In the context of China's aging population, the issue of urinary incontinence among the elderly is becoming increasingly severe.Urinary incontinence not only significantly impacts patients' quality of life, but also imposes a substantial economic burden and psychological stress.This article explores the challenges and prospects of the early intervention of elderly urinary incontinence in China, including improving early diagnosis rates, enhancing patients' self-management abilities, and early screening and prevention for high-risk groups.With the advancement of technology and medical innovations, digital self-management tools offer new possibilities for managing urinary incontinence, helping patients to better control their condition, especially when medical resources are limited.Furthermore, this article calls for greater attention from all sectors of the society to address elderly urinary incontinence and promote the implementation of more systematic research and management strategies to improve the quality of life for China's elderly population.

Objective The study aimed to investigate the impact of rare earth elements(REEs)exposure on pregnancy outcomes of in vitro fertilization-embryo transfer(IVF-ET)by analyzing samples from spouses. Methods A total of 141 couples were included.Blood and follicular fluid from the wives and semen plasma from the husbands,were analyzed for REEs using inductively coupled plasma mass spectrometry(ICP-MS).Spearman's correlation coefficients and the Mann-Whitney U test were used to assess correlations and compare REE concentrations among three types of samples,respectively.Logistic models were utilized to estimate the individual REE effect on IVF-ET outcomes,while BKMR and WQS models explored the mixture of REE interaction effects on IVF-ET outcomes. Results Higher La concentration in semen(median 0.089 ng/mL,P=0.03)was associated with a lower fertilization rate.However,this effect was not observed after artificial selection intervention through intracytoplasmic sperm injection(ICSI)(P=0.27).In semen,the REEs mixture did not exhibit any significant association with clinical pregnancy. Conclusion Our study revealed a potential association between high La exposure in semen and a decline in fertilization rate,but not clinical pregnancy rate.This is the first to report REEs concentrations in follicular fluid with La,Ce,Pr,and Nd found at significantly lower concentrations than in serum,suggesting that these four REEs may not accumulate in the female reproductive system.However,at the current exposure levels,mixed REEs exposure did not exhibit reproductive toxicity.

Fragile X syndrome(FXS)is caused by abnormal duplication and amplification of the FMR1 gene CGG.This article reports a pair of brothers diagnosed with FXS by genetic testing.Two patients,aged 15 and 14 years old respectively,both had clinical manifestations such as language disorders,intellectual disabilities,attention deficit disorder,autism spectrum disorder,and FXS's characteristic facial features.The proband had a rare late-onset epileptic seizure,which was well treated with levetiracetam,while his younger brother had no electroencephalogram abnormalities after repeated follow-up.This pair of cases suggests that the clinical phenotype of FXS has diversity and heterogeneity.

The purpose of this study was to investigate the damage mechanism of pathogenic E.coli on mouse brain microvascular endothelial cells(BMEC cells)and mouse alveolar macrophages(MH-S cells),as well as the lung and brain of healthy mice.In this study,BMEC cells and MH-S cells were infected with pathogenic E.coli strains,and cell morphological changes were observed.Plate counting method was used to detect the adhesion and invasion ability of the strains to cells and the number of bacteria in the lungs and brains of mice.RT-qPCR was used to detect the ex-pression of TNF-α,IL-1β and IL-6 genes in cells and mouse organs at different time periods.West-ern blot was used to detect the expression of p-NF-κB,p-JAK2 and p-STAT3 proteins related to inflammation in cells and mouse organs after infection.The results showed that the cell culture medium of the infection group was turbid,the cell vision became dark and blurred,some cells shrank and died,and more fragments were produced.The adhesion rate and invasion rate of BMEC cells at 3 h were significantly lower than those at 6 h(P＜0.050),and the adhesion rate and inva-sion rate of MH-S cells at 3 h were significantly higher than those at 6 h(P＜0.010).Infected mice had a large area of swelling and bleeding in the brain,and the lungs had different degrees of swell-ing and bleeding.The bacterial load in the brain and lung was the highest at 12 h.Compared with the control group,the mRNA expression levels of IL-1β,IL-6 and TNF-α in the infection group were significantly increased at 3 h and 6 h(P＜0.050),and the mRNA expression levels of inflam-matory factors in BMEC cells and MH-S cells were the highest at 6 and 3 h,respectively.The mR-NA expression of inflammatory factors in the brain and lung of infected mice showed a trend of in-creasing first and then decreasing with time,with the highest expression at 12 h after infection.The expression levels of p-NF-κB protein in BMEC cells,MH-S cells,lung and brain tissues of mice in the infection group were significantly higher than those in the control group(P＜0.001),and the expression levels of p-JAK2 protein and p-STAT3 protein were significantly lower than those in the control group(P＜0.050).The above results showed that pathogenic E.coli could adhere and invade BMEC cells and MH-S cells,colonize in lung and brain tissues of mice,promote the expres-sion of NF-κB protein in cells and tissues,inhibit the expression of JAK2 protein and STAT3 pro-tein,and then stimulate cells and tissues to produce inflammatory response.

Objective:The investigation and research on the application status of Hepatic Venous Pressure Gradient (HVPG) is very important to understand the real situation and future development of this technology in China.Methods:This study comprehensively investigated the basic situation of HVPG technology in China, including hospital distribution, hospital level, annual number of cases, catheters used, average cost, indications and existing problems.Results:According to the survey, there were 70 hospitals in China carrying out HVPG technology in 2021, distributed in 28 provinces (autonomous regions and municipalities directly under the central Government). A total of 4 398 cases of HVPG were performed in all the surveyed hospitals in 2021, of which 2 291 cases (52.1%) were tested by HVPG alone. The average cost of HVPG detection was (5 617.2±2 079.4) yuan. 96.3% of the teams completed HVPG detection with balloon method, and most of the teams used thrombectomy balloon catheter (80.3%).Conclusion:Through this investigation, the status of domestic clinical application of HVPG has been clarified, and it has been confirmed that many domestic medical institutions have mastered this technology, but it still needs to continue to promote and popularize HVPG technology in the future.

Melanoma is a highly invasive and lethal skin malignant tumor derived from melanocytes. It has the characteristics of high early metastasis and high mortality. In recent years, with the in-depth study of the pathogenesis of melanoma, it has been found that epigenetic modification, especially DNA methylation, is considered to be a universal intrinsic feature of melanoma development and evolution. This article reviews the research progress of abnormal DNA methylation genes in melanoma in detail, and summarizes the biomarker effect of DNA methylation genes, suggesting that the detection of abnormal DNA methylation genes in melanoma patients is hopeful as an early screening index and diagnostic marker for melanoma patients.

Melanoma is a highly invasive and lethal skin malignant tumor derived from melanocytes. It has the characteristics of high early metastasis and high mortality. In recent years, with the in-depth study of the pathogenesis of melanoma, it has been found that epigenetic modification, especially DNA methylation, is considered to be a universal intrinsic feature of melanoma development and evolution. This article reviews the research progress of abnormal DNA methylation genes in melanoma in detail, and summarizes the biomarker effect of DNA methylation genes, suggesting that the detection of abnormal DNA methylation genes in melanoma patients is hopeful as an early screening index and diagnostic marker for melanoma patients.

Neuromuscular disease (NMD) is a group of hereditary or acquired myopathy typically manifested as motor dysfunction. There is still no consensus in the standardized tools for evaluation of motor function. Among the tools widely used, Motor Function Measure can be used in all kinds of NMD, while North Star Ambulatory Assessment and Performance of the Upper Limb can be for Duchenne muscular dystrophy, and Hammersmith Functional Motor Scale, the Children's Hospital of Philadelphia Infant Test of Neuromuscular Disorders and Upper Limb Module for spinal muscular atrophy.

Objective:To analyse the evaluation and experience of clinical effect of minimally invasive drainage and craniotomy in the treatment of patient with epidural hematoa.Methods:100 cases of patients who were diagnosed as epidural hematoma from January 2015 to January 2016 were selected and randomly divided into two groups,where the control group were given craniotomy,and the observation group were given minimal invasive drainage.The effect of the surgery and the life qualities before and after treatment of the two groups were compared.Results:The effect of observation group is better than that of control group (P ＜ 0.05);craniocerebral defect and the re-hemorrhage incidence occurrence in the observation group were obviously lower than those in the control group,(0 ％,6 ％ vs 12 ％,20 ％) (P＜0.05).Conclusion:Compared with craniotomy,minimal invasive drainage in clinical treatment of epidural hematoma showed advantage in at smaller trauma,faster recovery,and better effect,thus deserving further promotion of clinic application.

Objective To investigate the efficacy of breast tissue flap cohesive treatment after breast augmentation injection mixture dis-placed.Methods A total of 78 patients with breast augmentation injection mixture polyacrylamide hydrogel(PAAG)shift in our hospital from January 2006 to March 2014 were divided into two groups according to different surgical methods,39 cases with the material shifted to abdominal wall in control group were treated by taking the cleaning operation to scrape residual cavity,39 patients in observation recieved new breast tissue flap design local treatment of breast fistula closed chest and abdominal wall channel after surgical elimination of the same abdom-inal wall cavities.Results The PAAG extensive deposition in the breast tissue,armpits,chest wall clearance were formed fistula communica-tion.The secretions of patients treated with tissue flap decreased 82%,the lacunar lesions reduced 80% after 2 weeks,while patients without tissue flap,the drain reduced 46%,the lesion size reduced 45%,the difference between the two groups was significant(P <0.01).The heal-ing rate of tissue flap group was higher than that of conventional group after 4 weeks.Conclusion The PAAG mixture shifting formed fistula communication in the abdominal wall is the main reason of the mass flow and a huge cavity.Flap can significantly promote abdominal wall fis-tula healing.