Objective To investigate the clinical efficacy and safety of six-hole moxibustion box therapy for stable chronic obstructive pulmonary diseases(COPD).Methods Sixty patients with thoracic facet joint disorder were randomly allocated to treatment and control groups, 30 cases each. The control group inhaled tiotropium bromide inhalation powder spray and the treatment group received six-hole moxibustion box therapy in addition. The COPD Assessment Test (CAT) score and the dyspnea score were recorded and peripheral blood oxygen saturation was measured in the two groups before and after treatment. The adverse reactions were monitored in the two groups. Results There were statistically significant pre-/post-treatment differences in the CAT score and the dyspnea score in the two groups (P<0.05). There were statistically significant post-treatment differences in the CAT score and the dyspnea score between the treatment and control groups (P<0.05). There were statistically significant differences in pre-/post- treatment CAT score difference value and dyspnea score difference value between the two groups (P<0.05). There was a statistically significant pre-/post-treatment difference in peripheral blood oxygen saturation in the treatment group (P<0.05). There was a statistically significant post-treatment difference in peripheral blood oxygen saturation between the two groups (P<0.05).Conclusion Six-hole moxibustion box therapy plus tiotropium bromide inhalation powder spray is safe and effective in treating stable COPD.

Objective:To explore the clinical effect of Huayu-Ningkun liquid enema and external application of dreg for treating chronic pelvic inflammatory disease. Methods:A total of 106 patients with chronic pelvic inflammatory disease who met the inclusion criteria in the gynecological outpatient department of Beijing Hospital of Integrated Chinese and Western Medicine from January 2018 to December 2019 were divided into 2 groups by random number table method, with 53 patients in each group. The control group was treated with conventional western medicine therapy, and the observation group was combined with Huayu-Ningkun liquid enema and external application of drug residue on the basis of the control group. TCM symptom scores were performed before and after treatment, and the Quality of Life of patients was evaluated by Generic Quality of Life Inventory-74 (GQOLI-74). Serum CRP and TNF-α levels were detected by ELISA, and adverse reactions during treatment were recorded. Results:The total effective rate was 96.2% (51/53) in the observation group and 83.0% (44/53) in the control group, and the difference between the two groups was statistically significant ( χ2=4.970, P=0.026). After treatment, the TCM symptom scores of the observation group was significantly lower than that of the control group ( t=8.205, P<0.01). The scores of physical function, mental function, material life and social function were significantly higher than those in the control group ( t value were 7.503, 8.786, 7.798, 9.353, all Ps<0.001). After treatment, the levels of serum CRP (4.52 ± 3.46 g/L vs. 8.23 ± 3.35 g/L, t=5.608) and TNF-α (1.00 ± 0.35 μg/L vs. 1.52 ± 0.28 μg/L, t=14.551) in the observation group were significantly lower than those in the control group ( P<0.01). Conclusion:The Huayu-Ningkun liquid enema and drug residue external application combined with western medicine can relieve the symptoms, reduce the level of inflammatory cytokines, improve clinical efficacy of the patients with chronic pelvic inflammatory disease.

Objective To evaluate the effects of nitrous oxide inhalation on conscious sedation of patients during colonoscopy and analyze its risk factors. Methods From October 2016 to July 2017, a total of 154 patients undergoing colonoscopy were included in the study. The comfort level was rated using Modified Gloucester Comfort Scale ( MGCS). Factors affecting comfort level were analyzed by univariate analysis and multivariate Logistic regression, and then a comfort stratification predicting model was created. Results All 154 patients finished colonoscopy. The mean time of ideal anesthesia state was 195. 15 s. Among the 154 cases, 115 ( 74. 7%) were identified as comfort ( grade of MGCS from 1 to 3) and 39 (25. 3%) were rated as discomfort ( grade of MGCS from 4 to 5). Multivariate regression indicated that age ≥60 years ( P＝0. 000, OR＝1. 074, 95%CI: 1. 036-1. 114) and mild anxiety ( P＝0. 018, OR＝3. 338, 95%CI: 1. 227-9. 079) were associated with comfort level during colonoscopy.The established model with the age (X1) and mild anxiety (X2) was P＝eY/(1+eY), Y＝－3. 812+0. 071X1+1. 205X2(no anxiety was assigned 1, mild anxiety was assigned 2), and the area under the receiver operating characteristics curve was 0. 746 (95%CI: 0. 661-0. 830), which showed moderate predictive power of the final model. The model reached the highest predictive accuracy when the Yoden Index was 0. 838 with sensitivity of 50. 4% and specificity of 89. 7% for predicting comfort level of patients in conscious sedation status induced by nitrous oxide inhalation during colonoscopy. Conclusion Nitrous oxide can ease pain during colonoscopy, especially for patients over 60 years old and with anxiety. We can use it as an option according to actual circumstance in practice.

Objective:To assess the changes of left ventricular systolic function and global synchronization and myocardial work in patients with left bundle branch pacing (LBBP) by two-dimensional multi-layered speckle tracking imaging.Methods:Forty-two patients with Ⅱ degree Ⅱ type or Ⅲ degree atrioventricular block (AVB) in the Cardiovascular Hospital of Xiamen University from April to December 2019 were selected as pacing group, which were further divided into two groups according to different pacemaker modes: twenty patients with right ventricular septal pacing (RVSP), twenty-two patients with LBBP, and twenty patients with normal ECG and cardiac structure were enrolled as control group. Echocardiography of pacing group and control group was performed and analyzed. The left ventricular subendocardial longitudinal strain peak(LSendo), the middle layer myocardial longitudinal strain peak(LSmid), subepicardial longitudinal strain peak(LSepi), global myocardial longitudinal strain peak(GLS), peak strain dispersion (PSD), global work index (GWI), global constructive work (GCW), global wasted work (GWW) and global work efficiency (GWE) were acquired. The differences among the three groups were analyzed and the high difference indexes were screened by statistical modeling.Results:LSendo in three groups had no difference ( P>0.05). LSmid, LSepi, GLS in the control group, LBBP group and RVSP groups were decreased gradually ( P<0.05). GLS in LBBP group was higher than in RVSP group ( P<0.05). Compared with the control group, the increases of QRS and PSD in LBBP group were not statistically significant ( P>0.05), while the decreases of QRS and PSD in LBBP group were statistically significant compared with the RVSP group ( P<0.05). The values of GCW among three groups had no statistical significance ( P>0.05). Compared with the control group, the decrease of GWI in LBBP group was not statistically significant ( P>0.05), while the increase of GWW and the decrease of GWE were statistically significant ( P<0.05). Compared with the RVSP group, the increases of GWI and GWE and the decrease of GWW in LBBP group were statistically significant ( P<0.05). QRS, LSendo, GLS, LSmid, left ventricular apex rotation to basal rotation peak time(ApexBase period) were the indexes with significant difference among LBBP and RVSP groups and all index characteristics showed better in LBBP than RVSP group. Conclusions:Two-dimensional multi-layered speckle tracking imaging can be used to evaluate the effect of LBBP on left ventricular systolic function and global synchronization and myocardial work. LBBP longitudinal mechanical synchronization is better than right ventricular septal pacing by improving the peak global myocardial longitudinal strain and myocardial work after pacemaker.

OBJECTIVE To evaluate the efficacy and safety of dydrogesterone in the treatment of dysmenorrhea. METHODS The prospective ，random-controlled，open-labeland multicenter clinical study was adopted. A total of 108 women with dysmenorrhea were randomly assigned into dydrogesterone group and control group according to the ratio of 1∶1，with 54 patients in each group. Dydrogesterone group was treated with dydrogesterone 10 mg orally ，twice a day ，on the 5th-25th day of menstrual cycle ，for 3 menstrual cycles. Control group received Guizhi fuling capsule 0.93 g orally ，three times a day，since the end of menstrual bleeding to the third day of the next menstruation ，for 3 menstrual cycles. Main results were the changes of visual analogue scale （VAS）scores in 2 groups after 3 menstrual cycles ；secondary results were the changes of COX menstrual symptom scale （CMSS），quality life of 36-item short form （SF-36），levels of carbohydrate antigen 125（CA125）and interleukin 6（IL-6）after 3 menstrual cycles ；other findings included additional benefits and drug safety. RESULTS The results of intention to analysis data set and the follow-up study protocol analysis data set showed that VAS scores of 2 groups after treatment of dysmenorrhea for 1，2 and 3 menstrual cycles were lower than those before treatment ，the longer the treatment time ，the more obvious the decrease of VAS score （P＜0.05），and VAS score decline of dydrogesterone group was better than that of control group（P＜0.05）. After 3 menstrual cycles ，both the two group showed significant reduction in the severity and duration scores of CMSS（P＜0.05）；and the decrease of the above scores in the dydrogesterone group was superior than in the control group （P＜ 0.05）. After 3 menstrual cycles ，among 8 dimensions of SF- 36 scale，the scores of 7 dimensions in dydrogesterone group were significantly higher than those before treatment ，such as the scores of physiological function ，physical role ，physical pain ， emotional function ，social function ，general health status and energy （P＜0.05）；the increase of the scores of four dimensions were higher than those in the control group ，such as physical pain ，social function ，general health status ，energy（P＜0.05）. There was no significant difference in the levels of CA 125 and IL- 6 between 2 groups before and after treatment （P＞0.05）. After 3 menstrual cycles，the menstrual cycle and menstrual period in the dydrogesterone group were shorter than those before treatment ，and the menstrual volume decreased （P＜0.05）；but there was no significant change in the above indexes of control group （P＞0.05）. After 3 menstrual cycles ，the incidence of adverse drug events and adverse reactions in dydrogesterone group was 32.69％（17/52）and 28.85％（15/52）；no serious adverse drug events or adverse reactions such as thrombosis occurred in both groups. CONCLUSIONS Dydrogesterone can effectively reduce the VAS score ，also relieve dysmenorrhea-related symptoms ，and improve the quality of life. The efficacy of dydrogesterone is superior than that of Guizhi fuling capsule in treatment for dysmenorrheal ，without serious adverse reactions. It is well tolerated.