Objective To analyze the risk factors of postpartum mild uterine prolapse and to investigate the effects of Buzhong Yiqi Decoction on serum transforming growth factor β1(TGF-β1),matrix metalloproteinase 2(MMP-2),and microRNA-30d(miRNA-30d).Methods By blinded and controlled methods and through convenience sampling,80 postpartum patients with mild uterine prolapse were retrospectively collected from Tangshan Maternal and Children Health Hospital from January 2020 to January 2022,and they served as the uterine prolapse group.In addition,80 postpartum patients without uterine prolapse from the same department of the hospital in the same period served as the healthy group.Questionnaire investigation was performed for collecting the basic information such as delivery manner,age,parity,gestational weeks,neonatal weight and body mass index(BMI).The risk factors of postpartum uterine prolapse were investigated by univariate analysis and multivariate logistic regression analysis.The patients in the uterine prolapse group were then divided into the observation group and the control group according to the medication of Buzhong Yiqi Decoction or not,with 40 cases in each group.The control group was treated with electromyographic biofeedback therapy(EBT),while the observation group was treated with Buzhong Yiqi Decoction combined with EBT,and the course of treatment for the two groups covered one month.The changes of pelvic floor function and levels of serum TGF-β1,MMP-2,miRNA-30d in the patients of the two groups were observed before and after treatment.After treatment,the clinical efficacy of patients in the two groups was evaluated.Results(1)The results of univariate analysis showed that compared with the healthy group,the patients in the uterine prolapse group were elder,usually had given two childbirths or more by vaginal delivery,and accounted for a high percentage of overweight/obesity(BMI≥24.0 kg/m2)and perineal laceration,the difference being statistically significant(P<0.05 or P<0.01).(2)The results of multivariate logistic regression analysis showed that age,delivery manner,parity,laceration of perineum,and BMI were risk factors for postpartum uterine prolapse(P<0.01).(3)After one month of treatment,the total effective rate of Buzhong Yiqi Decoction in the observation group was 95.00%(38/40),while that in the control group was 77.50%(31/40),and the intergroup comparison(tested by chi-square test)showed that the efficacy of the observation group was significantly superior to that of the control group(P<0.05).(4)The observation of effects of Buzhong Yiqi Decoction on pelvic floor function showed that after treatment,the distance between the cervix and the hymenal edge,the maximum intravaginal pressure,the voltage of vaginal muscles,the contraction time of pelvic floor muscles of typeⅠand Ⅱmuscle fibers in the two groups of patients were significantly improved compared with those before treatment(P<0.05),and the improvement in the observation group was significantly superior to that in the control group(P<0.01).(5)The observation of effects of Buzhong Yiqi Decoction on serological indicators showed the post-treatment serum TGF-β1 levels in the two groups were increased compared with those before treatment(P<0.05),and the serum levels of MMP-2 and miRNA-30d were decreased compared with those before treatment(P<0.05),and the increase of serum TGF-β1 level and the decrease of serum MMP-2 and miRNA-30d levels in the observation group were both significantly superior to those in the control group(P<0.01).Conclusion The incidence of postpartum uterine prolapse is related to age,delivery manner,parity,laceration of perineum,BMI,etc.The treatment of Buzhong Yiqi Decoction on the basis of EBT can improve the pelvic floor function of the patients and regulate the expression of serum TGF-β1,MMP-2,and miRNA-30d,and the clinical efficacy is remarkable.

Objective To study the role of manganese-enhanced MRI(MEMRI) in the depiction of cortical architecture of rat brain after systemic administration of Mn~(2+) through caudal vein and compare the effects of normal or opened blood-brain barrier on the manganese-enhanced MRI. Methods Fifteen SD rats were randomly divided into three groups according to ranked list of random. Blood-brain barrier was opened in short time by the injection of 30% mannitol via the right internal carotid artery, in group A, then 100 mmol/L MnCl_2 physiologic saline solution was delivered through vena caudalis, and MRI was performed 12 hours later. In group B, 100 mmol/L MnCl_2 physiologic saline solutions was administrated through vena caudalis, following normal saline injection into the right internal carotid artery, and MRI was performed 12 hours later. The group C served as normal control group. All images were acquired with a 7.0 T microMR scanner. Signal-to-noise ratios (SNR) in regions of interest were measured by Paravision 4.0 and the differences of three groups were compared by using one-way ANOVA. The differences of SNR on both sides of hemispheres were compared by using paired t test. Results MEMRI could show the gray matter and white matter of rat brain and the anatomy borders between somatosensory cortex and motor cortex clearly. Periventricular structures such as hippocampus, dentate gyms, habenula united, and olfactory bulb could also be showed clearly. Symmetrical enhancement on both sides of the cortex and banded structures was shown clearly in group B. The SNR increased and the differences were significant in right cerebral cortex, both sides of cerebellar cortex, hippocampus and pituitary, among three groups (right cerebral cortex 35.2±7.0,30.1±2.4,26.6±2.8,F =4.36,P=0.038;left cerebellar cortex 27.1±5.2,29.4±3.8,19.4±4.5, F=6.66, P=0.011;right cerebellar cortex 27.8±3.8,28.5±4.2,20.4±4.8, F=5.84, P=0.017; left hippocampus 34.5±4.9,38.1±5.3,24.5±3.6, F=11.38, P=0.002; right hippocampus 35.3±5.5, 37.6±4.7,25.6±3.0,F=9.93,P=0.003;pituitary 39.5±3.8,52.6±9.1,26.2±4.2,F=22.80, P=0.001) after systemic administration of Mn~(2+). Asymmetric enhancement on two sides of cortex was shown in group A. The mannitol-infused side was enhanced obviously but displayed blurring banded structures. However,the SNR differences of both sides of hemispheres in group A and B were not significant (P >0.05). Conclusions After systemic administration of MnCl_2 through vena caudalis, MEMRI could map the laminar architectures and the anatomy border of functional zone of somatosensory cortex specifically. High concentration of mannitol could open blood brain barrier(BBB) effectively and have distinct impacts on the architectures displayed in MEMRI. Opening or maintaining BBB in MEMRI had respective characteristics, and it should be selected according to practical needs.