Objective:To explore the etiology of primary amenorrhea,analyze its clinical features,and improve the level of clinical diagnosis and treatment.Methods:A retrospective analysis was conducted on the clinical data of 75 patients with primary amenorrhea who attended the gynecological endocrine clinic of Nanjing Women and Children's Healthcare Hospital from January 2020 to September 2022,and the etiology of their diagnosis was ana-lyzed.Results:aChromosomal karyotype analysis showed 14 cases(18.67％)of abnormal karyotypes,including 2 cases of autosomal abnormalities,7 cases of sex chromosome abnormalities,and 5 cases of sexual differentia-tion abnormalities.②According to reproductive hormones,there were 15 cases(20.00％)of hypogonadotropic a-menorrhea and 18 cases(24.00％)of hypergonadotropic amenorrhea.③By the location of the cause,utero-inferi-or genital tract amenorrhea was the most common in 23 cases(30.67％),including 20 cases of mayer-rokitan-sky-küster-hauser syndrome(MRKH syndrome)and 3 cases of androgen insensitivity syndrome(AIS).It was followed by ovarian amenorrhea in 18 cases(24.00％)including 6 cases of Turners syndrome,10 cases of 46,XX simple gonadal hypoplasia and 2 cases of 46,XY gonadal hypoplasia(Swyer syndrome);hypothalamic-pituitary amenorrhea in 17 cases(22.67％),including idiopathic hypogonadotropic hypogonadism(IHH)in 9 cases,Kall-mann s syndrome in 4 cases,and hyperprolactinemia in 4 cases;and also amenorrhea with hyperandrogenic mani-festations in 17 cases(22.67％),with a higher number of suspicious polycystic ovary syndrome in 16 cases.Con-clusions:Primary amenorrhea has a variety of etiologies and clinical features,and requires examination of sex hormones and pelvic ultrasound from the lower genital tract up to the central nervous system to find the site of the etiology and to optimize the diagnostic process;in the case of hypogonadotropic amenorrhea,chromosomal test is necessary.

Objective:To explore the etiology of primary amenorrhea,analyze its clinical features,and improve the level of clinical diagnosis and treatment.Methods:A retrospective analysis was conducted on the clinical data of 75 patients with primary amenorrhea who attended the gynecological endocrine clinic of Nanjing Women and Children's Healthcare Hospital from January 2020 to September 2022,and the etiology of their diagnosis was ana-lyzed.Results:aChromosomal karyotype analysis showed 14 cases(18.67％)of abnormal karyotypes,including 2 cases of autosomal abnormalities,7 cases of sex chromosome abnormalities,and 5 cases of sexual differentia-tion abnormalities.②According to reproductive hormones,there were 15 cases(20.00％)of hypogonadotropic a-menorrhea and 18 cases(24.00％)of hypergonadotropic amenorrhea.③By the location of the cause,utero-inferi-or genital tract amenorrhea was the most common in 23 cases(30.67％),including 20 cases of mayer-rokitan-sky-küster-hauser syndrome(MRKH syndrome)and 3 cases of androgen insensitivity syndrome(AIS).It was followed by ovarian amenorrhea in 18 cases(24.00％)including 6 cases of Turners syndrome,10 cases of 46,XX simple gonadal hypoplasia and 2 cases of 46,XY gonadal hypoplasia(Swyer syndrome);hypothalamic-pituitary amenorrhea in 17 cases(22.67％),including idiopathic hypogonadotropic hypogonadism(IHH)in 9 cases,Kall-mann s syndrome in 4 cases,and hyperprolactinemia in 4 cases;and also amenorrhea with hyperandrogenic mani-festations in 17 cases(22.67％),with a higher number of suspicious polycystic ovary syndrome in 16 cases.Con-clusions:Primary amenorrhea has a variety of etiologies and clinical features,and requires examination of sex hormones and pelvic ultrasound from the lower genital tract up to the central nervous system to find the site of the etiology and to optimize the diagnostic process;in the case of hypogonadotropic amenorrhea,chromosomal test is necessary.

Objective:To explore the etiology of primary amenorrhea,analyze its clinical features,and improve the level of clinical diagnosis and treatment.Methods:A retrospective analysis was conducted on the clinical data of 75 patients with primary amenorrhea who attended the gynecological endocrine clinic of Nanjing Women and Children's Healthcare Hospital from January 2020 to September 2022,and the etiology of their diagnosis was ana-lyzed.Results:aChromosomal karyotype analysis showed 14 cases(18.67％)of abnormal karyotypes,including 2 cases of autosomal abnormalities,7 cases of sex chromosome abnormalities,and 5 cases of sexual differentia-tion abnormalities.②According to reproductive hormones,there were 15 cases(20.00％)of hypogonadotropic a-menorrhea and 18 cases(24.00％)of hypergonadotropic amenorrhea.③By the location of the cause,utero-inferi-or genital tract amenorrhea was the most common in 23 cases(30.67％),including 20 cases of mayer-rokitan-sky-küster-hauser syndrome(MRKH syndrome)and 3 cases of androgen insensitivity syndrome(AIS).It was followed by ovarian amenorrhea in 18 cases(24.00％)including 6 cases of Turners syndrome,10 cases of 46,XX simple gonadal hypoplasia and 2 cases of 46,XY gonadal hypoplasia(Swyer syndrome);hypothalamic-pituitary amenorrhea in 17 cases(22.67％),including idiopathic hypogonadotropic hypogonadism(IHH)in 9 cases,Kall-mann s syndrome in 4 cases,and hyperprolactinemia in 4 cases;and also amenorrhea with hyperandrogenic mani-festations in 17 cases(22.67％),with a higher number of suspicious polycystic ovary syndrome in 16 cases.Con-clusions:Primary amenorrhea has a variety of etiologies and clinical features,and requires examination of sex hormones and pelvic ultrasound from the lower genital tract up to the central nervous system to find the site of the etiology and to optimize the diagnostic process;in the case of hypogonadotropic amenorrhea,chromosomal test is necessary.

Objective:To explore the etiology of primary amenorrhea,analyze its clinical features,and improve the level of clinical diagnosis and treatment.Methods:A retrospective analysis was conducted on the clinical data of 75 patients with primary amenorrhea who attended the gynecological endocrine clinic of Nanjing Women and Children's Healthcare Hospital from January 2020 to September 2022,and the etiology of their diagnosis was ana-lyzed.Results:aChromosomal karyotype analysis showed 14 cases(18.67％)of abnormal karyotypes,including 2 cases of autosomal abnormalities,7 cases of sex chromosome abnormalities,and 5 cases of sexual differentia-tion abnormalities.②According to reproductive hormones,there were 15 cases(20.00％)of hypogonadotropic a-menorrhea and 18 cases(24.00％)of hypergonadotropic amenorrhea.③By the location of the cause,utero-inferi-or genital tract amenorrhea was the most common in 23 cases(30.67％),including 20 cases of mayer-rokitan-sky-küster-hauser syndrome(MRKH syndrome)and 3 cases of androgen insensitivity syndrome(AIS).It was followed by ovarian amenorrhea in 18 cases(24.00％)including 6 cases of Turners syndrome,10 cases of 46,XX simple gonadal hypoplasia and 2 cases of 46,XY gonadal hypoplasia(Swyer syndrome);hypothalamic-pituitary amenorrhea in 17 cases(22.67％),including idiopathic hypogonadotropic hypogonadism(IHH)in 9 cases,Kall-mann s syndrome in 4 cases,and hyperprolactinemia in 4 cases;and also amenorrhea with hyperandrogenic mani-festations in 17 cases(22.67％),with a higher number of suspicious polycystic ovary syndrome in 16 cases.Con-clusions:Primary amenorrhea has a variety of etiologies and clinical features,and requires examination of sex hormones and pelvic ultrasound from the lower genital tract up to the central nervous system to find the site of the etiology and to optimize the diagnostic process;in the case of hypogonadotropic amenorrhea,chromosomal test is necessary.

Objective:To explore the etiology of primary amenorrhea,analyze its clinical features,and improve the level of clinical diagnosis and treatment.Methods:A retrospective analysis was conducted on the clinical data of 75 patients with primary amenorrhea who attended the gynecological endocrine clinic of Nanjing Women and Children's Healthcare Hospital from January 2020 to September 2022,and the etiology of their diagnosis was ana-lyzed.Results:aChromosomal karyotype analysis showed 14 cases(18.67％)of abnormal karyotypes,including 2 cases of autosomal abnormalities,7 cases of sex chromosome abnormalities,and 5 cases of sexual differentia-tion abnormalities.②According to reproductive hormones,there were 15 cases(20.00％)of hypogonadotropic a-menorrhea and 18 cases(24.00％)of hypergonadotropic amenorrhea.③By the location of the cause,utero-inferi-or genital tract amenorrhea was the most common in 23 cases(30.67％),including 20 cases of mayer-rokitan-sky-küster-hauser syndrome(MRKH syndrome)and 3 cases of androgen insensitivity syndrome(AIS).It was followed by ovarian amenorrhea in 18 cases(24.00％)including 6 cases of Turners syndrome,10 cases of 46,XX simple gonadal hypoplasia and 2 cases of 46,XY gonadal hypoplasia(Swyer syndrome);hypothalamic-pituitary amenorrhea in 17 cases(22.67％),including idiopathic hypogonadotropic hypogonadism(IHH)in 9 cases,Kall-mann s syndrome in 4 cases,and hyperprolactinemia in 4 cases;and also amenorrhea with hyperandrogenic mani-festations in 17 cases(22.67％),with a higher number of suspicious polycystic ovary syndrome in 16 cases.Con-clusions:Primary amenorrhea has a variety of etiologies and clinical features,and requires examination of sex hormones and pelvic ultrasound from the lower genital tract up to the central nervous system to find the site of the etiology and to optimize the diagnostic process;in the case of hypogonadotropic amenorrhea,chromosomal test is necessary.

Objective:To explore the etiology of primary amenorrhea,analyze its clinical features,and improve the level of clinical diagnosis and treatment.Methods:A retrospective analysis was conducted on the clinical data of 75 patients with primary amenorrhea who attended the gynecological endocrine clinic of Nanjing Women and Children's Healthcare Hospital from January 2020 to September 2022,and the etiology of their diagnosis was ana-lyzed.Results:aChromosomal karyotype analysis showed 14 cases(18.67％)of abnormal karyotypes,including 2 cases of autosomal abnormalities,7 cases of sex chromosome abnormalities,and 5 cases of sexual differentia-tion abnormalities.②According to reproductive hormones,there were 15 cases(20.00％)of hypogonadotropic a-menorrhea and 18 cases(24.00％)of hypergonadotropic amenorrhea.③By the location of the cause,utero-inferi-or genital tract amenorrhea was the most common in 23 cases(30.67％),including 20 cases of mayer-rokitan-sky-küster-hauser syndrome(MRKH syndrome)and 3 cases of androgen insensitivity syndrome(AIS).It was followed by ovarian amenorrhea in 18 cases(24.00％)including 6 cases of Turners syndrome,10 cases of 46,XX simple gonadal hypoplasia and 2 cases of 46,XY gonadal hypoplasia(Swyer syndrome);hypothalamic-pituitary amenorrhea in 17 cases(22.67％),including idiopathic hypogonadotropic hypogonadism(IHH)in 9 cases,Kall-mann s syndrome in 4 cases,and hyperprolactinemia in 4 cases;and also amenorrhea with hyperandrogenic mani-festations in 17 cases(22.67％),with a higher number of suspicious polycystic ovary syndrome in 16 cases.Con-clusions:Primary amenorrhea has a variety of etiologies and clinical features,and requires examination of sex hormones and pelvic ultrasound from the lower genital tract up to the central nervous system to find the site of the etiology and to optimize the diagnostic process;in the case of hypogonadotropic amenorrhea,chromosomal test is necessary.

Objective:To explore the etiology of primary amenorrhea,analyze its clinical features,and improve the level of clinical diagnosis and treatment.Methods:A retrospective analysis was conducted on the clinical data of 75 patients with primary amenorrhea who attended the gynecological endocrine clinic of Nanjing Women and Children's Healthcare Hospital from January 2020 to September 2022,and the etiology of their diagnosis was ana-lyzed.Results:aChromosomal karyotype analysis showed 14 cases(18.67％)of abnormal karyotypes,including 2 cases of autosomal abnormalities,7 cases of sex chromosome abnormalities,and 5 cases of sexual differentia-tion abnormalities.②According to reproductive hormones,there were 15 cases(20.00％)of hypogonadotropic a-menorrhea and 18 cases(24.00％)of hypergonadotropic amenorrhea.③By the location of the cause,utero-inferi-or genital tract amenorrhea was the most common in 23 cases(30.67％),including 20 cases of mayer-rokitan-sky-küster-hauser syndrome(MRKH syndrome)and 3 cases of androgen insensitivity syndrome(AIS).It was followed by ovarian amenorrhea in 18 cases(24.00％)including 6 cases of Turners syndrome,10 cases of 46,XX simple gonadal hypoplasia and 2 cases of 46,XY gonadal hypoplasia(Swyer syndrome);hypothalamic-pituitary amenorrhea in 17 cases(22.67％),including idiopathic hypogonadotropic hypogonadism(IHH)in 9 cases,Kall-mann s syndrome in 4 cases,and hyperprolactinemia in 4 cases;and also amenorrhea with hyperandrogenic mani-festations in 17 cases(22.67％),with a higher number of suspicious polycystic ovary syndrome in 16 cases.Con-clusions:Primary amenorrhea has a variety of etiologies and clinical features,and requires examination of sex hormones and pelvic ultrasound from the lower genital tract up to the central nervous system to find the site of the etiology and to optimize the diagnostic process;in the case of hypogonadotropic amenorrhea,chromosomal test is necessary.

Objective:To explore the etiology of primary amenorrhea,analyze its clinical features,and improve the level of clinical diagnosis and treatment.Methods:A retrospective analysis was conducted on the clinical data of 75 patients with primary amenorrhea who attended the gynecological endocrine clinic of Nanjing Women and Children's Healthcare Hospital from January 2020 to September 2022,and the etiology of their diagnosis was ana-lyzed.Results:aChromosomal karyotype analysis showed 14 cases(18.67％)of abnormal karyotypes,including 2 cases of autosomal abnormalities,7 cases of sex chromosome abnormalities,and 5 cases of sexual differentia-tion abnormalities.②According to reproductive hormones,there were 15 cases(20.00％)of hypogonadotropic a-menorrhea and 18 cases(24.00％)of hypergonadotropic amenorrhea.③By the location of the cause,utero-inferi-or genital tract amenorrhea was the most common in 23 cases(30.67％),including 20 cases of mayer-rokitan-sky-küster-hauser syndrome(MRKH syndrome)and 3 cases of androgen insensitivity syndrome(AIS).It was followed by ovarian amenorrhea in 18 cases(24.00％)including 6 cases of Turners syndrome,10 cases of 46,XX simple gonadal hypoplasia and 2 cases of 46,XY gonadal hypoplasia(Swyer syndrome);hypothalamic-pituitary amenorrhea in 17 cases(22.67％),including idiopathic hypogonadotropic hypogonadism(IHH)in 9 cases,Kall-mann s syndrome in 4 cases,and hyperprolactinemia in 4 cases;and also amenorrhea with hyperandrogenic mani-festations in 17 cases(22.67％),with a higher number of suspicious polycystic ovary syndrome in 16 cases.Con-clusions:Primary amenorrhea has a variety of etiologies and clinical features,and requires examination of sex hormones and pelvic ultrasound from the lower genital tract up to the central nervous system to find the site of the etiology and to optimize the diagnostic process;in the case of hypogonadotropic amenorrhea,chromosomal test is necessary.

Objective:To develop the Self-management Behavior Questionnaire for Middle-aged and Young Patients with Myocardial Infarction and test its reliability and validity.Methods:Using social cognitive theory, self-efficacy theory, and self-management theory as theoretical frameworks, a preliminary questionnaire was formed through literature review, semi-structured interviews, and Delphi expert consultation. Convenience sampling was used to select middle-aged and young patients with myocardial infarction from the First Affiliated Hospital of Henan University of Chinese Medicine, Henan Provincial Chest Hospital, and the Second Affiliated Hospital of Zhengzhou University from June to July 2022 for investigation, and item analysis and exploratory factor analysis of the questionnaire were conducted. From August to November 2022, middle-aged and young patients with myocardial infarction from the Heart Center of the First Affiliated Hospital of Henan University of Chinese Medicine were selected for investigation, and confirmatory factor analysis and reliability testing of the questionnaire were conducted.Results:A total of 300 and 480 questionnaires were distributed, respectively, and 280 and 468 valid questionnaires were collected, with effective response rates of 93.33% (280/300) and 97.50% (468/480), respectively. The Self-management Behavior Questionnaire for Middle-aged and Young Patients with Myocardial Infarction included 31 items. The total Cronbach 's α coefficient of the questionnaire was 0.918, the half reliability coefficient was 0.853, and the retest reliability coefficient was 0.975. The content validity index of the questionnaire level was 0.965, and the content validity index of the item level was 0.830 to 1.000. Exploratory factor analysis extracted 6 common factors with a cumulative variance contribution rate of 69.795%. Confirmatory factor analysis showed that the model fitted well and the questionnaire factor structure was stable. Conclusions:The Self-management Behavior Questionnaire for Middle-aged and Young Patients with Myocardial Infarction developed in this study has good reliability and validity, which can provide references for medical and nursing staff to evaluate the self-management behavior of middle-aged and young patients with myocardial infarction.

Objective To assess the effect of different postoperative body positions on respiratory func-tion of patients undergoing shoulder arthroscopy under general anesthesia with interscalene brachial plex-us block.Methods Seventy patients undergoing arthroscopic repair of the supraspinatus tendon were ran-domly allocated to a supine position group and a group with a 30° head elevation.Patients in both groups were in a horizontal position before anesthesia,and diaphragm movement was measured under B-ultrasound as baseline.Promptly after removal of the endotracheal tube upon arrival at the anesthe-sia recovery room,the supine group was conducted blood gas analysis,and monitored heart rate,res-piration,non-invasive arterial blood pressure and blood oxygen saturation,wearing a mask for oxygen supplementation,while the group with a 30° head elevation was given identical nursing procedures af-ter the bed's head was elevated 30°.Then right after entering the anesthesia recovery room,as well as 5 and 15 minutes after deoxygenation,the oxygen partial pressure(PaO2),carbon dioxide partial pressure(PaCO2)and percutaneous oxygen saturation(SpO2)were recorded and compared between the two groups.Moreover,the diaphragmatic movements during deep breathing before nerve block and pri-or to discharge from the anesthesia recovery room were measured,and such adverse reactions as hypox-emia,labored breathing and glossoptosis were observed.Results Compared with the supine position group,a significant increase in the average PaO2 and SpO2 15 minutes after deoxygenation,diaphrag-matic movement during deep breathing and comfort was observed in the group with a 30° head eleva-tion,but a significant decrease in the incidence of postoperative laboured breathing and glossoptosis.However,no significant differences were found between the two groups in the incidence of hypoxemia and the average PaO2,PaCO2 and SpO2 immediately after entering the anesthesia recovery room and 5 minutes after deoxygenation.Conclusion Elevating the head of the bed by 30° enhances respiratory function in patients undergoing shoulder surgery with general anesthesia intubation and intermuscular groove brachial plexus block,compared to the supine position.Although no significant reduction in hy-poxemia incidence is observed,there is a notable relief of adverse reactions such as laboured breath-ing and glossoptosis,which makes patients feel more comfortable.Therefore,such posture care is wor-thy of application in clinical practice.