ObjectiveTo develop and validate a diagnostic prediction model for differentiating pulmonary tuberculosis from community-acquired pneumonia based on routine blood parameters. MethodsA total of 642 patients with pulmonary tuberculosis and 503 patients with community-acquired pneumonia were retrospectively enrolled from the Seventh Hospital of Tangshan. They were randomly divided into a training set and an internal validation set at a 7∶3 ratio. Additionally， 218 patients from the 981st Hospital were independently included as an external validation set. The Boruta algorithm and recursive feature elimination were employed to select predictors from 82 blood parameters， sex， and age. A multivariate Logistic regression model was established and evaluated using receiver operating characteristic （ROC） curves， calibration curves， and decision curve analysis. ResultsThe final model incorporated eight predictors， namely uric acid， urea nitrogen， alkaline phosphatase， monoamine oxidase， alanine aminotransferase， glutathione， neutrophil percentage， and age. The model achieved areas under the curve （AUCs） of 0.800 （95%CI： 0.769-0.830）， 0.787 （95%CI： 0.738-0.836）， and 0.736 （95%CI： 0.667-0.835） in the training， internal validation， and external validation sets， respectively. The model demonstrated good calibration， and decision curve analysis showed clinical net benefit within the threshold probability range of 10%-80%. ConclusionThe developed model exhibits good discriminative ability and clinical utility， serving as an effective early screening tool for primary healthcare institutions.

Objective To investigate the efficacy of noninvasive matrix RF technology in promoting functional rehabilitation of the pelvic floor in postpartum women who have undergone natural delivery.Methods A prospective study was conducted on 80 nulliparous women who underwent spontaneous vaginal delivery at the hospital from January 2022 to April 2023.Participants were randomly allocated into a control group and an observation group,each comprising 40 individuals,using the random number table method.The control group received biofeedback electrical stimulation therapy,while the observation group was treated with non-invasive matrix radiofrequency(RF)technology.Both groups were assessed for pelvic floor muscle strength,pelvic floor structural parameters(levator hiatus area,levator muscle thickness),and levator ani muscle[measured by the maximum value of Young's modulus(Emax)in both resting and contracting states]before treatment,after one session,and at the end of the treatment period.At the conclusion of the treatment,vaginal lubrication and vaginal sensitivity were evaluated using the Female Sexual Function Index(FSFI).Additionally,the incidence of adverse events was compared between the two groups before and after the completion of treatment.Results After one treatment,there were no significant changes in pelvic floor muscle strength,levator ani muscle hiatus area,and levator ani muscle thickness in the control group compared to pre-treatment levels(P>0.05).In contrast,the observation group showed significant improvements in pelvic floor muscle strength and levator ani muscle thickness compared to pre-treatment levels,while the levator ani muscle hiatus area was significantly reduced(P<0.05).Additionally,at this point,the pelvic floor muscle strength and levator ani muscle thickness in the observation group were significantly higher than those in the control group,whereas the levator ani muscle hiatus area was significantly smaller(P<0.05).By the end of the treatment,both groups demonstrated further improvements in pelvic floor muscle strength and levator ani muscle thickness compared to pre-treatment and post-first-treatment levels,with a continued reduction in the levator ani muscle hiatus area.Notably,the observation group consistently exhibited superior outcomes in all three parameters compared to the control group(P<0.05).At the end of treatment,the Emax differences in the subpubic branch,abdominal muscles,and posterior hypothalamus were significantly greater than those before and after a single treatment session in both groups(P<0.05).Moreover,the Emax differences in these regions were significantly higher in the observation group compared to the control group(P<0.05).Post-treatment,both groups showed increased scores for vaginal lubrication,vaginal sensitivity,and FSFI,with more pronounced improvements observed in the observation group(P<0.05).Following treatment,no significant differences were noted between the two groups regarding the incidence of urinary incontinence,lumbosacral pain,uterine prolapse,and vaginal wall bulge(P>0.05).However,the observa-tion group exhibited a lower frequency of adverse events compared to the control group(P<0.05).Additionally,maternal rehabilitation satisfaction was 100%(40/40)in the observation group,which was significantly higher than 85.00%(34/40)in the control group(P<0.05).Conclusions The application of noninvasive matrix RF technology in the rehabilitation of pelvic floor muscle function in postpartum women who have undergone vaginal delivery demonstrates rapid efficacy.It can enhance pelvic floor muscle strength within a short period,restore pelvic floor structure,and significantly improve vaginal lubrication and sensitivity,thereby enhancing sexual well-being.

Objective To investigate the efficacy of noninvasive matrix RF technology in promoting functional rehabilitation of the pelvic floor in postpartum women who have undergone natural delivery.Methods A prospective study was conducted on 80 nulliparous women who underwent spontaneous vaginal delivery at the hospital from January 2022 to April 2023.Participants were randomly allocated into a control group and an observation group,each comprising 40 individuals,using the random number table method.The control group received biofeedback electrical stimulation therapy,while the observation group was treated with non-invasive matrix radiofrequency(RF)technology.Both groups were assessed for pelvic floor muscle strength,pelvic floor structural parameters(levator hiatus area,levator muscle thickness),and levator ani muscle[measured by the maximum value of Young's modulus(Emax)in both resting and contracting states]before treatment,after one session,and at the end of the treatment period.At the conclusion of the treatment,vaginal lubrication and vaginal sensitivity were evaluated using the Female Sexual Function Index(FSFI).Additionally,the incidence of adverse events was compared between the two groups before and after the completion of treatment.Results After one treatment,there were no significant changes in pelvic floor muscle strength,levator ani muscle hiatus area,and levator ani muscle thickness in the control group compared to pre-treatment levels(P>0.05).In contrast,the observation group showed significant improvements in pelvic floor muscle strength and levator ani muscle thickness compared to pre-treatment levels,while the levator ani muscle hiatus area was significantly reduced(P<0.05).Additionally,at this point,the pelvic floor muscle strength and levator ani muscle thickness in the observation group were significantly higher than those in the control group,whereas the levator ani muscle hiatus area was significantly smaller(P<0.05).By the end of the treatment,both groups demonstrated further improvements in pelvic floor muscle strength and levator ani muscle thickness compared to pre-treatment and post-first-treatment levels,with a continued reduction in the levator ani muscle hiatus area.Notably,the observation group consistently exhibited superior outcomes in all three parameters compared to the control group(P<0.05).At the end of treatment,the Emax differences in the subpubic branch,abdominal muscles,and posterior hypothalamus were significantly greater than those before and after a single treatment session in both groups(P<0.05).Moreover,the Emax differences in these regions were significantly higher in the observation group compared to the control group(P<0.05).Post-treatment,both groups showed increased scores for vaginal lubrication,vaginal sensitivity,and FSFI,with more pronounced improvements observed in the observation group(P<0.05).Following treatment,no significant differences were noted between the two groups regarding the incidence of urinary incontinence,lumbosacral pain,uterine prolapse,and vaginal wall bulge(P>0.05).However,the observa-tion group exhibited a lower frequency of adverse events compared to the control group(P<0.05).Additionally,maternal rehabilitation satisfaction was 100%(40/40)in the observation group,which was significantly higher than 85.00%(34/40)in the control group(P<0.05).Conclusions The application of noninvasive matrix RF technology in the rehabilitation of pelvic floor muscle function in postpartum women who have undergone vaginal delivery demonstrates rapid efficacy.It can enhance pelvic floor muscle strength within a short period,restore pelvic floor structure,and significantly improve vaginal lubrication and sensitivity,thereby enhancing sexual well-being.

Objective:To investigate the efficacy and characteristics of levonorgestrel intrauterine system in in vitro fertilization (IVF) assisted pregnancy for infertility patients with atypical endometrial hyperplasia and adenomyosis. Methods:The clinical characteristics of 3 infertility patients with atypical endometrial hyperplasia and adenomyosis admitted to the Reproductive Medicine Center, the Fifth Clinical Medical College of Shanxi Medical University from 2019 to 2021 were retrospectively analyzed. All patients underwent IVF as soon as possible after the successful treatment of levonorgestrel intrauterine system. Using progestin-primed ovarian stimulation protocol and gonadotropin-releasing hormone antagonist protocol, the ring was removed before frozen-thawed transfer.Results:Two cases of atypical endometrial hyperplasia were completely relieved, one case received healthy singleton fetus, and one case received biochemical pregnancy. One case had complete remission of adenomyosis and received healthy singleton fetus.Conclusion:Levonorgestrel intrauterine system in the treatment of infertility caused by atypical endometrial hyperplasia and adenomyosis can not only achieve better therapeutic effect but also effectively improve endometrial receptivity.

Objective:To investigate the efficacy and characteristics of levonorgestrel intrauterine system in in vitro fertilization (IVF) assisted pregnancy for infertility patients with atypical endometrial hyperplasia and adenomyosis. Methods:The clinical characteristics of 3 infertility patients with atypical endometrial hyperplasia and adenomyosis admitted to the Reproductive Medicine Center, the Fifth Clinical Medical College of Shanxi Medical University from 2019 to 2021 were retrospectively analyzed. All patients underwent IVF as soon as possible after the successful treatment of levonorgestrel intrauterine system. Using progestin-primed ovarian stimulation protocol and gonadotropin-releasing hormone antagonist protocol, the ring was removed before frozen-thawed transfer.Results:Two cases of atypical endometrial hyperplasia were completely relieved, one case received healthy singleton fetus, and one case received biochemical pregnancy. One case had complete remission of adenomyosis and received healthy singleton fetus.Conclusion:Levonorgestrel intrauterine system in the treatment of infertility caused by atypical endometrial hyperplasia and adenomyosis can not only achieve better therapeutic effect but also effectively improve endometrial receptivity.

Objective:To analyze the association between CRHR1 gene(rs1876828)polymorphism and the effect of inhaled corticosteroids(ICS)in children with bronchial asthma.Methods:A total of 60 children with moderate persistent asthma who were treated in the Department of Pediatrics of the First Affiliated Hospital of Harbin Medical University from January 2018 to June 2019 were included.The CRHR1 gene rs1876828 locus in children with asthma was detected by Sanger sequencing.The children were divided into TT genotype group(TT group) and CC genotype group(CC group)according to the different base sequences of gene loci.There were 22 cases in TT group(36.7%)and 38 cases in CC group(63.3%). Both groups were given aerosol inhalation of ICS and symptomatic treatment.Clinical symptoms and signs were observed and scored before and after treatment for 3d, 10d and 30d, and the days required for complete disappearance of symptoms and signs were recorded.Results:After 3d of treatment, clinical symptoms and signs of TT group and CC group were improved to a certain extent, but there was no statistical significant difference between two groups( P>0.05). At 10d and 30 d after treatment, the recovery of the two groups was better than that at 3d, and the improvement degree of the TT group was significantly better than that of the CC group, with statistical significance( P<0.05). The time of complete remission of symptoms and signs in TT group and CC group was(8.68±7.42)d and(16.21±7.82)d; the difference was statistically significant( P<0.01). Conclusion:There is a polymorphism of CRHR1 rs1876828 locus in children with bronchial asthma, which manifests as TT genotype and CC genotype, and CC genotype is the majority.The polymorphism of CRHR1 gene rs1876828 in asthmatic children is associated with the efficacy of ICS.The efficacy of ICS in children with TT genotype is better than that of CC genotype.

Overactive bladder is a syndrome characterized by urgent urination, often accompanied by frequent urination and nocturia. The incidence of the disease is high all over the world, and it has a great impact on the lives of patients, which has been paid more and more attention by scholars at home and abroad. It is currently estimated that 50 million to 100 million people worldwide suffer from the disease. Mirabegron is an agonist of human β-3 adrenergic receptor used to treat symptoms of overactive bladder. In this study, the synthesis process of mirabegron was improved based on literatures. Using p-nitrophenethylamine hydrochloride, R-(-)-mandelicacid and 2-aminothiazole-4-acetic acid as starting materials, the target product with high purity was obtained through four steps of amide condensation, carbonyl reduction, nitro reduction and amide condensation, and one-step purification, with a total yield of 39%. In this study, the hydrogen source of nitro reduction in step 3 was changed from hydrogen to ammonium formate, which increased the feasibility of industrialization, and mirabegron was refined to improve the purity of the product. The improved process has the advantages of simplified operation and mild reaction conditions, which provides a new method for the preparation and purification of mirabegron.

Objective To investigate the effect of different extraction methods on anti-inflammatory and analgesic activity of Anemone hupehensis.Methods The different abstracts were prepared from the whole herb of Anemone hupehensis.The analgesic effect was observed by adopting the mouse torsion and electric heating plate method,and the anti-inflammatory activity was comprehensively evaluated by using the mouse ear tumefaction,toe tumefaction and tampon granulation tumefaction exprements.Results Compared with the blank model group,the anti-inflammatory action difference of low dose in the water layer parts of mouse ear tumefaction,toe tumefaction and tampon granulation tumefaction had no statistical significance(P＞0.05),and the extracting parts of rest doses all had significant anti-inflammatory and analgesic effect (P＜0.05).Ethyl acetate part had strongest activity in the electric heating plate experiment.N-butanol part had strongest activity in the ear tumefaction,toe tumefaction,tampon granulation tumefaction experiments and torsion method.Conclusion The whole herb of Anemone hupehensis has prominent anti-inflammatory and analgesic effect,and the ethyl acetate part E and N-butanol part are main effective parts.