Objective To investigate the correlation of sperm aneuploidy with unexplained recurrent spontaneous abortion(URSA).Methods Thirty-four male partners of couples diagnosed with URSA in the Center of Reproductive Medicine of Northwest Women's and Children's Hospital from November 2021 to December 2023 were enrolled as the experimental group,after excluding chromosomal structural or numerical abnormalities in either partner of the couples,female age≥37 years,and other known female-related causes of miscarriage.Meanwhile,30 men,who had given birth to healthy children,or were infertile only due to female factors and had normal semen parameters,were selected as control group.Fluorescence in situ hybridization(FISH)was used to detect sperm aneuploidy after routine semen analysis for the males of the two groups.Results There were no significant differences in male age,semen volume,sperm concentration,percentage of progressively motile sperm,and percentage of sperm with normal morphology between the two groups(all P＞0.05).However,in the experimental group,the total nullisomy rate(2.10±1.93)％ versus(0.54±0.27)％,total dip-loidy rate(0.25±0.27)％ versus(0.05±0.05)％,and disomy rate of chromosome 18(0.77±1.15)％ versus(0.18±0.21)％,sex chromosomes(2.79±2.38)％ versus(0.78±0.52)％,chromosome 13(0.79±0.99)％ versus(0.21±0.22)％,and chromosome 21(1.24±1.68)％ versus(0.22±0.19)％ were significantly higher than those in the control group(P＜0.05).When the the mean aneu-ploidy rate in the control group(x+2s)was set as the upper limit of the normal reference value,the proportions of disomy rates of chro-mosomes 18,13,21 and sex chromosomes,as well as the total diploidy rate exceeding the threshold in the experimental group were 41.18％,35.29％,41.18％,55.88％,and 47.06％,respectively,with the proportion of abnormal disomy rate of sex chromosomes be-ing the highest.Conclusion The aneuploidy rate of sperm may be a related factor leading to unexplained recurrent spontaneous abor-tion in females,which has certain clinical significance for the assessment of male fertility and the diagnosis of male infertility.

Objective:To evaluate the therapeutic value of radiotherapy in combined immunotherapy and chemotherapy as first-line treatment for patients with oligometastatic non-small cell lung cancer (NSCLC).Methods:A retrospective analysis was conducted on data from 195 NSCLC patients who lacked epidermal growth factor receptor (EGFR) or anaplastic lymphoma kinase (ALK) mutations and were treated at the Anyang Tumor Hospital and the Fourth Hospital of Hebei Medical University from January 2019 to December 2021. These patients consisted of 166 male and 29 female cases, aged from 28 to 85 years, with an average age of (61.4 ± 9.3) years. These patients were divided into two groups, with each group receiving the radiotherapy and combined immunotherapy and chemotherapy (the radiotherapy and combination group, n = 60) and combined immunotherapy and chemotherapy only (the combination group, n = 135). Then, propensity score matching (PSM) was performed to analyze the differences in prognosis between both groups before and after PSM, as well as the short-term efficacy and adverse reactions after PSM. Results:For the 195 NSCLC patients, the median follow-up time was 31.8 months, with median overall survival (OS) and median progression-free survival (PFS) recorded at 23.8 months and 9.2 months, respectively. The radiotherapy and combination group exhibited enhanced 1-, 2-, and 3-year survival rates of 78.5%, 55.9%, and 45.1%, respectively, significantly higher than the combination group (48.3%, 35.6%, and 26.6%, respectively, χ2 = 14.65, P < 0.001). Similarly, the radiotherapy and combination group displayed 1-, 2-, and 3-year PFS rates of 51.9%, 29.5%, and 22.7%, respectively, exceeding those of the combination group (30.0%, 24.5%, and 16.9%, respectively, χ2=6.09, P=0.014). After PSM, the radiotherapy and combination group manifested an objective response rate (ORR) of 60.0% (33/55) and a disease control rate (DCR) of 89.1% (49/55), which were 16.4% (9/55) and 56.4% (31/55), respectively for the combination group. These results suggested that the radiotherapy and combination group demonstrated significantly higher ORR and DCR ( χ2 = 22.18, 14.85, P<0.001). After PSM, the radiotherapy and combination group yielded 1-, 2-, and 3-year survival rates of 70.9%, 52.3%, and 41.9%, respectively, significantly than the combination group (43.6%, 29.8%, and 27.1%, respectively, χ2=8.95, P=0.003). The radiotherapy and combination group exhibited 1-, 2-, and 3-year PFS rates of 47.3%, 27.3%, and 18.7%, respectively, significantly higher than the combination group (23.6%, 17.6%, and 15.4%, respectively, χ2 = 6.71, P = 0.010). Multivariate Cox regression analysis revealed that independent factors affecting OS included clinical stage, treatment regimen, number of immunotherapy cycles, and treatment efficacy ( HR = 1.88, 2.11, 0.23, 1.79, P < 0.05). Similarly, independent factors affecting PFS consisted of treatment regimen, number of immunotherapy cycles, and treatment efficacy ( HR = 1.62, 0.37, 3.42, P <0.05). There were no statistical differences in the incidence of grade ≥ 2 bone marrow suppression (18.2% vs. 12.7%) and grade ≥ 2 pneumonia (21.8% vs. 14.5%) between both groups ( P>0.05). Conclusions:Introducing radiotherapy into combined immunotherapy and chemotherapy as first-line treatment for oligometastatic NSCLC can optimize both local and systemic disease control and significantly improve patient prognosis without increasing treatment-related adverse reactions.

OBJECTIVE To observe the effects of measures dominated by intensifying link quality on prevention and control of carbapenem-resistant Klebsiella pneumoniae(CRKP)among general ICU patients.METHODS The conventional intervention measures were taken from Jan.2016 to Oct.2020,which was assigned as the pre-inter-vention period;the intervention measures dominated by enhancement of link quality were taken for the general ICU patients(the study group)from Nov.2020 to Oct.2021,which was set as the intervention period,the inter-vention measures were taken for the neurosurgery ICU patients and the surgery ICU patients(the control group).A two-group interrupted time series of a quasi-experimental study was analyzed,and whether or not the intervention measures could reduce the incidence of CRKP hospital-associated infection among the general ICU patients was evaluated.RESULTS A total of 23 713 case-times of patients from three ICU wards were enrolled in the study.The incidence of CRKP hospital-associated infection among the general ICU patients was 4.49 cases per thousand patient-days during intervention period,3.71 cases per thousand patient-days during pre-intervention pe-riod,and there was no significant difference(u=-1.412,P=0.079);it was lower than 7.06 cases per thousand patient-days during nearly one year before the intervention period(from Nov.2019 to Oct.2020),and there was significant difference(u=3.128,P=0.002).The result of analysis of the interrupted time series showed that there was significant difference in the slope change between the study group and the control group after the inter-vention(P=0.035),indicating that the intervention measures could reduce the incidence of CRKP hospital-associ-ated infection in the study group,and there was significant difference in the changing trend between the study group and the control group.CONCLUSIONS The prevention and control measures for CRKP dominated by the link quality management can effectively reduce the incidence of CRKP hospital-associated infection among the gen-eral ICU patients.The prevention and control strategies may provide reference for prevention and control of CRKP in ICUs of other medical institutions.

Objective:To observe the efficacy of transcutaneous electrical acupoint stimulation (TEAS) when it is combined with warm moxibustion scraping therapy (WMST) in the treatment of myofascial pain syndrome (MPS) in the lumbodorsal region.Methods:A total of 112 patients with lumbodorsal MPS were randomly divided into a control group and a combination group, each of 56. All of the patients received TEAS, but those in the combined group additionally received warm moxibustion scraping therapy. The treatment consisted of 3 consecutive courses, with each course lasting 2 weeks and a 1-day rest interval between courses. Before the treatment and after completing 3 courses (post-treatment), the therapeutic effects were evaluated using traditional Chinese medicine (TCM) syndrome scores, visual analogue scale (VAS) ratings for pain, a pain rating index (PRI), present pain intensity (PPI), the Oswestry Disability Index (ODI), and the Pittsburgh Sleep Quality Index (PSQI).Results:After the treatment, significant decreases were observed in the average TCM syndrome, VAS pain, PRI, PPI, ODI and PSQI scores of both groups, but the combination group′s averages were all significantly lower than those of the control group. Efficacy among the combination group (92.9%) was significantly higher than among the controls (62.5%).Conclusions:Supplementing TEAS with warm moxibustion scraping can more effectively relieve lumbodorsal pain and dysfunction among patients with lumbodorsal MPS, and improve their sleep quality.

Objective:To evaluate the therapeutic value of radiotherapy in combined immunotherapy and chemotherapy as first-line treatment for patients with oligometastatic non-small cell lung cancer (NSCLC).Methods:A retrospective analysis was conducted on data from 195 NSCLC patients who lacked epidermal growth factor receptor (EGFR) or anaplastic lymphoma kinase (ALK) mutations and were treated at the Anyang Tumor Hospital and the Fourth Hospital of Hebei Medical University from January 2019 to December 2021. These patients consisted of 166 male and 29 female cases, aged from 28 to 85 years, with an average age of (61.4 ± 9.3) years. These patients were divided into two groups, with each group receiving the radiotherapy and combined immunotherapy and chemotherapy (the radiotherapy and combination group, n = 60) and combined immunotherapy and chemotherapy only (the combination group, n = 135). Then, propensity score matching (PSM) was performed to analyze the differences in prognosis between both groups before and after PSM, as well as the short-term efficacy and adverse reactions after PSM. Results:For the 195 NSCLC patients, the median follow-up time was 31.8 months, with median overall survival (OS) and median progression-free survival (PFS) recorded at 23.8 months and 9.2 months, respectively. The radiotherapy and combination group exhibited enhanced 1-, 2-, and 3-year survival rates of 78.5%, 55.9%, and 45.1%, respectively, significantly higher than the combination group (48.3%, 35.6%, and 26.6%, respectively, χ2 = 14.65, P < 0.001). Similarly, the radiotherapy and combination group displayed 1-, 2-, and 3-year PFS rates of 51.9%, 29.5%, and 22.7%, respectively, exceeding those of the combination group (30.0%, 24.5%, and 16.9%, respectively, χ2=6.09, P=0.014). After PSM, the radiotherapy and combination group manifested an objective response rate (ORR) of 60.0% (33/55) and a disease control rate (DCR) of 89.1% (49/55), which were 16.4% (9/55) and 56.4% (31/55), respectively for the combination group. These results suggested that the radiotherapy and combination group demonstrated significantly higher ORR and DCR ( χ2 = 22.18, 14.85, P<0.001). After PSM, the radiotherapy and combination group yielded 1-, 2-, and 3-year survival rates of 70.9%, 52.3%, and 41.9%, respectively, significantly than the combination group (43.6%, 29.8%, and 27.1%, respectively, χ2=8.95, P=0.003). The radiotherapy and combination group exhibited 1-, 2-, and 3-year PFS rates of 47.3%, 27.3%, and 18.7%, respectively, significantly higher than the combination group (23.6%, 17.6%, and 15.4%, respectively, χ2 = 6.71, P = 0.010). Multivariate Cox regression analysis revealed that independent factors affecting OS included clinical stage, treatment regimen, number of immunotherapy cycles, and treatment efficacy ( HR = 1.88, 2.11, 0.23, 1.79, P < 0.05). Similarly, independent factors affecting PFS consisted of treatment regimen, number of immunotherapy cycles, and treatment efficacy ( HR = 1.62, 0.37, 3.42, P <0.05). There were no statistical differences in the incidence of grade ≥ 2 bone marrow suppression (18.2% vs. 12.7%) and grade ≥ 2 pneumonia (21.8% vs. 14.5%) between both groups ( P>0.05). Conclusions:Introducing radiotherapy into combined immunotherapy and chemotherapy as first-line treatment for oligometastatic NSCLC can optimize both local and systemic disease control and significantly improve patient prognosis without increasing treatment-related adverse reactions.

In the YY 0989.3-2023 standard, clause 27.106 specifies the protection test against electromagnetic interference, but it only briefly describes the test level for electromagnetic exposure, and does not detail the parameters of the torso. This study aims to explore the internal field distribution for different torso parameters under electromagnetic exposure, and explore the patterns of field distribution through modeling and simulation. The results indicate that the parameters of the torso significantly affect the internal field distribution. The findings of this study provide a basis and reference for the electromagnetic compatibility test for implantable neurostimulator products.
Electromagnetic Fields ; Implantable Neurostimulators ; Computer Simulation

OBJECTIVE To observe the effects of measures dominated by intensifying link quality on prevention and control of carbapenem-resistant Klebsiella pneumoniae(CRKP)among general ICU patients.METHODS The conventional intervention measures were taken from Jan.2016 to Oct.2020,which was assigned as the pre-inter-vention period;the intervention measures dominated by enhancement of link quality were taken for the general ICU patients(the study group)from Nov.2020 to Oct.2021,which was set as the intervention period,the inter-vention measures were taken for the neurosurgery ICU patients and the surgery ICU patients(the control group).A two-group interrupted time series of a quasi-experimental study was analyzed,and whether or not the intervention measures could reduce the incidence of CRKP hospital-associated infection among the general ICU patients was evaluated.RESULTS A total of 23 713 case-times of patients from three ICU wards were enrolled in the study.The incidence of CRKP hospital-associated infection among the general ICU patients was 4.49 cases per thousand patient-days during intervention period,3.71 cases per thousand patient-days during pre-intervention pe-riod,and there was no significant difference(u=-1.412,P=0.079);it was lower than 7.06 cases per thousand patient-days during nearly one year before the intervention period(from Nov.2019 to Oct.2020),and there was significant difference(u=3.128,P=0.002).The result of analysis of the interrupted time series showed that there was significant difference in the slope change between the study group and the control group after the inter-vention(P=0.035),indicating that the intervention measures could reduce the incidence of CRKP hospital-associ-ated infection in the study group,and there was significant difference in the changing trend between the study group and the control group.CONCLUSIONS The prevention and control measures for CRKP dominated by the link quality management can effectively reduce the incidence of CRKP hospital-associated infection among the gen-eral ICU patients.The prevention and control strategies may provide reference for prevention and control of CRKP in ICUs of other medical institutions.

Objective To investigate the correlation of sperm aneuploidy with unexplained recurrent spontaneous abortion(URSA).Methods Thirty-four male partners of couples diagnosed with URSA in the Center of Reproductive Medicine of Northwest Women's and Children's Hospital from November 2021 to December 2023 were enrolled as the experimental group,after excluding chromosomal structural or numerical abnormalities in either partner of the couples,female age≥37 years,and other known female-related causes of miscarriage.Meanwhile,30 men,who had given birth to healthy children,or were infertile only due to female factors and had normal semen parameters,were selected as control group.Fluorescence in situ hybridization(FISH)was used to detect sperm aneuploidy after routine semen analysis for the males of the two groups.Results There were no significant differences in male age,semen volume,sperm concentration,percentage of progressively motile sperm,and percentage of sperm with normal morphology between the two groups(all P＞0.05).However,in the experimental group,the total nullisomy rate(2.10±1.93)％ versus(0.54±0.27)％,total dip-loidy rate(0.25±0.27)％ versus(0.05±0.05)％,and disomy rate of chromosome 18(0.77±1.15)％ versus(0.18±0.21)％,sex chromosomes(2.79±2.38)％ versus(0.78±0.52)％,chromosome 13(0.79±0.99)％ versus(0.21±0.22)％,and chromosome 21(1.24±1.68)％ versus(0.22±0.19)％ were significantly higher than those in the control group(P＜0.05).When the the mean aneu-ploidy rate in the control group(x+2s)was set as the upper limit of the normal reference value,the proportions of disomy rates of chro-mosomes 18,13,21 and sex chromosomes,as well as the total diploidy rate exceeding the threshold in the experimental group were 41.18％,35.29％,41.18％,55.88％,and 47.06％,respectively,with the proportion of abnormal disomy rate of sex chromosomes be-ing the highest.Conclusion The aneuploidy rate of sperm may be a related factor leading to unexplained recurrent spontaneous abor-tion in females,which has certain clinical significance for the assessment of male fertility and the diagnosis of male infertility.

Objective:To observe the efficacy of transcutaneous electrical acupoint stimulation (TEAS) when it is combined with warm moxibustion scraping therapy (WMST) in the treatment of myofascial pain syndrome (MPS) in the lumbodorsal region.Methods:A total of 112 patients with lumbodorsal MPS were randomly divided into a control group and a combination group, each of 56. All of the patients received TEAS, but those in the combined group additionally received warm moxibustion scraping therapy. The treatment consisted of 3 consecutive courses, with each course lasting 2 weeks and a 1-day rest interval between courses. Before the treatment and after completing 3 courses (post-treatment), the therapeutic effects were evaluated using traditional Chinese medicine (TCM) syndrome scores, visual analogue scale (VAS) ratings for pain, a pain rating index (PRI), present pain intensity (PPI), the Oswestry Disability Index (ODI), and the Pittsburgh Sleep Quality Index (PSQI).Results:After the treatment, significant decreases were observed in the average TCM syndrome, VAS pain, PRI, PPI, ODI and PSQI scores of both groups, but the combination group′s averages were all significantly lower than those of the control group. Efficacy among the combination group (92.9%) was significantly higher than among the controls (62.5%).Conclusions:Supplementing TEAS with warm moxibustion scraping can more effectively relieve lumbodorsal pain and dysfunction among patients with lumbodorsal MPS, and improve their sleep quality.

To develop a framework for clinical teaching management (CTM) position competencies, and to initiate the preliminary application of this framework.