Objective To explore the effect of physical exercise on semen quality in order to provide basic data and theoretical basis for the improvement of male reproductive health.Methods A cross-sectional study was conducted on 1 059 males who visited the Reproductive Medicine Center of Shandong Maternal and Child Health Hospital for medical treatment and physical examination during July 2022 and April 2023.Their demographic data and physical exercise data were surveyed with questionnaires.Total sperm count,sperm concentration,total sperm motility,forward movement and normal sperm morphology were analyzed with computer aided analysis.Logistic regression model and multiple linear regression model were applied to analyze the effects of physical exercise on semen quality.Results After adjustment for confounding factors such as age,body mass index,alcohol consumption and smoking,logistic regression analysis showed that the risk of abnormal semen quality was increased in patients with moderate and heavy exercise intensity(OR=2.103,OR=2.229).Compared with the participants with physical exercise ≤10 min per session,those with＞20 min per session had a lower risk of abnormal semen quality(OR=0.357,0.256,0.289 for exercise time for＞20～30,＞30～60,＞60 min,respectively).There was no statistical significance between physical exercise frequency and semen quality(P＞0.05).The participants having exercise well were at a lower risk for abnormal semen quality(OR=0.711).Multiple linear regression analysis revealed that the frequency of physical exercise was an influencing factor of sperm concentration(β=7.474,95％CI:4.800～10.149,P＜0.05);the time of physical exercise per session was an influencing factor for total sperm count(β=20.632,95％CI:7.634～33.629);the intensity of physical exercise(β=-1.461,95％CI:-2.392～-0.530)and time of physical exercise per session(β=2.608,95％CI:1.404～3.812,P＜0.05)were influencing factors for percentage of forward motility sperm(P＜0.05);and physical exercise intensity(β=-1.934,95％CI:-3.238～-0.630),time of physical exercise per session(β=4.211,95％CI:2.525～5.897)and frequency of physical exercise(β=-2.008,95％CI:-3.480～-0.536)were influencing factors of total sperm motility(P＜0.05).Conclusion Physical exercise may affect semen quality,greater intensity of physical exercise may be a risk factor for abnormal semen quality,and longer physical exercise time may be related to improving semen quality.Therefore,proper physical exercise can help improve semen quality.

Objective:To compare the clinical outcomes of polyetheretherketone (PEEK) and titanium mesh as repair materials in the cranioplasty for cranial defect patients, and to screen the independent factors for postoperative complications of cranioplasty.Methods:A total of 95 patients with cranial defects admitted to our hospital from June 2012 to June 2019 were selected for this study. According to the different repair materials used in cranioplasty, these patients were divided into PEEK group ( n=36) and titanium mesh group ( n=59). General data (hospitalization cost, hospital stay, et al), postoperative complications (intracranial hemorrhage, subcutaneous effusion, infection, seizures, and implant exposure), postoperative plastic satisfaction, and improvement of postoperative neurological function (differences of Glasgow outcome scale [GOS] scores and Mini-mental State Examination [MMSE] scores before and 6 months after surgery) were compared between the 2 groups. Univariate and multivariate Logistic regression analyses were used to screen the independent factors for postoperative complications of cranioplasty. Results:The patients in the PEEK group had significantly higher hospitalization cost but significantly shortened length of hospital stay as compared with those in the titanium mesh group ( P<0.05). The overall incidence of complications in PEEK group was significantly lower than that in titanium mesh group ( P<0.05); the incidence of subcutaneous effusion in PEEK group was significantly lower than that in titanium mesh group ( P<0.05). The PEEK group had significantly higher proportion of patients with good satisfaction in postoperative plasticity, and significantly higher proportions of patients having increased GOS and MMSE scores as compared with the titanium mesh group ( P<0.05). Multivariate Logistic regression analysis showed that repair material was an independent factor for postoperative complications of cranioplasty ( OR=4.550, P=0.019, 95%CI: 1.281-16.161). Conclusion:As compared with titanium mesh, PEEK costs more, but its clinical application effect is better, especially in reducing postoperative complications; selection of appropriate repair materials can be used as one of the methods to reduce postoperative complications.

Objective:To explore the effect of "Internet +" blood glucose management model in patients with gestational diabetes mellitus (GDM) .Methods:From January 2020 to March 2021, convenience sampling was used to select 95 GDM patients who were treated in the Outpatient Department of Lu'an People's Hospital of Anhui Province as the research object. According to the random number table method, the patients were divided into the control group ( n=47) and the intervention group ( n=48) . The control group received routine nursing, and the intervention group was given the "Internet +" blood glucose management model on the basis of routine nursing. The scores of the Diabetes Management Self-Efficacy Scale (DMSES) , GDM Self-management Behavior Scale and blood glucose control, including fasting blood glucose, 2-hour postprandial blood glucose (2hPG) , and glycosylated hemoglobin (HbA1c) , were compared before and after management, and the pregnancy outcomes were calculated. Results:After management, the DMSES and GDM self-management behavior scores of the intervention group were higher than those of the control group, and the 2 hPG, fasting blood glucose and HbA1c were lower than those of the control group, and the differences were statistically significant ( P<0.05) . The incidences of cesarean section, abnormal amniotic fluid volume and neonatal hypoglycemia in the intervention group were lower than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The "Internet +" blood glucose management model can improve the self-efficacy of GDM patients, strengthen self-management behaviors, effectively control blood glucose, and improve maternal and infant pregnancy outcomes.

Objective:To explore the effect of "Internet +" blood glucose management model in patients with gestational diabetes mellitus (GDM) .Methods:From January 2020 to March 2021, convenience sampling was used to select 95 GDM patients who were treated in the Outpatient Department of Lu'an People's Hospital of Anhui Province as the research object. According to the random number table method, the patients were divided into the control group ( n=47) and the intervention group ( n=48) . The control group received routine nursing, and the intervention group was given the "Internet +" blood glucose management model on the basis of routine nursing. The scores of the Diabetes Management Self-Efficacy Scale (DMSES) , GDM Self-management Behavior Scale and blood glucose control, including fasting blood glucose, 2-hour postprandial blood glucose (2hPG) , and glycosylated hemoglobin (HbA1c) , were compared before and after management, and the pregnancy outcomes were calculated. Results:After management, the DMSES and GDM self-management behavior scores of the intervention group were higher than those of the control group, and the 2 hPG, fasting blood glucose and HbA1c were lower than those of the control group, and the differences were statistically significant ( P<0.05) . The incidences of cesarean section, abnormal amniotic fluid volume and neonatal hypoglycemia in the intervention group were lower than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The "Internet +" blood glucose management model can improve the self-efficacy of GDM patients, strengthen self-management behaviors, effectively control blood glucose, and improve maternal and infant pregnancy outcomes.

Objective:To explore the clinical significance of standardized screening for diagnosis and treatment of early gastric cancer in Qinghai Province.Methods:Opportunistic early gastric cancer screening was conducted in outpatients of Digestive Department, Physical Examination Center and inpatients of Qinghai Provincial People′s Hospital from January 2016 to December 2020, according to the optimal cut-off values of serum pepsinogen (PG)Ⅰ, PGⅠ/PGⅡ ratio (PGR) and serum gastrin 17 (G17) obtained from the previous screening study of gastric cancer and precancerous diseases in different areas of Qinghai Province. At the same time, the standardized early gastric cancer screening program was applied in 10 municipal (county-level) hospitals in Qinghai Province. The detection rate, early diagnosis rate and endoscopic treatment rate of early gastric cancer in Qinghai Provincial People′s Hospital and the above 10 hospitals in the past five years were analyzed respectively.Results:In the five years, the total detection rate, early diagnosis rate and endoscopic treatment rate of early gastric cancer in Qinghai Provincial People′s Hospital were 0.214% (407/190 178), 17.54% (407/2 321) and 81.82% (333/407), respectively. The above indices in 10 other hospitals were 0.085% (264/309 217), 12.94% (264/2 040) and 37.12% (98/264), respectively. The overall detection rate of early gastric cancer was higher than 0.024% reported previously.Conclusion:The standardized early gastric cancer screening program can not only improve the diagnosis rate of early gastric cancer in Qinghai Province, but also save medical resources. It is an economical, efficient and feasible program, suitable for the highin-cidence area of gastric cancer in Qinghai Province.

Objective:To evaluate the screening value of serum pepsinogen (PG) Ⅰ, pepsinogen ratio (PGR, PG Ⅰ/PG Ⅱ) and gastrin 17 (G17) levels combined with gastroscopy for early-stage gastric cancer in high incidence areas of gastric cancer in Qinghai Province.Methods:A total of 2 700 cases were identified as the appropriate age (40-69 years) target population through the questionnaire survey from 25 000 local residents in high incidence areas of gastric cancer in Qinghai Province. The serum PGⅠ, PGⅡ and G17 levels of the 2 700 target population were determined by ELISA, and PGR were calculated. And then 949 patients with abnormal levels of PG and G17 were screened out as a high-risk group of gastric cancer to receive gastroscopy and pathologic biopsy. According to the results of gastroscopy and biopsy, the patients were divided into non-atrophic gastritis group, atrophic gastritis group, peptic ulcer group, early-stage gastric cancer group, and advanced gastric cancer group. The optimal threshold and its sensitivity and specificity of serum PG Ⅰ, PGR and G17 levels for diagnosis of early-stage and advanced gastric cancer were determined based on the receiver operator characteristic curve (ROC).Results:Totally 949 cases received gastroscopy and 649 cases received pathological biopsy, including 239 cases of non-atrophic gastritis, 500 cases of atrophic gastritis, 197 cases of peptic ulcer, 5 cases of early-stage gastric cancer, and 8 cases of advanced gastric cancer. The level of serum PG Ⅰ in the early-stage gastric cancer group (70.00±12.35 μg/L) and advanced gastric cancer group (38.39±2.77 μg/L) was significant lower than that in the non-atrophic gastritis group (103.89±37.45 μg/L, both P<0.05), and the value of early-stage gastric cancer group was obviously higher than that of advanced gastric cancer group ( P<0.05). The PGR of the early-stage gastric cancer group (3.74±1.40) and the advanced gastric cancer group (2.05±0.59) was significantly lower than that in the non-atrophic gastritis group (9.18±4.10, both P<0.05), and the value of early-stage gastric cancer group was significantly higher than that of the advanced gastric cancer group ( P<0.05). The level of serum G17 in the early gastric cancer group (18.03±4.52 pmol/L) and the advanced gastric cancer group (25.15±3.76 pmol/L) was significantly higher than that in the non-atrophic gastritis group (14.99±7.12 pmol/L, both P<0.05), and the level of early-stage gastric cancer group was significantly lower than that of advanced gastric cancer group ( P<0.05). According to the analysis of ROC in the diagnosis of early-stage gastric cancer, the best threshold of PG Ⅰ, PGR and G17 was 71.85 μg/L, 5.04, and 15.65 pmol/L, respectively, and the corresponding sensitivity and specificity was 80.0% and 59.0%, 100.0% and 70.4%, and 80.0% and 69.3%, respectively, for PG Ⅰ, PGR and G17. The analysis of ROC in the diagnosis of advanced gastric cancer showd that the best critical value of PG Ⅰ, PGR and G17 was 42.55 μg/L, 2.79 and 20.55 pmol/L, respectively, and the corresponding sensitivity and specificity was 100.0% and 95.3%, 100.0% and 92.1%, and 100.0% and 89.7%, respectively. Conclusion:Using serological detection of PG and G17 to screen high-risk group of gastric cancer, and then making diagnosis by gastroscopy and biopsy is an effective, low-cost and non-invasive approach for the early-stage gastric cancer in high incidence areas of gastric cancer in Qinghai Province.

Objective To investigate the characteristics of multimodal MRI of breast cancer with different molecular subtypes and the correlation between each molecular type and MRI findings. Methods Multimodality MRI date of 87 patients with breast cancer confirmed by pathology were retrospectively analyzed. According to the expression of estrogen receptors(ER),progesterone receptors(PR)and human epidermal growth factor receptor-2 (HER-2),the tumors were classified into triple-negative breast cancer,HER-2 overexpression,Luminal A and Lu-minal B subtypes. The MRI features of breast cancers of different molecular subtypes were compared. Results Among the 87 cases of breast cancer,luminal type A accounted for 29.9%(26/87),luminal type B accounted for 36.8%(32/87),HER-2 type accounted for 19.5%(17/87),and triple-negative type accounted for 13.8%(12/87). The average ADC value is 0.97 × 10-3 mm2/s;those whose irregular or edge burr like mass were more often Lu-minal type MRI,triple-negative breast cancer showed the edge smooth,clear boundary,annular enhancement, more easily showed enhanced mode of TIC type Ⅲ. The mean ADC values of type Luminal and HER-2 over-expres-sion were lower than the mean ADC values of the triple-negative type. Conclusion The different molecular sub-types of breast cancer MRI morphologic and hemodynamic characteristics and the value of ADC has certain charac-teristics. The MRI features of breast cancer can be predicted to analyze the molecular typing,providing a reference for clinical treatment.

Objective To explore the clinical effect of precise radiotherapy in the treatment of cancer in elderly patients. Methods We selected 88 elderly patients with advanced cancer at our hospital from January 2012 to December 2015.The patients were assigned into a control group(n＝44) treated with conventional radiation therapy and an intervention group (n＝44)receiving precise radiation therapy.Clinical effects and treatment reactions and adverse events were compared between the two groups. Results The total effective rate was higher in the intervention group than in the control group ,but the difference was not significant [40.9%(18/44)vs 56.8%(25/44) ,χ2＝ 2.228 ,P ＝0.135] .The control rate of clinical diseases was higher in the intervention group [77.3%(34/44)]than in control group[56.8%(25/44)](χ2＝ 4.166 ,P＝ 0.041).The incidence of adverse reactions was significantly lower in the intervention group [43.2%(19/44 )] than in the control group [68.2%(30/44)] ,(χ2＝ 5.572 ,P ＝ 0.018 ). Conclusions Precise radiotherapy has a precisely clinical efficacy and a lower incidence of adverse events. It is worth recommending and generalizing.

Objective To explore the cognition, emotion and will experience of nurses in rescue of major traffic accidents. Methods The study was carried out with the phenomenological approach within qualitative research. From January 2014 to June 2017, a total of 10 nurses of China-Japan Union Hospital of Jilin University taking part in traffic accident rescue were selected as interviewees. Colaizzi method was used to sort out and analyze data. Results According to data analysis, 7 themes were induced including management capacity, operation skills of first aid, shock and heartache, sense of responsibility and mission, fear, being conscious of negative emotions as well as finding ways to control negative emotions. Conclusions The controlling ways of psychological pressure problem for first aid nurses are put forward by analyzing psychological experience of nurses in rescue of traffic accident so as to provide a basis for managers to formulate training system.

To investigate the mutation site of pathogenic gene in patients with hypertrophic cardiomyopathy (HCM) and to analyze the relationship between the genotype and clinical phenotype. Methods: Targeted exon capture sequencing was conducted in a HCM proband for 30 coding exons related HCM gene by all exon amplification and high-throughput sequencing. Furthermore, Sanger sequencing was performed in other family member and in 200 healthy volunteers for verification. The familial investigation included in clinical presentation, physical examination, electrocardiogram and echocardiography. Results: There were 3/6 blood relatives carrying cardiac myosin-binding protein gene MyBPC3 G772A heterozygous mutation, the mutation site was at 258 amino acid of MyBPC3 as glutamic acid (Glu) was substitute to lysine (Lys), such mutation was not found in rest of family member and not in healthy volunteers. The onset of proband and her daughter was rather late, they had palpitation and chest tightness; echocardiography showed interventricular septum basal segment thickening (16-18) mm. Proband was complicating paroxysmal ventricular tachycardia, malignant arrhythmia and heart failure, the maximum pressure gradient of left ventricular outflow was 56 mmHg, which with the high risk for sudden death. Conclusion: Comprehensive gene test has been helpful for clinical stratification, early diagnosis and treatment. MYBPC3 site mutation c.G772A might be the pathogenic mutation in that specific HCM family.