ObjectiveTo compare the clinical efficacies of acupuncture, auricular point sticking, and the combination of the two methods in treating primary dysmenorrhea by using randomized controlled method, for selecting the optimal treatment in treating primary dysmenorrhea, and to explore the nursing care method for primarydysmenorrhea from the perspective of Chinese medicine. MethodNinety patients with primary dysmenorrhea were randomized into an acupuncture group of 30 cases (group A), an auricular point sticking group of 30 cases (group B), and a combined group of acupuncture plus auricular point sticking of 30 cases (group C). The patients were given treatment 7 d ahead of the menstrual period, a menstrual cycle as a treatment course, totally for 3 courses. The pain score and clinical efficacies were observed and compared among the three groups for statistical analyses.Result The pain scores were significantly changed in the three groups after intervention (P<0.05), there were significant differences in comparing the pain scores among the three groups after intervention (P<0.05), group A and C were superior to group B (P<0.05), and group C was superior to group A (P<0.05). The total effective rate was 96.7% in group A, versus 93.3% in group B and 100.0%in group C, and the rank-sum test showed thatZ=7.675,P=0.022 (P<0.05).ConclusionThe three treatment methods are all effective in treating primary dysmenorrhea, while combining acupuncture and auricular point sticking can approach the optimal effect.

Objective:To evaluate the association between the use of emergency medical services (EMS) and the severity of disease among patients admitted to the emergency room, to analyze the characteristics of the patients, and to build prediction model providing evidence-based use of EMS resources.Methods:The data of patients admitted to the Emergency Room of the First Affiliated Hospital of University of Science and Technology of China from January 2020 to July 2021 were extracted from the Chinese Emergency Triage Assessment and Treatment (CETAT) database. Patients were divided into the EMS use group (AB+ group) and self-seeing group (AB-group) according to whether they used EMS. The patients’ general condition, vital signs and laboratory tests results were recorded. The severity of patients’ condition was judged based on whether the patient was admitted to the department of critical medicine, specialized care unit, emergency operation and/or emergency percutaneous intervention. A 9-variable model that did not require laboratory inspection and 22-variable model that required laboratory inspection were established to correct the propensity score to analyze the correlation between the severity of disease and the EMS use. In the subgroup analysis, the correlation between the EMS use and severity of the patients was analyzed according to the reason of the patient’s visit.Results:During the study period, 16 489 patients were admitted to the emergency room, and 6975 patients were finally enrolled in this study. There were 2768 patients (39.7%) in the AB+ group and 4207 patients (60.3%) in the AB-group. In the AB+ group 522 patients (18.9%) were in high risk, and in the AB-group 563 patients (13.4%) were in high risk. Compared with the AB-group, patients in the AB+ group were older and had a higher proportion of coma, a faster autonomic heart rate, and a lower diastolic blood pressure and peripheral oxygen saturation (SpO 2). In the 9-variable model, sex, consciousness, temperature, heart rate and diastolic blood pressure were associated with the EMS use. In the 22-variable model, consciousness, SpO 2, neutrophils, and albumin were the relevant factors for patients using EMS. Before the correction of propensity score, the EMS use was an independent risk factor for critically ill patients ( OR=1.5, 95% CI 1.32-1.72, P<0.001). After adjusted using 9-variable propensity score, the EMS use ratio decreased significantly compared with that without correction ( OR=1.24,95% CI 1.08-1.42, P<0.001). Interestingly, after adjusted with propensity score match with 22-variable model, there was no association between the severity of disease and t the EMS use ( OR=1.10,95% CI 0.95-1.28, P=0.195). In subgroup analysis, patients’ chief complaint of central nervous system, cardiovascular system, and trauma were the top three reasons at admission. Before the propensity score correction, the EMS calling patients with chief complaint of central nervous system, digestive system, and trauma were related to the severity of the patients. After adjusted with 9-variable model the EMS use was associated with the severity of the disease only in trauma patients, and after adjusted with 22-variable model there was no statistical difference considering the severity of the disease in all subgroups. Conclusions:The EMS use is common. However, the association of the EMS use with the severity of disease is decreased with variable models using propensity score. These findings indicate that the EMS use should be based on multivariable models, which may be important in detecting critically ill patients, optimizing the EMS use, and avoiding unnecessary call in the future.

Objective:To develop a robotic digestive endoscope system (RDES) and to evaluate its feasibility, safety and control performance by experiments.Methods:The RDES was designed based on the master-slave control system, which consisted of 3 parts: the integrated endoscope, including a knob and button robotic control system integrated with a gastroscope; the robotic mechanical arm system, including the base and arm, as well as the endoscopic advance-retreat control device (force-feedback function was designed) and the endoscopic axial rotation control device; the control console, including a master manipulator and an image monitor. The operator sit far away from the endoscope and controlled the master manipulator to bend the end of the endoscope and to control advance, retract and rotation of the endoscope. The air supply, water supply, suction, figure fixing and motion scaling switching was realized by pressing buttons on the master manipulator. In the endoscopy experiments performed on live pigs, 5 physicians each were in the beginner and advanced groups. Each operator operated RDES and traditional endoscope (2 weeks interval) to perform porcine gastroscopy 6 times, comparing the examination time. In the experiment of endoscopic circle drawing on the inner wall of the simulated stomach model, each operator in the two groups operated RDES 1∶1 motion scaling, 5∶1 motion scaling and ordinary endoscope to complete endoscopic circle drawing 6 times, comparing the completion time, accuracy (i.e. trajectory deviation) and workload.Results:RDES was operated normally with good force feedback function. All porcine in vivo gastroscopies were successful, without mucosal injury, bleeding or perforation. In beginner and advanced groups, the examination time of both RDES and ordinary endoscopy tended to decrease as the number of operations increased, but the decrease in time was greater for operating RDES than for operating ordinary endoscope (beginner group P=0.033; advanced group P=0.023). In the beginner group, the operators operating RDES with 1∶1 motion scaling or 5∶1 motion scaling to complete endoscopic circle drawing had shorter completion time [1.68 (1.40, 2.17) min, 1.73 (1.47, 2.37) min VS 4.13 (2.27, 5.16) min, H=32.506, P<0.001], better trajectory deviation (0.50±0.11 mm, 0.46±0.11 mm VS 0.82±0.26 mm, F=38.999, P<0.001], and less workload [42.00 (30.00, 50.33) points, 43.33 (35.33, 54.00) points VS 52.67 (48.67, 63.33) points, H=20.056, P<0.001] than operating ordinary endoscope. In the advanced group, the operators operating RDES with 1∶1 or 5∶1 motion scaling to complete endoscopic circle drawing had longer completion time than operating ordinary endoscope [1.72 (1.37, 2.53) min, 1.57 (1.25, 2.58) min VS 1.15 (0.86, 1.58) min, H=13.233, P=0.001], but trajectory deviation [0.47 (0.13, 0.57) mm, 0.44 (0.39, 0.58) mm VS 0.52 (0.42, 0.59) mm, H=3.202, P=0.202] and workload (44.62±21.77 points, 41.24±12.57 points VS 44.71±17.92 points, F=0.369, P=0.693) were not different from those of the ordinary endoscope. Conclusion:The RDES enables remote control, greatly reducing the endoscopists' workload. Additionally, it gives full play to the cooperative motion function of the large and small endoscopic knobs, making the control more flexible. Finally, it increases motion scaling switching function to make the control of endoscope more flexible and more accurate. It is also easy for beginners to learn and master, and can shorten the training period. So it can provide the possibility of remote endoscopic control and fully automated robotic endoscope.

Objective To understand the prevalence,treatment and influence factors of hypertension in maintenance hemodialysis (MHD) patients in Anhui Province.Methods A total of 2724 adult patients on MHD from January 1st 2014 to March 31st 2014 in 26 hospitals of southern,northern and central Anhui Province were investigated.Their demographic characteristics,primary disease,complications,medications,dialysis and laboratory examination were explored.The prevalence treatment rate and control rate of hypertension were analyzed.Associated factors for controlling hypertension [systolic blood pressure (SBP) ＜ 140 mmHg and diastolic blood pressure (DBP) ＜ 90 mmHg] were assessed by logistic regression analysis.Results (1) The prevalence of hypertension in the hemodialysis patients was 87.0％.Their treatment rate and control rate were 93.2％ and 23.9％ respectively.The average of SBP was (145.90±21.18) mmHg,and the DBP on average was (83.60± 12.21) mmHg.The most commonly used anti-hypertensive drug is calcium channel blocker (88.2％).Over one third (45.7％) of patients were treated with two kinds of anti-hypertensive drug,26.2％ with 1 kind,21.7％ with 3 kinds,and 6.4％ with 4 kinds or more.(2) Compared with non-hypertension patients,patients with hypertension have older age,higher body mass index (BMI),phosphorus,SBP and DBP,as well as lower hemoglobin and Kt/V (all P ＜ 0.05).(3) The multivariate logistic regression analysis showed that Ca ＞ 2.50 mmol/L (OR=2.084,95％CI 1.008-4.307,P=0.047) positively correlated with controlling hypertension,while smoke (OR=0.594,95％CI 0.356-0.911,P=0.046) and BMI 18.5 ～ 23.9 kg/m2 (OR=0.516,95％CI 0.293-0.907,P=0.022) negatively correlated with it.Conclusions High prevalence yet low control rate of hypertension in MHD patients in Anhui Province were observed.Hypocalcemia may be a protective factor for hypertension control,while smoke and BMI may be risk factors for it.