Objective: To observe and compare the clinical effects of different electroacupuncture waveforms on primary dysmenorrhea. Methods: This was a prospective, randomized, three-group, parallel-controlled trial. Participants with primary dysmenorrhea were randomly divided into dense-sparse wave, continuous wave, and discontinuous wave groups in a 1:1:1 ratio. Two lateral Ciliao (BL 32) points were used. All three groups started treatment 3–5 days before menstruation, once a day for six sessions per course of treatment, one course of treatment per menstrual cycle, and three menstrual cycles. The primary outcome measure was the proportion with an average visual analog scale (VAS) score reduction of ≥50% from baseline for dysmenorrhea in the third menstrual cycle during treatment. The secondary outcome measures included changes in dysmenorrhea VAS scores, Cox Menstrual Symptom Scale scores and the proportion of patients taking analgesic drugs. Results: The proportion of cases where the average VAS score for dysmenorrhea decreased by ≥50% from baseline in the third menstrual cycle was not statistically significant (P > .05). Precisely 30 min after acupuncture and regarding immediate analgesia on the most severe day of dysmenorrhea, there was a statistically significant difference in the dense-sparse wave group compared with the other two groups during the third menstrual cycle (P < .05). Additionally, there was a statistically significant difference between the dense-sparse wave and discontinuous wave groups 24 h after acupuncture (P < .05). Conclusions Waveform electroacupuncture can alleviate primary dysmenorrhea and its related symptoms in patients. The three groups showed similar results in terms of short- and long-term analgesic efficacy and a reduction in the number of patients taking analgesic drugs. Regarding achieving immediate analgesia, the dense-sparse wave group was slightly better than the other two groups.

Objective To explore the effects of target value management for quality control indexes in chest pain center on the efficiency and effectiveness of in-hospital treatment for STEMI patients.Methods The database of Chest Pain Center in General Hospital of Guangzhou Military Command was retrospectively analyzed.STEMI patients who visited our hospital from March 2011 to March 2018 were selected as the research subjects.During the review period,the target values of quality control indexes were adjusted 4 times.Before and after the 4 adjustment,the efficiency indexes of in-hospital treatment STEMI patients were compared,including the first medical contact to the first electrocardiogram (FMC2ECG) time,catheter lab activation time and Door-to-Balloon (D2B) time.Length of hospital stay,in-hospital mortality and hospitalization cost were compared as well.Results A total of 332 STEMI patients were included in the study.As the quality control target values became stricter,the median and the average value of FMC2ECG time,catheter lab activation time and D2B time showed a downward trend.Among these data,the D2B time decreased from 95 (74,134.5) min to 50 (44.5,71) min,and its differences were of the most significance.However,there is no significant difference in the hospitalization cost,length of hospital stay and in-hospital mortality of STEMI patients.Conclusions The target value management of quality control indexes can improve the in-hospital treatment efficiency for STEMI patients,but the improvements of treatment efficiency and effectiveness cannot be immediately revealed.It takes a certain amount of time and needs enough cases to reach a significant difference.

Objective: To analyze the hematological characteristics of a patient with Hb Ottawa in conjunction with β-thalassemia. Methods: Peripheral blood samples from the proband and her parents were collected and subjected to red blood cell analysis and hemoglobin electrophoresis. Genotypes of α- and β-globin genes were also analyzed. Results: The proband and her mother were both heterozygotes for Hb Ottawa and β-thalassemia variant IVS II-654, and presented with typical β-thalassemia trait featuring hypochromic microcytic anemia. An abnormal hemoglobin band was detected upon electrophoresis. Conclusion Co-existence of Hb Ottawa and β-thalassemia may not aggravate the phenotype.

Objective To explore the effects of the Kano model on preventing incontinence-associated dermatitis (IAD) in inpatients and to offer reference for nursing management of IAD. Methods Totally 100 inpatients hospitalized in Xinxiang Central Hospital from January 2016 to December 2017 were selected by convenient sampling. Patients admitted from January to December 2016 were divided into the control group (n=50), while patients admitted between January and December 2017 were divided into the observation group (n=50). Patients in the control group received conventional nursing care, while patients in the observation group received targeted and optimal nursing services by investigating the patients' needs with the Kano model on the basis of conventional nursing. The self-designed nursing service satisfaction questionnaire was used to evaluate the patients' satisfaction. The incidence rate of IAD was calculated. Results A total of 49 patients in oberservation group completed the investigation, and 48 in control group completed investigation. The total score of satisfaction and the scores in the patients' satisfaction with nursing attitude, nursing skills, follow-ups and health education were higher in the observation group than in the control group (P＜ 0.05). Only 1 IAD case was found in the 49 patients in the observation group, with an incidence rate of 2.04%;however, totally 9 IAD cases were found in the 48 patients in the control group, with an incidence rate of 18.75% (χ2=5.625, P=0.018). Conclusions The Kano model can improve the inpatients' satisfaction with IAD nursing and reduce the incidence rate of IAD, which is worth promoting in clinical practice.

Objective To observe the efficacy of melbine combined with clomifene citrate in treatment of patients with polycystic ovarian syndrome ( PCOS) .Methods 60 patients aged 20 to 39 with PCOS were randomly divided into observation group and control group, 30 patients in each group.In the menstrual cycle of 3~7 d, the control group received clomifene citrate orally (50 mg per time, qd), and the observation group received melbine (2.5 mg per time, qd)combined with clomifene citrate (50 mg per time, qd), with a course of 5 days.Results The number of mature follicles and score of cervical mucus in obsercation group was significant higher than that in control group, respectively(P<0.05).The rate of follicular development and ovulation rate of single follicle in obsercation group was significant higher than that in control group, respectively(P<0.05), but there were no significant differences of pregnancy rate, first trimester abortion rate and periodic ovulation rate between two groups.The rate of endometrial thickness<7 mm patients in observation group was significantly lower and positive rate of three line was higher than that in control group, respectively ( P<0.05).The follicle stimulating hormone level in observation group was significantly lower than that in control group(P<0.05), but there was no significant difference of luteinizing hormone between two groups.Conclusion Melbine combined with clomifene citrate has a good effect on mature follicles number and endometrial thickness in anovulatory infertility women caused by polycystic ovary syndrome.

Objective To investigate the correlations between the time of thoracic endovascular aortic repair (TEVAR) and prognosis in patients with type B acute aortic dissection (AADB). Methods The clinical data of 156 AADB patients with TEVAR was retrospectively analyzed and divided into 3 groups according to the time from onset of symptom to TEVAR:less than seven days was deifned as group 1 (G1, n=87), seven days to fourteen days group 2 (G2, n=48);more than fourteen days was group 3 (G3, n=21). The status of aortic reconstruction at three months TEVAR, in-hospital mortalities, mean hospital expense and length of stay were compared among three groups. Results Before TEVAR, there was no signiifcant differences in the ratio of smallest true lumen diameter and largest false lumen diameter amony the three groups (0.47±0.33, 0.42±0.18, 0.47±0.27, respectively, P>0.05). At three months after TEVAR, the ratio of largest true lumen diameter and largest false lumen diameter among the three groups was signiifcantly greater in group 1 (1.76±0.51) than group 2(1.42±0.30) and group 3(1.34±0.34, P < 0.05), when there was no signiifcant difference between the later two groups. Complete aortic reconstruction (8 from group 1 and 4 from group 2) was achieved in 12 patients at 3 months after TAVAR. Eight patients died during hospitalization, 5 from visceral ischemic, 2 from proximal aortic dissection, one patient from sudden death. Compared with G3, the hospital expense of group 1 and group 2 was cut down about ￥20000. Length of stay was signiifcant greater in group 3 than in group 1 and group 2 (P<0.05). Conclusions Early TEVAR for AADB was safe and beneifcial for aortic reconstruct and reducing the hospital expense and length of stay.

Objective This study intends to explore the impacts of the establishment of chest pain center(CPC) on the door-to-balloon(D-to-B) time in patients with ST-elevation myocardial infarction (STEMI) by different transfer ways to hospital. Methods A regular CPC and a regional cooperative network were established based on the pre-hospital transmitted real-time 12-lead electrocardiogram system. The STEMI patients were divided into the following three groups by the different transfer ways to hospital before and after the establishment of chest pain center:self-referral groups (group A1, n=52, and group A2, n=65), EMS (emergency medical service ) groups (group B1, n=31, and group B2, n=92) and transfer PCI groups (group C1, n=23, and group C2, n=552). The mean D-to-B time and the rate of D-to-B below 90 minutes were compared between before and after the establishment of CPC and the reasons of reperfusion delay were analyzed. Results There were no statistical differences of the average D-to-B time [(123±78) min vs.(140±123)min, P > 0.05] and the rate of D-to-B time below 90 min (44.2%vs. 46.2%) between group A1 and group A2. The average D-to-B time was significantly shortened in group B2 [(89±66)min] while compared with that in group B1 [(155±115)min, P<0.05] and the rate of D-to-B time below 90 min was remarkably elevated in group B2 compared with that of group B1 (69.6%vs. 32.3%, P<0.05). The average D-to-B time was significant shorter in group C2 than in group C1 [(77±43)min vs. (337±662)min, P<0.05] and the rate of D-to-B time below 90 min was remarkable higher in group C2 than in group C1 (75.7%vs. 21.7%, P<0.05). The longer D-to-B time in self-referral groups was mainly due to the delay of getting informed consent before PCI when occupied catheterization laboratory was the major cause of reperfusion delay in EMS groups and transfer PCI groups. Conclusions The establishment of CPC may significantly shorten the D-to-B time and increase the rate of D-to-B time below 90 min for these patients admitted by EMS and transferred from non-PCI hospitals. However, the pathway for the self-referral patients should be further modified.

Objective To evaluate the pre-hospital diagnostic reliability of real-time tele-transmission of 12-lead electrocardiogram of patients with ST-segment elevated acute myocardial infarction (STEMI).Methods The 12-lead electrocardiogram was simultaneously recorded with real-time tele-transmission system and a conventional electrocardiograph in 40 STEMI cases.The width and amplitude of each wave,the deviated amplitude of ST-segment in the same leads were compared by t-test and rank-sum test.Results There were no statistical differences in the width and amplitude of P wave,QRS wave and t wave as well as the deviated altitude of ST-segment between the two separate electrocardiographs (P ＞0.05).There was a significant positive correlation between the two ECG devices in respect of ST-segment elevated altitude (r =0.912,P =0.000).The differential ability of ST-segment elevation between two separate ECG devices kept highly consistent (Kappa value:0.976).Conclusions Real-time tele-transmission of 12-lead electrocardiogram is reliable for the pre-hospital diagnosis of STEMI.

Objective To investigate the expression of integrin β1 and VEGF in gastric carcinoma and evaluate its correlation with invasion and metastasis.Methods Immunohistochemistry techniques were used to study the expression of integrin β1 and VEGF in 63 gastric carcinoma specimens.We analyzed the variance with histological grade and stage and classification of clinical date.Results No significant relationship was observed among age,sex and histological classification of the expression of integrin β1 in the gastric cancer group (P>0.05).With the depth of invasion and lymphatic metastasis increasing,integrin β1 expression improved.The positive rate of integrin β1 among tubular adenocarcinoma,papillary carcinoma,mucinous carcinoma and undifferentiated carcinoma was 70.00 %,55.56 %,57.14 % and 64.86 %.No significant relationship was observed in it.Integrin β1 in cases with lymphnode metastasis was significantly higher than those without lymph node metastasis (P<0.05).No significant relationship was observed among VEGF expression and age,sex,histological classification and depth of invasion (P>0.05).Significant relationship was observed among VEGF expression and lymphatic metastasis.VECF in cases with lymph node metastasis was significantly higher than those without lymph node metastasis (P<0.05).Conclusion Immunohistochemistry techniques indicated that integrin β1 participated in the procession of invasion and metastasis.The expression of integrin β1 and VEGF are important factor,forecasting the invasion and metastasis.VEGF is an important factor for lymphnade metastasis of gastric carcinoma.VEGF in cases with lymphnode metastasis was significantly higher than those without lymphnode metastasis(P<0.05).The usage of integrin β1 and VEGF will improve the rightness in forecasting the invasion and lymph node metastasis of gastric carcinoma.

Objective To discuss the perioperative nursing measures for interventional treatment of priapism caused by arteriovenous fistula of penis in order to reduce the operation-related complications and to promote rehabilitation.Methods A series of nursing steps were carried out in 2 patients who suffered from priapism caused by arteriovenous fistula of penis and received interventional therapy.The nursing measures included preoperative psychological nursing,routine preoperative examinations,promotion of friendly relations between nurse and patient,preparation for the operation method,the preparation of skin,postoperative nursing of patient's position,observation of penis erection and vital signs,postoperative psychological nursing,and the health guidance at the time of discharge.Results After the interventional therapy two patients were successfully cured at the time of discharge.No complications related to the operation occurred.Three months after the operation the erect function of the penis remained normal.Conclusion The interventional therapy is a safe and reliable technique for priapism caused by arteriovenous fistula of penis.The proper and effective perioperative and postoperative nursing measures can surely improve the successful rate of interventional treatment as well as prevent the occurrence of complications.