胚胎移植术前指导患者憋尿对移植结局影响的研究

摘要 目的：探讨胚胎移植术前患者憋尿准备的细化指导方法,并分析其对患者移植结局的影响。方法：选取2019年9月至2020年12月期间我院收治的194例胚胎移植患者（包括新鲜周期胚胎移植和冻融周期胚胎移植）,按随机数字表法分为指导组（101例）和对照组（93例）。对照组患者给予常规指导憋尿,指导组患者在对照组的基础上给予更细化的憋尿指导方法。比较两组总妊娠率、不同年龄段患者的移植妊娠率,分析提前指导憋尿对瘢痕子宫和无子宫手术史患者移植妊娠率的影响。结果：指导组总妊娠率为59.41%,对照组总妊娠率为53.76%,指导组总妊娠率高于对照组,但是未见显著性差异（P>0.05）;在<35岁的患者中,指导组妊娠率（76.47%）高于对照组（58.33%）,差异有统计学意义（P<0.05）;在瘢痕子宫和无子宫手术史的患者中,两组移植妊娠率比较未见显著性差异（P>0.05）。结论：胚胎移植术前给予患者细化的憋尿指导方法能提高<35岁患者的移植妊娠率,对瘢痕子宫和无子宫手术史患者的移植妊娠率无明显影响。     

Dramatic changes in the return date of Guillemots Uria aalge to colonies in Shetland, 1962–2005

Capsule Changes in return date coincided with marked changes in population size that probably resulted in fluctuating competition for nest-sites.

Aims To document the changes in return dates over a 44-year period and to identify the factors associated with these changes.

Methods We compared changes in return date at Shetland colonies with those for the Isle of May, southeast Scotland, and with the available information on population size, the abundance of some fish species eaten by Common Guillemots and large-scale changes in the oceanography and climate of the eastern Atlantic as reflected by the winter index of the North Atlantic Oscillation (NAO).

Results Common Guillemots normally return to colonies in Shetland in late winter. However, during the 1960s return dates became gradually earlier with birds present from early October. Autumn return remained the norm for about ten years after which return dates gradually reverted back to late winter. In contrast, Common Guillemots on the Isle of May, 400 km south of Shetland, showed no marked shift, returning in October each year. There was a strong negative correlation between date of return of Shetland birds and population size, whereas on the Isle of May birds came back earlier when there was a large positive winter NAO index. There was no convincing evidence that changes in wintering areas or fish abundance influenced when birds returned to the colonies, although the fish data may not have been collected on the correct spatial scale.

Conclusion Competition for high quality nest-sites is the most likely reason for Common Guillemots returning to the colonies during the autumn and winter.     

Osteomesopyknosis: A Case Report and Review Of Sclerosing Bone Disorders

ObjectiveWe present a case of osteomesopyknosis, a nonmalignant sclerosing bone dysplasia of the axial skeleton, with unknown etiology and unknown prevalence.MethodsWe studied a 49-year-old female who suffered from back and pelvic pain. Her history was obtained, a physical examination performed, and the laboratory results and imaging diagnostics were studied to describe her disease.ResultsA 49-year-old, perimenopausal female suffered excruciating, intermittent, dull back and pelvic pain for 1.5 years. Nonmalignant blastic bone lesions along her spine and pelvis were discovered on computed tomography (CT) and confirmed by magnetic resonance imaging (MRI) and bone scans. Other metabolic/endocrine conditions were ruled out. Her son also has similar symptoms, and corresponding changes were observed on his vertebrae MRI. Both were diagnosed with osteomesopyknosis.ConclusionOsteomesopyknosis is a rare, autosomal dominant condition characterized by nonmalignant osteosclerosis restricted to the axial skeleton. The disease may produce chronic low-grade back pain in the thoracic and lumbar regions. (Endocr Pract. 2014;20:e106-e111)     

Community survey of factors associated with consultation for low back pain

ObjectiveTo investigate the psychosocial factors associated with consultation for low back pain.DesignTwo phase cross sectional postal survey.SettingBradford Metropolitan Health District.Subjects1813 adults responding to the phase 1 questionnaire. 540 of the 782 with an episode of low back pain in the past 12 months completed the second questionnaire.Results406 (52%) of the respondents reporting back pain in the past 12 months had not consulted a health professional. Logistic regression showed that consultation was associated with externalised beliefs regarding pain management (odds ratio 3.6; 95% confidence interval 2.1 to 6.0). Duration of pain affected the factors associated with consultation. Consultation for episodes lasting less than two weeks (n=290) was associated with greater than median pain (3.0; 1.7 to 5.5), consultation for episodes over two weeks (n=243) was associated with increased disability (3.7; 1.5 to 9.0), and consultation for episodes over three months (n=143) with increased depression (3.9; 1.3 to 11.8).ConclusionsThe results support a role for psychosocial factors in consultation for low back pain and suggest that the reasons for consultation vary with duration of pain. Duration of the episode may be a useful guide to management of non-specific low back pain.

Key messages

• Only half of those who experience low back pain consult a health service professional
• Most of those who consult have had low back pain for more than two weeks
• The severity of pain may influence consulting behaviour at the acute stage, but after the acute period those who consult are more likely to have increased disability, externalised beliefs about pain management, and depressive symptoms.
• Management of low back pain may need to vary according to the duration of pain

     

Increased trunk muscle recruitment during the golf swing is linked to developing lower back pain: A prospective longitudinal cohort study

BackgroundThis is the first study that presents electromyographic measurements prior to the development of lower back pain in young elite golfers.Study designProspective longitudinal cohort study.MethodsThirty-three injury free elite golfers were included. Muscle activity from latissimus dorsi, rectus abdominis, external oblique and erector spinae muscles were recorded during 10 drive golf swings. Lower back pain, training and performance were monitored over a six-month period. Muscle activation comparisons were made between the baseline results of those who went on to develop lower back pain versus those who did not go on to develop lower back pain.ResultsAfter the six-month monitoring period 17 participants developed lower back pain. The group that developed lower back pain had increased dominant rectus abdominis and dominant latissimus dorsi activation at various time points throughout the swing.DiscussionThe increased dominant rectus abdominis and dominant latissimus dorsi during the golf swing is linked with developing lower back pain. Training strategies aimed at reducing these muscles activation during the swing may reduce the incidence of lower back pain in young elite male golfers.     

平行侧入法硬膜外穿刺CSEA对剖宫产术后腰背痛的影响

目的:探讨平行侧入法硬膜外穿刺腰硬联合麻醉对剖宫产术后腰背痛的影响。方法:选择2014年10月至2016年9月在我院行剖宫产的产妇95例,将其随机分为两组。对照组45例,产妇接受平行直入法硬膜外穿刺腰硬联合麻醉,观察组50例产妇接受平行侧入法硬膜外穿刺麻醉。比较两组产妇术后宫缩、伤口、腰背疼痛VAS评分、术中穿刺情况、术后使用镇痛泵的有效按压次数及术后3 d、7 d、14 d和2个月后腰背疼痛的情况。结果:观察组产妇术后宫缩、伤口以及腰背疼痛评分、术后使用镇痛泵的有效按压次数均显著低于对照组(P0.05),且术中一次性穿刺成功率显著高于对照组(P0.05),且术后7 d、14 d以及2个月腰背痛的发生率显著低于对照组(P0.05)。结论:平行侧入穿刺法行腰硬联合麻醉可有效提高剖宫产产妇一次穿刺成功率,显著缓解产妇的术后疼痛,并降低术后腰背疼痛的发生率。     

Which Stage of ADPKD Is More Appropriate for Decortication? A Retrospective Study of 137 Patients from a Single Clinic

ObjectiveTo study retrospectively the efficacy of decortication in patients with different stages of ADPKD and to determine which stage for decortication is more appropriate.ResultsIn 70 patients who underwent decortication, significant differences were observed in operative duration and bleeding volume between patients with stage I and II ADPKD (P<0.05), but no significant differences were observed in intestinal recovery time, pain medication dose, and the days of postoperative hospitalization (P > 0.05). The total complication occurrence rate was significantly different between them (P < 0.05). The serum creatinine (Scr) levels in patients with stage I ADPKD were within normal limits 1 and 3 years postoperatively and did not differ significantly (P > 0.05). Scr levels were significantly decreased in patients with stage II ADPKD in the 1st postoperative year (P < 0.05), but these were not significant differences in the 3rd postoperative year (P > 0.05). In the 1st postoperative year, VAS value, blood pressure and renal volume significantly differed (P < 0.05). However, no significant differences were observed 3 years later (P > 0.05).ConclusionsDecortication in patients with stage I ADPKD can alleviate back pain symptoms and decrease blood pressure within 1 year, but the long-term efficacy is not ideal. Scr levels can be maintained within normal limits, suggesting that decortication does not lead to deterioration of renal function. For patients with stage II ADPKD, decortication can significantly improve renal function over the short term. However, after 3 years, renal function returns to the preoperative level, and surgical difficulties and complications also increase.     

Scottish-breeding Greenshanks Tringa nebularia do not migrate far

ABSTRACT

Capsule: Scottish-breeding Greenshanks Tringa nebularia migrate largely to Ireland.

Aims: To describe the migration timings and determine the non-breeding areas (staging and wintering areas) of Scottish-breeding Greenshanks.

Methods: Breeding adult Greenshanks were marked with geolocators and/or unique permutations of colour-rings in Sutherland, northern Scotland. Sightings of the colour-ringed birds and data from geolocators on recaptured birds provided information on the migrations and locations of the non-breeding areas.

Results: Scottish-breeding Greenshanks spent the winter mainly in Ireland, with the range also including Wales, southern England and western France. Departure from the breeding grounds, as determined by the geolocators, took place in June and July; the median date for the last day in the breeding area was 16 July. Arrival on the breeding grounds took place in March and April; the median date for the first day back in the breeding area was 7 April. Some birds fed at an estuary close to their territories prior to breeding. There was fidelity to wintering areas, both within and between years. Short-term staging took place during both the southward and northward migrations for some birds, and one bird used the same staging area in different autumns. Members of one pair had separate wintering areas.

Conclusions: Scottish-breeding Greenshanks have a short migration, largely to the coasts of Ireland. The migrations involved short-term staging for some birds.     

Immaculate conceptions in sub‐Saharan Africa: Exploratory analysis of inconsistencies in the timing of first sexual intercourse and first birth

Abstract

Survey data from a number of developing countries show that a considerable proportion of parous women report that they had their first birth one or more years before they first had sexual intercourse. In this paper, I use data from eight African Demographic and Health Surveys to explore factors that contribute to cross‐national differentials in the prevalence of these “immaculate conceptions.” The results suggest that this data problem results not only from recall errors, but also from the fact that some respondents misinterpret the question on first sexual intercourse and report their age at the onset of intercourse with either their first or current husband rather than their age at sexual initiation.     

Finding your mate in a seabird colony: contrasting strategies of the Guillemot Uria aalge and King Penguin Aptenodytes patagonicus

Capsule King Penguins recognize their mates by voice, but Guillemots do not need acoustic cues even though their calls show individual variation.

Aims To determine whether the structure of Guillemot calls could allow individual recognition, as with King Penguin, and whether acoustic cues are used to locate mates among a dense mass of conspecifics at a colony.

Methods Observations were made on breeding Guillemots and King Penguins. Calls made by birds returning to their mates were recorded, the signals digitized and the calls analysed. Calls were later played back to the mates of the birds concerned and the effects noted on both them and their neighbours.

Results Both Guillemots and King Penguins emitted calls on return to the breeding site which contained individual signatures and were therefore potentially usable for mate recognition. In King Penguins, auditory recognition was essential for finding a mate, whereas in Guillemots most of the arriving birds located their mate in a dense crowd of conspecifics without the help of acoustic signals. Guillemots could differentiate neighbours from strangers without auditory cues.

Conclusion Calls are essential for the successful identification of mates by King Penguins but not by Guillemots.     

A Retrospective Look at the Cationic Peanut Peroxidase Structure

ABSTRACT:?

The cationic peanut peroxidase has been studied in detail, not only with regard to its peptide structure, but also to the sites and role of the three moieties linked to it. Peanut peroxidase lends itself well to a close examination as a potential example for other plant peroxidase studies. It was the first plant peroxidase for which a 3-D structure was derived from crystals, with the glycans intact. Subsequent analysis of peroxidases structures from other plants have not shown great differences to that of the peanut peroxidase. As the period of proteomics follows on the era of genomics, the study of glycans has been brought back into focus. With the potential use of peroxidase as a polymerization agent for industry, there are some aspects of the overall structure that should be kept in mind for successful use of this enzyme. A variety of techniques are now available to assay for these structures/ moieties and their roles. Peanut peroxidase data are reviewed in that light, as well as defining some true terms for isozymes. Because a high return of the enzyme in a pure form has been obtained from cultured cells in suspension culture, a brief review of this is also offered.     

MicroRNA expression profiling of endocrine sensitive and resistant breast cancer cell lines

BackgroundMicroRNAs (miRs) regulate gene expression through translation inhibition of target mRNAs. One of the most promising approaches for cancer therapy is through mimicking or antagonizing the action of miRs. In this report, we analyzed the miRnome profile of several human breast cancer cell lines to determine the influence of estrogen receptor (ER) silencing previously shown to result in epithelial to mesenchymal transition (EMT) and enhanced tumor invasion.MethodsMicroRNA extracted from MDA-MB-231 (de novo ER-) and ER-silenced (acquired ER-) pII and IM-26 or ER-expressing (YS1.2) siRNA transfected derivatives of MCF7 cells was deep sequenced on Illumina NextSeq500. Respective miRnomes were compared with edgeR package in R and Venny2.1 and target prediction performed with miRTarBase. Mimics and inhibitors of selected differentially expressed miRs associated with EMT mediators (miR-200c-3p targeting ZEB1, miR-449a targeting δ-catenin and miR-29a-3p) were transfected into pII cells and mRNA targets, as well as E-cadherin and keratin 19 (epithelial and mesenchymal markers respectively) were measured using taqman PCR.ResultsEach cell line expressed about 20% of the total known human miRnome; There was a high degree of similarity between the 3 tested ER-lines. Out of these expressed miRs, 50–60% were significantly differentially expressed between ER- and ER + lines. Transfection of miR-200c-3p mimic into pII cells down regulated ZEB1 and vimentin, and increased E-cadherin and keratin 19 with accompanying morphological changes, and reduced cell motility, reflecting a reversal back into an epithelial phenotype. On the other hand, transfecting pII with miR-449a inhibitor reduced cell invasion but did not induce EMT. Transfecting pII cell line with the mimic or inhibitor of miR-29a-3p showed no change in EMT markers or cell invasion suggesting that the EMT induced by loss of ER function can be reversed by blocking some but not just any random EMT-associated genes.ConclusionsThese data suggest that differences in miR expression can be exploited not only as mediators (using mimics) and targets (using miR antagonists) for general cancer therapies aimed at regulating either individual or multiple mRNAs, but also to re-sensitize endocrine resistant breast cancers by turning them back into a type that will be susceptible to endocrine agents.     

Randomised study of long term outcome after epidural versus non-epidural analgesia during labour

ObjectiveTo determine whether epidural analgesia during labour is associated with long term backache.DesignFollow up after randomised controlled trial. Analysis by intention to treat.SettingDepartment of obstetrics and gynaecology at one NHS trust.Participants369 women: 184 randomised to epidural group (treatment as allocated received by 123) and 185 randomised to non-epidural group (treatment as allocated received by 133). In the follow up study 151 women were from the epidural group and 155 from the non-epidural group.ResultsThere were no significant differences between groups in demographic details or other key characteristics. The mean time interval from delivery to interview was 26 months. There were no significant differences in the onset or duration of low back pain, with nearly a third of women in each group reporting pain in the week before interview. There were no differences in self reported measures of disability in activities of daily living and no significant differences in measurements of spinal mobility.ConclusionsAfter childbirth there are no differences in the incidence of long term low back pain, disability, or movement restriction between women who receive epidural pain relief and women who receive other forms of pain relief.

What is already known on this topic

Previous research has suggested an association between epidural analgesia during labour and low back painIt is not known whether this association is causal

What this study adds

This long term follow up study found no evidence of a causal link between epidural analgesia during labour and low back pain     

A comparison of the accuracy and precision of several open-water oxygen productivity techniques

Several methods for the estimation of the reaeration coefficient were compared by determining the ability of the methods to recover the correct K value from a computer-simulated stream oxygen record affected by a variety of non-ideal conditions. Noisy data and long observation intervals were not a serious problem for most methods. Saturating photosynthesis, fluctuating light intensity, afternoon depression and temperature variation caused failures by some methods but were well handled by others. Serious impairment of all methods occurred with low productivity or high K. In general, the best-performing methods were the modified hysteresis, nighttime regression, daytime regression, Odum and Hornberger-Kelly daytime methods.     

So similar and yet so different: taxonomic status of Pallid Swift Apus pallidus and Common Swift Apus apus

Capsule: Common Swift Apus apus and Pallid Swift Apus Pallidus are morphologically very similar but are genetically distinct and diverged 1.9–2.1 million years ago (mya).

Aims: To examine genetic differentiation and to estimate separation time between Common and Pallid Swifts.

Methods: Estimation of differences in three different mitochondrial DNA markers (COI, ND2 and control region), and a fourth marker, the cytb, that did not differ between taxa. Fossils were used to calibrate the estimate of separation date between the two taxa.

Results: The genetic between-species distances were 0.010, 0.006 and 0.033 for the three markers, respectively. These values were from three to ten times higher than within-species distances. Results show that the separation dates back to 1.9–2.1?mya, at the Plio-Pleistocene transition, when global climate underwent a period of significant cooling and Northern latitudes were probably more favourable to the Common than to the Pallid Swift.

Conclusion: Differences in breeding biology, migration, moult and vocalizations between the two species are mirrored by a clear genetic separation.     

Temporal changes in breast cancer incidence in South Asian women

BackgroundBreast cancer in the UK resident population of South Asian ethnicity has been lower than that in indigenous women. Leicester has a large South Asian population and a breast cancer unit with comprehensive data on diagnosed cancers. This study analysed the annual incidence of new breast cancer diagnoses in females from 1998 to 2009 to determine any changes in recent years.MethodsEthnicity was known in over 98% of cases. Population denominators were based on published figures for 2001 and 2011, projected back to 1998. Age-adjusted directly standardised incidence rates were determined by ethnicity and broken down by invasive status and screening classification. Incidence rates were analysed using logistic regression in order to identify statistically significant effects of age, ethnicity, deprivation and year of diagnosis. Interactions with invasive status and screening classification were also investigated.ResultsAt the start of the study period South Asian incidence was estimated to be 45% of that of the white population (p < 0.001); by the end of the period the difference was still significant (p = 0.022) but smaller, at 17%.ConclusionSouth Asians should no longer be considered at low risk of breast cancer.     

Life Course Trajectories of Labour Market Participation among Young Adults Who Experienced Severe Alcohol-Related Health Outcomes: A Retrospective Cohort Study

BackgroundLong-term employment trajectories of young problem drinkers are poorly understood.MethodsWe constructed retrospective labour market participation histories at ages 18–34 of 64 342 persons born in 1969–1982. Beginning from the year of each subject’s 18^th birthday, we extracted information from the records of Statistics Finland on educational attainment, main type of economic activity, months in employment, and months in unemployment for a minimum of seven years (range 7–16 years). We used information on the timing of alcohol-related hospitalizations and deaths in the same period to define problem drinkers with early onset limited course, early onset persistent course, and late onset problem drinking.ResultsEarly onset limited course problem drinkers improved their employment considerably by age, whereas early onset persistent problem drinkers experienced a constant decline in their employment by age. From the age of 18 to 34, early onset persistent problem drinkers were in employment merely 12% of the time, in comparison with 39% among the early onset limited course problem drinkers, and 58% among the general population.ConclusionsThese results indicate that young adults who were retrospectively defined as having early onset persistent course problem drinking were extensively marginalized from the labour market early on during their life course, and that their employment trajectory was significantly worse compared to other problem drinkers.     

Monitoring of spine curvatures and posture during pregnancy using surface topography – case study and suggestion of method

Background

Low back and pelvic pain is one of the most frequently reported disorders in pregnancy, however etiology and pathology of this problem have not been fully determined. The relationship between back pain experienced during pregnancy and posture remains unclear. It is challenging to measure reliably postural and spinal changes at the time of pregnancy, since most imaging studies cannot be used due to the radiation burden. 3D shape measurement, or surface topography (ST), systems designed for posture evaluation could potentially fill this void. A pilot study was conducted to test the potential of monitoring the change of spine curvatures and posture during pregnancy using surface topography. A single case was studied to test the methodology and preliminarily assess the usefulness of the procedure before performing a randomized trial. The apparatus used in this study was metrologically tested and utilized earlier in scoliosis screening.

Case presentation

The subject was measured using a custom-made structured light illumination scanner with accuracy of 0.2 mm. Measurement was taken every 2 weeks, between 17th and 37th week of pregnancy, 11 measurements in total. From the measurement the thoracic kyphosis and lumbar lordosis angles, and vertical balance angle were extracted automatically. Custom-written software was used for analysis. Oswestry Low Back Pain Disability Questionnaire (ODI) was done with every measurement. The values were correctly extracted from the measurement. The results were: 50.9 ± 2.4° for kyphosis angle, 58.1 ± 2.1° for lordosis angle and 4.7 ± 1.7° for vertical balance angle. The registered change was 7.4° in kyphosis angle, 8.4° in lordosis angle and 5.5° in vertical balance angle. The calculated ODI values were between moderate disability and severe disability (22 to 58 %).

Conclusions

This case study presents that surface topography may be suitable for monitoring of spinal curvature and posture change in pregnant women. The ionizing radiation studies are contraindicated during pregnancy. Surface topography data connected with information from pain level questionnaires allows to investigate the connection between changes in posture and back pain.

     

Ergonomics for surgeons – prototype of an external surgeon support system reduces muscular activity and fatigue

BackgroundSince the unergonomic postures cannot be changed during a surgery, it seems reasonable to externally support the surgeon's posture in order to relieve the musculature. To evaluate this matter, we conducted a pilot study to investigate if a prototype of an external surgeon support system (S3) relieves the musculature in an objectively measurable manner.MethodsSimultaneous surface electromyography (EMG) was used alongside a combination of a laser Doppler flowmeter and a tissue spectrometer to record back and leg muscles during a simulated surgical situation.FindingsWith S3, muscle activity was significantly lower (p < 0.05) and also fatigue decreased when compared to without S3. Muscle blood flow and oxygenation were relatively close to baseline with S3, but increased without S3.InterpretationAn ergonomic S3 is a possible approach to reduce muscle activity and fatigue and may therefore prevent chronic back pain amongst surgeons in the long term.     

Estimating the Risk of Chronic Pain: Development and Validation of a Prognostic Model (PICKUP) for Patients with Acute Low Back Pain

BackgroundLow back pain (LBP) is a major health problem. Globally it is responsible for the most years lived with disability. The most problematic type of LBP is chronic LBP (pain lasting longer than 3 mo); it has a poor prognosis and is costly, and interventions are only moderately effective. Targeting interventions according to risk profile is a promising approach to prevent the onset of chronic LBP. Developing accurate prognostic models is the first step. No validated prognostic models are available to accurately predict the onset of chronic LBP. The primary aim of this study was to develop and validate a prognostic model to estimate the risk of chronic LBP.ConclusionsBased on its performance in these cohorts, this five-item prognostic model for patients with acute LBP may be a useful tool for estimating risk of chronic LBP. Further validation is required to determine whether screening with this model leads to a net reduction in unnecessary interventions provided to low-risk patients.