Abstract:Cardiac autonomic neuropathy(CAN)in diabetes is a common complication of type 2 diabetes mellitus,which seriously affects the quality of life and life span of the patients.Exercise training,as an economical and effective intervention method,has significant effects on preventing and delaying the progression of CAN,as well as improving cardiac autonomic nervous function(CAF).Exercise training can improve CAF by improving heart rate variability,activating baroreceptor reflex,and strengthening heart rate recovery after exercise.In this paper,the research progress in effects of exercise training on CAF in type 2 diabetes mellitus patients is reviewed.

Abstract:Objective To investigate the association of Epstein-Barr virus(EBV)infection with the severity of connective tissue disease-associated interstitial lung disease(CTD-ILD)and immune dysregulation.Methods A retrospective analysis was conducted on the clinical data of 63 CTD-ILD patients(CTD-ILD group)who were admitted to Xiangyang Central Hospital Affiliated to Hubei University of Arts and Science from September 2023 to January 2025.Forty-five patients with connective tissue disease(CTD)(CTD group)and 45 healthy individuals undergoing physical examinations(control group)were selected according to the matching criteria including gender,age,and body mass index(BMI).The EBV-DNA load was detected by using real-time fluorescence quantitative polymerase chain reaction(FQ-PCR).According to the detection results,the CTD-ILD patients were further divided into EBV-DNA positive group(22 patients)and EBV-DNA negative group(41 patients).The levels of T lymphocyte subsets were detected by using flow cytometry,and the levels of serum interferon-γ(IFN-γ)and interleukin-4(IL-4)were detected by using enzyme-linked immunosorbent assay(ELISA).The effect of the use of immunosuppressants on the risk of EBV infection in the CTD-ILD patients was analyzed.Results The positive rates of EBV-DNA in the CTD-ILD group,the CTD group and the control group were 34.92％(22/63),17.78％(8/45)and 6.67％(3/45),respectively,with statistically significant differences among the three groups(x2=12.929 P=0.002).The positive rate of EBV-DNA in the CTD-ILD group was significantly higher than that in the CTD group and the control group(P＜0.05),while there was no statistically significant difference in the positive rate of EBV-DNA between the CTD group and the control group(P＞0.05).The use of immunosuppressants did not significantly affect the risk of EBV infection in the CTD-ILD patients(P＞0.05).In the CTD-ILD patients,the levels of forced vital capacity percent predicted(FVC％pred),percent predicted diffusing capacity of the lung for carbon monoxide(DLCO％pred),IFN-γ,CD4+and CD4+/CD8+ratio in the EBV-DNA positive group were lower than those in the EBV-DNA negative group,while the high-resolution computed tomography(HRCT)scores,IL-4 and CD8+levels in the EBV-DNA positive group were higher than those in the EBV-DNA negative group,with statistically significant differences between the two groups(P＜0.05).The results of Pearson correlation analysis showed that in the CTD-ILD patients,IL-4 was negatively correlated with FVC％pred and DLCO％pred(P＜0.05),and positively correlated with HRCT scores(P＜0.05),and the IFN-γ,CD4+and CD4+/CD8+ratio were positively correlated with FVC％pred and DLCO％pred(P＜0.05),and negatively correlated with HRCT scores(P＜0.05).Conclusion EBV infection is closely related to the severity of pulmonary interstitial fibrosis in CTD-ILD patients,and the mechanism may be related to immune dysregulation and persistent inflammation.

Abstract:Objective To analyze the effects of chemotherapy on survival prognosis of patients with distant metastatic nasopharyngeal carcinoma.Methods A retrospective analysis was conducted on the clinical data and follow-up data of 187 patients with distant metastatic nasopharyngeal carcinoma who were admitted to the People's Hospital of Guangxi Zhuang Autonomous Region from June 2010 to June 2019.Among them,100 patients were willing to receive chemotherapy(chemotherapy group),and 87 patients abandoned chemotherapy(non-chemotherapy group).The effects of factors such as metastatic sites,chemotherapy regimens and chemotherapy cycles on the patients' survival prognosis were analyzed by using survival curve and Cox regression.Results By January 2020,82 patients in the non-chemotherapy group and 70 patients in the chemotherapy group died.The survival prognosis of the patients in the chemotherapy group was significantly better than that of the patients in the non-chemotherapy group(log-rank test:x2=9.565,P=0.002).For the patients receiving chemotherapy,the results of multivariate Cox regression analysis showed that,with lung metastasis as a reference,liver metastasis[RR(95％CI)=2.823(1.284-6.210)]and multiple metastases[RR(95％CI)=3.920(2.118-7.255)]were independent risk factors for poor survival prognosis in them(P＜0.05);with chemotherapy cycles ≤4 cycles as a reference,chemotherapy cycles＞4 cycles[RR(95％CI)=0.276(0.142-0.536)]were independent protective factors for promoting better survival prognosis in them(P＜0.05).Conclusion Chemotherapy can significantly improve the survival prognosis of patients with distant metastatic nasopharyngeal carcinoma.Metastatic site and chemotherapy cycle are important factors affecting the patients' survival prognosis.

Abstract:Objective To compare therapeutic effects of programmed cell death protein-1(PD-1)inhibitors combined with neoadjuvant chemotherapy(NAT)versus simple NAT in treatment of locally advanced head and neck squamous cell carcinoma(LA HNSCC).Methods A retrospective analysis was conducted on the clinical data of 140 patients with LA HNSCC who were admitted to Sun Yat-sen University Cancer Center from February 2012 to February 2023.According to different therapeutic regimens received by the patients,they were divided into immunochemotherapy group(118 patients)and simple chemotherapy group(22 patients).The baseline characteristics were balanced by using propensity score overlap weighting method.The simple chemotherapy group received a TP-based NAT regimen.The immunochemotherapy group received a regimen of intravenous infusion of a PD-1 inhibitor(200 mg)on the first day of each treatment cycle in addition to the TP-based NAT.After the NAT,the patients underwent radical surgical treatment.The objective response rate(ORR),pathological downstaging rate,pathological complete response(pCR)rate,overall survival(OS),and progression-free survival(PFS)were compared between the two groups.Cox regression model was used to analyze the factors influencing the survival prognosis of the LA HNSCC patients.Results The ORR,pathological downstaging rate and pCR rate in the immunochemotherapy group were higher than those in the simple chemotherapy group,with statistically significant differences between the two groups(P＜0.05).By August 2025,the median follow-up time for the immunochemotherapy group was 33.81 months,with 22 cases of disease progression and 15 deaths,and the median follow-up time for the simple chemotherapy group was 24.32 months,with 12 cases of disease progression and 12 deaths.The OS and PFS in the immunochemotherapy group were significantly better than those in the simple chemotherapy group[HR(95％CI)=0.233(0.106-0.512),P＜0.001;HR(95％CI)=0.323(0.155-0.672),P=0.002].After the matching of propensity score overlap weighting method,the OS and PFS in the immunochemotherapy group were still significantly better than those in the simple chemotherapy group[HR(95％CI)=0.236(0.073-0.759),P=0.016;HR(95％CI)=0.337(0.122-0.936),P=0.037].The results of multivariate Cox regression analysis showed that age ≥60 years was an independent risk factor for shortening OS and PFS in the LA HNSCC patients(P＜0.05),and the combined immunotherapy was an independent protective factor for prolonging OS and PFS in the LA HNSCC patients(P＜0.05).Conclusion Compared with the simple NAT,the combination of PD-1 inhibitors and NAT can significantly improve the survival prognosis of LA HNSCC patients and the combination therapy is worthy of clinical recommendation.

Abstract:This paper reports a case of Ohtahara syndrome caused by DMXL2 gene mutation.

Abstract:Objective To explore the therapeutic effect of anemoside B4(AB4)on androgenetic alopecia(AGA)in mice and its mechanism of action.Methods Forty-eight male C57BL/6 mice were selected and randomly divided into control group,model group,low-dose AB4 group,medium-dose AB4 group,high-dose AB4 group and 5％minoxidil tincture group,with 8 mice in each group.The mice in the control group were fed normally without special interventions.The model group and each intervention group were topically applied with testosterone solution[10 mg/(kg·d)]on the skin on the neck and back of the mice to establish the AGA model.After construction of the AGA model,the model group was topically applied with 20％glycerol solution on the skin on the neck and back of the mice,twice daily,0.2 mL per time,and the low-dose AB4 group,the medium-dose AB4 group and the high-dose AB4 group were topically applied with 5 mg/mL,10 mg/mL and 20 mg/mL AB4 solution on the skin on the neck and back of the mice,respectively,twice daily,0.2 mL per time,and the 5％minoxidil tincture group was topically applied with 5％minoxidil tincture on the skin on the neck and back of the mice,twice daily,0.1 mL per time.The interventions lasted for 23 days,during which testosterone solution[5 mg/(kg·d)]was topically applied on the skin on the neck and back of the mice to maintain the AGA model.The hair growth of the mice was observed and recorded by taking photos every week,and skin hair follicles were observed by using hematoxylin and eosin(HE)staining after the last intervention.The serum testosterone,estradiol(E2)and type Ⅱ 5-α reductase(5 AR2)levels were detected by using enzyme-linked immunosorbent assay(ELISA)and the testosterone/E2 ratio was calculated.The levels of transforming growth factor-β1(TGF-β1),tumor necrosis factor-α(TNF-α),interleukin-1 β(IL-1 β)and interleukin-6(IL-6)in the skin tissues of the neck and back of the mice were detected.Results After 23 days of interventions,compared with the model group,the number of skin hair follicles in the AB4 intervention groups was significantly increased(P＜0.05),with larger hair follicle volume.Moreover,the number of hair follicles in the medium-dose AB4 group and the high-dose AB4 group was larger than that in the 5％minoxidil tincture group(P＜0.05).The levels of serum testosterone,5AR2 and testosterone/E2 ratio in the AB4 intervention groups were significantly lower than those in the model group(P＜0.05),while the levels of E2 in the AB4 intervention groups were significantly higher than those in the model group(P＜0.05).The level of serum E2 in the high-dose AB4 group was higher than that in the 5％minoxidil tincture group,and the testosterone/E2 ratio in the high-dose AB4 group was lower than that in the 5％minoxidil tincture group,with statistically significant differences(P＜0.05).The levels of TGF-β1 and IL-6 in skin tissues of the AB4 intervention groups were significantly lower than those in the model group and the 5％minoxidil tincture group(P＜0.05).Conclusion AB4 may exert therapeutic effect on AGA by regulating serum hormone balance and inhibiting skin inflammatory response.

Abstract:Objective To explore influencing factors of postpartum urinary retention(PUR)in vaginal delivery primiparas without labor analgesia,and to provide evidence-based basis for the formulation of targeted preventive measures in clinical practice.Methods A total of 105 primiparas who were admitted to Beijing Obstetrics and Gynecology Hospital,Capital Medical University for vaginal delivery without labor analgesia from December 2021 to December 2024 were selected.According to whether the patients developed PUR,they were divided into non-PUR group(70 patients)and PUR group(35 patients).The general data and clinical indicators were compared between the two groups.Multivariate logistic regression was used to analyze the factors affecting the development of PUR and receiver operating characteristic(ROC)curve was used to analyze the efficacy of the research indicators in predicting PUR.Results There were statistically significant differences between the two groups in terms of postpartum hemorrhage volume,duration of the third stage of labor,classification of gestational weight gain,and midwifery method(P＜0.05).The results of multivariate logistic regression analysis indicated that excessive weight gain during pregnancy[OR(95％CI)=5.028(1.500-16.854),P=0.009],insufficient weight gain during pregnancy[OR(95％CI)=2.892(1.010-8.283),P=0.048]and large postpartum hemorrhage volume[OR(95％CI)=1.009(1.003-1.015),P=0.002]were independent risk factors for the development of PUR.The prediction model was constructed based on the above 3 risk factors.The results of ROC curve analysis indicated that the model could effectively predict the development of PUR[area under the curve(AUC)(95％CI)=0.762(0.663-0.861)],with a sensitivity of 65.7％,a specificity of 78.6％,and a Youden's index of 0.443.Conclusion The risk factors for the development of PUR after vaginal delivery in primiparas without labor analgesia are abnormal gestational weight gain(excessive weight gain or insufficient weight gain)and large postpartum hemorrhage volume.Reasonable management of weight during pregnancy and prevention and control of postpartum hemorrhage should be strengthened in clinical practice to reduce the incidence of PUR.

Abstract:Objective To explore the effect of syndrome-specific element nursing based on the integrated theory of health behavior change on gastrointestinal dysfunction in patients with acute pancreatitis.Methods A total of 120 patients with gastrointestinal dysfunction due to acute pancreatitis who were admitted to Northern Jiangsu People's Hospital from June 2022 to March 2024 were recruited as the research subjects.In the 120 patients,58 patients admitted to the hospital from June 2022 to July 2023 were included in the control group,and the other 62 patients admitted to the hospital from August 2023 to March 2024 were included in the observation group.The control group received conventional nursing intervention measures,while the observation group received syndrome-specific element nursing interventions based on the integrated theory of health behavior change.After 2 weeks of interventions,the recovery of gastrointestinal dysfunction,the levels of gastrointestinal function indicators,disease cognition,self-management ability and quality of life were compared between the two groups.Results After the interventions,compared with the control group,the observation group had shorter time of bowel sound recovery,shorter time of abdominal pain relief,shorter time to first flatus and shorter time to first defecation,and lower levels of D-lactic acid and diamine oxidase(DAO),and higher levels of motilin(MTL)and gastrin(GAS),and lower scores of Brief Illness Perception Questionnaire(BIPQ),and higher scores of Exercise of Self-Care Agency Scale(ESCA)and 36-Item Short Form Health Survey(SF-36),with statistically significant differences between the two groups(P＜0.05).Conclusion The syndrome-specific element nursing system based on the integrated theory of health behavior change can rapidly improve the gastrointestinal function of patients with gastrointestinal dysfunction caused by acute pancreatitis,enhance the patients' disease cognitive ability and self-management ability,and improve their quality of life.

Abstract:Objective To construct and validate a nomogram prediction model for multiple myeloma(MM)complicated with nervous system damage.Methods A retrospective analysis was conducted on the clinical data of 202 patients with MM who were admitted to the Affiliated Hospital of Southwest Medical University from October 2019 to October 2023.The patients were divided into the occurrence group(86 patients)and the non-occurrence group(116 patients)according to the occurrence of nervous system damage during the follow-up period.Multivariate logistic regression was used to analyze the influencing factors of MM complicated with nervous system damage.A nomogram prediction model for MM complicated with nervous system damage was constructed.The predictive efficacy of the model for MM complicated with nervous system damage was evaluated using receiver operating characteristic(ROC)curve,calibration curve,Hosmer-Lemeshow goodness-of-fit test and decision curve analysis(DCA).Results The incidence of MM complicated with nervous system damage was 42.57％.The results of multivariate logistic regression analysis showed that older age,higher levels of lactate dehydrogenase(LDH)and immunoglobulin(Ig)G,and International Staging System(ISS)stage Ⅲ were independent risk factors for MM complicated with nervous system damage(P＜0.05),and longer activated partial thromboplastin time(APTT),longer prothrombin time(PT),and higher hemoglobin level were independent protective factors for MM complicated with nervous system damage(P＜0.05).Based on the above 7 influencing factors,a nomogram prediction model for MM complicated with nervous system damage was constructed.The results of ROC curve analysis showed that the area under the curve of the model for predicting MM complicated with nervous system damage was 0.917(95％CI:0.861-0.956),and the sensitivity and specificity were 95.35％and 87.85％,respectively.The Hosmer-Lemeshow goodness-of-fit test results(x2=2.944,P=0.872)proved that the model had an adequate goodness-of-fit.The calibration curve showed that the predicted probability of the model was close to the actual probability,indicating a good calibration.DCA showed that net clinical benefits could be achieved when the prediction threshold probability of the model was between 20％and 93％,or between 94％and 100％.Conclusion The nomogram prediction model which is constructed for MM complicated with nervous system damage based on 7 influencing factors including age,LDH,IgG,APTT,PT,hemoglobin and ISS stage has good predictive value.

Abstract:Objective To analyze the expression characteristics of CD38 and CD138 in endometria of patients with failed in vitro fertilization-embryo transfer(IVF-ET)and their correlations with chronic endometritis(CE).Methods A total of 114 patients who underwent IVF-ET but failed to conceive in Changzhou Maternal and Child Health Care Hospital from April 2023 to September 2024 were recruited.All the patients underwent hysteroscopy and their endometrial tissues were obtained.The endometrial tissues of the patients were stained by using hematoxylin-eosin(HE)and the pathological typing was performed.The expressions of CD38 and CD138 were detected by using immunohistochemical staining,and according to the detection results the patients were divided into CD38+/CD138+group(34 cases),CD38+/CD138-group(37 cases),CD38-/CD138+group(23 cases)and CD38-/CD138-group(20 cases).The associations of the expressions of CD38 and CD138 with the occurrence of CE as well as the pregnancy outcomes of the patients who received assisted reproduction after doxycycline treatment were analyzed.Results In the 114 patients,the incidence of CE was 38.60％(44/114).There was a statistically significant difference in the incidence of CE among the four groups(P＜0.05),with the highest incidence of CE in the CD38+/CD138+group(70.59％).The difference in the proportion of normal endometria was statistically significant among the four groups(P＜0.05),with the highest normal rate(55.00％)in the CD38-/CD138-group.Among the 94 patients treated with doxycycline,48 patients(51.06％)became pregnant after assisted reproduction.The pregnancy rates of the CD38+/CD138+group,the CD38+/CD138-group and the CD38-/CD138+group were 35.29％(12/34),67.57％(25/37)and 47.83％(11/23),respectively.There was a statistically significant difference in the pregnancy rate among the three groups(x2=7.513,P=0.023),and the pregnancy rate of the CD38+/CD138+group was significantly lower than that of the CD38+/CD138-group(x2=7.395,P=0.007).The results of multivariate logistic regression analysis showed that CD38+/CD138+was an independent risk factor for pregnancy failure in patients after they received doxycycline treatment[OR(95％CI)=3.749(1.093-12.862),P=0.036].Conclusion The expressions of CD38 and CD138 are related to the occurrence of CE in patients with failed IVF-ET implantation and have impacts on the therapeutic effect of doxycycline.The individualized treatment strategies carried out on the basis of these results may help to improve the pregnancy outcomes of the patients.

Abstract:Pediatric hematopoietic stem cell transplantation(HSCT),as an important means of treating various malignant and non-malignant hematological diseases,has been widely applied in recent years.However,the conditioning protocols before transplantation,such as chemotherapy and radiotherapy,may cause irreversible damage to the gonadal function of the pediatric patients,potentially impacting their future fertility.Therefore,implementing fertility preservation measures is of great significance in pediatric HSCT.At present,relevant researches in this field at home and abroad are gradually increasing,but there are still problems such as non-standard application of technology and ethical disputes.This paper aims to review the latest progress of fertility preservation measures in pediatric HSCT,with an interpretion on Chinese Expert Consensus on Fertility Preservation for Female Patients Undergoing Hematopoietic Stem Cell Transplantation released in 2022,analyzing the current status,ethical challenges encountered,and future development directions of the existing technologies in clinical practice,in order to provide valuable reference and guidance for clinical practice.

Abstract:This paper reports the misdiagnosis of one case of nasopharyngeal carcinoma presenting with paralytic strabismus.

Abstract:Objective To observe the therapeutic effect of modified Xiaotong Anshen prescription in adjuvant treatment of gouty nephropathy(GN)and to explore the related mechanisms.Methods A total of 106 patients with GN who were admitted to Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine from April 2021 to March 2024 were recruited.The stages of chronic kidney disease of these patients were stages 3 to 4.The GN patients were divided into observation group and control group by using random number table method,with 53 patients in each group.The control group was treated with conventional Western medicine,while the observation group was treated with conventional Western medicine plus modified Xiaotong Anshen prescription.The treatment course for both groups was 3 weeks.The clinical efficacy,as well as the scores of traditional Chinese medicine(TCM)symptoms,renal function indicators[blood urea nitrogen(BUN),serum creatinine(Scr),24-hour urine total protein(24 h UTP),β2-microglobulin(β2-MG)],serum uric acid,erythrocyte sedimentation rate(ESR),and the levels of proteins related to the phosphoinositide 3-kinase(PI3K)/threonine kinase(AKT)/nuclear factor-κB(NF-κB)signaling pathway were compared between the two groups before and after treatment.The occurrence of adverse reactions during the patients'treatment period was recorded.Results The total clinical effective rate of the observation group was significantly higher than that of the control group(94.34％vs 77.36％,x2=6.290,P=0.012).After treatment,the TCM syndrome scores of joint skin redness and swelling,joint burning,joint pain,facial or lower limb edema,and heavy limbs in both groups were lower than those before treatment,and the TCM syndrome scores of the observation group were lower than those of the control group after treatment,with statistically significant differences(P＜0.05).After treatment,the levels of BUN,Scr,24 h UTP,β2-MG,serum uric acid and ESR in both groups were lower than those before treatment,and the levels in the observation group were lower than those in the control group after treatment,with statistically significant differences(P＜0.05).After treatment,the levels of phosphorylated PI3K(p-PI3K),phosphorylated AKT(p-AKT),and phosphorylated NF-κB(p-NF-κB)proteins in both groups were lower than those before treatment,and the levels in the observation group were lower than those in the control group after treatment,with statistically significant differences(P＜0.05).During the treatment period,1 case of diarrhea occurred in the observation group,and 2 cases of nausea and 2 cases of constipation occurred in the control group.There was no statistically significant difference in the total incidence of adverse reactions between the two groups(P＞0.05).Conclusion The modified Xiaotong Anshen prescription combined with Western medicine has definite effect and good safety in treatment of GN.It may play a therapeutic role through the PI3K/AKT/NF-κB signaling pathway.

Abstract:With the widespread application of general anesthesia techniques in pediatric patients,the effects of drugs for general anesthesia on their developing brain function have become one of the issues that people pay high attention to.The prolonged and repeated exposures of drugs for general anesthesia to infants and young children during their infancy and early childhood may lead to long-term cognitive and behavioral function impairments,significantly increasing the risk of developing diseases such as learning disabilities and attention deficit disorders.The neurotoxic mechanisms such as apoptosis,mitochondrial dysfunction and oxidative stress caused by early exposure to drugs for general anesthesia may be significant causes of long-term cognitive and behavioral function impairments in infants and young children.In this paper,the research progress in the effects of drugs for general anesthesia on brain development of infants and young children is reviewed.

Abstract:Objective To explore the feasibility and clinical efficacy of a novel hysteroscopic levonorgestrel-releasing intrauterine system(LNG-IUS)non-suture fixation in treatment of adenomyosis.Methods Forty-four patients with adenomyosis who were admitted to Beijing Tiantan Hospital,Capital Medical University from January 2024 to March 2025 and were treated with hysteroscopic LNG-IUS non-suture fixation for adenomyosis were selected.The patients'general data,clinical manifestations,operative duration,operative complications,postoperative LNG-IUS expulsion and other follow-up data were collected.The operation effects were assessed by using a one way ANOVA paired T test.Results A total of 44 patients were included,with average age of(40.16±4.54)years,average number of pregnancy of(2.30±1.62),average number of delivery of(1.14±0.80),average uterine cavity depth of(10.58±1.03)cm,average uterine volume of 130.31(90.60,174.04)mL,average operative duration of(14.54±5.01)min,and intraoperative blood loss of(4.59±3.34)mL.Among them,there were 36 cases(81.82％)of dysmenorrhea,44 cases(100.00％)of menorrhagia,23 cases(52.27％)of anemia,17 cases(38.64％)with a history of LNG-IUS expulsion,and 7 cases(15.91％)with a history of LNG-IUS dislodgement.Among the 44 patients,13 patients underwent hysteroscopic electroresection of endometrial polyps simultaneously,and 3 patients underwent electroresection of submucosal myoma of the uterus simultaneously,and 24 patients underwent aspiration of uterine lining to thin the endometrium at the same time.None of the patients presented with complications such as uterine perforation,massive hemorrhage,fluid overload and postoperative infection.The average postoperative follow-up time was(7.01±1.20)months,and no postoperative LNG-IUS expulsion occurred in all the patients.The follow-up results at 6 months after the operation showed that the effective rate of dysmenorrhea was 91.67％(33/36),and the effective rate of menorrhagia was 95.45％(42/44).At 1 month after the operation,the hemoglobin content of the patients was 124.00(114.50,130.00)g/L,which was significantly increased compared with that before the operation[108.00(96.25,118.75)g/L](Z=5.661,P＜0.001).At 1 month and 6 months after the operation,the patients'menstrual Pictorial Blood Loss Assessment Chart(PBLAC)scores,Visual Analogue Scale(VAS)scores for dysmenorrhea,and uterine volume were decreased compared with those before the operation,and the differences were statistically significant(P＜0.05).Conclusion The hysteroscopic LNG-IUS non-suture fixation is a safe and effective technique,especially suitable for adenomyosis patients with a history of LNC-IUS expulsion or a history of LNG-IUS dislodgement.This surgical method is simple to operate,minimally invasive,with a short operation time,less hemorrhage and a quick postoperative recovery in the patients,and thus is worthy of clinical application.

Abstract:Objective To explore the effects of different intervention movements on intravaginal pressure in research subjects.Methods A total of 163 subjects who underwent pelvic floor examination in Gynecological Pelvic Floor Center,Henan Provincial People's Hospital from June 2024 to August 2024 were selected,among whom 50 subjects who suffered from stress urinary incontinence(SUI)were selected as SUI group and 113 subjects without SUI were selected as non-SUI group.Using body mass index(BMI)≥28 kg/m2 as the obesity standard,there were 8 obese individuals(obese group)and 155 non-obese individuals(non-obese group).The changes in intravaginal pressure of the subjects under the conditions of lying on the back at rest,electrical stimulation of abdominal muscles,abdominal crunch movement,forceful coughing and forceful defecation were observed.Results For the subjects,their intravaginal pressure was the highest when they underwent forceful coughing movement[(111.02±15.37)cmH2O],followed by that when they underwent forceful defecation movement[(97.72±11.35)cmH2O],then followed by that when they underwent abdominal crunch movement[(87.15±10.72)cmH2O]and finally followed by that when they underwent electrical stimulation of abdominal muscles[(78.95±7.98)cmH2O].There were statistically significant differences between the intravaginal pressure measured under the conditions of different movements mentioned above and the intravaginal pressure measured under the condition of lying on the back at rest[(75.72±7.85)cmH2O](P＜0.001).Under the conditions of lying on the back at rest,electrical stimulation of abdominal muscles,abdominal crunch movement and forceful defecation movement,the intravaginal pressure of the SUI group was significantly higher than that of the non-SUI group(P＜0.05).However,there was no statistically significant difference in the intravaginal pressure between the two groups under the condition of forceful coughing movement(P＞0.05).Under the conditions of lying on the back at rest,electrical stimulation of abdominal muscles and abdominal crunch movement,the intravaginal pressure of the obese group was significantly higher than that of the non-obese group(P＜0.05),and under the conditions of forceful coughing movement and forceful defecation movement,there was no statistically significant difference in the intravaginal pressure between the two groups(P＞0.05).Conclusion Both forceful coughing and forceful defecation can exert considerable pressure on the pelvic floor,so in daily life,it is advisable to avoid forceful coughing and keep a normal bowel movement.Compared with abdominal crunch movement,electrical stimulation of abdominal muscles has a smaller impact on pelvic floor pressure.Therefore,electrical stimulation of abdominal muscles is a better choice for treating diastasis recti abdominis.

Abstract:Objective To explore the differences in effects of progesterone receptor membrane component 1(PGRMC1)in a nude mouse model with human breast cancer xenografts on the proliferation of breast cancer xenografts under the stimulation of progesterone and norethisterone(NET).Methods A human breast cancer cell line(MCF7)with stable expression of PGRMC1 was constructed.Thirty-six female BALB/c-nu nude mice were divided into MCF7/HA-PGRMC1 group(n=18)and MCF7/HA-Vector group(n=18)according to random number table method.Estradiol(E2)sustained-release tablets were subcutaneously embedded in the neck of each mouse.After subcutaneous embedding of E2 sustained-release tablets for 24 hours,MCF7/HA-PGRMC1 and MCF7/HA-Vector cell suspensions were respectively injected into the subcutaneous tissues on the left and right sides of the nude mice in the two groups at a dose of 150 μL,with a cell count of 1 × 107.When tumors grew to about 100 mm3 in size,the nude mice in the two groups were further divided into three subgroups:the E2+placebo subgroup(receiving subcutaneous embedding of E2 plus placebo)(n=6),the E2+progesterone subgroup(receiving subcutaneous embedding of E2 plus progesterone sustained-release tablets)(n=6)and the E2+NET subgroup(receiving subcutaneous embedding of E2 plus NET sustained-release tablets)(n=6).The volume changes of the tumors were recorded and tumor growth curves were plotted.After 45 days,the tumor tissues were completely excised,and immunohistochemical staining was performed to detect PGRMC1 and Ki67 expressions in the xenograft tissues.Results The MCF7/HA-PGRMC1 strain was successfully constructed.In the MCF7/HA-PGRMC1 group,there was no statistically significant difference in tumor growth between the E2+progesterone subgroup and the E2+placebo subgroup(P＞0.05),while the E2+NET subgroup showed significant tumor growth compared with the E2+placebo subgroup(P＜0.05).In the MCF7/HA-Vector group,there was no statistically significant difference in tumor growth between the E2+NET subgroup and the E2+placebo subgroup(P＞0.05)as well as between the E2+progesterone subgroup and the E2+placebo subgroup(P＞0.05).In the MCF7/HA-PGRMC1 group,Ki67 showed strong positive expression in the E2+NET subgroup,and PGRMC1 was positively correlated with Ki67 expression(r=0.892,P=0.014).Conclusion This experiment confirms that overexpression of PGRMC1 can specifically mediate the proliferation-promoting effect of NET combined with E2 on breast cancer in nude mice in vivo,while the combination with progesterone does not promote the additional proliferation.This discovery provides crucial animal experimental evidence for the selection of progesterone types in clinical hormone therapy.

Abstract:Objective To observe the application effect of Artificial Intelligence of Things(AIoT)wearable devices for walking with the function of treating stroke on rehabilitation training of ischemic stroke patients.Methods One hundred patients with ischemic stroke who were admitted to Longgang Central Hospital of Shenzhen from January 2023 to December 2024 were selected.The patients were divided into control group and observation group according to random number table method,with 50 patients in each group.The control group received routine rehabilitation training,while the observation group received walking training with AIoT-based wearable devices with the function of treating stroke plus daily routine rehabilitation training.The Holden Functional Walking Classification,modified Ashworth Scale for lower limb muscle tension,Brunnstrom Classification for lower limbs,joint range of motion and gait conditions were compared between the patients in the two groups before treatment and 4 weeks after treatment.Results Before treatment,there were no statistically significant differences in the grades of Holden Functional Walking Classification,grades of modified Ashworth Scale for lower limb muscle tension,grades of Brunnstrom Classification for lower limbs,joint range of motion and gait conditions between the two groups(P＞0.05).After treatment,the grades of Holden Functional Walking Classification,grades of modified Ashworth Scale for lower limb muscle tension,grades of Brunnstrom Classification for lower limbs,joint range of motion and gait conditions in the two groups were improved compared with those before treatment,and the improvements in the observation group were better than those in the control group,with statistically significant differences.Conclusion The application of AIoT-based wearable devices for walking with the function of treating stroke in rehabilitation training for patients with ischemic stroke can significantly improve their walking function,lower limb muscle tension,motor function and joint range of motion.

Abstract:Parkinson's disease(PD)is a common neurodegenerative disease with insidious onset and atypical early symptoms,posing challenges for early diagnosis and treatment.Eye movement abnormalities,as an important window reflecting the dysfunction of the central nervous system,show a good application prospect in the research of PD.In this paper,the research progress in pathological mechanisms and clinical application value of eye movement abnormalities in PD is reviewed.

Abstract:Endometriosis and adenomyosis are common chronic gynecological diseases in women of childbearing age,with pain,infertility and pelvic masses as the main clinical manifestations in endometriosis and diverse clinical manifestations in adenomyosis.The mechanisms by which endometriosis and adenomyosis affect fertility involve multiple aspects,including reduction of ovarian reserve function,alterations to the immune system and pelvic anatomy,impairments of endometrial receptivity and surgical-related iatrogenic injuries,which negatively affect female fertility and lead to infertility.This paper provides an in-depth interpretation of the latest guidelines and expert consensuses at home and abroad according to evidence-based researches.It systematically sorts out the diagnosis and treatment strategies related to fertility in endometriosis and adenomyosis women complicated with infertility,providing comprehensive references for clinicians to gain a deep understanding of these diseases and their clinical practice.