Low-intensity extracorporeal shock wave therapy (LiESWT), as a non-invasive physical therapeutic modality, is increasingly recognized for its potential in treating lower urinary tract dysfunction (LUTD). This article systematically explores the potential molecular mechanisms through which LiESWT acts on various types of LUTD, including the downregulation of pro-inflammatory cytokine expression, induction of neovascularization, mobilization and activation of tissue stem cells, regulation of neural regeneration and repair processes, and restoration of lower urinary tract muscle function. It also elaborates the latest therapeutic advances in the application of LiESWT for overactive bladder, underactive bladder, stress urinary incontinence, chronic prostatitis/chronic pelvic pain syndrome, and interstitial cystitis/bladder pain syndrome. This review also provides an in-depth analysis of the therapeutic efficacy differences associated with various treatment parameters (energy density, number of shocks, treatment frequency, and total sessions), summarizing the challenges currently faced in clinical translation and proposes future research directions and perspectives, so as to offer new feasible ideas for the treatment of LUTD and provide a theoretical basis for clinical practice.

Objective To investigate the risk factors of in-hospital mortality and establish a risk prediction model for patients receiving venoarterial extracorporeal membrane oxygenation(VA-ECMO).Methods We retrospectively collected the data of 302 patients receiving VA-ECMO in ICU of 3 hospitals in Guangdong Province between January,2015 and January,2022 using a convenience sampling method.The patients were divided into a derivation cohort(201 cases)and a validation cohort(101 cases).Univariate and multivariate logistic regression analyses were used to analyze the risk factors for in-hospital death of these patients,based on which a risk prediction model was established in the form of a nomogram.The receiver operator characteristic(ROC)curve,calibration curve and clinical decision curve were used to evaluate the discrimination ability,calibration and clinical validity of this model.Results The in-hospital mortality risk prediction model was established based the risk factors including hypertension(OR=3.694,95%CI:1.582-8.621),continuous renal replacement therapy(OR=9.661,95%CI:4.103-22.745),elevated Na2+ level(OR=1.048,95%CI:1.003-1.095)and increased hemoglobin level(OR=0.987,95%CI:0.977-0.998).In the derivation cohort,the area under the ROC curve(AUC)of this model was 0.829(95%CI:0.770-0.889),greater than those of the 4 single factors(all AUC<0.800),APACHE Ⅱ Score(AUC=0.777,95%CI:0.714-0.840)and the SOFA Score(AUC=0.721,95%CI:0.647-0.796).The results of internal validation showed that the AUC of the model was 0.774(95%CI:0.679-0.869),and the goodness of fit test showed a good fitting of this model(χ2=4.629,P>0.05).Conclusion The risk prediction model for in-hospital mortality of patients on VA-ECMO has good differentiation,calibration and clinical effectiveness and outperforms the commonly used disease severity scoring system,and thus can be used for assessing disease severity and prognostic risk level in critically ill patients.

Compared with simple stress urinary incontinence (SUI), complicated female SUI is more diverse in etiology and more difficult to treat.Based on domestic and foreign literature and our diagnosis and treatment experience, this paper makes a detailed introduction to the definition, diagnosis, evaluation and clinical treatment of complicated female SUI, so as to provide guidance and reference for the treatment of this disease.

Objective To investigate the risk factors of in-hospital mortality and establish a risk prediction model for patients receiving venoarterial extracorporeal membrane oxygenation(VA-ECMO).Methods We retrospectively collected the data of 302 patients receiving VA-ECMO in ICU of 3 hospitals in Guangdong Province between January,2015 and January,2022 using a convenience sampling method.The patients were divided into a derivation cohort(201 cases)and a validation cohort(101 cases).Univariate and multivariate logistic regression analyses were used to analyze the risk factors for in-hospital death of these patients,based on which a risk prediction model was established in the form of a nomogram.The receiver operator characteristic(ROC)curve,calibration curve and clinical decision curve were used to evaluate the discrimination ability,calibration and clinical validity of this model.Results The in-hospital mortality risk prediction model was established based the risk factors including hypertension(OR=3.694,95%CI:1.582-8.621),continuous renal replacement therapy(OR=9.661,95%CI:4.103-22.745),elevated Na2+ level(OR=1.048,95%CI:1.003-1.095)and increased hemoglobin level(OR=0.987,95%CI:0.977-0.998).In the derivation cohort,the area under the ROC curve(AUC)of this model was 0.829(95%CI:0.770-0.889),greater than those of the 4 single factors(all AUC<0.800),APACHE Ⅱ Score(AUC=0.777,95%CI:0.714-0.840)and the SOFA Score(AUC=0.721,95%CI:0.647-0.796).The results of internal validation showed that the AUC of the model was 0.774(95%CI:0.679-0.869),and the goodness of fit test showed a good fitting of this model(χ2=4.629,P>0.05).Conclusion The risk prediction model for in-hospital mortality of patients on VA-ECMO has good differentiation,calibration and clinical effectiveness and outperforms the commonly used disease severity scoring system,and thus can be used for assessing disease severity and prognostic risk level in critically ill patients.

OBJECTIVE: To explore the clinical characteristics and genetic basis of a child with autism spectrum disorder (ASD) in conjunct with congenital heart disease (CHD). METHODS: A child who was hospitalized at the Third People's Hospital of Chengdu on April 13, 2021 was selected as the study subject. Clinical data of the child were collected. Peripheral blood samples of the child and his parents were collected and subjected to whole exome sequencing (WES). A GTX genetic analysis system was used to analyze the WES data and screen candidate variants for ASD. Candidate variant was verified by Sanger sequencing and bioinformatics analysis. Real-time fluorescent quantitative PCR (qPCR) was carried out to compare the expression of mRNA of the NSD1 gene between this child and 3 healthy controls and 5 other children with ASD. RESULTS: The patient, an 8-year-old male, has manifested with ASD, mental retardation and CHD. WES analysis revealed that he has harbored a heterozygous c.3385+2T>C variant in the NSD1 gene, which may affect the function of its protein product. Sanger sequencing showed that neither of his parent has carried the same variant. By bioinformatic analysis, the variant has not been recorded in the ESP, 1000 Genomes and ExAC databases. Analysis with Mutation Taster online software indicated it to be disease causing. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), the variant was predicted to be pathogenic. By qPCR analysis, the expression level of mRNA of the NSD1 gene in this child and 5 other children with ASD was significantly lower than that of the healthy controls (P < 0.001). CONCLUSION The c.3385+2T>C variant of the NSD1 gene can significantly reduce its expression, which may predispose to ASD. Above finding has enriched the mutational spectrum the NSD1 gene.
Male ; Child ; Humans ; Autism Spectrum Disorder/genetics* ; Heart Defects, Congenital/genetics* ; Computational Biology ; Genomics ; Mutation ; RNA, Messenger/genetics* ; Histone-Lysine N-Methyltransferase/genetics*

Objective:To collect data on urinary flow rate in the elderly female population across the country and to analyze the range of reference values.Methods:This study enrolled 333 subjects from July 2020 to June 2022.The study implementation process was divided into two steps.In the first step, subjects completed an electronic questionnaire, which included basic information about the subject, a short form for urinary incontinence, and a scoring form for the symptoms of overactive bladder syndrome.In the second step, the staff introduced the use of a mobile uroflowmetric device and distributed the instrument and materials.Uroflow rate data were automatically uploaded to a cloud database via the mobile phone.Subsequently, two or more physicians specializing in urinary control performed Uroflow rate-qualifying screenings and conducted statistical analyses.Results:A total of 333 subjects were enrolled in the study, and the researchers collected 1375 qualified urine flow rate records using a mobile urine flow rate instrument.The age of the subjects ranged from 60 to 84 years, with a mean age of 69 years.The reference ranges for urinary flow rate were found to be 24.8-26.2 s, with a mean urinary flow rate of 12.2-12.9 ml/s, a maximum urinary flow rate of 22.2-23.4 ml/s, and a time to peak of 8.5-9.7 s. The study observed a tendency for both maximal and mean urinary flow rates to decrease in older women as their age increased(Pearson correlation coefficient: -0.1, P<0.001). Conclusions:The uroflow rate of older women decreases with aging.Specifically, the average uroflow rate of women over 80 years old is lower than that of other age groups.This study aims to establish normal uroflow parameters for uroflowmetry in healthy older women in China.

Objective To compare the principles and performance of three Hough transform algorithms(standard Hough transform,gradient based Hough transform,and random Hough transform)in order to establish a suitable control basis for precise and rapid recognition of targets and acquisition of target center coordinates for craniocerebral puncture robots.Methods A simulation environment in MATLAB software was built to study and analyze image feature recognition,filtering,edge detection,cumulative voting and other processing engineering.Contour recognition and fitting of target circles were achieved in multiple scenarios before their center coordinates were obtained.The recognition and fitting performance of these algorithms was quantitatively compared.Finally,a better detection algorithm based on the actual environment of the craniocerebral puncture robot was determined.Results The standard Hough transform algorithm had the largest error between the mark circle and the target circle,and the running time of this algorithm was the longest due to large computation.The detection speed of the random Hough transform algorithm was lower than that of the gradient-based Hough transform algorithm,but the fitting accuracy was slightly better than that of the standard Hough transform algorithm.The speed and accuracy of circle fitting based on the gradient Hough transform algorithm had significant advantages over the other two.Conclusion The gradient based Hough transform algorithm is more suitable for obtaining the target center coordinates of the craniocerebral puncture robot system.

Objective:To explore the predictive value of peripheral blood CD34-positive cell count for the stem cell mobilization effect of plerixafor in patients with multiple myeloma (MM).Methods:The clinical data of 12 MM patients who used plerixafor for stem cell mobilization in the First Affiliated Hospital of Guangxi Medical University from December 2019 to February 2021 were retrospectively analyzed. The changes of peripheral blood CD34-positive cell count and the collection status of stem cell in all patients before and after the mobilization of plerixafor were analyzed.Results:Twelve patients were included in this study. These patients were in international staging system (ISS) stage Ⅱ-Ⅲ, and the induction therapy was mainly VRD regimen. The CD34-positive cell count was increased after the use of plerixafor in all patients no matter which mobilization strategies were used before plerixafor. The CD34-positive cell count was 3.63/μl (0.72-13.53/μl) and 32.11/μl (8.52-53.68/μl) before and after the use of plerixafor, and the difference was statistically significant ( Z = -0.40, P<0.001); the median increasing time was 11.50 times (1.61-23.71 times). The mobilization failure occurred in 1 patient. The CD34-positive cell count in his blood was less than 1/μl before the use of plerixafor; though increased 11.83 times after the use of plerixafor, the CD34-positive cell count was still less than 10/μl. Pearson analysis showed that among the patients with CD34-positive cell count less than 4/μl before the use of plerixafor, there was a positive correlation in peripheral blood CD34-positive cell count before and after the use of plerixafor ( r = 0.80, P = 0.032). Conclusions:The peripheral blood CD34-positive cell count has a certain predictive value for the stem cell mobilization effect of plerixafor in MM patients.

Objective:To investigate the changes of choroid thickness in adolescents with different types of non-pathological high myopia (HM).Methods:A retrospective observational study. From January 2021 to April 2022, 179 eyes of 101 adolescents with myopia in Liaocheng Aier Eye Hospital were collected and analyzed. According to the spherical equivalent (SE) and corneal curvature, subjects were divided into mild myopia or emmetical eye group (control group), HM group, occult HM group (OHM group) and super HM group (SHM group). There were 52 eyes in 30 cases, 47 eyes in 26 cases, 42 eyes in 24 cases and 38 eyes in 21 cases, respectively. Medical optometry, intraocular pressure, optical coherence tomography (OCT), axial length (AL) and corneal curvature were measured. The macular foveal choroidal thickness was analyzed by using spectral-domain OCT. The diopter was expressed in SE. The thickness of choroid in the fovea of macular region was measured by enhanced deep imaging with frequency domain OCT. The thickness of choroid was measured in 9 regions within 1 mm, 3 mm from the fovea, including the upper, lower, nasal and temporal regions. Generalized estimating equation was used to compare the data among groups, and the least significant difference t-test was used to compare the data among groups. The correlation between AL, corneal curvature, intraocular pressure and choroidal thickness was analyzed by Pearson correlation. Results:The choroidal thickness in the foveal macula and the areas 1 mm and 3 mm away from the fovea were compared among the control group, HM group, OHM group and SHM group, the difference were significant ( χ2=76.646, 36.715, 27.660, 35.301, 24.346, 38.093, 36.275, 33.584, 36.050; P<0.05). Compared with the control group, the choroidal thickness of the fovea and the choroidal thickness in each area within 1 and 3 mm from the fovea in the HM group, the OHM group and the SHM group were significantly thinner than those in the control group, and the difference was statistically significant ( P<0.05). There were statistically significant differences in choroidal thickness in each region between the group and the SHM group, and between the OHM group and the SHM group ( P<0.05). The results of correlation analysis showed that AL was negatively correlated with choroidal thickness in various regions ( P<0.05); SE was positively correlated with choroidal thickness in various regions ( P<0.05); corneal curvature and intraocular pressure had no significant correlation with choroidal thickness in various regions ( P>0.05). Conclusions:The choroidal thickness of SHM is significantly lower than that of OHM and HM; OHM patients have lower SE. However, the choroidal thickness is significantly thinner. AL and SE are the influencing factors of choroidal thickness.

OBJECTIVE: To assess the predictors and outcomes of acute kidney injury (AKI) among patients with coronavirus disease 2019 (COVID-19). OBJECTIVE: This retrospective observational study was conducted among patients with a confirmed diagnosis of COVID-19 admitted to Hankou Hospital between January, 5 and March 8, 2020. We evaluated the association of AKI with the demographic and biochemical parameters and clinical outcomes of the patients using univariate regression analysis. OBJECTIVE: Atotal of 287 COVID-19 patients, including 55 with AKI and 232 without AKI, were included in the analysis. Compared with the patients without AKI, the patients with AKI were older, predominantly male, and were more likely to have hypoxia and pre-existing hypertension and cerebrovascular diseases. The patients with AKI also had higher levels of white blood cells, D-dimer, aspartate aminotransferase, total bilirubin, creatine kinase, lactate dehydrogenase, procalcitonin, C-reactive protein, a higher prevalence of hyperkalemia, lower lymphocyte counts, and higher chest computed tomographic scores. The incidence of stage 1 AKI was 14.3% and that of stage 2 or 3 AKI was 4.9%. The patients with AKI had much higher mortality rate than those without AKI. OBJECTIVE AKI is an important complication of COVID-19. An older age, a male gender, multiple pre- existing comorbidities, lymphopenia, increased infection indicators, elevated D-dimer, and impaired heart and liver functions are all potential risk factors ofAKI. COVID- 19 patients with AKI that progresses into stages 2 or 3 AKI have a high mortality rate. Prevention of AKI and monitoring kidney function is critical in the care of COVID-19 patients.
Acute Kidney Injury/epidemiology* ; Aged ; COVID-19 ; China/epidemiology* ; Humans ; Male ; Retrospective Studies ; SARS-CoV-2