Objective:To analyze the influencing factors of pelvic floor muscle exercise (PFME) compliance in patients with urinary incontinence after laparoscopic radical prostatectomy (LRP) based on the theory of disease uncertainty, and construct a structural equation model, so as to explore the impact mechanisms of disease uncertainty, social support, PFME self-efficacy, and disease coping styles on exercise compliance in patients with urinary incontinence after LRP.Methods:Convenience sampling was used to select 300 postoperative urinary incontinence patients who underwent LRP and PFME at Tenth People's Hospital of Tongji University between June 2023 and June 2024 as study subjects. Patients were assessed using the General Information Questionnaire, PFME Compliance Scale, Mishel Uncertainty in Illness Scale-Adult (MUIS-A), Broome Pelvic Muscle Self-Efficacy Scale (BPMSES), Social Support Rating Scale (SSRS), and Medical Coping Modes Questionnaire (MCMQ). Multiple linear regression analysis was employed to identify factors influencing PFME compliance in patients with urinary incontinence after LRP. Pearson correlation was used to analyze the correlation between PFME compliance and disease uncertainty, self-efficacy, social support, and medical coping styles in patients with urinary incontinence after LRP. AMOS 26.0 software was used for path analysis.Results:A total of 300 questionnaires were distributed, and 282 valid questionnaires were collected, with a valid response rate of 94.00% (282/300). Among 282 patients with urinary incontinence after LRP, the PFME Compliance Scale, MUIS-A, BPMSES, SSRS, and MCMQ scores for confrontation, avoidance, and resignation coping styles were (11.92±2.60), (72.37±14.56), (166.98±17.10), (50.69±6.73), (14.46±2.56), (14.12±2.91), and (12.32±2.58), respectively. PFME compliance showed negative correlations with MUIS-A scores and resignation coping style ( r=-0.559, -0.606; P<0.01), while exhibiting positive correlations with PFME self-efficacy, social support and confrontation coping style ( r=0.494, 0.539, 0.118; P<0.05). Bootstrap mediating analysis showed that disease uncertainty not only directly affected PFME compliance in patients with urinary incontinence after LRP, but also indirectly affected PFME compliance through three pathways: disease uncertainty→ PFME self-efficacy→ PFME compliance, with an effect value of -0.147 [95% CI (-0.250, -0.085) ], accounting for 18.1% of the total effect; disease uncertainty→ resignation coping style→ PFME compliance, with an effect value of -0.184 [95% CI (-0.270, -0.115) ], accounting for 22.7% of the total effect; disease uncertainty→ social support → PFME compliance, with an effect value of -0.173 [95% CI (-0.300, -0.070) ], accounting for 21.4% of the total effect. The indirect total effect constituted 62.2% of the total effect. Conclusions:Patients with urinary incontinence after LRP have low PFME compliance. Disease uncertainty not only directly affects PFME compliance, but also indirectly affects it through PFME self-efficacy, social support, and coping styles.

Objective:To analyze the influencing factors of pelvic floor muscle exercise (PFME) compliance in patients with urinary incontinence after laparoscopic radical prostatectomy (LRP) based on the theory of disease uncertainty, and construct a structural equation model, so as to explore the impact mechanisms of disease uncertainty, social support, PFME self-efficacy, and disease coping styles on exercise compliance in patients with urinary incontinence after LRP.Methods:Convenience sampling was used to select 300 postoperative urinary incontinence patients who underwent LRP and PFME at Tenth People's Hospital of Tongji University between June 2023 and June 2024 as study subjects. Patients were assessed using the General Information Questionnaire, PFME Compliance Scale, Mishel Uncertainty in Illness Scale-Adult (MUIS-A), Broome Pelvic Muscle Self-Efficacy Scale (BPMSES), Social Support Rating Scale (SSRS), and Medical Coping Modes Questionnaire (MCMQ). Multiple linear regression analysis was employed to identify factors influencing PFME compliance in patients with urinary incontinence after LRP. Pearson correlation was used to analyze the correlation between PFME compliance and disease uncertainty, self-efficacy, social support, and medical coping styles in patients with urinary incontinence after LRP. AMOS 26.0 software was used for path analysis.Results:A total of 300 questionnaires were distributed, and 282 valid questionnaires were collected, with a valid response rate of 94.00% (282/300). Among 282 patients with urinary incontinence after LRP, the PFME Compliance Scale, MUIS-A, BPMSES, SSRS, and MCMQ scores for confrontation, avoidance, and resignation coping styles were (11.92±2.60), (72.37±14.56), (166.98±17.10), (50.69±6.73), (14.46±2.56), (14.12±2.91), and (12.32±2.58), respectively. PFME compliance showed negative correlations with MUIS-A scores and resignation coping style ( r=-0.559, -0.606; P<0.01), while exhibiting positive correlations with PFME self-efficacy, social support and confrontation coping style ( r=0.494, 0.539, 0.118; P<0.05). Bootstrap mediating analysis showed that disease uncertainty not only directly affected PFME compliance in patients with urinary incontinence after LRP, but also indirectly affected PFME compliance through three pathways: disease uncertainty→ PFME self-efficacy→ PFME compliance, with an effect value of -0.147 [95% CI (-0.250, -0.085) ], accounting for 18.1% of the total effect; disease uncertainty→ resignation coping style→ PFME compliance, with an effect value of -0.184 [95% CI (-0.270, -0.115) ], accounting for 22.7% of the total effect; disease uncertainty→ social support → PFME compliance, with an effect value of -0.173 [95% CI (-0.300, -0.070) ], accounting for 21.4% of the total effect. The indirect total effect constituted 62.2% of the total effect. Conclusions:Patients with urinary incontinence after LRP have low PFME compliance. Disease uncertainty not only directly affects PFME compliance, but also indirectly affects it through PFME self-efficacy, social support, and coping styles.

Objective:To investigate the risk factors of urethrovesical anastomotic leakage after laparoscopic radical prostatectomy.Methods:The clinical data of 292 patients who underwent laparoscopic radical prostatectomy in the Tenth People's Hospital Affiliated to Tongji University from January to December 2021 were retrospectively analyzed. According to whether there was anastomotic leakage, the patients were divided into leakage group (27 cases) and non-leakage group (265 cases). There were no significant differences in age [(71.5±6.5) years vs. (70.2±6.4) years], body mass index [(24.5±3.6) kg/m 2 vs. (24.2±3.0) kg/m 2], prostate volume[40(27.3, 63.2)ml vs. 38(28.1, 56.2)ml], Gleason score, clinical stage, and risk classification between the leakage group and the non-leakage group ( P>0.05), but the total prostate-specific antigen in the leakage group was significantly higher than that in the non-leakage group[20.0 (9.6, 79.0) ng/ml vs. 13.7 (8.5, 25.0) ng/ml, P=0.049]. Propensity score matching (PSM) was used to match the above indicators between the leakage group and the non-leakage group as 1∶1, so that the baseline of the two groups was balanced. The perioperative indicators of the matched two groups of patients were compared and analyzed. Statistically significant indicators were selected and included in univariate and multivariate logistic regression to analyze the risk factors of anastomotic leakage after radical prostatectomy. Finally, the receiver operating characteristic (ROC) curve was drawn, and the area under the curve (AUC) was calculated. The accuracy of each factor in predicting urine leakage was obtained. Results:After PSM, 24 cases were successfully matched. The leakage group had shorter membranous urethral length (MUL) [(15.5±2.2)mm vs. (17.5±1.5)mm, P<0.001], thinner membranous urethral wall thickness (UWT) [(9.5±1.9)mm vs. (10.6±1.5)mm, P=0.024], longer anastomotic time of urethrovesical neck[(21.6±4.1)min vs. (16.9±2.9)min, P<0.001] and higher failure rate of water injection test [16.7% (4/24) vs. 4.2% (1/24), P=0.045] than the non-leakage group. There was no significant difference in other indicators between the two groups. The results of multivariate logistic regression analysis showed that short MUL ( OR=0.544, 95% CI 0.335-0.884, P=0.014), narrow UWT ( OR=0.538, 95% CI 0.313-0.924, P=0.025) and long anastomotic time of urethrovesical neck ( OR=1.519, 95% CI 1.122-2.110, P=0.009) were independent risk factors for anastomotic urine leakage. ROC curve analysis showed that the AUC of MUL, UWT, and anastomotic time were 0.789 (95% CI 0.651-0.927), 0.715 (95% CI 0.562-0.868), and 0.842 (95% CI 0.731-0.953), respectively. Conclusions:Narrow and short membranous urethra and long anastomosis time in patients with laparoscopic radical prostatectomy may be independent risk factors for postoperative anastomotic leakage, which may predict the occurrence of anastomotic leakage.

Objective:To detect the expression levels of miR-3074-5p and its target gene p27 in the placental tissues of pre-eclampsia (PE) patients, and to preliminarily explore the association of miR-3074-5p/p27 pathway in the pathogenesis of PE. Methods:From September 2017 to March 2018, 16 pregnant women with PE (PE group) and 9 normal pregnant women (control group) were enrolled in Obstetrics Department in the Second Hospital of Tianjin Medical University. The placental expression levels of miR-3074-5p, p27, cyclin D1 (CCND1) and cyclin dependent kinase 2 (CDK2) were determined by quantitative PCR (qPCR), Western blotting and immunohistochemistry (IHC) analyses. The dual-luciferase reporter assay was applied to authenticate the directly targeted effect of miR-3074-5p on expression of p27 mRNA. The expression of p27 in the human extravillous trophoblast cell line HTR-8/SVneo was down-regulated by its specific shRNA, and the effects of down-regulated p27 expression on physiological activities of HTR-8/SVneo cells were detected. Results:Compared with control group, the expression levels of miR-3074-5p ( P=0.034) and CCND1 ( P=0.031) protein in the placenta of PE patients were significantly decreased, whereas the placental p27 ( P=0.010) protein expression was significantly increased in PE group. IHC analysis showed that, the signals of p27 and CCND1 proteins were dominantly detected in syncytiotrophoblast. The results of dual-luciferase reporter assay confirmed that miR-3074-5p could inhibit the expression of p27 by directly bound to the 3'UTR of p27 mRNA. After the p27 expression was down-regulated, the proliferative and invasive activities of HTR-8/SVneo cells were significantly enhanced ( P=0.014, P=0.045). Conclusion:miR-3074-5p might participate in the regulation of physiological activities of extravillous trophoblast cells by its targeted inhibition on p27 expression, and the abnormally decreased miR-3074-5p in trophoblast cells might be associated with the pathogenesis of PE by promoting the expression of p27.

Objective:To detect the expression levels of miR-3074-5p and its target gene p27 in the placental tissues of pre-eclampsia (PE) patients, and to preliminarily explore the association of miR-3074-5p/p27 pathway in the pathogenesis of PE. Methods:From September 2017 to March 2018, 16 pregnant women with PE (PE group) and 9 normal pregnant women (control group) were enrolled in Obstetrics Department in the Second Hospital of Tianjin Medical University. The placental expression levels of miR-3074-5p, p27, cyclin D1 (CCND1) and cyclin dependent kinase 2 (CDK2) were determined by quantitative PCR (qPCR), Western blotting and immunohistochemistry (IHC) analyses. The dual-luciferase reporter assay was applied to authenticate the directly targeted effect of miR-3074-5p on expression of p27 mRNA. The expression of p27 in the human extravillous trophoblast cell line HTR-8/SVneo was down-regulated by its specific shRNA, and the effects of down-regulated p27 expression on physiological activities of HTR-8/SVneo cells were detected. Results:Compared with control group, the expression levels of miR-3074-5p ( P=0.034) and CCND1 ( P=0.031) protein in the placenta of PE patients were significantly decreased, whereas the placental p27 ( P=0.010) protein expression was significantly increased in PE group. IHC analysis showed that, the signals of p27 and CCND1 proteins were dominantly detected in syncytiotrophoblast. The results of dual-luciferase reporter assay confirmed that miR-3074-5p could inhibit the expression of p27 by directly bound to the 3'UTR of p27 mRNA. After the p27 expression was down-regulated, the proliferative and invasive activities of HTR-8/SVneo cells were significantly enhanced ( P=0.014, P=0.045). Conclusion:miR-3074-5p might participate in the regulation of physiological activities of extravillous trophoblast cells by its targeted inhibition on p27 expression, and the abnormally decreased miR-3074-5p in trophoblast cells might be associated with the pathogenesis of PE by promoting the expression of p27.