Objective To observe the therapeutic effect of treating primary dysmenorrhea with cold coagulation and blood stasis with warming-necdle. Methods 60 cases of primary dysmenorrhea with cold cougulation and blood stasis,which were treated during 2007 to 2008, were randomly divided into an acupuncture group and a medication group. The acupuncture group was treated with acupuncture at Ciliao and Sanyinjiao, while the medication group was treated with indomethacin. Results The total effective rate was 100% in the acupuncture group, and 93.3% in the medication group. The effects of the two groups were significantly different (P＜0.05). Conclusion Warming-needle is an effective therapy for primary dysmenorrhea with cold eougulation and blood stasis

Objective To analyze clinical effects of gastric tube operation for treatment of esophageal cancer in elderly patients and evaluate its clinical efficacy and safety.Methods A total of 171 patients aged 60-72 years with esophageal cancer in our hospital were selected.They were randomly divided into treatment group and control group.Treatment group was treated with gastric tube operation,and control group was traditionally treated with complete replacement of esophagus with stomach.The quality of life,patient satisfaction and safety of operation were evaluated after 3 weeks,6 months and 12 months after operation,respectively.Results The operation for esophageal cancer in 171 patients were successful.At 3 weeks after the operation,the score of life quality in treatment group and control group were both low [(67.3±9.6) vs.(65.3±8.4)],and there were no significant differences between the two groups (P＞0.05).At 6 months and 12 months after operation,the scores of life quality were (89.2±8.3) and (90.3±9.6) in treatment group,and (66.5± 10.4) and (60.5 ± 11.2) in contol group,respectively.There were statistical differences between the two groups after 6 months and 12 months of operation (P＜0.05).The complication rate in treatment group (6.9％) was much lower than that in control group (30.6％),and there were significant differences between the two groups (x2 =18.43,P＜0.01).The patient satisfaction was in no differences between the two groups at 3 weeks after operation (P＞ 0.05),while there were statistically significant differences at 6 and 12 weeks after the operation (P＜0.05).Conclusions Gastric tube operation in treatment of elderly patients with esophageal cancer,can effectively improve the life quality,and prevent the occurrence of postoperative complications,which is worthy of clinical application.

Objective To evaluate the safety and effectiveness of conscious sedation and intravenous anesthesia used to endoscopic retrograde cholangio pancreatiography (ERCP) in treatment of extrahepatic bile duct stones.Methods A total of 100 cases of extrahepatic bile duct stones patients in treatment of ERCP were encoded by the group order,50 cases of odd used intravenous anesthesia (intravenous anesthesia group),intravenous injection of propofol; 50 cases of even used conscious sedation (conscious sedation group),muscle injection of diazepam and pethidine.Intraoperative reaction (extubation behavior,own postural changes),changes in vital signs,operating time,the success rate of stone and complication were observed in two groups.Results The incidence of intraoperative extubation behavior and own postural changes in conscious sedation group were significantly higher than those in intravenous anesthesia group [24％ (12/50) vs.2％ (1/50),18％ (9/50) vs.0],and the differences were statistically significant (P ＜ 0.01).The heart rate and mean artery pressure in two groups were decreased at 5 minutes after administration than that before operation,and the difference was statistically significant (P ＜ 0.05),but there was no statistical significance at 10 min after entering the mirror and postoperative awake compared with before operation (P ＞ 0.05).Pulse oxygen saturation between two groups had no statistical significance (P ＞0.05).The success rate of stone in two groups were 98％ (49/50).Operating time in intravenous anesthesia group was obviously shorter than that in conscious sedation group [(38.2 ± 6.3) min vs.(49.1 ± 9.9) min] (P ＜ 0.01).The complications between two groups had no statistical significance (P ＞ 0.05).Conclusion Conscious sedation and intravenous anesthesia can be used to ERCP in treatment of extrahepatic bile duct stones,but intravenous anesthesia can obviously reduce patients discomfort,shorten the operation time.

Objective To analyze and study the connections between hypovolemia and lower extremity deep venous thrombosis (LDVT)in patients with cerebral infarction. Methods A total of 504 hospitalized patients with cerebral in-farction were selected. According to the comparison between infarction group and non-infarction group, ROC curves of urea nitrogen/creatinine ratio, plasma osmotic pressure, combined index of the two indices above and D-dimer were created, cut-off value of the indices above was calculated, and sensitivity and specificity were compared. Results Analysis on the results of ROC curves showed ROC area under the curve of urea nitrogen/creatinine ratio in the diag-nosis of LDVT in 10-14 days after admission was 0.788(95%CI 0.727-0.848),the optimal diagnostic cut-off point was 101.705, the sensitivity was 58%, and the specificity was 88.7%; ROC area under the curve of plasma osmotic pres-sure was 0.892 (95%CI 0.836-0.949), the optimal diagnostic cut-off point was 305.77 mmol/L, the sensitivity was 85.5%, and the specificity was 90.8%; ROC area under the curve of the combined index was 0.895 (95%CI 0.837-0.952); ROC area under the curve of D-dimer was 0.883(95%CI0.832-0.935), the optimal diagnostic cut-off point was 3.055 ug/L,the sensitivity was 85.5%, and the specificity was 82.1%. Conclusion Combined index of urea nitro-gen/creatinine ratio and plasma osmotic pressure in the diagnosis of LVDT is better than D-dimer, which is beneficial for early diagnosis.

Objective:A one-day nutritional survey study was conducted on geriatric inpatients in the Zhejiang region to evaluate their nutritional and health status.The study aimed to assess the nutritional and health status of elderly patients in the hospital, as well as perform a correlation analysis on the factors influencing the nutritional status of geriatric inpatients.The findings aim to provide evidence to support clinical interventions.Methods:This multicenter cross-sectional study involved conducting a one-day nutritional survey among geriatric inpatients in 42 medical units across Zhejiang, China.Questionnaires were utilized to gather demographic information, record 24-hour dietary intake, calculate total calorie and protein intake, screen for nutrition-related geriatric syndromes, and collect laboratory data from inpatients in the geriatrics department of these medical facilities.Analysis of the data was performed using SPSS 25.0 software to compare groups with varying nutritional statuses and identify potential influencing factors on the nutritional status of elderly hospitalized patients.Results:A total of 325 valid surveys(97.9%)were collected from 332 senior inpatients.Among them, 30 individuals(9.2%)were classified in the malnutrition group, 120 individuals(36.9%)were in the group at risk for malnutrition, and 175 individuals(53.8%)were in the group with appropriate nutrition.Approximately 37.8%(123 out of 325)of elderly hospitalized patients met the recommended minimum daily protein intake of 1g/(kg·d).Following adjustment for confounding variables, the results of multifactorial logistic regression analysis revealed that shorter daily sedentary time(2-4h), independent ambulation, assisted ambulation, maintaining regular food intake before hospitalization, and good or fair self-perceived health were protective factors for the nutritional status of elderly hospitalized patients.Conversely, having fewer than 5 teeth was identified as a risk factor.Conclusions:The prehospital living status of elderly hospitalized patients is closely related to their nutritional status.It is important to prioritize nutritional assessment and provide intervention guidance for lifestyle improvements in this population.

Eight compounds were isolated from Bufonis periostracum by repeated column chromatography on silica gel, ODS and Sephadex LH-20 and their structures were characterized as palmitatic acid cholesteryl ester (1), cholesterol (2), 5alpha, 8alpha-epidioxycholesta-6-en-3beta-ol (3), cholest-5-en-3beta, 7beta-diol (4), cholest-7-en-3beta, 5alpha, 6beta-triol (5), 3-octaddecyloxy-1, 2-propanediol (6), isisamide (7) and bufothionine (8) on the base of spectral analysis. Compounds 1-8 were isolated from Bufonis periostracum for the first time and compounds 3, 5, 6, 7 were obtained from Bufo bufo gargarizans and Bufo genus for the first time. The bioassays showed all tested samples displayed no antitumor activity against the cell lines such as A549, BeL 7402, HGC-27 and HL-60, except the control compound bufalin.
Animals ; Antineoplastic Agents ; pharmacology ; Bufo bufo ; metabolism ; Bufonidae ; metabolism ; Humans

Objective To explore the dilution conditions and standards in detecting the semen samples with high sperm concentration using computer-aided sperm analysis(CASA)systems.Methods CASA systems with 10 μm depth disposable counting chambers were used for the examination.The samples were divided into undiluted group(Group 1∶sperm concentration＜50×106/mL)and diluted groups(Group 2∶50×106/mL≤ sperm concentration＜100× 106/mL;Group 3∶sperm concentration≥100× 106/mL).When sperm concentration＜50×106/mL,no dilution was performed.When sperm concentration≥50× 106/mL,the samples were diluted with saline at 1∶n/(50×106)ratio(n=sperm concentration,n/[50×106]rounded down)to＜50×106/mL of sperm concentration.The sperm concentration,progressive motility(PR),non-progressive motility(NP),total motility(PR+NP)and immotile sperm percent-age(IM)were analyzed before and after dilution.The consistency of results pre-and post-dilution was compared.ROC curve was used to analyze the optimal dilution threshold.Results The differences in the parameters pre-and post-dilution gradually rosed with the increased sperm concentration.ROC curve analysis showed optimal dilution thresholds were 133.05 × 106/mL,101.75 × 106/mL,118.60×106/mL,90.90×106/mL,111.83×106/mL for the sperm concentration,PR+NP,PR,NP and IM respectively.Considering sperm concentration and NP were most affected the undiluted high concentration samples,the optimal comprehensive dilution threshold was determined as 125.08× 106/mL.Conclusion When sperm concentration exceeds 125×106/mL,it is recommended to dilute semen sample with normal saline.

Objective To investigate the current status of semen testing in the hospitals without assisted reproductive technology in Hu-nan Province,propose improvement strategies to enhance the diagnosis of male infertility and promote reproductive health services in these hospitals.Methods Questionnaire surveys and on-site investigations were conducted to examine the semen testing status in 67 hospitals without assisted reproductive technology in Hunan Province.The existing problems were summarized,and improvement strate-gies were suggested.Results Among the 67 hospitals,59.7％(40/67)performed semen testing.Of these,45％(18/40)possessed dedicated personnel,60％(24/40)possessed staff received relevant training,and 22.5％(9/40)held certificates.Only 30％(12/40)conducted sperm morphology testing,among them 20％(8/40)able to stain and interpret following WHO standards.The hospitals of 37.5％(15/40)used computer-assisted sperm analysis(CASA)systems,and 22.5％(9/40)were equipped with phase-contrast microscopes.30％(12/40)had dedicated examination areas,and 32.5％(13/40)had independent ejaculation rooms,17.5％(7/40)used disposable slides to observe sperm concentration.In 2022,the hospitals of 57.5％(23/40)had an average daily sample volume＜1.The hospital of 67.5％(27/40)performed standard operating procedures,40％(16/40)followed the WHO 5th la-boratory manual for routine testing,15％(6/40)conducted internal quality control,and 12.5％(5/40)participated in external quali-ty assessment(EQA).Another 55％(22/40)wished to participate in EQA.Conclusion The semen testing capacity in the hospitals,in which assisted reproductive technology is not yet carried out currently,urgently requiring multifaceted improvements.The proposed strategies include emphasizing semen testing,establishing reproductive medicine consortia for comprehensive support,establishing a provincial quality control center for EQA,founding a professional committee for a learning platform,offering training to enhance staff expertise,and including the pre-pregnancy semen testing in public health programs.

Objective:To investigate the awareness of sarcopenia and knowledge about its prevention and control in elderly patients with cardiovascular disease and analyze potential influencing factors for the awareness rate of sarcopenia, in order to provide a theoretical foundation for further developing a precise health education program for elderly patients with cardiovascular disease and sarcopenia.Methods:In this multicenter cross-sectional study, the representative sampling method was used via a questionnaire to collect demographic data, awareness of sarcopenia, and knowledge about its prevention and control from 576 elderly patients aged 60 years and over receiving treatment between March and August 2022 at 12 hospitals including Zhejiang Hospital.Meanwhile, possible influencing factors on the awareness rate of sarcopenia in elderly cardiovascular disease patients were analyzed.Results:The overall awareness rate of sarcopenia in elderly patients with cardiovascular disease was 43.2%(249/576).The awareness rates for sarcopenia-related declines in grip strength and walking speed were 39.9%(230/576)and 39.8%(229/576), respectively.The rates of awareness that sarcopenia is more likely to occur in very elderly people was 37.8%(218/576)and the rate of awareness for its more likely occurrence in elderly people with chronic diseases was 29.3%(169/576).The rates of awareness that resistance exercise and protein supplementation could prevent or improve sarcopenia were 33.9%(195/576)and 37.0%(213/576), respectively.Multivariate Logistic regression analysis found that being female and being 70-89 years old were independent risk factors affecting the awareness of sarcopenia and related knowledge about its prevention and control, while high school education and above and living alone were independent protective factors.Conclusions:The awareness rate of sarcopenia and knowledge about its prevention and control in elderly patients with cardiovascular disease is low and is significantly correlated to the female gender, advanced age, high educational achievement, living alone and other factors.Therefore, when education about sarcopenia is conducted, a precise health education program for sarcopenia should be established to improve the awareness rate of sarcopenia in elderly patients with cardiovascular disease, thus minimizing or delaying the occurrence and development of sarcopenia as much as possible.

Objective To compare the effects of different statistical protocols on the results of external quality assessment(EQA)of se-men,and select appropriate statistical protocols for the promotion of EQA of semen.Methods Taking sperm concentration as an ex-ample,the semen EQA data of 20 laboratories in Hunan Province in 2022 were selected,and the advantages and disadvantages of the traditional statistical scheme(TSS),robust statistical scheme(RSS)and traditional statistical scheme after eliminating the"outliers"(TSEOS)combined with robust statistical technology were analyzed and compared.Results The"outliers"could not be excluded from the sperm concentration data of the four groups in the TSS,which led to the difference between TSS and RSS or TSEOS.The num-ber of qualified laboratories for TSS and RSS were 19 vs 16,19 vs 16,19 vs 19,and 19 vs 19,respectively.Conclusion The results of RSS are similar to those of TSEOS.Compared with TSS,RSS do not need to remove outlier data steps,and are more suitable for se-men EQA data analysis with small data volume.