Comparison of Urodynamics and Perineal Ultrasound for Diagnosis of Mixed Urinary Incontinence in Women / 中国康复理论与实践

Objective To compare urodynamic studies (UDS) and perineal sonography for assessing mixed urinary incontinence (MUI) in women. Methods A total of 118 adult females with MUI and 30 controls were enrolled from September, 2010 to December, 2017. Their baseline clinical characteristics were recorded. The MUI patients were divided into stress-predomi-nant (S-MUI, n=51), urge-predominant (U-MUI, n=34) and equal predominance (E-MUI, n=33) according to King's Health Questionnaire. Both UDS and perineal sonography were performed in all the subjects. Tolerability of the two methods was compared. Results For sonography parameters, compared with the controls, S-MUI patients had greater dynamic posterior urethral angle, dynamic angle of urethral inclination, dynamic pubo-urethral distance and descent of bladder neck (P<0.001), U-MUI patients had greater detrusor thickness (P<0.05), and E-MUI patients had greater descent of blad- der neck (P<0.05). For UDS parameters, compared with the controls, S-MUI patients had lower Pure.clos.max and functional urethral length; U-MUI patients had lower Qmax, smaller bladder volume, higher Pdet.open, high-er Pdet.Qmax and higher incidence of detrusor overactivity; and E-MUI patients had higher Pdet.Qmax and low-er Pure.clos.max (P<0.05). All UDS and sonography parameters differed significantly between S-MUI and U-MUI patients. The descent of the bladder neck, dynamic angle of urethral inclination, and dynamic puboure-thral distance were negatively correlated with detrusor pressure at maximal flow and functional urethral length, while detrusor wall thickness was positively correlated with detrusor pressure at maximal flow and functional urethral length. Perineal ultrasound was better tolerated than UDS in 82.3% patients. Conclusion Perineal sonography parameters show good correlation with UDS parameters. Ultrasonography is better tol-erated than UDS and provides additional morphologic data. Perineal sonography could facilitate to diagnose U-MUI.

Effect of surgical scope on postoperative fibrosis of knee joints / 中国骨伤

Knee arthrofibrosis is a common complication after surgery, which is one of the key factors affecting the surgical outcome. It often causes the decrease of joint activity, chronic arthralgia, degeneration of cartilage tissues and joint disuse change, which seriously affects the daily life of the patients. How to reduce the occurrence of knee arthrofibrosis is the key to improve the expected effect of surgery, which is also an important problem to solve in clinical medicine; with our team's previous and recent research, we found that the degree of knee arthrofibrosis is closely related to the rang of the surgical. The use of minimally invasive and arthroscopic treatment can reduce the damage to synovial, cartilage and fat pad tissue, at the same time, combining with early postoperative rehabilitation training is the future effective prevention of postoperative arthrofibrosis of knee.

Progress in the treatment and prevention of knee intra-articular adhesion / 中国组织工程研究

BACKGROUND:Knee intra-articular adhesion has a serious impact on the postoperative patient's daily life,but the efficacy of traditional treatment is limited.To reduce knee intra-articular adhesion is the key to improve the expectations of surgery,which is an urgent problem to be solved.OBJECTIVE:To analyze various articles concerning knee intra-articular adhesion,and summarize the research achievements in the last decade,so as to provide new ideas and methods for the prevention of knee intra-articular adhesion.METHODS:The first author retrieved PubMed database using computer and searched the relevant articles published from 2006 to 2016.The keywords were "tissue adhesions,arthrofibrosis,joint stiffness,prevent,treatment".Totally 1 500 articles were retrieved,and finally 59 eligible articles were included in accordance with the inclusion criteria.RESULTS AND CONCLUSION:In recent years,a large number of scholars have found that trauma or surgery can cause knee joint bleeding and inflammation,which result in the increased expression of vascular endothelial growth factor and interleukin-6,enhance the activity of fibroblasts and secrete a large amount of collagen deposition,thereby causing knee intra-articular adhesion.The modification of traditional methods and application of minimally invasive technology have achieved a certain effect on the knee intra-articular adhesion,but there is still a risk for re-adhesion.A remarkable achievement has been obtained in the basic research of preventing knee adhesion with intra-articular drug that can become an effective method for preventing intra-articular adhesion,but its clinical feasibility is still controversial,and further investigation is needed to find the drug possessing exact effect and less adverse reactions.