Pelvic floor muscle training (PFMT) is the first-line intervention for non-surgical treatment of female patients with stress urinary incontinence (SUI). However, due to the particularity of the physiological position of the pelvic floor muscles, 13% to 53% of patients are unable to perform PFMT correctly after the initial visit. In view of this, scholars at China and abroad put forward some other sports rehabilitation methods and achieve good clinical results. In this paper, exercise rehabilitation methods for female SUI patients were reviewed, including PFMT, core muscle training, Pilates, yoga, physical activities, etc., in order to provide reference for medical personnel to formulate scientific and feasible exercise rehabilitation programs for female SUI patients.

Objective To systematically evaluate the effect of red ginseng on improving metabolic syndrome,and to provide basis for clinical practice.Methods Retrieval from PubMed,Embase,The Cochrane Library,Web of Science,Clinical Trials Gov,WanFang Data and CNKI databases,articles of RCTs about red ginseng on improving metabolic syndrome were included.The searching range was from the establishment of the database to May 2022.The articles were screened according to inclusion and exclusion criteria,and then the inclusion study was analyzed through RevMan 5.4.1 software.Results Totally 17 randomized controlled trials involving 957 patients were included.Compared with the control group,red ginseng exhibited significant effect on fasting blood glucose,total cholesterol,low-density lipoprotein,systolic blood pressure and diastolic blood pressure(P<0.05),and its effect was related to the disease,age,duration of administration and dosage.Conclusion Red ginseng could significantly improve the symptoms of hyperglycemia,hyperlipidemia and hypertension in metabolic syndrome,which provides a theoretical basis for clinical use of red ginseng in treating metabolic syndrome.

Objective:To investigate CT manifestations of perivascular epithelioid cell tumors.Methods:The multi-slice spiral CT manifestations in 11 patients with perivascular epithelioid cell tumors which were pathologically confirmed in the First Affiliated Hospital of Shantou University Medical College between October 2012 and August 2021 were retrospectively analyzed.Results:Perivascular epithelioid cell tumors were located in the kidney of eight patients, in the right lobe of the liver of two patients, and in the descending colon of one patient. The largest tumor, approximately 20.0 cm × 26.0 cm × 11.0 cm, was located in the kidney. The smallest tumor, 2.4 cm × 2.6 cm × 3.4 cm, was located in the colon. CT plain scans showed uniform density without bleeding, calcification, or fat in two patients, and non-uniform density with fatty change in two patients. Contrast-enhanced CT images showed non-uniform enhancement in the arterial phase in 10 patients and uniform enhancement in one patient. Contrast-enhanced CT images showed decreased degrees of enhancement of the lesions in 11 patients from the portal venous phase to the delayed phase and dilated and tortuous vascular shadows in 11 patients.Conclusion:The multi-slice spiral CT manifestations of perivascular epithelioid cell tumors are characteristic and the multi-slice spiral CT is of value for the diagnosis of perivascular epithelioid cell tumors.

Metastasis and resistance are main causes to affect the outcome of the current anticancer therapies. Heat shock protein 90 (Hsp90) as an ATP-dependent molecular chaperone takes important role in the tumor metastasis and resistance. Targeting Hsp90 and downregulating its expression show promising in inhibiting tumor metastasis and resistance. In this study, a redox-responsive dual-drug nanocarrier was constructed for the effective delivery of a commonly used chemotherapeutic drug PTX, and a COA-modified 4-arm PEG polymer (4PSC) was synthesized. COA, an active component in oleanolic acid that exerts strong antitumor activity by downregulating Hsp90 expression, was used as a structural and functional element to endow 4PSC with redox responsiveness and Hsp90 inhibitory activity. Our results showed that 4PSC/PTX nanomicelles efficiently delivered PTX and COA to tumor locations without inducing systemic toxicity. By blocking the Hsp90 signaling pathway, 4PSC significantly enhanced the antitumor effect of PTX, inhibiting tumor proliferation and invasiveness as well as chemotherapy-induced resistance in vitro. Remarkable results were further confirmed in vivo with two preclinical tumor models. These findings demonstrate that the COA-modified 4PSC drug delivery nanosystem provides a potential platform for enhancing the efficacy of chemotherapies.

Objective: To evaluate the safety and feasibility of treating de novo coronary lesions with paclitaxel-eluting balloon. Methods: This is a retrospective study, which enrolled 76 patients with 80 de novo coronary lesions treated with paclitaxel-eluting balloons(<30% residual stenosis and there was no blood flow limited dissection after pretreatment) from April 2015 to November 2016 in Guangdong general hospital. The data of basic characteristics,procedures,devices and follow-up information were retrieved and analyzed. The primary endpoint was the composite of cardiac death, recurrent myocardial infarction and target lesion revascularization. Results: (1)The age was (63.3±10.3) years. There were 68.4%(52/76) acute coronary syndrome patients, prevalence of type 2 diabetes was 36.8%(28/76), and 64.5%(49/76)patients with at least one high bleeding risk. (2)The lesion length was (17.4±7.6)mm, and the stenosis was (88.1±8.2)%.The reference vessel diameter≥2.75 mm accounted for 51.2% (41/80), and bifurcation stenosis accounted for 67.5%(54/80). (3)53.7%(43/80) lesions were pretreated with scoring balloon to optimize plaque modification. The paclitaxel-eluting balloon length and diameter were (22.3±5.5)mm and (2.74±0.52)mm.The residual stenosis was (12.3±10.3)%. Procedural success was 88.8%(71/80).Bail-out stenting rate was 5.0%(4/80). (4)The median follow-up duration was 12(6, 25) months. Primary endpoint occurred in 3 cases (3.9%), including 2 cardiac deaths(1 patient died of recurrent myocardial infarction, and 1 patient died of acute heart failure induced by severe mitral insufficiency), and one patient receivedtarget lesion revascularization. Conclusion In case of no more than 30% residual stenosis and no blood flow limited dissection after lesion pretreatment,it is safe and feasible to treat de novo coronary lesionsusing paclitaxel-eluting balloon.

Objective We retrospectively analyzed the causes,diagnosis,clinical characteristics,treatment and prognosis of 17 patients with rhabdomyolysis.Methods Rhabdomyolysis cases diagnosed from January 2005 to March 2014 in our department were included.Results A total of 17 rhabdomyolysis patients (male 13,mean age (60.4 ± 15.7)years) were analyzed.Four cases had coronary heart disease combined with hypertension,hyperlipaemia,atrial fibrillation,10 cases had dilated cardiomyopathy combined with coronary heart disease,hyperlipaemia,atrial fibrillation,8 cases had atrial fibrillation combined with hypertension,coronary heart disease,hyperlipaemia,1 patient had pulmonary embolism combined with hyperlipaemia,1 patient had aortic dissection combined with hypertension,10 hypertension patients were combined with coronary heart disease,hyperlipaemia,atrial fibrillation,aortic dissection and 1 patient with ventricular tachycardia was combined with depression.Various degrees of liver and kidney dysfunction,reduced hemoglobin and myoglobinuria were found in all patients.Fever was found in 7 cases,relevant neurological signs in 5 cases.Digestive tract discomfort and muscle weakness or muscle pain symptoms were seen in all patients during hospitalization.All cases underwent renal replacement therapy and respirator was used in 14 patients to support breathing.Post therapy,10 cases improved but 7 cases died.All 17 patients had history of statin use.Conclusion Statin may be the major cause of rhabdomyolysis in these patients,and the mortality of rhabdomyolysis is high despite various therapy stratigies.

Objective To explore the value of left atrium volume index (LAVI) in the diagnosis of heart failure with preserved ejection fraction (HFPEF). Methods Seventy-seven patients with HFPEF and 33 patients without HFPEF who had been treated from May 2012 to September 2013 in Guangdong General Hospital were en-rolled. The clinical data and a series of ultrasound parameters were collected and analysed. The relationship between LAVI, LAV, and other indexes of diastolic function was determined by Pearson correlation analysis. The value of LAVI and LAV for diagnosing HFPEF was compared by the ROC curve. Results LAVI and LAV of were signifi-cantly greater in HFPEF group than in non-HFPEF group. LAV and LAVI were significantly associated wtih HEPEF. The area under the ROC curve (AUC) of LAVI increased significantly as compared with the AUC of LAV (0.832 vs. 0.799, P<0.05). With a cut-off value of 30 mL/m2, the specificity and sensitivity for diagnosing HEPEF were 64.9%and 84.8%, respectively. Conclusions LAVI may be valuable in the diagnosis of HFPEF.

Objective To characterize the clinical features of patients with cardiac amyloidosis (CA).Methods Totally 42 patients with CA admitted to Guangdong General Hospital since 2008 were included and retrospectively analyzed in the present study.CA was confirmed by abdomen and endocardium biopsy examination.Clinical manifestations,electrocardiogram and echocardiography were collected for the evaluation.Results Several clinic features are common in CA.In the present study,37 cases (88.1％) presented with chest tightness,dyspnea,20 cases(47.6％) with chest pain,27 cases(64.3％) with right heart failure,27 cases (64.3％) with fatigue,and 30 cases (71.4％) with renal insufficiency and proteinuria.Electrocardiogram (ECG) showed that 32 of the patients (76.2％) were with low voltage in limb leads,29 cases (69％) of them were with poor R wave progression in precordial leads,17 cases (40.5％) with ST-T change,28 cases(66.7％) with pseudo-necrotic Q wave and 36 cases (85.7％) with various kinds of arrhythmia.Echocardiography indicated that all of the subjects (100％) were with different degrees of left ventricular posterior wall or ventricular septal thickness,and left atrial hypertrophy with different degree of myocardial grain appearance or ground-glass opacity.Thirty-six cases (85.7％) were with pericardial effusion,and 27 cases (64.3％) were with abnormal left ventricular eject function.Conclusion For those who were with unexplained clinical cardiac insufficiency,renal insufficiency,myocardial hypertrophy,but normal of ventricular size in echocardiography and low voltage on ECG limb leads,a tissue biopsy from abdomen,labial glands or endocardium should be considered in the diagnosis of CA.

OBJECTIVETo study the relationship between carbon dioxide combining power(CO₂-CP) and contrast-induced acute kidney injury (CI-AKI) in patients with ST segment elevation myocardial infarction and undergoing percutaneous coronary intervention.

METHODSWe retrospectively analyzed 174 patients admitted to our hospital from March 2012 to August 2013 with ST segment elevation myocardial infarction and underwent emergency percutaneous coronary intervention. Patients were divided into three tertiles according to pre-operative CO₂-CP: T1 (CO₂-CP < 22.62 mmol/L), T2(CO₂-CP 22.62-24.30 mmol/L), T3(CO₂-CP > 24.30 mmol/L). Baseline clinical data, CI-AKI incidence, in-hospital mortality and dialysis rate were compared among groups. An increase in serum creatinine of >26.4 µmol/L and/or >50% from baseline within 48 hours after contrast exposure was defined as CI-AKI. Univariate logistic regression analysis was used to identify the risk factors of CI-AKI. The relationship between CO₂-CP and CI-AKI was assessed by multivariate logistic regression analysis. Receiver operating characteristic curve was used to identify the optimal cutoff of the CO₂-CP for predicting CI-AKI.

RESULTSCI-AKI occurred in 25 (14.4%) patients, and lower CO₂-CP was related to higher incidence of CI-AKI (27.6% (16/58) in group T1, 5.3% (3/57) in group T2, 1.7 % (1/59) in group T3, P = 0.002) and higher in-hospital mortality (10.3% (6/58) vs. 0 and 1.7% (1/59), P = 0.010). Dialysis rate was similar among 3 groups (5.2% (3/58) vs. 0 and 1.7% (1/59), P = 0.168). The incidence of CI-AKI was significantly associated with CO₂-CP < 22.00 mmol/L in univariate analyses (OR = 6.767, 95% CI 2.731-16.768, P < 0.001). After adjusting for potential confounding risk factors, CO₂-CP < 22.00 mmol/L remained significantly associated with the incidence of CI-AKI (OR = 5.835, 95%CI 1.800-18.914, P = 0.003) in multivariate logistic regression. ROC analysis revealed that the optimal cutoff of CO₂-CP to predict CI-AKI was 22.00 mmol/L (sensitivity 64.0%, specificity 79.1%, AUC = 0.714).

CONCLUSIONSPre-percutaneous coronary intervention CO₂-CP in patients with ST segment elevation myocardial infarction undergoing percutaneous coronary intervention is related to CI-AKI. CO₂-CP < 22.00 mmol/L predicts higher risk of CI-AKI in this patient cohort.

Acute Kidney Injury ; etiology ; Carbon Dioxide ; analysis ; Contrast Media ; Hospital Mortality ; Humans ; Incidence ; Kidney ; Logistic Models ; Myocardial Infarction ; complications ; physiopathology ; Percutaneous Coronary Intervention ; ROC Curve ; Retrospective Studies ; Risk Factors

Objective To study the relationship between carbon dioxide combining power ( CO2-CP) and contrast-induced acute kidney injury ( CI-AKI) in patients with ST segment elevation myocardial infarction and undergoing percutaneous coronary intervention.Methods We retrospectively analyzed 174 patients admitted to our hospital from March 2012 to August 2013 with ST segment elevation myocardial infarction and underwent emergency percutaneous coronary intervention.Patients were divided into three tertiles according to pre-operative CO2-CP: T1 (CO2-CP <22.62 mmol/L),T2(CO2-CP 22.62 -24.30 mmol/L), T3(CO2-CP>24.30 mmol/L).Baseline clinical data, CI-AKI incidence, in-hospital mortality and dialysis rate were compared among groups.An increase in serum creatinine of >26.4 μmol/L and/or >50%from baseline within 48 hours after contrast exposure was defined as CI-AKI.Univariate logistic regression analysis was used to identify the risk factors of CI-AKI.The relationship between CO 2-CP and CI-AKI was assessed by multivariate logistic regression analysis.Receiver operating characteristic curve was used to identify the optimal cutoff of the CO 2-CP for predicting CI-AKI.Results CI-AKI occurred in 25(14.4%) patients, and lower CO2-CP was related to higher incidence of CI-AKI (27.6% (16/58) in group T1, 5.3%(3/57) in group T2, 1.7 % (1/59) in group T3, P=0.002) and higher in-hospital mortality (10.3%(6/58) vs.0 and 1.7%(1/59), P=0.010).Dialysis rate was similar among 3 groups (5.2%(3/58)vs.0 and 1.7%(1/59), P=0.168).The incidence of CI-AKI was significantly associated with CO2-CP<22.00 mmol/L in univariate analyses ( OR=6.767,95%CI 2.731-16.768, P<0.001).After adjusting for potential confounding risk factors , CO2-CP <22.00 mmol/L remained significantly associated with the incidence of CI-AKI (OR=5.835,95%CI 1.800-18.914, P=0.003) in multivariate logistic regression.ROC analysis revealed that the optimal cutoff of CO 2-CP to predict CI-AKI was 22.00 mmol/L (sensitivity 64.0%,specificity 79.1%, AUC=0.714).Conclusions Pre-percutaneous coronary intervention CO 2-CP in patients with ST segment elevation myocardial infarction undergoing percutaneous coronary intervention is related to CI-AKI.CO2-CP<22.00 mmol/L predicts higher risk of CI-AKI in this patient cohort.