OBJECTIVES: According to the World Health Organization (WHO), infertility rates have been steadily rising worldwide. Identifying risk factors for contrast agent reflux into the myometrium during hysterosalpingo-contrast sonography (HyCoSy) is of clinical significance in reducing this complication and improving infertility treatment. However, there is currently no standardized pre-evaluation method for predicting intra-myometrial contrast reflux, with clinical assessment often relying on physician experience and patient symptoms. This study aims to identify imaging risk factors for contrast agent reflux into the myometrium using four-dimensional (4D) HyCoSy and to construct a nomogram-based predictive model to assist in clinical decision-making. METHODS: A retrospective analysis was conducted on 1 274 infertile women who underwent 4D HyCoSy at the Women and Children's Hospital of Hunan and the the Third Xiangya Hospital of Central South University from January 1, 2020, to December 15, 2022. Patients were divided into a reflux group (n=234) and a non-reflux group (n=1 040) based on the presence of intra-myometrial contrast reflux. Univariate and multivariable Logistic regression analyses were used to identify significant predictors, which were then used to construct a nomogram model. Internal validation was performed using 500 bootstrap resamples. RESULTS: The age of the reflux group was significantly higher than that of the non-reflux group [(31.82±5.27) years vs (30.66±4.83) years, P=0.001 1]. Primary infertility was more common in the non-reflux group (50.96%), while secondary infertility dominated in the reflux group (76.50%), with 72.65% having a history of gynecological surgery (P<0.001). Abnormal menstrual volume and discomfort during the procedure were more common in the reflux group, while the non-reflux group tolerated higher contrast agent doses (P<0.001). Imaging differences included endometrial thickness, tubal wall smoothness, and peritoneal contrast dispersion, with the non-reflux group showing thicker endometrium and smoother, more patent tubes. The nomogram model yielded an area under the curve (AUC) of 0.854, indicating good predictive performance. The AUC of the decision curve analysis (DCA) for internal validation of the model was 0.737. When the threshold probability for contrast agent reflux into the myometrium ranged from 0.05 to 0.95, the maximum net benefit reached 0.18. The net benefit of applying the nomogram predictive model exceeded that of either full intervention or no intervention, indicating that the model demonstrates good clinical predictive performance. CONCLUSIONS The nomogram model, based on infertility type, endometrial thickness, contrast agent dose, and discomfort symptoms, effectively predicts intra-myometrial contrast agent reflux after 4D HyCoSy. It provides a valuable tool for clinicians to implement early preventive measures and reduce the risk of contrast leakage and associated complications.
Humans ; Female ; Nomograms ; Contrast Media/adverse effects* ; Retrospective Studies ; Adult ; Ultrasonography/methods* ; Hysterosalpingography/methods* ; Infertility, Female/diagnostic imaging* ; Myometrium/diagnostic imaging* ; Risk Factors

Objective To establish a quality standard for the medicinal bath formula for treating exogenous fever(composed of Forsythiae Fructus,Peucedani Radix,Schizonepetae Spica,Isatidis Radix,Gypsum Fibrosum,Chrysanthemi Flos,Lophatheri Herba,etc.)based on its efficacy and indications.Methods Thin-layer chromatography(TLC)was used to establish identification method for the monarch drugs Forsythiae Fructus and Peucedani Radix.Enzyme-linked immunosorbent assay(ELISA)was employed to measure the interleukin 1β(IL-1β)regulatory activity of the main components in the formula.High-performance liquid chromatography(HPLC)was used to determine the content of active components in 10 batches of samples.Results Spots of Forsythiae Fructus and Peucedani Radix were successfully detected in the test samples.ELISA identified active components in the formula,including praeruptorin A,pulegone,rutin,praeruptorin B,forsythoside,and(R,S)-goitrin.The content determination results of 10 batches of samples showed that the content of praeruptorin A ranged from 0.493 to 0.694 mg·mL-1.Conclusion Based on its efficacy and indications,TLC identification and HPLC content determination methods were established for the medicinal bath formula for treating exogenous fever.The obtained standard can more accurately control the efficacy of the formula.

Background Alzheimer's disease(AD)is the most common type of dementia.There has been an increasing trend in incidence rate.The drug therapy has been proven ineffective in improving the cognitive function of AD patients or delaying the disease progression,leading to perceived low adherence with treatment and low efficacy.Previous basic research shows that blue light irradiation is helpful to improve the cognitive function of AD model rats,but there is no corresponding clinical study on the improvement effect of blue light irradiation on cognitive function of AD patients.Objective To explore the efficacy of blue light irradiation in improving the cognitive function of AD patients,so as to provide references for cognitive stabilization or improvement of AD patients.Methods A sample of 155 patients who were hospitalized in Geriatric Department of Shenzhen Kangning Hospital from June 2019 to December 2023 and met the International Classification of Diseases,tenth edition(ICD-10)diagnostic criteria for AD were retrospectively selected.Among them,80 cases who received blue light irradiation combined with memantine therapy and conventional psychotherapy were the study group,and 75 cases who only received memantine therapy and conventional psychotherapy were the control group.Blue light irradiation therapy lasted for 4 weeks,5 times per week,with each session lasting for 30 min.Then Mini-Mental State Examination(MMSE)and Activity of Daily Living Scale(ADL)were administered at the baseline and after treatment.Results After treatment,study group reported an increase in MMSE total score,orientation,immediate recall,attention/calculation,delayed recall and language dimension scores(Z=-6.931,-5.773,-4.123,-3.649,-3.508,-4.733,P<0.05),and a decrease in ADL total score(Z=-7.020,P<0.05)compared to baseline data.Analysis indicated that study group scored higher on MMSE total scale,orientation,immediate recall and language dimensions(Z=-2.784,-4.621,-2.483,-3.463,P<0.05),and lower on ADL total score(Z=-3.704,P<0.05)than those of control group after treatment.Conclusion Blue light irradiation for AD patients may improve their cognitive function and activities of daily living.

OBJECTIVE: To investigate the effectiveness of modified temporomandibular joint disc reduction and suture with tragus incision assisted by arthroscopy for temporomandibular joint anterior disc displacement (ADD). METHODS: A clinical data of 30 patients (45 sides) with temporomandibular joint ADD, who met selective criteria and were admitted between September 2022 and February 2024, was retrospectively analyzed. Among them, 15 patients (23 sides) were treated with temporomandibular joint disc reduction and suture via small incision (open operation group), and 15 patients (22 sides) with modified temporomandibular joint disc reduction and suture with tragus incision assisted by arthroscopy (arthroscopy group). There was no significant difference in gender, age, disease duration, affected side, Wilkes-Bronstein stage, preoperative visual analogue scale (VAS) score, maximal interincisal opening (MIO), and temporomandibular joint dysfunction index (DI), craniomandibular index (CMI), palpation index (PI), and other baseline data between groups ( P>0.05). VAS score, MIO, and temporomandibular joint function indicators (PI, DI, CMI) of patients were recorded at 3 months after operation, and the difference (change value) of the above indicators between pre- and post-operation was calculated. At 1 week after operation, MRI was performed to evaluate the reduction of the articular disc compared to the preoperative image. The results were classified as excellent, good, and poor, with excellent and good being considered effective reduction. The condition of condyle process repair was observed by cone beam CT (CBCT) at 3 months after operation. RESULTS: All incisions healed by first intention in the two groups. All patients were followed up 3-18 months (mean, 8.2 months). Facial nerve injury occurred in 3 cases in the open operation group and 1 case in the arthroscopy group, all of which returned to normal after physiotherapy and drug treatment. At 3 months after operation, MIO and VAS scores of both groups significantly improved when compared with those before operation ( P<0.05), and temporomandibular joint function indicators (PI, DI, CMI) significantly decreased ( P<0.05). The change values of MIO and temporomandibular joint function indicators in arthroscopy group were significantly higher than those in open operation group ( P<0.05). There was no significant difference in the change value of VAS score between groups ( P>0.05). There was no recurrence during follow-up. Postoperative MRI review showed that the effective reduction rate of joint disc was 95.65% (22/23) in the open operation group and 95.45% (21/22) in the arthroscopy group, with no significant difference between groups ( P>0.05). Postoperative CBCT found that early and timely effective reduction of joint disc was conducive to condyle process repair and reconstruction. CONCLUSION Modified temporomandibular joint disc reduction and suture with tragus incision assisted by arthroscopy has a clear effect in the treatment of ADD, with less trauma, fewer postoperative complications, and good early effectiveness.
Humans ; Arthroscopy/methods* ; Retrospective Studies ; Temporomandibular Joint Disorders/surgery* ; Temporomandibular Joint Disc/surgery* ; Male ; Treatment Outcome ; Female ; Suture Techniques ; Adult ; Joint Dislocations/surgery* ; Range of Motion, Articular ; Middle Aged ; Pain Measurement ; Young Adult ; Sutures

Purpose: This study aimed to investigate reproductive concerns among breast cancer patients of reproductive age, analyze the influencing factors, explore the relationship between coping styles, fear of progression (FOP), and reproductive concerns, and identify the multiple effects of coping styles on the relationship between FOP and reproductive concerns among Chinese breast cancer patients. Methods: A cross-sectional, descriptive study was conducted among breast cancer patients in four tertiary grade A hospitals in Fujian, China, from January 2022 to September 2022. A total of 210 patients were recruited to complete paper-based questionnaires, which included the general data questionnaires, the Reproductive Concerns After Cancer Scale (RCACS), the Fear of Progression Questionnaire-Short Form (FOP-Q-SF), and the Medical Coping Modes Questionnaire (MCMQ). Structural equation models were utilized to evaluate the multiple effects of coping styles on FOP and reproductive concerns. Results: Reproductive concerns in breast cancer patients had a mean score of 53.02 (SD, 10.69), out of a total score of 90, and coping styles for cancer (confrontation, avoidance) were closely associated with FOP and reproductive concerns. FOP showed a significant positive correlation with reproductive concerns (r = .52, p < .01). At the same time, confrontation was significantly negatively correlated with both FOP (r = −.28, p < .01) and reproductive concerns (r = −.39, p < .01). Avoidance was positively correlated to both FOP (r = .25, p < .01) and reproductive concerns (r = .34, p < .01). The impact of FOP on reproductive concerns is partially mediated by confrontation and avoidance, with effect sizes of .07 and .04, respectively. These mediating factors account for 22.0% of the total effect. Conclusions The FOP directly impacted reproductive concerns, while coping styles could partially mediate the association between FOP and reproductive concerns. This study illustrates the role of confrontation and avoidance in alleviating reproductive concerns, suggesting that it is necessary to focus on the changes in reproductive concerns among reproductive-age breast cancer patients. Healthcare professionals can improve disease awareness and reduce patients' FOP, thereby promoting positive psychological and coping behaviors and ultimately alleviating reproductive concerns.

BackgroundThe diagnosis of Alzheimer's disease （AD） still faces great challenges， and the advantage of electroencephalogram （EEG） diagnosis lies in its portable and non-invasive nature， so the EEG diagnosis of AD has occupied an important place in clinical research. ObjectiveTo evaluate the value of resting state EEG for AD diagnosis， and to provide references for early recognition of AD in clinical practice. MethodsClinical data of AD patients （n=59） in an Inpatient Geriatric Psychiatry Unit of Shenzhen Kangning Hospital from May 2019 to May 2022 were retrospectively analyzed， and healthy elderly individuals attending outpatient clinics at the hospital during the same period were enrolled as control group （n=54）. Eight-channel resting state EEG data were acquired， and the absolute power values in the α， β， θ and δ frequency bands and the α/θ ratio were obtained and calculated using Fast Fourier Transform （FFT）. Cognitive function assessments of patients were done by Mini-Mental State Examination （MMSE） and Montreal Cognitive Assessment （MoCA）. Spearman correlation analysis was used to examine the correlation between EEG findings and MMSE and MoCA scores of AD patienrs. Logistic regression prediction model for AD was built using currently available EEG and clinical variables， and the model performance was assessed using the receiver operating characteristic （ROC） curve and the area under curve （AUC）. ResultsThe θ-band absolute powers in the right mid-frontal （F4） and mid-lateral （F7， F8） regions were higher in AD patients than those in healthy controls， with statistically significant difference （t=-2.844， -2.825， -3.014， P<0.05 or 0.01）. The absolute powers of α/θ ratio in prefrontal （Fp1， Fp2）， mid-frontal （F3， F4） and mid-lateral （F7， F8） regions showed a notable reduction in AD patients compared with healthy controls， with statistical difference （t=2.081， 2.327， 3.423， 2.358， 3.272， 2.445， P<0.05 or 0.01）. Spearman correlation analysis denoted that MMSE score was positively correlated with the absolute powers of α-band， β-band and α/θ ratio （r=0.206， 0.288， 0.372， P<0.05 or 0.01）. MoCA score was positively correlated with β absolute powers and α/θ ratio （r=0.201， 0.315， P<0.05 or 0.01）， and negatively correlated with θ absolute power （r=-0.218， P<0.05）. ROC curve revealed an AUC of 0.882 （95% CI： 0.820~0.943）， a sensitivity of 0.966 and a specificity of 0.673 for the AD prediction model based on EEG variables， while the prediction model for AD using comprehensive variables achieved better predictive efficacy， reaching an AUC， sensitivity and specificity of 0.946 （95% CI： 0.905~0.986）， 0.948 and 0.873， respectively. ConclusionResting state EEG of AD patients is correlated with cognitive function， and are of great value in the diagnosis of AD， with θ absolute power and α/θ ratio in EEG being the most strongly correlated with AD.