Equal Improvement in Men and Women in the Treatment of Urologic Chronic Pelvic Pain Syndrome Using a Multi-modal Protocol with an Internal Myofascial Trigger Point Wand

Both men and women require treatment for urologic chronic pelvic pain syndromes (UCPPS), which includes interstitial cystitis/painful bladder syndrome, pelvic floor dysfunction, and chronic prostatitis/chronic pelvic pain syndrome. However, it is unknown if men and women respond differently to a protocol that includes specific physical therapy self-treatment using an internal trigger point wand and training in paradoxical relaxation. We performed a retrospective analysis by gender in a single arm, open label, single center clinical trial designed to evaluate the safety and effectiveness of a protocol for the treatment of UCPPS from October, 2008 to May, 2011. 314 adult men (79.9 %) and 79 (20.1 %) women met inclusion criteria. The median duration of symptoms was 60 months. The protocol required an initial 6-day clinic for training followed by a 6-month self-treatment period. The treatment included self-administered pelvic floor trigger point release with an internal trigger point device for physical therapy along with paradoxical relaxation training. Notable gender differences in prior treatments were observed. Men had a lower median [Interquartile Range] NIH-CPSI score at baseline than women (27 [21, 31] vs. 29 [22, 33], p = 0.04). Using a 1–10 scale with 10 = Most Severe, the median reduction in trigger point sensitivity was 3 units for both men and women after 6 months therapy (p = 0.74). A modified Intention to Treat analysis and a multivariate regression analysis found similar results. We conclude that men and women have similar, significant reductions in trigger point sensitivity with this protocol.     

Compressive Viscoelasticity of Freshly Excised Mouse Skin Is Dependent on Specimen Thickness,Strain Level and Rate

Although the skin’s mechanical properties are well characterized in tension, little work has been done in compression. Here, the viscoelastic properties of a population of mouse skin specimens (139 samples from 36 mice, aged 5 to 34 weeks) were characterized upon varying specimen thickness, as well as strain level and rate. Over the population, we observed the skin’s viscoelasticity to be quite variable, yet found systematic correlation of residual stress ratio with skin thickness and strain, and of relaxation time constants with strain rates. In particular, as specimen thickness ranged from 211 to 671 μm, we observed significant variation in both quasi-linear viscoelasticity (QLV) parameters, the relaxation time constant (τ₁ = 0.19 ± 0.10 s) and steady-state residual stress ratio (G_∞ = 0.28 ± 0.13). Moreover, when τ₁ was decoupled and fixed, we observed that G_∞ positively correlated with skin thickness. Second, as steady-state stretch was increased (λ_∞ from 0.22 to 0.81), we observed significant variation in both QLV parameters (τ₁ = 0.26 ± 0.14 s, G_∞ = 0.47 ± 0.17), and when τ₁ was fixed, G_∞ positively correlated with stretch level. Third, as strain rate was increased from 0.06 to 22.88 s⁻¹, the median time constant τ₁ varied from 1.90 to 0.31 s, and thereby negatively correlated with strain rate. These findings indicate that the natural range of specimen thickness, as well as experimental controls of compression level and rate, significantly influence measurements of skin viscoelasticity.     

同种异体肌腱不同时段深低温保存对肌腱愈合影响的实验研究

目的:探讨深低温(-80℃)保存异体肌腱的最佳时间段.方法:体重250-300g的雌雄不分的SD大鼠144只,随机分为Ⅰ、Ⅱ两组.每组72只.Ⅰ组为供腱组,提供144条供移植用的肌腱.Ⅱ组又随机分为A、B、C、D四组,每组18只,分别接受由Ⅰ组提供的经深低温保存1天、10天、1个月、3个月的肌腱.术后3天时、10天时分别从A组、B组、C组、D组随机抽取3只,近端自肌肉肌腱移行处,远端自跟腱附着处切断(包括近、远端吻合口),进行大体观察,组织学观察;术后4W、8W时分别从A组、B组、C组、D组随机抽取6只,进行大体观察,组织学观察,最大载荷测定.结果:保存10天以上的三个时间段的肌腱移植后和保存1天的比较,保存10天以上的肌腱术后粘连较轻,肌腱抗拉力强度降低.保存10天以上三个时间段的肌腱移植后大体观察、组织学观察无明显差异;最大载荷测定,结果:分析无统计学意义(P＞0.05).结论:肌腱在深低温(-80℃)环境中长时间保存后,其用于功能修复,愈合情况无明显差别.     

虎纹蛙的含肉率及蛙肉和蛙皮氨基酸组成分析

测定了8只人工养殖虎纹蛙的含肉率及氨基酸组成。结果表明,虎纹蛙的含肉率平均为35．27％;蛙肉和蛙皮干物质中水解氨基酸总量分别为71．740％和79．084％,其中必需氨基酸分别为22．95％和15．88％,分别占氨基酸总量的32．00％和20．08％;游离氨基酸中6种呈味氨基酸含量丰富,分别占游离氨基酸总量的45．50％和60．40％;蛙肉和蛙皮限制氨基酸均为缬氨酸,必需氨基酸指数分别为43.83和27．66。认为虎纹蛙是一种营养价值和养殖价值都较高的品种。     

Induction of Periostin-like Factor and Periostin in Forearm Muscle, Tendon, and Nerve in an Animal Model of Work-related Musculoskeletal Disorder

Work-related musculoskeletal disorders (WMSDs), also known as repetitive strain injuries of the upper extremity, frequently cause disability and impairment of the upper extremities. Histopathological changes including excess collagen deposition around myofibers, cell necrosis, inflammatory cell infiltration, and increased cytokine expression result from eccentric exercise, forced lengthening, exertion-induced injury, and repetitive strain–induced injury of muscles. Repetitive tasks have also been shown to result in tendon and neural injuries, with subsequent chronic inflammatory responses, followed by residual fibrosis. To identify mechanisms that regulate tissue repair in WMSDs, we investigated the induction of periostin-like factor (PLF) and periostin, proteins induced in other pathologies but not expressed in normal adult tissue. In this study, we examined the level of PLF and periostin in muscle, tendon, and nerve using immunohistochemistry and Western blot analysis. PLF increased with continued task performance, whereas periostin was constitutively expressed. PLF was located in satellite cells and/or myoblasts, which increased in number with continued task performance, supporting our hypothesis that PLF plays a role in muscle repair or regeneration. Periostin, on the other hand, was not present in satellite cells and/or myoblasts. (J Histochem Cytochem 57:1061–1073, 2009)     

全膝关节置换术后皮温与血清指标变化的相关性研究

目的:研究膝骨性关节炎(knee osteoarthritis,KOA)患者行单侧全膝关节置换术手术前后膝关节皮温、血清指标的变化规律以及与膝关节功能恢复之间相关性。方法:将2016年9月-2017年3月在我院行单侧全膝关节置换术且术后未发生假体周围感染的患者作为研究对象,测量并记录基本信息、术前及术后膝关节皮温、血清指标及膝关节功能评分,并进行统计学分析。结果:本研究共收集病例65例,随访时间为6个月。双膝皮温、双膝皮温差于术后第5天达到峰值,PCT、CRP、ESR均于术后第3天达到峰值,IL-6、WBC于术后第1天达到峰值,HGB下降至最低水平为术后5-7天。患者非手术侧膝关节皮温于术后30天恢复至术前水平,而手术侧膝关节皮温及双膝皮温差直至术后6个月仍未恢复至术前水平;PCT、IL-6、CRP于术后60天恢复至术前水平,ESR于术后90天恢复至术前水平,WBC于术后15天恢复至术前水平。结论:KOA患者TKA术后双膝皮温差直至术后6月仍高于术前水平,而研究中的各项血清指标均于术后3月内恢复至术前水平。     

Effects of Incubation Temperature on Crocodiles and the Evolution of Reptilian Oviparity

Crocodylus porosus is a mound-nesting crocodilian in which incubationtemperature influences the rate of embryonic development, theprobability that embryos will survive to hatching, post-hatchinggrowth rates and the probability of hatchlings surviving to2 yr of age. Similar responses have been described in Alligatormississippiensis (Joanen et al., 1987) and C. niloticus (Hutton,1987), and they reflect a suite of "non-sexual" effects of incubationtemperature. Temperature-dependent sex determination allocatessex on the basis of these "non-sexual" effects. In C. porosus,it results in maleness being assigned to embryos with high probabilitiesof surviving and good potential for post-hatching growth. Withinthe limits of survival, effects of the moisture environmenton embryological development rate and hatchling fitness seemminor relative to those of the temperature environment. Reptilian orders have either obligate oviparity (chelonians,crocodilians and rhynchocephalians) or facultative oviparity(squamates), depending on the extent of embryonic developmentwithin the oviducts. The distinction is equally one betweenembryos which are buffered from thermal effects within a female'sbody (facultative oviparity) and those that are not (obligateoviparity). Facultative oviparity and internal thermal bufferingmay be the primitive condition within the Class Reptilia, andthe "shell-less" eggs of extant squamates may reflect the originalamniote egg. Obligate oviparity, which also exists in birds,appears to have been a specialized development, and is a blindend in the evolution of viviparity among vertebrates. The significanceof thermal buffering being lost in obligate oviparous reptilesremains unclear.     

A Survey of the FDA's AERS Database Regarding Muscle and Tendon Adverse Events Linked to the Statin Drug Class

Background

Cholesterol management drugs known as statins are widely used and often well tolerated; however, a variety of muscle-related side effects can arise. These adverse events (AEs) can have serious impact, and form a significant barrier to therapy adherence. Surveillance of post-marketing AEs is of vital importance to understand real-world AEs and reporting differences between individual statin drugs. We conducted a review of post-approval muscle and tendon AE reports in association with statin use, to assess differences within the drug class.

Methods

We analyzed all case reports from the FDA AE Reporting System (AERS) database linking muscle-related AEs to statin use (07/01/2005–03/31/2011). Drugs examined were: atorvastatin, simvastatin, lovastatin, pravastatin, rosuvastatin, and fluvastatin.

Results

Relative risk rates for rosuvastatin were consistently higher than other statins. Atorvastatin and simvastatin showed intermediate risks, while pravastatin and lovastatin appeared to have the lowest risk rates. Relative risk of muscle-related AEs, therefore, approximately tracked with per milligram LDL-lowering potency, with fluvastatin an apparent exception. Incorporating all muscle categories, rates for atorvastatin, simvastatin, pravastatin, and lovastatin were, respectively, 55%, 26%, 17%, and 7.5% as high, as rosuvastatin, approximately tracking per milligram potency (Rosuvastatin>Atorvastatin>Simvastatin>Pravastatin≈Lovastatin) and comporting with findings of other studies. Relative potency, therefore, appears to be a fundamental predictor of muscle-related AE risk, with fluvastatin, the least potent statin, an apparent exception (risk 74% vs rosuvastatin).

Interpretation

AE reporting rates differed strikingly for drugs within the statin class, with relative reporting aligning substantially with potency. The data presented in this report offer important reference points for the selection of statins for cholesterol management in general and, especially, for the rechallenge of patients who have experienced muscle-related AEs (for whom agents of lower expected potency should be preferred).     

Wrist Skin Temperature,Motor Activity,and Body Position as Determinants of the Circadian Pattern of Blood Pressure

Although the circadian blood pressure (BP) pattern has been extensively studied, the determinants of this rhythm are not fully understood. Peripheral vasodilatation is a regulatory mechanism for BP maintenance. However, it remains to be established whether the increase of nocturnal distal skin temperature associated with heat loss could also reflect the dipping status. For the first time, this paper investigates the relationship between BP and skin wrist temperature (WT), to evaluate whether the WT circadian rhythm can serve as screening procedure to detect dipping/non-dipping BP patterns. In addition, the authors compare the relationship between WT and other variables previously described as determinants of the BP pattern, such as physical activity and body position. Measurements of WT, motor activity, and body position for 5 d, plus ambulatory BP for 24-h during that span, were obtained from 28 diurnally active normotensive volunteers. WT was negatively correlated, whereas activity and body position were positively correlated, with systolic and diastolic BPs. However, these relationships were stronger during the rest than activity phase. In addition, a 78.6% concordance was detected between the observed dips in BP and the predicted BP pattern calculated based on the WT rhythm. Thus, these results suggest that the increase in WT produced by heat loss during the rest phase through peripheral skin blood vessels is the result of blood vessel vasodilatation reflexes in response to a shift from a standing to a supine position, together with shift in the circadian sympathetic/parasympathetic balance (nocturnal parasympathetic activation). In conclusion, WT could be considered as a potential new screening procedure to implement the diagnosis of non-dipping BP pattern. (Author correspondence: angerol@um.es)     

On the Evolution of Feathers from an Aerodynamic and Constructional View Point

The evolution of birds and feathers are examined in terms ofthe aerodynamic constraints imposed by the arboreal and cursorialmodels of flight evolution. The cursorial origin of flight isassociated with the putative coelurosaurian ancestry of birds.As presently known, coelurosaurs have a center of mass locatedin the pelvic region and an elongated pubis that is ventrallyor anteriorly directed. Both of these characteristics make itdifficult to postulate an origin of flight that would involvea gliding phase because the abdomen cannot be flattened intoan aerodynamic shape. Moreover, the cursorial model must counteractgravity using the hindlimb and, thus, selection for the powerrequirement for lift-off would not focus on the forelimb. Therefore,if the hypothesis proposing a coelurosaurian ancestry of birdsis to remain viable, it must be via an as yet undiscovered taxonthat is compatible with the morphological and aerodynamic constraintsimposed by flight evolution. The arboreal model, currently centers around non-dinosauriantaxa and is more parsimonious in that early archosaurs haveshort pubes that do not preclude an aerodynamic body profile.Moreover, the arboreal proavis uses gravity to create the airflowover the body surfaces and is, thus, energy efficient. Considerationof the initial aerodynamic roles of feathers and feather designare consistent with a precursory gliding phase. Whether avianancestry lies among coelurosaur theropods or earlier archosaurs,we must remain mindful of the complex aerodynamic dictates ofgliding and powered flight and avoid formalistic approachesthat co-opt sister taxa, with their known body form, as functionalancestors.     

Effect of External Calcium and of Temperature on Contraction in Snake Muscle Fibers

The effect of external calcium and of temperature on the contractile responses has been studied in voltage clamped snake twitch muscle fibers. Increasing [Ca⁺⁺]_o from 0.2 to 7.0 mM raised contractile threshold by 15–20 mV, the latter coinciding with the appearance of delayed rectification. The duration of contracture, the rates of rise and decay of tension depended on the level of depolarization and [Ca⁺⁺]_o. The minimum duration of repolarization necessary to restore the contractile response was much shorter in high [Ca⁺⁺]_o. When the bathing solution was cooled to 10 from 20°C the time-course of contracture was markedly prolonged and the outward current was reduced without significant change in maximum tension. The threshold for contraction tended to be somewhat lower at the lower temperature. The contractile repriming was much slower at low temperature. However, reduction in temperature slowed the rate of recovery much less at low [Ca⁺⁺]_o than at normal [Ca⁺⁺]_o.     

温度对花斑副沙鳅仔鱼发育、摄食及不可逆点的影响

2011年4～5月,研究了温度对花斑副沙鳅(Parabotia fasciata)早期仔鱼的发育、初次摄食时间、群体摄食率及不可逆点(PNR)的影响。结果发现,花斑副沙鳅仔鱼出膜后2 d已开始摄食;初次群体摄食率最高值出现在卵黄囊耗尽后的1～2 d,花斑副沙鳅仔鱼的摄食强度随温度升高而增大。仔鱼抵达PNR的时间随温度升高而缩短:22℃时,仔鱼的PNR出现在出膜后的8.0～9.0 d;26℃时,PNR为7.0 d;28℃时,PNR为5.5 d;30℃时,PNR为5.0 d。最大初次摄食率至PNR之间为不可逆饥饿期,22℃时为3.5 d,30℃时仅为1.5 d,说明温度越高,仔鱼耐受饥饿的能力越差,越不利于仔鱼的存活。研究认为,温度对花斑副沙鳅仔鱼发育、摄食及不可逆点的影响较大;在苗种培育过程中,应根据温度确定投饵时间,适时投饵对仔鱼的成活显得尤其重要。     

皮肤类器官的构建、功能及其应用研究进展

皮肤类器官作为一种新型的类器官模型,不仅能高度模拟皮肤组织的生理结构和功能,更好地在不同体外环境下还原较真实的皮肤生态,还可以应用于皮肤发育研究、皮肤疾病病理研究及药物筛选等领域。在干细胞研究中,皮肤类器官模型可以在特殊的生境下对具有特定功能的皮肤细胞及其附属物进行重建和改造,以弥补现有体外皮肤模型在结构、功能等方面的不足。基于此,皮肤类器官将会在皮肤再生、组织修复、药物筛选及医学美容等方面扮演越来越重要的角色。本文详述了皮肤类器官构建中所参与的细胞来源及近年来的应用,并对未来皮肤类器官的发展与优化做出了展望。     

The Influence of the Rate of Stimulus Temperature Rise on Local Skin Thermal Thresholds

The influence of the rate of stimulus temperature rise on the interthreshold interval of the appearance of thermal sensitivity of the skin was studied in 14 male volunteers using the MarStock method. The maximal skin thermal sensitivity was shown to occur at the optimum rate of stimulus increase equal to 0.2°C/s, while an increase in the interthreshold interval at other rates of stimuli predominantly occurs due to the increase in the temperature thresholds of the appearance of warmth sensations. A rapid reaction of the acquisition of a new temperature sensitivity level with a sharp change in the rate of stimulus increase was revealed. A critical view was taken of the increased (up to 1 to 3°C) rate of thermal stimulus presentation used in clinical practice. The physiological mechanisms underlying the regularities obtained are discussed on the basis of known data.     

密点麻蜥几种组织SDH和LDH活性对温度的适应

研究了密点麻蜥肝脏、骨骼肌、大脑组织中琥珀酸脱氢酶(SDH)、乳酸脱氢酶(LDH)活性对温度的依赖关系.结果表明:密点麻蜥3种组织中SDH在5～35℃范围内随温度的升高而升高,在35℃时达到峰值后随着温度的升高而下降,35℃可能为SDH的最适温度;3种组织的LDH活性随温度的升高而升高;大脑中的SDH和LDH活性最高.这表明SDH和LDH的活性与动物组织的能量代谢相适应.     

激光针灸对穴位组织温度和血流灌注率的影响

本文在Pennes方程的基础上研究了激光针灸治疗对穴位组织的温度和血流灌注率的影响。结果显示,连续激光与脉冲激光针灸都能使穴位组织的温度和血流灌注率升高,随着激光的功率密度升高则穴位组织的温度和血流灌注率亦升高。通过这些研究为激光针灸的临床实际应用提供了理论基础。     

辣椒素的皮肤美容作用及其应用的研究

依据辣椒素的药理作用,提出将其应用于皮肤美容的领域.通过理论分析、动物试验以及人体皮肤实验,提出并验证了辣椒素对皮肤的美容效果的产生机理.结果,确定了含辣椒素的乳膏中所添加辣椒素的最佳浓度.给出了应用含辣椒素乳膏时不同使用部位的最佳辣椒素含量的差别.对辣椒素在皮肤美容领域中的应用前景进行了分析.