OBJECTIVES: Stress urinary incontinence (SUI) is a common condition among women that severely impairs quality of life. Pelvic floor proprioceptive training (PFPT) has attracted increasing attention for its potential to enhance pelvic floor muscle function and alleviate SUI symptoms. This study aims to observe and compare the clinical efficacy of PFPT combined with electroacupuncture, electrical stimulation, and biofeedback therapy versus conventional therapy consisting of electroacupuncture, electrical stimulation, and biofeedback alone in women with SUI, and to explore the role of PFPT in improving symptom and functional outcomes. METHODS: In this randomized controlled trial, 72 women with mild to moderate SUI were recruited from the Department of Rehabilitation Medicine at Third Xiangya Hospital, Central South University, between December 2021 and October 2023. Participants were randomly assigned to an experimental group (n=36) or a control group (n=36). Both groups received health education. The control group underwent electroacupuncture combined with electrical stimulation and biofeedback therapy, while the experimental group additionally received PFPT 3 times per week for 4 weeks. The primary outcome was assessed using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF). Secondary outcomes included pelvic floor muscle strength, bladder neck mobility, and balance ability. The ICIQ-SF was reassessed at 1, 3, 6, and 12 months post-treatment. RESULTS: Both groups showed statistically significant improvements in all parameters after treatment (all P<0.05). However, there were no statistically significant differences between groups in most measures (all P>0.05). The experimental group demonstrated longer single-leg stance duration with eyes closed than the control group (left leg: P=0.026; right leg: P=0.006), with a significant increase from baseline (P<0.001). At 6 months post-treatment, the cure rate in the experimental group was significantly higher than that in the control group (P=0.037). CONCLUSIONS Conventional therapy effectively improves SUI symptoms, but adding PFPT provides notable additional benefits, including enhanced balance ability and sustained mid-term cure rates. These findings suggest that PFPT is a valuable adjunct to standard SUI management strategies.
Humans ; Female ; Urinary Incontinence, Stress/physiopathology* ; Pelvic Floor/physiopathology* ; Middle Aged ; Biofeedback, Psychology ; Adult ; Exercise Therapy/methods* ; Proprioception ; Electroacupuncture/methods* ; Quality of Life ; Electric Stimulation Therapy/methods* ; Treatment Outcome ; Combined Modality Therapy

Objective:To evaluate the effectiveness and safety of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in children with stage 4/M neuroblastoma (NB).Methods:This study was a prospective, single-arm, multicenter clinical trial conducted by Sun Yat-sen Memorial Hospital, Children′s Hospital of Nanjing Medical University, Children′s Hospital, Zhejiang University School of Medicine, the First Affiliated Hospital of Guangxi Medical University, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine. From March, 2019 to August, 2023, 25 children with confirmed with stage 4/M NB and received allo-HSCT were enrolled. The patients received either unrelated cord blood transplantation (UCBT) or peripheral blood stem cell transplantation (PBSCT). Conditioning regimens for UCBT was fludarabine+busulfan+cyclophosphamide+topotecan, and for PBSCT was fludarabine+busulfan+melphalan+thiotepa+antithymocyte globulin, respectively. Until the last follow-up date of September, 2023, the overall survival (OS) rate and event free survival (EFS) rate were analyzed to evaluate efficacy. The engraftment rate and transplant-related complications were statistically assessed to evaluate safety. Survival analysis was performed using the Kaplan-Meier method.Results:Of the 25 patients, there were 15 males and 10 females. The age at transplantation was 5.7 (3.8, 7.3) years. The engraft rate was 100%, with recovery time of neutrophil as 15.7 (12.5, 17.0) d, and the recovery time of platelets as 33.5 (18.0, 48.0) d. Seventeen of the 25 children (68%) developed acute graft versus host disease (aGVHD), occurred at 18.0 (13.0, 22.5) d after transplantation, including 13 of grade Ⅲ-Ⅳ cases. The main sites of aGVHD were skin and intestinal tract. After treatment, 13 cases improved, 4 patients developed chronic graft-versus-host disease (cGVHD). After allo-HSCT, 14 children received maintenance therapy. Twenty of the 25 patients survived, the 2-year cumulative OS rate was (80±9)%, and 2-year EFS rate was (56±11)%. Nine cases (36%) relapsed, the time from allo-HSCT to disease relapse was 10.9 (5.5, 16.0) months. Five cases (20%) died. The hematopoietic stem cell transplantation associated mortality rate was 4% (1/25).The 2-year OS rate of patients who had partial remission prior to allo-HSCT was significant lower than those who had complete remission prior to allo-HSCT ((33±25)% vs. 100%, P=0.037). Conclusion:allo-HSCT is an effective treatment for patients with stage 4/M NB.

Objective:To investigate the efficacy of warm needle acupuncture combined with bone manipulation and Tuina treatment in the treatment of lumbar disc herniation (LDH) and its effects on patients' lumbar function and quality of life. Methods:Fifty patients with LDH admitted to Wenzhou Traditional Chinese Medicine Hospital from December 2022 to December 2023 were included in this study. The patients were randomly divided into an observation group ( n = 25) and a control group ( n = 25) using the random number table method. Patients in the control group received bone manipulation and Tuina treatment, while those in the observation group received warm needle acupuncture combined with bone manipulation and Tuina treatment. Both groups underwent a treatment course of 4 weeks. The therapeutic effects were compared between the two groups. Additionally, the Oswestry Disability Index score, Visual Analog Scale score, Japanese Orthopaedic Association score, and the General Quality of Life Inventory (GQOLI-74) score were compared between the two groups before and after treatment. Results:The total effective rate of treatment in the observation group was significantly higher than that in the control group [96.00% (24/25) vs. 68.00% (17/25), χ2 = 4.88, P < 0.05]. After treatment, the Oswestry Disability Index score and Visual Analog Scale score in the observation group were (9.82 ± 1.76) and (1.72 ± 0.46), respectively, which were significantly lower than those in the control group [(13.97 ± 2.54), (2.89 ± 0.71), t = 6.71, 6.91, both P < 0.001]. In the observation group, the scores for limitations in daily activities, clinical symptoms, subjective symptoms, and the total score were (12.32 ± 2.17), (4.89 ± 0.72), (7.32 ± 1.18), and (24.53 ± 2.94), respectively. These scores were all significantly higher than those in the control group [(9.98 ± 1.64), (3.67 ± 0.58), (5.98 ± 0.76), (19.63 ± 2.87), t = 4.30, 6.60, 4.77, 5.96, all P < 0.001]. Additionally, the scores for social function, psychological function, and physical function in the observation group were (76.82 ± 6.08), (73.42 ± 6.92), and (78.28 ± 6.98), respectively. These scores were significantly higher than those in the control group [(63.32 ± 7.13), (60.09 ± 5.85), (65.21 ± 5.59), t = 7.20, 7.35, 7.31, all P < 0.001]. Conclusions:Warm needle acupuncture combined with bone manipulation and Tuina treatment is highly effective on LDH. The approach can improve patients' lumbar function and quality of life.

Objective:To investigate the efficacy of warm needle acupuncture combined with bone manipulation and Tuina treatment in the treatment of lumbar disc herniation (LDH) and its effects on patients' lumbar function and quality of life. Methods:Fifty patients with LDH admitted to Wenzhou Traditional Chinese Medicine Hospital from December 2022 to December 2023 were included in this study. The patients were randomly divided into an observation group ( n = 25) and a control group ( n = 25) using the random number table method. Patients in the control group received bone manipulation and Tuina treatment, while those in the observation group received warm needle acupuncture combined with bone manipulation and Tuina treatment. Both groups underwent a treatment course of 4 weeks. The therapeutic effects were compared between the two groups. Additionally, the Oswestry Disability Index score, Visual Analog Scale score, Japanese Orthopaedic Association score, and the General Quality of Life Inventory (GQOLI-74) score were compared between the two groups before and after treatment. Results:The total effective rate of treatment in the observation group was significantly higher than that in the control group [96.00% (24/25) vs. 68.00% (17/25), χ2 = 4.88, P < 0.05]. After treatment, the Oswestry Disability Index score and Visual Analog Scale score in the observation group were (9.82 ± 1.76) and (1.72 ± 0.46), respectively, which were significantly lower than those in the control group [(13.97 ± 2.54), (2.89 ± 0.71), t = 6.71, 6.91, both P < 0.001]. In the observation group, the scores for limitations in daily activities, clinical symptoms, subjective symptoms, and the total score were (12.32 ± 2.17), (4.89 ± 0.72), (7.32 ± 1.18), and (24.53 ± 2.94), respectively. These scores were all significantly higher than those in the control group [(9.98 ± 1.64), (3.67 ± 0.58), (5.98 ± 0.76), (19.63 ± 2.87), t = 4.30, 6.60, 4.77, 5.96, all P < 0.001]. Additionally, the scores for social function, psychological function, and physical function in the observation group were (76.82 ± 6.08), (73.42 ± 6.92), and (78.28 ± 6.98), respectively. These scores were significantly higher than those in the control group [(63.32 ± 7.13), (60.09 ± 5.85), (65.21 ± 5.59), t = 7.20, 7.35, 7.31, all P < 0.001]. Conclusions:Warm needle acupuncture combined with bone manipulation and Tuina treatment is highly effective on LDH. The approach can improve patients' lumbar function and quality of life.

Objective:To evaluate the effectiveness and safety of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in children with stage 4/M neuroblastoma (NB).Methods:This study was a prospective, single-arm, multicenter clinical trial conducted by Sun Yat-sen Memorial Hospital, Children′s Hospital of Nanjing Medical University, Children′s Hospital, Zhejiang University School of Medicine, the First Affiliated Hospital of Guangxi Medical University, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine. From March, 2019 to August, 2023, 25 children with confirmed with stage 4/M NB and received allo-HSCT were enrolled. The patients received either unrelated cord blood transplantation (UCBT) or peripheral blood stem cell transplantation (PBSCT). Conditioning regimens for UCBT was fludarabine+busulfan+cyclophosphamide+topotecan, and for PBSCT was fludarabine+busulfan+melphalan+thiotepa+antithymocyte globulin, respectively. Until the last follow-up date of September, 2023, the overall survival (OS) rate and event free survival (EFS) rate were analyzed to evaluate efficacy. The engraftment rate and transplant-related complications were statistically assessed to evaluate safety. Survival analysis was performed using the Kaplan-Meier method.Results:Of the 25 patients, there were 15 males and 10 females. The age at transplantation was 5.7 (3.8, 7.3) years. The engraft rate was 100%, with recovery time of neutrophil as 15.7 (12.5, 17.0) d, and the recovery time of platelets as 33.5 (18.0, 48.0) d. Seventeen of the 25 children (68%) developed acute graft versus host disease (aGVHD), occurred at 18.0 (13.0, 22.5) d after transplantation, including 13 of grade Ⅲ-Ⅳ cases. The main sites of aGVHD were skin and intestinal tract. After treatment, 13 cases improved, 4 patients developed chronic graft-versus-host disease (cGVHD). After allo-HSCT, 14 children received maintenance therapy. Twenty of the 25 patients survived, the 2-year cumulative OS rate was (80±9)%, and 2-year EFS rate was (56±11)%. Nine cases (36%) relapsed, the time from allo-HSCT to disease relapse was 10.9 (5.5, 16.0) months. Five cases (20%) died. The hematopoietic stem cell transplantation associated mortality rate was 4% (1/25).The 2-year OS rate of patients who had partial remission prior to allo-HSCT was significant lower than those who had complete remission prior to allo-HSCT ((33±25)% vs. 100%, P=0.037). Conclusion:allo-HSCT is an effective treatment for patients with stage 4/M NB.

BACKGROUND:In recent years,increasing studies have shown that low-intensity pulsed ultrasound can promote the healing of acute tendon injuries,but the specific mechanism is still unclear. OBJECTIVE:To observe the effect of low-intensity pulsed ultrasound on early angiogenesis after acute tendon injury,and to detect the regulatory relationship of low-intensity pulsed ultrasound with vascular endothelial growth factor-related signaling pathways,so as to reveal its potential mechanism of action. METHODS:Animal models of acute Achilles tendon injury were established using local injection of type I collagenase for 3 days in SPF male Sprague-Dawley rats aged 8-12 weeks,and were then randomly divided into ultrasound group and control group.In the ultrasound group,low-intensity pulsed ultrasound was treated daily with a small ultrasonic probe with an effective radiation area of 1 cm2 perpendicular to the Achilles tendon.No intervention was performed in the control group.Ultrasound imaging examination was performed 2 weeks later to observe the early healing of the tendon.Hematoxylin-eosin staining and CD31 immunohistochemical staining were performed to observe the changes in the number of blood vessels in the tissues after 1 and 2 weeks of treatment.The expression of vascular endothelial growth factor-related signaling pathway molecules in Achilles tendon tissues was detected by western blot or qRT-PCR. RESULTS AND CONCLUSION:Compared with the control group,the Achilles tendon in the ultrasound group was more continuous,the echo intensity was lower and more uniform,and the tendon thickness was significantly reduced(P<0.05).Hematoxylin-eosin staining and CD31 immunohistochemical staining results showed that after 2 weeks of treatment,the number of new vessels in the ultrasound group was significantly increased compared with the control group(P<0.05).Western blot and qRT-PCR results showed that after 2 weeks of continuous ultrasound intervention,the protein or mRNA expressions of vascular endothelial growth factor,Yes-associated protein,angiopoietin-2 and cysteine-rich angiogenic inducer 61 in the Achilles tendon of the ultrasound group were significantly higher than those of the control group(P<0.05).These finding indicate that low-intensity pulsed ultrasound significantly increases the number of blood vessels in the early stage of acute tendon injury and accelerate tendon healing by up-regulating vascular endothelial growth factor expression.

Objective:To compare the efficacy and safety of Castor single-branch stent and in vitro fenestration stent in treating thoracic aortic diseases with insufficient landing zone.Methods:The clinical data of patients with thoracic aortic diseases treated with Castor single-branch stent or in vitro fenestrated stent between December 2017 and June 2021 in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed. A total of 184 patients were included, 99 patients were treated with Castor branch stent, and 85 patients with in vitro fenestration stent. All patients′ general clinical data, surgical data, perioperative and follow-up clinical and imaging data, and postoperative complications were collected. The χ2 test was used to compare the incidence of complications between the two groups, and the Kaplan-Meier method was used to plot the survival rate without adverse events between the two groups. Results:Stent placement was successful in all patients, and the success rate of the technique was 100%. Other branches were reconstructed in 2 patients in the Castor group and double fenestrated stent were reconstructed in 12 patients in the fenestrated group. The mean operation time of the Castor group was significantly shorter than that of the fenestrated group, the number of patients who received local anesthesia was significantly lower than that of the fenestrated group, and the endoleak rate during follow-up was significantly lower than that of the fenestrated group ( P<0.05). There was no significant difference in the postoperative hospital stay, the incidence rate of perioperative complications, mortality, the incidence rate of neurological complications, new dissection or aneurysm rate, branch stent stenosis rate, second surgical intervention rate, and false lumen thrombosis between the two groups ( P>0.05). The adverse event-free survival rate of the Castor group was slightly higher than that of the fenestrated group, but its difference was not statistically significant ( P>0.05). Conclusion:Castor branch stent and in vitro fenestration stent have good short-term and mid-term efficacy in the treatment of aortic diseases with insufficient landing zone, which are safe and effective options for reconstruction of LSA and other branch arteries.

Objective:To retrieve, screen, and summarize the best evidence for non-pharmacological management of Parkinson's disease patients with depression, so as to provide evidence-based basis for medical and nursing staff to standardize the non-pharmacological management.Methods:Following the "6S" evidence model, relevant literature was systematically searched from top to bottom in UpToDate, British Medical Journal, Joanna Briggs Institute Evidence-Based Health Care Center Database, National Institute for Health and Clinical Excellence, Guidelines International Network, Agency for Healthcare Research and Quality, Scottish Intercollegiate Guidelines Network, Medlive, Parkinson's Society of Canada, Cochrane Library, CINAHL, PubMed, Web of Science, Embase, China Biology Medicine, China National Knowledge Infrastructure, and WanFang Data. The search period was from database establishment to March 31, 2023. After conducting methodological quality evaluation based on literature standards, evidence was extracted and summarized from literature that met the standards, and the level of each evidence was determined.Results:A total of 22 articles were included, including one clinical decision-making, three guidelines, 14 systematic reviews, and four expert consensuses. A total of 30 best evidence were formed from six aspects, namely screening and evaluation, psychological intervention, physical therapy, traditional Chinese medicine therapy, exercise, and health education.Conclusions:The best evidence for non-pharmacological management of Parkinson's disease patients with depression summarized provides evidence-based basis for the development of non-pharmacological management plans for Parkinson's disease patients with depression.

Objective:To analyze the short-term clinical efficacy and safety of arsenic trioxide (ATO) combined with a modified N7 induction regimen in the treatment of children with high-risk neuroblastoma (NB).Methods:This study was a prospective, single-arm, multicenter phase Ⅱ clinical study. Sixty-seven high-risk NB children from eight units of Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Wuhan Children′s Hospital of Tongji Medical College of Huazhong University of Science and Technology, First Affiliated Hospital of Guangxi Medical University, Hainan General Hospital, Affiliated Hospital of Guangdong Medical University, Kunming Children′s Hospital, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, and Guangdong Provincial Agricultural Reclamation Center Hospital were enrolled from January 2019 to August 2023 and were treated with ATO combined with a modified N7 induction regimen. The efficacy and adverse effects at the end of induction chemotherapy were assessed and analyzed, and the differences in the clinical characteristics were further compared between the treatment-responsive and treatment-unresponsive groups by using the Fisher′s exact test.Results:Among 67 high-risk NB children, there were 40 males (60%) and 27 females (40%), with the age of disease onset of 3.5 (2.6, 4.8) years. Primary NB sites were mostly in retroperitoneum (including adrenal gland) (56/67, 84%) and the common metastases sites at initial diagnosis were distant lymph node in 25 cases (37%),bone in 48 cases (72%),bone marrow in 56 cases (84%) and intracalvarium in 3 cases (4%). MYCN gene amplification were detected in 28 cases (42%). At the end of induction, 33 cases (49%) achieved complete remission, 29 cases (43%) achieved partial remission, 1 case (1%) with stable disease, and 4 cases (6%) were assessed as progressive disease (PD). The objective remission rate was 93% (62/67) and the disease control rate was 94% (63/67). The percentage of central system metastases at the initial diagnosis was higher in the treatment-unresponsive group than in the treatment-responsive group (2/5 vs. 2% (1/62), P=0.013), whereas the difference in MYCN gene amplification was not statistically significant between two groups (3/5 vs.40% (25/62), P=0.786). Grade Ⅲ or higher adverse reactions during the induction chemotherapy period were myelosuppression occurred in 60 cases (90%), gastrointestinal symptoms occurred in 33 cases (49%), infections occurred in 20 cases (30%), hepatotoxicity occurred in 4 cases (6%), and cardiovascular toxicity occurred in 1 case (2%). There were no chemotherapy-related deaths. Conclusion:ATO combined with N7-modified induction regimen had a superiority in efficacy and safety, which deserved further promotion in clinical practice.

Polygoni multiflori radix praeparata is a processed product of Polygoni multiflori radix(Polygonum multiflorum Thunb.),and its main components include stilbene glycosides,anthraquinones,flavonoids,alkaloids,phenolic acids,etc.It has antioxidant,antianemic,anti-tumor,hypoglycemic,anti-inflammatory effects,etc,and is widely used in clinical practice.The processing technology is mainly stewinging with black bean juice,steaming,processing for 9 times and braising and simmering.After processing,the color deepens and the content of composition changes.By consulting domestic and foreign literature,the research on Polygoni multiflori radix praeparata is not comprehensive enough compared with Polygoni multiflori radix.Therefore,this paper mainly summarizes the processing technology,chemical composition and pharmacological activity of Polygoni multiflori radix preparata reported in the past 20 years,and provides a reference for further development of Polygoni multiflori radix preparata.