Purpose To explore factors influencing vaginal delivery during the first stage of labor using intrapartum ultrasound and to construct predictive models for delivery decision-making.Materials and Methods A total of 473 nulliparous women admitted to Heping Hospital,Northern Theater General Hospital from July to December 2021 were prospectively enrolled as the training set.Clinical data on admission and fetal biometric parameters(biparietal diameter,femur length,head circumference and abdominal circumference)measured within one week before delivery were collected.Ultrasound assessments of fetal position,angle of progression(AOP)and head-perineum distance(HPD)were performed during the first stage of labor.The latent phase group(n=255)was subdivided into vaginal delivery group(n=186)and cesarean section group(n=69);the active phase group(n=218)was divided into vaginal delivery group(n=168)and cesarean section group(n=50).The associations between fetal position,AOP,HPD and vaginal delivery were analyzed,and predictive models were constructed for the latent phase(model 1)and active phase(model 2).A validation set of 547 women from January to September 2022 was used to evaluate model performance via area under the curve(AUC),calibration curves and decision curve analysis.Results In the latent phase,multivariate regression identified maternal height(OR=3.970,P=0.002),pre-pregnancy body mass index(OR=0.893,P=0.036),labor onset type(OR=2.415,P=0.045),neonatal birth weight(OR=3.728,P=0.002),AOP(OR=11.649,P<0.001)and HPD(OR=4.240,P=0.004)as significant predictors.The training and validation sets showed AUCs of 0.917 and 0.869,respectively.Goodness-of-fit tests indicated excellent model calibration(χ2=3.437,P=0.904;χ2=10.877,P=0.209).Decision curve analysis demonstrated strong clinical utility.For the active phase,significant predictors included maternal height(OR=6.532,P<0.001),neonatal birth weight(OR=11.890,P<0.001),fetal position(OR=4.600,P=0.003),AOP(OR=7.229,P<0.001)and HPD(OR=4.722,P=0.005).AUCs were 0.943(training)and 0.906(validation),with good calibration(χ2=4.340,P=0.740;χ2=9.836,P=0.277)and clinical applicability.Conclusion First stage ultrasound assessment of fetal position,AOP and HPD correlates with delivery outcomes.The developed nomogram models combining these parameters with clinical factors provide valuable guidance for delivery decision-making.

Aim To identify the underlying target of bullatine A(BA)against rheumatoid arthritis(RA)u-sing limited proteolysis-small molecule mapping(LiP-SMap)drug target proteomics and to provide a scientif-ic basis for clinical application of Aconiti brachypodi Radix in the treatment of RA.Methods LiP-SMap drug target proteomics was employed to perform bioin-formatics analysis for comparing and validating the dif-ferential protein expression after BA intervention.A collagen-induced arthritis(CIA)model was estab-lished in DBA/1 mice using bovine type Ⅱ collagen.The mice were then divided into the CIA model group,methotrexate-positive control group(MTX group),and BA groups(10 mg·kg-1 and 20 mg·kg-1)based on their clinical scores.After drug intervention,the thera-peutic efficacy against RA was assessed by joint index scores and foot thickness measurements.Histopatholog-ical changes in the arthritic joints of CIA mice were e-valuated using hematoxylin and eosin(HE)staining.Enzyme-linked immunosorbent assay(ELISA)was employed to detect inflammatory cytokines interleukin-17(IL-17)and total IgG and IgG3 anti-collagen-spe-cific antibodies levels from the serum of CIA mice.Flow cytometry was used to detect the expression levels of intracellular Th17 cells(IL-17+CD4+T cells)and Th1 cells(IFN-γ+CD4+T cells).Fluorescent quanti-tative PCR was performed to detect the expression of genes related to differential proteins.Results The proteomic analysis identified Serpinb1a as a protein with strong binding affinity to BA,and KEGG enrich-ment analysis indicated IL-17 signaling pathway was a crucial pathway of BA in against RA.BA treatment significantly reduced clinical scores and foot thickness,improved local arthritis symptoms in CIA mice,and al-leviated inflammatory cell infiltration into arthritic joints(P＜0.05).Differential protein validation re-sults showed that BA had strong affinity with Serpinb1a(-5.92 kJ·mol-1)and downregulated the expres-sion of Serpinb1a mRNA.Furthermore,the administra-tion of BA markedly reduced serum IL-17 A levels from CIA mice,inhibited the expression of intracellular IL-17 A and IFN-γ cytokines in splenic CD4+T cells(P＜0.05),and significantly downregulated the transcrip-tional expression of IL-17F(P＜0.05).Conclusion BA exhibits therapeutic effects on collagen-induced arthritis,and its mechanism of action may involve the regulation of Serpinb1a and the IL-17 signaling path-way.

Objective:To investigate the prevalence of scoliosis among middle school students through school-based screening, and to analyze the correlations between axial trunk rotation (ATR) angle and Cobb angle among those with scoliosis considering gender, age, body mass index (BMI) and curve type, so as to provide references for early prevention and treatment.Methods:Random cluster sampling was used to enroll 9501 middle school students from 11 schools in the Hanyang District of Wuhan. They underwent a six-step scoliosis screening with a forward bending test, scoliometer measurements, and confirmatory X-ray examinations. The students exhibiting scoliosis were stratified by gender, age, BMI, and curve type. The correlation between ATR angle and Cobb angle was subsequently analyzed within each subgroup.Results:Scoliosis was observed in 358 of the students (150 boys and 208 girls), a positive screening rate of 3.8%. Moreover, the positive screening rate was significantly higher among the girls (4.8%) than among the boys (2.9%). There was a moderate Spearman correlation ( r=0.69) between the ATR and Cobb angles in 358 of the students with scoliosis, both the boys ( r=0.69) and the girls ( r=0.70). When it came to age, there was a positive correlation between the ATR and Cobb angles for students aged 13 to 16 irrespective of their BMI classification, except that there was no significant correlation between the two angles for those classified as obese. In terms of Peking Union Medical College (PUMC) classification, there was a positive correlation for those in types Ia, Ib, Ic, IIa, IIb, IIc and IId, but there was no significant correlation between the two angles for those in type III. Conclusions:Scoliosis is prevalent among the group of adolescents studied. Society, schools and parents need to prioritize prevention, heightened awareness, timely diagnosis and early treatment, particularly for girls. The ATR angle may serve as a practical surrogate for estimating Cobb angle severity in scoliosis screening for single-curve or double-curve cases. However, ATR measurements may yield false-negative results among those with triple-curve deformities or the obese, underscoring the need for supplementary diagnostic methods among such populations.

Objective:To investigate the prevalence of scoliosis among middle school students through school-based screening, and to analyze the correlations between axial trunk rotation (ATR) angle and Cobb angle among those with scoliosis considering gender, age, body mass index (BMI) and curve type, so as to provide references for early prevention and treatment.Methods:Random cluster sampling was used to enroll 9501 middle school students from 11 schools in the Hanyang District of Wuhan. They underwent a six-step scoliosis screening with a forward bending test, scoliometer measurements, and confirmatory X-ray examinations. The students exhibiting scoliosis were stratified by gender, age, BMI, and curve type. The correlation between ATR angle and Cobb angle was subsequently analyzed within each subgroup.Results:Scoliosis was observed in 358 of the students (150 boys and 208 girls), a positive screening rate of 3.8%. Moreover, the positive screening rate was significantly higher among the girls (4.8%) than among the boys (2.9%). There was a moderate Spearman correlation ( r=0.69) between the ATR and Cobb angles in 358 of the students with scoliosis, both the boys ( r=0.69) and the girls ( r=0.70). When it came to age, there was a positive correlation between the ATR and Cobb angles for students aged 13 to 16 irrespective of their BMI classification, except that there was no significant correlation between the two angles for those classified as obese. In terms of Peking Union Medical College (PUMC) classification, there was a positive correlation for those in types Ia, Ib, Ic, IIa, IIb, IIc and IId, but there was no significant correlation between the two angles for those in type III. Conclusions:Scoliosis is prevalent among the group of adolescents studied. Society, schools and parents need to prioritize prevention, heightened awareness, timely diagnosis and early treatment, particularly for girls. The ATR angle may serve as a practical surrogate for estimating Cobb angle severity in scoliosis screening for single-curve or double-curve cases. However, ATR measurements may yield false-negative results among those with triple-curve deformities or the obese, underscoring the need for supplementary diagnostic methods among such populations.

AIM To establish a UPLC method for the simultaneous content determination of liquiritin,ammonium glycyrrhizate,naringin,neohesperidin,hesperidin,rosmarinic acid,baicalin,wogonoside,baicalein,wogonin and praeruptorin A in Tongxuan Lifei Pills,and to make chemometric investigation.METHODS The analysis was performed on a 30 ℃ thermostatic SVEA C18 column(2.1 mm×150 mm,2.5 μm),with the mobile phase comprising of acetonitrile-0.1％phosphoric acid flowing at 0.5 mL/min in a gradient elution manner,and the detection wavelength was set at 250 nm.Subsequently,cluster analysis,principal component analysis and partial least square discriminant analysis were performed.RESULTS Eleven constituents showed good linear relationships within their own ranges(R2＞0.990 0),whose average recoveries were 90.00％-98.32％with the RSDs of 0.35％-1.89％.Forty batches of samples were clustered into 3 types.Baicalein,baicalin,liquiritin,wogonin,wogonoside and neohesperidin were taken as quality differential markers.CONCLUSION This simple and reproducible method can provide the basis for quality control and evaluation of Tongxuan Lifei Pills.

PURPOSE: To judge the injury mode and injury severity of the real human body through the measured values of anthropomorphic test devices (ATD) injury indices, the mapping relationship of lumbar injury between ATD and human body model (HBM) was explored. METHODS: Through the ATD model and HBM simulation, the mapping relationship of lumbar injury between the 2 subjects was explored. The sled environment consisted of a semi-rigid seat with an adjustable seatback angle and a 3-point seat belt system with a seatback-mounted D-ring. Three seatback recline states of 25°, 45°, and 65° were designed, and the seat pan angle was maintained at 15°. A 23 g, 47 km/h pulse was used. The validity of the finite element model of the sled was verified by the comparison of ATD simulation and test results. ATD model was the test device for human occupant restraint for autonomous vehicles (THOR-AV) dummy model and HBM was the total human model for safety (THUMS) v6.1. The posture of the 2 models was adjusted to adapt to the 3 seat states. The lumbar response of THOR-AV and the mechanical and biomechanical data on L1 - L5 vertebrae of THUMS were output, and the response relationship between THOR-AV and THUMS was descriptive statistically analyzed. RESULTS: Both THOR-AV and THUMS were submarined in the 65° seatback angle case. With the change of seatback angle, the lumbar spine axial compression force (F_z) of THOR-AV and THUMS changed in the similar trend. The maximum F_z ratio of THOR-AV to THUMS at 25° and 45° seatback angle cases were 1.6 and 1.7. The flexion moment (M_y) and the time when the maximum M_y occurred in the 2 subjects were very different. In particular, the form of moment experienced by the L1 - L5 vertebrae of THUMS also changed. The changing trend of M_y measured by THOR-AV over time can reflect the changing trend of maximum stress of L1 and L2 of THUMS. CONCLUSION The F_z of ATD and HBM presents a certain proportional relationship, and there is a mapping relationship between the 2 subjects on F_z. The mapping function can be further clarified by applying more pulses and adopting more seatback angles. It is difficult to map M_y directly because they are very different in ATD and HBM. The M_y of ATD and stress of HBM lumbar showed a similar change trend over time, and there may be a hidden mapping relationship.
Humans ; Lumbar Vertebrae/injuries* ; Finite Element Analysis ; Biomechanical Phenomena ; Manikins ; Spinal Injuries/physiopathology*

This study primarily aimed to investigate the prevalence of human papillomavirus (HPV) and other common pathogens of sexually transmitted infections (STIs) in spermatozoa of infertile men and their effects on semen parameters. These pathogens included Ureaplasma urealyticum, Ureaplasma parvum, Chlamydia trachomatis, Mycoplasma genitalium , herpes simplex virus 2, Neisseria gonorrhoeae, Enterococcus faecalis, Streptococcus agalactiae, Pseudomonas aeruginosa , and Staphylococcus aureus . A total of 1951 men of infertile couples were recruited between 23 March 2023, and 17 May 2023, at the Department of Reproductive Medicine of The First People's Hospital of Yunnan Province (Kunming, China). Multiplex polymerase chain reaction and capillary electrophoresis were used for HPV genotyping. Polymerase chain reaction and electrophoresis were also used to detect the presence of other STIs. The overall prevalence of HPV infection was 12.4%. The top five prevalent HPV subtypes were types 56, 52, 43, 16, and 53 among those tested positive for HPV. Other common infections with high prevalence rates were Ureaplasma urealyticum (28.3%), Ureaplasma parvum (20.4%), and Enterococcus faecalis (9.5%). The prevalence rates of HPV coinfection with Ureaplasma urealyticum, Ureaplasma parvum, Chlamydia trachomatis, Mycoplasma genitalium , herpes simplex virus 2, Neisseria gonorrhoeae, Enterococcus faecalis, Streptococcus agalactiae , and Staphylococcus aureus were 24.8%, 25.4%, 10.6%, 6.4%, 2.4%, 7.9%, 5.9%, 0.9%, and 1.3%, respectively. The semen volume and total sperm count were greatly decreased by HPV infection alone. Coinfection with HPV and Ureaplasma urealyticum significantly reduced sperm motility and viability. Our study shows that coinfection with STIs is highly prevalent in the semen of infertile men and that coinfection with pathogens can seriously affect semen parameters, emphasizing the necessity of semen screening for STIs.
Humans ; Male ; Infertility, Male/epidemiology* ; Coinfection/microbiology* ; Papillomavirus Infections/virology* ; Adult ; Sexually Transmitted Diseases/complications* ; China/epidemiology* ; Staphylococcus aureus/isolation & purification* ; Chlamydia trachomatis/isolation & purification* ; Prevalence ; Mycoplasma genitalium/isolation & purification* ; Ureaplasma urealyticum/isolation & purification* ; Neisseria gonorrhoeae/isolation & purification* ; Enterococcus faecalis/isolation & purification* ; Streptococcus agalactiae/isolation & purification* ; Herpesvirus 2, Human/genetics* ; Pseudomonas aeruginosa/isolation & purification* ; Semen/virology* ; Sperm Motility ; Spermatozoa/microbiology* ; Human Papillomavirus Viruses

OBJECTIVE: To investigate the therapeutic effect of the short-penis treatment apparatus and wide-band infrared therapy apparatus on penile dysplasia (PDP) in children and establish objective parameters for assessing the severity of PDP. METHODS: This study included 252 children received in the Department of pediatric urology of the First Affiliated Hospital of Xinjiang Medical University from January to December 2023, 102 with PDP (the PDP group) and the other 150 with normal penile development (the control group), those of the former group treated with the short-penis therapeutic apparatus and wide-band infrared therapy apparatus. Before and after 30 days of treatment, we measured the flaccid penile length (FPL), stretched penile length (SPL) and penile diameters (PD) of the children, and defined the penile dysplasia index as the FPL/SPL and FPL/PD ratios. RESULTS: The penile parameters exhibited statistically significant differences between the PDP and control groups, (FPL:［1.97±0.72］cm vs ［3.25±0.51］ cm, P<0.01; SPL:［3.80±0.81］cm vs ［5.21±0.79］cm,P<0.01).The FPL remarkably increased in the PDP group after treatment(［1.97±0.72］cm vs ［2.90±1.20］ cm, P<0.01). Both FPL and SPL were notably shorter in the PDP cases than in the controls, with the cutoff values of 0.57 and 2.09, sensitivities of 80.7% and 95.3%, and specificities of 69.6% and 82.4% for FPL/SPL and FPL/PD, respectively. CONCLUSION The short-penis therapeutic apparatus and wide-band infrared therapy apparatus can promote the growth and development of the penis in children. The ratio of FPL/PD can serve as an objective indicator to effectively describe the severity of penile developmental abnormalities.
Humans ; Male ; Penis/abnormalities* ; Child ; Penile Diseases/therapy* ; Child, Preschool ; Infant

AIM To establish a UPLC method for the simultaneous content determination of liquiritin,ammonium glycyrrhizate,naringin,neohesperidin,hesperidin,rosmarinic acid,baicalin,wogonoside,baicalein,wogonin and praeruptorin A in Tongxuan Lifei Pills,and to make chemometric investigation.METHODS The analysis was performed on a 30 ℃ thermostatic SVEA C18 column(2.1 mm×150 mm,2.5 μm),with the mobile phase comprising of acetonitrile-0.1％phosphoric acid flowing at 0.5 mL/min in a gradient elution manner,and the detection wavelength was set at 250 nm.Subsequently,cluster analysis,principal component analysis and partial least square discriminant analysis were performed.RESULTS Eleven constituents showed good linear relationships within their own ranges(R2＞0.990 0),whose average recoveries were 90.00％-98.32％with the RSDs of 0.35％-1.89％.Forty batches of samples were clustered into 3 types.Baicalein,baicalin,liquiritin,wogonin,wogonoside and neohesperidin were taken as quality differential markers.CONCLUSION This simple and reproducible method can provide the basis for quality control and evaluation of Tongxuan Lifei Pills.

This paper reported a case of 77-year-old male patient who developed generalized ery-thematous macules,bullae and erosion,accompanied by genital mucosa involvement five days after taking compound sulfamethoxazole tablets.Based on patient's clinical manifestations and auxiliary ex-amination results,the diagnosis of generalized bullous fixed drug eruption was confirmed.Clinicians should be vigilant about generalized bullous fixed drug eruption with genital mucosa involvement and strive for early detection,diagnosis,and treatment.