Objective: To investigate the clinical efficacy and safety of pudendal nerve modulation (PNM) in the treatment of female pudendal neuralgia (PN)，so as to promote the clinical application of this technique. Methods: A retrospective analysis was conducted on 20 female PN patients who failed conservative treatment at Gongli Hospital during Nov.2020 and Oct.2023.All patients underwent simultaneous PNM and sacral nerve modulation (SNM) with the assistance of 3D printing navigation.Dual-stage test electrodes for PNM and SNM were implanted，followed by alternate therapeutic trial for each modality.Secondary conversion rates and longitudinal outcomes，including visual analogue score (VAS)，patient health questionnaire-9 (PHQ-9)，and quality of life (QoL) scores were compared preoperatively，post-stage Ⅰ，and at 3，6，and 12 months post-stage Ⅱ. Results: All operations were successful.After the trial phase，the secondary conversion rate for PNM was significantly higher than that for SNM; 16 patients (16/20，80%) chose the second-phase PNM implantation surgery，3 (3/20，15%) chose second-phase SNM implantation，and 1 (1/20，5%) had electrodes removed due to ineffective results from both trials.Further assessment revealed that the improvements in VAS，PHQ-9，and QoL scores for PNM patients were significantly better than those for SNM patients after the first phase of surgery and at 3，6 and 12 months after the second-phase conversion (P<0.05).No complications such as electrode migration or infection were observed during the follow-up of 12-15 months. Conclusion: PNM provides more effective relief of pain symptoms and improvements in depressive states for female PN patients compared to SNM.With the assistance of 3D printing navigation，the operation is simple and safe，and offers stable therapeutic effects.It is worthy of clinical promotion and application.

Objective To construct intrauterine adhesion (IUA) mouse models induced by two different concentrations of ethanol injury, compare the phenotypes, and optimize a more stable IUA modeling method. Methods Twenty 8-week-old female C57BL/6N mice were randomly divided into two groups: the 95% ethanol injury group and the 50% ethanol injury group. Using a self-control method, the left uterine horn was infused with ethanol to establish the IUA model, while the right uterine horn was infused with saline as the sham operation. Five mice from each group were euthanized on day 7 and 15 after modeling, and uterine tissues were collected. Hematoxylin-eosin (HE) staining was used to observe the endometrial pathology, and Masson staining was used to assess the degree of endometrial fibrosis. Quantitative real-time PCR was employed to detect the expression levels of fibrosis markers and pro-inflammatory factors in the uterine tissues. Results Compared to the sham operation, these two ethanol injury led to a significant reduction in elasticity of the uterus, an increase in inflammatory infiltration, and a marked increase in the degree of fibrosis on day 7 after modeling (P<0.05). The 95% ethanol injury group showed a significant decrease in endometrial thickness (P<0.05), whereas no significant change was observed in the 50% ethanol injury group when compared to the sham operation (P>0.05). The expression levels of fibrotic marker molecules collagen type Ⅳ alpha 1 chain (Col4A1), α-smooth muscle actin (α-SMA), transforming growth factor-β (TGF-β), and pro-inflammatory factors tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) were significantly elevated in the 50% ethanol injury group when compared to the sham operation (P<0.05), although there was an increasing trend of the same markers in the 95% ethanol injury group, the differences were not statistically significant (P>0.05). On day 15 after modeling, the histopathological changes in both ethanol injury groups were not significant when compared to the sham operation, the expression levels of Col4A1, TGF-β, TNF-α and IL-1β remained significantly higher in the 50% ethanol injury group (P<0.05), while only IL-1β was significantly elevated in the 95% ethanol injury group (P<0.05). Conclusion Uterine infusion with 95% ethanol results in more marked histopathological changes in the IUA mouse model compared to the 50% ethanol injury group. The 95% ethanol injury model is suitable for histopathological studies. However, the 50% ethanol injury group shows higher expression levels of fibrosis markers and pro-inflammatory factors compared to the 95% ethanol injury group, suggesting that the 50% ethanol injury model is more suitable for molecular pathological study.

To establish a method for detecting Toxoplasma gondii based on recombinant polymerase amplification(RPA)technology and apply it to clinical sample validation of pet cats.Using the 529 repeat sequence of the Toxoplasma gondii gene as the target gene sequence,primers and probes were designed,and the Rep-529 recombinant plasmid was constructed as the standard.A fluorescent RPA reaction system was established.Dilute the plasmid standard 10 times to different concentrations as the detection template for sensitivity testing;Specific testing was conducted using genomic DNA from several parasitic spe-cies,including Toxoplasma gondii,Cryptosporidium,Neosporidium,Trichinella spiralis,Giardia flagellata,Babesia bo-vis and Theileria annulata as templates;Simultaneously,fluorescence RPA and RT-PCR were used to detect 52 positive and 40 negative cats clinical samples,and the coincidence rate of the detection results of the two methods were compared and ana-lyzed.The RPA reaction system was successfully established using PTRep recombinant plasmid as the standard,ToxD-F/ToxD-R as the primer,and RepD-P as the fluorescent probe.The reaction temperature was constant at 39 ℃,the reaction time was 30 minutes,and the detection sensitivity was 1 copy/μL.There is no significant cross reaction with parasites such as Cryptosporidium,Neosporidium,Trichinella spiralis,Giardia,Babesia bovis and Theileria annulata,and the specificity is good.A total of 92 clinical fecal samples from cats were tested,and the positive coincidence rate of fluorescence RPA detection method was higher than that of conventional RT-PCR method(98.08％vs.82.69％),and the difference of the positive rate was not statistically significant(X2=1.392,P＞0.05).The fluorescence RPA detection method for Toxoplasma gondii suc-cessfully established in this study has the characteristics of being fast,sensitive,specific,accurate,and reliable.It can be used as a rapid clinical detection kit for Toxoplasma gondii in cats and other animals,providing new technical support for the subsequent epidemiological monitoring and precise clinical diagnosis of toxoplasmosis in cats,other animals,and humans in the future.

Objective:To investigate the efficacy of 3D-printed navigation guided pudendal lead implantation on nervous regula-tion of lower urinary tract symptoms(LUTS)in male patients.Methods:Twenty-eight male patients who underwent perineal nervous regulation treatment for LUTS in Gongli Hospital of Pudong New Area from October 2021 to October 2023 were randomly divided into observation group and control group.The technology assisted with 3D-printed navigation to regulate the genital nerves was used in ob-servation group.And the patients in control group were treated with regulation of the genital nerves by routine puncture.Operation time of puncture,number of surgical punctures,and stimulator debugging time compared between the two groups.The improvement of post-operative symptoms and surgical complications of patients in the observation group were recorded as well.Result:A total of 12 male LUTS patients were included in the observation group,with an average age of 36.5±6.5 years,including 7 cases of frequent micturi-tion,3 cases of perineal pain,and 2 cases of dysuria.Four patients showed no significant improvement in symptoms,including two pa-tients with pain and two cases of frequent micturition who did not undergo secondary surgery.While the other eight patients showed sig-nificant improvement in symptoms.The average time for successful puncture in control group was(21.13±4.53)minutes,which was longer than that of the 3D-printed navigation group([10.32±3.42]min)significantly(P＜0.05).The average number of punctures in the ordinary puncture group was 5.62±1.43,which was significantly higher than that in the 3 D-printed navigation group(1.5±0.56).There was no statistically significant difference in the average time for stimulator debugging between the two groups of patients.The conversion rate of the 3D-printed navigation group in the second phase was 66.7％,which was higher than that(37.5％)significantly(P＜0.05).Conclusion:3D printing navigation of pudendal nerve electrode wire implantation can improve the accuracy of electrode implantation and the conversion rate to a certain extent,which has the advantages of reducing the difficulty of surgery.

Objective To analyze the occurrence and risk factors of needlestick and sharps injuries(NSIs)among oral health care workers(HCWs).Methods NSIs reported by West China Hospital of Stomatology from 2020 to 2023 were collected,and factors relevant to NSIs were analyzed.Results A total of 391 cases of NSIs were repor-ted.Only one case of injury was caused by a sterile device,while the remaining 390 cases were caused by contamina-ted devices.There were 85,107,113,and 86 cases in 2020,2021,2022,and 2023,respectively.Most NSIs oc-curred among interns(n=235,60.1％).294 cases(75.2％)of NSIs occurred among HCWs who had less than 3 years of clinical experience.The distribution of NSIs among 235 interns in different months showed that NSIs ac-counted for a relatively high proportion from April to June and July to September,and the difference was statistica-lly significant(P＜0.05).The ventral side of the left thumb was the most common site of NSIs(n=53,13.6％),followed by the ventral side of the right index finger(n=45,11.5％)and the ventral side of the left index finger(n=44,11.3％).The most common devices involved in NSIs were various types of syringe needles(n=84,21.5％),followed by various types of dental burs(n=76,19.4％)and suture needles(n=49,12.5％).Injuries mainly oc-curred during the treatment process(n=212,54.2％)and in the department of endodontics(n=86,22.0％).This study didn't find any occupational bloodborne infection case caused by NSIs.Conclusion NSIs mainly occur among inexperienced oral interns,and devices causing NSIs are related to the treatment process.

Aim To evaluate the role of the glucose transporter protein 1(GLUT1)-dependent glycolytic in the attenuation of oxygen-glucose deprivation-reoxygen-ation(OGD/R)injury in HK-2 cells by dexmedetomi-dine(Dex).Methods C57/BL6 mice were random-ly divided into three groups(n=6),namely,sham operation group(Sham group),renal ischemia reper-fusion group(I/R group)and Dex group(I/R+Dex group).Serum creatinine(Cr)and urea nitrogen(BUN)were measured,while the levels of key glyco-lytic enzymes HK2,PFKFB3 and GLUT1 were meas-ured.HK-2 cells were cultured and randomised into seven groups(n=6),which was treated with OGD/R,overexpression or interference with GLUT1,Dex and glycolysis inhibitor 2-DG.CCK-8 and LDH activi-ty were used to detect cellular damage.Glycolysis lev-els were detected by lactate and ECAR.The inflamma-tory level was reflected by qRT-PCR for IL-6 and TNF-α.qRT-PCR and Western blot were performed to de-tect the levels of GLUT1,HK2,and PFKFB3.Results Dex significantly ameliorated kidney injury and HK-2 cell injury(P＜0.05).Dex inhibited the OGD/R-induced rise in lactate and extracellular acidification rate(ECAR),as evidenced by suppression of the ex-pression of GLUT1,HK2 and PFKFB3(P＜0.05).In vitro experiments showed that GLUT1 knockdown sig-nificantly improved OGD/R-induced cellular damage.Lactate,ECAR,glycolysis-related mRNAs and pro-teins were inhibited by GLUT1 knockdown(P＜0.05).Significantly,there were no significant differ-ences in above indexes after Dex treatment based on GLUT1 knockdown.Overexpression of GLUT1 abroga-ted the protective effects of Dex,while reversing the inhibitory effects of Dex on the expression of GLUT1,HK2,and PFKFB3(P＜0.05).Conclusions Dexmedetomidine attenuates OGD/R induced injury in HK-2 cells by inhibiting GLUT1-dependent glycolysis.

OBJECTIVE To investigate the ameliorative effect of Pinelliae Rhizoma Praeparatum Cum Alumine and its effective components on inflammatory response in mice with acute lung injury(ALI).METHODS A mice model of acute lung injury induced by lipopolysaccharide(LPS)was used as the in vivo animal model.The levels of inflammatory factors TNF-α,IL-6,and IL-1β,the total protein concentration,the number of inflammatory cells in bronchoalveolar lavage fluid,the ratio of lung wet weight to dry weight,and the pathological damage of lung tissues were taken as the evaluation indexes.RAW264.7 macrophages induced by LPS were used as the in vitro experimental model,with the mRNA levels of intracellular inflammatory factors TNF-α,IL-1β,and IL-6 as indicators,systematic solvent extraction and silica gel column chromatography were used to separate and screen the effective parts and components of Pinelliae Rhizoma Praeparatum Cum Alumine for treating acute lung injury.The component composition of the effective fractions was analyzed by mass spectrometry,the content of cyclic dipeptide components in the effective fraction was determined,and the anti-in-flammatory activity of cyclic dipeptides was verified in vitro.RESULTS The ethyl acetate extraction fraction obtained by extracting the supernatant of water extraction and ethanol precipitation of Pinelliae Rhizoma Praeparatum Cum Alumine(referred to as the ethyl acetate fraction for short)significantly improved the inflammatory response in mice with acute lung injury and significantly reduced the mRNA levels of TNF-α,IL-1β,and IL-6 in RAW264.7 cells induced by LPS.The Fr.1 fraction isolated from the ethyl acetate frac-tion by silica gel column chromatography had anti-inflammatory effects in vitro.Mass spectrometry determined the content of two main cyclic dipeptide components,cyclo-(Pro-Phe)and cyclo-(Pro-Val),in the Fr.1 fraction.After mixing these two cyclic dipeptide components in the molar ratio in the Fr.1 fraction and administering them in vitro,the results showed that the combination of these two cyclic dipeptide components could significantly inhibit the mRNA expression levels of TNF-α,IL-1β,and IL-6 in RAW264.7 cells induced by LPS.CONCLUSION Cyclic dipeptide component is one of the main material basis categories for the anti-inflammatory effect of Pinelliae Rhizoma Praeparatum Cum Alumine.

Objective To explore the relationship between plantar fascia stiffness and windlass mechanism and their impact on the arch,and provide a biomechanical mechanism explanation for plantar fascia and arch-related diseases.Methods A foot-plate model with 30° flexion angle at the metatarsophalangeal joint was constructed.The musculoskeletal model combined with the three-dimensional finite element analysis method was used,and the dynamic data of the foot during walking at the speed of 5 km/h was obtained using dual fluoroscopic imaging system(DFIS).The finite element model was verified,and the influence of plantar fascia stiffness on the capstan mechanism and arch-related mechanical parameters was explored.Results The finite element simulation analysis results were highly consistent with the foot data obtained by DFIS,confirming the validity of the model.With the increase of plantar fascia stiffness,the windlass effect and the stiffness of the longitudinal arch of the foot both showed an increasing trend,but the flexion angle of the metatarsophalangeal joint decreased,the distal stress of the plantar fascia gradually decreased,and the proximal stress increased;when the plantar fascia stiffness was 25％-150％,the width of the transverse arch of the foot increased with the increase of plantar fascia stiffness,while the height of the transverse arch decreased with the increase of plantar fascia stiffness;when the plantar fascia stiffness was 150％-200％,the width of the transverse arch of the foot decreased,the height increased,and the stiffness also increased.Conclusions An increase in plantar fascia stiffness can enhance the windlass mechanism to some extent,but it also leads to a reduction in metatarsophalangeal joint flexion.The stiffness of the plantar fascia affects the metatarsophalangeal joint flexion,thereby impacting the windlass mechanism and the distal tensile force of the plantar fascia.Together with the ground reaction force at the distal end of the metatarsals,these factors collectively influence the stiffness of the transverse arch of the foot.

Objective To predict the invasion degree of subsolid nodule(SSN)lung adenocarcinoma using a combined model incorporating artificial intelligence(AI)quantitative parameters and imaging signs,and to validate the predictive efficacy of this model.Methods A total of 281 SSN lung adenocarcinoma CT images in 243 patients were retrospectively collected and randomly divided into training set(224 cases)and validation set(57 cases)in an 8∶2 ratio,with atypical adenomatous hyperplasia(A AH)+adenocarcinoma in situ(AIS)+minimally invasive adenocarcinoma(MIA)(191 cases)as the non-invasive adenocarcinoma(I AC)group and I AC(90 cases)as the IAC group.Multivariate logistic regression analysis was performed based on the AI quantitative parameters and CT signs in the training set to obtain independent predictors of IAC.A combined model and nomogram were then constructed and validated.The diagnostic efficacy and clinical applicability of the model were evaluated by the receiver operating characteristic(ROC)curve,calibration curve,and clinical decision curve analysis(DCA).Results Multivariate logistic regression analysis of the training set showed nodule type,spicule sign,vascular abnormality,long diameter＞11.5 mm,median CT value＞—426.25 HU,and mass＞391.5 mg were independent predictors of IAC(P＜0.05).The area under the curve(AUC)of the training set model,based on these independent predictive factors,was 0.915[95％confidence interval(CI)0.875-0.954],and the AUC of the validation set model was 0.903(95％CI 0.824-0.982),indicating both the training set and validation set models had high efficacy in distinguishing IAC.The nomogram model,which quantified these independent factors,demonstrated enhanced predictive power for IAC.The calibration curve indicated good fit of the prediction model,and the clinical DCA showed the model had good clinical applicability.Conclusion The model combining AI quantitative parameters and imaging signs has a higher ability to predict the risk of IAC,compared to a single indicator.It helps clinicians in determining the appropriate surgical timing,formulating surgical methods,and reducing overtreatment.

Objective:To analyze the influencing factors of pelvic floor muscle exercise (PFME) compliance in patients with urinary incontinence after laparoscopic radical prostatectomy (LRP) based on the theory of disease uncertainty, and construct a structural equation model, so as to explore the impact mechanisms of disease uncertainty, social support, PFME self-efficacy, and disease coping styles on exercise compliance in patients with urinary incontinence after LRP.Methods:Convenience sampling was used to select 300 postoperative urinary incontinence patients who underwent LRP and PFME at Tenth People's Hospital of Tongji University between June 2023 and June 2024 as study subjects. Patients were assessed using the General Information Questionnaire, PFME Compliance Scale, Mishel Uncertainty in Illness Scale-Adult (MUIS-A), Broome Pelvic Muscle Self-Efficacy Scale (BPMSES), Social Support Rating Scale (SSRS), and Medical Coping Modes Questionnaire (MCMQ). Multiple linear regression analysis was employed to identify factors influencing PFME compliance in patients with urinary incontinence after LRP. Pearson correlation was used to analyze the correlation between PFME compliance and disease uncertainty, self-efficacy, social support, and medical coping styles in patients with urinary incontinence after LRP. AMOS 26.0 software was used for path analysis.Results:A total of 300 questionnaires were distributed, and 282 valid questionnaires were collected, with a valid response rate of 94.00% (282/300). Among 282 patients with urinary incontinence after LRP, the PFME Compliance Scale, MUIS-A, BPMSES, SSRS, and MCMQ scores for confrontation, avoidance, and resignation coping styles were (11.92±2.60), (72.37±14.56), (166.98±17.10), (50.69±6.73), (14.46±2.56), (14.12±2.91), and (12.32±2.58), respectively. PFME compliance showed negative correlations with MUIS-A scores and resignation coping style ( r=-0.559, -0.606; P<0.01), while exhibiting positive correlations with PFME self-efficacy, social support and confrontation coping style ( r=0.494, 0.539, 0.118; P<0.05). Bootstrap mediating analysis showed that disease uncertainty not only directly affected PFME compliance in patients with urinary incontinence after LRP, but also indirectly affected PFME compliance through three pathways: disease uncertainty→ PFME self-efficacy→ PFME compliance, with an effect value of -0.147 [95% CI (-0.250, -0.085) ], accounting for 18.1% of the total effect; disease uncertainty→ resignation coping style→ PFME compliance, with an effect value of -0.184 [95% CI (-0.270, -0.115) ], accounting for 22.7% of the total effect; disease uncertainty→ social support → PFME compliance, with an effect value of -0.173 [95% CI (-0.300, -0.070) ], accounting for 21.4% of the total effect. The indirect total effect constituted 62.2% of the total effect. Conclusions:Patients with urinary incontinence after LRP have low PFME compliance. Disease uncertainty not only directly affects PFME compliance, but also indirectly affects it through PFME self-efficacy, social support, and coping styles.