Objective:To develop a laser-induced graphene (LIG)-based multimodal electrochemical sensor for monitoring the burn wound microenvironment and to evaluate its performance.Methods:This study was an experimental study. LIG three-electrode substrates were functionalized with L-lactate oxidase, polyaniline, and sortase A to fabricate lactate sensor, pH sensor, and bacterial sensor, respectively, thereby constituting the LIG-based multimodal electrochemical sensor. An electrochemical workstation was used to assess the electrochemical performance of the lactate sensor and bacterial sensor by cyclic voltammetry, with voltammetric response curves being plotted. An electrochemical workstation was used to assess the lactate sensor's response to lactate by chronoamperometry (with current-time curve being recorded and calibration curve being plotted during the test in the L-lactic acid solution with a molar concentration of 10-60 mmol/L), the pH sensor's response to pH by open-circuit potential measurement (with open-circuit potential-time curve being recorded and calibration curve being plotted during the test in the standard buffer solutions with pH values ranging from 3 to 8), and the bacterial sensor's response to bacteria by differential pulse voltammetry (with current-voltage curve being recorded and calibration curve being plotted during the test in gradient suspensions of Staphylococcus aureus ranging from 1×103-1×10? colony forming unit (CFU)/mL). The sample size for all the above experiments was 3. The correlation analysis was performed on the current value of the lactate sensor and the lactate concentration, the average value of steady-state open circuit potential of the pH sensor and the pH value, and the peak current value of the bacterial sensor and the bacterial concentration value. Each of the prepared standard test system solutions for lactate, pH value, and bacteria were all aliquoted into 30 samples. The lactate concentration, pH value, and bacterial concentration were determined by the lactate sensor and a L-lactate assay kit, the pH sensor and a precision pH meter, and the bacterial sensor and a microvolume spectrophotometer, respectively. Fifteen pairs of matched data were selected according to the random number table method for comparison, and the correlation analysis was performed on the measured values of each sensor and the reference values of the corresponding standard methods. Results:The voltammetric response curves showed that the lactate sensor and the bacterial sensor exhibited distinct oxidation peak currents at oxidation peak potentials of approximately 0.74 and 0.65 V, respectively. In the lactate sensor, the change in current after addition of phosphate buffered solution was (0.025±0.041) μA, which was significantly lower than that after addition of L-lactate solution (0.228±0.117) μA ( t=2.85, P<0.05). In the L-lactic acid solution with a molar concentration of 10-60 mmol/L, the current value of the lactate sensor was significantly linearly correlated with the lactate concentration ( r=0.98, P<0.05). In the standard buffer solutions with pH values ranging from 3 to 8, the average value of steady-state open circuit potential of the pH sensor was significantly linearly correlated with the corresponding pH values ( r=0.96, P<0.05). In gradient suspensions of Staphylococcus aureus ranging from 1×103 to 1×10? CFU/mL, the peak current value of the bacterial sensor was significantly linearly correlated with the logarithm of bacterial concentration ( r=0.95, P<0.05). There were no statistically significant differences between the lactate concentrations measured by the lactate sensor and by the L-lactate assay kit, pH values measured by the pH sensor and by the precision pH meter, and logarithmic bacterial concentrations measured by the bacterial sensor and by the microvolume spectrophotometer ( P>0.05), but there were significant positive correlations between the two (with r values of 0.97, 0.96, and 0.95, respectively, P<0.05). Conclusions:After functional modification, the developed LIG-based multimodal electrochemical sensor enables accurate monitoring of lactate concentration, pH value, and bacterial load in the burn wound microenvironment with the results being of high sensitivity and stability. This platform provides a reliable new approach for non-invasive monitoring of the critical indicators of burn wound microenvironment, which shows great prospects for clinical application.

Objective To explore the prevalence of 9 respiratory pathogens from March 2023 to February 2024,as well as the detection efficiency of various methods for pathogens.Methods A retrospective analysis was conducted on the detection of 9 pathogens in 38 948 patients who first presented with respiratory symp-toms from March 2023 to February 2024,as well as the detection efficacy of nucleic acid,antigen,antibody and other methods.Results Firstly,among 38 948 patients,a total of 8 345 cases(21.43%)were detected with at least one pathogen,of which 8 158 cases(20.95%)were detected with only one pathogen,and 187 cases(2.29%,187/8 158)were detected with two or more pathogens.The top three detection rates were SARS-CoV-2(20.37%),mycoplasma pneumoniae(MP,15.58%)and influenza A virus(IVA,10.79%).Secondly,among patients who detected at least one of the nine pathogens,the detection rate was 24.94%in autumn,21.45%in spring,18.54%in summer,and 19.22%in winter,and the difference in detection rates between the four seasons was statistically significant(P<0.001).Thirdly,except for the relatively high detection rates of SARS-CoV-2 in spring(51.24%)and summer(37.31%),and the highest detection rate of IVB in winter(11.28%),the detection rates of other pathogens were highest in autumn.Fourthly,there was a statistically significant difference in the total detection rates among the children group(31.83%),the youth group(12.48%),the middle-aged group(10.70%),and the elderly group(12.43%)(P<0.001).The detection rates of 7 pathogens,including MP,IVA,Influenza B virus(IVB),syncytial virus,CP,adenovirus,and parain-fluenza virus type 1,were highest in children,and there was a statistically significant difference in comparison between different age groups(P<0.05).The detection rate of SARS-CoV-2 in the children group(3.45%)was lower than that in other age groups(30.90%,29.09%,32.16%,P<0.001).There was no statistically significant difference in HPIV-3 between different age groups(P=0.478).Fifthly,there was no significant difference in overall detection rate between male and female(P>0.05).However,the detection rates of MP and CP in female were higher than those in male(P<0.05),while IVA in male was slightly higher than that in female(P=0.014).There were no significant differences in the detection rate of other 6 pathogens between female and male(P>0.05).Sixthly,the detection rate of MP antigen was lower than that of MP nucleic acid detection(P<0.001),and the detection rate of MP antibody detection was lower than that of MP nucleic acid detection(P<0.001).The detection rate of MP antibody detection increased significantly with the extension of time from initial symptoms to medical treatment(P<0.001).Seventhly,the detection rates of antigen of IVA,IVB,RSV and ADV were significantly lower than those of the corresponding nucleic acid(P<0.001),and the detection rates of nucleic acid testing for 4 kinds of pathogen was about 5 times that of the correspond-ing antigen testing(4.75-6.25 times).And the consistency of the detection rate between antigen detection and nucleic acid detection was poor(Kappa=0.046-0.239).Conclusion The prevalence of common respir-atory pathogens from March 2023 to February 2024 exhibits certain characteristics.Moreover,the detection ef-ficiency of different methods for pathogens varies greatly,and appropriate detection methods should be select-ed based on a thorough understanding of their performance.

Objective To investigate the changes of 22 bile acid sub components and 17 traditional bio-chemical indicators in serum of patients with non-alcoholic fatty liver disease(NAFLD),and the diagnostic value of detecting the above indicators alone or in combination for NAFLD.Methods A total of 168 NAFLD patients(NAFLD group)and 216 non-NAFLD apparently healthy individuals(non-NAFLD group)were se-lected,bile acid sub components were determined by liquid chromatography tandem mass spectrometry,and traditional biochemical indicators were detected by automatic biochemical analyzer.Results There were sta-tistically significant differences in the levels of 12 bile acid sub components and 12 traditional biochemical indi-cators between NAFLD group and non-NAFLD group(P<0.05).Compared to traditional biochemical indica-tors,bile acid sub components were less affected by body mass index(BMI).The area under the curve for di-agnosing NAFLD by combining three bile acid sub components[taurocholic acid(TCA),sodium taurodeoxy-cholate(TDCA),and tauroursodeoxycholic acid(UDCA)]with three traditional biochemical indicators[ala-nine aminotransferase(ALT),5'Nucleotidase(5'-NT),and small and dense low-density lipoprotein cholester-ol(sd-LDL-C)]was the largest,which was 0.810.Conclusion Twelve kinds of bile acid sub components in the blood of NAFLD patients have changed,and the combined detection of bile acid sub components and tradi-tional biochemical indicators could improve the diagnostic efficacy of NAFLD to a certain extent.

Objective:To develop a laser-induced graphene (LIG)-based multimodal electrochemical sensor for monitoring the burn wound microenvironment and to evaluate its performance.Methods:This study was an experimental study. LIG three-electrode substrates were functionalized with L-lactate oxidase, polyaniline, and sortase A to fabricate lactate sensor, pH sensor, and bacterial sensor, respectively, thereby constituting the LIG-based multimodal electrochemical sensor. An electrochemical workstation was used to assess the electrochemical performance of the lactate sensor and bacterial sensor by cyclic voltammetry, with voltammetric response curves being plotted. An electrochemical workstation was used to assess the lactate sensor's response to lactate by chronoamperometry (with current-time curve being recorded and calibration curve being plotted during the test in the L-lactic acid solution with a molar concentration of 10-60 mmol/L), the pH sensor's response to pH by open-circuit potential measurement (with open-circuit potential-time curve being recorded and calibration curve being plotted during the test in the standard buffer solutions with pH values ranging from 3 to 8), and the bacterial sensor's response to bacteria by differential pulse voltammetry (with current-voltage curve being recorded and calibration curve being plotted during the test in gradient suspensions of Staphylococcus aureus ranging from 1×103-1×10? colony forming unit (CFU)/mL). The sample size for all the above experiments was 3. The correlation analysis was performed on the current value of the lactate sensor and the lactate concentration, the average value of steady-state open circuit potential of the pH sensor and the pH value, and the peak current value of the bacterial sensor and the bacterial concentration value. Each of the prepared standard test system solutions for lactate, pH value, and bacteria were all aliquoted into 30 samples. The lactate concentration, pH value, and bacterial concentration were determined by the lactate sensor and a L-lactate assay kit, the pH sensor and a precision pH meter, and the bacterial sensor and a microvolume spectrophotometer, respectively. Fifteen pairs of matched data were selected according to the random number table method for comparison, and the correlation analysis was performed on the measured values of each sensor and the reference values of the corresponding standard methods. Results:The voltammetric response curves showed that the lactate sensor and the bacterial sensor exhibited distinct oxidation peak currents at oxidation peak potentials of approximately 0.74 and 0.65 V, respectively. In the lactate sensor, the change in current after addition of phosphate buffered solution was (0.025±0.041) μA, which was significantly lower than that after addition of L-lactate solution (0.228±0.117) μA ( t=2.85, P<0.05). In the L-lactic acid solution with a molar concentration of 10-60 mmol/L, the current value of the lactate sensor was significantly linearly correlated with the lactate concentration ( r=0.98, P<0.05). In the standard buffer solutions with pH values ranging from 3 to 8, the average value of steady-state open circuit potential of the pH sensor was significantly linearly correlated with the corresponding pH values ( r=0.96, P<0.05). In gradient suspensions of Staphylococcus aureus ranging from 1×103 to 1×10? CFU/mL, the peak current value of the bacterial sensor was significantly linearly correlated with the logarithm of bacterial concentration ( r=0.95, P<0.05). There were no statistically significant differences between the lactate concentrations measured by the lactate sensor and by the L-lactate assay kit, pH values measured by the pH sensor and by the precision pH meter, and logarithmic bacterial concentrations measured by the bacterial sensor and by the microvolume spectrophotometer ( P>0.05), but there were significant positive correlations between the two (with r values of 0.97, 0.96, and 0.95, respectively, P<0.05). Conclusions:After functional modification, the developed LIG-based multimodal electrochemical sensor enables accurate monitoring of lactate concentration, pH value, and bacterial load in the burn wound microenvironment with the results being of high sensitivity and stability. This platform provides a reliable new approach for non-invasive monitoring of the critical indicators of burn wound microenvironment, which shows great prospects for clinical application.

Objective:To evaluate the feasibility of pelvic floor muscle reconstruction for women with vaginal laxity accompanied by stress urinary incontinence (SUI).Methods:A prospective cohort clinical study was conducted to collect clinical data from patients with vaginal laxity and SUI admitted to the Urogenital Reconstructive and Gender-affirming Department at the Plastic Surgery Hospital, Chinese Academy of Medical Sciences, and the Department of Urology, Third Medical Center, Chinese PLA General Hospital, from January 2019 to September 2022. Patients underwent surgical treatment for pelvic floor muscle reconstruction. The cough provocation test and the patient global impression of improvement (PGI-I) scale were utilized as objective and subjective indicators of treatment effecacy, respectively. The urinary incontinence quality of life scale (I-QOL) and the pelvic organ prolapse and urinary incontinence sexual function questionnaire 12(PISQ-12) were used to evaluate the changes in quality of life and sexual funtion. The changes in pelvic floor anatomical structure were evaluated by pelvic floor ultrasound. Data analysis was performed using SPSS version 23.0. The I-QOL and PISQ-12 scores, posterior vesicourethral angle, urethral rotation angle, and bladder neck motion before and after surgery were analyzed using paired t-test, with P<0.05 was considered statistically significant. Results:A total of 36 female patients were included, with an average age of 41.7 years (ranged 24-51 years) and an average body mass index of 23.8 kg/m 2. The average operation time was 76.2 minutes, and the average blood loss was 84.5 milliliters. After 12-27 months of postoperative follow-up, the objective and subjective cure rates were 86.1% (31/36) and 88.9% (32/36), respectively. The sexual function and quality of life of the patients were significantly improved compared with the preoperative results, and postoperative pelvic floor ultrasound results showed significant improvement. The I-QOL and PISQ-12 scores 12 months after surgery were statistically significant compared with those before surgery ( P<0.01). Postoperative pelvic floor ultrasonography revealed statistically significant differences in posterior vesicourethral angle, urethral rotation angle, and bladder neck motion during maximum Valsalva maneuver compared to preoperative data ( P<0.01). Conclusion:Pelvic floor muscle reconstruction is a safe and effective surgical method for patients with vaginal laxity combined with SUI. This procedure can significantly improve sexual quality of life and alleviates SUI symptoms, restores anatomical structure in the female pelvic floor, and enhances overall quality of life.

Diabetic nephropathy (DN) is a clinical syndrome characterized by persistent proteinuria and progressive decline in renal function, and is one of the microvascular complications of diabetes. With the in-depth understanding of the pathogenesis of DN, the role of intestinal flora imbalance in the disease has been found clinically. This suggests that restoring the host′s healthy gut flora may be a means of improving DN. In fact, recent studies have shown that many of the drugs currently used to treat DN affect gut microbiota composition. In this review, intestinal flora is regarded as one of the main factors affecting the development of DN, and DN therapy targeting intestinal flora is summarized to provide new ideas for the diagnosis and treatment of DN.

Objective:To evaluate the feasibility of pelvic floor muscle reconstruction for women with vaginal laxity accompanied by stress urinary incontinence (SUI).Methods:A prospective cohort clinical study was conducted to collect clinical data from patients with vaginal laxity and SUI admitted to the Urogenital Reconstructive and Gender-affirming Department at the Plastic Surgery Hospital, Chinese Academy of Medical Sciences, and the Department of Urology, Third Medical Center, Chinese PLA General Hospital, from January 2019 to September 2022. Patients underwent surgical treatment for pelvic floor muscle reconstruction. The cough provocation test and the patient global impression of improvement (PGI-I) scale were utilized as objective and subjective indicators of treatment effecacy, respectively. The urinary incontinence quality of life scale (I-QOL) and the pelvic organ prolapse and urinary incontinence sexual function questionnaire 12(PISQ-12) were used to evaluate the changes in quality of life and sexual funtion. The changes in pelvic floor anatomical structure were evaluated by pelvic floor ultrasound. Data analysis was performed using SPSS version 23.0. The I-QOL and PISQ-12 scores, posterior vesicourethral angle, urethral rotation angle, and bladder neck motion before and after surgery were analyzed using paired t-test, with P<0.05 was considered statistically significant. Results:A total of 36 female patients were included, with an average age of 41.7 years (ranged 24-51 years) and an average body mass index of 23.8 kg/m 2. The average operation time was 76.2 minutes, and the average blood loss was 84.5 milliliters. After 12-27 months of postoperative follow-up, the objective and subjective cure rates were 86.1% (31/36) and 88.9% (32/36), respectively. The sexual function and quality of life of the patients were significantly improved compared with the preoperative results, and postoperative pelvic floor ultrasound results showed significant improvement. The I-QOL and PISQ-12 scores 12 months after surgery were statistically significant compared with those before surgery ( P<0.01). Postoperative pelvic floor ultrasonography revealed statistically significant differences in posterior vesicourethral angle, urethral rotation angle, and bladder neck motion during maximum Valsalva maneuver compared to preoperative data ( P<0.01). Conclusion:Pelvic floor muscle reconstruction is a safe and effective surgical method for patients with vaginal laxity combined with SUI. This procedure can significantly improve sexual quality of life and alleviates SUI symptoms, restores anatomical structure in the female pelvic floor, and enhances overall quality of life.

Objective To investigate the vaginal microbilme characterization in women with human papillomavirus(HPV)16 and 18 infection and high-grade cervical intraepithelial neoplasia(CIN).Methods Three groups were set,including control group(without HPV infection and with colpitis),low-grade CIN group(with HPV 16 or/and 18 infection),and high-grade CIN group(with HPV 16 or/and 18 infection).Virginal microbial composition was determined by using 16S rRNA amplication sequencing and hierarchical clustering analysis among three groups was applied.Rank sum test was used to determine statistical significance.Results Diversity and complexity of bacteria was significantly elevated in high-grade group.Compared with the control,the growth of Lactobacillus crispatus(L.crispatus) and Lactobacillus casei(L.casei) was significantly decreased,while Lactobacillus iners(L.iners) was significantly increased in low-grade CIN group and high-grade CIN group,and both were proportionally correlated to the grade of the disease.Brucella canis(B.canis),as colonized bacteria,was significantly decreased in both low-grade and high-grade CIN groups,and the changes were proportional to the grade of disease.The growth of Dialistersuccinatiphilus(D.succinatiphilus),Gardnerella vaginalis(G.vaginalis) and Prevotellabivia(P.bivia) were significantly elevated and proportional to the grade of disease.Conclusion The diversity and complexity of virginal microbial composition could be significantly expanded in women with HPV infection and high-grade CIN.In contrast to the important role of lactobacillus in virginal health,L.inners could be pathogenic.The colonization of B.canis,D.succinatiphilus,G.vaginalis and P.bivia might be highly correlated with HPV chronic infection and further development of CIN.

Objective To study the difference between intensity-modulated radiation therapy (IMRT) and three dimensional conformal radiation therapy (3D-CRT) for pelvic radiation of post-operative treatment with gynecologic malignant tumor. Methods A prospective investigation study was conducted on 183 patients of post-operative patients with whole pelvic radiation therapy of cervical cancer or endometrial cancer in Zhejiang Cancer Hospital [IMRT group (n=85) and 3D-CRT group (n=98)] from Oct. 2015 to Oct. 2016. The two groups received same dose (45 Gy in 25 fractions). Comparison of two groups with radiation dosimetry:the score according to the Radiation Therapy Oncology Group (RTOG) acute radiation injury grading standards before and after radiotherapy reaction, the score from functional assessment of cancer therapy scale-cervix (FACT-Cx) scale and expanded prostate cancer index composite for clinical practice (EPIC-CP) scale were also analyzed. Results (1) There were no significant effect with age, culture level, family economic condition and ratio of radiochemotherapy between two groups (all P>0.05). (2) Dosimetric comparison for IMRT vs 3D-CRT:the average dose of planning target volume (PTV) decreased(46.1 ± 0.4) vs(46.4 ± 0.5)Gy, V45 dose percentage increased(95.2 ± 1.0)%vs (93.3 ± 2.0)%, intestinal bag dose of V40 decreased(24.4 ± 6.8)%vs (36.5 ± 15.9)%, rectal V40 dose percentage decreased(73.9 ± 12.3)%vs (85.4 ± 8.4)%, and lower rectal V45 dose percentage(32.8 ± 13.4)%vs (71.5 ± 13.7)%, bladder V40 dose percentage decreased(55.5 ± 13.0)% vs (84.4 ± 13.0)%. Bone marrow V20 lower:(67.9 ± 5.4)% vs (79.5 ± 6.6)%, V10 lower:(82.1 ± 6.0)% vs (86.3 ± 6.6)%; there were significant differences (all P<0.05). There was no significant difference between the dose of V45 in the intestinal pouch and bladder (P>0.05). (3) Acute radiation injury classification for IMRT vs 3D-CRT:big or small intestine:Ⅱ-Ⅲreaction [13%(11/85) vs 24% (24/98); χ2=3.925, P=0.048], there was significant difference. Bladder: Ⅲ reaction [19% (16/85) vs 26% (25/98); χ2=1.171, P=0.279], there was no significant difference. Radiochemotherapy of bone marrow suppression:Ⅲ-Ⅳreaction (14/20), the incidence rate [26%(14/54) vs 31%(20/65);χ2=0.339, P=0.562], the difference was not statistically significant. (4) Quality of life scale by FACT-Cx scale in IMRT vs 3D-CRT:there were no significant difference before radiotherapy (82 ± 16 vs 85 ± 16;t=1.279, P=0.203), while there was significant difference after radiotherapy (76 ± 14 vs 71 ± 18;t=-2.160, P=0.032). EPIC-CP scale score:before radiotherapy they were (16±7 vs 15±6;t=-0.174, P=0.862) ,but after radiotherapy (18±7 vs 22± 7; t=3.158, P=0.002), there was significant difference between them. Before and after radiotherapy, the increased EPIC-CP scale of the IMRT group vs 3D-CRT group were 3 ± 4 and 6 ± 4, the 3D-CRT group was significantly higher, the difference was statistically significant (t=5.500, P=0.000). Conclusion IMRT has shown that there are a significant benefit for the post-operative patients with cervical cancer and endometrial cancer compared to 3D-CRT.

Objective To investigate the effects of hyperbaric oxygen (HBO) combined with mecobalamin on electrophysiological changes in the treatment of carpal tunnel syndrome (CTS).Methods Eighty-four cases of CTS were randomly divided into the mecobalamin group (n =28),the HBO group (n =28) and the HBO + mecobalamin group (n =28).The mecobalamin group was treated with mecobalamin,the HBO group received HBO therapy,and the latter group was given combined therapy,i.e.HBO plus mecobalamin.Both before and after treatment,all the patients received electrophysiological detection.Results After treatment,the median nerve sensory nerve conduction velocity (SCV),motor nerve conduction velocity (MCV),and the wave amplitude of the motor nerve compound muscle action potential (CMAP) of the combined group were all higher than those before treatment (P ＜ 0.05),while CMAP latency (BML) was lower than that before treatment (P ＜ 0.05).Following treatment,SCV of the Mecobalamin group was higher than that before treatment (P ＜ 0.05).SCV and MCV of the HBO group after treatment were higher than those before treatment (P ＜ 0.05).SCV and CMAP wave amplitude of the combined group significantly elevated as compared with that of the mecobalamin group (P ＜ 0.05),and SCV of the combined group was significantly higher than that of the HBO group (P ＜ 0.05).Conclusions HBO combined with mecobalamin could produce significant effects in the treatment of CTS.