1.Modified Xiehuangsan Regulates Microglial Polarization and TLR4/MyD88/NF-κB Pathway to Treat Tic Disorders in Rats
Mengjie ZHAO ; Qiong ZHAO ; Cuiling YANG ; Hongyun ZHOU ; Xiangjuan SUN ; Xinyi GUO ; Sajiyue HUANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(4):10-18
ObjectiveTo explore the mechanism of modified Xiehuangsan in treating tic disorders (TD) based on microglial polarization and the Toll-like receptor 4 (TLR4)/myeloid differentiation factor 88 (MyD88)/nuclear factor (NF)-κB pathway. MethodsSeventy-two Sprague-Dawley (SD) rats were randomly assigned into six groups: control, model, tiapride (0.025 g·kg-1), and low-, medium-, and high-dose (12, 24, 48 g·kg-1, respectively) modified Xiehuangsan, with 12 rats in each group. Except the control group, the other groups received intraperitoneal injection of 3,3'-iminodipropionitrile (IDPN) for 7 consecutive days for the modeling of TD. After successful modeling, the control and model groups were given normal saline via gavage, and the other groups were administrated with corresponding drugs by gavage. After 28 days of continuous intervention, rat behaviors were observed, and the modified Xiehuangsan group showing the best anti-TD effect was selected for deciphering the treatment mechanism. Hematoxylin and eosin staining was conducted to observe morphological changes in the rat striatum. Immunohistochemistry was employed to detect the expression of CD16 and CD206 in the striatum. Real-time PCR was employed to measure the mRNA levels of interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), IL-4, TLR4, MyD88, and NF-κB p65 in the striatum. Western blot was employed to determine the protein levels of ionized calcium-binding adapter molecule 1 (Iba1), Fc receptor family for immunoglobulin (Ig)G type Ⅲ (CD16), mannose receptor (CD206), TLR4, MyD88, and NF-κB p65 in the striatum. ResultsCompared with the control group, the model group showed increased stereotyped behaviors, locomotor activity, total movement distance, and movement speed, shortened resting time (P<0.01), and noticeable pathological changes in the striatum. Compared with the model group, the tiapride group and modified Xiehuangsan groups exhibited reduced stereotyped behavior, locomotor activity, total movement distance, and movement speed, prolonged resting time (P<0.05, P<0.01), and alleviated pathological changes in the striatum. Among the modified Xiehuangsan groups, the high-dose group had the best intervention effect and the mildest pathological changes. Therefore, the high-dose group was selected for further research. Compared with the control group, the modeling of TD increased Iba1 and CD16 expression (P<0.05, P<0.01), up-regulated the mRNA levels of IL-1β and TNF-α (P<0.05, P<0.01), down-regulated the mRNA level of IL-4 (P<0.05), up-regulated the mRNA and protein levels of TLR4 and MyD88 (P<0.05, P<0.01), and up-regulated the protein level of NF-κB p65 (P<0.01). Compared with the model group, modified Xiehuangsan reduced Iba1 and CD16 expression (P<0.05, P<0.01), up-regulated the protein level of CD206 (P<0.05, P<0.01), down-regulated the mRNA levels of IL-1β and TNF-α (P<0.05), up-regulated the mRNA level of IL-4 (P<0.01), and down-regulated the mRNA and protein levels of TLR4, MyD88, and NF-κB p65 (P<0.05, P<0.01). ConclusionModified Xiehuangsan demonstrated a definite therapeutic effect on TD in rats. It may reduce neuroinflammation in TD rats by regulating the polarization of microglia in the striatum via the TLR4/MyD88/NF-κB signaling pathway.
2.Effects of Modified shaoyao gancao decoction on intestinal transit function,intestinal flora and metabolite content in slow transit constipation rat
Ziqi ZHANG ; Hongyun ZHOU ; Qiong ZHAO ; Yuan DENG ; Yu ZHAN
China Pharmacy 2025;36(2):154-159
OBJECTIVE To observe the effects of Modified shaoyao gancao decoction on intestinal transit function, intestinal flora and the contents of metabolites [γ aminobutyric acid (GABA) and 5-hydroxytryptamine (5-HT)] in slow transit constipation (STC) rats. METHODS SD rats were randomly divided into blank group (10 rats) and modeling group (30 rats), with half male and half female. The STC model was established by intragastric administration of Compound diphenoxylate tablets in the modeling group. The successfully modeled rats were randomly divided into model group, Modified shaoyao gancao decoction group [56 g/(kg·d), calculated by crude drug] and positive control group [lactulose 2.09 g/(kg·d)], with 10 rats in each group. Each administration group was given relevant medicine intragastrically, the blank group and model group received an equivalent volume of normal saline, once a day, for 14 consecutive days. During the experiment, the general situation of rats was observed in each group. After the last medication, the body weight was measured, and the Bristol score was used to evaluate the fecal characteristics. The fecal moisture content, intestinal propulsion rate, and the contents of GABA and 5-HT in intestinal content were detected; the diversity of intestinal flora in intestinal contents was investigated, and the correlation between the contents of GABA, 5-HT and relative abundance of microbiota was analyzed. RESULTS Compared with the model group, general conditions such as small body shape, sparse and rough fur, and slow movement were all improved in Modified shaoyao gancao decoction body weight, Bristol score, fecal moisture content,intestinal propulsion rate, 5-HT content, Chao1 index and Shannon index were increased significantly, while GABA content and Simpson index were decreased significantly (P<0.05). The intestinal flora of rats in the Modified shaoyao gancao decoction group could be classified as the same as the blank group, but was far from the model group; the relative abundances of Desulfobacterota, Firmicutes and Bacteroidota in this group showed a tendency of pull back, but the differences were not statistically significant compared to model group (P>0.05). Desulfobacterota was an intergroup differential factor (P<0.05). The content of GABA was negatively correlated with the relative abundance of Bacteroidota, Cyanobacteria, Patescibacteria and Actinobacteriota (P<0.05). The content of 5-HT was positively correlated with the relative abundance of Campilobacterota (P<0.05). CONCLUSIONS Modified shaoyao gancao decoction can improve the fecal properties and intestinal motility of STC rats. Its mechanism may be related to improving intestinal flora and then affecting the contents of GABA and 5-HT in intestinal contents. In addition, the contents of GABA and 5-HT may be significantly correlated with the relative abundance of specific bacterial phyla such as Bacteroidota and Campilobacterota.
3.Effects of Modified shaoyao gancao decoction on intestinal transit function,intestinal flora and metabolite content in slow transit constipation rat
Ziqi ZHANG ; Hongyun ZHOU ; Qiong ZHAO ; Yuan DENG ; Yu ZHAN
China Pharmacy 2025;36(2):154-159
OBJECTIVE To observe the effects of Modified shaoyao gancao decoction on intestinal transit function, intestinal flora and the contents of metabolites [γ aminobutyric acid (GABA) and 5-hydroxytryptamine (5-HT)] in slow transit constipation (STC) rats. METHODS SD rats were randomly divided into blank group (10 rats) and modeling group (30 rats), with half male and half female. The STC model was established by intragastric administration of Compound diphenoxylate tablets in the modeling group. The successfully modeled rats were randomly divided into model group, Modified shaoyao gancao decoction group [56 g/(kg·d), calculated by crude drug] and positive control group [lactulose 2.09 g/(kg·d)], with 10 rats in each group. Each administration group was given relevant medicine intragastrically, the blank group and model group received an equivalent volume of normal saline, once a day, for 14 consecutive days. During the experiment, the general situation of rats was observed in each group. After the last medication, the body weight was measured, and the Bristol score was used to evaluate the fecal characteristics. The fecal moisture content, intestinal propulsion rate, and the contents of GABA and 5-HT in intestinal content were detected; the diversity of intestinal flora in intestinal contents was investigated, and the correlation between the contents of GABA, 5-HT and relative abundance of microbiota was analyzed. RESULTS Compared with the model group, general conditions such as small body shape, sparse and rough fur, and slow movement were all improved in Modified shaoyao gancao decoction body weight, Bristol score, fecal moisture content,intestinal propulsion rate, 5-HT content, Chao1 index and Shannon index were increased significantly, while GABA content and Simpson index were decreased significantly (P<0.05). The intestinal flora of rats in the Modified shaoyao gancao decoction group could be classified as the same as the blank group, but was far from the model group; the relative abundances of Desulfobacterota, Firmicutes and Bacteroidota in this group showed a tendency of pull back, but the differences were not statistically significant compared to model group (P>0.05). Desulfobacterota was an intergroup differential factor (P<0.05). The content of GABA was negatively correlated with the relative abundance of Bacteroidota, Cyanobacteria, Patescibacteria and Actinobacteriota (P<0.05). The content of 5-HT was positively correlated with the relative abundance of Campilobacterota (P<0.05). CONCLUSIONS Modified shaoyao gancao decoction can improve the fecal properties and intestinal motility of STC rats. Its mechanism may be related to improving intestinal flora and then affecting the contents of GABA and 5-HT in intestinal contents. In addition, the contents of GABA and 5-HT may be significantly correlated with the relative abundance of specific bacterial phyla such as Bacteroidota and Campilobacterota.
4.Four new sesquiterpenoids from the roots of Atractylodes macrocephala
Gang-gang ZHOU ; Jia-jia LIU ; Ji-qiong WANG ; Hui LIU ; Zhi-Hua LIAO ; Guo-wei WANG ; Min CHEN ; Fan-cheng MENG
Acta Pharmaceutica Sinica 2025;60(1):179-184
The chemical constituents in dried roots of
5.Mechanism of electroacupuncture treating detrusor-bladder neck dyssynergia after suprasacral spinal cord injury by proteomics
Liya TANG ; Qirui QU ; Jincan LIU ; Ming XU ; Lu ZHOU ; Qiong LIU ; Kun AI
Digital Chinese Medicine 2025;8(2):267-278
Objectives:
To elucidate the potential mechanisms of electroacupuncture (EA) in restoring detrusor-bladder neck dyssynergia (DBND) following suprasacral spinal cord injury (SSCI).
Methods:
A total of 52 specific pathogen-free (SPF) grade famale Sprague-Dawley (SD) rats (10 – 12 weeks, 250 – 280 g) were randomly assigned to either a sham group (n = 12) or a spinal cord injury model group (n = 40). In the model group, DBND was induced through Hassan Shaker spinal cord transection at T10 level, with 24 rats meeting inclusion criteria and subsequently randomized into DBND group (n = 12) and EA intervention group (DBND + EA group, n = 12). After spinal shock recovery (day 19 after modeling), DBND + EA group received EA treatment at Ciliao (BL32), Zhongji (RN3), and Sanyinjiao (SP6) acupoints for 20 min per session at 10/50 Hz frequencies, once daily for 10 d. Sham and DBND groups received anesthesia only without EA intervention. On day 29 post-modeling, all rats underwent urodynamic assessments, followed by hematoxylin and eosin (HE) staining, tandem mass tag (TMT) proteomics, and Western blot (WB) analysis of detrusor and bladder neck tissues. Differentially expressed proteins (DEPs) were defined as proteins with P < 0.05, unique peptides ≥ 2, and fold change > 1.2 or < 0.83. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis was performed using KOBAS 3.0 (P < 0.01), and protein-protein interaction (PPI) networks were analyzed using Search Tool for the Retrieval of Interacting Genes/Proteins (STRING) 11.5 and Cytoscape 3.9.1.
Results:
Compared with sham group, DBND group showed significantly elevated leak point pressure (LPP) and maximum cystometric capacity (MCC) (both P < 0.01). EA treatment significantly reduced both LPP and MCC compared with DBND group (P < 0.01 and P < 0.05, respectively). HE staining revealed that EA reduced detrusor fibrosis and improved bladder neck inflammation. TMT proteomics identified 30 overlapping DEPs in detrusor and 59 overlapping DEPs in bladder neck when comparing DBND + EA/DBND groups with sham group. In detrusor tissue, KEGG analysis revealed 10 significantly enriched pathways (P < 0.01), including mitogen-activated protein kinase (MAPK) signaling pathway. PPI analysis showed 22 of 30 DEPs were interconnected. In bladder neck tissue, 14 pathways were significantly enriched (P < 0.01), including relaxin signaling pathway, with 51 of 59 DEPs showing interconnections. Both TMT and WB validations demonstrated that compared with sham controls, DBND rats exhibited upregulated collagen type IV alpha 2 chain (Col4a2) and downregulated guanine nucleotide-binding protein G(z) subunit alpha (Gnaz) in detrusor tissue, while EA treatment normalized both proteins (both P < 0.05). In bladder neck tissue, DBND rats showed decreased expression of smoothelin (Smtn) and calcium-activated potassium channel subunit beta-1 (Kcnmb1) compared with sham controls (both P < 0.01), which were both upregulated following EA treatment (P < 0.01 and P < 0.05, respectively).
Conclusion
EA restores detrusor-bladder neck coordination in DBND through dual-target mechanisms. In detrusor tissue, EA modulates contraction via extracellular matrix remodeling, cyclic adenosine monophosphate (cAMP) signaling pathway regulation, and enhanced adenosine triphosphate (ATP) biosynthesis mediated by neurotransmitters. In bladder neck tissue, EA promotes relaxation by maintaining contractile phenotypes, reducing fibrosis, suppressing smooth muscle excitation, and regulating presynaptic neurotransmitter release. These findings provide mechanistic insights into EA's therapeutic role in managing DBND.
6.Defocusing state and myopia control of single focus, defocus and orthokeratology in myopic children observed by multispectral refraction topography
Xinyao MAO ; Jiang LIN ; Rui WANG ; Shiping ZHOU ; Xuemei FU ; Qiong WANG ; Xuemei ZENG
International Eye Science 2025;25(8):1324-1329
AIM:To observe the defocus state and myopia control in myopic children wearing single-vision, defocus, and orthokeratology lenses using multispectral refraction topography(MRT).METHODS: A total of 279 myopic patients aged 8-14 years old, with a spherical equivalent(SE)from -7.00 to -0.50 D, treated at the Chengdu Aier Eye Hospital from June 2022 to December 2023. Patients who volunteered for the study were assigned to three groups. A total of 94 cases were provided with single-vision spectacle lenses(SVL group), 90 cases received individualized ocular refraction customization(IORC group), and 95 cases received orthokeratology lenses(OK group). Simultaneously, the three groups were further categorized into low(-3.00 to -0.50 D), moderate(-6.00 to -3.25 D), and high myopia(-7.00 to -6.25 D)groups according to different SE. MRT was used to measure and compare the defocus changes of the retina in supperior, inferior, nasal, and temporal quadrants(RDV-S, RDV-I, RDV-N, RDV-T), and three angles of field of view, including 0-15°, 15°-30°, and 30°-45°(RDV-15, RDV-30, RDV-45)in the three groups(the data divide for the connected regions is grouped to the latter group). A one-way analysis of variance was used for intergroup comparisons. Univariate and multivariate linear regression analyses were used to analyze the factors related to changes in the axial length(AL)at 1 a after intervention.RESULTS:There were significant differences in 1-year SE and AL growth among patients in the SVL, IORC, and OK groups before and after intervention(P<0.001). The 1-year SE and the difference of AL growth in patients with low myopia was significantly different among SVL, IORC, and OK groups(P<0.001); however, there was no significant difference between the IORC and OK groups(P>0.05); there were significant differences in the SE and AL growth changes between the OK group and the IORC and SVL groups in moderate myopia(P<0.001); and there were significant differences between the OK group and the IORC and SVL groups in SE and AL growth of high myopia group after wearing lenses for 1 a(P<0.001), while there were no significant differences between the IORC and SVL groups(P>0.05). In addition, there were significant differences in the relative peripheral refractive errors(RPRE)of 4 quadrants and 3 eccentric regions among the three groups of patients in different degrees of myopia groups(P<0.001). Pair-wise comparison of the growth difference of eccentric D-RDV-15 in low myopia group after wearing lenses for 1 a showed significant differences between the SVL, IORC, and OK groups(P<0.001), but no significant differences between the IORC and OK groups(P>0.05). The angle of field of view D-RDV-30 in moderate myopia subgroups was statistically different between the SVL group and the IORC and OK groups after wearing lenses for 1 a(P<0.001), while the IORC and OK groups showed no significant differences(P>0.05); the angle of field of view D-RDV-15 in high myopia subgroups was statistically different between the OK group and the IORC and SVL groups after wearing lenses for 1 a(P<0.001), but there was no significant difference between the IORC and SVL groups(P>0.05). Univariate and multivariate linear regression model analysis showed that the changes in D-TRVD, D-RDV-45, D-RDV-N, and D-RDV-I correlated with the increase in the difference in 1 a AL.CONCLUSION: MRT can be used to guide the clinical control of myopia. Myopia development is related to the peripheral retinal defocus state, and the difference of defocus quantity in the inferior nasal side at 30°-45° eccentricity may be a factor regulating the rapid progression of myopia.
7.Study on the mechanism of Shaoyao gancao decoction in improving intestinal motility in rats with slow transit constipation by regulating the ASIC3/ERK signaling pathway
Ziqi ZHANG ; Hongyun ZHOU ; Qiong ZHAO ; Yuan DENG ; Mengjie ZHAO ; Chen ZHAO ; Jingyi CHEN
China Pharmacy 2025;36(15):1852-1858
OBJECTIVE To explore the mechanism of Shaoyao gancao decoction in improving intestinal motility in rats with slow transit constipation (STC) by regulating acid-sensitive ion channel 3 (ASIC3)/extracellular signal-regulated kinase (ERK) signaling pathway. METHODS SD rats were used to construct an STC model by gavage with compound diphenoxylate. The successfully modeled rats were randomly divided into model group, Shaoyao gancao decoction group (1.5 g/mL), lactulose group (208.4 mg/mL, positive control), and combined inhibition group (Shaoyao gancao decoction 1.5 g/mL+amiloride hydrochloride 20 μg/kg), with 12 rats in each group. Additionally, 12 healthy rats were selected as the blank group. They were given relevant medicine once a day and continuously intervened for 14 days. After intervention, the intestinal propulsion function and visceral sensitivity of the model rats were detected. The expression of ASIC3 in the colon tissue of rats was observed by immunohistochemical staining. mRNA expressions of ASIC3, ERK1 and ERK2 as well as protein expressions of ASIC3, ERK1/2 and phosphorylated ERK1/2 (p-ERK1/2) in colon tissue of rats were detected; the ultrastructural changes of the enteric nervous system (ENS) -interstitial cell of Cajal (ICC)-smooth muscle cell (SMC) network in the rat colon were observed under electron microscopy. RESULTS Compared with the model group, the intestinal propulsion rate of the Shaoyao gancao decoction group was significantly increased, while the visceral pain threshold was significantly decreased. The proportion of the positive area of ASIC3 in the colonic tissue was significantly increased. The relative mRNA expression levels of ERK1, ERK2, and ASIC3, as well as the relative protein expression levels of p-ERK1/2 and ASIC3, and the p-ERK1/2 to ERK1/2 in the colonic tissue, were all significantly increased (P<0.05 or P<0.01). Additionally, there was marked repair of the morphological structure of ICC and SMC, with closer gap junctions observed. Compared with the Shaoyao gancao decoction group, the combined inhibition group exhibited a diminished improvement in intestinal motility of rats, with statistically significant differences in the levels of some indicators (P<0.05 or P<0.01); the repairing of the morphological structure of ICC and SMC was notably attenuated. CONCLUSIONS Shaoyao gancao decoction can effectively improve the intestinal transmission function and promote intestinal repair in STC rats, and its mechanism may be related to regulating the balance of the ENS-ICC-SMC network mediated by the ASIC3/ERK signaling pathway, thus promoting intestinal motility and reducing visceral sensitivity.
8.Analysis of the incidence and relevant factors of visual acuity abnormalities in preschool children undergoing kindergarten entrance physical examinations in Shannan City, Xizang, 2022
Sangzhu LABA ; Zhuoma QIONG ; Fei YANG ; Zhuoga SUOLANG ; Ruiqi ZHANG ; Jun CHEN ; Hui YIN ; Hong ZHOU
Shanghai Journal of Preventive Medicine 2025;37(6):535-539
ObjectiveTo investigate the incidence and relevant factors of visual acuity abnormalities in preschool children undergoing kindergarten entrance physical examinations in Shannan City, Xizang, in 2022, so as to formulate policies for protecting children’s visual acuity and provide a basis for optimizing the children’s health service system in this region. MethodsA cross sectional study was conducted among the children undergoing kindergarten entrance physical examinations in Shannan City in 2022. A diopter examination was performed for these children, and a questionnaire survey was administered to their caregivers. Additionally, factors affecting children’s visual acuity abnormalities were analyzed using the χ² test and binary logistic regression analysis. ResultsA total of 759 children were included in the analysis, with an incidence rate for visual acuity abnormalities of 11.20%. Univariate analysis showed that statistically significant differences were observed in the incidence rate for visual acuity abnormalities among preschool children in terms of different family monthly income (χ²=17.395, P<0.001), father’s education level (χ²=5.133, P=0.023), postnatal vitamin A and D supplementation (χ²=9.575, P=0.008), and feeding method within the first 6 months after birth (χ²=9.330, P=0.009). Multivariate analysis results indicated that family monthly income <5 000 yuan (OR=2.599, P=0.003), insufficient postnatal vitamin A and D supplementation (OR=1.912, P=0.011), and formula feeding (OR=2.131, P=0.010) were relevant factors for abnormal visual development in children. ConclusionThe incidence of visual acuity abnormalities in preschool children in Shannan City is slightly higher than that previously reported in other regions of Xizang. The occurrence of visual acuity abnormalities in children is related to factors such as family monthly income, postnatal vitamin A and D supplementation, and feeding method within the first 6 months after birth. Future interventions should be strengthened on the promotion and dissemination of knowledge related to eye use, such as improve parental awareness of eye care, promote timely vitamin A and D supplementation and encourage breast feeding for children after birth, more specifically, attentions need to be focused on the visual acuity problems of children from low-income families to safeguard the visual health in preschool children in Shannan City, Xizang.
9.Inflammatory and Immunomodulatory Effects of Tripterygium wilfordii Multiglycoside in Mouse Models of Psoriasis Keratinocytes.
Shuo ZHANG ; Hong-Jin LI ; Chun-Mei YANG ; Liu LIU ; Xiao-Ying SUN ; Jiao WANG ; Si-Ting CHEN ; Yi LU ; Man-Qi HU ; Ge YAN ; Ya-Qiong ZHOU ; Xiao MIAO ; Xin LI ; Bin LI
Chinese journal of integrative medicine 2024;30(3):222-229
OBJECTIVE:
To determine the role of Tripterygium wilfordii multiglycoside (TGW) in the treatment of psoriatic dermatitis from a cellular immunological perspective.
METHODS:
Mouse models of psoriatic dermatitis were established by imiquimod (IMQ). Twelve male BALB/c mice were assigned to IMQ or IMQ+TGW groups according to a random number table. Histopathological changes in vivo were assessed by hematoxylin and eosin staining. Ratios of immune cells and cytokines in mice, as well as PAM212 cell proliferation in vitro were assessed by flow cytometry. Pro-inflammatory cytokine expression was determined using reverse transcription quantitative polymerase chain reaction.
RESULTS:
TGW significantly ameliorated the severity of IMQ-induced psoriasis-like mouse skin lesions and restrained the activation of CD45+ cells, neutrophils and T lymphocytes (all P<0.01). Moreover, TGW significantly attenuated keratinocytes (KCs) proliferation and downregulated the mRNA levels of inflammatory cytokines including interleukin (IL)-17A, IL-23, tumor necrosis factor α, and chemokine (C-X-C motif) ligand 1 (P<0.01 or P<0.05). Furthermore, it reduced the number of γ δ T17 cells in skin lesion of mice and draining lymph nodes (P<0.01).
CONCLUSIONS
TGW improved psoriasis-like inflammation by inhibiting KCs proliferation, as well as the associated immune cells and cytokine expression. It inhibited IL-17 secretion from γ δ T cells, which improved the immune-inflammatory microenvironment of psoriasis.
Male
;
Animals
;
Mice
;
Tripterygium
;
Psoriasis/drug therapy*
;
Keratinocytes
;
Skin Diseases/metabolism*
;
Cytokines/metabolism*
;
Imiquimod/metabolism*
;
Dermatitis/pathology*
;
Disease Models, Animal
;
Mice, Inbred BALB C
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Skin/metabolism*
10.A real-world retrospective study of pelvic floor muscle training efficacy using an APP-based home device
Ji-Qiong ZHENG ; Shi-Ping ZHOU ; Zhong-Yun ZHANG ; Wei-Qing QIAN ; Zheng-Wang ZHANG
Fudan University Journal of Medical Sciences 2024;51(1):96-101
Objective To retrospectively investigate the efficacy of pelvic floor muscle training(PFMT)using APP-based home device in the real-world scenario.Methods A retrospective survey was conducted among 171 000 Chinese female users over 18 years old who freely registered APP and performed PFMT using a domestic manufactured home device from Oct 1,2019 to Mar 31,2021.The Patient Global Impression of Improvement(PGI-I)questionnaires concerning pelvic floor general condition,sexual satisfaction and other three major symptoms related to pelvic floor muscle laxity such as stress urinary incontinence(SUI),pelvic organ prolapse(POP),and vaginal laxity(VL)were broadcast public online for users to self-assess the improvement.The vaginal muscle strength values prior and post training recorded by APP were also reported.All data were collected anonymously for further stratified analysis.Results A total of 984 valid questionnaires were collected by systematic sampling.The PGI-I scores of pelvic floor general condition(P=0.000 1),sexual satisfaction(P=0.009),SUI(P=0.000 1),POP(P=0.044)and VL(P=0.034)were statistically significant in users who reported to use the device for 3 months or more compared with those less than 3 months.In addition,the increase of vaginal muscle strength was related to the improvement of PGI-I scores in SUI and POP with statistical significance.There were no significant difference in subgroups such as age,education,parity,and delivery mode.Conclusion The subjective benefit of pelvic floor function-related symptoms and the improvement of vaginal muscle strength could be observed after PFMT for three months or more using APP-based home device in Chinese women in the real-world scenario.

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