Objective To investigate the rehabilitative effects of pelvic floor muscle training(PFMT)combined with electromyography biofeedback(EMG-BF)in patients with post-prostatectomy incontinence(PPI),aims to provide refer-ence for clinical nursing practice.Methods 98 patients with PPI who were treated at the urinary incontinence nurse-led clinic of a tertiary hospital in Shanghai were included using the method of convenience sampling.Patients enrolled from June to September 2022 were assigned to a control group(n=49),receiving PFMT alone at home.Those enrolled from November 2022 to February 2023 were assigned to an experimental group(n=49),receiving PFMT at home combined with EMG-BF at the nurse-led clinic.Both groups received intervention for 3 months,preceded by guidance for PFMT provided by incontinence specialist nurses.The urine leakage in 24-hour pad test,the International Consultation on Incontinence Questionnaire-Short Form(ICIQ-SF),the Incontinence Quality of Life Questionnaires(I-QOL),and the Broome Pelvic Muscle Self-Efficacy Scale(BPMSES)were used to assess objective and subjective incontinence severity,quality of life,and self-efficacy of PFMT on the day of catheter removal and at 1,2,and 3 months post-intervention.Results A total of 46 patients were included in each group.The 24-hour urine leakage volume and I-QOL scores demonstrated significant between-group and over-time effects(P＜0.05),with no interaction effect between groups and time(P＞0.05)The ICIQ-SF and BPMSES scores exhibited interactive ef-fects between time and groups(P＜0.05).At 2 and 3 months post-intervention,the intervention group showed signifi-cantly lower ICIQ-SF scores(P＜0.001),and higher BPMSES scores(P＜0.05),compared to those in the control group.Conclusion PFMT combined with EMG-BF can effectively alleviate the objective and subjective severity of PPI,enhance patients'self-efficacy in PFMT,and improve their postoperative quality of life.

Objective To explore the effect of bionic electrical stimulation(BES)combined with resistance tightening leg training on postpartum pelvic floor dysfunction(PFD).Methods A total of 205 patients with PFD were divided into the BES group(n=102)and the combined group(n=103)by random number table method.All subjects received routine pelvic floor muscle training.In addition,the BES group was treated with BES intervention,and the combined group was treated with BES combined with resistance tightening leg training,with 8 weeks of treatment.The classification of pelvic floor muscle strength,electrophysiological indexes of pelvic floor function,urodynamics and stress urinary incontinence(SUI)classification/pelvic organ prolapse(POP)degree were compared between the two groups before and after treatment.Results After treatment,the pelvic floor muscle strength classification,SUI classification and POP degree in the combined group were significantly better than those in the BES group(P<0.05).After treatment,ClassⅠ/ClassⅡmuscle fiber fatigue,vaginal dynamic pressure and maximal electromyography(EMG)value of fast muscle in the combined group were(-1.20±0.35)%,(-0.90±0.30)%,(76.30±5.51)cmH2 O,(43.00±5.82)μV,respectively,which were all significantly higher than those in the BES group(P<0.05).After treatment,the indexes of urodynamics in both groups were significantly improved,and the combined group was better than the BES group(P<0.05).Conclusions BES combined with resistance tightening leg training can significantly improve pelvic floor muscle strength,muscle fiber fatigue and urodynamics in patients with PFD,thus alleviating SUI/POP symptoms.

Objective:To analyze the status of nurse-led clinics at home and abroad, and to explore the research hotspots and development trends.Methods:China National Knowledge Infrastructure and Web of Science Core Collection database were searched for literature on nurse-led clinics. The search period was from January 1, 2000 to May 26, 2024. Visual analysis was implemented using CiteSpace software on the collected literature.Results:A total of 206 articles in Chinese and 1 990 articles in English were included. The number of English language publications in nurse-led clinics was higher than that of Chinese language publications, and the top three countries in terms of English language publications were the United Kingdom (533), the United States (420), and Australia (355). The number of publications in the Chinese literature grew slowly, and the journal with the highest number of publications was Chinese Nursing Management (69). Keywords such as "nurse specialist", "nursing management" and "health education" in the Chinese literature and "quality of life", "management" and "randomized controlled trial" in the English literature had a high degree of centrality. Rehabilitative care and hospice care for oncology patients was a common research trend in international nurse-led clinics. Conclusions:Nurse-led clinics have gained widespread attention as a model of advanced nursing practice. China's nurse-led clinics in general show a good development trend, but the amount of relevant research publications is relatively small, and the level of research still needs to be further improved.

Objective To explore the effect of bionic electrical stimulation(BES)combined with resistance tightening leg training on postpartum pelvic floor dysfunction(PFD).Methods A total of 205 patients with PFD were divided into the BES group(n=102)and the combined group(n=103)by random number table method.All subjects received routine pelvic floor muscle training.In addition,the BES group was treated with BES intervention,and the combined group was treated with BES combined with resistance tightening leg training,with 8 weeks of treatment.The classification of pelvic floor muscle strength,electrophysiological indexes of pelvic floor function,urodynamics and stress urinary incontinence(SUI)classification/pelvic organ prolapse(POP)degree were compared between the two groups before and after treatment.Results After treatment,the pelvic floor muscle strength classification,SUI classification and POP degree in the combined group were significantly better than those in the BES group(P<0.05).After treatment,ClassⅠ/ClassⅡmuscle fiber fatigue,vaginal dynamic pressure and maximal electromyography(EMG)value of fast muscle in the combined group were(-1.20±0.35)%,(-0.90±0.30)%,(76.30±5.51)cmH2 O,(43.00±5.82)μV,respectively,which were all significantly higher than those in the BES group(P<0.05).After treatment,the indexes of urodynamics in both groups were significantly improved,and the combined group was better than the BES group(P<0.05).Conclusions BES combined with resistance tightening leg training can significantly improve pelvic floor muscle strength,muscle fiber fatigue and urodynamics in patients with PFD,thus alleviating SUI/POP symptoms.

Objective To investigate the rehabilitative effects of pelvic floor muscle training(PFMT)combined with electromyography biofeedback(EMG-BF)in patients with post-prostatectomy incontinence(PPI),aims to provide refer-ence for clinical nursing practice.Methods 98 patients with PPI who were treated at the urinary incontinence nurse-led clinic of a tertiary hospital in Shanghai were included using the method of convenience sampling.Patients enrolled from June to September 2022 were assigned to a control group(n=49),receiving PFMT alone at home.Those enrolled from November 2022 to February 2023 were assigned to an experimental group(n=49),receiving PFMT at home combined with EMG-BF at the nurse-led clinic.Both groups received intervention for 3 months,preceded by guidance for PFMT provided by incontinence specialist nurses.The urine leakage in 24-hour pad test,the International Consultation on Incontinence Questionnaire-Short Form(ICIQ-SF),the Incontinence Quality of Life Questionnaires(I-QOL),and the Broome Pelvic Muscle Self-Efficacy Scale(BPMSES)were used to assess objective and subjective incontinence severity,quality of life,and self-efficacy of PFMT on the day of catheter removal and at 1,2,and 3 months post-intervention.Results A total of 46 patients were included in each group.The 24-hour urine leakage volume and I-QOL scores demonstrated significant between-group and over-time effects(P＜0.05),with no interaction effect between groups and time(P＞0.05)The ICIQ-SF and BPMSES scores exhibited interactive ef-fects between time and groups(P＜0.05).At 2 and 3 months post-intervention,the intervention group showed signifi-cantly lower ICIQ-SF scores(P＜0.001),and higher BPMSES scores(P＜0.05),compared to those in the control group.Conclusion PFMT combined with EMG-BF can effectively alleviate the objective and subjective severity of PPI,enhance patients'self-efficacy in PFMT,and improve their postoperative quality of life.

Objective:To analyze the status of nurse-led clinics at home and abroad, and to explore the research hotspots and development trends.Methods:China National Knowledge Infrastructure and Web of Science Core Collection database were searched for literature on nurse-led clinics. The search period was from January 1, 2000 to May 26, 2024. Visual analysis was implemented using CiteSpace software on the collected literature.Results:A total of 206 articles in Chinese and 1 990 articles in English were included. The number of English language publications in nurse-led clinics was higher than that of Chinese language publications, and the top three countries in terms of English language publications were the United Kingdom (533), the United States (420), and Australia (355). The number of publications in the Chinese literature grew slowly, and the journal with the highest number of publications was Chinese Nursing Management (69). Keywords such as "nurse specialist", "nursing management" and "health education" in the Chinese literature and "quality of life", "management" and "randomized controlled trial" in the English literature had a high degree of centrality. Rehabilitative care and hospice care for oncology patients was a common research trend in international nurse-led clinics. Conclusions:Nurse-led clinics have gained widespread attention as a model of advanced nursing practice. China's nurse-led clinics in general show a good development trend, but the amount of relevant research publications is relatively small, and the level of research still needs to be further improved.

Currently， there are many difficulties in formulating recommendations of traditional Chinese medicine （TCM） clinical practice guidelines. This paper analyzed and summarized the unique or prominent difficult issues in the formulation of recommendations faced by TCM guidelines， such as experts' professional background and experience bringing about the preferance from the academic emotion， inconsistency between different academic schools making it difficult to reach consensus， lack of guiding principles of the decision weight of different dimensions for recommendations. Therefore， methodological suggestions have been put forward， including organizing parallel TCM and western medicine consensus group， improving the method of combining TCM and western medicine paradigm， attaching great importance to the evidence-based governance of academic schools， and promoting the research on different dimensions for recommendation formulation， which may provide a methodological reference for the guideline development.

Syndrome differentiation and treatment is a unique mode of diagnosis in traditional Chinese medicine （TCM）. The establishment of scientific and standardized syndrome diagnosis standards is an important link to evaluate the clinical efficacy of TCM objectively and systematically， and also a prerequisite for the promotion and development of TCM to obtain international recognition. This article reviewed the basic modes and existed problems of the current syndrome diagnosis criteria， and proposed to construct a multidimensional core information set integrating the minimized core symptoms， the artificial intelligence signs， the multi-modal laboratory indicators， and multi-omics specific markers， so as to present syndrome characteristics from multiple perspectives systematically. This paper also described the basic mode， constructure， as well as the process and methodology to be adopted in the establishment of the standardized diagnostic research method. The core information set of diagnostic symptoms not only took into account the specificity of the disease， but also improved the inconsistency due to the complexity and subjectivity of the syndrome differentiation， thereby providing a methodological basis for the standardization of TCM syndrome differentiation in clinical research.

Orthodontic tooth movement elicits alveolar bone remodeling and orofacial pain that is manifested by tooth mechanical hyperalgesia. Nerve growth factor (NGF) is upregulated in periodontium and may modulate tooth mechanical hyperalgesia. The objectives were to examine the role of NGF in tooth mechanical hyperalgesia and to elucidate the underlying mechanisms. Tooth mechanical hyperalgesia was induced by ligating closed coil springs between incisors and molars in Sprague-Dawley rats. Retrograde labeling was performed by periodontal administration of fluor-conjugated NGF and the detection of fluorescence in trigeminal ganglia (TG). Lentivirus vectors carrying NGF shRNA were employed to knockdown the expression of NGF in TG. The administration of agonists, antagonists, and virus vectors into TG and periodontium was conducted. Tooth mechanical hyperalgesia was examined through the threshold of biting withdrawal. Our results revealed that tooth movement elicited tooth mechanical hyperalgesia that could be alleviated by NGF neutralizing antibody and that NGF was upregulated in periodontium (mainly in periodontal fibroblasts) and TG. Retrograde labeling revealed that periodontal NGF was retrogradely transported to TG after day 1. Acid-sensing ion channel 3 (ASIC3) and NGF were co-expressed in trigeminal neurons and the percentage of co-expression was significantly higher following tooth movement. The administration of NGF and NGF neutralizing antibody into TG could upregulate and downregulate the expression of ASIC3 in TG, respectively. NGF aggravated tooth mechanical hyperalgesia that could be alleviated by ASIC3 antagonist (APETx2). Moreover, NGF neutralizing antibody mitigated tooth mechanical hyperalgesia that could be recapitulated by ASIC3 agonist (GMQ). NGF-based gene therapy abolished tooth mechanical hyperalgesia and downregulated ASIC3 expression. Taken together, in response to force stimuli, periodontal fibroblasts upregulated the expressions of NGF that was retrogradely transported to TG, where NGF elicited tooth mechanical hyperalgesia through upregulating ASIC3. NGF-based gene therapy is a viable method in alleviating tooth-movement-induced mechanical hyperalgesia.

Background:This study aimed to investigate the changes in the clinical indicators and influencing factors of treatment duration among human immunodeficiency virus (HIV) patients in whom antiretroviral therapy (ART) was unsuccessful.Methods:In this retrospective study,a total of 9,418 HIV patients who failed in ART during 2004-2016 were included and divided into two treatment groups-Group 1 (treatment time ≤ 3 years,n1 =5,218) and Group 2 (treatment time ＞ 3 years,n2 =4,200).Patient follow-up data,including age,cluster of differentiation 4 (CD4) count,and viral load,glucose,creatinine,and triglyceride levels,were extracted from electronic health record databases.Covariance analysis for repeated measures was used to analyze the biochemical indicators,and multiple logistic regression modeling was used to compare relevant data extracted from the Group 1 and Group 2 HIV patient cohorts with different treatment time.Results:The median initial CD4 count was 175.0 cells/μl (interquartile range,77.0-282.0),while the initial CD4 counts for Group 1 were lower than those for Group 2 (P ＜ 0.05).A significant interaction between group and time effects was observed (P ＜ 0.05) in total cholesterol (TC).Changes in hemoglobin level among HIV patients were also significantly associated with treatment time (P =0.001).The initial CD4 count (odds ratio [OR] =0.756),female sex (OR =0.713),Zerit (d4T) (OR =1.443),TC (OR =1.285),and aspartate aminotransferase level (OR =1.002) were significantly associated with the survival time of dead patients with HIV (P ＜ 0.05).Additionally,the initial CD4 count (OR =1.456),age (OR =1.022),time interval (OR =0.903),patient's living status (OR =0.597),d4T (OR =2.256),and triglyceride (OR =0.930) and hemoglobin levels (OR =0.997) were significantly associated with the treatment time of HIV patients with drug withdrawal (P ＜ 0.05).Conclusion:The initial biochemical parameters can affect the survival and treatment time of HIV patients.With a comprehensive understanding of the physiological and biochemical indicators of patients,we can reduce the probability of drug withdrawal and prolong the survival time of HIV patients.