Objective To evaluate the safety and effectiveness of different doses of epidural oxycodone injection for traction reaction during cesarean sections to determine the optimal dose.Methods Totally 119 cases of parturients who underwent cesarean sections from October 2023 to May 2024 were selected and randomly divided into groups A,B,C and D.All four groups of lying-in women received epidural injection after the umbilical cord was cut.Groups A,B and C were given oxycodone 3 mg,5 mg and 7 mg respectively,and group D was given an equal amount of normal saline.The primary outcomes were documentation of maternal vital signs and traction reaction during the surgery.Secondary outcomes included patient-controlled intravenous analgesia(PCIA)times within 48 hours and documentation of any postoperative adverse events within 24 hours.Results The comparison of in-tra?operative vital signs among the four groups of patients revealed no statistically significant differences.In groups A,B and C the incidence of traction reactions was significantly lower at 20％,17.2％and 3.3％,respectively,compared to group D at 53.3％,showing statistically significant differences(P<0.05).Additionally,the inci?dence of traction reaction in group C was significantly lower than in group A(P<0.05).Groups A,B and C pro?duced significantly better results than group D in terms of the duration of anesthesia.PCIA presses were substan?tially less in groups A and C than in group D(P<0.05),and group C had a significantly higher total incidence of adverse events than group A and group D(P<0.05).Conclusions Epidural injection of 3 mg,5 mg and 7 mg oxycodone has been proved to significantly reduce traction reaction during cesarean sections while minimally im?pacting intraoperative vital signs.This intervention has the potential to extend the duration of anesthesia,decrease the frequency of PCIA presses.Among these,7 mg is the most effective but has the highest incidence of adverse effects,requiring carefully post?operative monitoring.

Objective To investigate the effect of individualized lifestyle intervention on sexual function in obese patients with polycystic ovarian syndrome(PCOS).Methods The study was conducted on obese patients with PCOS in the Department of Endocrinology,Beijing Obstetrics and Gynecology Hospital,Capital Medical University from October 2022 to December 2023.There were 160 cases in both the experimental group and the control group,progesterone was administered to both groups for 3 months to regulate menstruation.For women in the experimental group received individualized comprehensive lifestyle intervention combining diet,exercise,and behavior modifications,along with dedicated follow-up and weight management.The control group received routine clinical education for lifestyle intervention aimed at weight loss.Female Sexual Function Index(FSFI)and 12-item Short-Form Health Survey(SF-12)scale were applied to evaluate the sexual function and quality of life.The clinical data that may affect sexual function were collected and sex hormone levels were measured,including anthropometric indicators,estradiol,sex hormone-binding globulin,total testosterone,bioactive testosterone,and dehydroepiandrosterone sulfate in serum.Results After 3 months of intervention,the body mass index,waist circumference,body fat percentage,insulin resistance index,total testosterone,bioactive testosterone and dehydroepiandrosterone sulfate in experimental groups were significantly lower(P<0.05),and the sex hormone binding globulin level was significantly higher(P<0.001),compared with the control group.SF-12 mental health scores,FSFI total scores,sexual desire,orgasm and sexual satisfaction scores were significantly increased in experimental groups(P<0.05),however,there were no significant differences in SF-12 physical health scores,as well as the scores of sexual arousal,vaginal lubrication,and coital pain.Conclusions Individualized lifestyle intervention can better improve the sexual function and mental health of obese patients with PCOS.

Objective To investigate the effect of individualized lifestyle intervention on sexual function in obese patients with polycystic ovarian syndrome(PCOS).Methods The study was conducted on obese patients with PCOS in the Department of Endocrinology,Beijing Obstetrics and Gynecology Hospital,Capital Medical University from October 2022 to December 2023.There were 160 cases in both the experimental group and the control group,progesterone was administered to both groups for 3 months to regulate menstruation.For women in the experimental group received individualized comprehensive lifestyle intervention combining diet,exercise,and behavior modifications,along with dedicated follow-up and weight management.The control group received routine clinical education for lifestyle intervention aimed at weight loss.Female Sexual Function Index(FSFI)and 12-item Short-Form Health Survey(SF-12)scale were applied to evaluate the sexual function and quality of life.The clinical data that may affect sexual function were collected and sex hormone levels were measured,including anthropometric indicators,estradiol,sex hormone-binding globulin,total testosterone,bioactive testosterone,and dehydroepiandrosterone sulfate in serum.Results After 3 months of intervention,the body mass index,waist circumference,body fat percentage,insulin resistance index,total testosterone,bioactive testosterone and dehydroepiandrosterone sulfate in experimental groups were significantly lower(P<0.05),and the sex hormone binding globulin level was significantly higher(P<0.001),compared with the control group.SF-12 mental health scores,FSFI total scores,sexual desire,orgasm and sexual satisfaction scores were significantly increased in experimental groups(P<0.05),however,there were no significant differences in SF-12 physical health scores,as well as the scores of sexual arousal,vaginal lubrication,and coital pain.Conclusions Individualized lifestyle intervention can better improve the sexual function and mental health of obese patients with PCOS.

Neurexin-3α, discovered in 2016, is a new type of autoimmune encephalitis antibody. Anti-neurexin-3α antibody-associated encephalitis is generally associated with prodromal symptoms or mood changes, having main clinical manifestations as seizures, memory disorders, confusion or loss of consciousness, central ventilation insufficiency, abnormal behavior, and speech disorders. This paper reviews the relevant research progress at home and abroad about pathogenesis, diagnosis and differential diagnosis, treatment and prognosis of anti-neurexin-3α antibody-associated encephalitis, so as to expand the understanding of clinicians for this disease.

Objective:To establish a quality evaluation method for the simultaneous determination of Calycosin-7-O-β-D-Glucopyranoside and Lobetyolin in Danqi Xinmaikang boiled powders and pieces.Methods:Quantitative analysis of multi-components was performed to determine contents of Calycosin-7-O-β-D-Glucopyranoside and Lobetyolin with Calycosin-7-O-β-D-Glucopyranoside as the reference substance by single-maker (QAMS). The chromatogram conditions were established, with C18 column as solid phase, acetonitrile-water as flowing phase, 268 nm as detecting wavelength, 1.0 ml/min as flowing rate, 30 ℃ as column temperature, and 10 μl as injection volume.Results:The relative correction factor between Calycosin-7-O-β-D-Glucopyranoside and Lobetyolin was 1.14. There was no significant difference of measured values between the external standard method and QAMS ( P>0.05). With Calycosin-7-O-β-D-Glucopyranoside retention time of 1.00, the relative retention time of Lobetyolin was 1.51 and RSD was less than 5%. Conclusion:It is feasible and accurate to evaluate the quality of Danqi Xinmaikang boiled powders and pieces by QAMS.

Objective:To retrospectively analyze the failure patterns and outcomes of patients with locally advanced hypopharyngeal squamous cell carcinoma (HPSCC) after undergoing induction chemotherapy (IC) followed by definitive radiotherapy.Methods:For patients with locally advanced HPSCC who were treated with IC and definitive radiotherapy from August 2008 to December 2019, their data were collected from the medical records system, and their clinical characteristics, failure patterns, and survival were retrospectively analyzed.Results:A total of 116 eligible patient with squamous cell carcinoma were included in this study. with a median age of 59 (39-79), and 3, 3, 60, and 50 of them had stage Ⅱ, Ⅲ, Ⅳ A, and Ⅳ B HPSCC, respectively. Among these patients, 81 received 1~2 cycles of IC, and 35 received 3-4 cycles of IC. After treatment with IC, 54, 13, and 49 patients received concurrent chemoradiotherapy, radiotherapy combined with targeted therapy, and radiotherapy alone, respectively. The median follow-up was 34.6 months (95% CI: 28.7-40.5 months). The 3-year local recurrence-free survival (LRFS), regional recurrence-free survival (RRFS), metastasis-free survival (MFS), progression-free survival (PFS), and overall survival (OS) of all the patients were 63.5%, 82.8%, 75.2%, 47.3%, and 43.1%, respectively. Median PFS and OS were 26.1 and 28.0 months, respectively. Treatment failure was reported in 59 patients, of whom 22, 5, 12, 10, 3, 6 and 1 experienced local, regional, distant only, local-regional, regional-distant, local-distant, and local-regional-distant failure, respectively. The objective response rate (CR+ PR) of patients after IC was 55.2% (64/116). The LRFS, RRFS, PFS, and OS of IC responders (CR+ PR) were better than those of IC non-responders (SD+ PD) ( χ2 = 12.52, 5.16, 13.19, 11.72, all P< 0.05). Conclusions:IC combined with radical radiotherapy has efficacy to a certain extent in the treatment of locally advanced HPSCC, and locoregional recurrence predominates the failure patterns. The prognosis of IC responders is significantly better than that of IC non-responders.

Objective:To describe the characteristics of genotype and phenotype in 3 families with X-linked retinoschisis (XLRS) due to RS1 mutations. Methods:A cross-sectional approach was adopted.Three XLRS families at the Ningxia Eye Hospital from October 2017 to March 2019 were included.Clinical data and peripheral blood of patients and related families were collected and clinically staged were formulated through a comprehensive eye examination.The disease-causing genes screened by panel sequencing underwent conservative analysis, pathogenicity analysis and protein structure prediction by software tools.Analysis of the mutations pathogenicity was performed according to the American College of Medical Genetics and Genomics guidelines.The research was approved by Medical Ethics Committee of the People's Hospital of Ningxia Hui Autonomous Region and followed the Declaration of Helsinki.Written informed consent was obtained from each participant.Results:Total 5 young male patients and 1 middle-aged patient in these three families.The optical coherence tomography(OCT) findings of 5 young patients showed typical macular retinoschisis, which were characterized by stage I of XLRS.One middle-aged patient (Ⅱ-9) showed a stage Ⅲ lesion of macular atrophy.The mutations of c. 668G>A, c.618G>A and exon 1 deletion in RS1 gene were found in the three families.C223 and W206 were verified to be highly conserved in mammals and were predicted to be pathogenic mutations by software and the change of protein structure.Conservation analysis and prediction of protein structure were not performed for the mutation of exon 1 deletion.All the mutations were pathogenic variants according to the ACGM guidelines. Conclusions:Mutations of c. 668G>A/p.C223Y, c.618G>A/p.W206X and exon 1 deletion in RS1 gene are pathogenic mutations in Chinese XLRS families.The combination of Panel sequencing with pathogenicity analysis and protein structure prediction have important effect to diagnosis and identify the causative genes for the hereditary retinal diseases.

Objective To evaluate the morbidity and the influence factors of the geriatric syndrome in the elderly inpatients. Methods The characteristics of comprehensive geriatric assessment of180 elderly inpatients (83 male and 97 female) with age older than 65 in geriatric department from November 2014 to November 2015 were analyzed. Results Of 180 elderly patients, the incidences of visual loss, multiple co-morbidity, polypharmacy, impairment in activities of daily living, urinary incontinence, chronic constipation and chronic pain were 86.11%(155/180), 85.56%(154/180), 82.78%(149/180), 56.11%(101/180), 49.44%(89/180), 46.67%(75/180) and 42.22%(76/180). Female patients had more incidences compared with male in urinary incontinence [56.70%(55/97) vs. 40.96%(34/83)], chronic pain [56.70% (55/97) vs. 25.30%(21/83)] , impairment in activities of daily living [64.95%(63/97) vs. 45.78%(38/83)] and high risk of falling [43.30%(42/97) vs. 21.69%(18/83)], and there were significant differences (P<0.05). In addition, it was found that with the increasing of age, the incidences of hearing loss and chronic constipation, as well as medications were accordingly higher. When the patients′education level was higher, the incidences of urinary incontinence and impairment in activities of daily living were generally declined. Compared with non-diabetes mellitus group, diabetes mellitus group had higher incidences of comorbidities, multiple co-morbidity, medications, polypharmacy and impairment in activities of daily living:(10.59 ± 3.72) kinds vs. (8.29 ± 4.03) kinds, 94.59%(105/111) vs. 71.01%(49/69), (10.07 ± 3.77) kinds vs. (6.87 ± 3.07) kinds, 89.19%(99/111) vs. 72.46%(50/69), 62.16%(69/111) vs. 46.38% (32/69). With the increasing of the numbers of diabetes- related chronic complications, the incidences of visual loss, chronic constipation and multiple co- morbidity, comorbidities and medications were higher (P<0.05). Conclusions Geriatric syndrome such as visual loss, multiple co- morbidity, polypharmacy, impairment in activities of daily living and urinary incontinence are very common in the elderly inpatients. Elderly patients with diabetes mellitus are much easier to suffer from geriatric syndrome such as multiple co-morbidity, polypharmacy and impairment in activities of daily living.