Objective: To explore the efficacy of pelvic floor optimization training of Yun-type with the aid of myoelectric biofeedback in the treatment of mild to moderate female stress urinary incontinence (SUI). Methods: Female SUI patients treated in our hospital during Jan.and Oct.2024 were included as the research subjects.They were randomly divided into the control group (n=47) and observation group (n=48) by random number method.The control group received conventional Yun-type pelvic floor optimization training，while the observation group received Yun-type pelvic floor optimization training assisted with myoelectric biofeedback.The total treatment course lasted for 12 weeks.The clinical efficacy，as well as the changes in international consultation on incontinence questionnaire for symptoms and impact (ICI-Q-SF)，incontinence quality of life (I-QoL)，female sexual function index (FSFI)，and pelvic floor electromyographic values before and after treatment were compared. Results: The total effective rate of the observation group was 93.6%，which was significantly higher than that of the control group (79.2%，P<0.05).After 12 weeks of treatment，the ICI-Q-SF [(6.12±1.11) vs. (6.97±1.24)]，I-QoL [(85.05±4.51) vs. (82.14±4.60)]，and FSFI [(30.01±4.10) vs. (26.32±3.32)] scores of the observation group were significantly better than those of the control group (P<0.05).After 12 weeks of treatment，the myoelectric values of the pelvic floor muscles of the observation group at the pre-rest stage，fast muscle (type Ⅱ muscle) stage，slow muscle (type Ⅰ muscle) stage，endurance test stage，and post-rest stage were significantly improved compared with those before treatment and were greatly enhanced compared with those of the control group (P<0.05).No serious adverse reactions occurred in either groups during treatment and follow-up. Conclusion: The Yun-type pelvic floor optimization training assisted with myoelectric biofeedback can precisely enhance the therapeutic effects of the conventional Yun-type pelvic floor optimization training，and significantly improve the female sexual function index.It is worthy of clinical promotion and application.

Objective:To study the current status of longitudinal extrauterine growth restriction (EUGR) in extremely preterm infants (EPIs) and to develop a prediction model based on clinical data from multiple NICUs.Methods:From January 2017 to December 2018, EPIs admitted to 32 NICUs in North China were retrospectively studied. Their general conditions, nutritional support, complications during hospitalization and weight changes were reviewed. Weight loss between birth and discharge > 1SD was defined as longitudinal EUGR. The EPIs were assigned into longitudinal EUGR group and non-EUGR group and their nutritional support and weight changes were compared. The EPIs were randomly assigned into the training dataset and the validation dataset with a ratio of 7∶3. Univariate Cox regression analysis and multiple regression analysis were used in the training dataset to select the independent predictive factors. The best-fitting Nomogram model predicting longitudinal EUGR was established based on Akaike Information Criterion. The model was evaluated for discrimination efficacy, calibration and clinical decision curve analysis.Results:A total of 436 EPIs were included in this study, with a mean gestational age of (26.9±0.9) weeks and a birth weight of (989±171) g. The incidence of longitudinal EUGR was 82.3%(359/436). Seven variables (birth weight Z-score, weight loss, weight growth velocity, the proportion of breast milk ≥75% within 3 d before discharge, invasive mechanical ventilation ≥7 d, maternal antenatal corticosteroids use and bronchopulmonary dysplasia) were selected to establish the prediction model. The area under the receiver operating characteristic curve of the training dataset and the validation dataset were 0.870 (95% CI 0.820-0.920) and 0.879 (95% CI 0.815-0.942), suggesting good discrimination efficacy. The calibration curve indicated a good fit of the model ( P>0.05). The decision curve analysis showed positive net benefits at all thresholds. Conclusions:Currently, EPIs have a high incidence of longitudinal EUGR. The prediction model is helpful for early identification and intervention for EPIs with higher risks of longitudinal EUGR. It is necessary to expand the sample size and conduct prospective studies to optimize and validate the prediction model in the future.

The price supervision of medical services can affect the whole process of medical order issuance,treatment op-eration,inspection and examination execution,surgical anesthesia,nursing management,etc.It plays an important role in provi-ding standardized diagnosis and treatment services and saving treatment costs.This article analyzes the current status of hospital price management,sorts out price supervision policies,and uses the pre-remind,intervening and post-event supervision functions of the intelligent price monitoring platform to solve the problem of unreasonable charges such as repeated charges and over-restrict-ed frequency charges,so as to screen and rectify illegal diagnosis and excessive medical treatment.Take the price intelligent su-pervision platform as the starting point,let information and data go more widely,optimize related business processes,promote the satisfaction of both patients and hospital staff,and further improve the hospital management level and service level.

Objective·To analyze the epidemiological characteristics of risk factors for cardiovascular diseases and malignant tumors based on the Shanghai community elderly cohort.Methods·The study subjects were selected from the Shanghai community elderly cohort established from February to August 2019,with a total of 17 948 people.The study subjects were divided into 4 groups according to self-reported presence or absence of tumors and/or cardiovascular diseases during the baseline survey:tumor-free and non-cardiovascular disease group,single cardiovascular disease group,single tumor group and tumor cardiovascular disease co-occurrence group.The differences among the four groups of subjects were collected and compared in terms of demographic characteristics and physiological indicators,daily living habits(smoking,drinking tea,drinking coffee,drinking carbonated drink,drinking alcohol,sedentary time,physical activity level and sleep quality),past medical history,psychological status(depression and anxiety)and dietary compliance.Results·Among the study subjects,60.1%of tumor patients were complicated with cardiovascular diseases.The differences among the four groups of subjects in age,gender,educational level,pre-retirement occupation,waist circumference,hip circumference and body mass index were statistically significant(all P<0.05).Compared with the tumor-free and non-cardiovascular disease group,the single cardiovascular disease group,single tumor group and tumor cardiovascular disease co-occurrence group all exhibited lower proportions of smoking and high physical activity levels(all P<0.05),and higher proportion of sedentary time exceeding 4 h/d and poor sleep quality(all P<0.05);the proportion of subjects with past medical histories including hyperlipidemia,peripheral vascular disease,endocrine system disease,respiratory system disease,urinary system disease and digestive system disease of the single cardiovascular disease group and the tumor cardiovascular disease co-occurrence group was higher(all P<0.05),and the proportion of subjects with depression and anxiety was also higher(all P<0.05).Furthermore,compared with the tumor-free and non-cardiovascular disease group,the single cardiovascular disease group had lower compliance rates of poultry,fish,fruit and liquid milk(all P<0.05).Among the four groups,only the compliance rate of vegetable intake exceeded 50%,while the compliance rates of poultry,fish,fruit,liquid milk and tubers were all below 20%.Conclusion·In the elderly population of Shanghai communities,over half of malignant tumor patients are concomitant with cardiovascular diseases.Unhealthy daily habits are prevalent among those with cardiovascular diseases,tumors and tumor-cardiovascular disease co-occurrence.The intake of many foods in the elderly of the community do not reach the levels recommended by Chinese Dietary Guidelines.

Objective·In view of the low funding rate of the Young Scientists Fund of National Natural Science Foundation of China in the medical field,this research conducted an in-depth investigation of the applicants in a medical school and quantitatively analyzed the influencing factors of project establishment,so as to provide reference for further improving the quality of project application and strengthening the training of young medical talents.Methods·A cross-sectional survey was used to select applicants from secondary schools of Shanghai Jiao Tong University School of Medicine and its 13 affiliated hospitals who had experience in applying for the fund from 2020 to 2022.Logistic stepwise regression model was applied to modeling and analysis by using the project application result as the dependent variable and the applicants'basic information and application status as independent variables.Results·The analysis results of 921 applicants showed that educational background(OR=1.86,95%CI 1.14?3.04),graduate university(OR=2.45,95%CI 1.47?4.08),sufficient preliminary work foundation(OR=4.22,95%CI 2.44?7.29),average impact factor of representative works(OR=1.10,95%CI 1.04?1.17),and total self-evaluation score of application documents(OR=1.06,95%CI 1.04?1.08)were the main influencing factors for project approval.The average impact factor and the highest impact factor of the approved representative works showed an increasing trend year by year.In addition,the influencing factors for the approval of young doctors and full-time researchers were different.The longer the graduation time of young doctors,the lower the approval rate.Conclusion·The funding rate of Young Scientists Fund is low,and the requirements for scientific research achievements are increasing year by year.Attention should be paid to early accumulation and improving the quality of application writing.Further measures should be taken to strengthen the early training of young medical talents,improve cultivation measures and consolidate research foundations.

A case of secondary Burkitt lymphoma of prostate was reported. A 39-year-old patient was admitted to the hospital with no apparent cause for impaired urination with frequent/urgent urination. CT scan of the whole abdomen showed irregular soft tissue mass of the prostate, involving the bladder and rectum, and mild obstructive hydronephrosis of the renal pelvis and ureter. Biopsy of the prostatic mass was performed, and the pathological findings were consistent with Burkitt lymphoma. PET-CT examination showed multiple lesions and lymph node enlargement throughout the body, secondary prostate lymphoma was diagnosed. After diagnosis, the patient was treated with R-DA-EPOCH chemotherapy and followed up for 9 months. Prostate lymphoma is rare and needs to be combined with clinical manifestations and laboratory tests to determine whether it is primary or secondary, but also to distinguish from prostate diseases such as prostatitis and poorly differentiated prostate cancer.

Objective:To compare the perioperative outcomes of laparoscopic duodenal-preserving pancreatic head resection(LDPPHR) with laparoscopic pancreaticoduodenectomy(LPD) in the treatment of borderline and benign diseases of the pancreatic head.Methods:This is a retrospective cohort study. Perioperative data from 87 patients with non-malignant pancreatic head diseases who underwent LDPPHR or LPD were retrospectively collected in the Department of Biliary-Pancreatic Surgery,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology from January 2020 to December 2022. There were 49 male and 38 female patients with an age ( M(IQR)) of 57.0(16.5) years (range: 20 to 75 years). Forty patients underwent LDPPHR and 47 patients underwent LPD. Quantitative data following a normal distribution were compared using Student′s t-test, while quantitative data not following a normal distribution were compared using the Mann-Whitney U test. Comparisons of categorical or ordinal variables were made using χ2 test or Fisher′s exact test. Logistic regression analysis was used to estimate the risk factors associated with the rate of complications. Results:There were no statistically significant differences between the LDPPHR group and the LPD group in terms of reoperation rate,total hospital stay duration,postoperative hospital stay duration,90-day mortality rate,30-day and 90-day readmission rates,and 2-year tumor recurrence rate (all P>0.05). The complication rate was higher in the LDPPHR group compared to the LPD group (80.0%(32/40) vs. 51.1%(24/47), χ2=7.89, P=0.005),but there was no difference in the rate of Clavien-Dindo classification of surgical complications ≥Ⅲ between the two groups (10.0%(4/40) vs. 12.8%(6/47), χ2<0.01, P=0.947). Additionally,the rate of delayed gastric emptying (DGE) was higher in the LDPPHR group compared to the LPD group ( χ2=10.79, P=0.001),but there was no statistically significant difference in the rate of B,C grade DGE between the two groups ( χ2=0.48, P=0.487). There were no statistically significant differences in the rates of postoperative pancreatic fistula,bile leakage,post-pancreatectomy hemorrhage,intra-abdominal infection,and pulmonary infection between the two groups (all P>0.05). The results of the univariate logistic regression analysis showed that LDPPHR (compared to LPD, OR=3.83, 95% CI: 1.46 to 10.04, Z=2.73, P=0.006) and preoperative biliary stent placement (compared to non-use of biliary stent, OR=5.30, 95% CI: 1.13 to 25.00, Z=2.11, P=0.035) were risk factors for the complication rate,but neither was an independent risk factor for complication rate (all P>0.05). Conclusion:The preliminary results suggest that LDPPHR can achieve perioperative safety and effectiveness comparable to LPD.

Objective:To compare the perioperative outcomes of laparoscopic duodenal-preserving pancreatic head resection(LDPPHR) with laparoscopic pancreaticoduodenectomy(LPD) in the treatment of borderline and benign diseases of the pancreatic head.Methods:This is a retrospective cohort study. Perioperative data from 87 patients with non-malignant pancreatic head diseases who underwent LDPPHR or LPD were retrospectively collected in the Department of Biliary-Pancreatic Surgery,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology from January 2020 to December 2022. There were 49 male and 38 female patients with an age ( M(IQR)) of 57.0(16.5) years (range: 20 to 75 years). Forty patients underwent LDPPHR and 47 patients underwent LPD. Quantitative data following a normal distribution were compared using Student′s t-test, while quantitative data not following a normal distribution were compared using the Mann-Whitney U test. Comparisons of categorical or ordinal variables were made using χ2 test or Fisher′s exact test. Logistic regression analysis was used to estimate the risk factors associated with the rate of complications. Results:There were no statistically significant differences between the LDPPHR group and the LPD group in terms of reoperation rate,total hospital stay duration,postoperative hospital stay duration,90-day mortality rate,30-day and 90-day readmission rates,and 2-year tumor recurrence rate (all P>0.05). The complication rate was higher in the LDPPHR group compared to the LPD group (80.0%(32/40) vs. 51.1%(24/47), χ2=7.89, P=0.005),but there was no difference in the rate of Clavien-Dindo classification of surgical complications ≥Ⅲ between the two groups (10.0%(4/40) vs. 12.8%(6/47), χ2<0.01, P=0.947). Additionally,the rate of delayed gastric emptying (DGE) was higher in the LDPPHR group compared to the LPD group ( χ2=10.79, P=0.001),but there was no statistically significant difference in the rate of B,C grade DGE between the two groups ( χ2=0.48, P=0.487). There were no statistically significant differences in the rates of postoperative pancreatic fistula,bile leakage,post-pancreatectomy hemorrhage,intra-abdominal infection,and pulmonary infection between the two groups (all P>0.05). The results of the univariate logistic regression analysis showed that LDPPHR (compared to LPD, OR=3.83, 95% CI: 1.46 to 10.04, Z=2.73, P=0.006) and preoperative biliary stent placement (compared to non-use of biliary stent, OR=5.30, 95% CI: 1.13 to 25.00, Z=2.11, P=0.035) were risk factors for the complication rate,but neither was an independent risk factor for complication rate (all P>0.05). Conclusion:The preliminary results suggest that LDPPHR can achieve perioperative safety and effectiveness comparable to LPD.

Objective To establish a HPLC method for simultaneous determination of neochlorogenic acid,chlorogenic acid,cryptochlorogenic acid,puerarin,polydatin,isochlorogenic acid A,isochlorogenic acid C,resveratrol,glycyrrhizic acid and emodin in Yinhua Pinggan Granules.Methods The analysis was performed on Thermo Acclaim-C18 column(250 mm×4.6 mm,5 μm)by gradient elution of acetonitrile-0.1%phosphoric acid solution at a flow rate of 1.0 mL·min-1.The detection wavelength was set at 327 nm for detecting neochlorogenic acid,chlorogenic acid,cryptochlorogenic acid,polydatin,isochlorogenic acid A,isochlorogenic acid C and resveratrol,at 252 nm for detecting puerarin,glycyrrhizic acid and emodin.The column temperature was 30℃and the injection volume was 10 μL.Results Good resolution of 10 constituents of Yinhua Pinggan Granules was obtained.The linear ranges of neochlorogenic acid,chlorogenic acid,cryptochlorogenic acid,puerarin,polydatin,isochlorogenic acid A,isochlorogenic acid C,resveratrol,glycyrrhizic acid and emodin were 1.744-17.44,10.75-107.5,1.863-18.63,14.62-146.2,4.784-47.84,1.208-12.08,4.427-44.27,1.971-19.71,3.624-36.24 and 4.142-41.42 μg·mL-1,respectively.The results showed good linear relationships(r≥0.999 4).The average recoveries ranged from 99.17%to 102.97%(RSD≤2.65%).The content ranges of ten constituents in five batches were 1.065-3.238,20.11-25.14,1.785-2.973,23.60-35.55,7.157-9.469,1.224-2.421,6.430-7.879,1.354-2.006,4.907-8.052,4.387-9.484 mg·g-1,respectively.Conclusion This method is simple and accurate,which can be used for the quality control and evaluation of Yinhua Pinggan Granules.

Objective To explore and compare the efficacy and safety of different transurethral enucle-ation procedures for treating benign prostatic hyperplasia.Methods A retrospective analysis was conducted on the clinical data of 215 patients with benign prostatic hyperplasia admitted to our hospital from January 2021 to May 2023.According to the surgical procedures,they were divided into plasma resection group(n=81),treated with transurethral plasma resection of the prostate,laser resection group(n=92),treated with transurethral laser resection of the prostate,and green laser enucleation group(n=42),treated with transurethral green laser enucle-ation of the prostate.The three groups were compared in terms of perioperative indicators(surgical time,intraop-erative bleeding volume,bladder flushing time,indwelling catheter time,postoperative hemoglobin concentration,and hospital stay),urodynamic indicators(RUV,IPSS score,Qmax,and QOL score),and postoperative compli-cations.Results The green laser enucleation group and laser resection group demonstrated a significantly higher total effective rate compared to the plasma electrosurgery group(P<0.05).The three groups showed no statisti-cally significant difference in hospital stay(P>0.05),but the green laser enucleation group showed a signifi-cantly shorter surgical time compared to the other two group(P<0.05).The green laser enucleation group and laser resection group had superiority in intraoperative bleeding,bladder flushing time,and indwelling catheter time compared to the plasma resection group,and a significantly higher postoperative hemoglobin concentration compared to the plasma resection group(P<0.05).Repeated measurement analysis of variance showed that the three groups all exhibited significantly decreases in RUV,IPSS score,and QOL score(P<0.05),and a signifi-cantly increase in Qmax at 1 month and 3 months after surgery(P<0.05).The laser resection group and green laser enucleation group presented with significant decreases in RUV,IPSS score,and QOL score(P<0.05),and a significantly decrease in Qmax compared to the plasma resection group at 1 month and 3 months after surgery(P<0.05).However,the laser resection group and the green laser enucleation group had no statistically signifi-cant difference in RUV,IPSS score,Qmax,and QOL score at 1 month and 3 months after surgery(P>0.05).The green laser enucleation group had the lowest total incidence of postoperative complications,following by the laser resection group and plasma resection group in order(7.14%vs.21.74%vs.35.80%,P<0.05).Conclusion The three surgical procedures all have good therapeutic effects on benign prostatic hyperplasia.Transurethral laser prostatectomy and green laser enucleation have superiority to those of transurethral plasma resection of the prostate in efficacy and safety,and they can promote early recovery of patients.Transurethral green laser enucleation is the best in safety.