Oligoasthenospermia （OAS） is the common cause of male infertility，bringing fertility problems to many families. Its pathogenesis is complex，involving endocrine disorders，reproductive system infection，oxidative stress injury，immune dysfunction and other aspects. At present，the Western medicine treatment of OAS is mainly based on drugs，surgery，and assisted reproductive technology. However，drug therapy has certain side effects，and long-term use is easy to produce drug resistance. Surgical treatment has certain trauma and risk. Assisted reproductive technology is not widely available because of its high cost. Therefore，there is an urgent need to develop safer，economical，and effective treatment options. Traditional Chinese medicine （TCM） has obvious advantages in the treatment of OAS. It can play a role in the treatment of OAS by reducing oxidative stress，inhibiting inflammatory response，reducing apoptosis，and regulating cell autophagy through multiple pathways and targets. Recent studies have shown that TCM compound prescriptions，single medicinal materials，medicinal pairs，and their active components can ameliorate OAS by regulating several key signaling pathways such as the phosphatidylinositol 3-kinase/protein kinase B （PI3K/Akt） pathway，Janus kinase 2/signal transducer and activator of transcription 3（JAK2/STAT3） pathway，nuclear factor E₂-related factor 2/heme oxygenase-1 （Nrf2/HO-1） pathway，stem cell factor/tyrosine kinase receptor （SCF/c-kit） pathway，nuclear factor-κB （NF-κB） pathway，transforming growth factor-β （TGF-β）/Smads pathway，and extracellular regulated protein kinase （ERK） pathway. This article summarizes the role of the above signaling pathways in the occurrence and development of OAS and the therapeutic mechanism of TCM，aiming to provide a scientific basis for the clinical treatment of OAS and the research and development of drugs.

Objective:To explore the current situation and influencing factors of amputation decision-making dilemma of diabetic foot patients.Methods:From July to December 2023, 200 patients with diabetic foot in the Tianjin Medical University General Hospital and Tianjin Medical University Chu Hsien-I Memorial Hospital were selected as study subjects by convenience sampling. General Information Questionnaire, Decisional Conflict Scale (DCS), Family APGAR Index, and Hospital Anxiety and Depression Scale were used to conduct a cross-sectional survey. Pearson correlation was used to analyze the correlation between diabetic foot patients' amputation decision-making dilemma and family caring, anxiety and depression, and multiple linear regression was used to analyze the influencing factors of diabetic foot patients' amputation decision-making dilemma.Results:A total of 200 questionnaires were distributed, and 180 valid questionnaires were collected, with a valid response rate of 90.0% (180/200). The DCS score of 180 patients with diabetic foot was (30.04±9.77), 76.7% (138/180) patients scored ≥25.0, and they had decision-making dilemma, and 25.0% (45/180) of patients scored ≥37.5, indicating decision-making delay. Multiple linear regression analysis showed that occupational status, diabetes course, family caring, anxiety and depression were the influencing factors of amputation decision-making dilemma of diabetic foot patients ( P<0.05) . Conclusions:Diabetic foot patients face certain dilemmas in the process of amputation decision-making. Clinical medical and nursing staff should reasonably evaluate the patient's occupational status, disease course, family caring, and psychological state, and develop personalized decision support strategies to improve decision quality and prevent changes in the patient's condition caused by delayed decision-making.

OBJECTIVE： To systematically evaluate the efficacy of Compound xuanju capsules combined with chemical medicine versus chemical medicine alone in the treatment of polycystic ovarian syndrome （PCOS）， in order to provide evidence-based medicine guidelines for clinical medication. METHODS： Retrieved from PubMed， Embase， Cochrane library， CBM， VIP， CJFD and Wanfang database from database establishment to Apr. 5， 2019， randomized controlled trials （RCTs） about therapeutic efficacy （total response rate， ovulation rate， pregnancy rate， FSH level， LH level， testosterone level， degree of endometrial thickening） of Compound xuanju capsules combined with chemical medicine （trial group） versus chemical medicine alone （control group） in the treatment of PCOS were collected. After data extraction and quality evaluation of included studies with modified Jadad scale， Meta-analysis was conducted by using STATA 14.0 software. Trial sequential analysis （TSA） was conducted by using TSA 0.9 software. RESULTS： A total of 15 RCTs were included， involving 1 259 patients. The results of Meta-analysis showed that the total response rate [RR＝1.27，95％CI（1.13，1.44），P＜0.001]， ovulation rate [RR＝1.18，95％CI（1.03，1.37），P＜0.001]， pregnancy rate [RR＝1.34，95％CI（1.11，1.61），P＜0.001]， serum hormone level {FSH [SMD＝－0.66，95％CI （－0.51，  －0.82），P＜0.001]， 95％CI（－1.76，－1.41），P＜0.001]， LH [SMD＝－1.24，95％CI（－1.39， －1.08），P＜0.001]， testosterone [SMD＝－1.59，95％CI（－1.76，－1.41），P＜0.001]} and endometrial thickness [SMD＝1.20，95％CI（1.04，1.37），P＜0.001] of the trial group were better than those of the control group， with statistical significance. The results of TSA were reliable. CONCLUSIONS： In the treatment of PCOS， Compound xuanju capsules combined with chemical medicine is better than chemical medicine alone in improving total response rate， pregnancy rate， ovulation rate and endometrial thickness， and reducing serum hormone levels.

The classic treatise on febrile disease is one of the four great classics of traditional Chinese medicine,is the bridge of TCM theory and clinical courses.We think there are the following three aspects to cultivate the students' clinical thinking through this classic,teaching:the first is case teaching method throughout the class; the second is the application of multiple teaching methods to improve the teaching effect; and the third is the reform of examination way and improving the students' clinical interest.

0.05).The patients with positive P gp and LRP expression responded more poorly to chemotherapy than those with negative P gp and LRP expression ( P