Objective:Previous studies have demonstrated that the metals cadmium and arsenic exhibit estrogen-like effects and may influence the occurrence and development of gynecological tumors.This study aims to explore the as...Objective:Previous studies have demonstrated that the metals cadmium and arsenic exhibit estrogen-like effects and may influence the occurrence and development of gynecological tumors.This study aims to explore the association between urinary cadmium and arsenic levels and the prevalence of gynecologic cancers using data from the National Health and Nutrition Examination Survey(NHANES).Methods:Data from female participants in NHANES 2003—2018 were analyzed.Using R software,datasets(DEMO,BMX,etc.)were merged,and complete cases were retained by intersecting row names,yielding a total of 2999 participants.After applying strict exclusion criteria,2802 participants were included:83 with gynecologic cancer(cancer group)and 2719 without(control group).Demographic,reproductive health,and urinary cadmium and arsenic data were collected.Binary Logistic regression models were employed to assess associations between urinary cadmium and arsenic levels and gynecologic cancer risk.Results:High urinary cadmium and arsenic levels were risk factors for gynecologic cancers,with odds ratios(ORs)of 1.623(95%CI 1.217 to 2.166)and 1.003(95%CI 1.001 to 1.005),respectively.After propensity score matching(PSM),the trend remained;cadmium was still a statistically significant risk factor with an OR of 2.182(95%CI 1.343 to 3.545),while arsenic’s association,though not statistically significant,still trended toward risk(OR=1.004,95%CI 0.999 to 1.009).Subgroup analyses showed that both cadmium and arsenic were risk factors for ovarian cancer(OR=1.745,95%CI 1.178 to 2.586 and OR=1.005,95%CI 1.002 to 1.008,respectively);these associations persisted after PSM.Additionally,cadmium increased the risk of endometrial cancer(OR=1.617,95%CI 1.109 to 2.356).Conclusion:Exposure to cadmium and arsenic is associated with an increased risk of ovarian and endometrial cancers.These findings suggest that reducing environmental exposure to heavy metals such as cadmium and arsenic may help prevent certain gynecologic cancers.展开更多
Objective:Urinary calculi are characterized by a high recurrence rate,and patients’adherence to self-management after discharge directly affects health outcomes.Traditional offline follow-up models often face problem...Objective:Urinary calculi are characterized by a high recurrence rate,and patients’adherence to self-management after discharge directly affects health outcomes.Traditional offline follow-up models often face problems such as poor compliance and uneven allocation of medical resources,making it difficult to meet individualized health management needs.Remote follow-up provides a novel solution to optimize long-term management,improve health literacy,and enhance clinical outcomes.This study aims to evaluate the effect of remote follow-up under an intelligent medical collaborative model on quality of life and health-promoting lifestyle in patients with urinary calculi,and to assess its short-term impact on clinical outcomes.Methods:A total of 118 patients with urinary calculi admitted to a tertiary hospital in Hunan Province between August and November 2024 were recruited and randomly assigned to a control group(n=59)or an intervention group(n=59).The control group received routine departmental follow-up,while the intervention group underwent remote follow-up based on an intelligent medical collaborative model for one month.Assessments were conducted before discharge(T0),15 days after discharge(T1),and one month after discharge(T2),using the Wisconsin Stone Quality of Life Questionnaire and the Health-Promoting Lifestyle Profile.At T2,the incidence of forgotten ureteral stents(FUS),ureteral stent-related complications,unplanned readmissions,and patient satisfaction were evaluated.Results:No significant differences were observed between groups at T0 in baseline characteristics or outcome measures(all P>0.05).At T1 and T2,the intervention group had significantly higher health-related quality of life scores than the control group(P<0.05).Generalized estimating equation(GEE)analysis showed significant between-group effects(Wald's χ^(2)=22.961,P<0.001),time effects(Wald's χ^(2)=23.065,P<0.001),and interaction effects(Wald's χ^(2)=6.930,P<0.05).Similarly,at T1 and T2,the intervention group scored significantly higher on health-promoting lifestyle than the control group(P<0.05),with significant between-group effects(Wald's χ^(2)=22.936,P<0.001),time effects(Wald's χ^(2)=10.694,P<0.001),and interaction effects(Wald's χ^(2)=18.921,P<0.05).No significant differences were found between groups in the incidence of FUS,ureteral stent-related complications,or unplanned readmissions(all P>0.05).Patient satisfaction was significantly higher in the intervention group(t=4.089,P<0.001).Conclusion:Remote follow-up under an intelligent medical collaborative model helps improve quality of life,promote health-oriented lifestyles,and enhance patient satisfaction among individuals with urinary calculi.展开更多
Objective To observe the value of self-supervised deep learning artificial intelligence(AI)noise reduction technology based on the nearest adjacent layer applicated in ultra-low dose CT(ULDCT)for urinary calculi.Metho...Objective To observe the value of self-supervised deep learning artificial intelligence(AI)noise reduction technology based on the nearest adjacent layer applicated in ultra-low dose CT(ULDCT)for urinary calculi.Methods Eighty-eight urinary calculi patients were prospectively enrolled.Low dose CT(LDCT)and ULDCT scanning were performed,and the effective dose(ED)of each scanning protocol were calculated.The patients were then randomly divided into training set(n=75)and test set(n=13),and a self-supervised deep learning AI noise reduction system based on the nearest adjacent layer constructed with ULDCT images in training set was used for reducing noise of ULDCT images in test set.In test set,the quality of ULDCT images before and after AI noise reduction were compared with LDCT images,i.e.Blind/Referenceless Image Spatial Quality Evaluator(BRISQUE)scores,image noise(SD ROI)and signal-to-noise ratio(SNR).Results The tube current,the volume CT dose index and the dose length product of abdominal ULDCT scanning protocol were all lower compared with those of LDCT scanning protocol(all P<0.05),with a decrease of ED for approximately 82.66%.For 13 patients with urinary calculi in test set,BRISQUE score showed that the quality level of ULDCT images before AI noise reduction reached 54.42%level but raised to 95.76%level of LDCT images after AI noise reduction.Both ULDCT images after AI noise reduction and LDCT images had lower SD ROI and higher SNR than ULDCT images before AI noise reduction(all adjusted P<0.05),whereas no significant difference was found between the former two(both adjusted P>0.05).Conclusion Self-supervised learning AI noise reduction technology based on the nearest adjacent layer could effectively reduce noise and improve image quality of urinary calculi ULDCT images,being conducive for clinical application of ULDCT.展开更多
Objective:Pelvic floor sensory training is commonly used in clinical practice for the treatment of stress urinary incontinence(SUI);however,there is a lack of comparative studies evaluating pelvic floor sensation betw...Objective:Pelvic floor sensory training is commonly used in clinical practice for the treatment of stress urinary incontinence(SUI);however,there is a lack of comparative studies evaluating pelvic floor sensation between women with SUI and healthy controls.Additionally,normative data for two-point discrimination thresholds in the female pelvic floor region remain scarce.This study aims to compare the results of 4 sensory tests in the pelvic floor region between women with mild SUI and healthy women,in order to provide reference values for two-point discrimination thresholds in this area.Methods:From April 1 to October 30,2023,108 healthy women[(32.5±3.6)years]and 90 women with mild SUI[(32.9±3.3)years]were recruited from the Third Xiangya Hospital,Central South University.Participants underwent 4 sensory tests in the pelvic floor region:Two-dot discrimination,weight perception,shape recognition,and 9-grid localization.The results were compared between the 2 groups.Results:Compared with healthy women,those with mild SUI had lower sensitivity and higher thresholds in 2-dot discrimination tests in the pelvic floor region(all P<0.001).No significant differences were found between groups in weight perception,shape recognition,or grid localization tests(P>0.05).Conclusion:Women with mild stress urinary incontinence have impaired two-point discrimination ability in the pelvic floor region.展开更多
Objective:Stress urinary incontinence(SUI)is a common condition among women that severely impairs quality of life.Pelvic floor proprioceptive training(PFPT)has attracted increasing attention for its potential to enhan...Objective:Stress urinary incontinence(SUI)is a common condition among women that severely impairs quality of life.Pelvic floor proprioceptive training(PFPT)has attracted increasing attention for its potential to enhance pelvic floor muscle function and alleviate SUI symptoms.This study aims to observe and compare the clinical efficacy of PFPT combined with electroacupuncture,electrical stimulation,and biofeedback therapy versus conventional therapy consisting of electroacupuncture,electrical stimulation,and biofeedback alone in women with SUI,and to explore the role of PFPT in improving symptom and functional outcomes.Methods:In this randomized controlled trial,72 women with mild to moderate SUI were recruited from the Department of Rehabilitation Medicine at Third Xiangya Hospital,Central South University,between December 2021 and October 2023.Participants were randomly assigned to an experimental group(n=36)or a control group(n=36).Both groups received health education.The control group underwent electroacupuncture combined with electrical stimulation and biofeedback therapy,while the experimental group additionally received PFPT 3 times per week for 4 weeks.The primary outcome was assessed using the International Consultation on Incontinence Questionnaire-Short Form(ICIQ-SF).Secondary outcomes included pelvic floor muscle strength,bladder neck mobility,and balance ability.The ICIQ-SF was reassessed at 1,3,6,and 12 months post-treatment.Results:Both groups showed statistically significant improvements in all parameters after treatment(all P<0.05).However,there were no statistically significant differences between groups in most measures(all P>0.05).The experimental group demonstrated longer singleleg stance duration with eyes closed than the control group(left leg:P=0.026;right leg:P=0.006),with a significant increase from baseline(P<0.001).At 6 months post-treatment,the cure rate in the experimental group was significantly higher than that in the control group(P=0.037).Conclusion:Conventional therapy effectively improves SUI symptoms,but adding PFPT provides notable additional benefits,including enhanced balance ability and sustained midterm cure rates.These findings suggest that PFPT is a valuable adjunct to standard SUI management strategies.展开更多
基金supported by the Science and Technology Innovation Program of Hunan Province,China(2020SK2073).
文摘Objective:Previous studies have demonstrated that the metals cadmium and arsenic exhibit estrogen-like effects and may influence the occurrence and development of gynecological tumors.This study aims to explore the association between urinary cadmium and arsenic levels and the prevalence of gynecologic cancers using data from the National Health and Nutrition Examination Survey(NHANES).Methods:Data from female participants in NHANES 2003—2018 were analyzed.Using R software,datasets(DEMO,BMX,etc.)were merged,and complete cases were retained by intersecting row names,yielding a total of 2999 participants.After applying strict exclusion criteria,2802 participants were included:83 with gynecologic cancer(cancer group)and 2719 without(control group).Demographic,reproductive health,and urinary cadmium and arsenic data were collected.Binary Logistic regression models were employed to assess associations between urinary cadmium and arsenic levels and gynecologic cancer risk.Results:High urinary cadmium and arsenic levels were risk factors for gynecologic cancers,with odds ratios(ORs)of 1.623(95%CI 1.217 to 2.166)and 1.003(95%CI 1.001 to 1.005),respectively.After propensity score matching(PSM),the trend remained;cadmium was still a statistically significant risk factor with an OR of 2.182(95%CI 1.343 to 3.545),while arsenic’s association,though not statistically significant,still trended toward risk(OR=1.004,95%CI 0.999 to 1.009).Subgroup analyses showed that both cadmium and arsenic were risk factors for ovarian cancer(OR=1.745,95%CI 1.178 to 2.586 and OR=1.005,95%CI 1.002 to 1.008,respectively);these associations persisted after PSM.Additionally,cadmium increased the risk of endometrial cancer(OR=1.617,95%CI 1.109 to 2.356).Conclusion:Exposure to cadmium and arsenic is associated with an increased risk of ovarian and endometrial cancers.These findings suggest that reducing environmental exposure to heavy metals such as cadmium and arsenic may help prevent certain gynecologic cancers.
基金supported by the Innovation Platform’s Open Foundation of Education Department of Hunan Province(18K004)the Natural Science Foundation of Hunan Province(2025JJ50508),China.
文摘Objective:Urinary calculi are characterized by a high recurrence rate,and patients’adherence to self-management after discharge directly affects health outcomes.Traditional offline follow-up models often face problems such as poor compliance and uneven allocation of medical resources,making it difficult to meet individualized health management needs.Remote follow-up provides a novel solution to optimize long-term management,improve health literacy,and enhance clinical outcomes.This study aims to evaluate the effect of remote follow-up under an intelligent medical collaborative model on quality of life and health-promoting lifestyle in patients with urinary calculi,and to assess its short-term impact on clinical outcomes.Methods:A total of 118 patients with urinary calculi admitted to a tertiary hospital in Hunan Province between August and November 2024 were recruited and randomly assigned to a control group(n=59)or an intervention group(n=59).The control group received routine departmental follow-up,while the intervention group underwent remote follow-up based on an intelligent medical collaborative model for one month.Assessments were conducted before discharge(T0),15 days after discharge(T1),and one month after discharge(T2),using the Wisconsin Stone Quality of Life Questionnaire and the Health-Promoting Lifestyle Profile.At T2,the incidence of forgotten ureteral stents(FUS),ureteral stent-related complications,unplanned readmissions,and patient satisfaction were evaluated.Results:No significant differences were observed between groups at T0 in baseline characteristics or outcome measures(all P>0.05).At T1 and T2,the intervention group had significantly higher health-related quality of life scores than the control group(P<0.05).Generalized estimating equation(GEE)analysis showed significant between-group effects(Wald's χ^(2)=22.961,P<0.001),time effects(Wald's χ^(2)=23.065,P<0.001),and interaction effects(Wald's χ^(2)=6.930,P<0.05).Similarly,at T1 and T2,the intervention group scored significantly higher on health-promoting lifestyle than the control group(P<0.05),with significant between-group effects(Wald's χ^(2)=22.936,P<0.001),time effects(Wald's χ^(2)=10.694,P<0.001),and interaction effects(Wald's χ^(2)=18.921,P<0.05).No significant differences were found between groups in the incidence of FUS,ureteral stent-related complications,or unplanned readmissions(all P>0.05).Patient satisfaction was significantly higher in the intervention group(t=4.089,P<0.001).Conclusion:Remote follow-up under an intelligent medical collaborative model helps improve quality of life,promote health-oriented lifestyles,and enhance patient satisfaction among individuals with urinary calculi.
文摘Objective To observe the value of self-supervised deep learning artificial intelligence(AI)noise reduction technology based on the nearest adjacent layer applicated in ultra-low dose CT(ULDCT)for urinary calculi.Methods Eighty-eight urinary calculi patients were prospectively enrolled.Low dose CT(LDCT)and ULDCT scanning were performed,and the effective dose(ED)of each scanning protocol were calculated.The patients were then randomly divided into training set(n=75)and test set(n=13),and a self-supervised deep learning AI noise reduction system based on the nearest adjacent layer constructed with ULDCT images in training set was used for reducing noise of ULDCT images in test set.In test set,the quality of ULDCT images before and after AI noise reduction were compared with LDCT images,i.e.Blind/Referenceless Image Spatial Quality Evaluator(BRISQUE)scores,image noise(SD ROI)and signal-to-noise ratio(SNR).Results The tube current,the volume CT dose index and the dose length product of abdominal ULDCT scanning protocol were all lower compared with those of LDCT scanning protocol(all P<0.05),with a decrease of ED for approximately 82.66%.For 13 patients with urinary calculi in test set,BRISQUE score showed that the quality level of ULDCT images before AI noise reduction reached 54.42%level but raised to 95.76%level of LDCT images after AI noise reduction.Both ULDCT images after AI noise reduction and LDCT images had lower SD ROI and higher SNR than ULDCT images before AI noise reduction(all adjusted P<0.05),whereas no significant difference was found between the former two(both adjusted P>0.05).Conclusion Self-supervised learning AI noise reduction technology based on the nearest adjacent layer could effectively reduce noise and improve image quality of urinary calculi ULDCT images,being conducive for clinical application of ULDCT.
基金supported by the Key Research and Development Program of Hunan Province,China(2023SK2038).
文摘Objective:Pelvic floor sensory training is commonly used in clinical practice for the treatment of stress urinary incontinence(SUI);however,there is a lack of comparative studies evaluating pelvic floor sensation between women with SUI and healthy controls.Additionally,normative data for two-point discrimination thresholds in the female pelvic floor region remain scarce.This study aims to compare the results of 4 sensory tests in the pelvic floor region between women with mild SUI and healthy women,in order to provide reference values for two-point discrimination thresholds in this area.Methods:From April 1 to October 30,2023,108 healthy women[(32.5±3.6)years]and 90 women with mild SUI[(32.9±3.3)years]were recruited from the Third Xiangya Hospital,Central South University.Participants underwent 4 sensory tests in the pelvic floor region:Two-dot discrimination,weight perception,shape recognition,and 9-grid localization.The results were compared between the 2 groups.Results:Compared with healthy women,those with mild SUI had lower sensitivity and higher thresholds in 2-dot discrimination tests in the pelvic floor region(all P<0.001).No significant differences were found between groups in weight perception,shape recognition,or grid localization tests(P>0.05).Conclusion:Women with mild stress urinary incontinence have impaired two-point discrimination ability in the pelvic floor region.
基金supported by the Natural Science Foundation of Hunan Province(2024JJ8121,2024JJ6626)the Hunan Provincial Key Research and Development Program(2023SK2038),China.
文摘Objective:Stress urinary incontinence(SUI)is a common condition among women that severely impairs quality of life.Pelvic floor proprioceptive training(PFPT)has attracted increasing attention for its potential to enhance pelvic floor muscle function and alleviate SUI symptoms.This study aims to observe and compare the clinical efficacy of PFPT combined with electroacupuncture,electrical stimulation,and biofeedback therapy versus conventional therapy consisting of electroacupuncture,electrical stimulation,and biofeedback alone in women with SUI,and to explore the role of PFPT in improving symptom and functional outcomes.Methods:In this randomized controlled trial,72 women with mild to moderate SUI were recruited from the Department of Rehabilitation Medicine at Third Xiangya Hospital,Central South University,between December 2021 and October 2023.Participants were randomly assigned to an experimental group(n=36)or a control group(n=36).Both groups received health education.The control group underwent electroacupuncture combined with electrical stimulation and biofeedback therapy,while the experimental group additionally received PFPT 3 times per week for 4 weeks.The primary outcome was assessed using the International Consultation on Incontinence Questionnaire-Short Form(ICIQ-SF).Secondary outcomes included pelvic floor muscle strength,bladder neck mobility,and balance ability.The ICIQ-SF was reassessed at 1,3,6,and 12 months post-treatment.Results:Both groups showed statistically significant improvements in all parameters after treatment(all P<0.05).However,there were no statistically significant differences between groups in most measures(all P>0.05).The experimental group demonstrated longer singleleg stance duration with eyes closed than the control group(left leg:P=0.026;right leg:P=0.006),with a significant increase from baseline(P<0.001).At 6 months post-treatment,the cure rate in the experimental group was significantly higher than that in the control group(P=0.037).Conclusion:Conventional therapy effectively improves SUI symptoms,but adding PFPT provides notable additional benefits,including enhanced balance ability and sustained midterm cure rates.These findings suggest that PFPT is a valuable adjunct to standard SUI management strategies.
