Objective To observe clinical efficacy of warm-promotion needling for the treatment of cold coagulation and blood stasis of primary dysmenorrhea.Methods Totally 120 patients with cold coagulation and blood stasis of primary dysmenorrhea were randomly divided into warm-promotion needling group (60 cases) and control group (60 cases). Warm-promotion needling group was treated with warm-promotion needling at Guanyuan (RN4), Sanyinjiao (SP6), Shiqizhui (EX-B8), and Diji (SP8), and cooperated with Ciliao (BL32), Hegu (LI4), and Taichong (LR3). Control group took same acupoints and applied uniform reforcing-reducing method. The two groups began treatment 5-7 d before menstruation, 1 times a day, for 7 times. The treatment was given 3 menstrual cycles. The visual analogue scale (VAS) and COX menstrual symptom scale (CMSS) were used to observe the pain degree at the end of 1, 2, 3 menstrual cycles. The clinical efficacy was evaluated 3 months after treatment.Results The scores of VAS and CMSS was obviously reduced in the two groups after the treatment compared with those before treatment (P<0.01). The synperiodic scores of VAS and CMSS in warm-promotion needling group was obviously lower than those in the control group (P<0.05). The total effective rate of warm-promotion needling group was 96.67% (58/60), and the control group was 73.33% (44/60), the difference was significant (P<0.05).Conclusion Warm- promotion needling can obviously relieve dysmenorrhea symptoms and shorten the time of pain of patients with cold coagulation and blood stasis of primary dysmenorrhea, which has affirmative clinical efficacy.

Objective To compare the characteristics of intrahepatic cholangiocarcinoma (ICC) and different differentiated hepatocellular carcinoma (HCC) by CEUS and evaluate the diagnostic value of CEUS.Methods The cases who underwent CEUS and were pathologically demonstrated as ICC (n=34) and HCC (n=136) were observed.The characteristics of ICC and different differentiated HCC in conventional ultrasound and CEUS were analyzed,and the diagnostic efficiency of wash out time were calculated.Results ICC had higher percentage (24/34,70.59％) of washout emerging in early portal phase than those of HCC.And ICC had lower percentage (0;4/34,11.76％) of washout emerging in middle and late portal phase than poorly and moderate differentiated HCC.Poorly differentiated HCCs had higher percentage (16/41,39.02％) of washout emerging in middle portal phase than well differentiated HCC.The sensitivity,specificity,positive predictive value,negative predictive value,accuracy,positive likelihood ratio and negative likelihood ratio of washout time in diagnosis of ICC were 82.35 ％ (28/34),91.18％ (124/136),70.00％ (28/40),95.38％ (124/130),89.41％ (152/170),9.4,0.2,respectively.The rise time of ICC and well,moderate and poorly differentiated HCC were (13.03 ± 3.49) s,(13.80 ± 3.04)s,(14.89±4.12)s,(16.00±3.38)s,respectively,and the difference was significant (F=4.369,P＜0.05).The rise time of ICC was significantly higher than that of well differentiated HCC (P＜0.05).Conclusion The CEUS performances are different significantly among ICCs and different differentiated HCCs,which has value for the differential diagnosis.

Objective To observe the effect of atropine in the treatment of bromiderosis with anhydrous alcohol injection. Methods Patients were randomly divided into two groups (A and B): the patients in Group A was injected with both anhydrous alcohol and atropine, and that in Group B was only injected with anhydrous alcohol. The effect of the operation was evaluated at 1, 3 and 6 months after the treatment. Results From August 2004 to January 2008, 72 patients were involved in this study. 37 cases were included in Group A, and 35 patients were included in Group B. The effective rate in the Group A was 83.78 %, and that in the Group B was 82.86 %. There was no statistical difference between these two groups. Conclusion Atropine has no effect on the treatment of axillary bromidrosis with anhydrous alcohol injection and it is, therefore, not necessarily included in the treatment.

Objective:To evaluate the safety and feasibility of the in-situ needle fenestration combined with the in vitro physician modified fenestration technique to reconstruct supra-aortic branches during thoracic endovascular aortic repair (TEVAR) for aortic arch lesions requiring landing at Z0 and Z1.Methods:From Nov 2017 to Dec 2019, eighteen patients who underwent both the in-situ needle fenestration and the in vitro physician modified fenestration techniques to extend the proximal landing zone to Z0 and Z1 during TEVAR were included in our study.Results:Sixteen patients underwent in vitro physician modified fenestration ,two patients underwent in vitro physician modified fenestration to reconstruct both the left common carotid artery and the innominate artery. All eighteen patients received in-situ needle fenestration to preserve the left subclavian artery. Supra aortic branches were preserved in all patients (38/38, 100%). There was no Type Ⅰ endoleak. Type Ⅱ endoleak was found in four paitnets (4/18). Type Ⅲ endoleak occurred in one patient (1/18). Type Ⅳ endoleak in four patients (4/18). Type Ⅲ endoleak needed open aortic arch repair 6 months later. The median follow-up time was 12 months. One (1/18) died in 12 months and the other patients were doing well.Conclusions:The joint application of the in-situ needle fenestration and the in vitro physician modified fenestration to reconstruct supra-aortic branches during TEVAR for aortic arch pathologies requiring landing at Z0 and Z1 was satisfactory.

Objective To investigate the application value of the ultrasonic elastic tissue dispersion quantitative analysis technique in different stages of subacute thyroiditis (SAT).Methods One hundred and forty-four SAT lesions detected from 81 patients were enrolled in the patient group.They were further divided into three subgroups,including acute group (group Ⅰ),medium group (group Ⅱ) and recovery group (group Ⅲ).Another 59 healthy volunteers were collected as control group.All the participants accepted conventional ultrasound and elastographic examinations.Eleven parameters were obtained by the tissue dispersion quantitative analysis software.These parameters were compared between groups and among subgroups by ANOVA.The correlation between all the parameters and the course of SAT were analyzed by Spearman and Multiple linear regression methods.Results Between groups and among subgroups,the complexity (COMP) and correlation (CORR) were not statistically different(all P ＞0.05).Differences of kurtosis (KURT) and angular secon moment (ASM) among the three subgroups were not significant (all P ＞0.05).Differences between groups and among subgroups were significantly different among the value of all the other seven indexes (all P ＜0.01).Moreover,they were all correlated with the clinical staging,with the highest coefficient in area ration of low-strain region (％ AREA)(r =-0.881).Regression model was constructed and only ％ AREA was selected into the regression equation.ROC curves were constructed to estimate the clinic value of ％ AREA in staging patients of SAT,the areas under ROC curves were0.986(group Ⅰ vs group Ⅱ-Ⅲ) and 0.988 (group Ⅰ-Ⅱ vs group Ⅲ[) for ％AREA,respectively.Conclusions The tissue dispersion quantitative analysis technique is helpful in estimating the stiffness of thyroid in patients with SAT.

As a stressor, burn not only causes physical damage to the patient, but also causes depression and anxiety, which is not conducive to the rehabilitation and restoration of normal life of the patient. The results of studies on the incidence of depression and anxiety disorders in burn patients are different, and the possible pathogenesis remains to be studied. Whether the screening scales of depression and anxiety disorders that are suitable for the general population are equally suitable for burn patients remains questionable. The efficacy of non-pharmaceutical therapy for depression and anxiety disorders in burn patients remains to be studied. This article reviews the possible pathogenesis of depression and anxiety disorders in burn patients, the commonly used screening scales, and the progress of non-pharmaceutical therapy in recent years, aiming to provide a reference for accurately assessing depression and anxiety disorders in burn patients.

Objective:To investigate the pathogenic genes, clinical features and treatment as well as follow-up of children with congenital long QT syndrome (LQTS).Methods:The clinical data, genetic test results and follow-up data of 16 congenital LQTS children with syncope as the first manifestation admitted to the Department of Cardiology, Beijing Children′s Hospital Affiliated to Capital Medical University from August 2016 to March 2023 were collected and retrospectively analyzed.Results:Among the 16 LQTS patients, the age of first syncope onset was 1.3-13.3 (7.37±3.41) years, and the interval between first syncope onset and clinical diagnosis was 0-48 (14.8±16.2) months.A total of 13 (81.3%) patients had triggers of syncope, of which nine were exercise-induced and four were emotional induced.Genetic testing was performed in 13 patients with LQTS, of which 12 (92.3%) were found to have pathogenic or suspected pathogenic mutations from KCNQ1, KCNH2, and SCN5A gene.The corrected QT interval of 16 patients was (550.0±50.2) ms, all cases≥460 ms.Schwartz scored 6.0 (5.0, 6.0) points, all cases≥4 points.All patients were initially treated with metoprolol or propranolol, of which 14 patients were followed up to date, three patients had recurrent syncope, and five patients stopped taking the medicines by themselves.One patient with high-dose metoprolol (LQT2) was treated with mexiletine after recurrent episodes.One patient who was intolerant to high-dose propranolol underwent left cardiac sympathectomy and was followed up after surgery without syncope episodes.None of the patients underwent implantable cardioverter defibrillator implantation. Conclusion:Children with LQTS and syncope symptoms have high positive rate of genetic tests.The genetic results could assist typing of patients with LQTS and guide treatment.Routine electrocardiogram screening in children with syncope may diagnose LQTS earlier and reduce misdiagnosis and missed diagnosis.β-blockers are the cornerstone of treatment for patients with LQTS.Strengthening follow-up management and improving patients′ treatment compliance is conducive to further improving the treatment response rate of patients.

Objective To evaluate the effectiveness of tumor cell Vimentin combined with endoscopic ultrasound-guided fine-needle biopsy(EUS-FNB)in diagnosing solid pancreatic tumors.Methods Clinical data from 110 patients who underwent EUS-FNB from October 2021 to December 2023 were retrospectively analyzed.Solid pancreatic tumors including but not limited to pancreatic cancer and pancreatic neuroendocrine tumors.The sensitivity,specificity,and accuracy of EUS-FNB were assessed by comparing its results with the final pathological diagnoses.Result Clear histopathological diagnoses were obtained in 106 cases,accounting for 96.37%.Among them,87 cases were definitively diagnosed as adenocarcinoma or pancreatic ductal adenocarcinoma.Immunohistochemical staining showed that Vimentin was expressed in the tumor cells.There was no statistically significant difference in positive rates among biopsies from different anatomical sites(P>0.05),but significant differences were observed in lesions of different diameters(P<0.05).Immunohistochemical staining suggested that Vimentin expression levels might be associated with the nature of the lesions.The overall diagnostic accuracy,sensitivity,and specificity of Vimentin combined with EUS-FNB for pancreatic masses were 86.09%,84.57%,and 100.00%,respectively.Specifically,for solid masses,the diagnostic accuracy,sensitivity,and specificity were 87.67%,86.55%,and 100.00%,respectively.For pancreatic cystic tumors,the diagnostic accuracy,sensitivity,and specificity were 65.42%,69.79%,and 100.00%,respectively.Conclusion The combination of tumor cell Vimentin and EUS-FNB demonstrates high diagnostic accuracy for solid pancreatic tumors,making it a valuable tool for clinical application.

Objective: To evaluate the scale, efficiency and quality of secondary and tertiary public hospitals in Anhui province, and analyze the degree of coupling and coordination among the three dimensions. Methods: Thirty-two hospitals′ data were extracted from the direct reporting system of Anhui Health Commission. Hospital efficiency was evaluated by DEA model, hospital quality was evaluated by TOPSIS model, and coupling coordination degree was analyzed by coupling function. Results: In the single-dimension evaluation, there were significant differences in the distribution of the three dimensions among different levels of hospitals, and the efficiency and quality of secondary hospitals were better than those of tertiary hospitals. In the coupling evaluation, the average degree of coupling coordination in Anhui was 0.637, which was in the " primary coordination" level. The overall coupling and coordination degree of the tertiary hospitals were better than that of the secondary hospitals, and the highest score was in central Anhui. Conclusions Single-dimensional evaluation method cannot objectively represent a general picture of the hospitals. On the other hand, coupling coordination degree evaluation can provide a more comprehensive and objective result. The development strategy of hospitals should be made to fit local conditions and to coordinate the development of scale, efficiency and quality.

Objective:To study the efficacy of laparoscopic limited anatomical hepatectomy (LLAH) for hepatocellular carcinoma (HCC) within the right anterior section.Methods:The clinical data of 144 patients with HCC confined in the right anterior section undergoing hepatectomy at the First Affiliated Hospital of Army Medical University from January 2015 to December 2022 were retrospectively analyzed, including 122 males and 22 females, aged (54.5±9.7) years. Patients were divided into LLAH ( n=27), laparoscopic anatomical hepatectomy (LAH, n=69), and laparoscopic non-anatomical hepatectomy (LNAH, n=48). Propensity score matching was used to compare the operative time, postoperative hospital stay, postoperative complications, serum total bilirubin and albumin, and the prognostic indicators such as tumor-free survival (DFS) rate and cumulative survival rate between the groups. Results:After propensity score matching, there were 26 cases each in LLAH and LNAH group. There was no significant difference in operative time, intraoperative blood loss and postoperative hospital stay between LLAH group and LNAH group (all P<0.05). The total bilirubin and albumin in LLAH on the third day after operation were [ M( Q1, Q3)] 24.1(20.9, 29.1) μmol/L and (35.8±2.9) g/L, better than those in LNAH group 39.3(33.2, 57.0) μmol/L and (33.9±2.5) g/L, respectively. The 1- and 3-year DFS rates in LLAH group were 92.3% and 57.7%, higher than those in LNAH group (80.8% and 19.2%) (all P<0.05). After propensity score matching, there were 25 patients each in LLAH and LAH group. The operative time, postoperative hospital stay and postoperative complications of LLAH group were lower than those of LAH group, and the liver function parameters of LLAH group was also better than those of LAH group (all P<0.05). There was no significant difference in DSF rate between the two groups LLAH group and LAH group ( χ2=0.10, P=0.800). Conclusions:The perioperative outcome of LLAH for HCC within the right anterior section are similar to that of LNAH and better than that of LAH. The DFS of LLAH were better than that of LNAH and similar to that of LAH.