Objective:To perform two-step clustering analysis based on urodynamics in patients with neurogenic bladder (NB) and exploring characteristics affecting success rate of sacral neuromodulation (SNM).Methods:The data of 174 NB patients who received SNM therapy in our hospital from September 2018 to August 2023, were retrospectively analysed. There were 94 males and 80 females, with average age of (50.4±17.9)years, median duration of 2 (1, 3)years, and body mass index of 21.5 (20, 25) kg/m 2. Among them, 50 patients had chronic diseases (hypertension or diabetes). Additionally, 77 patients (44.3%) presented with voiding symptoms, 47 patients (27.0%) with storage symptoms, and 50 patients (28.7%) with mixed symptoms. The etiologies included spinal cord lesions in 110 patients (63.2%), brain lesions in 21 patients (12.1%), peripheral nerve lesions in 36 patients (20.7%), and other causes in 7 patients (4.0%). All patients underwent urodynamics and SNM phase 1 test. If patient's subjective symptoms or objective indicators improved > 50%, it is defined as treatment success and feasible to received second stage of SNM. The success rate was analyzed. Clinical indicators and urodynamic parameter were collected for exploring the difference of the above indicators between two groups (with or without conversion). The 174 patients were grouped using two-step clustering analysis, dividing them into two groups. The differences in clinical data, urodynamic parameters, and the conversion rate of SNM phase II between the two groups were compared. Results:Among these patients, 126 (72%) underwent the second stage of SNM. Compared with the non-conversion group, patients in the conversion group exhibited the following characteristics: high proportion of female[51.6% (65/126) vs. 31.2% (15/48)], younger[(48.1± 18.3)year vs. (56.4±15.4) year], lower proportion of history of chronic disease[23.9% (30/126) vs. 41.7% (20/48)], storage predominant symptoms predominant[33.3% (42/126) vs. 10.4% (5/48)], sensitive bladder sensation[50.0% (63/126) vs. 11.1% (14/48)], normal detrusor contractility [26.2% (33/126) vs. 10.4% (5/48)] and detrusor-sphincter dyssynergia [21.4% (27/126) vs. 4.2% (2/48)]and lower post-void residual [105.5(49.3, 231.3) ml vs. 197.9(114.8, 284.8) ml], ( P<0.05). After excluding multicollinearity, patients were divided into two group mainly based on coordination, detrusor stability, and detrusor contractility through two-step clustering analysis: 98 patients in Group 1 and 76 patients in Group 2. The success rate was higher in Group 2 [82.9% (63/76) vs. 64.3% (63/98), P=0.006]. Compared with Group 1, Group 2 exhibited the following characteristics: higher proportion of storage symptoms [43.4% (33/76) vs. 14.3% (14/98)], sensitive bladder sensation [67.1% (51/76) vs. 26.5% (26/98)], detrusor overactivity [46.1% (35/76) vs. 3.1% (3/98)], normal detrusor contractility [43.4% (33/76) vs. 5.1% (5/98)], and detrusor-sphincter dyssynergia [38.2% (29/76) vs. 0] ( P all<0.05). Additionally, group 2 had lower post-void residual [69.0 (23.8, 136.6) ml and 197.9 (123.2, 287.4) ml] and smaller bladder capacity [(281.9±144.9) ml vs. (430.4±176.7) ml] ( P all<0.01). Conclusions:Patients with storage symptoms, low post-void residual, sensitive bladder sensation, detrusor overactivity, normal contractility, or detrusor-sphincter dyssynergia indicate a higher conversion rate to second stage, making them more suitable for SNM testing.

Objectives:To evaluate the preoperative prediction methods of osteotomy angle of thoracolumbar kyphosis in ankylosing spondylitis(AS)patients,and to analyze their clinical values in reconstruction of spinopelvic sagittal alignment.Methods:22 AS patients with thoracolumbar kyphosis,who underwent single segment pedicle subtraction osteotomy(PSO)from January 2015 to January 2022 in the First Affiliated Hospital of Xinjiang Medical University,were retrospectively reviewed.There were 17 males and 5 females with a mean age of 44.3±7.4 years(range,29-56 years).Preoperative and postoperative spinopelvic parameters were measured on X-ray lateral radiographs,osteotomy angles were predicted with different methods,full balance integated index(FBI),spine femoral angle(SFA),hilus pulmonis-hip axis(HP-HA),center of both acoustic meati-hip axis(CAM-HA),and Surgimap method.And theoretical spinopelvic parameters and theoretical os-teotomy angle were calculated according to pelvic incidence(PI).The differences between preoperative,final follow-up and theoretical spinopelvic parameters,and between the predictive,actual and theoretical osteotomy angles,were compared.Results:The osteotomy sites of the 22 cases included 4 in L1,10 in L2 and 8 in L3.All the patients achieved ideal imaging and surgical results.The differences in pelvic tilt(PT),sacral slope(SS),lumbar lordosis(LL),thoracic kyphosis(TK),thoracolumbar kyphosis(TLK),global kyphosis(GK),and sagittal vertical axis(SVA)between final follow-up and preoperation were statistically significant(P＜0.05).The osteotomy angles predicted with FBI,SFA,HP-HA,CAM-HA,and Surgimap methods were 50.5°±12.1°,52.0°±11.3°,53.9°±8.1°,51.3°±5.8°,and 43.2°±9.2°,respectively,with statistically significant differences(F=2.342,P=0.046).The theoretical osteotomy angle required by simulated osteotomy to restore the ideal spinopelvic sagittal alignment was 51.2°±8.1°,which wasn't statistically different from the osteotomy angles predicted with FBI,SFA,HP-HA or CAM-HA methods(P＞0.05).The actual osteotomy angle during the operation was 41.1°±5.4°,which was statistically different from the osteotomy angles predicted with FBI,SFA,HP-HA and CAM-HA methods(P＜0.05),but not statistically different with the angle predicted with Surgimap method(P＞0.05).Conclusions:The osteotomy angles predicted with FBI,SFA,HP-HA,and CAM-HA methods are similar with the theoretical osteotomy angle,while different from the actual osteotomy angle to some extent;The osteotomy angle predicted with Surgimap method is similar with the actual osteotomy angle.

Objective: To investigate the antibacterial effect of a new photosensitizer, indocyanine green (ICG)-mediated photodynamic therapy, on a biofilm of Fusobacterium nucleatum (F. nucleatum) in vitro. Methods: The biocompatibility of the photosensitizer ICG was detected by CCK8. F. nucleatum (108 CFU/mL) was cultured in anaerobic conditions (80% N2, 10% H2 and 10% CO2) mixed with the photosensitizer ICG at concentrations of 0, 10, 20, 30, and 40 μg/mL and then treated with antibacterial photodynamic therapy (808 nm near infrared light with an intensity of 0.1 W/cm2 for 3 min), and a mature biofilm was formed after 2 days. The bacteriostatic effects of different concentrations of ICG on F. nucleatum biofilms were compared by colony formation unit count (CFU). The effect of ICG on the formation of F. nucleatum biofilms and biofilm metabolic activity was determined by crystal violet quantification and MTT assays. The effect of ICG on the formation of extracellular polysaccharides in F. nucleatum biofilms was determined by the phenol-sulfuric acid method. The change in the number of bacteria was observed by confocal microscopy. Results : CFU and biomass of the biofilm gradually decreased with increasing ICG concentration, and there were significant differences compared with the control group. Meanwhile, the metabolic activity of the biofilm and the production of extracellular polysaccharides also showed a significant difference between the ICG groups and the control group (P<0.01). At the same time, laser confocal microscopy showed that the number of living bacteria decreased gradually. Conclusion Antibacterial photodynamic therapy with photosensitizer ICG can effectively inhibit the formation of F. nucleatum biofilms.

The vagina contains at least a billion microbial cells,dominated by lactobacilli.Here we perform metagenomic shotgun sequencing on cervical and fecal samples from a cohort of 516 Chinese women of reproductive age,as well as cervical,fecal,and salivary samples from a second cohort of 632 women.Factors such as pregnancy history,delivery history,cesarean section,and breastfeeding were all more important than menstrual cycle in shaping the microbiome,and such information would be necessary before trying to interpret differences between vagino-cervical micro-biome data.Greater proportion of Bifidobacterium breve was seen with older age at sexual debut.The relative abundance of lactobacilli especially Lactobacillus crispatus was negatively associated with pregnancy history.Potential markers for lack of menstrual regularity,heavy flow,dysmenor-rhea,and contraceptives were also identified.Lactobacilli were rare during breastfeeding or post-menopause.Other features such as mood fluctuations and facial speckles could potentially be predicted from the vagino-cervical microbiome.Gut and salivary microbiomes,plasma vitamins,metals,amino acids,and hormones showed associations with the vagino-cervical microbiome.Our results offer an unprecedented glimpse into the microbiota of the female reproductive tract and call for international collaborations to better understand its long-term health impact other than in the settings of infection or pre-term birth.

The adjacent anatomy of the pelvis is complicated, with digestive, urinary, reproductive and other organs as well as important blood vessels and nerves. Therefore, accurate resection of pelvic tumors and precise reconstruction of defects after resection are extremely difficult. The development of medical 3D printing technology provides new ideas for precise resection and personalized reconstruction of pelvic tumors. The “triune” application of 3D printing personalized lesion model, osteotomy guide plate and reconstruction prosthesis in pelvic tumor limb salvage reconstruction treatment has achieved good clinical results. However, the current lack of normative guidance standards such as preparation and application of 3D printing personalized lesion model, osteotomy guide plate and reconstruction prosthesis restricts its promotion and application. The formulation of this consensus provides normative guidance for 3D printing personalized pelvic tumor limb salvage reconstruction treatment.

The main content of the 2019 Myasthenia Gravis Foundation of America Scientific Session is summarized, and the main conclusions are presented as follows: Muscle-specific receptor tyrosine kinases antibody positive myasthenia gravis (MuSK-MG) is still the research hot spot in MG research fields, including the clinical researches, the clinical pharmaceutical researches and the fundamental experiment researches. Thymectomy shows safety and effectiveness for acetycholine receptor antibody positive MG (AChR-MG). However, thymectomy needs further discussion about the safety and effectiveness for other types of MG. AChR-MG patients with or without thymoma can benefit from thymectomy. Now there are still no special effective drugs to cure MG, and monoclonal antibody drugs are the hopes for MG patients. With the emergence of different kinds of monoclonal antibodies, MG will be more likely to be conquered. More attention has been paid to the role of B cells′ origin and apoptosis abnormality in the pathogenesis of MG in MG researches.

The authors introduced the hotspots and forefront of 2018 Myasthenia Gravis Foundation of America′s Scientific Session, including the research forefront and trend of the following:International research hotspots in the myasthenia gravis (MG) had been changed from the most common acetylcholine receptor antibody positive MG (AChR?MG) into other subtypes, particularly muscle specific tyrosine kinase receptor antibody positive MG; The efficacy of thymectomy was effective in the whole AChR?MG group, but not in other MG subgroups; Existing drugs in MG treatment can not achieve the expected effect, so endless new drug development had become a hot field of MG research; In terms of basic research, more attention had been paid to exploring the specific mechanisms involved in MG pathogenesis, including the study of antigen specific B cells and even antigen specific T cells.

Objective: To evaluate the effect of the "Interner Plus-based AIDS Comprehensive Prevention Service System" among MSM in Guangzhou, during 2010-2017, using a dynamic compartmental model. Methods: A dynamic compartmental model was developed to describe the HIV situation among MSM in Guangzhou. This model was parameterized on data from published literature or surveillance programs from the Guangzhou CDC. The Matlab 7.0 software was used for coding and analysis on collected data. HIV prevalence was analyzed among MSM under the status quo data and estimated the impact by the "Internet Plus" AIDS prevention services project. Results: HIV prevalence would have increased to 22.75% in 2017, and the total number of new HIV infections would have been 11 038, from 2010 to 2017, using the data status quo. Under the Guangzhou "Internet Plus" AIDS prevention services project, the prevalence of HIV among MSM from 2010 to 2017 was estimated to be 8.44%, 9.68%, 10.65%, 11.34%, 11.73%, 11.83%, 11.71% and 11.43% in Guangzhou, which were similar to the surveillance data. The total number of new infections in the past 8 years under the "Internet Plus" scenario was estimated to be 4 009. The "Internet Plus" program would have prevented 7 029 (63.68%) new infections during 2010-2017 as compared to the number, status quo. Conclusions The fitting result of dynamic compartmental model seemed more reasonable, which was applicable to predict HIV epidemic among MSM in Guangzhou, suggesting that the increase of HIV prevalence had been curbed since the "Internet Plus" project which was launched in 2010, and the "Interner Plus-based AIDS Comprehensive Prevention Service System" had achieved the purpose as planned, epidemiologically.

The authors introduced the hotspots and forefront of 2018 Myasthenia Gravis Foundation of America′s Scientific Session, including the research forefront and trend of the following: International research hotspots in the myasthenia gravis (MG) had been changed from the most common acetylcholine receptor antibody positive MG (AChR-MG) into other subtypes, particularly muscle specific tyrosine kinase receptor antibody positive MG; The efficacy of thymectomy was effective in the whole AChR-MG group, but not in other MG subgroups; Existing drugs in MG treatment can not achieve the expected effect, so endless new drug development had become a hot field of MG research; In terms of basic research, more attention had been paid to exploring the specific mechanisms involved in MG pathogenesis, including the study of antigen specific B cells and even antigen specific T cells.

Objective To introduce the development strategy of“Internet Plus”AIDS prevention services and its implementation results from 2010 to 2015 in Guangzhou, China. Methods A gay men's health column was created for an active website aimed at men who have sex with men (MSM), in collaboration with local community organizations and the Guangzhou CDC. We designed intervention tools (including scenario-based applications and HIV risk self-assessment systems) and an online HIV testing service platform, integrated with applied psychology and behavioral theory as well as the“Internet Plus”concept, to intervene in HIV infection risk factors among MSM. Data of clients who accessed the“Internet Plus”AIDS services from 2010 to 2015 were used to evaluate service operation. Six-year consecutive surveys, conducted between April and July of each service year, were collected using a national AIDS sentinel surveillance questionnaire. For each year of surveillance, information on HIV prevalence, HIV interventions received during the past year, unprotected anal intercourse in the past 6 months, and HIV testing in the past year were compared using the chi-squared (χ2) test, to roughly reflect the effect of“Internet Plus”AIDS prevention services. Results As of 31 December 2015, a total of 34 395 MSM had received“Internet Plus”services and HIV testing. The number of MSM tested increased from 2 338 in 2010 to 8 054 in 2015. From 2010 to 2015, newly identified HIV cases in each year were 59, 166, 312, 283, 291, and 270, which accounted for 25.0%, 32.8%, 38.8%, 35.1%, 30.5%, and 23.2% of MSM HIV cases of Guangzhou, respectively. Sentinel surveillance data showed that during the study period, 3 047 MSM were investigated, with 405, 400, 401, 633, 608, and 600 each year, respectively. The proportion of participants who had received any HIV intervention during the past year was 74.3% (301), 70.8% (283), 83.3% (334), 85.0%(538), 69.1%(420), and 83.8%(503) each year, respectively (trend χ2=6.53, P=0.011). HIV testing done during the past year accounted for 44.0%(178), 44.3%(177), 49.4%(198), 53.4%(338), 56.1%(341), and 60.2%(361) each year, respectively (trendχ2=40.83, P<0.001). Unprotected anal intercourse in the past 6 months accounted for 59.3% (240), 62.0% (248), 56.6% (227), 57.0% (361), 48.4% (294), and 43.7%(262) each year, respectively (trend χ2=42.21, P<0.001). Conclusion The“Internet Plus”AIDS prevention services in this study represent a manner to enhance traditional HIV prevention strategies. We found these services to be effective in implementation of the national AIDS control and prevention strategy, especially for the expansion of intervention, testing, and case identification among high-risk populations.