Objective To discuss the relativity of dyschesia with the change of puborectalismuscle.Methods 68 patients with dyschesia were compared with 68 healthy volunteers at lithotomy position undergoing 3D ultrasonography on resting,contracting and maximum exertion phase respectively.Three dimensionally reconstructed images were reconstructed and pubo-rectal angle and the thickness of puborectalis muscle at 6 o'clock position were measured.Results The pubo-rectal angle of the study group and control group had no significant differences at either resting [(86 ± 8) ° vs.(86 ± 8)°] or contracting phases [(88 ± 9) ° vs.(86 ± 7) °] (t =-0.145,t =0.434,P ＞ 0.05).While at maximum exertion the differences were significant [(80 ± 6) °vs.(95 ± 5) °,t =-5.397,P ＜ 0.05].The d-value of pubo-rectal angle between maximum and resting exertion statistically different [(6 ± 3) °,(-9 ± 7) °,t =5.551,P ＜ 0.05].The thickness of puborectalis muscle between the two groups differed statistically significant only at maximum exertion phase [(4.60 ± 0.60) mm vs.(3.97 ± 0.32) mm,t =6.872,P ＜ 0.05].The d-value of the thickness of puborectalis muscle between maximum and resting exertion were statistically different (t =-11.474,P ＜ 0.05).Conclusions The pubo-rectal angle of the study group is smaller at maximum exertion than the control group.The thickness of puborectalis muscle at six o'clock (lithotomy position) in study group is larger at maximum exertion than the control group.And the severity of constipation changed with the variation of angle.

Objective:To evaluate the effect of sacral nerve stimulation (SNS) for STC by receptor tyrosine kinase c-kit.Methods:Wistar rats were fed with diphenoxylate to make slow transit constipation(STC) rat model.Sacral nerve stimulation(SNS) for the SNS Rat Group.The studied animals were allocated into three experimental groups:STC Rat Group;SNS Rat Group;Normal Rat Group;Every group included 10 rats.The c-kit of ICC in the subserosal layer of rats were analyzed by immunohistochemistry,western blot and RT-PCR.Results:The morphological characteristics of STC Rat Group were not comparable to those of the multipolar c-Kit positive ICC seen in the subserosa of colon of normal rat.In the colon of rat,c-kit protein and c-kit gene in SNS rat group and Normal rat group was significantly higher than STC rat group detecting by western blot.Statistical differences between STC Group and SNS Rat Group were found (P＜0.05);statistical differences between STC Group and Normal Rat Group were also found (P＜0.05).There was not statistical differences between SNS rat group and Normal Rat Group.Conclusion:SNS has effective treatment for the STC rat.

Objective:With the full liberalization of China's fertility policy,the gradual increase in maternal age during pregnancy,and the rising proportion of overweight and obesity among women of childbearing age,the number of pregnant women with chronic hypertension(CHTN)combined with gestational diabetes mellitus(GDM)is increasing,leading to a significantly increased risk of adverse pregnancy outcomes.This study aims to analyze the prevalence of CHTN and CHTN complications with GDM,and compare the adverse pregnancy outcomes between the 2 conditions,providing a basis for intervention measures. Methods:This study was a prospective cohort study.A total of 378 366 cases from a large cohort of pregnant women between January 1,2016 to December 31,2020 were screened to identify 1 418 cases of pregnant women with CHTN,among which 1 027 were cases of CHTN alone and 391 were cases of CHTN combined with GDM.SAS9.4 was used to statistically analyze the basic characteristics,clinical data,and pregnant outcomes of pregnant women and to analyze the risk factors affecting the pregnancy outcomes of patients with CHTN and its complications with GDM. Results:The prevalence rate of CHTN with pregnancy was 3.8‰,and the prevalence rate of CHTN combined with GDM was 1.0‰.Patients with CHTN combined with GDM accounted for 27.57%(391/1 418)of all pregnant women with CHTN.Maternal age,number of pregnancies,parity,previous cesarean section,systolic blood pressure,diastolic blood pressure,and mean arterial pressure at the time of enrollment were statistically significant differences between the 2 groups(all P<0.05).After adjusting for potential confounding factors such as maternal age,parity,and number of pregnancies,binary Logistic regression analysis showed that pregnant women with CHTN combined with GDM had a 1.348 times higher risk of cesarean section(OR=1.348,95%CI 1.043 to 1.741),a 2.029 times higher risk of placental adhesion(OR=2.029,95%CI 1.190 to 3.462),a 1.540 times higher risk of preeclampsia(OR=1.540,95%CI 1.101 to 2.152),and a 2.670 times higher risk of macrosomia(OR=2.670,95%CI 1.398 to 5.100)compared to pregnant women with CHTN alone. Conclusion:Pregnant women with CHTN combined with GDM have a high risk,and their pregnancy outcomes differ from those of pregnant women with CHTN alone in terms of cesarean section,placental adhesion,preeclampsia,and macrosomia.Prenatal care for this population,especially the management of blood pressure and blood sugar,needs to be given special attention.