Objective:To identify the risk factors associated with early postpartum pelvic floor muscle strength following cesarean delivery.Methods:A total of 352 women who underwent cesarean section at the Department of Obstetrics and Gynecology,Affiliated Zhongshan Hospital of Dalian University between September 2022 and Sep-tember 2024 and attended a pelvic floor rehabilitation clinic 6 to 8 weeks postpartum were enrolled in this study,and lectromyographic(EMG)values during anterior and posterior resting phases,as well as fast-twitch and slow-twitch muscle phases,were recorded so as to analyze the factors that might affect the pelvic floor strength in the early postnatal period after cesarean section.Factors with statistically significant differences were further ana-lyzed by multifactorial Logistic analysis.Results:Pre-pregnancy body mass index(BMI)＞24 kg/m2,increase in body mass during pregnancy ≥ 11.5 kg,gestational hypertension and term delivery were identified as independent risk factors for abnormal EMG values during the anterior resting phase of the pelvic floor(OR＞1,P＜0.05).In-crease in body mass during pregnancy≥11.5 kg,preterm rupture of membranes,and term delivery were risk fac-tors for abnormal pelvic floor EMG values in the post-resting stage(OR＞1,P＜0.05).Pre-pregnancy BMI＞24 kg/m2 and pre-eclampsia were risk factors for abnormal pelvic floor EMG values in the fast-muscle stage(OR＞1,P＜0.05).and a history of uterine fibroids was a risk factor for abnormal pelvic floor EMG values in the slow-muscle stage(OR＞1,P＜0.05).Conclusions:Early postpartum pelvic floor muscle strength following ce-sarean delivery is influenced by several risk factors,including pre-pregnancy BMI＞24 kg/m2,increase in body mass during pregnancy ≥ 11.5 kg,gestational hypertension,full-term labor,premature rupture of membranes,pre-eclampsia,and history of uterine fibroids,pelvic floor muscle strength is more likely to be impaired in the early postpartum period after the prenatal combination of the above risk factors,and Targeted pelvic floor rehabilitation should be initiated as early as possible during the postpartum period.

Objective To analyze the MRI imaging characteristics of brain metastases in non-small cell lung cancer(NSCLC)with different epidermal growth factor receptor(EGFR)mutation types and programmed cell death-ligand 1(PD-L1)expression,and to provide imaging diagnostic support for patients who can't undergo genetic and immunohistochemical testing.Methods A retrospec-tive selection was performed in 88 patients diagnosed with brain metastases of NSCLC,all patients were divided into EGFR mutation group and wild group according to the results of genetic testing,and patients with EGFR mutation group were divided into EGFR mutation with PD-L1 expression positive group and EGFR mutation with PD-L1 expression negative group according to whether the expression of PD-L1 was≥1％.The clinical data and MR image characteristics of brain metastases were compared in EGFR mutation group and wild group,as well as in EGFR mutation with PD-L1 expression positive group and EGFR mutation with PD-L1 expres-sion negative group.Results There were statistically significant differences in smoking history and intracranial symptoms between EGFR mutation group and wild group(P＜0.05).The edema diameter,edema index and enhancement ratio of EGFR mutation group and wild group were(0.67±1.10)cm,0.39±0.54,0.32±0.17 and(1.57±2.04)cm,1.05±1.21,0.53±0.27,respectively,and the differences were statistically significant(P＜0.05).There were 43 cases and 23 cases in EGFR mutation group and wild group with ≥2 metastases,respectively,and the difference was statistically significant(P＜0.05).Compared with＞60 years old,there were 15 patients(75％)of EGFR mutation with PD-L1 expres-sion positive in≤60 years old(P＜0.05).Conclusion Compared with EGFR wild patients,patients with EGFR mutation have more brain metastases(≥2),milder enhancement,less peritumoral edema,and fewer intracranial symptoms at initial diagnosis,and patients with EGFR mutation aged≤60 years are more likely to have PD-L1 expression positive.

Objective:To identify the risk factors associated with early postpartum pelvic floor muscle strength following cesarean delivery.Methods:A total of 352 women who underwent cesarean section at the Department of Obstetrics and Gynecology,Affiliated Zhongshan Hospital of Dalian University between September 2022 and Sep-tember 2024 and attended a pelvic floor rehabilitation clinic 6 to 8 weeks postpartum were enrolled in this study,and lectromyographic(EMG)values during anterior and posterior resting phases,as well as fast-twitch and slow-twitch muscle phases,were recorded so as to analyze the factors that might affect the pelvic floor strength in the early postnatal period after cesarean section.Factors with statistically significant differences were further ana-lyzed by multifactorial Logistic analysis.Results:Pre-pregnancy body mass index(BMI)＞24 kg/m2,increase in body mass during pregnancy ≥ 11.5 kg,gestational hypertension and term delivery were identified as independent risk factors for abnormal EMG values during the anterior resting phase of the pelvic floor(OR＞1,P＜0.05).In-crease in body mass during pregnancy≥11.5 kg,preterm rupture of membranes,and term delivery were risk fac-tors for abnormal pelvic floor EMG values in the post-resting stage(OR＞1,P＜0.05).Pre-pregnancy BMI＞24 kg/m2 and pre-eclampsia were risk factors for abnormal pelvic floor EMG values in the fast-muscle stage(OR＞1,P＜0.05).and a history of uterine fibroids was a risk factor for abnormal pelvic floor EMG values in the slow-muscle stage(OR＞1,P＜0.05).Conclusions:Early postpartum pelvic floor muscle strength following ce-sarean delivery is influenced by several risk factors,including pre-pregnancy BMI＞24 kg/m2,increase in body mass during pregnancy ≥ 11.5 kg,gestational hypertension,full-term labor,premature rupture of membranes,pre-eclampsia,and history of uterine fibroids,pelvic floor muscle strength is more likely to be impaired in the early postpartum period after the prenatal combination of the above risk factors,and Targeted pelvic floor rehabilitation should be initiated as early as possible during the postpartum period.

Objective To analyze the MRI imaging characteristics of brain metastases in non-small cell lung cancer(NSCLC)with different epidermal growth factor receptor(EGFR)mutation types and programmed cell death-ligand 1(PD-L1)expression,and to provide imaging diagnostic support for patients who can't undergo genetic and immunohistochemical testing.Methods A retrospec-tive selection was performed in 88 patients diagnosed with brain metastases of NSCLC,all patients were divided into EGFR mutation group and wild group according to the results of genetic testing,and patients with EGFR mutation group were divided into EGFR mutation with PD-L1 expression positive group and EGFR mutation with PD-L1 expression negative group according to whether the expression of PD-L1 was≥1％.The clinical data and MR image characteristics of brain metastases were compared in EGFR mutation group and wild group,as well as in EGFR mutation with PD-L1 expression positive group and EGFR mutation with PD-L1 expres-sion negative group.Results There were statistically significant differences in smoking history and intracranial symptoms between EGFR mutation group and wild group(P＜0.05).The edema diameter,edema index and enhancement ratio of EGFR mutation group and wild group were(0.67±1.10)cm,0.39±0.54,0.32±0.17 and(1.57±2.04)cm,1.05±1.21,0.53±0.27,respectively,and the differences were statistically significant(P＜0.05).There were 43 cases and 23 cases in EGFR mutation group and wild group with ≥2 metastases,respectively,and the difference was statistically significant(P＜0.05).Compared with＞60 years old,there were 15 patients(75％)of EGFR mutation with PD-L1 expres-sion positive in≤60 years old(P＜0.05).Conclusion Compared with EGFR wild patients,patients with EGFR mutation have more brain metastases(≥2),milder enhancement,less peritumoral edema,and fewer intracranial symptoms at initial diagnosis,and patients with EGFR mutation aged≤60 years are more likely to have PD-L1 expression positive.

Objective:To explore the value of the logistic regression model with three-dimensional CT quantitative parameters in combination with qualitative parameters in predicting the invasiveness of pure ground glass nodules (pGGN).Methods:The clinical data and image features of 191 patients (196 lesions) with pGGN on CT confirmed as lung adenocarcinoma by pathology from April 2019 to December 2019 in Anhui Chest Hospital were retrospectively analyzed. Totally, 196 lesions were divided into atypical adenomatous hyperplasia (AAH)+adenocarcinoma in situ (AIS)+minimally invasive adenocarcinoma (MIA) group ( n=128) and invasive adenocarcinoma (IAC) group ( n=68). CT quantitative parameters included the maximum diameter, volume, average CT value and quality of pGGN, and the qualitative parameters included the intrinsic vascular changes, abnormal air-bronchogram, lobulated signs, bubble-like sign, pleura-traction sign, and fuzzy tumor-lung interface sign. The Mann-Whitney U test was used to compare the quantitative parameters and the Pearson χ 2 test was used to compare the qualitative parameters between two groups. The independent predictors of IAC and predictive probability value were screened by univariate analysis in combination with multivariate logistic regression analysis. The ROC curves were drawn to compare the diagnostic probability of logistic regression prediction probability and each single parameter. Results:There were statistically significant differences in maximum diameter [0.92(0.77,1.14) cm vs. 1.41(1.12, 1.93) cm, Z=-7.366, P<0.001], volume[0.31(0.20, 0.53) cm 3 vs. 0.88(0.41, 2.00) cm 3, Z=-6.254, P<0.001], average CT value[-571.5(-637.2, -477.0) HU vs. -418.1(-532.4, -338.5) HU, Z=-5.882, P<0.001], quality[0.14(0.09, 0.25) g vs. 0.42(0.26, 1.21) g, Z=-7.438, P<0.001], intrinsic vascular changes(23 vs. 49, χ2=55.906, P<0.001), abnormal air-bronchogram(13 vs. 30, χ2=29.908, P<0.001) and pleura-traction sign(39 vs. 32, χ2=5.291, P=0.021) between the two groups. The logistic regression analysis showed that the maximum diameter, average CT value, intrinsic vascular changes and abnormal air-bronchogram were the independent risk factors of IAC, and the odds ratio value(95%CI) were 10.624(1.275-88.522), 1.004(1.000-1.008), 3.424(1.458-8.043) and 2.993(1.114-8.043), respectively. The ROC curve demonstrated that the area under the curve, sensitivity and specificity of the logistic regression model were 0.899, 0.912, and 0.711 respectively, which were better than separate analysis results from each single parameter. Conclusion:The logistic regression model with a combination of three-dimensional CT quantitative and qualitative parameters can predict the invasiveness of pGGN better.

Objective:To explore the association of urinary phenol concentration and blood biochemical indices in coke oven workers.Methods:From April to may 2019, we investigated 771 employing coke oven workers from a coke plant in Taiyuan city, and categorized into benzene-exposed group ( n=402) and control group ( n=369) based on their benzene exposures in workplace and urophenol concentrations. All subjects were interviewed face-to-face using a questionnaire including name, age (year) , gender, smoking and drinking habits, personal vocational history, working length (year) , and occupational protection, etc. Post-shift urine samples detected using a gas chromatography-hydrogen flame ionization detector. Fasting venous blood was drawn in the morning and centrifuged, the separated serum were detected the following items using an automatic blood biochemistry analyzer. Covariance and multiple linear regression were used to test the association of urinary phenol concentration and the levels of all the blood biochemical indices. Results:The subjects were predominantly males ( n=719, 93.3%) , with an average age of (42.3±8.2) years and an average working length of (20.6±8.2) years. Compared with the control group, the benzene-exposed group were significantly different in age, working length of years, gender, smoking and drinking habits ( P<0.05) . The median (interquartile interval) concentration of urinary phenol was 6.00 (0.00-33.00) μg/ml in the benzene-exposed group, which was significantly higher than that in the control group ( P<0.05) . Covariance analysis indicated that the fasting blood glucose, total cholesterol and high density cholesterol in the benzene-exposed group were significantly reduced compared with the control group, yet the serum creatinine, serum uric acid and triglyceride were significantly increased ( P<0.05) . Multiple linear regression showed that, an increase of each natural logarithm (Ln) transformed urinary phenol concentration was significantly associated with increases in serum uric acid level [9.82 (95% CI: 2.18-17.47) μmol/L] and cholesterol level[0.10 (95% CI:0.00-0.20) mmol/L]. An increase of each Ln-transformed accumulated benzene exposure levels was significantly associated with an increase in total cholesterol level[0.09 (95% CI: 0.01-0.17) mmol/L]. Conclusion:Occupational benzene exposure is possibly related to the variation of purine and total cholesterol metabolism in coke oven workers.

Objective:To explore the association of urinary phenol concentration and blood biochemical indices in coke oven workers.Methods:From April to may 2019, we investigated 771 employing coke oven workers from a coke plant in Taiyuan city, and categorized into benzene-exposed group ( n=402) and control group ( n=369) based on their benzene exposures in workplace and urophenol concentrations. All subjects were interviewed face-to-face using a questionnaire including name, age (year) , gender, smoking and drinking habits, personal vocational history, working length (year) , and occupational protection, etc. Post-shift urine samples detected using a gas chromatography-hydrogen flame ionization detector. Fasting venous blood was drawn in the morning and centrifuged, the separated serum were detected the following items using an automatic blood biochemistry analyzer. Covariance and multiple linear regression were used to test the association of urinary phenol concentration and the levels of all the blood biochemical indices. Results:The subjects were predominantly males ( n=719, 93.3%) , with an average age of (42.3±8.2) years and an average working length of (20.6±8.2) years. Compared with the control group, the benzene-exposed group were significantly different in age, working length of years, gender, smoking and drinking habits ( P<0.05) . The median (interquartile interval) concentration of urinary phenol was 6.00 (0.00-33.00) μg/ml in the benzene-exposed group, which was significantly higher than that in the control group ( P<0.05) . Covariance analysis indicated that the fasting blood glucose, total cholesterol and high density cholesterol in the benzene-exposed group were significantly reduced compared with the control group, yet the serum creatinine, serum uric acid and triglyceride were significantly increased ( P<0.05) . Multiple linear regression showed that, an increase of each natural logarithm (Ln) transformed urinary phenol concentration was significantly associated with increases in serum uric acid level [9.82 (95% CI: 2.18-17.47) μmol/L] and cholesterol level[0.10 (95% CI:0.00-0.20) mmol/L]. An increase of each Ln-transformed accumulated benzene exposure levels was significantly associated with an increase in total cholesterol level[0.09 (95% CI: 0.01-0.17) mmol/L]. Conclusion:Occupational benzene exposure is possibly related to the variation of purine and total cholesterol metabolism in coke oven workers.

Objective To explore the effect of core competence oriented advanced course in wound ostomy specialist nurse training.Methods A total of 101 Chongqing municipal wound ostomy specialist nurse training students from September 2016 to June 2017 were selected.Among them,50 students in 2016 served as the control group and trained by traditional training methods;51 students in 2017 served as the observation group and adopted the core competence oriented advanced courses for conducting the training.Then the effects after training were compared between the two groups.Results The core competence score after training in the observation group [(3.11±0.11) point]was higher than that in the control group [(2.87±0.13) point],the difference was statistically significant (P＜0.05).Conclusion The core competency oriented advanced course is effective for training the wound ostomy nurses.

Objective To analyze the perfusion status of lung cancer before radiotherapy and the relationship between changes in CT perfusion parameters after radiotherapy and the efficacy of radiotherapy.Methods Twenty-eight patients clinically and pathologically diagnosed with lung cancer were enrolled as subjects.Those patients received CT perfusion imaging scan and perfusion parameters including blood flow (BF),blood volume (BV),mean transit time (MTT),and permeability surface (PS) were calculated.We use linear correlation analysis for relation between value of CT perfusion imaging and the target volume of lung cancer before radiotherapy,t-test for difference between the remission groups and non-remission groups,compared paired sample t-test for value of CT perfusion imaging before and after radiotherapy.Results According to the efficacy of radiotherapy,28 patients with lung cancer were divided into response group (n=16) and non-response group (n=12).The response group had significantly smaller tumor sizes before and after radiotherapy than the non-response group (58.72±22.95 cm3 vs.24.53±13.79 cm3,P=0.000).However,there was no significant correlation of target volume before radiotherapy with any perfusion parameter (P=0.628).The response group had significantly larger BF and BV than the non-response group before radiotherapy (1.23±1.36 vs.6.42±2.57,P=0.024 and 1.23±0.31 vs.0.59±0.18,=0.041),suggesting a low perfusion state of tumor tissue in the non-response group.However,there were no significant differences in MTT and PS between the two groups (0.93±0.58 vs.0.93±0.66,P=0.851 and 1.46±0.83 vs.1.17±0.56,P=0.141).All the 28 patients had significantly smaller BF,BV,MTT,and PS after radiotherapy (9.81±3.56 vs.7.48±3.31,P=0.006;0.96±0.41 vs.0.64±0.38,P=0.003;0.93±0.60 vs.0.53±0.30,P=0.007;1.34±0.73 vs.0.74±0.44,P=0.001).Conclusions CT perfusion imaging can predict the efficacy of radiotherapy for lung cancer,which may guide the planning and implementation of precise radiotherapy for lung cancer.

Objective To explore the effects of theophylline plus salmeterol/fluticasone propionate combination product (SFC) on clinical control,lung function and airway inflammation in asthmatics.Methods A total of 146 asthmatics received 200 mg theophylline plus 50/250 μg SFC twice daily for 24 weeks.The level of asthma control was assessed by the asthma control test.Testing of lung function and inflammatory markers in induced sputum were performed.And 142 asthmatics received 50/250 μg SFC twice daily for 24 weeks as control.Results Asthma was completely controlled in 61 and 59 in the theophylline plus SFC and SFC groups respectively after a 24-week treatment period (P ＞ 0.05).Theophylline plus SFC improved the FEF25％ 75％ value,indicating small airway function,to a greater extent than SFC [(66.7 ± 18.2) ％ & (56.6 ± 17.4) ％,P ＜ 0.01].Percentage of eosinophil and concentration of eosinophil cationic protein in induced sputum were significantly lower in the theophylline plus SFC group than those in the SFC group [(4.1 ±2.3)％ vs.(6.2±2.7)％ & (63.9±39.4) vs.(90.3 ±46.2) μg/Lrespeetively] (all P ＜ 0.01).Conclusion The therapy of theophylline plus SFC may provide greater improvements in small airway function and airway inflammation.