ObjectiveTo observe the clinical efficacy and safety of Shugan Bushen Yulin Decoction （疏肝补肾毓麟汤， SBYD） in the treatment of asthenospermia and infertility with liver constraint and kidney deficiency. MethodsA multicenter， randomized， controlled clinical study was conducted in three hospitals in central China. Totally 95 patients with asthenospermia and infertility were controlled. According to random number table， the patients were divided into treatment group （47 cases） and control group （48 cases）. The control group was given vitamin E soft capsules （100 mg per time， twice daily） orally， and the treatment group was given SBYD （one dose daily， 30 min after breakfast and dinner， about 200 ml each time） orally. The course of treatment was 12 weeks in both groups. After the treatment， the sperm concentration， percentage of forward motile sperm （PR）， and percentage of total sperm activity， that is PR + percentage of non-progressively motile sperm （NP） were compared between groups， and the clinical efficacy was judged. Traditional Chinese medicine （TCM） syndrome score （inlcuding 6 single symptom scores and total symptoms score） and 21-item depression， anxiety， and stress scale （DASS-21） scores （including depression， anxiety and stress scores） were compared between the two groups before and after treatment. The patients were followed up for 6 months， and the pregnancy status of spouse between groups was compared. The occurrence of adverse events and vital signs during the trial were recorded for safety assessment. ResultsTwo cases in the treatment group and three cases in the control group dropped out. Finally， 45 cases in each group were included in the statistical analysis. The total effective rate was 86.67% （39/45） in the treatment group， significantly higher than 73.74% （33/45） in the control group （P＜0.05）. After treatment， PR and PR + NP significantly increased in both groups， and were much higher in the treatment group than in the control group （P＜0.05）. The scores of lumbar and knee soreness， emotional disturbance， cold sperm， chest and rib-side and lesser abdomen distension and pain， frequent sighing， and the total TCM syndrome score in the treatment group decreased after treatment （P＜0.05）； and except for cold sperm， the scores of other symptoms mentioned above as well as the total TCM syndrome score in the treatment group were lower than those in the control group （P＜0.05）. The scores of depression， anxiety and stress of DASS-21 in the treatment group decreased after treatment， and were lower than those in the control group （P＜0.05）. After 6 months of follow-up， the spouses of 5 patients in the treatment group and 3 patients in the control group got pregnant （P＞0.05）. No adverse events occurred in both groups during the treatment， and their vital signs were stable. ConclusionSBYD can obviously improve sperm vitality and effectively improve the clinical symptoms， anxiety and depression， and is safe in treating asthenospermia and infertility with liver constraint and kidney deficiency.

Objective:To investigate the epidemiological characteristics of pneumonia and the related factors of the length of hospitalization of pneumonia in the elderly aged 60 years and older in Ningbo in 2019.Methods:Data on hospitalized cases of pneumonia in the elderly aged 60 years and older in Ningbo in 2019 were collected through the regional health information platform, and the population data of Ningbo in 2019 were obtained through the Zhejiang Provincial Bureau of Statistics. A descriptive epidemiological analysis was conducted on hospitalized cases of pneumonia in the elderly population, and factors related to the length of hospitalization were explored.Results:A total of 15 956 hospitalized cases of pneumonia aged 60 years and older were reported in Ningbo in 2019, and the incidence of pneumonia requiring hospitalization was 1.02% (15 956/1 571 431). The incidence was 1.13% (8 613/760 357) in males and 0.83% (6 759/811 074) in females, and the ratio of male to female cases was 1.27∶1. The highest incidence was found in the ≥80 age group (2.52%), and the lowest incidence was found in the 60-69 age group (0.58%). March, February, and January were the peak period of pneumonia hospitalization. The main types of pneumonia diagnosed were not specified (65.12%), followed by bacterial pneumonia (34.60%). The M( Q1, Q3) of hospitalized patients with pneumonia was 9 (7, 13) days. The results of multivariate logistic regression analysis showed that gender (female: OR=0.911, 95% CI: 0.849-0.978) and older age (70-79 years old: OR=1.211, 95% CI: 1.111-1.321; ≥80 years old group: OR=1.486, 95% CI: 1.365-1.617), settlement method (self-payment: OR=0.567, 95% CI: 0.464-0.691), higher level of hospitals (Grade Ⅱ: OR=1.902,95% CI:1.723-2.100; Grade Ⅲ: OR=1.546,95% CI:1.407-1.698) were associated with the length of hospitalization for pneumonia in people aged 60 years and older in Ningbo. Conclusions:Hospitalization with pneumonia in people aged 60 years and older was high in winter and spring, men and older adults were in high-risk groups in Ningbo in 2019. Gender, age, billing method, and level of hospitals may be related factors to the length of hospitalization for pneumonia.

The incidence rate of aortic dissection (AD) is low, but it is highly fatal in the acute phase. Miss diagnosis and misdiagnosis can occur occasionally, resulting the miss of the best intervention time. Research on the epidemiological characteristics and of AD and related risk factors can identify high-risk groups, make screening and diagnosis as soon as possible and effectively control the changeable risk factors to reduce the incidence of AD and improve the outcome of AD cases. This paper summarizes the progress in research of the epidemiological characteristics of AD and related risk factors in order to promote early prevention and diagnosis of AD, improve the AD case management and intervention level.

Abstract Falls are the leading cause of accidental injury deaths among the elderly. Currently, the incidence and disease burden of falls among the elderly remain high. By understanding the influencing factors of falls among the elderly and formulating targeted preventive measures, the risk of falls can be effectively reduced. Studies have found that falls among the elderly are results of the interaction of multiple factors. When formulating fall prevention strategies, attention should be paid to fall risk assessment and stratification, fall prevention exercise support and health education, living environment improvement, and primary healthcare service enhancement. Reviewing publications pertaining to the epidemiological studies of falls from January 2004 to January 2024, this article summarizes the epidemiological characteristics, risk factors, prevention and control strategies of falls among the elderly, aiming to provide the reference for prevention and control.

With the increasing proportion of human papilloma virus(HPV)infection in the pathogenic factors of oro-pharyngeal cancer,a series of changes have occurred in the surgical treatment.While the treatment mode has been im-proved,there are still many problems,including the inconsistency between diagnosis and treatment modes,the lack of popularization of reconstruction technology,the imperfect post-treatment rehabilitation system,and the lack of effective preventive measures.Especially in terms of treatment mode for early oropharyngeal cancer,there is no unified conclu-sion whether it is surgery alone or radiotherapy alone,and whether robotic minimally invasive surgery has better func-tional protection than radiotherapy.For advanced oropharyngeal cancer,there is greater controversy over the treatment mode.It is still unclear whether to adopt a non-surgical treatment mode of synchronous chemoradiotherapy or induction chemotherapy combined with synchronous chemoradiotherapy,or a treatment mode of surgery combined with postopera-tive chemoradiotherapy.In order to standardize the surgical treatment of oropharyngeal cancer in China and clarify the indications for surgical treatment of oropharyngeal cancer,this expert consensus,based on the characteristics and treat-ment status of oropharyngeal cancer in China and combined with the international latest theories and practices,forms consensus opinions in multiple aspects of preoperative evaluation,surgical indication determination,primary tumor re-section,neck lymph node dissection,postoperative defect repair,postoperative complication management prognosis and follow-up of oropharyngeal cancer patients.The key points include:① Before the treatment of oropharyngeal cancer,the expression of P16 protein should be detected to clarify HPV status;② Perform enhanced magnetic resonance imaging of the maxillofacial region before surgery to evaluate the invasion of oropharyngeal cancer and guide precise surgical resec-tion of oropharyngeal cancer.Evaluating mouth opening and airway status is crucial for surgical approach decisions and postoperative risk prediction;③ For oropharyngeal cancer patients who have to undergo major surgery and cannot eat for one to two months,it is recommended to undergo percutaneous endoscopic gastrostomy before surgery to effectively improve their nutritional intake during treatment;④ Early-stage oropharyngeal cancer patients may opt for either sur-gery alone or radiation therapy alone.For intermediate and advanced stages,HPV-related oropharyngeal cancer general-ly prioritizes radiation therapy,with concurrent chemotherapy considered based on tumor staging.Surgical treatment is recommended as the first choice for HPV unrelated oropharyngeal squamous cell carcinoma(including primary and re-current)and recurrent HPV related oropharyngeal squamous cell carcinoma after radiotherapy and chemotherapy;⑤ For primary exogenous T1-2 oropharyngeal cancer,direct surgery through the oral approach or da Vinci robotic sur-gery is preferred.For T3-4 patients with advanced oropharyngeal cancer,it is recommended to use temporary mandibu-lectomy approach and lateral pharyngotomy approach for surgery as appropriate;⑥ For cT1-2N0 oropharyngeal cancer patients with tumor invasion depth＞3 mm and cT3-4N0 HPV unrelated oropharyngeal cancer patients,selective neck dissection of levels ⅠB to Ⅳ is recommended.For cN+HPV unrelated oropharyngeal cancer patients,therapeutic neck dissection in regions Ⅰ-Ⅴ is advised;⑦ If PET-CT scan at 12 or more weeks after completion of radiation shows intense FDG uptake in any node,or imaging suggests continuous enlargement of lymph nodes,the patient should undergo neck dissection;⑧ For patients with suspected extracapsular invasion preoperatively,lymph node dissection should include removal of surrounding muscle and adipose connective tissue;⑨ The reconstruction of oropharyngeal cancer defects should follow the principle of reconstruction steps,with priority given to adjacent flaps,followed by distal pedicled flaps,and finally free flaps.The anterolateral thigh flap with abundant tissue can be used as the preferred flap for large-scale postoperative defects.

Objective:The Self-Compassion Scale(SCS)is used to evaluate self-compassion in general popu-lation.The study was designed to evaluate the validity and reliability of the Chinese version of SCS in patients with eating disorders.Methods:Ten experts in the related disciplines completed the content validity evaluation.A total of 136 patients who met the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5)eating dis-order diagnostic criteria were surveyed with SCS to evaluate structural validity.Using the Rosenberg Self-Esteem Scale(SES),Satisfaction with Life Scale(SWLS),and Eating Disorder Examination Questionnaire 6.0(EDE-Q 6.0)as gold criterion,the criterion validity of SCS was measured.Twenty patients were selected for retesting to e-valuate test-retest reliability.Results:The item-level content validity index(I-CVI)of each item was between 0.70 and 1.00,and the average scale-level content validity index(S-CVI/Ave)was 0.96,indicating good content validi-ty.Factor analysis indicated a good fit for the six-factor model with reasonable factor loadings:x2/df=1.70,RM-SEA=0.07,CFI=0.92,TLI=0.91.The Chinese version of the SCS had an ICC of 0.31 with both SES and SWLS,and a negative correlation with EDE-Q 6.0 scores(r=-0.32).The test-retest reliability of the scale was 0.80.Conclusion:The Chinese version of the SCS has moderate validity and high reliability in patients with eating disorders,and can provide a clinical measure tool for psychological assessment in the Chinese population with eating disorders.

Objective To explore the intrinsic steady-state electrophysiological properties of mouse heart under physiological conditions by high-resolution quantitative analysis.Methods Twenty-two young adult C57BL/6 mice with a 1:1 male-to-female ratio were used.The limbs of the mice were fixed without anesthesia,and electrocardiographic waveforms,including characteristic P-waves,R-waves,and ST-waves,were recorded using a sensitive 12-lead electrophysiological recorder(ECGsqa)under spontaneous breathing.LabScribe software was used to extract and quantify high-resolution time course and amplitude parameters within a single cardiac cycle from the V3 precordial lead.Pearson correlation test combined with simple linear regression was used to generate a scatter plot of ECG parameter fitting.The common and unique correlation parameters were separately identified by joint associations for profiling the quantitative association network.Results ECGsqa analysis identified and quantified 14 characteristic ECG parameters,28.6%of which showed statistical differences between the groups.Compared to male mice,female mice exhibited higher amplitudes and velocities of R and ST waves.Among the 51 association pairs identified in primary association analysis,47.1%were positively correlated,including shared(29.2%),male-specific(29.2%),and female-specific(41.7%)association groups.Second-order clustering of the association pairs revealed that the amplitude-rate association pairs of each waveform voltage in both male and female mouse hearts were strongly correlated.The male mice showed an atrioventricular interconnection pattern,while the female mice showed a unique atrial conduction system quality dependence.The distribution network characteristics of the association groups showed that sex-specific and common correlation sets formed a certain series pattern.Conclusion We discovered a novel intrinsic correlation network of cardiac electrophysiological traits in male and female mice,which reveals the key internal quantitative characteristics and gender difference of both atrial and ventricular conduction systems.

Purpose To analyze the gene subtypes and characteristics of human papilloma virus(HPV)infection among women attending outpatient and physical examination centers at our hospital.Methods We utilized Polymerase Chain Reaction(PCR)combined with reverse dot hybridization to detect 28 HPV gene subtypes.Results HPV infection rate among the women was 24.15％.The five most prevalent high-risk(HR)and low-risk(LR)HPV gene subtypes were HPV 52,16,53,58,39,and HPV 61,81,54,42,44,respectively.Single and double infections accounted for 68.97％and 20.72％,with no signifi-cant difference found in the combination of multiple infection types.When stratified by age,the highest HPV infection rate was found among the group aged ≤25 years,followed by the group aged ≥66 years and then the group aged 56-65 years.This pattern of HPV infection rates across age groups revealed an approximate U-shaped curve.Conclusion The majority of female HPV in-fections in Huadu district are single infections,primarily affecting young and middle-aged women.HPV gene subtypes exhibit the characteristics of population or region-specific distribution.The overall infection rate of HPV is 24.15％,with the most common types being 52,16,and 53.The three peak age groups for HPV infection ranges are ≤25 years,56-65 years,and ≥66 years.

Objective:To assess the feasibility of using the posterosuperior tetralogy (PS-Tetra) score for predicting the prognosis of repair of posterosuperior massive rotator cuff tears.Methods:Data were retrospectively reviewed for patients who underwent repair of posterosuperior massive rotator cuff tears from February 2016 to June 2020. A total of 95 (male 48, female 47) shoulders with an average age of 58.52±8.33 years (range, 27-76 years) were included. The American Shoulder and Elbow Surgeons (ASES) scores and shoulder range of motions (ROM) were used to evaluate shoulder function. MRI was used to assess preoperative fatty infiltration (FI), atrophy, modified Patte's classification, PS-Tetra score and postoperative tendon integrity. The shoulder function was compared between groups of different PS-Tetra scores. The binary logistic regression was used to determine the risk factors of irreparability and retear.Results:83 cases of repair of posterosuperior massive rotator cuff tears were finally included. Complete repairs were performed in 83 cases, and partial repairs were performed in 12 cases. Retear was observed in 17 (20%) cases. The ASES scores (postoperative 58.52±8.33 vs. preoperative 47.30±17.40, t=-19.642, P<0.001), ROM of forward flexion (postoperative 157.60°±13.85° vs. preoperative 116.88°±50.89°, t=-7.272, P<0.001), external rotation (postoperative 45.26°±14.69° vs. preoperative 37.34°±18.65°, t=-4.043, P<0.001) and internal rotation [postoperative L 1 (T 7-buttock) vs. preoperative L 2 (T 7-buttock), Z=-2.737, P=0.006] were significantly improved postoperatively in the group with PS-Tetra score between 0 and 2. In the group with PS-Tetra score of 3 and 4, the ASES scores (postoperative 69.17±15.91 vs. preoperative 46.85±20.73, t=-11.167, P=0.001) were significantly improved postoperatively, while the ROMs were not. Modified Patte stageⅢ[ OR=26.827, 95% CI (2.089, 344.500), P=0.012] was the risk factor of irreparability. Dominant side involvement [ OR=9.407, 95% CI (1.044, 84.784), P=0.046) and PS-Tetra score of 3 and 4 [ OR=5.037, 95% CI (1.028, 26.623), P=0.046] were risk factors of retear. Conclusions:For repair of posterosuperior massive rotator cuff tears, preoperative PS-Tetra score of 3 and 4 was the risk factors of poor postoperative shoulder functions and retear.

Objective To explore the intrinsic steady-state electrophysiological properties of mouse heart under physiological conditions by high-resolution quantitative analysis.Methods Twenty-two young adult C57BL/6 mice with a 1:1 male-to-female ratio were used.The limbs of the mice were fixed without anesthesia,and electrocardiographic waveforms,including characteristic P-waves,R-waves,and ST-waves,were recorded using a sensitive 12-lead electrophysiological recorder(ECGsqa)under spontaneous breathing.LabScribe software was used to extract and quantify high-resolution time course and amplitude parameters within a single cardiac cycle from the V3 precordial lead.Pearson correlation test combined with simple linear regression was used to generate a scatter plot of ECG parameter fitting.The common and unique correlation parameters were separately identified by joint associations for profiling the quantitative association network.Results ECGsqa analysis identified and quantified 14 characteristic ECG parameters,28.6%of which showed statistical differences between the groups.Compared to male mice,female mice exhibited higher amplitudes and velocities of R and ST waves.Among the 51 association pairs identified in primary association analysis,47.1%were positively correlated,including shared(29.2%),male-specific(29.2%),and female-specific(41.7%)association groups.Second-order clustering of the association pairs revealed that the amplitude-rate association pairs of each waveform voltage in both male and female mouse hearts were strongly correlated.The male mice showed an atrioventricular interconnection pattern,while the female mice showed a unique atrial conduction system quality dependence.The distribution network characteristics of the association groups showed that sex-specific and common correlation sets formed a certain series pattern.Conclusion We discovered a novel intrinsic correlation network of cardiac electrophysiological traits in male and female mice,which reveals the key internal quantitative characteristics and gender difference of both atrial and ventricular conduction systems.