Purpose:To investigate the management and prognosis of urethral calcali.Methods:46 case of urethral calculi have been studied and followed up, 45 cases are males, 1 case is female. Mean age of the patients was 41 years. All patients complained of dysuria and urinary pains, acute retention was present in 10 cases. 3 cases have haematuria. Associated urethral disease was found in 12 patients.Results:The 37 cases were treated by endoscopic manipulation of choice for urethral calculi and have been followed up and have been all recovered except only 1 case.Conclusions:Endoscopic manipulation was found to be the safest and the most effective procedure.

Objective: To explore the analgesic effects and uterine hemodynamics of perpendicular needling (PN) and transverse needling (TN) at SP 6 in patients with primary dysmenorrhea (PD). Methods: In this randomized controlled trial, patients with PD diagnosed with cold-dampness con-gealing pattern were randomly assigned in a ratio of 1:1 to receive PN or TN at bilateral SP 6 for 10 min. Acupuncture was performed when the menstrual pain score was over 40 mm on the first day of menstruation, as measured using the visual analog scale for pain (VAS-P). The primary outcome was average menstrual pain (VAS-P). Secondary outcomes included the pulsatility index (PI), resistance index (RI), and systolic-diastolic peaks ratio (S/D) in uterine arteries as measured using color Doppler ultra-sonography;anxiety as assessed using the Hamilton Anxiety Rating Scale (HAMA), blood pressure (BP), and heart rate (HR). Results: Forty-eight patients completed the study. The TN group exhibited a significant reduction in VAS-P scores (-5.71 mm, 95％ confidence interval (CI): -8.78, -2.63, P = .001), RI values (-0.05, 95％ CI:-0.09,-0.01, P=.015), and HAMA values (-2.50, 95％CI:-4.78,-0.22, P=.032) when compared with the PN group. No significant differences in PI, S/D, BP, or HR values were observed between the two groups (P>.05). Conclusion: TN at SP 6 was superior to PN in alleviating menstrual pain and anxiety in patients with PD. This analgesic effect of TN may be due to its better ability to improve uterine arterial blood flow via decreases in RI values.

Objective: The Commonwealth of the Northern Mariana Islands (CNMI) is a remote Pacific island territory with a population of 47 329 that successfully prevented the significant introduction of coronavirus disease (COVID-19) until late 2021. This study documents how the response to the introduction of COVID-19 in CNMI in 2021 was conducted with limited resources without overwhelming local clinical capacity or compromising health service delivery for the population. Methods: Data from COVID-19 case investigations, contact tracing, the Commonwealth’s immunization registry and whole genome sequencing were collated and analysed as part of this study. Results: Between 26 March 2020 and 31 December 2021, 3281 cases and 14 deaths due to COVID-19 were reported in CNMI (case fatality rate, 0.4%). While notification rates were highest among younger age groups, hospitalization and mortality rates were disproportionately greater among those aged >50 years and among the unvaccinated. The first widespread community transmission in CNMI was detected in October 2021, with genomic epidemiology and contact tracing data indicating a single introduction event involving the AY.25 lineage and subsequent rapid community spread. Vaccination coverage was high before widespread transmission occurred in October 2021 and increased further over the study period. Discussion: Robust preparedness and strong leadership generated resilience within the public health sector such that COVID-19 did not overwhelm CNMI’s health system as it did in other jurisdictions and countries around the world. At no point was hospital capacity exceeded, and all patients received adequate care without the need for health-care rationing.