Objective:To investigate the correlation between impulse oscillometry system examination indicators and conventional pulmonary ventilation function.Methods:The pulmonary ventilation function data of 10 883 patients from January 1, 2020 to December 31, 2022 at Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology were included. The one-second rate [ratio of forced expiratory volume in the first second (FEV 1) to forced vital capacity (FVC)] measured as a percentage of the predicted value was ≥92% for the control group ( n=3 478) and <92% for the pulmonary obstruction group ( n=7 405). The obstruction group was subdivided into five groups according to the degree of pulmonary dysfunction: mild group ( n=3 938),moderate group ( n=1 142),oderate-severe group ( n=917),severe group ( n=737),and extremely severe group ( n=671). Conventional pulmonary ventilatory function FVC, FEV 1, one-second rate, and forced expired flow at 50% of FVC (MEF50%), forced expired flow at 75% FVC (MEF25%), maximal mid-expiratory flow (MMEF), peak expiratory flow (PEF), and pulsed oscillation pulmonary function test were detected in both groups of patients. Impedance at 5 Hz (Z5) means total respiratory resistance, resistance at 5 Hz (R5) means total airway resistance, reactance at 5 Hz (X5) indicates the elastic recoil of the peripheral airways, and resistance at 20 Hz (R20) represents resistance of the central airways. R5-R20 reflects resistance in the small airways. Additionally, peripheral resistance (Rp), respiratory resonance frequency (Frex), and area under the reactance curve (Ax) were also measured. Correlation between the indicators of the two groups and the sensitivity and specificity of the impulse oscillometry system parameters for the diagnosis of obstructive pulmonary ventilation dysfunction were analyzed. Results:Pulmonary function force expiratory volume in the first second as a percentage of predicted value (FEV 1%Pre) [80.10 (54.95,97.10)%],one-second rate [62.43(48.67, 67.02)%],MEF50% [1.33 (0.62,1.97)L/s],MEF25% [0.28 (0.17,0.41)L/s], MMEF [0.85 (0.43,1.29)L/s],and PEF [5.64 (3.73,7.50)]L/s in the obstruction group were significantly lower than those in the control group ( P<0.05). The differences within the subgroups of the obstruction group were also significant ( P<0.05). Pulsed oscillation Z5 [0.42 (0.33,0.55)kPa·L -1·s -1],Rp [0.25 (0.20,0.45)kPa·L -1·s -1], R5 [0.39 (0.31,0.49)kPa·L -1·s -1], R20 [0.28 (0.24,0.34)kPa·L -1·s -1], R5-R20 [0.09 (0.05,0.17)kPa·L -1·s -1],Frex [16.32 (13.07,20.84)Hz], and Ax [0.67 (0.28,1.64)] indices in the obstruction group were significantly higher than those in the control group. X5 [-0.14 (-0.23, -0.10)kPa·L -1·s -1] was significantly lower than that in the control group ( P<0.05). Z5, Rp, X5, R5, R5-R20, Frex, and Ax were statistically significant between different degrees of obstruction in the obstruction group ( P<0.05). The impulse oscillometry system parameters Z5, Rp, R5, R20, R5-20, Frex, and Ax were negatively correlated with the indices of conventional pulmonary ventilation ( r=-0.21-0.68, P<0.05), and the parameter X5 was positively correlated with the indices of conventional pulmonary ventilation ( r=0.41-0.68, P<0.05). The pulsed oscillation pulmonary function test parameters X5 (58.60%-95.68%) and Ax (57.08%-98.06%) presented the best sensitivity; X5 (86.29%-98.82%), Frex (86.69%-94.71%), and Ax (88.10%-98.53%) displayed the best specificity; and R20 presented the worst sensitivity and specificity. The sensitivity and specificity were slightly better in female patients than in male patients. Conclusion:The technical parameters of the impulse oscillometry system showed significant correlation with relevant indices of conventional pulmonary ventilation function detection. These well reflect the changes of different degrees of pulmonary ventilation function and have greater significance for reference in evaluating the degree of pulmonary function impairment.

Endometriosis is a common, estrogen-dependent, inflammatory, gynecologic disease process in which normal endometrial tissue is abnormally present outside the uterine cavity. [1] Endometriosis is a common cause of chronic pain, dyspareunia, dysmenorrhea, and infertility. Most commonly, endometriosis is found within the pelvis, specifically on the ovaries. Because of rupture, bleeding, infection, or torsion, ovarian endometriosis (OMA) may cause acute abdominal pain, which is similar to acute abdominal pain caused by other reasons and is not easy to diagnose.[2,3] Determining the clinical and pathological features of OMA is crucial for accurate assessment, diagnosis, and treatment.

BACKGROUNDS: At present, there is no consensus on the induction methods in term pregnancy with borderline oligohydramnios. This study aimed to compare the effectiveness and pregnancy outcomes of labor induction with dinoprostone or single-balloon catheter (SBC) in term nulliparous women with borderline oligohydramnios. METHODS: We conducted a retrospective cohort study from January 2016 to November 2018. During the study period, a total of 244 cases were enrolled. Of these, 103 cases were selected for induction using dinoprostone and 141 cases were selected for induction with SBC. The pregnancy outcomes between the two groups were compared. Primary outcomes were successful vaginal delivery rates. Secondary outcomes were maternal and neonatal adverse events. Multivariate logistic regression was used to assess the risk factors for vaginal delivery failure in the two groups. RESULTS: The successful vaginal delivery rates were similar between the dinoprostone group and the SBC group (64.1% [66/103] vs. 59.6%, [84/141] P = 0.475), even after adjustment for potential confounding factors (adjusted odds ratio [aOR]: 1.07, 95% confidence interval [CI]: 0.57-2.00, P = 0.835). The incidence of intra-amniotic infection was lower in the dinoprostone group than in the SBC group (1.9% [2/103] vs. 7.8%, [11/141] P < 0.001), but the presence of non-reassuring fetal heart rate was higher in the dinoprostone group than in the SBC group (12.6% [13/103] vs. 0.7%, [1/141] P < 0.001). Multivariate logistic regression showed that nuchal cord was a risk factor for vaginal delivery failure after induction with dinoprostone (aOR: 6.71, 95% CI: 1.96-22.95). There were three factors related to vaginal delivery failure after induction with SBC, namely gestational age (aOR: 1.51, 95% CI: 1.07-2.14), body mass index (BMI) >30 kg/m2 (aOR: 2.98, 95% CI: 1.10-8.02), and fetal weight >3500 g (aOR: 2.49, 95% CI: 1.12-5.50). CONCLUSIONS Term nulliparous women with borderline oligohydramnios have similar successful vaginal delivery rates after induction with dinoprostone or SBC, with their advantages and disadvantages. In women with nuchal cord, the risk of vaginal delivery failure is increased if dinoprostone is used in the induction of labor. BMI >30 kg/m2, large gestational age, and estimated fetal weight >3500 g are risk factors for vaginal delivery failure after induction with SBC.
Administration, Intravaginal ; Catheters ; Dinoprostone/therapeutic use* ; Female ; Fetal Weight ; Humans ; Infant, Newborn ; Labor, Induced/methods* ; Nuchal Cord ; Oligohydramnios ; Oxytocics ; Pregnancy ; Pregnancy Outcome ; Retrospective Studies

The incidence of inflammatory myofibroblastic sarcoma is low, and bladder origin is more rare. We reported a 58-year-old patient with painless gross hematuria for one week. Total abdominal CT examination showed soft tissue mass in the anterior wall of the bladder, which was considered as bladder cancer, and bladder tumor resection was performed. Postoperative pathology showed inflammatory myofibroblastic sarcoma. Therefore, radical cystectomy was performed because of the high degree of malignancy. There was no recurrence during 3 years follow-up.

Human induced pluripotent stem cells (hiPSCs) have the potential to differentiate into multiple cell types. Motor neurons (MNs) differentiated from hiPSCs are important models of many motor neuron diseases. To simplify the identification of MNs, lentivirus vectors were used to transfer MNs-specific promoter HB9 and red fluorescent protein (RFP) gene into hiPSCs-derived human neural stem cells (hNSCs). Stable positive cells hNSCs-HB9-RFP-Puro were obtained after antibiotic selection. Subsequently, the positive cell line was infected with lentiviruses LV-Ngn2-Sox11-GFP and LV-Isl1-Lhx3-Hygro, which overexpressed the MNs differentiation transcription factor, and differentiated to MNs directly. Differentiated mature MNs showed neuron-like structure, expressed RFP and neuron-related markers β-tubulin and choline acetyltransferase (ChAT) under the control of the MNs-specific promoter HB9. The fluorescence reporter system provides a visual method for directed differentiation and identification of MNs, and may promote the applications of MNs in disease models and drug screening.
Cell Differentiation ; Fluorescence ; Humans ; Induced Pluripotent Stem Cells ; Motor Neurons ; Transcription Factors

The pathogenesis of endometriosis is not well understood at the moment, and the lack of effective biomarkers often leads to delayed diagnosis of the disease. Lipidomics provides a new approach for the diagnosis and prediction of endometriosis. Sphingomyelin, phosphatidylcholine and phosphatidylserine in peripheral blood, endometrial fluid, peritoneal fluid and follicular fluid have good diagnostic value for endometriosis and disease classification; the lipid metabolites in the eutopic endometrium tissue are expected to be biomarkers of early endometriosis; and the lipid metabolites in peripheral blood are also of great value for predicting endometriosis-related infertility. The development of lipidomics technique will further advance the progress on the pathogenesis, prediction, diagnosis and treatment of endometriosis.
Biomarkers/blood* ; Blood Chemical Analysis/trends* ; Body Fluids/chemistry* ; Endometriosis/diagnosis* ; Female ; Humans ; Lipidomics/trends*

Objective:To evaluate the influence of optimized rehabilitation process on prognosis of old patients with Evans type III and IV femoral intertrochanteric fractures and investigate the related efficacy.Methods:A retrospective case-control study was performed on 207 old patients with Evans type III and IV femoral intertrochanteric fractures fixed by proximal femoral nail anti-rotation (PFNA Ⅱ) in People's Hospital of Chongqing Banan District from March 2012 to January 2017. Normal rehabilitation group ( n=100) had rehabilitation education and training after operation and started off-bed exercise at postoperative 48 hours, including 38 males and 62 females, with age from 65 to 75 years in 69 patients and 75 years and over in 31 patients. There were 49 patients with Evans type III fractures and 51 with Evans IV fractures. Optimized rehabilitation group ( n=107) had rehabilitation education and training at admission and started off-bed exercise within 48 hours after operation, including 43 males and 64 females, with age from 65 to 75 years in 79 patients and 75 years and over in 28 patients. There were 63 patients with Evans III fractures and 44 with Evans IV fractures. Operation time, intraoperative bleeding, complications during hospital stay, fracture healing time, internal fixation rupture, femoral head cut, second fracture and mortality rate were recorded and compared between the two groups. Harris hip score was evaluated at postoperative 3, 6 and 12 months. Results:All patients were followed up for 3-12 months, with the average of 11.6 months. Normal rehabilitation group showed introperative bleeding of (119.3±1.9)ml and operation time of (1.13±0.22)hours, which were not significantly differed from that in optimized rehabilitation group [( 121.6±1.2)ml, (1.07±0.25)h] ( P>0.05). In normal rehabilitation group, the complications were hypostatic pneumonia in 19 patients, heart failure or acute myocardial infarction in 8, urinary infection in 18, lower-extremity deep vein thrombosis in 5, pressure ulcer in 4, with 5 deaths within 3 months after surgery. While in optimized rehabilitation group, the complications during hospitalization were hypostatic pneumonia in 6 patients, urinary infection in 6, heart failure or acute myocardial infarction in 1, lower-extremity deep vein thrombosis in 1, pressure ulcer in 0 during hospital ( P<0.05). Within 3 months, mortality rate was 5% in normal rehabilitation group compared to zero in optimized rehabilitation group ( P<0.05). At postoperative 3 months, 6 months and 12 months, Harris hip scores in optimized rehabilitation group[(69.7±6.3)points, (80.2±4.6)points, (89.3±10.2)points] were significantly higher than that in normal rehabilitation group [(53.6±5.4)points, (75.1±9.2)points, (77.5±7.5)points]( P<0.05). Fracture healing time, internal fixation rupture, femoral head cut, second fracture and mortality rate at postoperative 12 months had no significant differences between the two groups ( P>0.05). Conclusion:Optimized rehabilitation process can improve hip function, reduce complication rate and mortality rate at postoperative 3 months in old patients with Evans type III and IV femoral intertrochanteric fractures, which deserves clinical application.

Drug therapy plays an important role in alleviating the symptoms related to adenomyosis, improving the curative effect of surgery, delaying the progress of disease and promoting assisted reproduction. Non-steroidal anti-inflammatory drugs (NSAIDs) are the first choice to control pain associated with adenomyosis, and are the only choice for patients with recent fertility requirements; steroid hormones, gonadotropin releasing hormone agonists and mifepristone can effectively relieve pain and control uterine bleeding, among which oral contraceptives, levonorgestrel-releasing intranterine system (Mirena) and dienogest are more effective and commonly used in clinic. Drug selection should be based on patient's age, symptoms, uterine size, fertility requirements and economical conditions. At present, there is no specific drug for adenomyosis, and symptoms are easy to recur after drug withdrawal, so the long-term drug use needs further study.
Adenomyosis ; drug therapy ; Disease Management ; Female ; Humans ; Recurrence

OBJECTIVE: To determine the efficacy of second generation endometrial ablation (NovaSure) combined with levonorgestrel-releasing intrauterine system (Mirena) in the treatment of adenomyosis. METHODS: Clinical data of patients with adenomyosis admitted in Women's Hospital, Zhejiang University School of Medicine from January 2015 to December 2018 were retrospectively analyzed. Among 66 patients, 44 received Mirena placement only (control group) and 22 received Mirena placement and NovaSure treatment (study group). The menstruation blood loss, dysmenorrhea score, uterine size, expulsion rate of Mirena and the patients' satisfaction rate were assessed in two groups. RESULTS: There was a significant reduction in menstruation blood loss (<0.05) and significant improvement in dysmenorrhea (<0.05) after the treatment in both groups. The patients in study group had more marked improvement in menstruation blood loss than those in control group (<0.05). The patients' satisfaction was higher and the expulsion rate of Mirena was lower in study group than that in control group (all <0.05). The score of dysmenorrhea and the size of uterine had no significant difference between two groups (all >0.05). CONCLUSIONS NovaSure can improve the efficacy of Mirena in treatment of adenomyosis.
Adenomyosis ; therapy ; Dysmenorrhea ; Endometrial Ablation Techniques ; Female ; Humans ; Levonorgestrel ; administration & dosage ; Organ Size ; Retrospective Studies ; Uterus ; anatomy & histology

OBJECTIVE: To evaluate the efficacy and adverse effects of levonorgestrel-releasing intrauterine system (Mirena) in the treatment of adenomyosis. METHODS: The clinical data of 75 patients with adenomyosis who had Mirena insertion in Women's Hospital,Zhejiang University School of Medicine from September 2013 to December 2013 were retrospectively analyzed. The patients were followed up to 39 months. The efficacy and adverse effects were assessed. RESULTS: Pictorial Blood Loss Assessment Chart (PBAC) scores were decreased significantly after Mirena insertion both in patients with menorrhea (118±13 vs. 29±33, <0.01) and normal menstruation (82±15 vs. 14±13, <0.01); the patients with menorrhea showed a more significant decrease in PBAC score than those with normal menstruation (90±35 vs. 69±19,<0.01). The visual analogue scale (VAS) score decreased significantly after Mirena insertion compared with pre-treatment[7(6,7) vs. 1(0,2), <0.01]. The expulsion of Mirena occurred in 18 cases (24.0%); 9 cases (12.0%) had no effect and 28 cases (37.3%) had changes of menstruation patterns. Multivariate Cox regression analysis showed that the expulsion of Mirena was not associated with post-treatment VAS score, PBAC score before and after treatment or menstrual stabilization time (all >0.05). CONCLUSIONS Mirena is effective and safe in the long term management of adenomyosis, but about one third patients may require further treatment because of the expulsion or ineffectiveness of Mirena.
Adenomyosis ; Female ; Humans ; Intrauterine Devices, Medicated ; adverse effects ; standards ; Levonorgestrel ; administration & dosage ; adverse effects ; standards ; Retrospective Studies