Objective To study the clinical manifestations,diagnosis,treatments and prognosis of the pulmonary change in mixed connective tissue disease(MCTD).Methods From January 1996 to June 2008,112 patients with definite MCTD in Second Affiliated Hospital of Harbin Medical University were retrospectively studied,and the clinical feature about pulmanary manifestations,echocardiography feature,radiology features and treatments were reviewed and analyzed.44 patients were followed up.Results 48(5 male)had pulmonary manifestation.The median age of onset of symptoms was 39 years and the median duration of disease was three years.The most common manifestation was pleural effusion and(or)pachynsis pleurae(21 cases,18.8%).16 patients(14.3%) had interstitial lung disease,and 8 cases(7.1%)had pulmonary hypertension.The cardinal symptom was short breath.Thirteen patients(11.6%)had dyspnea,4 cases(3.6%)had chest pain,and 4 cases(3.6%)had cough.Reductions of pulmonary function or abnormalities of ultrasonographic image were noted in 25(52.1%)of 48 patients with pulmonary involvement of MCTD who had not any complaint of respiratory symptoms.Six patients had reductions in diffusing capacity of the lung for carbon monoxide(DLCO),17 patients had pulmonary abnormality on chest X ray or CT,and two patients had pulmonary hypertension on doppler echocardiography.Conclusion Pulmonary involment of MCTD may contribute to prognosis seriously.DLCO was the most sensitive parameter.Pulmonary hypertension was the most common cause of death.

Objective To explore the relationship between embryo damage and anxiety,depression and life events during pregnancy. Methods A case control study was carried out. 192 women diagnosed with embryo damage were selected as the case group,and 192 normal pregnant women or normal parturition within 7 days were selected as the control group from March to June,2014.All cases were from two 3-A-grade general hospitals of Jining. Self-rating anxiety scale ( SAS ) , center for epidemiological survey, depression scale( CES-D) and life events scale for pregnant women( LESPW) were used to evaluate the anxiety,depres-sion and life events of the two groups,so as to analyze the association between these factors and embryo dam-age. Results Multiple non-conditional logistic regression analysis showed that anxiety ( β=0. 409, OR=1.050,95%CI =1.003-1.009) ,depression( β=0.085, OR=1.088,95%CI =1.035-1.145) ,life events dur-ing pregnancy( β=0.003, OR=1.003,95%CI =1.001-1.005) were the risk factors of embryo damage,while education ( β=-0.749, OR=0.452,95%CI=0.298-0.685) ,pre pregnancy health status ( β=-1.366, OR=0.255,95%CI =0.098-0.655) and taking the initiative to acquire knowledge of eugenics ( β=-0.884, OR=0.413,95%CI =0.203-0.840) were the protective factors of embryo damage. Conclusion Anxiety,depres-sion and life events during pregnancy are related to the occurrence of embryo damage. High degree of educa-tion,pre pregnancy in good health and taking the initiative to acquire eugenics knowledge can reduce the oc-currence of embryo damage.

Objective:To explore the effects of the LEARNS model in health education of urinary incontinence for patients undergoing laparoscopic radical prostatectomy.Methods:From September 2019 to August 2020, totally 60 patients who underwent laparoscopic radical prostatectomy in the Department of Urinary Surgery, Peking University First Hospital were selected by convenience sampling and divided into a control group and an intervention group according to the time of admission, with 30 cases in each group. Patients in the control group underwent conventional health education, while patients in the intervention group received nursing using the LEARNS model, with specific steps including listen (L), establish (E), adopt (A), reinforce (R), name (N), and strengthen (S). The mastery of knowledge about pelvic floor muscle before discharge was compared between the two groups, and the urinary continence of the two groups at 1 and 3 months after discharge was observed.Results:The knowledge level and correctness of pelvic floor muscle in the intervention group were higher than those in the control group, and the differences were statistically significant ( P<0.01). At 3 months after surgery, the urinary incontinence score of the intervention group was lower than that of the control group; the number of urine pads used was less than that of the control group; the rate of continence was higher than that of the control group, with statistically significant differences ( P<0.01) . Conclusions:The LEARNS mode can effectively improve the mastery of knowledge about pelvic floor muscle in patients undergoing laparoscopic radical prostatectomy, and improve their postoperative urinary continence.

Objective To assess the effect of ischemic postconditioning on the Notch1 signaling pathway,and learning and memory in rats with global cerebral ischemia.Methods A total of 128 healthy male SD rats were randomly divided into the sham operation (sham),whole-brain ischemia(CIR),ischemic treatment(CIP),and inhibitor(DAPT) groups,with 32 rats in each group.A global cerebral ischemia model was generated using the modified Pulsinelli's four-vascular occlusion model,and the inhibitor group was injected intraperitoneally with gamma secretase inhibitors (DAPT) before ischemic treatment.Rats' learning and memory function results from the Morris water maze test were assessed by observing the changes in hippocampal CA1 neurons with HE staining.The expression of Notch1 in the CA1 area of the hippocampus was assessed using immunohistochemical and Western blotting methods in rats.Results Compared with the sham group,the hippocampal cell survival rate in the CIR group decreased significantly (P ＜ 0.05) and the expression level of Notch1 increased significantly (P ＜ 0.05).Compared with the CIR group,the CIP group revealed a significantly higher hippocampal cell survival rate (P ＜ 0.05) and an increase in Notch 1 expression (P ＜ 0.05);compared with the CIP group,the hippocampal cell survival rate significantly decreased after DAPT administration (P ＜ 0.05) and Notch1 expression decreased significantly.Conclusion Ischemic postconditioning can promote the recovery of learning and memory ability,which may relate to the activation of the Notch 1 signaling pathway.

Objective To explore the effect of robotic training under position limitation on upper limb of patients with shoulder sub-luxation after stroke. Methods From March to December,2023,sixty patients with shoulder subluxation after stroke in the First Affiliated Hospital of Bengbu Medical University were randomized into conventional group(n = 20),robot group(n = 20)and position-limited group(n = 20).All the groups accepted conventional rehabilitation,while the robot group underwent robot training and the position-limited group underwent robot training under position limitation,for four weeks.Before and after treatment,Fugl-Meyer Assessment-Upper Extremities(FMA-UE)and modified Bar-thel Index(MBI)were used for evaluation,surface electromyography(sEMG)was used to measure the average electromyography(AEMG)and root mean square(RMS)of posterior deltoid fasciculus and supraspinatus during contraction,and musculoskeletal ultrasonography was used to determine the distance of acromion-greater tuber-osity(AGT)of the affected side. Results After treatment,FMA-UE score,MBI score,AEMG,RMS and the distance of AGT improved in all the groups(|t|>10.850,P<0.001),and all the indexes were optimal in the position-limited group(F>42.031,P<0.001). Conclusion Robotic training for upper limb under postural limitation can further improve upper limb function and sub-luxation status,activities of daily living,and peri-shoulder muscle in patients with shoulder subluxation after stroke.

Objective:To investigate the genetic and evolutionary characteristics of hemagglutinin (HA) and neuraminidase (NA) genes of influenza B/Victoria (BV) virus in Xi′an city from 2019 to 2023.Methods:Twenty-five BV strains isolated from the Xi′an influenza surveillance network laboratory between 2019 and 2023 were collected. The HA and NA genes were sequenced using MiniSeq high-throughput sequencing platform. An evolutionary tree was constructed using bioinformatics software to analyze homology and mutation sites, and to predict N-glycosylation sites online. The antigenicity of the strains was analyzed through hemagglutination inhibition tests.Results:The BV influenza in Xi′an exhibited a distinct seasonal transmission pattern from 2019 to 2023, with peak prevalence occurring during the winter and spring seasons. The evolutionary analysis of the HA genes shows that the strains from Xi′an in 2019 belong to the V1A.3 branch, and the strains from 2021 to 2023 belong to the V1A.3a.2 branch. Analysis of antigenic sites showed that there were variations in 6 sites of 3 antigenic determinants in the HA proteins of the BV strains from 2021-2022 compared to 2019, and 2 sites of 1 antigenic determinant changed in the HA proteins in 2023 compared to 2021-2022. The evolutionary analysis of the NA genes indicates that the BV strains from Xi′an in 2019 belong to the A. 1.1 branch. By 2021 and 2022, it had evolved into the A. 1.2 clade, and by 2023, it had further evolved into the B clade and its derivatives, with no strains showing mutations associated with resistance to NA inhibitors. Antigenic analysis indicated that the majority of BV strains in Xi′an were similar to the strains included in the vaccine composition. Furthermore, glycosylation analysis showed that the potential N-glycosylation sites in the HA proteins of BV strains from 2021-2023 were reduced by one compared to those from 2019, and only a few strains from 2023 displayed alterations in the potential N-glycosylation sites of the NA proteins.Conclusions:The HA and NA genes of the BV strains from 2019 to 2023 are continuously mutating and evolving into new branches. Since 2021, V1A.3a.2 has become the dominant evolutionary branch of the HA genes, while the evolutionary branches of the NA genes from 2019 to 2023 have been continuously changing.

Objective:To explore the predictive value of preoperative pelvic floor electromyography(EMG)parameters for the risk of urinary incontinence after prostate cancer surgery.Methods:This study retrospectively analyzed the medical records of 271 patients who underwent radical prostatectomy in the urology department of Peking University First Hospital from January 2020 to October 2022.The data included patient age,body mass index(BMI),international prostate symptom score(IPSS),prostate-specific antigen(PSA)levels,Gleason score,type of surgery,urethral reconstruction,lymph node dis-section,nerve preservation,catheterization duration,D'Amico risk classification,American Society of Anesthesiologists(ASA)score,Charlson comorbidity index,postoperative duration,prostate volume,and pelvic floor EMG parameters(pre-resting mean,fast muscle mean,and slow muscle mean scores).Independent risk factors affecting early postoperative urinary incontinence were identified through multiva-riate Logistic regression analysis.The predictive efficacy of pelvic floor EMG results was evaluated by cal-culating the area under the receiver operating characteristic(ROC)curve,and the optimal threshold for early postoperative urinary incontinence was determined based on the Youden index and clinical signifi-cance.Results:The study included 271 prostate cancer patients,with an 81.9％rate of voluntary urinary control post-surgery.The median score for fast pelvic floor muscles was 23.5(18.2,31.6),and for slow muscles,it was 12.5(9.6,17.3).Among the patients,179(66.1％)did not preserve nerves,and 110(40.6％)underwent urethral reconstruction.Advanced age and low fast muscle scores were identified as independent risk factors for urinary incontinence.Patients aged ≤60 had 5.482 times the voluntary urinary control rate compared with those aged ≥70(95％CI:1.532-19.617,P＜0.05).There was a significant correlation between fast muscle scores and urinary incontinence recovery(OR=1.209,95％CI:1.132-1.291,P＜0.05).When the optimal threshold for preoperative fast muscle score was set at 18.5,the ROC sensitivity and specificity were 80.6％and 61.2％,respectively.Con-clusion:Preoperative pelvic floor EMG parameters show good predictive accuracy and clinical applicabili-ty for the risk of urinary incontinence after prostate cancer surgery.These parameters can be used for ear-ly identification of urinary incontinence risk,with age and fast muscle scores being important predictors.

Objective:To investigate the safety and efficacy of pulsed Thulium fiber laser enucleation (ThuFLEP) in the treatment of benign prostatic hyperplasia (BPH).Methods:Clinical data of 238 BPH patients who underwent ThuFLEP from November 2022 to November 2023 at Peking University First Hospital were retrospectively analyzed. Patients were divided into two groups based on different surgical techniques: 199 patients underwent traditional continuous-wave Thulium fiber laser prostatectomy (C-ThuFLEP group), and 39 patients underwent Thulium fiber laser enucleation with pulse modulation (P-ThuFLEP group). Propensity score matching was used to balance baseline characteristics between the two groups. Operative time, resected tissue weight, pre- and postoperative hemoglobin decrease, postoperative hospital stay, and postoperative catheterization time were recorded and compared between the matched groups. Intraoperative and short-term postoperative complications were also recorded and compared between the two groups. Follow-up assessments at 1 month postoperatively were conducted to compare the maximum urinary flow rate (Q max), international prostate symptom score (IPSS), international index of erectile function (IIEF-5) score, quality of life (QOL) score, and International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) score between the two groups, as well as changes in Q max and IPSS, IIEF-5, and QOL before and after surgery. Results:After matching, a total of 60 patients were included, with 30 patients in each group. There were no statistically significant differences between the two groups in terms of age [(68.73±6.91) years vs. (71.07±7.34) years], American Society of Anesthesiologists (ASA) score (1-2/3-4: 23/7 vs. 23/7), comorbidity count (0-1/>1: 15/15 vs. 15/15), prostate volume [68.3 (50.0, 105.3) ml vs. 63.3 (45.7, 106.0) ml], preoperative IPSS score [24 (21, 29) vs. 23 (14, 26)], IIEF-5 score [5 (0, 15) vs. 5 (0, 13)], and QOL score [5 (4, 6) vs. 5 (5, 6)] (all P>0.05). The tissue removal rate in the P-ThuFLEP group was higher than that in the C-ThuFLEP group [0.82 (0.71, 1.18) g/min vs. 0.72 (0.46, 0.95) g/min, P=0.026], while there were no statistically significant differences between the two groups in operative time [47 (37, 79) min vs. 65 (33, 87) min], resected tissue weight [45 (31, 75) g vs. 33 (22, 65) g], postoperative hemoglobin decrease [17 (10, 23) g/L vs. 12 (7, 19) g/L], postoperative hospital stay [4 (3, 5) days vs. 4 (3, 5) days], and postoperative catheterization time [3 (3, 5) days vs. 3 (3, 6) days]. The incidence of intraoperative complications in both groups was 10% (3/30), with no statistically significant difference ( P=1.000), and no severe complications of grade Ⅲ or above occurred. There were no statistically significant differences in Q max [24 (15, 33) ml/s vs. 16 (10, 32) ml/s], IPSS score [14 (12, 15) vs. 9 (7, 12)], QOL score [2 (1, 3) vs. 2 (1, 3)], and IIEF-5 score [3 (0, 5) vs. 3 (0, 6)] between the C-ThuFLEP and P-ThuFLEP group at 1 month postoperatively (all P > 0.05), and both showed significant improvement compared to preoperative values (all P < 0.05). The ICIQ-SF score in the P-ThuFLEP group was lower than that in the C-ThuFLEP group [0 (0, 4) vs. 4 (3, 8)], with a statistically significant difference ( P=0.033). Conclusions:Compared with traditional continuous-wave Thulium fiber laser prostatectomy, pulse-modulated Thulium fiber laser enucleation demonstrates higher efficiency in tissue removal, lower early postoperative ICIQ-SF score for urinary incontinence, similar risk of intraoperative complications, and can be safely and effectively applied in the surgical treatment of BPH patients.

Objective To systematically evaluate and integrate the experiences of people living with HIV in peer support,and to provide references and suggestions for improving peer support for HIV patients in clinical practice.Methods The computer retrieval was performed in PubMed,CINAHL(EBSCO),Web of Science,ProQuest,CNKI and Wanfang Data from January 1,1996 to September 30,2022,to collect qualitative studies in the experience of people living with HIV participating in peer support.This qualitative systematic review was conducted under the Joanna Briggs Institute guideline.This paper was written according to the enhancing transparency in reporting the synthesis of qualitative research(ENTREQ).Results A total of 7 qualitative studies were included,and 26 findings were extracted,which were summarized into 12 categories and integrated into 4 synthesized findings.Findings included that peer support provides patients with information and help them establish and maintain a healthy lifestyle;patients receive emotional support in peer support;patients receive instrumental support in peer support;the objective requirements and scenarios of peer support.Conclusion AIDS peer support has a positive effect on AIDS prevention and treatment,and it is important to address the practical needs of people living with HIV/AIDS.The practice of HIV peer support needs further theoretical support and scientific guidance.Building an HIV peer support model,providing systematic training and professional guidance to HIV peers is conducive to improving the accuracy of HIV peer support behaviors,the development of HIV peer support activities,and optimizing the effectiveness and sustainability of peer support for people living with HIV/AIDS.