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Copyright of Journal of China Medical University is the property of Journal of China Medical University Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

ObjectiveTo explore the effects of four extralevator abdominoperineal excision (ELAPE) procedures on the biomechanics of female pelvic floor through finite element analysis. MethodsSix finite element models of the female pelvic floor were established, including a normal model, an ELAPE model, and four individual models. The maximum stress in each model was measured under the same pressure, and the stress distribution was observed. ResultsThe maximum stress of non-levator ani muscle tissues on the partially reserved side and totally removed side of the levator ani muscle were 3.101±0.133 and 4.868±0.123 MPa in individual model 1, respectively, which were lower than the maximum stress in the ELAPE model (5.111±0.081 MPa; both P0.05). The maximum stress of non-levator ani muscle tissues were 4.700±0.105 and 3.653±0.156 MPa in individual models 3 and 4, respectively, which were lower than the maximum stress in the ELAPE model (both P

Objective To explore the effects of four extralevator abdominoperineal excision (ELAPE) procedures on the biomechanics of female pelvic floor through finite element analysis. Methods Six finite element models of the female pelvic floor were established, including a normal model, an ELAPE model, and four individual models. The maximum stress in each model was measured under the same pressure, and the stress distribution was observed. Results The maximum stress of non-levator ani muscle tissues on the partially reserved side and totally removed side of the levator ani muscle were 3.101±0.133 and 4.868±0.123 MPa in individual model 1, respectively, which were lower than the maximum stress in the ELAPE model (5.111±0.081 MPa; both P<0.01). The maximum stress in the non-levator ani muscle tissue were 5.138±0.091 MPa on both sides in individual model 2, which were not significantly different from that in the ELAPE model (P>0.05). The maximum stress of non-levator ani muscle tissues were 4.700±0.105 and 3.653±0.156 MPa in individual models 3 and 4, respectively, which were lower than the maximum stress in the ELAPE model (both P<0.01). Conclusion Three ELAPE procedures, including ELAPE with unilateral levator ani muscle resection plane close to the rectum, and the bilateral pubococcygeal muscle lateral resection of levator ani muscle and levator ani muscle in front of the rectum preserved could decrease stress in the non-levator ani muscle tissue on both sides. The effect is evident on the levator ani muscle partially reserved side of ELAPE with unilateral levator ani muscle resection plane close to the rectum. ELAPE with unilateral levator ani muscle resection plane close to the pelvic wall has no significant reduction effect on the non-levator ani muscle tissue on either side. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Sichuan University (Medical Science Edition) is the property of Editorial Board of Journal of Sichuan University (Medical Sciences) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To investigate the morphological changes of pelvic diaphragm hiatus after vaginal delivery in primipara by perineal 3D ultrasound and its value in predicting pelvic organ prolapse. Methods A total of 112 primipara who were admitted to our hospital and had vaginal delivery from October 2016 to February 2020 were enrolled as study group, and 84 healthy women without pregnancy and history of childbirth who underwent physical examination in our hospital during the same period of time were enrolled as control group. The two groups were compared in terms of the proportion of patients with pelvic organ prolapse, parameters of pelvic diaphragm hiatus (anteroposterior diameter, left-right diameter, and area of pelvic diaphragm hiatus), thickness of levator ani muscle, and Young’s modulus after one year follow-up. The receiver operating characteristic (ROC) curve was plotted to analyze the efficacy of various parameters in predicting pelvic organ prolapse. Results There were significant differences in each parameter of pelvic diaphragm hiatus, the thickness of levator ani muscle, and Young’s modulus of the left and right sides under the resting state, the anal contraction state, and the Valsalva state between the study group and the control group and between the prolapse subgroup and the non-prolapse subgroup (t=4.645-37.691,P

Objective To evaluate the pelvic floor functional status of primiparous women undergoing different delivery modes within 2 years postpartum. Methods Primiparous women admitted to the Pelvic Floor Center of Department of Gynecology were enrolled in this study. All participants were divided into the vaginal delivery and cesarean section groups according to the delivery mode. General clinical data were collected. Pelvic Organ Prolapse Quantification (POP-Q), pelvic floor muscle strength and electromyographic analysis were performed. Chronic pelvic pain, urinary and bowel function were evaluated. The Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire -12 (PISQ-12), Incontinence Quality of Life Questionnaire (I-QOL), Pelvic Floor Distress Inventory-20 (PFDI-20), and Self-Rating Depression Scale (SDS) were performed. The differences in pelvic floor anatomy and clinical symptoms in primiparous women were assessed between the vaginal delivery and cesarean section groups. Results A total of 521 primiparous women completed the survey, including 402 cases undergoing vaginal delivery and 119 receiving cesarean section. Primiparous women who underwent vaginal delivery had lower levels of anterior vaginal wall POP-Q, uterine/cervix POP-Q, Class Ⅰ muscle strength, Class Ⅱ muscle strength, pre-rest, Class Ⅰ electromyography, Class Ⅱ electromyography, and post-rest compared with those who underwent cesarean section (all P < 0.05). Moreover, primiparous women who had vaginal delivery were more prone to experiencing stress urinary incontinence (SUI) and lower I-QOL score compared with those receiving cesarean section (both P < 0.05). In terms of clinical manifestations such as chronic pelvic pain, bowel disorders, sexual dysfunction, and depressive status, there were no significant differences observed between two groups (all P > 0.05). Conclusions Vaginal delivery may be a risk factor for the increased incidence of postpartum pelvic organ prolapse (POP) and SUI in primiparous women. In clinical practice, early postpartum pelvic floor rehabilitation exercises or interventions should be emphasized for primiparous women, especially for the changes in urinary function. [ABSTRACT FROM AUTHOR]

BACKGROUND: Postpartum diastasis rectus abdominis have a high incidence, which has a certain adverse effect on the physical and mental health of parturients. Exercise therapy is one of the main treatment methods, but there is still a lack of consensus on which exercise can promote its repair more effectively. OBJECTIVE: To observe the immediate effects of curl-up movement, abdominal breathing, pelvic floor muscle contraction and combined exercise on interrectus distance using high-frequency ultrasound. METHODS: Thirty-nine eligible subjects with postpartum diastasis rectus abdominis were recruited 2-6 months after delivery. Inter-rectus distance was measured using high-frequency ultrasound at 4.5 cm above the umbilicus, at the level of the umbilicus and at 4.5 cm below the umbilicus in five movement patterns: resting state, curl-up movement, abdominal breathing, pelvic floor contraction and combined movement. RESULTS AND CONCLUSION: There was no significant difference in the inter-rectus distance between the resting state and the other four movement patterns at 4.5 cm above the umbilicus (P > 0.05). At the level of the umbilicus, the inter-rectus distance was significantly decreased in the curl-up movement compared with the resting state (P < 0.01), while the inter-rectus distance significantly increased in the combined exercise compared with the resting state (P < 0.05). At the 4.5 cm below the umbilicus, the inter-rectus distance decreased in the curl-up movement compared with the resting state (P < 0.05), while the inter-rectus distance tended to increase in the other three movements compared with the resting state, but there was no statistical difference (P > 0.05). There was no significant difference in the inter-rectus distance between spontaneous delivery group and cesarean section group at the resting state (all P > 0.05). However, at the umbilical level, the inter-rectus distance in the multiparity group was significantly wider than that in the primiparity group (P < 0.05). At 4.5 cm below the umbilicus, the body mass index was positively correlated with the inter-rectus distance (r=0.359, P=0.025). In terms of immediate effects, curl-up movement can reduce the inter-rectus distance, while abdominal breathing, pelvic floor contraction and combined exercise have the opposite effects. Parturients with multiple births and a high body mass index may be more likely to develop postpartum diastasis rectus abdominis. Results from this study will provide a theoretical basis for the rehabilitation treatment of postpartum diastasis rectus abdominis. [ABSTRACT FROM AUTHOR]

Objective To explore the clinical efficacy of oral low-dose tadalafil combined with pelvic floor muscle rehabilitation training in the patients with erectile dysfunction caused by pelvic fracture and urethral injury after bone repositioning and fixation. Methods From September 2018 to September 2022, 110 male patients with erectile dysfunction caused by pelvic fracture and urethral injury admitted to our hospital were selected as the research subjects. All patients received bone repositioning and fixation surgery, and were divided into an observation group and a control group of 55 patients according to the intervention measures they received after surgery. The control group received oral low-dose tadalafil treatment after surgery. On the basis of the control group, the observation group received pelvic floor muscle group rehabilitation training treatment. After continuous intervention for 1 month, the curative effects of the two groups were evaluated, and the IIEF-5 score and NPT were comparatively analyzed between the two groups. Results No significant differences were found in the scores of IIEF-5 between the two groups before intervention (P > 0. 05), whereas IIEF-5 scores of the two groups of patients were all significantly improved after intervention, moreover IIEF-5 scores in the observation group increased more significantly (P <0.05). After intervention, the intensity, duration and frequency of erection in NPT indicators in the two groups were obviously improved, moreover the observation group showed better improvement (P < 0. 05 ). No serious adverse reactions in two groups during the treatment were observed ( P > 0. 05 ). Conclusion For the patients with organic erectile dysfunction caused by pelvic fractures and urethral injury after low-dose tadalafil combined with pelvic floor muscle rehabilitation training can effectively improve the erectile function of patients. The side effects are controllable, and the long-term efficacy needs further observation. [ABSTRACT FROM AUTHOR]

Objective: To explore the effect of real-time three-dimensional pelvic floor ultrasound on the evaluation of the efficacy of postpartum stress urinary incontinence (SUI) patients and its correlation with urodynamics. Methods: 139 postpartum SUI patients who were admitted to Shijiazhuang People’s Hospital from April 2020 to December 2022 were selected, and all patients received pelvic floor biofeedback electrical stimulation combined with pelvic floor muscle exercise. Real-time three-dimensional pelvic floor ultrasound and urodynamic examination were performed before and after treatment. The differences in real-time three-dimensional pelvic floor ultrasound parameters and urodynamic indicators before and after treatment were compared. The correlation between real-time three-dimensional pelvic floor ultrasound parameters and urodynamic indicators were analyzed by Pearson method. Results: Real-time three-dimensional pelvic floor ultrasound image feature showed that the structure inside the pelvic hiatus became loose, the echo became weak, the connective tissue of pelvic organs became loose, the gap widened, pelvic diaphragm hiatus area, urethral rotation angle, bladder urethra posterior angle, and bladder neck mobility was relatively large before treatment. After treatment, the puborectal muscles on both sides of the pelvic diaphragm hiatus were symmetrical, and the pubic visceral muscles showed banded hyperechogenicity, pelvic diaphragm hiatus area, urethral rotation angle, bladder urethra posterior angle, and bladder neck mobility decreased compared with before treatment. After treatment, the pelvic diaphragm hiatus area, urethral rotation angle, bladder urethra posterior angle, and bladder neck mobility decreased in postpartum SUI patients in resting state and Valsalva state compared with before treatment (P＜0.05), the abdominal pressure leakage point pressure and maximum detrusor muscle pressure increased compared with before treatment (P＜0.05) . The pelvic diaphragm hiatus area, urethral rotation angle, bladder urethra posterior angle, and bladder neck mobility in postpartum SUI patients in resting state and Valsalva state were negatively correlated with maximum detrusor muscle pressure, abdominal pressure leakage point pressure (P＜0.05),and it was not related to maximum bladder capacity and residual urine volume (P＞0.05) . Conclusion: The real-time three-dimensional pelvic floor ultrasound parameters in postpartum SUI patients after the treatment of pelvic floor biofeedback electrical stimulation combine with pelvic floor muscle exercise are lower than those before treatment, which is related to improvement in urodynamics. Real-time three-dimensional pelvic floor ultrasound examination can be used in clinical practice, evaluate the clinical efficacy in postpartum SUI patients, and to guide clinical treatment. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To investigate the acceptance, participation rate, and awareness rate of real-time three-dimensional pelvic floor ultrasonography among the female population, and to analyze the influence factors. Methods A total of 855 women were face-to-face surveyed by using the general data questionnaire. The acceptance, participation rate, and awareness rate of realtime three-dimensional pelvic floor ultrasonography were analyzed. According to the survey results, all participants were divided into those who accepted pelvic floor ultrasonography group cacceptance group) and those who rejected pelvic floor ultrasonography group (rejection group) . The differences in education level, type of medical insurance, annual household income per capita, clinical symptoms, history of disease and awareness of pelvic floor ultrasonography were compared between two groups. The influencing factors of low acceptance of pelvic floor ultrasonography in female population were analyzed. Results A total of 808 valid questionnaires were returned. Among all valid respondents (n=808), 86.6% (n=700) were willing to receive real-time three-dimensional pelvic floor ultrasonography. 95 participants (11.8%) had received pelvic floor ultrasonography before. The majority of respondents (92.6%) had little or no knowledge of pelvic floor ultrasonography.“ Paying attention to their health and finding problems as early as possible” was the main reason for being willing to accept pelvic floor ultrasound examination, while the main reason for rejection was“do not understand the work of the project”. Significant differences were observed in the educational level, type of medical insurance, annual household income per capita, clinical symptoms, and awareness rate between two groups (all P < 0.05) . Multivariate Logistic analysis showed that the population without urinary leakage symptoms (OR=0.162, 95%CI: 0.064-0.408, P < 0.001) and the population with low annual household income per capita (OR=0.495, 95%CI: 0.319-0.766, P = 0.002) were less willing to receive pelvic floor ultrasonography. Conclusions Real-time three-dimensional pelvic floor ultrasonography has high acceptance, low participation rate, and low awareness rate in the female population. Clinical symptoms and annual household income per capita are important factors associated with the acceptance of pelvic floor ultrasonography. [ABSTRACT FROM AUTHOR]

Objective: To investigate the pelvic ultrasound parameters and the vaginal delivery mothers postpartum pelvic floor functional relations and value for early prediction of pelvic organ prolapse. Methods: 80 vaginal parturients who came to our hospital from September 2021 to September 2022 for regular birth examination were selected as subjects. In this study, 80 parturient women underwent pelvic floor ultrasound examination at 6-8 weeks postpartum, and recorded the information of Valsalva, hiatus area of levator ANI muscle under anal contraction, anteroposterior diameter and posterior Angle of bladder and urethra during the examination.The hiatus area of levator anal muscle, anterior-posterior diameter and posterior Angle of bladder and urethra of the two groups were compared under resting and anal contraction and Valsalva movements, and the pelvic floor muscle function indexes of the two groups were analyzed, and the correlation between the pelvic floor muscle function indexes and ultrasonic parameters of the pelvic floor under resting, anal contraction and Valsalva movements in the case group was analyzed. ROC curve analysis of pelvic floor ultrasonic parameters predicting early pelvic organ prolapse. Results: The levels of hiatus area, anterior-posterior diameter and posterior Angle of vesicurethra of levator anal muscle at rest, anal retraction and Valsalva movement in case group were higher than those in control group (P<0.05). The class Ⅰ muscle strength, class Ⅱ muscle strength and vaginal finger diagnosis pelvic floor strength of case group were lower than those of control group (P<0.05). Pelvic floor class I muscle strength, pelvic floor class II muscle strength, and vaginal finger pelvic floor muscle strength were negatively correlated with the area of anal fissure, anterior-posterior diameter, and level of posterior vesicourethral angle during resting, retraction, and Valsalva maneuvers (all P<0.05). The AUC of pelvic floor ultrasound parameters indexed during resting, retraction, and Valsalva maneuvers for pelvic organ prolapse exceeded 0.5 (all P<0.05). Conclusion: Pelvic floor ultrasound parameters are negatively correlated with the puerperal pelvic floor function of primipara during vaginal delivery, which can be used to predict the early occurrence of pelvic organ prolapse and is worthy of clinical application. [ABSTRACT FROM AUTHOR]

Objective: To explore the effect of hip muscle exercise combined with pelvic floor electrical stimulation biofeedback on pelvic floor function and stress response in patients with pelvic floor dysfunction disease (PFD). Methods: 120 patients with PFD who were treated in our hospital from January 2021 to December 2022 were selected as the study subjects. They were divided into control group and observation group according to random number table method, with 60 patients in each group. The patients in the control group received hip muscle exercise, and the patients in the observation group received pelvic floor electrical stimulation biofeedback therapy on the basis of the control group. The changes of pelvic floor function and stress response in the two groups were observed and analyzed. Results: The total clinical effective rates of the observation group after treatment were significantly higher than those in the control group (P＜0. 05), the PFDI-20, PISQ-12 and PFIQ-7 scores in the two groups were significantly better than those before treatment, and the above indexes in the observation group were significantly better than those in the control group (P＜0. 05), and the anterior pelvic floor muscle potential, dynamic muscle tone, static muscle tone and contractility of the two groups after treatment were significantly improved compared with those before treatment. Compared with the control group, the above indexes in the observation group were significantly improved (P＜0. 05), and the levels of norepinephrine (NE), prostaglandins (PGE2) and cortisol (COR) in the two groups were significantly increased after treatment, and the observation group was significantly better than that in the control group (P＜0. 05). Conclusion: Hip muscle exercise combined with pelvic floor electrical stimulation biofeedback can exercise muscle function, improve the level of pelvic floor muscle tension, promote the recovery of pelvic floor function and improve stress response, and significantly improve the quality of life of patients. [ABSTRACT FROM AUTHOR]

Objective: To study the diagnostic value of transperineal pelvic floor ultrasound combined with serum estradiol in female stress urinary incontinence (SUI). Methods: 81 female SUI patients who were admitted to Affiliated Hospital of North Sichuan Medical University from January 2018 to December 2022 were selected as the observation group. Another 80 normal women in the same period of physical examination were selected as the control group. The ultrasonic parameters of pelvic floor and the levels of serum estradiol were compared between the two groups. The diagnostic efficacy of individual and joint tests of the above indicators was analyzed using the receiver operating characteristic(ROC) curve. Results: The Angle between the proximal urethra and the longitudinal axis of human body (UIA), the Angle between the proximal urethra and the posterior wall of bladder (PUVA) and the urethra rotation Angle (URA) under maximum Valsalva movement in the observation group were higher than those in the control group (all P<0.05). The serum estradiol level in the observation group was significantly lower than that in the control group(P<0.05). ROC curve analysis showed that the efficacy of pelvic floor ultrasound parameters combined with serum estradiol in the diagnosis of female SUI was better than that of each indicator alone. Conclusion: Transperineal pelvic floor ultrasound can diagnose female SUI, and when combined with serum estradiol, it has a higher value in diagnosing female SUI. [ABSTRACT FROM AUTHOR]

Objective·To explore the changes of pelvic floor structure in the early and middle pregnant women with the history of cervical incompetence (CIC) by ultrasound.Methods·The pregnant women during early and middle trimesters were collected from Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine from August 2022 to January 2023. All the pregnant women had only one history of premature delivery, abortion or induced labor in the middle trimester, and were divided into CIC group and control group according to whether having the history of CIC in the previous pregnancy. Age, body mass index (BMI), gestational age, the prevalence of funneling of internal urethral orifice and the prevalence of urinary incontinence were compared between the two groups. Two-dimensional, three-dimensional, and four-dimensional pelvic floor ultrasound was used to measure the pelvic floor structures of the women in the states of resting, pelvic floor muscle contraction (PFMC) and Valsalva maneuver (VM). The parameters of pelvic floor structure included bladder neck position, urethral inclination angle, urethral rotation angle, posterior angle of bladder, bladder neck mobility, cervix position, position of ampulla of rectum, area of urogenital hiatus (HA), hiatal transverse diameter, and hiatal anteroposterior diameter. General linear regression model was used to correct the influence of confounders and to analyze the association between the history of CIC and the different indexes of pelvic floor structure.Results·A total of 76 pregnant women in early and middle trimesters were collected, including 39 women in the CIC group and 37 women in the control group. There was no significant difference in the age between the two groups, while BMI and gestational age in the CIC group were significantly greater than those of the control group, and the differences were significant (both P 0.05); at the state of VM, HA (P=0.016) and hiatal anteroposterior diameter (P=0.014) increased in the CIC group, while other parameters did not change significantly. It was found that the CIC history was associated with HA (P=0.038) and hiatal anteroposterior diameter (P=0.049) at VM after adjusting gestational age and BMI by the general linear regression model. The incidence rates of funneling of internal urethral orific in the CIC group and the control group were 10.25% and 0, respectively; the incidence rates of stress incontinence were 23.07% and 13.51%, respectively. Neither of the differences were significant (both P>0.05).Conclusion·In the pregnant women with the history of CIC, HA and hiatal anteroposterior diameter at VM increase, and the morphological change of the levator ani hiatus is more obvious with the increase of the vertical axis.

BACKGROUND: Menstrual blood-derived stem cells are derived from female menstrual blood. Mesenchymal stem cells with multidirectional differentiation potential are easily accessible, weakly immunogenic, highly proliferative, stable passage, and free from ethical controversy. Exosomes derived from menstrual blood-derived stem cells have the same efficacy as menstrual blood-derived stem cells in tissue regeneration and injury recovery. Menstrual blood-derived stem cells and their exosomes have yielded exciting results in preclinical and clinical studies for the treatment of various diseases. OBJECTIVE: To review the progress of basic research and clinical applications related to menstrual blood-derived stem cells and their exosomes, as well as the potential future applications and issues to be considered. METHODS: A computerized search of PubMed and the CNKI database from 2000 to 2022 for literature related to menstrual blood-derived stem cells and menstrual blood-derived stem cell exosomes was conducted. Finally, 75 articles were selected for review analysis. RESULTS AND CONCLUSION: (1) Menstrual blood-derived stem cells are mesenchymal stem cells with multidirectional differentiation function, characterized by abundant source, weak immunogenicity and high proliferative capacity. (2) The exosomes are the main mediators of the paracrine function of menstrual blood-derived stem cells and have the same efficacy as the source cells in promoting tissue regeneration and injury repair. Both have the ability to be antiinflammatory, anti-apoptotic and promote tissue and organ function recovery, and have demonstrated more excellent therapeutic levels in animal test models of various systemic diseases, where menstrual blood-derived stem cells have been used in clinical patients in diseases such as uterine adhesions, congestive heart failure, multiple sclerosis and viral pneumonia, and have greatly delayed the disease progression without producing side effects such as tumor or allergic reactions. (3) However, only 15 years have passed since the discovery of menstrual blood-derived stem cells in 2007. Therefore, menstrual blood-derived stem cells and their exosomes have the shortcomings of insufficient samples and short years of application. Long-term preclinical trials are still needed to verify their safety and efficacy. In addition, to be truly applied in clinical practice, it is also necessary to find a more standardized way of administration, so it is necessary to issue relevant application guidelines in the future. (4) The combination of menstrual blood-derived stem cells and their exosomes with 3D scaffold technology has been used in animal trials for pelvic organ prolapse, skin damage due to diabetes, osteochondral defects, and bladder wall reconstruction. More clinical applications can be developed in the future by combining various advantages of menstrual blood-derived stem cells and their exosomes with tissue engineering and material science to gradually carry out clinical research. [ABSTRACT FROM AUTHOR]

Objective：To discuss the effect of Cav 3. 2 gene in the treatment of stress urinary incontinence (SUI) of the mice by pelvic floor electrical stimulation (PES), and to clarify its related mechanism. Methods：Thirty C57BL/6 mice were randomly divided into control group [without vaginal dilation (VD) modeling], VD group (VD modeling), and VD+PES group (VD modeling combined with PES) according to the intervention measures, and there were 10 mice in each group. The mice were divided into WT-VD group (wild-type VD modeling), WT-VD+PES group (wild-type VD modeling combined with PES), KO-VD group (Cav 3. 2 knockout type VD modeling), and KO-VD+PES group (Cav 3. 2 knockout type VD modeling combined with PES) according to the genotype and intervention mesures. Masson staining was used to observe the deposition and expression levels of collagen type Ⅰ (Col Ⅰ) and collagen type Ⅲ (Col Ⅲ) collagen fibers in urethral and anterior vaginal wall tissue of the mice in various groups. The maximum bladder capacity (MBC) and leakage point pressure (LPP) of the mice in various groups were detected, and the expression levels of integrins β1, calpain 2, Col Ⅰ, and Col Ⅲ proteins in urethral and anterior vaginal wall tissue of the mice in various groups were detected by Western blotting method. Results：Compared with VD group, the expression levels of Col Ⅰ and Col Ⅲ collagen fibers in urethral and anterior vaginal wall tissue of the mice in VD+PES group mice were significantly increased (P<0. 01)； compared with WT-VD group, the expression levels of Col Ⅰ and Col Ⅲ collagen fibers in urethral and anterior vaginal wall tissue of the mice in WT-VD+PES group were significantly increased (P<0. 01)； compared with WT-VD+PES group, the expression levels of Col I and Col Ⅲ collagen fibers in urethral and anterior vaginal wall tissue of the mice in KO-VD and KO-VD+PES groups were significantly decreased (P<0. 01). Compared with control group, the MBC and LPP of the mice in VD group were decreased (P<0. 05)； compared with VD group, the MBC and LPP of the mice in VD+ PES group were increased (P<0. 05). The Western blotting results showed that compared with VD group, the expression levels of Col Ⅰ and Col Ⅲ proteins in urethral and anterior vaginal wall tissue of the mice in VD+PES group were significantly increased (P<0. 01)； compared with WT-VD group, the expression levels of Col Ⅰ and Col Ⅲ proteins in urethral and anterior vaginal wall tissue of the mice in WT-VD+PES group were increased (P<0. 01)； compared with WT-VD+PES group, the expression levels of Col Ⅰ and Col Ⅲ proteins in urethral and anterior vaginal wall tissues of the mice in KO-VD and KO-VD+PES groups were significantly decreased (P<0. 01). Compared with WT-VD group, the expression levels of integrin β1 and calpain 2 proteins in urethral and anterior vaginal wall tissue of the mice in WT-VD+PES group were increased significantly (P<0. 01). Conclusion：PES can improve the urodynamic function of the mice and promote the generation of pelvic floor collagen and promote the repairment of pelvic floor through the Cav 3. 2 gene and its downstream integrin β 1 and calpain 2. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of SLK triple therapy combined with epidural labor analgesia on pelvic floor function and perinatal outcome of primipara. Methods: 200 pregnant women who delivered singleton in Jiangyin People’s Hospital and its group hospitals from January 2022 to December 2022 were selected and randomly divided into control group, SLK triple therapy group,epidural delivery analgesia group and combined group according to random number table, with 50 cases in each group. The control group received routine training, the SLK triple therapy group received Sopfrology delivery training, Lamaze breath training and Kegel training,the epidural delivery analgesia group received patient controlled epidural analgesia, and the combined group received epidural delivery analgesia on the basis of SLK triple therapy. The pelvic floor function indexes were detected by ultrasonic diagnostic instrument(2) The pelvic floor electrophysiological indexes were detected by neuromuscular stimulation biofeedback therapeutic instrument, and the prenatal fever rate, midwifery rate, postpartum hemorrhage rate, cesarean section rate, labor process and Apgar score were recorded and compared in each group. Results: Compared with the control group, the pelvic floor ultrasonic examination △ y α, β, γ There was no significant difference among the parameters(P＞0.05); Pelvic floor ultrasonic examination △ y α, β, γ All the parameters were significantly lower than those in the control group(P＜0.05); However, there was no significant difference between SLK group and combination group in the above indicators(P＞0.05). The muscle strength of class Ⅰand class Ⅱ muscle fibers and fatigue of class Ⅰ and class Ⅱ muscle fibers in SLK group and combination group were significantly better than those in the control group(P＜0.05); However, there was no significant difference between SLK group and combination group in the above indicators(P＞0.05). The postpartum hemorrhage rate and cesarean section rate in SLK group, epidural analgesia group and combination group were significantly lower than those in the control group(P＜0.05), the first and second stages of labor in epidural analgesia group were significantly higher than those in the control group(P＜0.05), the first and second stages of labor in SLK group were significantly lower than those in the control group, and the first and second stages of labor in combination group were significantly lower than those in epidural analgesia group, Apgar score of SLK group and combined group was significantly higher than that of control group. Conclusion: SLK triple therapy combined with epidural labor analgesia can effectively improve the pelvic floor function and perinatal outcome of primipara, and make up for the shortage of epidural labor analgesia alone, which is worthy of clinical promotion. [ABSTRACT FROM AUTHOR]

Pelvic floor dysfunction (PFD) is a group of diseases involving pelvic organ dysfunction caused by multiple factors, including vaginal laxity, vaginal atrophy, sexual dysfunction, stress urinary incontinence, etc. At present, PFD is most common in middle-aged and elderly women with increasing incidence year by year. The onset of PFD is insidious and easy to be prolonged and not recovered, which persist seriously affects the quality of life of patients. In recent years, compared with traditional surgical treatment, the temperature controlled radiofrequency technology has greatly promoted the treatment to a minimally invasive, accurate and safe direction, which has met the needs of female patients for the treatment of PFD, and has gradually been recognized by physicians and patients. And with the gradual increase of clinical application of temperature controlled radiofrequency technology, its treatment of the applicable population, advantages and safety have been widely emphasized and considered. This paper reviews the principles, effects and safety of temperature controlled radiofrequency technology applied in PFD, in order to provide some reference for clinical application. [ABSTRACT FROM AUTHOR]

Objective·To explore the changes of pelvic floor structure in the early and middle pregnant women with the history of cervical incompetence (CIC) by ultrasound. Methods·The pregnant women during early and middle trimesters were collected from Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine from August 2022 to January 2023. All the pregnant women had only one history of premature delivery, abortion or induced labor in the middle trimester, and were divided into CIC group and control group according to whether having the history of CIC in the previous pregnancy. Age, body mass index (BMI), gestational age, the prevalence of funneling of internal urethral orifice and the prevalence of urinary incontinence were compared between the two groups. Two-dimensional, three-dimensional, and four-dimensional pelvic floor ultrasound was used to measure the pelvic floor structures of the women in the states of resting, pelvic floor muscle contraction (PFMC) and Valsalva maneuver (VM). The parameters of pelvic floor structure included bladder neck position, urethral inclination angle, urethral rotation angle, posterior angle of bladder, bladder neck mobility, cervix position, position of ampulla of rectum, area of urogenital hiatus (HA), hiatal transverse diameter, and hiatal anteroposterior diameter. General linear regression model was used to correct the influence of confounders and to analyze the association between the history of CIC and the different indexes of pelvic floor structure. Results·A total of 76 pregnant women in early and middle trimesters were collected, including 39 women in the CIC group and 37 women in the control group. There was no significant difference in the age between the two groups, while BMI and gestational age in the CIC group were significantly greater than those of the control group, and the differences were significant (both P<0.05). At the states of resting and PFMC, there were no significant differences in structural parameters (all P> 0.05); at the state of VM, HA (P=0.016) and hiatal anteroposterior diameter (P=0.014) increased in the CIC group, while other parameters did not change significantly. It was found that the CIC history was associated with HA (P=0.038) and hiatal anteroposterior diameter (P= 0.049) at VM after adjusting gestational age and BMI by the general linear regression model. The incidence rates of funneling of internal urethral orific in the CIC group and the control group were 10.25% and 0, respectively; the incidence rates of stress incontinence were 23.07% and 13.51%, respectively. Neither of the differences were significant (both P>0.05). Conclusion·In the pregnant women with the history of CIC, HA and hiatal anteroposterior diameter at VM increase, and the morphological change of the levator ani hiatus is more obvious with the increase of the vertical axis. [ABSTRACT FROM AUTHOR]

Objective: To observe the effects of Crede technique combined with Kegel exercise on bladder function, pelvic floor muscle strength and quality of life of postpartum women with urinary retention. Methods: 92 cases of postpartum women with urinary retention who were admitted to our hospital from March 2021 to March 2022 were selected, and they were divided into control group（Kegel exercise, n=46) and study group（Crede technique combined with Kegel exercise, n=46) according to random number table method. The clinical efficacy, bladder function, pelvic floor muscle strength, clinical indicators and quality of life were compared between the two groups. Results: Compared with the control group（73.91%), the total effective rate of the study group（93.48%) was higher（P＜0.05). 4 weeks after intervention, the initial bladder volume, maximum bladder volume and maximum urine flow rate of the study group were higher than those of the control group（P＜0.05). 4 weeks after intervention, the number of grade 0 ～ 2 cases of the study group was lower than that of the control group, and the number of grade 3 and above was higher than that of the control group（P＜0.05).4 weeks after intervention, the scores of all dimensions of short-form 36 health survey scale（SF-36) of the study group were higher than those of the control group（P＜0.05). The residual urine volume of the study group was less than that of the control group, and the first urination time was shorter than that of the control group（P＜0.05). Conclusion: Crede technique combined with Kegel exercise is applied to postpartum women with urinary retention can promote the recovery of bladder function and pelvic floor muscle strength, improve the quality of life of women, and have good clinical application value. [ABSTRACT FROM AUTHOR]

BACKGROUND: Previous studies have shown that the expression of long non-coding RNA plasmacytoma variant translocation 1 (LncRNA PVT1) was significantly reduced in the uterine cardinal ligament of patients with pelvic organ prolapse through high-throughput sequencing. Transforming growth factor β1 signaling pathway is also one of the related pathways. OBJECTIVE: To investigate the effect of LncRNA PVT1 on pelvic floor ligament fibroblasts and its possible role in the pathogenesis of pelvic organ prolapse. METHODS: Tissue samples of the pelvic floor ligament were extracted from rats and fibroblasts were isolated for primary culture. LncRNA PVT1 interference and overexpression vectors were constructed by lentivirus and added into fibroblasts. Morphology, proliferation, migration and apoptosis of fibroblasts were detected by immunofluorescence, MTT, cell scratch assay and flow cytometry test respectively. The mRNA and protein expressions of transforming growth factor-β1, Smad2/3 and c-Myc were detected by RT-PCR and western blot respectively. RESULTS AND CONCLUSION: Overexpression of LncRNA PVT1 could significantly promote the proliferation of fibroblasts, improve the migration ability of cells, and inhibit the apoptosis of fibroblasts. The results of LncRNA PVT1 interference were opposite. In addition, the mRNA and protein relative expressions of c-Myc, transforming growth factor-β1 and Smad2/3 were significantly increased when LncRNA PVT1 gene was overexpressed, while the expressions of c-Myc and transforming growth factor-β1 were significantly inhibited when LncRNA PVT1 gene was interfered. To conclude, LncRNA PVT1 can affect the morphology and biological function of fibroblasts, which may be related to the transforming growth factor-β1/Smad2/3/c-Myc pathway. This study provides new ideas for the clinical diagnosis and treatment of pelvic organ prolapse. [ABSTRACT FROM AUTHOR]

Safe, effective and controllable labor analgesia has been the goal pursued by anesthesiologists and obstetricians. Intraspinal labor analgesia is the first choice for labor analgesia, which improves the quality of labor by reducing labor pain while ensuring the safety of mother and infants. Pelvic floor dysfunction (PFD) associated with labor dysfunction is one of the common postpartum diseases, mainly including stress urinary incontinence, obstetrical anal sphincter injuries, female sexual dysfunction, etc. The effect of intraspinal labor analgesia on the pelvic floor function of primipara has always been the focus of attention and research by many clinical and scientific researchers. Intraspinal labor analgesia has a protective effect on the pelvic floor muscle and anal sphincter, does not affect the electrophysiological function of pelvic floor muscle, can reduce the incidence of postpartum stress urinary incontinence, and has no adverse effect on the sexual function of parturient. To summarize the effects of intraspinal labor analgesia on the pelvic floor function of primipara, so as to provide more clinical basis for the further popularization of intraspinal labor analgesia and the prevention and treatment of PFD in primipara [ABSTRACT FROM AUTHOR]

Studies on the occurrence and development of pelvic organ prolapse (POP) was mostly based on gross anatomy and physical examination, but studies on patients are not thorough enough. In the process of disease diagnosis and treatment, surgeons' experience and subjective judgment results played an important role on the development and implementation of surgical program, which lacked objective data as support. Magnetic resonance imaging (MRI) has the unique advantage of highresolution pelvic floor structure, which can distinguish various support structures of pelvic floor organs and quantitatively analyze. Different levels of vaginal support structures of POP patients are studied according to the results. The weak parts of pelvic floor are judged. And then, an individualized surgical plan for the weak parts is made. It is of great significance to improve the orientation of pelvic floor reconstruction surgery and reduce the recurrence rate. We can realize the desire of minimally invasive surgery, anatomical reduction and functional recovery and minimize the occurrence of surgical complications. In addition, MRI can evaluate the quality of surgery and predict the recurrence of surgery. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To probe into the improvement of Wenyang Tongluo method combined with biofeedback on functional anorectal pain and its effects on pain mediators, stress response and serum endothelin(ET)expression. METHODS: A total of 86 patients with functional anorectal pain admitted into the department of proctology of the hospital from Aug. 2019 to Jan. 2021 were extracted to be divided into the control group and the treatment group by random number table method, with 43 cases in each group. The control group received biofeedback therapy, while the treatment group was given Wenyang Tongluo method based on biofeedback therapy. And 10 d was a course of treatment, patients in both groups were treated for 3 courses in a row. The efficacy was calculated after the course of treatment. The visual analogue scale (VAS) score, pelvic floor electromyography parameters serum substance P (SP), prostaglandin E2 (PGE2), bradykinin (BK), ET-1 before and after treatment were compared between two groups. RESULTS: The total effective rate of the treatment group was 95. 35% (41/43), significantly higher than 81. 40% (35/43) of the control group, the difference was statistically significant (P<0. 05). After treatment, the VAS scores of two groups were significantly lower than those before treatment, and the treatment group was significantly lower than the control group, with statistically significant differences (P < 0. 05). After treatment, there was no significant difference in pelvic floor electromyography signal between two groups before and after treatment (P>0. 05). After treatment, the pelvic floor electromyography signal in the rapid contraction stage, post-rest stage in two groups were significantly lower than those before treatment, endurance contraction stage and the pelvic floor electromyography signal in the continuous contraction stage was significantly higher than that before treatment, the differences were statistically significant (P<0. 05). After treatment, the pelvic floor electromyography signal of the treatment group was significantly lower than that of the control group in the rapid contraction stage, post-rest stage, and endurance contraction stage, the pelvic floor electromyography signal of the treatment group was significantly higher than that of the control group in the continuous contraction stage, the differences were statistically significant (P<0. 05). After treatment, the serum SP, PGE2, BK, ET-1 of two groups were significantly lower than those before treatment, and the serum SP, PGE2, BK, ET-1 of the treatment group were significantly lower than those of the control group, the differences were statistically significant (P < 0. 05). CONCLUSIONS: The efficacy of Wenyang Tongluo method combined with biofeedback on functional anorectal pain is significant, which can effectively reduce the pain level, the secretion of pain mediators, the stress response of the body, and the serum ET content. [ABSTRACT FROM AUTHOR]

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BACKGROUND: Rod Tuina is an effective treatment for stress urinary incontinence. However, the combination of Rod Tuina and electrical stimulation biofeedback therapy has not been reported. OBJECTIVE: To evaluate the clinical efficacy of Rod Tuina combined with electrical stimulation biofeedback therapy in the treatment of stress urinary incontinence in adult women. METHODS: A total of 72 female patients with urinary incontinence diagnosed in the Female Rehabilitation Outpatient Clinic of Daqing Hospital of Traditional Chinese Medicine from January 2021 to September 2021 were enrolled. These patients were randomly divided into treatment group (n=36) and control group (n=36). Patients in the treatment group received the combined therapy of Rod Tuina and electrical stimulation biofeedback, while those in the control group received electrical stimulation biofeedback only. Treatment in each group lasted for 20 days. Surface electromyography of pelvic floor muscles, 1-hour pad test, International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF), and modified Oxford muscle strength test were conducted before and after treatment. The changes of above observation indexes before and 20 days after treatment were compared between groups to evaluate the condition and efficacy of the patients. Follow-ups were conducted at 6 and 12 weeks after the course of treatment. RESULTS AND CONCLUSION: After 20 days of treatment, surface electromyography, 1-hour pad test, ICIQ-UI SF score and Oxford muscle strength classification were improved in both groups, and the improvement was more significant in the treatment group than the control group (P < 0.05). After the treatment course, the total effective rate in the treatment group (92%) was significantly higher than that in the control group (67%; P < 0.05). Follow-up results indicated that the ICIQ-UI SF score was significantly better in the treatment group than the control group (P < 0.05). To conclude, Rod Tuina combined with electrical stimulation biofeedback therapy can effectively reduce the frequency and severity of urinary incontinence, promote the strength of pelvic floor muscles, and improve the pelvic floor function. Moreover, Rod Tuina combined with electrical stimulation biofeedback therapy can also improve the accompanying symptoms of stress urinary incontinence and maintain a longer therapeutic effect. In addition, neuromuscular electrophysiological indicators that are more objective have been introduced to evaluate the curative effect. Rod Tuina combined with electrical stimulation biofeedback as a treatment plan of integrated traditional Chinese and Western medicine has certain in-depth research and promotion values. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To investigate the correlation between serum mi R-21 expression and uterine prolapse and vaginal wall prolapse. Methods: A total of 60 patients with uterine prolapse and vaginal wall prolapse who were treated in our hospital from December2017 to December 2020 were selected as the observation group, and another 60 healthy women who came to our hospital for physical examination were selected as the matched group, The correlation of serum mi R-21 expression with uterine prolapse and vaginal wall prolapse was analyzed. After pelvic floor reconstruction and related treatment, 40 patients who had no prolapse in Zigong and vaginal wall and whose POP-Q score was less than or equal to grade II one year after operation were divided into good prognosis group, and 20 patients who had uterine prolapse and vaginal wall prolapse again within one year after operation and whose POP-Q score was greater than or equal to grade II were divided into poor prognosis group. The prognostic value of serum mi R-21 expression level for uterine prolapse and vaginal wall prolapse was also evaluated. Results: There were differences in the expression levels of collagen I, III and serum mi R-21between the two groups. The levels of collagen I and III in the observation group were lower than those in the matched group, and the level of serum mi R-21 in the observation group was higher than that in the matched group (P<0.05); Spearman correlation analysis showed that the levels of collagen I and collagen III were negatively correlated with uterine prolapse and vaginal wall prolapse (P<0.05), and serum mi R-21 was positively correlated with uterine prolapse and vaginal wall prolapse (P<0.05); There was no difference in pregnancy times, prolapse site, collagen Ⅰ and collagen Ⅲ between the two groups (P<0.05). There were differences in age, BIM, parity and mi R-21 between the two groups (P<0.05); Logistic regression analysis showed that only serum mi R-21 level and BMI were independent prognostic factors for uterine prolapse and vaginal wall prolapse (P<0.05). Conclusion: Collagen I, III and serum mi R-21 expression levels are significantly correlated with uterine prolapse and vaginal wall prolapse, so three indicators can be considered for diagnosis and treatment of patients. However, only serum mi R-21 level and BIM level are independent prognostic factors for uterine prolapse and vaginal wall prolapse, and the two levels can be used to judge the prognosis of patients and take timely measures to improve treatment methods. [ABSTRACT FROM AUTHOR]

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BackgroundChina is seeing an increase in the ratio of parturients of advanced maternal age, a population at high risk of stress urinary incontinence (SUI) .ObjectiveTo quantitatively assess pelvic floor structure and function changes and SUI, and to determine the ultrasonic diagnostic indices and threshold values for SUI in the early postpartum period in parturients of advanced maternal age using 2D and 3D ultrasound and real-time shear wave elastography (SWE) of the pelvic floor.MethodsParticipants were 194 puerperants who received ambulatory services in the early postpartum period (within the first 6-8 weeks after childbirth) from North China University of Science and Technology Affiliated Hospital from August 2016 to February 2021, including 105 of advanced maternal age (≥35 years old) and 89 of proper maternal age (

Objective: To investigate the effects of electroacupuncture pudendal nerve stimulation therapy combined with Kegel pelvic floor rehabilitation training on pelvic floor muscle strength, urodynamics and quality of life in patients with postpartum stress urinary incontinence (SUI). Methods: 109 patients with postpartum SUI who were treated in our hospital from June 2019 to November 2021 were selected. According to the odd and even order of admission, they were divided into two groups, of which 54 cases in the control group, they were received Kegel pelvic floor rehabilitation training, and 55 cases in the study group, they were received electroacupuncture pudendal nerve stimulation therapy combined with Kegel pelvic floor rehabilitation training. The curative effect, urine leakage, degree of urinary incontinence, pelvic floor muscle strength, urodynamics and quality of life were compared between the two groups. Results: The total clinical effective rate of the study group was higher than that of the control group (P<0.05). After treatment, all indexes of pelvic floor muscle strength (hand measured muscle strength, maximum value of class I muscle fiber and average value of class II muscle fiber) increased in the two groups, and the study group was higher than the control group (P<0.05). The amount of urine leakage and the score degree of urinary incontinence in the two groups decreased after treatment, and the study group was lower than the control group (P<0.05). After treatment, the related indexes of urodynamics [abdominal pressure leak point pressure (AL-PP), maximum urinary flow rate (Qmax) and maximum urethral closure pressure (MUCP)] increased in the two groups, and the study group was higher than the control group (P<0.05). After treatment, the scores and total scores of all dimensions (restrictive behavior, psychological influence and limited social activities) of urinary incontinence quality of life scale (I-QOL) increased in the two groups, and the study group was higher than the control group (P<0.05). Conclusion: Electroacupuncture pudendal nerve stimulation therapy combined with Kegel pelvic floor rehabilitation training can effectively improve pelvic floor muscle strength and urinary incontinence in postpartum SUI patients, reduce urinary leakage, promote the recovery of urodynamics, and then improve the quality of life of patients. [ABSTRACT FROM AUTHOR]

Objective: To observe the effects of suspension training therapy combined with biofeedback electrical stimulation on pelvic floor function and urodynamics in patients with postpartum stress urinary incontinence (PSUI). Methods: 96 patients with PSUI who were received in our hospital from July 2019 to August 2021 were selected. The patients who met the requirements were divided into control group (48 cases) and study group (48 cases) by envelope lottery. The patients in the control group received suspension training therapy, and the patients in the study group received suspension training therapy combined with biofeedback electrical stimulation. The curative effects, pelvic floor function indexes and urodynamic indexes of the two groups were compared. The leakage volume of urine pad test and the score of international consultation on incontinence questionnaire-urinary incontinence-short form (ICI-Q-SF) questionnaire of the two groups were observed. Results: The total clinical effective rate of the study group was higher than that of the control group (P<0.05). 1 month after treatment, the leakage volume of 24 h urine pad test and the score of ICI-Q-SF questionnaire of the two groups decreased, and the study group was lower than the control group (P<0.05). The improvement effect of pelvic floor muscle strength in the study group was better than that in the control group after one month of treatment (P<0.05). 1 month after treatment, the maximum urethral closure pressure (MUCP), functional urethral length (LES), abdominal pressure, leak point pressure (ALPP) and maximum urinary flow rate (Qmax) of two groups increased, and the study group was higher than the control group (P<0.05). Conclusion: The suspension training therapy combined with biofeedback electrical stimulation intervention in patients with PSUI can effectively improve clinical symptoms and promote the recovery of pelvic floor function and urodynamics, the effect is remarkable. [ABSTRACT FROM AUTHOR]

Pelvic floor dysfunctions (PFD) have become a public health problem that is increasingly harmful to women′s health, and its pathogenesis has not yet been fully understood. Because human trials are constrained by medical ethics, animal models are particularly important as a powerful tool for exploring PFD. The current animal models of PFD are roughly divided into rodents, small mammals, large mammals and nonhuman primates according to different species. By researching the status quo, it is found that among the four types of animals, rodent models are the most used, and nonhuman primate models are the most ideal. Simulating childbirth is the primary modeling method and genetic technology can be used to construct animal models with specific properties. Biomechanical measurements provide objective data for the pathology of pelvic floor injury and the evaluation of treatment effects, which can further optimize animal models and will provide more help for exploring the pathogenesis and treatment methods of PFD. [ABSTRACT FROM AUTHOR]

Objective: To observe the value of electroacupuncture nerve stimulation therapy combined with pelvic floor muscle training in the rehabilitation of early cervical cancer after extensive total hysterectomy. Methods: 98 patients with early cervical cancer undergoing extensive total hysterectomy who were admitted to our hospital from March 2020 to October 2021 were prospectively collected. They were divided into study group and control group by random number table method. The control group was instructed to conduct pelvic floor muscle training, and the study group was given electroacupuncture nerve stimulation therapy on the basis of pelvic floor muscle training. The incidence of urinary retention and the recovery of bladder function, immune function and pelvic floor function were compared between the two groups. Results: The results of 13 weeks after operation showed that the normal rate of comprehensive muscle strength of pelvic floor muscle in the study group was higher than that in the control group (P<0.05). Initial urinary bladder volume (VS), maximum urinary flow rate (MFR) and maximum urinary bladder volume (MVS) in two groups at 13 weeks after operation were higher than those at 1 week after operation, while residual urine volume (PVR) was lower than that at 1 week after operation. FVS, MFR and MVS in the study group at 13 weeks after operation were higher than those in the control group, while PVR was lower than that in the control group (P<0.05). The levels of serum immunoglobulin A (Ig A), immunoglobulin G (Ig G),immunoglobulin M (Ig M), peripheral blood T lymphocyte CD3+, CD4+/CD8+in the two groups at 13 weeks after operation were higher than those at 1 week after operation, and the study group was higher than the control group (P<0.05). The incidence of urinary retention in the study group was 4.08% (2/49) lower than 22.45% (11/49) in the control group, and the difference was statistically significant (P<0.05). Conclusion: Electroacupuncture nerve stimulation therapy combined with pelvic floor muscle training can reduce the incidence of urinary retention in patients with early cervical cancer after extensive total hysterectomy, improve pelvic floor function and bladder function, and promote the recovery of immune function, and with good effect. [ABSTRACT FROM AUTHOR]

Objective: To study the efficacy of pelvic floor ultrasound parameters in predicting stress urinary incontinence (SUI) after cesarean section and analyze its relationship with the E-cadherin and Vimentin expression in pelvic floor tissue. Methods: 124 patients with cesarean section who were admitted to Hunan Maternal and Child Health Hospital from January 2020 to January 2021 were selected. According to the occurrence of SUI, they were divided into SUI group with 18 cases and non-SUI group with 106 cases. Pelvic floor ultrasonography was performed in all patients, and the posterior Angle of bladder and urethra (PUA), the horizontal and vertical distance from bladder neck to the lower margin of pubic symphysis (BNS), bladder neck mobility (BND) and urethra rotation Angle (UR) were compared between the two groups during rest (R) and tension (V) Valsalva movements. The efficacy of pelvic floor ultrasound parameters in predicting SUI after cesarean section was analyzed by receiver operating characteristic (ROC) curve analysis. In addition, the mRNA levels of E-cadherin and Vimentin in pelvic floor tissues were compared between the two groups, and the correlation between various pelvic floor ultrasound parameters and the E-cadherin and Vimentin expression in pelvic floor tissues was analyzed by Pearson correlation. Results: R-PUA, V-PUA, BND and UR in SUI group were higher than those in non-SUI group, while R-BNS and V-BNS were lower than those in non-SUI group (all P<0.05) . ROC curve analysis results: the combined efficacy of various pelvic floor ultrasound parameters in predicting SUI after cesarean section was better than that of various parameters alone. The mRNA level of E-cadherin in the pelvic floor tissues of SUI group was lower than that of the non-SUI group, while the mRNA level of Vimentin was higher than that of the non-SUI group (all P<0.05) . Pearson correlation analysis showed that R-PUA, V-PUA, BND, UR were negatively correlated with E-cadherin mRNA levels in pelvic floor tissues, and positively correlated with Vimentin mRNA levels. While R-BNS and V-BNS were positively correlated with E-cadherin mRNA level in pelvic floor tissue, and negatively correlated with Vimentin mRNA level (all P<0.05) . Conclusions: Pelvic floor ultrasound parameters are highly effective in predicting SUI after cesarean section, and are related to the E-cadherin and Vimentin expression in pelvic floor tissues. [ABSTRACT FROM AUTHOR]

Objective: To study the expression of Dystrophin, MGF and M-Cad in pelvic floor muscles of dystocia rat model, and to explore its relationship with stress urinary incontinence. Methods: Forty unborn female SD rats were selected and divided into 3 groups according to the random number table method: control group, model 1 group, model 2 group and model 3 group. The rats in the control group were fed normally, the rats in the model 1 group underwent guided dilatation surgery, the rats in the model 2 group had bilateral sciatic nerves removed, and the rats in the model 3 group underwent both vaginal dilation and bilateral sciatic nerve removal. After feeding for 1 month, the rats in each group were sacrificed after weighing, and the pelvic floor muscles were separated. After weighing, the expression of Dystrophin, MGF and M-Cad mRNA was detected by quantitative PCR (qPCR). Results: Compared with the control group, the body weight and pelvic floor muscle weight of the dystocia rat model group (model 1, model 2 and model 3) did not change significantly (P>0.05), and the leakage point pressure and maximum bladder volume were both significantly decreased(P<0.05), and the expression of Dystrophin, MGF and M-Cad mRNA in pelvic floor muscles were also both significantly decreased (P<0.05). Pearson correlation analysis: the expression levels of Dystrophin, MGF and M-Cad mRNA in the pelvic floor muscles of rats are closely related to the pressure of the leak point (Dystrophin: r=0.725, P=0.002; MGF: r=0.702, P=0.018 ; M-Cad: r=0.838, P<0.001); the expression levels of Dystrophin, MGF and M-Cad mRNA in rat pelvic floor muscles are also closely correlated with maximum bladder capacity (Dystrophin: r=0.733, P=0.001; MGF: R=0.682, P=0.025; M-Cad: r=0.819, P<0.001). Conclusion: The expression of Dystrophin, MGF and M-Cad in pelvic floor muscles of dystocia rat model decreased, and the decreased expression were thought to be related to stress urinary incontinence. [ABSTRACT FROM AUTHOR]

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BACKGROUND: Neuromuscular electrical stimulation therapy has been widely used in the field of rehabilitation. OBJECTIVE: To understand the hot spots and trends of neuromuscular electrical stimulation therapy research worldwide, analyze the research development framework, and provide references for further research and applications in this field. METHODS: Literature from January 1, 2010 to October 7, 2020 was retrieved from the China National Knowledge Infrastructure (CNKI) and Web of Science core aggregation databases. Among them, Chinese literatures were searched in the CNKI with “neuromuscular electrical stimulation” or “neuromuscular electrical stimulation therapy,” and English literatures were searched in the Web of Science with “neuromuscular electrical stimulation or NMES.” The CiteSpace V software was used to visualize the publication volume, country, author, institution, cited literature and keywords, and to draw the corresponding figures. RESULTS AND CONCLUSION: A total of 2 453 relevant literatures were finally included, 618 from the CNKI and 1 835 from the Web of Science. The author with the most publications in China is Lan Xiaoman from the First Affiliated Hospital of Guangxi University of Science and Technology (Guangxi, China). The institution with the most publications is the Department of Rehabilitation Medicine of the Fifth Affiliated Hospital of Sun Yat-sen University. In China, the high-cited keywords, such as stroke and hemiplegia, are connected with each other more closely. The foreign author with the most publications is GUILLAUMEY MILLET, University of Calgary, Canada, and Case Western Reserve University has the highest volume of publications. The high-cited keywords are stroke, skeletal muscle, and exercise. In recent years, the overall research of neuromuscular electrical stimulation has been stably popularized, and international research hotspots mainly focus on post-stroke dysfunction. In China, the research of neuromuscular electrical stimulation focuses on pelvic floor dysfunction as well as combined acupuncture for swallowing disorders after stroke, whereas the international research trends mainly emphasize on the intrinsic mechanism exploration of neuromuscular electrical stimulation for neuromuscular function and the clinical application combined with magnetic stimulation therapy. However, further explorations are required on the mechanism of neuromuscular electrical stimulation targeting swallowing function, pelvic floor dysfunction and the clinical application of neuromuscular electrical stimulation. [ABSTRACT FROM AUTHOR]

To explore the value of three-dimensional ultrasound technology in assessing pelvic floor muscle contraction and bladder neck mobility in female patients with stress urinary incontinence (SUI). Methods: 60 female patients with postpartum SUI admitted to our hospital from January 2020 to August 2021 were selected as the observation group, and 60 female subjects with normal postpartum during the same period were selected as the control group. All subjects underwent perineal three-dimensional ultrasound examine. The differences in related indexes such as pelvic floor muscle contraction and bladder neck mobility between the two groups were compared. Results: In the resting state and the maximum Valsalva state, the anterior and posterior diameter, the left and right diameters of the pelvic diaphragm hiatus, the area of the levator ani muscle and the posterior angle of the bladder neck in the observation group were significantly larger than those in the control group (P<0.05). The length of the urethra in the observation group was significantly lower than that in the control group (P<0.05); and only in the maximum Valsalva state, the bladder neck position of the observation group was significantly larger than that of the control group (P<0.05). In addition, the proportion of bladder funnelization in the observation group was significantly higher (P<0.05). Conclusion: Three-dimensional ultrasound technology can clearly and intuitively display the structure and function of the female pelvic floor. It has certain diagnostic value for assessing the pelvic floor muscle contraction and bladder neck mobility in female patients with SUI, and provides true and objective imaging evidence for the clinic [ABSTRACT FROM AUTHOR]

Changes in the structure and function of female pelvic floor organs, muscles and surrounding connective tissue are the main causes of pelvic floor disorders (PFD), and a detailed understanding of the spatial anatomy of the pelvic floor under physiological and pathological conditions can help clinicians make accurate diagnoses and optimize treatment strategies. The widespread use of magnetic resonance imaging (MRI) technology has improved clinicians' understanding of the pelvic floor structure, but presentation of the pelvic floor structure is still limited to two-dimensional planar images and the three-dimensional (3D) spatial structure cannot be visualized. The 3D reconstruction technology based on MRI can transform the structure of the female pelvic floor organs into digital models for observation, measurement and even 3D printing for inverse analysis, which greatly promotes the clinical understanding of the pathogenesis and treatment of PFD and provides basis for individualized treatment. However, the existing MRI-based 3D reconstruction technology is not yet mature, for example different advantages and disadvantages of different commercial softwares, different algorithms of different image recognition techniques, lack of uniform evaluation criteria for 3D reconstruction models, and difficulty of balancing modeling efficiency and quality, which limit it as an effective medical research tool for PFD. This paper reviews the research of 3D digital model reconstruction of female pelvic floor tissue and organs based on MRI, aiming to provide reference for clinical diagnosis, treatment and scientific research of PFD. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

To observe the effect of biofeedback electrical stimulation combined with Kegel training on the electrophysiological indexes of pelvic floor function and quality of life in patients with postpartum pelvic floor dysfunction (PFD) disease. The research objects were 80 cases of patients with postpartum PFD in our hospital from March 2018 to December 2020. The patients were randomly divided into control group (n=40) and study group (n=40) by the double chromosphere randomized grouping method. The control group was given Kegel training, and the study group was given biofeedback electrical stimulation combined with Kegel training, both groups were treated for 8 weeks. The curative effect and the improvement of urinary incontinence and degree of pelvic organ prolapse were compared between the two groups at 8 weeks after treatment. The electrophysiological indexes of pelvic floor function, quality of daily life and quality of sexual life between the two groups before treatment and after treatment were compared. 8 weeks after treatment, the total effective rate of the study group was higher than that of the control group (P<0.05). 8 weeks after treatment, the I muscle fiber fatigue degree, Ⅱ muscle fiber fatigue degree, fast muscle maximum electromyography and vaginal dynamic pressure of the study group were better than those of the control group (P<0.05). 8 weeks after treatment, the improvement of urinary incontinence and degree of pelvic organ prolapse of the study group were better than those of the control group (P<0.05). 8 weeks after treatment, the score of pelvic floor function impact questionnaire (PIFQ-7) and the score of pelvic organ prolapse incontinence function questionnaire (PISQ-12) of the study group were lower than those of the control group (P<0.05). The patients with postpartum PFD are treated with biofeedback electrical stimulation combined with Kegel training has a clear efficacy, which can improve the urinary incontinence and degree of pelvic floor organ prolapse, pelvic floor function improvement, improve the quality of daily life and quality of sexual life of patients. [ABSTRACT FROM AUTHOR]

To observe the efficacy of pelvic floor muscle rehabilitation training combined with pelvic floor reconstruction in the treatment of female pelvic floor dysfunction (PFD) diseases and its effect on inflammatory response and stress response. 200 patients with PFD who were treated in our hospital from January 2019 to January 2021 were selected, and they were randomly divided into control group (100 cases) and study group (100 cases) by random number table method. Patients in the control group received pelvic floor reconstruction, and patients in the study group received pelvic floor muscle rehabilitation training combined with pelvic floor reconstruction. The efficacy and postoperative complications of the two groups were observed, and the related scale scores, inflammatory response and stress response indexes of the two groups were compared. After treatment, the scores of pelvic floor impact questionnaire short form (PFIQ-7), pelvic floor distress inventory short form (PFDI-20) in the study group were lower than those in the control group (P<0.05). The pelvic floor class I muscle fiber voltage and pelvic floor class II muscle fiber voltage in the study group were higher than those in the control group after treatment (P<0.05). Interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) and high sensitivity C-reactive protein (hs-CRP) in the study group after treatment were lower than those in the control group (P<0.05). Cortisol (COR), norepinephrine (NE) and prostaglandin E2 (PGE2) in the study group after treatment were lower than those in the control group (P<0.05). The incidence of postoperative complications in the study group was lower than that in the control group (P<0.05). Pelvic floor muscle rehabilitation training combined with pelvic floor reconstruction in the treatment of PFD can promote the recovery of pelvic floor function, reduce inflammatory reaction and stress reaction, and reduce the incidence of postoperative complications. [ABSTRACT FROM AUTHOR]

To investigate the related factors of female pelvic floor dysfunction and the clinical significance of SUI measured by pelvic floor ultrasound. 63 patients with pelvic floor dysfunction in our hospital from 2019 to 2020 were selected as the research objects and divided into the research group. Another 63 healthy women who came to our hospital for physical examination in the same period were selected as the control group. Pelvic floor ultrasound was applied to all women, and the resting state and Valsalva were compared between the two groups through questionnaire survey, the general clinical treatment of two groups of women was investigated. The related factors of female pelvic floor dysfunction were analyzed by single factor analysis and multi factor analysis. Finally, the related factors of pelvic floor dysfunction were obtained. In the resting state, pelvic floor ultrasound showed that there were significant differences in the posterior angle of bladder and urethra, the area of levator ani hiatus and urethral inclination between the study group and the control group (P<0.05), but there were no significant differences in the position of bladder neck and bladder between the two groups (P>0.05). Pelvic ultrasound showed that there were significant differences in the posterior angle of bladder and urethra, levator ani hiatus area, urethral inclination, bladder neck position and bladder position between the study group and the control group (P<0.05); there were significant differences in age, BMI, pregnancy times, labor times, menopause and whether the cleanliness of leucorrhea was greater than or equal to grade III between the two groups (P<0.05). Logistic regression analysis showed that age, menopause, history of uterine fibroids and cleanliness of leucorrhea ≥ III were not independent risk factors of pelvic floor dysfunction (P>0.05), BMI, pregnancy and parity were independent risk factors of pelvic floor dysfunction (P<0.05). Pelvic floor ultrasound is of great value in the diagnosis of stress urinary incontinence in patients with pelvic floor dysfunction. The bladder movement and urethral inclination can be found in the resting state and Valsalva state. Age, BMI, times of pregnancy, times of labor, menopause and whether the cleanliness of leucorrhea is greater than or equal to grade III may be related to pelvic floor dysfunction. BMI, times of pregnancy and times of labor are independent risk factors for pelvic floor dysfunction. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: Numerous literatures have reviewed and analyzed acupuncture and moxibustion for stress urinary incontinence; however, there are some limitations, such as no comprehensive or targeted analysis of the individual efficacy of acupuncture and moxibustion on female patients. OBJECTIVE: To analyze the characteristics of clinical research regarding acupuncture for treating stress urinary incontinence to provide reference for acupuncture in clinical practice. METHODS: Randomized controlled trials (RCTs) related to acupuncture intervention on stress urinary incontinence published before March 15, 2020 were searched in PubMed, Embase, Cochrane Library, Clinical Evidence, CNKI, VIP, WanFang and SinoMed. Bibliometrics was used to extract data and information from the documents that met the inclusion criteria, and Cochrane was used to evaluate the quality of literature. We quantitatively analyzed acupuncture treatment for stress urinary incontinence from the number of publications, diagnostic criteria, treatment methods, selection of acupoints and meridians, frequency and duration of treatment, curative effect standards and outcome indicators, characteristics of acupuncture operation methods, and design of clinical research methods. RESULTS AND CONCLUSION: A total of 115 Chinese and English documents that met the requirements were screened out. The number of publications has been increasing year by year and tends to be stablely increased since 2012. The use of diagnostic criteria and efficacy criteria is not uniform and standardized; treatment methods are mainly acupuncture alone or in combination with other therapies (pelvic floor muscle training and biofeedback), moxibustion alone or in combination with other therapies, acupuncture combined with other therapies. Single acupuncture therapy is mostly body acupuncture and electric acupuncture. The top 10 acupoints used are Guanyuan (RN 4), Zhongji (RN 3), Sanyinjiao (SP 6), Qihai (RN 6), Shenshu (BL 23), Huiyang (BL 35), Zusanli (ST 36), Zhongliao (BL 33), Ciliao (BL 32), Baihui (DU 20). The BL, RN, GB and KI meridians are the most used. Subjective and objective indicators are combined with each other, and the effective rate is the most frequently used as the outcome indicator. Both clinical operation methods and the course of treatment are different in the documents. The quality of methodology and clinical reports are generally poor, and researches with high argumentation intensity are rare. Methods of acupuncture for stress urinary incontinence are various, mainly based on local selection of acupoints combined with acupoints selection along the meridian. The standards of design and method are different in the clinical researches, which need to be standardized and improved in the future. [ABSTRACT FROM AUTHOR]

Objective: To explore the effects of pelvic-abdominal mechanics exercises during pregnancy on improving pelvic floor function in primiparous women during the perinatal period. Methods: A single-center prospective study selected 200 primipara of singleton pregnancies with prenatal care and delivery established at Shanghai Tongren hospital from June 2022 to June 2023 as the study subjects. Participants were divided into two groups: the exercise group (100 cases) and the control group (100 cases) by using a random number table method, five participants dropped out of the study due to reasons such as follow-up failure. Ultimately, the exercise group consisted of 97 cases, while the control group consisted of 98 cases. Participants who engaged in pelvic-abdominal mechanics exercises for at least 3 months, exercising once a week, were included in the exercise group. Those who did not engage in exercise were included in control group. Comparing the two groups in terms of pregnancy discomfort symptoms, delivery outcomes, postpartum pelvic floor electromyography results, postpartum quality of life, and pelvic floor disease incidence. The statistical methods utilized included independent t -test, Pearson chi-square test, Fisher's exact test, and Mann-Whitney U test. Results: In the late stage of pregnancy, the VAS score for low back pain was 5.05±1.22 in the exercise group and 5.47±1.55 in the control group, with a statistically significant difference ( t =2.090, P <0.05). The PFDI-20 score was 23.33±8.41 in the exercise group and 25.76±8.34 in the control group, with a statistically significant difference ( t =2.026, P <0.05). The PFIQ-7 score was 19.21±7.69 in the exercise group and 26.66±6.19 in the control group, with a statistically significant difference ( t =6.851, P <0.05). There was no statistically significant difference in sleep quality and incidence of urinary incontinence between the two groups in late pregnancy ( t =1.252, P =0.396, P >0.05). In terms of childbirth outcomes, the exercise group had a vaginal delivery rate of 81.44% (79 cases), while the control group had a rate of 64.28% (63 cases), with a statistically significant difference (χ 2 =9.022, P <0.05). The duration of the second stage of labor was (42.68±21.38) minutes in the exercise group and (50.54±21.33) minutes in the control group, with a statistically significant difference ( t =2.178, P <0.05). At 42 days postpartum, the evaluation of pelvic floor function showed that the vaginal pressure in the exercise group was 62.19±10.04, while in the control group it was 52.68±15.55, with a statistically significant difference ( t =-5.074, P <0.05). The MOS grading in the exercise group was 3.82±1.26, whereas in the control group it was 2.34±1.55, with a statistically significant difference ( t =-7.355, P <0.05). In terms of the incidence of postpartum pelvic floor disorders, the occurrence of pelvic organ prolapse was 7.22% in the exercise group and 12.24% in the control group, with no statistically significant difference (χ 2 =1.402, P >0.05). The occurrence rate of stress urinary incontinence was 13.4% in the exercise group and 30.61% in the control group, with a statistically significant difference ( P =0.015, P <0.05). Conclusion: Pelvic-abdominal mechanics exercises may have some advantages in reducing symptoms related to perinatal pelvic floor dysfunction, enhancing pelvic floor function, and preventing the occurrence of pelvic floor disease.

Copyright of Imaging Science & Photochemistry is the property of Imaging Science & Photochemistry Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Imaging Science & Photochemistry is the property of Imaging Science & Photochemistry Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)