OBJECTIVES: Stress urinary incontinence (SUI) is a common condition among women that severely impairs quality of life. Pelvic floor proprioceptive training (PFPT) has attracted increasing attention for its potential to enhance pelvic floor muscle function and alleviate SUI symptoms. This study aims to observe and compare the clinical efficacy of PFPT combined with electroacupuncture, electrical stimulation, and biofeedback therapy versus conventional therapy consisting of electroacupuncture, electrical stimulation, and biofeedback alone in women with SUI, and to explore the role of PFPT in improving symptom and functional outcomes. METHODS: In this randomized controlled trial, 72 women with mild to moderate SUI were recruited from the Department of Rehabilitation Medicine at Third Xiangya Hospital, Central South University, between December 2021 and October 2023. Participants were randomly assigned to an experimental group (n=36) or a control group (n=36). Both groups received health education. The control group underwent electroacupuncture combined with electrical stimulation and biofeedback therapy, while the experimental group additionally received PFPT 3 times per week for 4 weeks. The primary outcome was assessed using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF). Secondary outcomes included pelvic floor muscle strength, bladder neck mobility, and balance ability. The ICIQ-SF was reassessed at 1, 3, 6, and 12 months post-treatment. RESULTS: Both groups showed statistically significant improvements in all parameters after treatment (all P<0.05). However, there were no statistically significant differences between groups in most measures (all P>0.05). The experimental group demonstrated longer single-leg stance duration with eyes closed than the control group (left leg: P=0.026; right leg: P=0.006), with a significant increase from baseline (P<0.001). At 6 months post-treatment, the cure rate in the experimental group was significantly higher than that in the control group (P=0.037). CONCLUSIONS Conventional therapy effectively improves SUI symptoms, but adding PFPT provides notable additional benefits, including enhanced balance ability and sustained mid-term cure rates. These findings suggest that PFPT is a valuable adjunct to standard SUI management strategies.
Humans ; Female ; Urinary Incontinence, Stress/physiopathology* ; Pelvic Floor/physiopathology* ; Middle Aged ; Biofeedback, Psychology ; Adult ; Exercise Therapy/methods* ; Proprioception ; Electroacupuncture/methods* ; Quality of Life ; Electric Stimulation Therapy/methods* ; Treatment Outcome ; Combined Modality Therapy

Objective:To evaluate the therapeutic effectiveness of adult patients with Kashin-Beck disease (KBD) in Gansu Province, and provide guidance for rational and effective treatment of KBD patients.Methods:The KBD patients who participated in the "2021 Basic Public Health Service Subsidy Key Endemic Disease Prevention and Control Project" in Gansu Province were selected as the research subjects. Gender, age, clinical grading characteristics, and treatment plan selection of all subjects were analyzed, and the treatment effectiveness of KBD patients in different regions was evaluated.Results:A total of 6 711 KBD patients were included in the treatment program, including 3 139 males (46.8%) and 3 572 females (53.2%), 3 157 cases (47.0%) of patients aged 60 and 3 554 cases (53.0%) over 60 years old. There were 3 921, 2 166, and 624 patients with grades Ⅰ, Ⅱ, and Ⅲ, respectively, accounting for 58.4%, 32.3%, and 9.3%, respectively. The gender, age composition, and clinical grading among KBD patients included in different regions were compared, and the differences were statistically significant (χ 2 = 194.34, 47.44, 408.61, P < 0.001). In the distribution of treatment schemes, the number of patients who selected "drug treatment", "drug treatment combined with physical therapy", "drug treatment combined with acupuncture and moxibustion/massage", "drug treatment combined with acupuncture and moxibustion/massage combined with physical therapy", and "other treatment schemes" were 4 084 (60.9%), 726 (10.8%), 672 (10.0%), 443 (6.6%), and 786 (11.7%), respectively. The distribution of treatment plans in different regions was compared, and the difference was statistically significant (χ 2 = 1 088.38, P < 0.001). The total effective rate of KBD patients was 84.5% (5 668/6 711). The total effective rates of KBD patients with different clinical grades were ranked from high to low as grade Ⅲ (87.3%, 545/624), grade Ⅱ (86.4%, 1 871/2 166), and grade Ⅰ (82.9%, 3 252/3 921). The total effective rate of KBD patients with different treatment schemes from high to low was "drug treatment combined with acupuncture and moxibustion/massage combined with physical therapy" (91.0%, 403/443), "drug treatment combined with physical therapy" (87.1%, 632/726), "drug treatment" (86.7%, 3 539/4 084), "drug treatment combined with acupuncture and moxibustion/massage" (82.3%, 553/672), and "other treatment schemes" (68.8%, 541/786). The total effective rate of KBD patients in different regions, from high to low, was as follows: Linxia Hui Autonomous Prefecture (100%, 144/144), Qingyang City (88.7%, 3 562/4 017), Pingliang City (85.0%, 1 327/1 562), Gannan Tibetan Autonomous Prefecture (83.9%, 78/93), Dingxi City (70.9%, 151/213), Tianshui City (62.5%, 125/200), and Longnan City (58.3%, 281/482). The total effective rate of KBD patients in different clinical grades, treatment schemes, and regions was compared, and the differences were statistically significant (χ 2 = 16.95, 181.72, 435.80, P < 0.001). Conclusions:The overall effective rate of treatment for KBD patients in Gansu Province is relatively high, but there are significant differences in therapeutic outcomes among cities (prefectures); it is related to the treatment scheme and the clinical grading of patients. The scheme of "drug treatment combined with acupuncture and moxibustion/massage combined with physical therapy" has better efficacy.

Objective:To analyze the liver histological characteristics and clinically related factors in inactive hepatitis B surface antigen (HBsAg) carriers (IHC), and also explore whether antiviral treatment is necessary for IHC, as defined in the 2022 version of the hepatitis B prevention and treatment guidelines.Methods:A multicenter, retrospective cohort study was conducted. Two hundred and thirty-one IHC cases who underwent liver biopsy histopathological examination in nine medical institutions, including Beijing Youan Hospital affiliated with Capital Medical University, from January 2018 to December 2023 were included. General informative data, clinical serological markers, and transient elastography (TE) examination results were collected. Patients were divided into a positive (148 cases) and a negative group (83 cases) according to the results of hepatitis B virus (HBV) DNA detection. The differences in liver pathological inflammatory activity (G) and liver fibrosis stage (S) were analyzed between the two groups to explore the correlation between liver tissue conditions and clinically related factors. Comparsions of normally distributed continwous data, skeukd continuous data, and categorical data between groups are performed using t tests, Mann-Whitney U tests and χ2 tests, respectively. Results:The age of 231 IHC cases was 43 (38, 51) years old, with 95.2% (220/231) aged ≥30 years, and males accounted for 64.9% (150/231). HBsAg and HBV DNA levels were 131.9 (20.8, 400.9) IU/mL and 94.0 (0, 448.5) IU/mL, respectively, of which 35.9% (83/231) were HBV DNA negative (<20 IU/mL). The remarkable proportions of G≥2, S≥2, and liver injury (G≥2 and/or S≥2) in liver tissue were 16.5% (38/231), 29% (67/231), and 35.9% (83/231), respectively. The S≥2 proportion was significantly higher in the HBV DNA-negative group than the positive group (42.2% vs. 21.6%, P<0.001), and it mainly occurred in the population cohort over 30 years old (44.9% vs. 31.0%, P=0.04). The liver stiffness measurement (LSM), aspartate transaminase to platelet ratio index (APRI), and platelet (PLT) were significantly higher in the S≥2 group than the S<2 group ( P<0.05). Conclusion:Clinicians can comprehensively evaluate the degree of liver fibrosis in IHC based on clinical factors such as age, PLT, APRI, and LSM, even if the liver histological results are lacking. The China 2022 version guidelines define that nearly half of IHC has histological indications for antiviral therapy, and liver biopsy and prompt treatment can be recommended.

Objective To investigate the predictive value of serum lactate dehydrogenase(LDH)level com-bined with high-throughput sequencing in children with severe Mycoplasma pneumoniae pneumonia(SMPP).Methods The clinical data of 99 children with Mycoplasma pneumoniae pneumonia(MPP)admitted to Hua-zhong University of Science and Technology Union Hospital from October 2023 to March 2024 were retro-spectively analyzed.According to the severity of the disease,the children were divided into mild group(33 ca-ses)and severe group(66 cases).Spearman correlation analysis was used for correlation analysis,Logistic re-gression was used to analyze the influencing factors of SMPP,and the receiver operating characteristic(ROC)curve was used to evaluate the value of LDH in predicting SMPP.Results The level of LDH in the severe group was higher than that in the mild group(P<0.05).The results of high-throughput sequencing showed that the proportions of virulence positive and drug resistance gene A2063G mutation in the severe group were higher than those in the mild group(P<0.05).Multivariate Logistic regression analysis showed that LDH level and drug resistance gene A2063G mutation were related to the SMPP(P<0.05).ROC curve analysis showed that LDH combined with high-throughput sequencing detection of drug resistance gene A2063G muta-tion had a high value in predicting SMPP,and the area under the curve was 0.724.Conclusion Serum LDH combined with high-throughput sequencing detection of drug resistance gene A2063G mutation can be used as an effective indicator to predict SMPP.

Objective:To explore the risk factors for severe acute kidney injury (AKI) in children with sepsis in the pediatric intensive care unit (PICU) and construct a prediction model to assist early clinical identification.Methods:A retrospective analysis was performed on clinical data of 987 children with sepsis admitted to the PICU of Hunan Children′s Hospital from July 1, 2018 to January 31, 2021. Children who developed severe AKI during hospitalization were included in the AKI stage 2-3 group ( n=228), and the remaining were included in the No-AKI/AKI stage 1 group ( n=759). General information and biochemical indicators were compared between the two groups. Logistic regression analysis was used to identify risk factors for severe AKI in children with sepsis, and a prediction model and nomogram were established. Results:The mortality rate in the AKI stage 2-3 group was 2.49 times that of the No-AKI/AKI stage 1 group [31.1%(71/228) vs 12.5%(95/759), P<0.05]. Compared with the No-AKI/AKI stage 1 group, the AKI stage 2-3 group had lower levels of platelet count (PLT), total protein (TP), albumin (ALB), antithrombin Ⅲ (AT3), and fibrinogen (FIB), but higher levels of lactate dehydrogenase (LDH), serum creatinine (SCr), blood urea nitrogen (BUN), magnesium ion (Mg 2+ ), activated partial thromboplastin time (APTT), fibrinogen degradation products (FDP), and D-dimer (D-D) (all P<0.05), with no significant difference in total bile acid (TBAC) ( P>0.05). Multivariate logistic regression analysis showed that decreased AT3 ( OR=0.989, 95% CI: 0.980-0.997, P=0.007), increased LDH ( OR=1.001, 95% CI: 1.000-1.001, P<0.001), increased SCr ( OR=1.051, 95% CI: 1.037-1.066, P<0.001), and increased BUN ( OR=1.099, 95% CI: 1.028-1.174, P=0.005) were risk factors for severe AKI in children with sepsis. The prediction model was Logist Pr=-3.184-0.012 X1+ 0.001 X2+ 0.050 X3+ 0.094 X4 ( X1=AT3, X2=LDH, X3=SCr, X4=BUN), with the optimal cut-off value of 0.374 (Youden index=0.560). A nomogram was constructed by binary assignment of predictive variables, with an area under the curve of 0.826 (95% CI: 0.790-0.861, P<0.001). Conclusions:The mortality rate of septic children with severe AKI in PICU is significantly increased. Decreased AT3, and increased LDH, SCr, and BUN are risk factors for severe AKI in children with sepsis. Clinicians should be alert to severe AKI when the predicted probability of the early warning model exceeds 0.374.

Purpose To investigate the distribution characteristics of tumor-associated macrophages(TAM)in different regions of breast cancer with enhanced contrast-enhanced ultrasound(CEUS),and to further explore the relationship between TAM and CEUS indicators and clinicopathology in different regions of breast cancer.Materials and Methods A total of 119 patients with suspected breast cancer admitted to the Cancer Hospital Affiliated to Xinjiang Medical University from March 2021 to March 2023 were prospectively included.CEUS was applied to the tumor,and ultrasound-guided puncture biopsy was also taken.The lesions diagnosed as breast cancer by pathology was outlined the central area,marginal area and normal area next to the cancer,and was obtained the time intensity curves of different areas.The tissues were taken for immunohistochemistry and flow cytometry,and the TAM cells were stained and distinguished.The characteristics of TAM in different regions of breast cancer and its correlation with clinical pathology were analyzed,respectively.Results By immunohistochemistry and flow cytometry,there were significant differences in the number of TAM infiltration in the border area,central area and adjacent area of breast cancer(immunohistochemistry:F=382.326,P<0.05;flow cytometry:F=24.955,P<0.05).The characteristics of CEUS in three different regions showed that the TAM in the central region of breast cancer increased when filling defect appeared(t=2.631,P<0.05),but the TAM in the peripheral region was more(t=2.999,P<0.05).After angiography,lesions showed high perfusion,and there was significantly more TAM in the edge and central area of the lesion than that in normal area next to the cancer(t=5.529,P<0.05;t=2.584,P<0.05).Clinical stage was related to the TAM in three regions.When the clinical stage was high,there were more TAM in all three regions(t=6.658,2.367,2.400,all P<0.05).Histological grading was high,and TAM in all three areas was high(F=101.151,16.922,26.822,all P<0.05).Conclusion There was a decreasing trend of TAM in the marginal area,central area and adjacent tissues of breast cancer during CEUS.The edge region has more malignant CEUS characteristics than that in the central region and the normal region adjacent to cancer;and the number of TAM is more in breast cancer with late clinical grading,poor tissue differentiation and obvious contrast-enhanced ultrasound malignant characteristics.The distribution characteristics of TAM represent the malignant degree and metastatic probability of breast cancer to a certain extent,and TAM is a factor related to the invasion of breast cancer.

Objective:To investigate the iodine nutrition status of children aged 8-10 and pregnant women in Longxi County, Gansu Province.Methods:Descriptive epidemiological method was used to analyze the water iodine monitoring data in 2017 and the iodine deficiency disorders monitoring data from 2017 to 2023 in Longxi County (sourced from the Institute for Endemic Disease Prevention and Control of Gansu Provincial Center for Disease Control and Prevention), including the data of water iodine, salt iodine and urinary iodine levels of children aged 8 to 10 and pregnant women, and children's thyroid B-mode ultrasound examination results. Iodine nutrition was evaluated based on the "Guidelines for Monitoring Salt Iodization Projects and Determining Population Iodine Nutrition".Results:In 2017, a total of 85 water samples were collected, with a median iodine level of 1.6 μg/L, ranging from 0.2 to 10.9 μg/L. Except for one water sample with an iodine level of 10.9 μg/L, the iodine level of all other water samples was less than 10 μg/L. From 2017 to 2023, a total of 1 585 children and 718 pregnant women were monitored. The urinary iodine levels were 190.8 (120.2, 252.2), 137.0 (79.8, 195.8) μg/L, respectively. The coverage rate of iodized salt in Longxi County from 2017 to 2023 ranged from 99.4% to 100%, the consumption rate of qualified iodized salt ranged from 61.8% to 93.0%, and the qualified rate of iodized salt ranged from 62.1% to 93.0%. The median range of the urinary iodine for children in Longxi County was 125.9 to 228.5 μg/L. There was a statistically significant difference in the urinary iodine levels among children from different years ( P < 0.001). There was no statistically significant difference in urinary iodine levels among children of different genders and ages ( P > 0.05). There were statistically significant differences in the composition ratio of iodine nutrition status among children of different years, genders, and ages ( P < 0.05). The median range of urinary iodine in pregnant women was 121.0-180.5 μg/L. Except for 2017, the median urinary iodine of pregnant women in all other years was less than 150 μg/L. There were statistically significant differences in the urinary iodine levels and composition ratio of iodine nutrition status among pregnant women in different years ( P < 0.001). There was no statistically significant difference ( P > 0.05) in the urinary iodine levels and composition ratio of iodine nutrition status among pregnant women during different stages of pregnancy, and all pregnant women were iodine deficient in the early, middle, and late stages (median urinary iodine < 150 μg/L). Six hundred and sixty-five children underwent B-mode ultrasound examination, with a goiter rate ranging from 0 to 5.0%. Conclusion:From 2017 to 2023, the iodine nutrition of children aged 8 to 10 in Longxi County is in an appropriate state, while the iodine nutrition of pregnant women is in a deficiency state.

OBJECTIVE To evaluate the current status of bacterial contamination control and prevention measures and construction of quality control laboratory in Chinese blood station,and find out the problems and put forward the improvement suggestions.METHODS A total of 41 questionnaires were sent out for performance comparison by secretariat of working group of Chinese blood collection and supply institutions from May 2024 to Jun.2024,and 40 questionnaires were received(14 blood centers and 26 central blood stations),39 of which were valid.The questionnaire survey covered four aspects,including disinfection and surveillance,construction of quality control laboratory,sterility test for blood component and monitoring of blood transfusion reactions.The data were pro-cessed through itemized statistics and descriptive analysis.RESULTS Totally 84.62％of the blood stations used io-dine-containing disinfectants for arm disinfection of the blood donors,and the monthly monitoring was the primary frequency.Among the quality control laboratories,43.59％were registered as biosafety level 2,while 35.90％lacked biosafety registration.As for the pressure settings of the laboratories,64.10％were under normal pres-sure,15.38％under negative pressure and 17.95％under positive pressure.In the sterility test,the utilization rate of ultra clean operating tables and biological safety cabinets was 48.72％,the blood stations that did not have the indoor quality control accounted for 79.49％,and only 35.90％participated the external quality assessment.Regarding the approaches to confirm the positive result,25.64％of the blood stations adopted the re-peated tests,and 15.38％adopted the combination with positive culture bottle.The shortage of fund was the ma-jor restricted factor for the sterility test,and the confirmation of positive result was the fundamental difficulty.The blood stations with the feedback of insufficient transfusion reactions reported from hospitals ac-counted for 53.85％,while the blood stations that encountered suspected bacterial transfusion reactions with nega-tive culture results accounted for 25.64％.CONCLUSIONS The infeciton control and prevention measures and the construction of quality control laboratory vary significantly in Chinese blood stations.The incomplete biosafety registration,non-standardized sterility test operation and weak surveillance of blood transfusion reactions are the major existing problems.It is suggested that the investment should be increased to push forward the standardi-zation and complete the laboratory biosafety system,and a hospital-blood station closed loop coordination mecha-nism should be established so as to raise the blood safety.

OBJECTIVE To evaluate the current status of bacterial contamination control and prevention measures and construction of quality control laboratory in Chinese blood station,and find out the problems and put forward the improvement suggestions.METHODS A total of 41 questionnaires were sent out for performance comparison by secretariat of working group of Chinese blood collection and supply institutions from May 2024 to Jun.2024,and 40 questionnaires were received(14 blood centers and 26 central blood stations),39 of which were valid.The questionnaire survey covered four aspects,including disinfection and surveillance,construction of quality control laboratory,sterility test for blood component and monitoring of blood transfusion reactions.The data were pro-cessed through itemized statistics and descriptive analysis.RESULTS Totally 84.62％of the blood stations used io-dine-containing disinfectants for arm disinfection of the blood donors,and the monthly monitoring was the primary frequency.Among the quality control laboratories,43.59％were registered as biosafety level 2,while 35.90％lacked biosafety registration.As for the pressure settings of the laboratories,64.10％were under normal pres-sure,15.38％under negative pressure and 17.95％under positive pressure.In the sterility test,the utilization rate of ultra clean operating tables and biological safety cabinets was 48.72％,the blood stations that did not have the indoor quality control accounted for 79.49％,and only 35.90％participated the external quality assessment.Regarding the approaches to confirm the positive result,25.64％of the blood stations adopted the re-peated tests,and 15.38％adopted the combination with positive culture bottle.The shortage of fund was the ma-jor restricted factor for the sterility test,and the confirmation of positive result was the fundamental difficulty.The blood stations with the feedback of insufficient transfusion reactions reported from hospitals ac-counted for 53.85％,while the blood stations that encountered suspected bacterial transfusion reactions with nega-tive culture results accounted for 25.64％.CONCLUSIONS The infeciton control and prevention measures and the construction of quality control laboratory vary significantly in Chinese blood stations.The incomplete biosafety registration,non-standardized sterility test operation and weak surveillance of blood transfusion reactions are the major existing problems.It is suggested that the investment should be increased to push forward the standardi-zation and complete the laboratory biosafety system,and a hospital-blood station closed loop coordination mecha-nism should be established so as to raise the blood safety.

Objective:To investigate the iodine nutrition status of children aged 8-10 and pregnant women in Longxi County, Gansu Province.Methods:Descriptive epidemiological method was used to analyze the water iodine monitoring data in 2017 and the iodine deficiency disorders monitoring data from 2017 to 2023 in Longxi County (sourced from the Institute for Endemic Disease Prevention and Control of Gansu Provincial Center for Disease Control and Prevention), including the data of water iodine, salt iodine and urinary iodine levels of children aged 8 to 10 and pregnant women, and children's thyroid B-mode ultrasound examination results. Iodine nutrition was evaluated based on the "Guidelines for Monitoring Salt Iodization Projects and Determining Population Iodine Nutrition".Results:In 2017, a total of 85 water samples were collected, with a median iodine level of 1.6 μg/L, ranging from 0.2 to 10.9 μg/L. Except for one water sample with an iodine level of 10.9 μg/L, the iodine level of all other water samples was less than 10 μg/L. From 2017 to 2023, a total of 1 585 children and 718 pregnant women were monitored. The urinary iodine levels were 190.8 (120.2, 252.2), 137.0 (79.8, 195.8) μg/L, respectively. The coverage rate of iodized salt in Longxi County from 2017 to 2023 ranged from 99.4% to 100%, the consumption rate of qualified iodized salt ranged from 61.8% to 93.0%, and the qualified rate of iodized salt ranged from 62.1% to 93.0%. The median range of the urinary iodine for children in Longxi County was 125.9 to 228.5 μg/L. There was a statistically significant difference in the urinary iodine levels among children from different years ( P < 0.001). There was no statistically significant difference in urinary iodine levels among children of different genders and ages ( P > 0.05). There were statistically significant differences in the composition ratio of iodine nutrition status among children of different years, genders, and ages ( P < 0.05). The median range of urinary iodine in pregnant women was 121.0-180.5 μg/L. Except for 2017, the median urinary iodine of pregnant women in all other years was less than 150 μg/L. There were statistically significant differences in the urinary iodine levels and composition ratio of iodine nutrition status among pregnant women in different years ( P < 0.001). There was no statistically significant difference ( P > 0.05) in the urinary iodine levels and composition ratio of iodine nutrition status among pregnant women during different stages of pregnancy, and all pregnant women were iodine deficient in the early, middle, and late stages (median urinary iodine < 150 μg/L). Six hundred and sixty-five children underwent B-mode ultrasound examination, with a goiter rate ranging from 0 to 5.0%. Conclusion:From 2017 to 2023, the iodine nutrition of children aged 8 to 10 in Longxi County is in an appropriate state, while the iodine nutrition of pregnant women is in a deficiency state.