Improvement of neurogenic urinary dysfunctions in female rats treated with an injection of botulinum toxin A at the epicenter of the spinal cord injured site.

OBJECTIVE: To assess the effect of an injection of botulinum toxin A (BoNT/A) at the epicenter of the spinal cord injury (SCI) site on the recovery of lower urinary tract function in female rats with thoracic SCI. MATERIALS AND METHODS: Twenty-four female Wistar rats with Sham (laminectomy at T8/T9 level) or SCI (at T8/T9; 30 g compression for 5 s) were assigned into Sham-SS (injected with 5 µL of saline solution), Sham-BoNT/A (injected with 15 pg/rat, equivalent to 7.5 Units/kg of BoNT/A in 5 µL volume), SCI-SS (injured and injected with saline), SCI-BoNT/A (injured and injected with BoNT/A), N = 6 per group. Weekly evaluation of stereotyped micturition behavior, hind-limb nociception, and locomotor activity was performed 1 week before and during 6 weeks after surgery. Subsequently, all groups underwent simultaneous electromyography of the external urethral sphincter (EUS-EMG) and cystometric (CMG) studies. RESULTS: A compression SCI at the T8/T9 thoracic level significantly impairs sensory and locomotive functions, as well as stereotyped micturition behavior. However, these impairments were improved by BoNT/A injection after SCI. Neither injections of saline solution nor BoNT/A had an appreciable effect on the same parameters evaluated in the Sham groups. The combined EUS-EMG and CMG evaluations revealed important improvements of lower urinary tract physiology, particularly a reduction in the frequency of non-voiding contractions and the properties of EUS bursting activity indicated as the amplitude of the EUS-EMG signal and duration of burst electrical activity during effective voiding. CONCLUSION: The severe impairments on sensory and locomotive functions as well stereotyped micturition caused by an SCI could be potentially attenuated by an injection of a small amount of BoNT/A directly into the epicenter of the SCI region. A reduction in the release of neurotoxic neurotransmitters requiring the SNARE complex may be the mechanism triggered by BoNT/A to reduce neurotoxicity and hyperexcitability created in the SCI area to improve the survival of spinal cord cells involved in micturition.

Charge density fluctuation determined the interlayer friction in bilayer MN4 (M = Be, Mg, and Pt).

MN4 (M = Be, Mg, and Pt) represents a new class of van der Waals materials. These materials are characterized by exceptional electrical and thermal conductivities, remarkable intralayer mechanical strength, and weak interlayer interactions, making them prone to shearing and slipping. Therefore, MN4 has significant potential applications as a solid lubricant. However, until now, there have been only limited comprehensive theoretical investigations focusing on the frictional properties of MN4 systems. Here, the frictional performances of MN4 are systematically analyzed by applying first-principles high-throughput calculations. The results reveal that interlayer friction of MN4 decreases from MgN4 to BeN4 and then to PtN4. The friction is directly determined by charge density variations during the sliding processes. The periodic formation and breaking of quasi-σ bonds in bilayer MgN4 leads to substantial variations in charge density and large interlayer friction. In contrast, the weak charge density alternations in PtN4 lead to rather low frictions in PtN4. Moreover, surface functionalization effectively diminishes friction within bilayer MgN4, but amplifies interlayer friction within bilayer PtN4, and under surface functionalization interlayer friction can be efficiently modulated by out-of-plane polarizations. Interestingly, HBr-MgN4 exhibits two orders of magnitude lower COF compared to intrinsic bilayer MgN4, leading to a phenomenon resembling superlubricity. These results significantly contribute to our understanding of the friction properties, offering valuable guidance for the practical implementation of MN4 in solid lubricants.

Global burden and trends in female premenstrual syndrome study during 1990-2019.

PURPOSE: Premenstrual syndrome (PMS) is prevalent worldwide and considered a crucial issue regarding women's health. In the present study, the Global Burden of Disease (GBD) Study 2019 dataset was utilized to assess the distributional trends in PMS burden and prevalence in regional, national, and sociodemographic index (SDI) categories. METHODS: The analytical methods and approaches used in the 2019 GBD study were adopted to investigate the incidence rates and disability-adjusted life years (DALY) related to PMS in 204 countries or regions. Age-standardized incidence rates (ASIR), 95% uncertainty intervals (95% UI), and annual percentage changes (EAPC) were calculated from the data. RESULTS: The global incidence and disability-adjusted life years of PMS exhibited a declining trend in the year 2019. Regions with medium-low SDI had the greatest burden of PMS, with the regions of South Asia (ASR = 7337.9 per 10,000) exhibiting the greatest Age-standardized incidence rates, while the high-income North American states presented the fastest upward trends in Age-standardized disability-adjusted life year rates. At the national level, 107 nations exhibited a decreasing trend in PMS incidence ASR, while 97 nations exhibited an increasing trend, with the United States presenting the greatest increase. CONCLUSIONS: The present study highlighted that even though the global PMS incidence and disability-adjusted life years have decreased from the year 1990 to 2019, PMS remains a prevalent health concern for women worldwide. While addressing preventive measures and treatment, it is also important to consider the regional and national differences in PMS to develop further effective and targeted health policies.

Distributed MIMO Measurements for Integrated Communication and Sensing in an Industrial Environment.

Many concepts for future generations of wireless communication systems use coherent processing of signals from many distributed antennas. The aim is to improve communication reliability, capacity, and energy efficiency and provide possibilities for new applications through integrated communication and sensing. The large bandwidths available in the higher bands have inspired much work regarding sensing in the millimeter-wave (mmWave) and sub-THz bands; however, the sub-6 GHz cellular bands will still be the main provider of wide cellular coverage due to the more favorable propagation conditions. In this paper, we present a measurement system and results of sub-6 GHz distributed multiple-input-multiple-output (MIMO) measurements performed in an industrial environment. From the measurements, we evaluated the diversity for both large-scale and small-scale fading and characterized the link reliability. We also analyzed the possibility of multistatic sensing and positioning of users in the environment, with the initial results showing a mean-square error below 20 cm on the estimated position. Further, the results clearly showed that new channel models are needed that are spatially consistent and deal with the nonstationary channel properties among the antennas.

Research progress in female pelvic floor rehabilitation aids. / å¥³æ€§ç›†åº•åº·å¤è¾ åŠ©å™¨å ·çš„ç ”ç©¶è¿›å±•.

Pelvic floor dysfunction (PFD) is a common clinical problem that can lead to bladder and bowel dysfunction such as urinary incontinence, urinary retention, fecal incontinence, pelvic organ prolapse, and sexual dysfunction. Pelvic floor rehabilitation aids are essential tools in the treatment of PFD. However, there is limited understanding of the efficacy and mechanisms of these aids, and there is a lack of standardized guidelines for selecting appropriate aids for different types of PFD. To assist patients in choosing suitable pelvic floor rehabilitation aids to their needs, it is necessary to summarize the existing types, mechanisms, and applications of these aids. Based on their mechanisms and target functions, pelvic floor rehabilitation aids can be mainly categorized into 3 main types. The first type includes aids that improve pelvic floor function, such as vaginal dumbbells, vaginal tampons, and vaginal dilators, which aim to strengthen pelvic floor muscles and enhance the contractility of the urethral, vaginal, and anal sphincters, thereby improving incontinence symptoms. The second type consists of aids that mechanically block the outlet, such as pessaries, urethral plugs, incontinence pads, incontinence pants, anal plugs, and vaginal bowel control systems, which directly or indirectly prevent incontinence leakage. The third type includes aids that assist in outlet drainage, such as catheters and anal excreta collection devices, which help patients effectively expel urine, feces, and other waste materials, preventing incontinence leakage. By summarizing the existing pelvic floor rehabilitation aids, personalized guidance can be provided to patients with PFD, helping them select the appropriate aids for their rehabilitation needs.

Rare cavitary lymphoepithelioma-like carcinoma of lung: clinical experience and literature review.

BACKGROUND: Lymphoepithelioma-like carcinoma of the lung is a rare primary malignancy of the lung, accounting for only 0.9% of primary malignancies of the lung. Those associated with cavities are even rarer, with fewer than five cases reported in the English literature. Concurrently, the imaging findings of tumors are usually non-specific, resulting in insufficient understanding of the disease by clinicians, thus leading to misdiagnosis and delayed treatment. CASE PRESENTATION: A 42-year-old female presented with a right lower lung mass with cavities. First identified on chest computed tomography (CT) in 2021, the mass persisted for 1 year and subsequently enlarged on chemotherapy and routine follow-up CT. Right lower lobectomy was then performed. Postoperative pathology confirmed primary pulmonary lymphoepithelioma-like carcinoma. After 10 months of follow-up, the patient was still alive and no recurrence was observed. CONCLUSIONS: This article aims to describe a rare case of cavitary lymphoepithelioma-like carcinoma of the lung and review it clinical and imaging characteristics reported in previous cases, which will be helpful for clinicians and imaging physicians in diagnosing this disease.

Platelet-rich Plasma Promotes Restoration of the Anterior Vaginal Wall for the Treatment of Pelvic Floor Dysfunction in Rats.

STUDY OBJECTIVE: To determine the efficacy of using platelet-rich plasma (PRP) for vaginal wall repair in rats with vaginal wall impairment induced by vaginal distension (VD). DESIGN: A single-blind, randomized study. SETTING: A certified animal research facility. ANIMALS: Twenty-four female Sprague Dawley rats. INTERVENTIONS: Female Sprague Dawley rats were divided into sham (n = 8), VD (n = 8), and VD + PRP (n = 8) groups. Vaginal tissues from the VD group were dissected at 28-day post injury. VD + PRP rats received vaginal PRP injections on the 1st, 7th, 14th, and 21st day after VD and sacrificed on the 28th day. MEASUREMENTS AND MAIN RESULTS: Urodynamic tests were performed in all rats. Immunohistochemistry was used to evaluate matrix metalloprotease-2 (MMP-2) and matrix metalloprotease-9 (MMP-9). Masson's staining was used to evaluate collagen fibers and calculate collagen volume fraction. Collagen fiber damage was confirmed in the VD group, evidenced by thinner and sparse distribution of collagen fibers, with significantly higher MMP-2 and MMP-9 expression than the sham group (p <.05). The collagen fiber damage in the vaginal wall likely led to pelvic floor dysfunction (PFD), evidenced by significantly decreased bladder leak-point pressure (p <.01) and abdominal leak-point pressure (p <.01) in the VD group compared with the sham group. After completion of the PRP treatment, a significantly higher collagen volume fraction (p <.01) and significantly increased bladder leak-point pressure (p <.05) and abdominal leak-point pressure (p <.01) were achieved in the VD + PRP compared with the VD group, thus indicating repair of the vaginal wall and improvement of PFD. CONCLUSION: PRP injections facilitate the regeneration of vaginal wall tissue, particularly collagen fiber, after VD, leading to functional improvement of PFD. Findings support the feasibility of using PRP as a novel treatment for PFD.

Social Support and Unmet Needs for Personal Assistance Among Community-Dwelling U.S. Chinese Older Adults: Does the Source of Support Matter?

This study examines the relationship between social support sources and unmet needs among U.S. Chinese older adults. Data were from the Population Study of Chinese Elderly in Chicago. Unmet needs were assessed by indexes of activities of daily living (ADL) and instrumental activities of daily living (IADL). Three specific sources of social support (spouse, family members, and friends) were included. Multivariable logistic regression models were conducted. Approximately 17% of the 3,157 respondents reported having unmet ADL/IADL needs. U.S. Chinese older adults with less overall social support were more likely to have unmet ADL needs (odds ratio [OR]=0.91, 95% CI=0.83-0.99) and IADL needs (OR=0.84, 95% CI=0.81-0.88). Family and friend support were associated with a lower likelihood of having unmet ADL needs. Support from spouse, family, and friends was associated with a lower likelihood of having unmet IADL needs. The findings highlight the importance of informal social support in addressing unmet needs .

Long-term efficacy of the pelvic floor muscle rehabilitation for women with stress urinary incontinence. / 女性压力性尿失禁盆底康复治疗的远期疗效.

OBJECTIVES: Stress urinary incontinence is a common disease with many therapeutic ways, but it lacks long-term follow-up. This study aims to conduct a retrospective study on the long-term efficacy of women with mild and moderate stress urinary incontinence after pelvic floor rehabilitation treatment for 3-years so as to provide a more effective treatment plan for this disease. METHODS: Data were collected from 279 female patients, who were diagnosed with stress urinary incontinence at the Pelvic Floor Rehabilitation Center of the Third Xiangya Hospital of Central South University from January 2017 to January 2019. All patients received health education and were instructed to perform Kegel exercises for 20 min daily at home. According to the treatment pattern, patients were divided into 3 groups as A, B, and C. Group A (n=94) received pelvic floor biofeedback, electrical stimulation and electroacupuncture; Group B (n=99) received pelvic floor biofeedback and electrical stimulation; Group C (n=86) only got pelvic floor function examinations and did not receive any pelvic floor treatment. The pelvic floor functional examinations included a pelvic floor electrophysiological test, pelvic organ prolapse quantitive examination (POP-Q), and stress urinary incontinence severity assessment. All patients were followed up with questionnaire consisting of the International Committee on Urinary Incontinence Questionnaire-Short Form (ICI-Q-SF) and the Quality of Life questionnaire of Urinary Incontinence (I-QOL) before and after the treatment, as well as at 1-, 2-, and 3-years after the treatment (5 times in total). Among the patients who received the treatment, 43 returned to the hospital, including 21 in group A (Group Areturn) and 22 in group B (Group Breturn). Pelvic floor electrophysiological test and POP-Q were performed on the 2 groups. RESULTS: For the leakage rate at the end of the treatment and the following 1-, 2-, and 3-years: Group A0.05), but the I-QOL scores of Group A and Group B were much higher than that in Group C (both P<0.05). On the other hand, the I-QOL scores at 1-, 2-, and 3-years after the treatment were Group A>Group B>Group C (all P<0.05). In addition, the ICI-Q-SF scores at the end of the treatment and 1-, 2-, and 3-years after the treatment were Group A0.05). While the pelvic floor muscle strength in Group Areturn was much higher than that in Group Breturn (P<0.05) after 3 years of the treatment. What's more, the pelvic floor muscle potential in Group Areturn was much higher than that in Group Breturn (both P<0.05) at the end of the treatment and after 3 years of the treatment. CONCLUSIONS: Compared with pelvic floor biofeedback and electrical stimulation for stress urinary incontinence, electroacupuncture combined with pelvic floor electrical stimulation and biofeedback reveal more remarkable short-term efficacy and more stable long-term efficacy, which can significantly improve the quality of life in female patients.

Effect of radiofrequency combined with magnetic stimulation on mild and moderate pelvic organ prolapse. / å°„é¢‘è”åˆç£åˆºæ¿€æ²»ç–—å¯¹è½»ä¸­åº¦ç›†è ”å™¨å®˜è„±åž‚çš„ç–—æ•ˆ.

OBJECTIVES: The efficacy of using a single electrical or magnetic stimulation for treating pelvic floor dysfunction is limited. This study aims to investigate the efficacy of radiofrequency combined with magnetic stimulation treatment for mild to moderate pelvic organ prolapse. METHODS: Patients who completed the treatment in the Third Xiangya Hospital, Central South University were screened, and were divided into 2 groups based on different treatment plans. There were 28 patients who completed magnetic stimulation therapy (the magnetic stimulation therapy group) and 21 patients who completed radiofrequency combined with magnetic stimulation therapy (the combined treatment group). The pelvic organ prolapse quantitation (POP-Q), pelvic floor muscle strength, and pelvic floor ultrasound results were analyzed to assess the efficacy before and after the treatment in both groups, and the POP-Q results of 3 months after the treatment were used to evaluate the maintenance effect of the treatment mode. RESULTS: The POP-Q evaluation results of Aa, Ap, and C points after the treatment in both groups were better than those before the treatment, with statistical significance (all P<0.05). The Aa point POP-Q result of the combined treatment group was better than that of the magnetic stimulation therapy group, with statistical significance (P<0.05). Pelvic floor ultrasound evaluation showed that the bladder neck position during the valsalva maneuver in the combined treatment group was higher than that in the magnetic stimulation treatment group, with statistical significance (P<0.05). The persistence effect of the combined treatment group was long better than that of the magnetic stimulation treatment group, with significant statistical significance (P<0.01). CONCLUSIONS: The combined treatment is more effective and has a longer lasting effect than single magnetic stimulation treatment.

Treatment with platelet-rich plasma attenuates proprioceptor abnormalities in a rat model of postpartum stress urinary incontinence.

INTRODUCTION AND HYPOTHESIS: Stress urinary incontinence (SUI) is the most prevalent form of urinary incontinence, and vaginal delivery is a major risk factor for developing SUI. We evaluated the hypothesis that applying the autologous platelet rich plasma (PRP) to the pelvic floor muscles via injection affects expression of proprioceptors and improves postpartum stress urinary incontinence (PSUI) in rats. METHODS: Virgin female Sprague-Dawley rats were divided into control (n = 10) and experimental group(n = 20). Vaginal dilation was used to establish PSUI, and the rats in the experimental group were further divided into the PSUI group (n = 10) and PSUI+PRP group (n = 10). Pelvic floor muscles from rats in the PSUI+PRP group were positioned under ultrasound guidance for PRP injection. The morphology and number of pelvic floor muscle spindles were assessed using H&E staining, proprioceptors evaluated by gold chloride staining, and changes in the expression of neurotrophin-3 (NT-3) and skeletal myosin MY-32 determined by immunohistochemistry. RESULTS: After 28 days,bladder leak point pressure (BLPP) and abdominal leaking-urine point pressure (ALPP) in rats with PSUI were significantly lower than in control animals (P<0.01). Both BLPP and ALPP increased significantly in the PSUI+PRP group (P<0.01). Compared with the control group, muscle spindle morphology and structure in the PSUI and PSUI+PRP groups had different pathological changes,with higher variations in the PSUI group. The positive signals for NT-3/MY-32 expression in control rats were higher than those from PSUI or PSUI+PRP groups, however, the expression for NT-3/MY-32 in PSUI+PRP animals was higher than that seen in the PSUI group (P < 0.01). CONCLUSIONS: PSUI rats have an abnormal expression of pelvic proprioceptors, which affect proprioceptive function, and further the contractibility of pelvic floor muscles. A PRP injection may restore the sensory function of pelvic proprioceptors, thus improving urine leakage in PSUI rats.

Validation of a Chinese version for the global Pelvic Floor Bother Questionnaire.

PURPOSE: The Pelvic Floor Bother Questionnaire (PFBQ) is a self-administered instrument for determining pelvic floor dysfunction (PFD). The PFBQ was validated in English, but lately in other languages. However, a Chinese version has not been established. Thus, we aimed at validating a Chinese PFBQ version. METHODS: We used a translation-back method to develop a PFBQ Chinese version and validated in 102 women, 51 with at least one PFD symptom participated in the patient group, and 51 without PFD in the control group. Construct validity was assessed by comparing groups and a content validity index (CVI) determined. For test-retest reliability, participants completed the questionnaire twice within 1-week interval and the interclass correlation coefficient (ICC) was determined. Internal consistency was calculated using Cronbach's statistics. RESULTS: Missing information after applying the translated PFBQ did not exceed 4% of any questions. Total scores between control and PFD women were significantly different (2.94 ± 1.84 vs. 10.29 ± 6.64; P < 0.001). The CVI for all items ranged from 0.800 to 1.000, and a good reliability was corroborated (α = 0.677, ICC = 0.938). CONCLUSION: The Chinese PFBQ version is a valid and reliable tool to identify the existence and severity of bothersome symptoms in Chinese women with PFD.

Medication non-adherence and its influencing factors in persons with schizophrenia in rural China.

BACKGROUND: Few studies have been conducted to explore medication non-adherence in persons with schizophrenia (PWS) and its influencing factors in rural China. This study aimed to investigate the medication non-adherence and its influencing factors among PWS in rural China. METHODS: A total of 269 PWS and their family caregivers in Xinjin district, Chengdu, China were investigated on medication adherence and related factors. Logistic regression was employed to identify the influencing factors. RESULTS: The results showed that 37.6% of PWS had medication non-adherence. PWS living with family caregivers had significantly lower rate of medication non-adherence (34.7%) than those not living with family caregivers (60.0%) (p < 0.01). Family caregivers' affiliate stigma of mental illness, knowledge of mental illness and self-esteem were significantly related to patients' medication non-adherence (p < 0.05). PWS' employment status, living with family caregiver, present mental status and social support were significantly related to medication adherence. CONCLUSION: This study shows medication non-adherence is severe among PWS in rural China. Both patient- and family-related factors affect patients' medication adherence seriously. Except improving patients' treatment and mental status, development of family caregiving, social support network and intervention on reducing stigma of mental illness should be crucial for enhancing PWS' medication adherence.

Correlation between postpartum pelvic floor dysfunction and vaginal microecological imbalance in late pregnancy. / äº§åŽç›†åº•åŠŸèƒ½éšœç¢ä¸Žå¦Šå¨ æ™šæœŸé˜´é“å¾®ç”Ÿæ€å¤±è¡¡çš„ç›¸å ³æ€§ï¼ˆè‹±æ–‡ï¼‰.

OBJECTIVES: Pelvic floor dysfunction (PFD) seriously affects women's physical and mental health. Pregnancy and childbirth are recognized as high-risk factors for PFD, and studies have shown that vaginal microenvironmental disorders can promote the development of pelvic organ prolapse. In this study, we intend to investigate whether the changes in vaginal microecology during pregnancy affect the pelvic floor function and participate in the development of postpartum PFD, and provide a basis for the prevention and treatment of PFD. METHODS: A total of 358 full-term mothers who delivered in Third Xiangya Hospital, Central South University from November 2019 to April 2020 were selected and underwent review 6 to 8 weeks after delivery. The pelvic floor structures were examined using pelvic floor ultrasound, and ultrasound values were measured at rest and at maximum Valsalva maneuver. One hundred and seventy women with PFD were assigned in a PFD group, and 188 women without PFD were assigned in a control group. The clinical data of all mothers were collected, and the clinical data and the results of microecological testing for vaginal secretions after 36 weeks of gestation and before delivery were compared between the 2 groups. The correlation of PFD with leucorrhoea cleanliness, lactobacillus level, bacterial vaginosis (BV), and vulvovaginal candidiasis (VVC) was analyzed, and logistic regression analysis was used to screen for independent risk factors for PFD. RESULTS: The incidences of VVC, BV, Lactobacillus vaginalis deficiency, and leucorrhoea cleanliness ≥III° were all higher in the PFD group than those in the control group (P<0.05). Among them, leukocyte cleanliness ≥III°and lack of Lactobacilli in the vagina were independent risk factors for the development of PFD, while VVC and BV were not independent risk factors for the development of PFD. CONCLUSIONS: Postpartum PFD is related to vaginal microecological imbalance in late pregnancy, among which Lactobacillus vaginalis deficiency and leucorrhoea cleanliness ≥III° are independent risk factors for the occurrence of PFD. Therefore, pregnant women with Lactobacillus vaginalis deficiency and leucorrhoea cleanliness ≥III° in late pregnancy should pay attention to the occurrence of postpartum PFD, and early diagnosis and effective intervention of postpartum PFD should be enhanced.

Therapeutic effect of proprioception training combined with pelvic floor electrical stimulation biofeedback on postpartum pelvic floor dysfunction. / æœ¬ä½“æ„Ÿè§‰è®­ç»ƒè”åˆç›†åº•ç”µåˆºæ¿€ç”Ÿç‰©åé¦ˆå¯¹äº§åŽç›†åº•åŠŸèƒ½éšœç¢æ€§ç–¾ç— çš„æ²»ç–—æ•ˆæžœ.

OBJECTIVES: Pelvic floor tendons, fascia, and ligaments are rich in proprioceptors. Proprioceptive training can stimulate local proprioceptors to increase neuromuscular responses and promote the recovery of muscle and fascial ligament functions. This study aims to observe the therapeutic effect of proprioception training combined with pelvic floor electrical stimulation biofeedback on postpartum pelvic floor dysfunction (PFD), and to provide evidence for the treatment of postpartum PFD. METHODS: A total of 108 puerpera with postpartum PFD were selected and divided into a control group ( n =50) and an experimental group ( n =58). Puerpera in the control group received pelvic floor electrical stimulation biofeedback treatment. Puerpera in the experimental group received proprioception training combined with pelvic floor electrical stimulation biofeedback treatment. After one course of treatment, the pelvic floor muscle strength, muscle endurance, repetitive contraction ability, rapid contraction ability, percentage of normal vaginal posterior wall elevation, percentage of normal lower abdominal muscle synergistic contraction, percentage of normal reflex contraction during coughing, incidence of stress urinary incontinence (SUI), and staging of pelvic organ prolapse (POP) were compared before and after treatment between the 2 groups. RESULTS: After treatment, all indexes of the 2 groups were better than those before treatment; the pelvic floor muscle strength, muscular endurance, repetitive contraction ability, and rapid contraction ability of the experimental group were better than those of the control group (all P <0.05); the percentage of normal lower abdominal muscle synergistic contraction and percentage of normal reflex contraction during coughing of the experimental group were higher than those of the control group (both P <0.05); the incidence of SUI in the experimental group was lower than that in the control group ( P <0.05); the percentage of POP staging II in the experimental group was significantly lower than that in the control group ( P <0.05). There was no significant difference in the percentage of normal posterior vaginal wall elevation after treatment between the 2 groups ( P >0.05). CONCLUSIONS: Proprioception training combined with pelvic floor electrical stimulation biofeedback could improve the rehabilitation effect of postpartum pelvic floor dysfunction and promote the recovery of pelvic floor function, which possesses important clinical application value.

Stigma of mental illness and cultural factors in Pacific Rim region: a systematic review.

BACKGROUND: Although cultural factors play a crucial role in experience of stigma, there is scant review on the impact and importance of culture on stigma of mental illness across Pacific Rim Region. This study aims to investigate: 1) the cultural factors related to stigmatizing beliefs about mental illness in Pacific Rim region, and 2) culture-specific measures and interventions on stigma of mental illness. METHODS: A systematic search of papers was conducted in the MEDLINE, Embase, CINAHL, Web of Science, PsycINFO, Scopus, Cochrane Library and Google scholar through January 2003 to April 2019. RESULTS: Forty-one studies in Pacific Rim region which met the inclusion criteria were included in the study. The rate of stigma of mental illness (e.g., public stigma: from 25.4 to 85.2%) was relatively high in Pacific Rim region. Culture factors (e.g., Collectivism, Confucianism, face concern and familism, religion and supernatural beliefs) contributed to people's stigmatizing behaviors and attitudes toward persons with mental illness, their relatives and mental health professionals. Certain measurements were developed and employed to assess different type of cultural factors related to stigma of mental illness. CONCLUSIONS: Cultural factors play an important role in influencing the rate and performance of stigma of mental illness. Further research on stigma of mental illness and culture-specific interventions to reduce the stigma should be conducted in the Pacific Rim region.

Therapeutic effect of myofascial trigger point electroacupuncture technology on the treatment of overactive bladder syndrome in female. / 电针刺激肌筋膜触发点治疗女性膀胱过度活动症的临床疗效.

OBJECTIVES: To explore the therapeutic effect of myofascial trigger point electroacupuncture technology on treating female overactive bladder syndrome. METHODS: Forty female patients with overactive bladder were randomly divided into 2 groups: an experimental group and a control group. The experimental group was treated with myofascial trigger point electroacupuncture therapy combined with solifenacin succinate while the control group was only treated with solifenacin succinate. Patients in both groups were treated for 12 weeks. The overactive bladder symptom score (OABSS), urinary urgency score and urination frequency of 24 h in the 2 groups were compared to analyze the therapeutic effect. RESULTS: Before the comprehensive treatment, there was no significant difference between the experimental group and the control group (P>0.05). After 2 and 12 weeks of continuous treatment, the OABSS, urinary urgency symptoms score and 24 h urination frequency in the experimental group and the control group were lower than those before the treatment, and the degree of decline in the experimental group was more obvious, with significant difference (P<0.05). CONCLUSIONS: Treating overactive bladder syndrome in women with myofascial trigger point electroacupuncture combined with solifenacin succinate can significantly improve the OABSS and improve the life quality of the patients.

Neural control properties of the external anal sphincter in young and elderly women.

AIMS: The prevalence of fecal incontinence (FI) increases with age and affects more than 15% of the elderly population. Sarcopenia, skeletal muscle structural, and functional decline with aging, is known to be caused by neuromuscular dysfunction. However, age-related alterations of the neuromuscular function of the external anal sphincter (EAS) have not been studied. This study aims to quantitatively characterize the effect of aging on the EAS by assessing the firing patterns and size of motor unit action potential (MUAP) using high-density surface electromyography (HD-sEMG) recording and analysis techniques. METHODS: Thirteen young (31.0 ± 3.6 years) and 14 elderly (64.3 ± 6.2 years) healthy women were recruited for this study. EMG activity of the EAS during maximal voluntary contraction was recorded by a 64-Channel, HD-sEMG intra-rectal probe. HD-sEMG signals were decomposed into MUAP spike trains to extract the firing rate and amplitudes thereof. RESULTS: HD-sEMG decomposition was successfully performed. For the young and elderly groups, mean motor unit (MU) firing rates of 11.4 ± 2.1 pulses per second (PPS) and 9.6 ± 2.3 PPS, and mean MUAP amplitudes of 45.2 ± 14.3 µV and 61.9 ± 21.2 µV were respectively obtained. Both the MU firing rate and MUAP amplitude were significantly different between two groups (P < .05). Moreover, the MUAP firing rate and amplitude correlated with age with a linear regression model (P < .05). CONCLUSIONS: This study represents the first effort to examine the effect of aging on the neuromuscular function of EAS. Results suggest an age-related impairment of lower motor neuron descending excitation to the EAS with a compensatory increase in mean MU size.

Effects of delivery mode and age on motor unit properties of the external anal sphincter in women.

INTRODUCTION AND HYPOTHESIS: This study aimed to assess the individual and interactive effects of delivery mode and age on the function of the external anal sphincter (EAS) by analyzing the motor unit properties with intramuscular electromyography (EMG). Results are expected to improve the understanding of delivery-related occult obstetric EAS injuries and its development over the aging process and further support early clinical detection and intervention. METHODS: A total of 49 postpartum women were recruited into four test groups according to their age and delivery mode: young vaginal delivery (Y-VD), elderly vaginal delivery (E-VD), young cesarean section (Y-CS), and elderly cesarean section (E-CS) groups. Anorectal ultrasonography, manometry, and intramuscular EMG were employed for comprehensive evaluation of EAS function. RESULTS: No significant difference in anorectal ultrasonography and most manometry measurements was associated with delivery age or mode. Intramuscular EMG, however, revealed a statistically significant difference in the characteristics of motor unit potentials (MUPs), including duration, turns, phases, and multiphase wave ratio between four subject groups. No significant interaction effect between age and delivery mode was found. CONCLUSIONS: Delivery mode and age have a significant effect on the neuromuscular function of the EAS, suggesting a potential protectiveness of cesarean section against impairment to the EAS. Our results do not provide significant evidence regarding the interaction effect of delivery mode and age; further investigations are needed to confirm this conclusion.

Innervation asymmetry of the external anal sphincter in aging characterized from high-density intra-rectal surface EMG recordings.

AIMS: The innervation zone asymmetry of the external anal sphincter (EAS) has been investigated as a risk factor for the development of fecal incontinence (FI). This study aims to utilize an intra-rectal high-density surface electromyogram (HD-sEMG) recording and advanced HD-sEMG decomposition technique to characterize the effects of aging on the asymmetry of EAS functional innervation. METHODS: HD-sEMG signals were recorded intra-rectally from six healthy young and seven healthy elderly women during voluntary contractions of the EAS. EMG signals were decomposed into constituent motor unit action potentials (MUAPs) and the innervation zone of each decomposed motor unit was identified. Asymmetry index (AI) was defined and calculated for all subjects. The maximum squeezing pressures of the EAS were also measured for all subjects as a comparison. RESULTS: The HD-sEMG decomposition and AI calculation were successfully performed from EMG data acquired from all the subjects. The AI values were 28.7 ± 17.0% for the young group and 55.6 ± 18.8% for the elderly group. The AI and EAS contraction strength were found to be negatively correlated (P < 0.05). A two-tailed student's t-test demonstrated a significant increase in AI with age by comparison between two groups (P < 0.05). CONCLUSIONS: Our work demonstrates, for the first time, that EAS functional innervation tends to become increasingly asymmetrical with advancing age, and this increase is associated with a compromised anorectal function. Results suggest that the intra-rectal HD-sEMG will serve as an advanced tool for assessing and monitoring the anorectal neuromuscular function minimally invasively under different pathophysiological conditions.