Urodynamics is a critical field that studies the physiological and biomechanical parameters involved in urine production, storage, and voiding.This paper first reviews the development process of urodynamics, expounds the development and progress of urodynamic testing instruments from early basic research to modern advanced equipment and the history of their introduction into China, and then introduces in detail the principle of action, system composition and clinical application status of major urodynamic instruments, and further points out the technical shortcomings of current instruments, and then proposes improvement directions, including the core load sensor technology, comfort and privacy of urodynamic testing instruments, work data transfer and close integration with artificial intelligence, in order to provide a valuable reference for clinical understanding of the development of this field.

Pulmonary fibrosis(PF)is a common,persistent,irreversible,fatal chronic lung disease with a median survival of 2-4 years after diagnosis.It is characterized by excessive extracellular matrix deposition and scarring in the lungs,leading to functional failure,severe respiratory problems and even death.Numerous studies have shown that CXC chemokines and their receptors play important roles in PF and other desmoplastic disorders.Sever-al studies have shown that chemokines may be-come new targets for the treatment of many dis-eases.Here,we review the role of key CXC chemo-kines and their receptors in PF to provide a refer-ence for the treatment of PF.

Construction of smart hospitals is of great significance to the substantial development of medical institutions and the reform of medical and health systems and meanwhile it serves as a crucial support for the high-quality development of pub-lic hospitals.Guangdong Second Provincial General Hospital actively responds to national policies,constantly exploring standard-ized application of new smart medical technology.It has successfully built itself into a first full-scene smart hospital.Through gradually deepening the intelligent construction of hospitals,the hospital has achieved obvious achievements in hospital manage-ment such as medical services,medical resources,medical data,hospital operation logistics,and medical environment improve-ment.Their practical experience can provide references for the intelligent construction of hospitals domestically.

Objective:To explore the trajectory of frailty changes in patients receiving maintenance hemodialysis and analyze its influencing factors.Methods:Maintenance hemodialysis patients at the Blood Purification Center of the Minda Hospital of Hubei Minzu University from January to October 2022 were selected by convenience sampling. The Clinical Frailty Scale (CFS) was used to survey patients at the start of dialysis and one, three, six, and 12 months of dialysis. Latent class growth modeling was employed to identify the potential classes of frailty trajectory changes and analyze the influencing factors of these classes.Results:A total of 255 questionnaires were distributed, with 212 valid responses, yielding an effective response rate of 83.14%. The changes in frailty among the patients receiving maintenance hemodialysis were categorized into three groups: moderate frailty worsening group ( n=64), frailty improvement group ( n=110), and stable pre-frailty group ( n=38). The average probabilities of patients belonging to each latent class were 0.948, 0.938, and 0.950, respectively. Age, gender, body mass index, anemia, continuing to work after illness onset, and comorbidities were identified as influencing factors of frailty trajectory changes in these patients (all P<0.05) . Conclusions:There are three types of frailty trajectory changes in patients receiving maintenance hemodialysis from the start of dialysis to 12 months of regular dialysis. Targeted interventions can be implemented based on the identified influencing factors.

Pulmonary fibrosis is a chronic, progressive and irreversible respiratory disease characterized by hyperposition of extracellular matrix leading to inflammation and extensive lung remodeling. There is currently no effective treatment. Multiple studies have shown that metformin is a classic antiglycemic drug with antifibrotic potential. However, at present, there is no consensus on the specific mechanism of metformin's anti-fibrosis effect, and this paper reviews the research progress of metformin in the field of pulmonary fibrosis in recent years, mainly from IGF-1/IGF-1R/PI3K signaling, AMPK/mTOR signaling, TGF-β/Smad signaling pathway, and intervening in myofibroblast proliferation and apoptosis, improving oxidative stress, inhibiting epithelial interstitial transformation and transglutaminase. In order to be able to more deeply and comprehensively understand the antifibrosis mechanism and clinical application scope of metformin in the future, and provide new ideas for the treatment of pulmonary fibrosis.

Pulmonary fibrosis is a common chronic interstitial lung disease. It is characterized by excessive deposition of extracellular matrix and remodeling of lung tissue structure, resulting in severe impairment of lung function. The cause of its pathogenesis is still unclear. Therefore, it is urgent to explore its pathogenesis and find new targets to combat pulmonary fibrosis. Studies have shown that nuclear factor erythroid 2-related factor 2 can maintain the body's redox homeostasis by regulating antioxidant genes and combining antioxidant response components, thereby protecting tissues and cells from oxidative stress. In recent years, many studies have proved that nuclear factor erythroid 2 -related factor 2 can play an anti-fibrotic role by alleviating oxidative stress, inhibiting macrophage polarization, activating autophagy, inhibiting ferroptosis, and blocking epithelial-mesenchymal transition. This paper provides a brief review of the association and research progress of nuclear factor erythroid 2-related factor 2 with pulmonary fibrosis, with the aim of providing a new direction for the precise treatment of pulmonary fibrosis.

ObjectiveTo conduct a systematic review of the susceptibility gene polymorphism sites of primary knee osteoarthritis (PKO). MethodsThe literature on genetic susceptibility and gene polymorphisms of PKO were retrieved from PubMed, Web of Science, CNKI, Wanfang Data, and China Biomedical Literature Database from establishment of the library to December, 2020, and systematically reviewed. ResultsA total of 42 papers on the polymorphism sites of human PKO susceptibility genes were included, involving cellular signaling pathways related to PKO pathogenesis, including inflammatory response, receptor signaling pathway, transcription factor signaling pathway, bone-related signaling pathway, etc. Multiple gene polymorphism sites located in inflammatory factor genes, chemokine genes, Toll-like receptor genes, transcription factor genes, obesity-related genes, and bone-related genes. ConclusionInflammatory factor genes and bone-associated allele polymorphisms are likely to be related to PKO susceptibility.

Objective To improve the surgical efficacy of bilateral lung transplantation for pediatric cystic fibrosis through multi-disciplinary team (MDT). Methods Preoperative MDT consultation was delivered for a 10-year-old child with rare end-stage cystic fibrosis to establish the corresponding treatment protocol. Results The child was diagnosed with cystic fibrosis for 5 years, and the indication of lung transplantation were confirmed. After preoperative MDT consultation, bilateral lung transplantation via a Clam-shell incision was determined. The vital signs were maintained stable during operation. Postoperatively, ventilator-assisted ventilation, anti-infection, immunosuppression, acid suppression, prevention of stress ulceration and other treatments were delivered. Individualized treatment was given according to the characteristics of the child, and the child was well recovered. Conclusions Through preoperative MDT consultation, lung transplantation yields satisfactory surgical efficacy in treating pediatric cystic fibrosis and lowers the risk of postoperative complications, which deserves application in clinical practice.

Objective:To analyze the clinical data on hospitalized spinal cord injury patients with calf muscle vein thromboses (MCVTs) seeking prevention and treatment techniques.Methods:The medical records of 423 patients with spinal cord injury were collected. Those with MCVT constituted the observation group, while those without served as controls. Their clinical data were compared.Results:The risk factors for MCVT were screened in logistic regression analyses. The results showed that age, an ASIA grade of A or B, spinal fusion, preventive anticoagulation, physiotherapy treatment and a homocysteine level >15μmol/L were risk factors for the occurrence of a MCVT.Conclusions:Age, an ASIA grade of A or B, spinal fusion or an elevated serum homocysteine level are all risk factors for MCVT. Active anticoagulation and physical therapy may reduce the risk.

Objective To approach the spine MRI features and its possibility of etiology for refractory lower urinary tract symptoms(LUTS) in female patients.Methods We conducted prospectively a cross sectional description study of female patients with refractory LUTS during January 16 through March 27 in 2017 based on a urologist's outpatient work.The including criteria were adult female patients with refractory LUTS which defined as having LUTS more than three months and having poor response to behavior therapy and medication treatment.The excluding criteria were patients having evidence of infection,tumor,stone in urinary tract,any central nerve system diseases,or any other diseases may potentially producing LUTS.Data collected included patients demographic information,main complains,present disease features,disease history,physical examination,urine routine,urodynamic study and spine MRI.The characteristics of clinical manifestation,urodynamic study and spine MRI were analyzed.Results During the time span of study,totally 70 cases had been diagnosed as having refractory LUTS and had qualified data of clinical recordings,urodynamic study and spine MRI.Among these 70 cases,63 (90.9％) had storage phase symptoms,11 (15.7％) had voiding phase symptoms,8 (11.4％) had postmicturition symptoms,12 (17.1％) also had disorders in defecating,45 (64.3％) had pain in lower abdomen or pelvic region.69 cases (98.6％) had urodynamic disorders,33 (47.1％) had oversensitivity of bladder,12 (17.1％) had smaller bladder volume,16(22.9％) had detrusor overactivity,15 (21.4％) had bladder outlet obstruction,39(55.7％) had detrusor underactivity.69 cases(98.6％)had spine MRI abnormalities,54(77.1％) had sacral nerve lesions,49 (70.0％) had cervical lesions,48 (68.6％) had lumbar lesions,4 had thorathic lesions.Conclusions The present study revealed extraordinary high prevalence of abnormality in urodynamic parameters and spine MRI in female patients with refractory LUTS,which implies possibility that the refractory LUTS are caused by lesions in spinal nerve system.