Perimenopausal syndrome （MPS）， a common endocrine system disease， is one of the diseases responding specifically to traditional Chinese medicine （TCM）. The China Association of Chinese Medicine organized experts in endocrinology， gynecology， and interdisciplinary fields of both Western and Chinese medicine to discuss the advantages and challenges of diagnosing and treating MPS with Western medicine， TCM， and integrative medicine. Experts at the conference believe that MPS is initiated by estrogen decline and rooted in deficiency， with the pathogenesis being imbalance between Yin and Yang in the kidney. The hormone replacement therapy in Western medicine for menopause can rapidly alleviate related symptoms by quickly restoring the estrogen level and timely detect and delay complications of menopause， whereas such a therapy has certain risks， necessitating close monitoring of adverse reactions. Moreover， the various contraindications and precautions limit the clinical application of the hormone replacement therapy. TCM has advantages in synergistically alleviating symptoms such as hot flashes， sweating， sleep disorders， and emotional abnormalities of MPS without causing obvious adverse reactions. However， its efficacy is slower than the hormone replacement therapy， and the TCM evidence for preventing and treating complications of menopause remains unclear. Three suggestions were proposed for the future development of both Western and TCM for ameliorating MPS. First， an integrated diagnosis and treatment system for MPS with both Western and Chinese medicine should be established. Second， high-quality evidence-based interventions for MPS should be developed with TCM alone or in combination with Western medicine. Third， efforts should be made to promote the new TCM drug development and the interdisciplinary cooperation for treating MPS.

Objective:To investigate the perinatal risk factors and correlation between bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP).Methods:A retrospective analysis was performed on 173 preterm infants born at less than 32 weeks' gestation with BPD who were admitted to the neonatal intensive care unit (NICU) of the Women and Children's Hospital of Qingdao University from June 2017 to July 2022. According to the diagnostic criteria for ROP, these preterm infants were divided into the ROP group ( n=64) and the non-ROP group ( n=109). Chi-square test, two independent samples t-test, and Mann-Whitney U test were used to compare the general data, treatment, and the incidence of complications between the two groups. Multivariate logistic stepwise regression analysis was used to analyze the independent risk factors of ROP in preterm infants with BPD and the receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of independent risk factors on ROP. The correlation between the severity of BPD and the incidence of ROP was analyzed. Results:The gestational age at birth [(28.0±1.1) vs. (28.8±1.2) weeks, t=4.01], the birth weight [(1 075.9±141.4) vs. (1 143.2±168.6) g, t=2.68], the partial pressure of carbon dioxide [42.5 mmHg (1 mmHg=0.133 kPa) (34.0-51.0 mmHg) vs. 47.0 mmHg (39.0-54.0 mmHg), Z=－2.31], and the total fluid intake on the first day of birth [80.0 ml (72.3-88.7 ml) vs. 83.6 ml (76.6-92.8 ml), Z=－2.28] in the ROP group were all lower than those in the non-ROP group (all P<0.05). While the prothrombin time [15.7 s (14.1-17.7 s) vs. 14.6 s (13.1-16.7 s), Z=－2.17], activated partial thromboplastin time [64.7 s (52.9-77.9 s) vs. 55.8 s (48.4-68.9 s), Z=－2.12], the proportion of patients treated with pulmonary surfactant [71.9% (46/64) vs. 49.5% (54/109), χ 2=8.25], the total duration of oxygen supplementation [50.5 d (40.0-64.0 d) vs. 45.0 d (37.0-52.0 d), Z=－2.77], the duration of invasive ventilation [5.0 d (1.0-11.0 d) vs. 1.0 d (0.0-5.0 d), Z=－4.03], the duration of noninvasive ventilation or high-flow oxygen therapy [(31.7±12.7) vs. (26.4±13.1) d, t=－2.59], and the incidence of neonatal respiratory distress syndrome [76.6% (49/64) vs. 57.8% (63/109), χ 2=6.22] were increased in the ROP group (all P<0.05). There was no significant difference in the proportion of BPD treated with corticosteroids between the ROP and non-ROP groups [60.3% (38/63) vs. 74.3% (81/109), χ 2=3.67, P=0.055]. Multivariate logistic stepwise regression analysis showed that smaller gestational age ( OR=1.599, 95% CI: 1.126-2.272, P=0.009), less fluid intake on the first day ( OR=1.033, 95% CI: 1.004-1.062, P=0.024), and longer duration of invasive ventilation ( OR=1.076, 95% CI:1.017-1.138, P=0.011) were independent risk factors for ROP in BPD infants, while glucocorticoid treatment was an independent protective factor ( OR=0.378, 95% CI:0.173-0.827, P=0.015). Most patients with mild or moderate BPD did not develop ROP [64.6% (73/113) and 66.7% (34/51)], while those with severe BPD were more likely to be complicated by ROP (7/9) ( χ 2=6.84, P=0.033). Conclusions:BPD infants with smaller gestational age, longer duration of invasive ventilation, and less fluid intake on the first day of birth are more likely to develop ROP, while glucocorticoid therapy can reduce the incidence of ROP in this population. Severe BPD may increase the risk of ROP in infants.

Objective To analyze the evaluation value of the standard deviation of erythrocyte volume distribution width(RDW-SD),erythrocyte volume distribution width standard deviation and platelet ratio(RPR)and erythrocyte volume distribution width standard deviation and lymphocyte ratio(RLR)in the de-compensation stage of cirrhosis in primary biliary cholangitis(PBC).Methods The blood routine indexes of 68 patients with PBC admitted and treated in this hospital from January 2019 to June 2021 were retrospective-ly analyzed and divided into the compensation stage(n=36)and decompensation stage(n=32)according to the diagnostic standard.2 mL venous blood was extracted from the patient on an empty stomach in the early morning.The red blood cell(RBC),mean corpuscular volume(MCV),hemoglobin(Hb),hematocrit(HCT),mean erythrocyte hemoglobin content(MCHC),RDW-SD,white blood cell(WBC),neutrophil absolute value(N#),lymphocyte absolute value(L#),platelet count(PLT),mean platelet volume(MPV),platelet volume distribution width(PDW),etc.were detected.The platelet to lymphocyte ratio(PLR),RPR and RLR were calculated.The influencing factors of decompensation stage of PBC cirrhosis were analyzed by binary logistic regression,and the receiver operating characteristic(ROC)curve was used to analyze the diagnostic values of different indicators in the decompensation stage of PBC cirrhosis.Results There were statistically significant differences in age,RBC,Hb,HCT,RDW-SD,L #,PLT,RPR and RLR between the compensation group and decompensation group in PBC cirrhosis(P＜0.05).The binary logistic regression analysis showed that the age[odds ratios(OR)=1.087,95％confidence intervals(CI):1.015-1.165,P＜0.05],RDW-SD(OR=1.144,95％CI:1.030-1.270,P＜0.05)and RLR(OR=1.041,95％CI:1.007-1.075,P＜0.05)were the independent risk factors for progressing to the decompensation stage in the patients with PBC cirrhosis com-pensation stage.The ROC curve analysis showed that the areas under ROC curve(AUC)of RDW-SD,RPR and RLR for the diagnosis alone of decompensation stage of PBC cirrhosis were 0.726,0.778 and 0.798,re-spectively,and the differences were not statistically significant(P＞0.05).Conclusion Combined with the age factor,regular monitoring of RDW-SD,RPR and RLR levels has a high predictive value for the develop-ment of PBC cirrhosis compensation stage to decompensation stage.

Objective: To evaluate the safety and effectiveness of repeated transcranial magnetic stimulation (rTMS) for treating non-fluent aphasia after stroke. Methods: Forty-five stroke survivors with non-fluent aphasia were randomly divided into a 0.5 Hz group, a 1 Hz group and a sham group, each of 15. In addition to routine linguistic training, the three groups were given rTMS over the inferior frontal gyrus of the right hemisphere at the corresponding frequency or sham stimulation. Before as well as 5 and 10 days after the treatment, all of the subjects were evaluated using the Chinese version of the Western Aphasia Battery (WAB). The occurrence of adverse events was also observed. Results: Before treatment, no significant differences were observed in the groups′ average aphasia ratio, spontaneous speech, listening comprehension, retelling and naming using the WAB. After 5 and 10 days significant increases were observed in the average WAB scores of all three groups, but the listening comprehension of the 0.5 Hz group was significantly better than that of the sham group 10 days later, as was the spontaneous speech of the 1 Hz group. Conclusion rTMS at either 1 Hz or 0.5 Hz can improve the linguistic functioning of stroke survivors with non-fluent aphasia. Both 0.5 Hz and 1 Hz rTMS are safe, but the latter is more effective.

Objective To observe the effect of the modified Yulin Decoction on improving the living quality of patients with yang-deficiency of the spleen and kidney of premature ovarian failure. Methods One hundred and twenty-seven patients were divided into experimental group (80) and control group (47) by non-randomized noninferiority comparative study. The experimental group was treated with modified Yulin Decoction daily orally once a day. The control group was treated with oral estradiol valerate and progesterone cycle. Two groups received continuous medication for 21 d, and treatment interval was 5 d. Three cycles of treatment were set as one course, and treated for 2 courses. The SF-36 scale was used to calculate the total scores and scores of eight dimensions before and after treatment. Results Before treatment, there was no significant difference (P>0.05) in the scores of SF-36 dimensions (except somatic pain) and total score between the two groups. Compared with before treatment, the score and total score of SF-36 in the experimental group increased (P<0.05, P<0.01). The mental health score of the control group was higher than that of before treatment (P<0.05, P<0.01). After treatment, there was statistical significance in the two dimensions of vitality and mental health in the two groups (P<0.05). There were significant differences (P<0.01) in the total score and scores of SF-36 physiological function, physical pain, general health, vigor, social function, emotional function and mental health between the two groups. Conclusion Modified Yulin Decoction can improve the living quality of patients with yang-deficiency of the spleen and kidney of premature ovarian failure.

Objective To investigate the clinical value of the ratio of ADA and CysC in the Pleural effusion and serum for the di-agnosis of Tuberculous pleural effusion .Methods In the first half of 2014 ,50 cases from a random sample of patients with tubercu-lous pleurisy admitted in our hospital were chosen as tuberculosis group ,20 cases of patiente with lung cancer pleural effusion as malignant group and 30 cases of patiente with hepatic hydrothorax as control group .The concentrations of CysC and ADA in the pleural effusion and serum were detected ,and the ratios of these two indexes in the pleural effusion and serum were calculated .Re-sults (1)The results in three groups including PADA and SADA ,SCysC and PCysC ,PCysC/SCysC and PADA/SADA were com-pared ,and the differences were statistically significant (P<0 .05) .(2) According to the ROC curve ,the critical value of PADA/SA-DA and PCysC/SCysC were set as 1 .58 and 2 .30 ,respectively ,and area under the curve of PADA/SADA and PCysC/SCysC were 0 .880 and 0 .786 respectively .Conclusion The diagnostic value of PADA/SADA and PCysC/SCys for tuberculous pleural effusion is higher than that of PADA ,SADA ,PCysC or SCysC alone ,which can be used for the differential diagnosis of tuberculous pleural effusion index for clinical application .

Objective To study the effect of community nursing and family members′participation on rehabilitation of patients with cerebral infarction. Methods Forty-two patients with cerebral infarction discharged from our hospital was chosen to take community rehabilitation training. The scores by modified Barthel index (MBI) and functional comprehensive assessment (FCA) before intervention were compared to those after intervention at the time points of pre-intervention and 1 month , three months after intervention. Results The scores by modified Barthel index (MBI) and functional comprehensive assessment (FCA) before intervention were significantly higher than those before intervention (P<0.01). The scores by MBI 1 month after intervention were significantly higher than those three months after intervention (P<0.01), indicating the longer the rehabilitation training, the better the effect. Conclusion The community rehabilitation care to patients with cerebral infarction sequelae can improve the quality of rehabilitation training and finally their quality of life.

Myofascial pain syndrome (MPS) is a common skeletal muscle pain and dysfunction,characterized by the presence of myofascial pain points (MTrPs).At present,the main method of locating MTrPs is palpation which has lower intra-rater reliability,and lacks an objective evaluation approach for therapeutic effects.Therefore,the research on objective evaluation of the characteristics of MPS has been receiving great attention.These studies involve stiffness of trigger points,fascia thickness,surface temperature and other aspects through various methods,such as ultrasonic imaging,magnetic resonance imaging,infrared thermal imaging.In this paper,the research progress and methods of MPS in imaging were surveyed,which can provide the basis for the clinical diagnosis and objective evaluation of therapeutic effects.

Objective To determine the value of MR in the diagnosis of the medial and lateral meniscal posterior root tears.Methods One hundred and twenty one patients underwent arthroscopy and MR of knee examinations were retrospectively reviewed,and all of them did not have the history of knee surgery before the MR examination.MR images were double-blinded,independently,retrospectively scored by radiology residency (doctor 1) and attending radiologist (doctor 2).The likelihood of the meniscus posterior root tear was scored on basis of arthroscopic findings constituted the gold standard.Sensitivity,specificity and accuracy of MR diagnosis of the lateral and medial meniscus posterior root tear by two physicians were calculated,and the consistency of diagnosis results by two physicians was evaluated using the Kappa statistics.Reasons leading to misdiagnosis or missed diagnosis were discussed.Results Thirty three of the 121 patients were diagnosed with meniscus posterior root tears by arthroscopy,including 14 cases of lateral tears and 19 cases of medial tears.The sensitivity,specificity and accuracy in the diagnosis of posterior lateral meniscus root tears (PLMRT) for doctor 1 were 71.4％ (10/14),82.2％ (88/107) and 81.0％ (98/121),respectively,and for doctor 2 were 71.4％ (10/14),86.0％ (92/107) and 84.3％ (102/121).The sensitivity,specificity and accuracy in the diagnosis of posterior medial meniscus root tears (PMMRT) for doctor 1 were 100.0％ (19/19),88.2％ (90/102) and 90.1％ (109/121),respectively,and for doctor 2 were 100.0％ (19/19),95.1％ (97/102) and 95.9％ (116/121),respectively.The Kappa statistics for PLMRT and PMMRT were 0.67 and 0.81,respectively,demonstrating a good interobserver agreement (P＜0.05).The misdiagnosed cases of the PMMRT were 12 for doctor 1 and 5 for doctor 2.There were 4 cases being commonly misdiagnosed by the two doctors,and there were no any missed cases in this study.For the PLMRT,the misdiagnosed cases were 19 for doctor 1 and 15 for doctor 2.Eleven cases were misdiagnosed and 4 were missed by the two physicians.Conclusion MR is a reliable diagnostic tool for detecting posterior root tears of the medial and lateral meniscus.

Objective To evaluate the correlation between diffusion tensor imaging(DTI)measurements,fiber tracking(FT)and the clinical symptoms in patients with cervical spondylotic myelopathy.Methods According to the Japanese orthopaedics association score(JOA),104 patients with cervical spondylopathy were divided into 4 groups:mild in 31 patients with 13-16 scores,moderate in 27 with 9-12 scores,severe in 25 with 5-8 scores,and serious in 21 with 0-4 scores.According to the lesion signal characters,all patients were divided into 3 groups:Group A with normal signal in both T1 WI and T2WI in 33 patients,Group B with normal signal in T1WI but high signal in T2WI in 30 patients,and Group C with low signal in T1 WI and high signal in T2WI in 41 patients.Apparent diffusion coefficient (ADC),fractional anisotropy(FA),λ1,λ2,λ3 were measured in the spinal cord at the serious pressed section,and fiber tractography was performed.The Spearman correlation analyses was used to correlate each of the DTI measurement with JOA score.Group difference was tested with one-way ANOVA method.Results High quality of DTI was acquired in all patients.The FA values in the mild,moderate,severe,and serious groups were respectively 0.69 ±0.13,0.58 ±0.03,0.46 ±0.08,and 0.37 ±0.11 and significant difference was found in different groups(F =100.59,P ＜ 0.05)and positively correlated with JOA scores (r =0.883,P ＜ 0.05).There was no statistical significance between JOA scores and ADC,λ1,λ2,λ3(r=0.232,0.217,0.113,0.127,P ＞0.05).The FA values in group A,B,and C were respectively 0.67 ±0.33,0.51 ±0.21,0.38 ±0.03,and significant difference was found among different groups(F =50.05,P ＜ 0.05).Decrease of JOA score and high signal in T2 companied with decrease of FA value.Decrease of FA values was found associated with increase of fiber bundle damage.The ADC,λ2,λ3 but not λ1 were significantly different among the JOA groups and the group A,B,and C.Conclusions The FA values are positively correlated with clinical symptoms.Decrease of FA values is found associated with increase of fiber bundle damage.DTI can show the severity and extent of damage of spinal cord in patients with cervical spondylotic myelopathy.