Objective To explore the impact of electrostimulation biofeedback therapy combined with pelvic floor muscle training on postpartum pelvic floor function in first vaginal birth women.Methods A retrospective analysis was conducted on the clinical data of in first vaginal birth women.The control group(n=49)received pelvic floor muscle training,while the observation group(n=49)received electrostimulation biofeedback therapy in addition to pelvic floor muscle training.Com-parisons were made between the two groups before treatment and 10 weeks after treatment in terms of uterine artery blood flow indicators[peak systolic velocity(PSV),resistance index(RI),and pulsa-tility index(PI)of uterine artery],serological indicators[C-reactive protein(CRP),interleukin-6(IL-6)],pelvic floor ultrasound indicators(bladder neck mobility,anteroposterior diameter of levator hi-atal area,levator hiatal volume),pelvic floor function[Pelvic Floor Distress Inventory-20(PFDI-20)],pelvic floor muscle strength,and quality of life[Short Form-36 Health Survey(SF-36)].The costs of the two treatments were compared at the end of treatment.Results Ten weeks after treatment,PSV,muscle potential values of type Ⅰ and type Ⅱ muscles,and SF-36 scores were significantly increased in both groups compared with those before treatment,with the observation group showing higher values than the control group(P＜0.05).RI,PI,CRP,IL-6,bladder neck mobility,anteroposterior di-ameter of levator hiatal area,levator hiatal volume,and PFDI-20 scores were decreased in both groups compared with those before treatment,with the observation group showing lower values than the control group(P＜0.05).After treatment,the treatment cost in the observation group was significantly higher than that in the control group(P＜0.05).Conclusion Electrostimulation biofeedback ther-apy combined with pelvic floor muscle training can effectively improve postpartum uterine artery blood flow indicators,serological indicators,pelvic floor ultrasound indicators,pelvic floor muscle strength,and promote pelvic floor function recovery in first vaginal delivery women.

Objective:To explore the potent effects of denatonium benzoate(DB)on Mas-related G protein-coupled receptor-B2(MrgprB2)-mediated rat mast cell degranulation.Methods:RBL-2H3 cells were treated with DB overnight,before challenged with MrgprB2 ligands substance P(SP).The release of β-hex from MrgprB2-activated RBL-2H3 was detected by substrate method.Detec-tion of LTC4,IL-6,TNF-α and cPLA2 activity were performed by ELISA.The Ca2+influx and the expression of RBL-2H3 MrgprB2 re-ceptors were measured by fluorescence assay.Results:The results showed 10 μmol/L,50 μmol/L,80 μmol/L,100 μmol/L DB treat-ments promoted β-hex and LTC4 releases from activated RBL-2H3,accompanied by increased Ca2+mobilization and cPLA2 activa-tion.DB treatments did not affect IL-6 and TNF-α LTC4 releases in MrgprB2-activated RBL-2H3,as well as the levels of MrgprB2 ex-pression in mast cells.Conclusion:Taken together,DB enhanced the MrgprB2-mediated RBL-2H3 degranulation in vitro,probably by up-regulating Ca2+mobilization in activated cells.

Objective: To compare the safety between cervical conization (CC) alone and hysterectomy for patients with adenocarcinoma in situ (AIS) of the cervix. Methods: Patients diagnosed with AIS after CC during 2007–2021 were identified by computerized databases at Women’s Hospital of Zhejiang University School of Medicine. A total of 453 AIS patients were divided into 2 groups according to uterus preservation: hysterectomy group (n=300) and CC(s) alone group (n=153). The prevalence of residual disease and disease recurrence was compared between patients treated by CC(s) alone and hysterectomy. The prevalence of residual disease in specimens from women who had a hysterectomy and repeat CC were compared between positive and negative margins of CC. The factors influencing residual disease and disease recurrence were assessed. Results: Among 310 specimens from women who had a hysterectomy or repeat CC, the prevalence of residual disease was 50.6% (45/89) for a positive margin and 2.3% (5/221) for a negative margin (p=0.000). Four patients had recurrence of vaginal intraepithelial neoplasia in those treated by hysterectomy and one had recurrence of cervical squamous intraepithelial neoplasia in those treated by CC(s) alone. The prevalence of recurrence was 0.7% (1/153) for CC(s) alone and 1.3% (4/300) for hysterectomy (p=0.431). Hysterectomy did not influence residual disease or disease recurrence. Conclusion CC is an efficacious and safe option for patients with AIS of the cervix provided the margin is negative.

Objective:To investigate the effect of ultrasound monitoring of inferior vena cava collapse index (IVC-CI) guiding fluid replacement on circulation in elderly patients during induction of general anesthesia.Methods:A total of 71 elderly patients who underwent elective surgery under general anesthesia and tracheal intubation at Hunan Provincial People′s Hospital from April 2021 to September 2022 were randomly divided into control group (35 cases) and observation group (36 cases) using a random number table method. Before anesthesia, both groups of patients underwent IVC ultrasound examination and calculated the IVC-CI value. For patients with IVC-CI≥40%, the observation group was given 8 ml/kg of crystal solution before anesthesia induction, while the control group was not treated. The incidence of hypotension, the use of vasoactive drugs, and the total infusion volume from anesthesia induction to skin incision were recorded in two groups. Mean arterial blood pressure (MBP), heart rate (HR), oxygen saturation (SpO 2), cardiac index (CI), and cardiac volume variability (SVV) before anesthesia (T 0), 5 min after induction (T 1), 1 min after tracheal intubation (T 2), 5 min after tracheal intubation (T 3), 10 min after tracheal intubation (T 4), and 1 min before skin incision (T 5) were recorded and compared between the two groups. Results:The incidence of hypotension (27.8% vs 60.0%) and utilization rate of vasoactive drugs (25.0% vs 48.6%) in the observation group were lower than those in the control group, and the total infusion volume during anesthesia induction was higher than that in the control group, with statistical significance (all P<0.05). SVV, CI and MBP at T 1, T 3, T 4 and T 5 were significantly different from those at T 0 in the control group ( F=3.85, 14.66, 3.96, all P<0.05). SVV, CI and MBP at T 1, T 3, T 4 and T 5 in the observation group were significantly different from those at T 0 ( F=3.51, 13.20, 4.35, all P<0.05). There was no significant difference in SVV, CI, MBP, HR and SpO 2 between 2 groups (all P>0.05). Conclusions:For the elderly patients with preoperative IVC-CI≥40%, pre-filling with 8ml/kg crystal solution before anesthesia induction can significantly reduce the incidence of hypotension and the utilization rate of vasoactive drugs in the elderly patients during anesthesia induction.

AIM: To analyze the chemical ingredients of Qingxin-zishen prescription decoction (QZPD) and predict its main pharmacodynamic substances and mechanism in the prevention and treatment of menopause syndrome (MPS) with the help of high performance liquid chromatography-quadrupole-time of flight mass spectrometry (HPLC-Q-TOF/MS) combined with network pharmacology. METHODS: The chemical ingredients of QZPD were identified after analyzing the retention time, exact mass, secondary mass spectrometry fragmentation and other information obtained from HPLC-Q-TOF/MS and comparing them with the established chemical ingredients database and the literatures. The targets of ingredients in QZPD were predicted by Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) and SwissTargetPrediction database. The disease targets of MPS were obtained through Online Mendelian Inheritance in Man (OMIM) and GeneCards Database. Gene ontology (GO) function enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis of potential targets were analyzed with the Metascape database. Cytoscape 3.7.2 software was used to construct the network of active components-key targets-pathways. AutoDockTools 4.2.5 software was applied in the molecular docking verification between the key active components and key targets. RESULTS: A total of 83 components were identified in QZPD and 847 drug targets were predicted. After intersection them with 3 050 disease targets, 395 common targets were obtained. After network topology analysis, 74 key targets were obtained, involving mitogen-activated protein kinase (MAPK), phosphatidylinositol-3 kinase/protein kinase B (PI3K/Akt), transforming growth factor-β (TGF-β) and other signaling pathways. Molecular docking analysis results indicated that 23 key active components, such as berberine, epiberberine, coptisine, geissoschizine methyl ether, liensinine, norcoclaurine, palmatine, quercetin, and luteolin, had good binding activity with several of the key targets. CONCLUSION: This study preliminarily identifies the potential effective chemical ingredients of QZPD, predicts its targets in the prevention and treatment of MPS, which provides supporting information for the further study of the pharmacodynamic substances and mechanisms of QZPD.

Objective:To observe the effect of esketamine on cardiac index in patients undergoing lumbar surgery in prone position under general anesthesia.Methods:Forty-five patients with prone lumbar surgery after general anesthesia in Hunan Provincial People′s Hospital from March to July 2021 were divided into observation group (24 cases, group A) and control group (21 cases, group B) according to random number table method. Group A received 0.5 mg/kg esketamine intravenously during induction, and 0.15 mg/(kg·h) esketamine intravenously for 2 h after prone position. Group B received the same amount of normal saline. Both groups were given sevoflurane and remifentanil during operation to maintain anesthesia, and sufentanil was given intermittently during operation. The mean arterial pressure (MAP), systolic blood pressure (SBP), diastolic pressure (DBP), cardiac index (CI), and heart rate (HR) before induction (T 0), during endotracheal intubation (T 1), 5 minutes after intubation (T 2), 5 minutes after prone position (T 3), 10 minutes after prone position (T 4), 30 minutes after prone position (T 5), 45 minutes after prone position (T 6), 60 minutes after prone position (T 7), 90 minutes after prone position (T 8), and 120 minutes after prone position (T 9) were recorded; The total dosage of norepinephrine 2 hours after anesthesia to prone position and extubation time after operation were also recorded. The Visual Analogue Scale (VAS) was performed 15 minutes after extubation, 6 and 24 hours after operation. Results:There was no significant difference in CI between T 3-T 9 and T 2 in group A ( P>0.05); the CI of group B at T 3-T 7 was significantly lower than that at T 2 (all P<0.05); there was no significant difference in CI between T 8-T 9 and T 2 in group B (all P>0.05); There was no significant difference in CI between group A and group B at T 0-T 2 (all P>0.05). The CI of group A at T 3-T 9 was significantly higher than that of group B (all P<0.05); The dosage of norepinephrine in group A was significantly lower than that in group B ( P<0.05); There was no significant difference in HR, MAP, SBP and DBP between the two groups at different time points (all P>0.05); there was also no significant difference in extubation time and VAS scores at 15 minutes, 6 hours and 24 hours after extubation between the two groups (all P>0.05). Conclusions:Intraoperative application of esketamine can increase CI after prone position and reduce the amount of norepinephrine during lumbar surgery.

Limb and CNS expressed 1 like (LIX1L) is over-expressed in several types of tumors. However, the function of LIX1L in glucose metabolism and hepatocellular carcinoma (HCC) progression remains elusive. Here we report that LIX1L is over-expressed in human HCC tissues, which predicts unfavorable prognosis. LIX1L deficiency

Objective To establish the high myopic choroidal neovascularization (CNV) in guinea pigs and to investigate the role of (matrix metalloproteinase-2,MMP-2) and tissue inhibitor-2 of metalloproteinase (TIMP-2) in high myopic CNV.Methods Seventy-two 2-week-old guinea pigs were randomized into control group (n =36) and high myopia group (n =36).Right eyes were indued form deprivation high myopia for 6 weeks.Thirty guinea pigs were randomly selected in each group,and CNV were induced in the right eyes br the 532 nm laser.MMP-2 and TIMP-2 expressions were investigated by immunohistochemistry pre-laser and 7,14,21,28,35 days after laser induction,respectively,while MMP-2 and TIMP-2 relative expression levels in retinal pigment epithelium (RPE)-choroid-sclera complex were detected by real-time PCR.Integral opitical density (IODs) of positive expression and mRNA relative expression levels of these factors were performed by statistical analyses.Results The expressions of MMP-2 and TIMP-2 were up-regulated in the two groups after laser photocoagulation through immunohistochemistry and real-time PCR examinations.Expression of MMP-2 peaked at 21 d and TIMP-2 at 28 d,respectively.IODs of positive expression and mRNA relative expression levels of MMP-2 were higher in high myopia group than those in control group at each inspective time point,and the differences were statistically significant (P ＜ 0.05).TIMP-2 expression was significantly reduced in high myopia group compared with control group before laser photocoagulation (P＜0,05),while there was no significant difference between the two groups at each time point after laser photocoagulation.Conclusions MMP-2 and TIMP-2 were closely related to the formation of high-myopic CNV.Balance disorders of MMP-2 and TIMP-2 might participate in the occurrence and development of high-myopic CNV.

Objective To quantitatively assess anterior chamber angle of primary angle-closure glaucoma (PACG) and primary angle-closure (PAC) patients after laser pheripheral iridotomy (LPI) by spectral-domain anterior segment optical coherence tomography (SD-AS-OCT),and investigate which parameters should be used in these patients and the clinical significance of these parameters in screening and follow-ups of glaucoma.Methods Fifty-five eyes of 40 patients diagnosed with PACG remission (11 eyes,8 patients),PAC (20 eyes,20 patients) or PAC suspect (24 eyes,12 patients) were examined.Each eye was examined by SD-AS-OCT at upper,lower,nasal,and temporal sides.Anterior chamber angle (ACA),trabecular iris angle (TIA),and trabecular iris space area (TISA500/750) were measured or calculated.All results were analyzed.Results The points from the inside to the corneal scleral spur 500 μm and 750 pm were selected,AOD,TIA,ACA,TISA at upper,lower,nasal,and temporal sides were measured,which were included into 500 series and 750 series.The mean values of TIA,ACA and AOD in the 500 series and 750 series were the largest in the temporal side and the lowest in the nasal side.The mean values of TISA measurement was the largest in the lower side and the smallest at the upper side.Pearson correlation analysis showed that TIA500 and ACA500 (r =0.799,P =0.00),TIA750 and ACA750 (r =0.799,P =0.00),TIA500 and TISA500 (r=0.919,P =0.00),TIA750 and TISA750 (r =0.920,P =0.00) had positive correlation.With TIA500 as independent variable x and TISA500 as dependent variable y,the regression equation was obtained:y =-0.300 + 0.005x (F =1195,P =0.00),which showed TISA500 and TIA500 were linearly positive correlated.With TIA750 as independent variable x,and TISA750 as dependent variable y,the regression equation was obtained:y =-0.440 + 0.009x (F =854,P =0.00),which showed TISA750 and TIA750 were linearly positive correlated.The coefficient of variation of the 750 series parameters were less than the 500 Series in the four directions.Conclusion SD-AS-OCT is an efficient tool for efficiency evaluation and follow-up during the course of PACG and PAC after LPI.For narrow angles,as the parameters of 750 series parameters have less variability,so 750 series are more recommended in clinical application.

Objective:To study the effects of dental fluorosis on the tooth movement following extraction of adjacent tooth in adoles-cents for orthodontic treatment.Methods:50 adolescents were divided into mild(n =1 3),moderat(n =1 0),severe(n =7)and healthy control(n =20)groups according to the fluorosis severity using Dean's index.4 4 were extracted and appliance was applied. X-ray image was taken 1 week and 1 ,2 and 3 months after appliace activation.Tooth movement was measured cephalometrically by Auto CAD.Results:Tooth moving distance was more(P <0.01 )and the alveolar bone resorption area was smaller in fluorosis group than those in healthy control group(P <0.01 )1 ,2 and 3 months after appliance activation.The moving distance was negativelly relat-ed with bone remodling area(P <0.05).Conclusion:Adolescent dental flurosis play an important role in bone remdodeling in extra-tion sites and tooth movement during orthodontic treatment.