Objective:To investigate the efficacy of pelvic floor neuromuscular stimulation combined with progesterone in the treatment of pelvic floor function recovery after hysterectomy.Methods:This study used a randomized controlled design, involving 108 patients with pelvic floor dysfunction who underwent hysterectomy at Shaanxi Provincial People's Hospital between January 2021 and December 2023. These patients were randomly assigned to either a control group or an observation group, with 54 patients in each group, using a random number table for allocation. Both groups received basic pelvic floor muscle training. The control group was treated solely with progesterone vaginal soft capsules, while the observation group also received neuromuscular stimulation through pelvic rehabilitation equipment. Before and after treatment, changes in muscle strength (measured by electromyography values of type I and type II muscle fibers), quality of life (assessed using the Pelvic Floor Dysfunction Index Questionnaire-7 and the Pelvic Floor Distress Inventory-Short Form 20), pelvic relaxation indicators (levels of laminin, relaxin, and transforming growth factor beta-3), and Pelvic Organ Prolapse Quantification staging were compared between the two groups. Additionally, stress urinary incontinence, lumbosacral pain, sexual satisfaction, vaginal prolapse conditions, and overall efficacy post-treatment were compared between the two groups.Results:After treatment, electromyography values for type I and type II muscle fibers in the observation group were (4.71 ± 0.61) μA and (5.63 ± 0.79) μA, respectively, which were significantly higher than those in the control group [(3.51 ± 0.53) μA, (4.53 ± 0.50) μA, t = -10.91, -8.65, both P < 0.001]. The scores for the Pelvic Floor Dysfunction Index Questionnaire-7 and Pelvic Floor Distress Inventory-Short Form 20 in the observation group were (4.56 ± 0.64) and (4.56 ± 0.64), respectively, both of which were significantly lower than those in the control group [(5.36 ± 0.70), (5.36 ± 0.70), t = 6.20, 26.74, both P < 0.001]. The levels of laminin, relaxin, and transforming growth factor beta-3 in the observation group were (27.28 ± 3.00) μg/L, (53.32 ± 6.40) μg/L, and (28.25 ± 3.67) mg/L, respectively, all of which were significantly lower than those in the control group [(32.14 ± 3.54) μg/L, (59.22 ± 6.51) μg/L, (36.25 ± 3.99) mg/L, t = 7.70, 4.75, 10.84, all P < 0.001]. The proportion of patients in the observation group with a POP-Q stage of 0 was 90.74% (49/54), which was significantly higher than that in the control group [68.52% (37/54), χ2=8.22, P < 0.05]. The proportion in the observation group with a stage of 1 was 7.41% (4/54), which was significantly lower than that in the control group [25.93% (14/54), χ2 = 6.67, P < 0.05]. The incidence rates of stress urinary incontinence, lumbosacral pain, sexual dissatisfaction, and vaginal prolapse in the observation group were all significantly lower than those in the control group ( χ2 = 4.41, 4.36, 4.70, 4.41, all P < 0.05). The overall effective rate in the observation group was 92.59% (50/54), which was significantly higher than that in the control group [74.07% (40/54), χ2 = 6.67, P < 0.05]. Conclusions:Pelvic floor neuromuscular stimulation combined with progesterone vaginal soft capsules can improve muscle strength in patients with pelvic floor dysfunction after hysterectomy, enhance life satisfaction, relieve pelvic relaxation, and promote comprehensive recovery of pelvic function.

Objective:To explore the characteristics of systemic immune microenvironment during the progression of dextran sulfate sodium(DSS)-induced acute ulcerative colitis(UC)induced in mice by Mass cytometry(CyTOF).Methods:Male C57BL/6 mice were randomly divided into control group and model group.The control group was given normal drinking water for 15 d.The mouse in the model group were given 5%DSS in drinking water,which was changed to normal drinking water after 7 days.In the model group,peripheral blood was collected on days 4,9 and 15,respectively.CyTOF was used to detect the expressions of 33 immune cell markers and changes in cell subsets in peripheral blood of mice,and the characteristics of systemic immune microenvironment in mice with acute UC were analyzed.Results:The cluster analysis of 33 kinds of immune cell markers showed that CD45+cells in peripheral blood of mice with DSS induced acute UC were divided into 23 fine subgroups,among which the proportions of B cell subgroup,T cell subgroup and neutrophil subgroup showed significant changes.A further dimensional reduction cluster analysis of T cell subsets found significant differences in the composition and proportion of the 10 identified T cell subsets.Conclusion:The systemic immune micro-environment map of mice with acute UC induced by DSS has been successfully constructed,and heterogeneity has been found in the systemic immune microenvironment of mice with acute UC.The changes and activation degree of T cell subpopulations are closely re-lated to disease progression and inflammation level.The results of this study provide theoretical basis for assisting the diagnosis,moni-toring the risk,progression,treatment and prognosis of acute UC.

Objective:To investigate the efficacy of pelvic floor neuromuscular stimulation combined with progesterone in the treatment of pelvic floor function recovery after hysterectomy.Methods:This study used a randomized controlled design, involving 108 patients with pelvic floor dysfunction who underwent hysterectomy at Shaanxi Provincial People's Hospital between January 2021 and December 2023. These patients were randomly assigned to either a control group or an observation group, with 54 patients in each group, using a random number table for allocation. Both groups received basic pelvic floor muscle training. The control group was treated solely with progesterone vaginal soft capsules, while the observation group also received neuromuscular stimulation through pelvic rehabilitation equipment. Before and after treatment, changes in muscle strength (measured by electromyography values of type I and type II muscle fibers), quality of life (assessed using the Pelvic Floor Dysfunction Index Questionnaire-7 and the Pelvic Floor Distress Inventory-Short Form 20), pelvic relaxation indicators (levels of laminin, relaxin, and transforming growth factor beta-3), and Pelvic Organ Prolapse Quantification staging were compared between the two groups. Additionally, stress urinary incontinence, lumbosacral pain, sexual satisfaction, vaginal prolapse conditions, and overall efficacy post-treatment were compared between the two groups.Results:After treatment, electromyography values for type I and type II muscle fibers in the observation group were (4.71 ± 0.61) μA and (5.63 ± 0.79) μA, respectively, which were significantly higher than those in the control group [(3.51 ± 0.53) μA, (4.53 ± 0.50) μA, t = -10.91, -8.65, both P < 0.001]. The scores for the Pelvic Floor Dysfunction Index Questionnaire-7 and Pelvic Floor Distress Inventory-Short Form 20 in the observation group were (4.56 ± 0.64) and (4.56 ± 0.64), respectively, both of which were significantly lower than those in the control group [(5.36 ± 0.70), (5.36 ± 0.70), t = 6.20, 26.74, both P < 0.001]. The levels of laminin, relaxin, and transforming growth factor beta-3 in the observation group were (27.28 ± 3.00) μg/L, (53.32 ± 6.40) μg/L, and (28.25 ± 3.67) mg/L, respectively, all of which were significantly lower than those in the control group [(32.14 ± 3.54) μg/L, (59.22 ± 6.51) μg/L, (36.25 ± 3.99) mg/L, t = 7.70, 4.75, 10.84, all P < 0.001]. The proportion of patients in the observation group with a POP-Q stage of 0 was 90.74% (49/54), which was significantly higher than that in the control group [68.52% (37/54), χ2=8.22, P < 0.05]. The proportion in the observation group with a stage of 1 was 7.41% (4/54), which was significantly lower than that in the control group [25.93% (14/54), χ2 = 6.67, P < 0.05]. The incidence rates of stress urinary incontinence, lumbosacral pain, sexual dissatisfaction, and vaginal prolapse in the observation group were all significantly lower than those in the control group ( χ2 = 4.41, 4.36, 4.70, 4.41, all P < 0.05). The overall effective rate in the observation group was 92.59% (50/54), which was significantly higher than that in the control group [74.07% (40/54), χ2 = 6.67, P < 0.05]. Conclusions:Pelvic floor neuromuscular stimulation combined with progesterone vaginal soft capsules can improve muscle strength in patients with pelvic floor dysfunction after hysterectomy, enhance life satisfaction, relieve pelvic relaxation, and promote comprehensive recovery of pelvic function.

Objective:To evaluate the outcomes of stroke treatment in neurology and rehabilitation departments using the International Classification of Functioning, Disability and Health′s Rehabilitation Set (ICF-RS).Method:The functional status of stroke survivors before and after treatment in the neurology and rehabilitation departments was evaluated using the ICF-RS (30 items). Each patient′s functioning was graded (normal, mild, moderate or severe dysfunction) by an experienced clinical evaluator and also by the intelligent evaluation model in the ICF-RS app. Medical expenditure data during hospitalization were extracted from the hospital′s case records. Rank sum tests compared the functional changes in a patient before and after their rehabilitation. Kappa coefficients were computed to evaluate the consistency of the functional grades assigned by the evaluators and the app.Results:Before the rehabilitation treatment, all 30 items of the ICF-RS were abnormal for all of the patients from the neurology and rehabilitation departments. After their rehabilitation treatment, 25 items had improved significantly for the neurology patients and 8 had improved significantly for those from the rehabilitation department. After their rehabilitation treatment, the average functional improvement among the neurology patients was 25%. For the rehabilitation patients it was 13%. The total expenditure for every 1% improvement in function was Y977 for the neurology patients (including Y143 for rehabilitation) and Y1, 481 for the rehabilitation patients (including Y862 of actual rehabilitation). The proportions of rehabilitation expenditure were thus 14% and 58% respectively. The kappa coefficients quantifying overall consistency were both greater than 0.8.Conclusion:The national standard ICF-RS can be used to evaluate functional changes, rehabilitation efficacy and the composition of stroke patients′ medical expenditures in the early stage of neurology and the recovery period in the rehabilitation department. The consistency of the functional level evaluations between the app and human evaluators is good.

Objective:To evaluate the efficacy and safety of high-frequency repetitive transcranial magnetic stimulation (hrTMS) in postherpetic neuralgia (PHN).Methods:A prospective randomized controlled trial was performed; 63 PHN patients treated in Department of Neurology and Department of Dermatology and Venereology of Anqing Municipal Hospital from June 2024 to March 2025 were enrolled; they were randomly assigned to 2 groups: an hrTMS group ( n=32) received hrTMS (frequency: 10 Hz; total pulses: 2,400; intensity: 90% of resting motor threshold) to the contralateral primary motor cortex (M1), and a sham stimulation group ( n=31) received sham stimulation using a sham figure-of-eight coil generating no actual magnetic field. Scores of short-form McGill pain questionnaires (pain rating index [PRI] total score, PRI sensory subscore, PRI affective subscore, visual analogue scale [VAS] score, present pain intensity [PPI] score) and N100 amplitude were collected before treatment and at 1, 2, 3, and 4 weeks after treatment. Adverse events during treatment were recorded. Results:At 2 weeks after treatment, significant difference was observed between the hrTMS group and sham stimulation group in PRI total score, VAS score, and N100 amplitude ( P<0.05). At 3 and 4 weeks after treatment, significant differences were found between the two groups in PRI total score, PRI sensory subscore, PRI affective subscore, VAS score, PPI score and N100 amplitude (3 weeks after treatment: 8.59±1.13 vs. 9.61±1.20, 5.34±0.79 vs. 5.90±0.94, 3.25±0.57 vs. 3.71±0.46, 5.78±0.66 vs. 6.42±0.92, 2.16±0.37 vs. 2.55±0.51, and [2.53±0.51] μV vs. [2.13±0.34] μV; 4 weeks after treatment: 7.53±0.92 vs. 9.68±1.35, 4.94±0.62 vs. 6.00±1.07, 2.59±0.56 vs. 3.68±0.60, 5.06±0.67 vs. 6.23±1.06, 1.97±0.17 vs. 2.52±0.51, and [2.81±0.40] μV vs. [2.16±0.52] μV, P<0.05). In the hrTMS group, PRI total score, PRI sensory subscore, PRI affective subscore, VAS score, PPI score and N100 amplitude were significantly different at 2, 3, and 4 weeks after treatment compared with those before treatment ( P<0.05). Incidence of adverse events (headache, dizziness or tinnitus) did not differ significantly between the two groups ( P>0.05). Conclusion:The hrTMS applied to the M1 region in PHN patients is effective by obviously reducing pain intensity and improving negative emotional states, with favorable safety profile.

Nonunion of osteoporotic vertebral fractures (OVF), predominantly affecting the elderly, can lead to intractable pain, vertebral collapse, progressive kyphotic deformity, and neurological impairment, significantly compromising patients′ quality of life. There exists considerable debate on diagnosis and management of OVF, encompassing key issues such as clinical diagnosis and staging criteria for nonunion, surgical indications and procedure selection, and postoperative rehabilitation planning. Currently, there lacks standardized clinical guideline and expert consensus on the diagnosis and management of OVF nonunion in China. To address this gap, Minimally Invasive Surgery Group of Chinese Orthopedic Association, Osteoporosis Committee of Chinese Association of Orthopedic Surgeons, Prevention and Rehabilitation Committee for Osteoporosis of Chinese Association of Rehabilitation Medicine and Minimally Invasive Orthopedic Surgery Branch of China Association for Geriatric Care jointly organized domestic experts in spinal surgery, endocrinology, and rehabilitation to formulate the Clinical guideline for the diagnosis and treatment for nonunion of osteoporotic vertebral fractures ( version 2025), based on existing literature and clinical experience and adhering to principles of scientific rigor and practicality. The guideline provided 13 evidence-based recommendations encompassing diagnosis and treatment of OVF nonunion, aiming to standardize its clinical management.

Objective:To evaluate the efficacy and safety of percutaneous nephrolithotomy (PCNL) in the treatment of severe acute pancreatitis (SAP) with infected pancreatic necrosis (IPN).Methods:A retrospective analysis was conducted on the clinical data of 113 patients with SAP and IPN admitted to Qingdao Municipal Hospital between January 2018 and June 2023. The cohort included 66 males and 47 females, aged (46.2±13.6) years. Based on the treatment approach, patients were divided into two groups: those who underwent percutaneous catheter drainage (PCD) alone were assigned to the PCD group ( n=60), and those who received PCNL were assigned to the PCNL group ( n=53). Clinical parameters such as age, sex, number of debridement procedures, and postoperative complications were recorded. Results:Compared with the PCD group, the PCNL group had a higher CT severity index [8(6, 9) vs. 7(6, 8)], a greater proportion of patients with multiloculated abscesses [71.7%(38/53) vs. 41.7%(25/60)], and a higher percentage of patients with IPN involving >50% necrosis [56.6%(30/53) vs. 33.3%(20/60)]. These differences were statistically significant (all P<0.05). The PCNL group also showed a higher proportion of patients with post-treatment IPN necrosis involving <30% [91.4%(49/53) vs. 70.8%(42/60)], a lower rate of requiring step-up laparoscopic or open surgery [3.8%(2/53) vs. 10.0%(6/60)], fewer debridement sessions [2(1, 4) vs. 4(2, 6)], and a shorter total hospital stay [45(35, 58) d vs. 54(23, 72) d]. These differences were statistically significant (all P<0.05). Additionally, the PCNL group had lower rates of postoperative complications, including enteric fistula [3.8%(2/53) vs. 11.7%(7/60)], intra-abdominal bleeding [5.7%(3/53) vs. 13.3%(8/60)], and pancreatic fistula [15.1%(8/53) vs. 20.0% (12/60)]. These differences were also statistically significant (all P<0.05). The recurrence rate of abscesses was significantly lower in the PCNL group [11.3%(6/53) vs. 16.7%(10/60), χ2=4.14, P=0.042]. Conclusion:PCNL is an effective treatment for SAP complicated by IPN. Compared with PCD, it improves the clearance of necrotic tissue, reduces the number of debridement procedures, shortens the total hospital stay, and lowers the risk of postoperative complications.

Objective:To explore the characteristics of systemic immune microenvironment during the progression of dextran sulfate sodium(DSS)-induced acute ulcerative colitis(UC)induced in mice by Mass cytometry(CyTOF).Methods:Male C57BL/6 mice were randomly divided into control group and model group.The control group was given normal drinking water for 15 d.The mouse in the model group were given 5%DSS in drinking water,which was changed to normal drinking water after 7 days.In the model group,peripheral blood was collected on days 4,9 and 15,respectively.CyTOF was used to detect the expressions of 33 immune cell markers and changes in cell subsets in peripheral blood of mice,and the characteristics of systemic immune microenvironment in mice with acute UC were analyzed.Results:The cluster analysis of 33 kinds of immune cell markers showed that CD45+cells in peripheral blood of mice with DSS induced acute UC were divided into 23 fine subgroups,among which the proportions of B cell subgroup,T cell subgroup and neutrophil subgroup showed significant changes.A further dimensional reduction cluster analysis of T cell subsets found significant differences in the composition and proportion of the 10 identified T cell subsets.Conclusion:The systemic immune micro-environment map of mice with acute UC induced by DSS has been successfully constructed,and heterogeneity has been found in the systemic immune microenvironment of mice with acute UC.The changes and activation degree of T cell subpopulations are closely re-lated to disease progression and inflammation level.The results of this study provide theoretical basis for assisting the diagnosis,moni-toring the risk,progression,treatment and prognosis of acute UC.

Nonunion of osteoporotic vertebral fractures (OVF), predominantly affecting the elderly, can lead to intractable pain, vertebral collapse, progressive kyphotic deformity, and neurological impairment, significantly compromising patients′ quality of life. There exists considerable debate on diagnosis and management of OVF, encompassing key issues such as clinical diagnosis and staging criteria for nonunion, surgical indications and procedure selection, and postoperative rehabilitation planning. Currently, there lacks standardized clinical guideline and expert consensus on the diagnosis and management of OVF nonunion in China. To address this gap, Minimally Invasive Surgery Group of Chinese Orthopedic Association, Osteoporosis Committee of Chinese Association of Orthopedic Surgeons, Prevention and Rehabilitation Committee for Osteoporosis of Chinese Association of Rehabilitation Medicine and Minimally Invasive Orthopedic Surgery Branch of China Association for Geriatric Care jointly organized domestic experts in spinal surgery, endocrinology, and rehabilitation to formulate the Clinical guideline for the diagnosis and treatment for nonunion of osteoporotic vertebral fractures ( version 2025), based on existing literature and clinical experience and adhering to principles of scientific rigor and practicality. The guideline provided 13 evidence-based recommendations encompassing diagnosis and treatment of OVF nonunion, aiming to standardize its clinical management.

Objective:To evaluate the outcomes of stroke treatment in neurology and rehabilitation departments using the International Classification of Functioning, Disability and Health′s Rehabilitation Set (ICF-RS).Method:The functional status of stroke survivors before and after treatment in the neurology and rehabilitation departments was evaluated using the ICF-RS (30 items). Each patient′s functioning was graded (normal, mild, moderate or severe dysfunction) by an experienced clinical evaluator and also by the intelligent evaluation model in the ICF-RS app. Medical expenditure data during hospitalization were extracted from the hospital′s case records. Rank sum tests compared the functional changes in a patient before and after their rehabilitation. Kappa coefficients were computed to evaluate the consistency of the functional grades assigned by the evaluators and the app.Results:Before the rehabilitation treatment, all 30 items of the ICF-RS were abnormal for all of the patients from the neurology and rehabilitation departments. After their rehabilitation treatment, 25 items had improved significantly for the neurology patients and 8 had improved significantly for those from the rehabilitation department. After their rehabilitation treatment, the average functional improvement among the neurology patients was 25%. For the rehabilitation patients it was 13%. The total expenditure for every 1% improvement in function was Y977 for the neurology patients (including Y143 for rehabilitation) and Y1, 481 for the rehabilitation patients (including Y862 of actual rehabilitation). The proportions of rehabilitation expenditure were thus 14% and 58% respectively. The kappa coefficients quantifying overall consistency were both greater than 0.8.Conclusion:The national standard ICF-RS can be used to evaluate functional changes, rehabilitation efficacy and the composition of stroke patients′ medical expenditures in the early stage of neurology and the recovery period in the rehabilitation department. The consistency of the functional level evaluations between the app and human evaluators is good.