacceptable damage could been observed on the surface of ribs.When the ribs were far away from the focal plane, the ribs were safe. Conclusions The volume of necrosis decrease when the ribs are placed in HIFU beam path. The relative location of ribs and HIFU beam axis, the location of ribs away from the focal plane are relative with the volume of the coagulated necrosis. When directing the beam axis through the intercostals space, the volume of necrosis is large, and the shape of coagulated necrosis is regulated. When the ribs are closed with the focal plane,ribs are damaged probably.
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Objective To study the metabolic characteristics in type 2 diabetes mellitus with different BMI.Methods 233 patients with type 2 diabetes mellitus were divided into 2 groups. The first group was the BMI ＜25kg/m2 ,the second group with BMI ≥25kg/m2. The blood sugar、 blood-fat 、blood uric acid、type-B ultrasonic of liver were analyzed. Results The waistline、hip circumference、limosis c-peptide 、total cholesterol 、triglyceride and morbidity of fatty liver and hypertension of the second group were higher than the first group. Conclusion Over weigh patients of type 2 diabetes had IR、hyperlipemia、hypertension 、fatty liver. The rate and the severity of the artery diseases in type 2 diabetes mellitus increased wit the increase of the BMI. So weigh reduction could decrease the development of the artery diseases in type 2 diabetes.
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Objective To investigate the enhancing effect of microbubble contrast agent SonoVue of different dosage on high-intensity focused ultrasound (HIFU) ablation in goat livers in vivo. Methods Twenty goats were divided into 4 groups randomly. Animals in group 1,2 and 3 were bolus-injected of 0.01 ml/kg,0. 03 ml/kg and 0.05 ml/kg of SonoVue intravenously before HIFU exposure, respectively,and those in group 4 were not given injections as control. After injection 20s, the livers were ablated using HIFU performed in the manner of a single dot set by a computer system using a clinical device. The frequency of HIFU was 0.8 MHz,the intensity of HIFU was 19 100 W/cm2 ,the distance from skin to the target liver tissue was 30 mm,the exposure time was set at 15 s for all animals in the four groups. All animals were euthanized 7 days after HIFU, volumes of coagulated necrosis were measured. Pathological examinations were performed to analysis the exposure regions. Results Under the same parameters of exposure, coagulated volumes in group 1,2 and 3 were larger than those in group 4, the difference was significant (P < 0.05),and the coagulated volumes increased gradually with the dosage of SonoVue increasing from group 1 to group 3, the difference was significant (P<0.05). Pathological examinations confirmed that there were no residual unaffected tissues within the exposed volume. Two remarkable changes were observed in one goat in group 37 days after HIFU:the surrounding adjacent tissue outside the reactive zone necrotized and the skin were destroyed. Conclusions The enhancing effects of microbubble contrast agent in HIFU ablation is related with the dosage of the microbubble contrast agent SonoVue. The higher the SonoVue dosage,the larger the volume destroy in the target tissue.
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High-intensity focused ultrasound (HIFU) has been used to precisely ablate a targeted area within the body without harming the overlying tissues. In recent years, HIFU, as a noninvasive, effective and feasible modality, has been used for cancer therapy. The development of HIFU transducer is the key technology of HIFU. This paper shows the acoustic lens transducer, spherical auto-focused transducer, pluralistic auto-focused transducer and the electronic phased array transducer in HIFU treatment, and the performance of each of the four HIFU transducers was evaluated.
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Humains , Conception d'appareillage , Tumeurs , Thérapeutique , Transducteurs , Ultrasonothérapie , MéthodesRésumé
Objective To investigate the feasibility of enhancing therapeutic effects on goats' liver in vivo treated by high intensity focused ultrasound(HIFU)combined with microbubble contrast agent SonoVue.Methods Fifteen Nanjiang goats were adopted,own control was adopted in this study.One group received purely HIFU therapy(control group),another one was radiated with HIFU combined with SonoVue contrast agent(SonoVue group).The HIFU irradiating mode was dotted with 30 mm focal length and 150 W,250 W,350 W acoustic power respectively,and the exposure time was 15 s.Animals were sacrificed and dissected 24h later,and the sizes of necrotic region were measured.Specimens were collected for histological inspection.Results Under the same parameter of exposure,the maximum length,width,depth,and the mean volume of the tissue coagulated by HIFU in the SonoVue group were all significantly greater than those in control group(P＜0.05),the change of volume coagulated tissue was much more significant with the increase of the acoustic power.The energy effciency factor (EEF)of SonoVue group was significantly smaller than that of control group(P＜0.05).The demarcation line between the necrosis and normal region was clear and the necrosis was complete,no living cell.The boundary exist amount of bubbles.Conclusions The therapy of HIFU combined with microbubble eontrast agent can substantially enhance the biological effects of the treatment and improve the efficiency of HIFU therapy on goats liver.