ObjectiveTo evaluate the effect of women's body mass index （BMI） on pregnancy outcomes of ovulation induction intrauterine insemination （OI-IUI） in patients with unexplained primary infertility. MethodsThe study included 764 OI-IUI cycles from January 2016 to December 2022 in reproductive center of Sun Yat-sen Memorial Hospital. According to BMI，patients were divided into three groups：low BMI （BMI<18.5 kg/m²）， normal BMI （18.5 kg/m² ≤BMI＜23.0 kg/m²）， and high BMI （BMI≥23.0 kg/m²）. Comparison of clinical data and pregnancy outcomes was performed between the groups. Logistic regression was used to analyze the association between BMI and live birth rate. ResultsFrom the low BMI group to the high BMI group， the HCG positive rate （7.08%，9.74%， 13.19%）， clinical pregnancy rate（5.51%， 7.91%， 13.19%）， and live birth rate （4.72%， 6.90%， 12.50%） increased. Among them， the live birth rate of the high BMI group was significantly higher than that of the low BMI group and the normal BMI group， with a statistically significant difference （P=0.034）. While the early miscarriage rate （14.28%， 10.26%， 5.26%） decreased from the low BMI group to the high BMI group. The binary logistic regression analysis revealed that BMI was an independent factor in live birth， and high BMI resulted in a better live birth rate than low BMI （OR=3.15，95%CI=1.191-8.329，P=0.021）. ConclusionLow BMI is associated with poor OI-IUI outcomes in patients with unexplained primary infertility. These patients are encouraged to gain weight in a healthy manner.

ObjectiveTo screen out the transcriptomes related to the intervention of Wuzi Yanzongwan on the spermatogenic function of semi-castrated male mice， and to explore its potential mechanism in the intervention of the progress of low spermatogenic function. MethodBalb/c mice were randomly divided into sham-operated group， model group， testosterone propionate group（0.2 mg·kg^-1·d^-1， intramuscular injection） and Wuzi Yanzongwan group（1.56 g·kg^-1·d^-1， intragastric administration） according to body weight， with 12 mice in each group. The right testicle and epididymis were extracted from the model group and the drug administration group to construct the semi-castrated model of low spermatogenic function， while the fur and the right scrotum of the sham-operated group were only cut and immediately sterilized and sutured. At the end of the intervention， hematoxylin-eosin（HE） staining was used to observe the histopathology of testis， enzyme-linked immunosorbent assay（ELISA） was used to detect the levels of serum testosterone（T）， luteinizing hormone（LH） and follicle stimulating hormone（FSH）. The sperm count and motility of epididymis were measured by automatic sperm detector of small animal. Transcriptomic microarray technology was used to detect the mRNA expression level of testicular tissue in each group， the transcriptome of genes related to the regulation of Wuzi Yanzongwan was screened， and three mRNAs were selected for Real-time fluorescence quantitative polymerase chain reaction（Real-time PCR） to verify the transcriptome data. Through the annotation analysis of Gene Ontology（GO） and the signaling pathway analysis of Kyoto Encyclopedia of Genes and Genomes（KEGG）， the related functions of drugs regulating transcriptome were analyzed. ResultCompared with the sham-operated group， the testicular tissue of mice in the model group showed spermatogenic injury， contraction and vacuolization of the seminiferous tubules， reduction of spermatogenic cells at all levels， widening of the interstitial space， obstruction of spermatogonial cell development and other morphological abnormalities， and serum T significantly decreased， LH significantly increased（P<0.01）， and FSH elevated but no statistically significant difference， the count and vitality of epididymal sperm significantly decreased（P<0.01）. There were 882 differentially expressed mRNAs in the testicular tissues， of which 565 were up-regulated and 317 were down-regulated. Cluster analysis showed that these differentially expressed mRNA could effectively distinguish between the sham-operated group and the model group. Compared with the model group， the damage to testicular tissue in the Wuzi Yanzongwan group was reduced， the structure of the seminiferous tubules was intact， vacuolization was reduced， and the number of spermatogenic cells at all levels was significantly increased and arranged tightly. The serum T significantly increased， LH significantly decreased（P<0.01）， and FSH decreased but the difference was not statistically significant. The count and vitality of sperm in the epididymis were significantly increased（P<0.01）. Moreover， Wuzi Yanzongwan could regulate 159 mRNA levels in the testes of semi-castrated mice， of which 32 were up-regulated and 127 were down-regulated， and the data of the transcriptome assay was verified to be reliable by Real-time PCR. GO and KEGG analysis showed that the transcriptome functions regulated by Wuzi Yanzongwan were involved in the whole cell cycle process of sperm development such as sex hormone production of interstitial cells in testis， renewal， differentiation， metabolism， apoptosis and signal transduction of spermatogenic cells， and were closely related to the biological behaviors of signaling pathways such as spermatogenic stem cell function， endoplasmic reticulum protein processing and metabolic program. ConclusionWuzi Yanzongwan can effectively improve the low spermatogenic function of semi-castrated male mice， and its mechanism may be related to the regulation of testicular transcriptional regulatory network， the synthesis of sex hormones in testicular interstitial cells， the function of spermatogenic stem cells， the whole cell cycle process of spermatogenesis， as well as the expression of endoplasmic reticulum protein processing and metabolic program related genes transcription.

By sorting out and analyzing the contents about pulse diagnosis in Tanksuqnameh, it was found that in terms of pulse theory, the book contains academic viewpoints of different periods and doctors about three portions and nine readings pulse method and nutritive qi operation law in Huang Di Nei Jing, the Cunkou pulse-taking method and the Cunguanchi theory in Nan Jing, the Renying and Qikou pulse-taking method and the three-region pulse-taking method in Mai Jing, and the seven superficies-indicating, eight interior-indicating and nine channels pulse of Mai Jue, etc.; in terms of pulse theory interpretation, multiple annotations from famous doctors are cited, and TCM basic theories and knowledge of astronomy and mathematics are applied, combined with the background of ancient Iranian medicine and local medical experience for explanation; in terms of pulse diagnosis techniques, pulse diagnosis techniques such as "three fingers determining three guan", "adjusting finger density", "floating and sinking pulse", "foot back pulse breaking life and death" were recorded in books of Nan Jing, Mai Jue, Lei Zheng Huo Ren Shu, etc.; in terms of influencing pulse factors, the male and female pulse, physical pulse, and four time pulse were recorded. Tanksuqnameh is a universal work of Persian Traditional Chinese Medicine, compiled by the author Rashid-ul-Din based on his research on Chinese culture and medical knowledge, combined with the unique customs, language and culture, and way of thinking in the Middle East region, to reorganize various pulse theories from before the Han Dynasty to the Tang and Song Dynasties in China. The publication of this book indicates that TCM pulse diagnosis had been promoted to the Middle East in the 14th century and provided valuable experience for local medical development. The author's sense of identification and research spirit towards different cultures provide a historical example for achieving cross-cultural communication between TCM and medicine in different regions. The preserved literature from the Tang and Song Dynasties in the book can provide clues for a deeper understanding of ancient pulse theory in TCM, but some details do not explain thoroughly or does not match the current clinical practice. Therefore, attention should be paid to distinguishing in research and application.

Prostate cancer is one of the malignant tumors with high incidence. Although most patients with prostate cancer respond well to standard treatment, they often have a poor prognosis once they develop hormone resistance. Radionuclide targeted therapy is an important method to treat malignant tumors after surgery and chemo-radiotherapy. New radioligand therapy (RLT), represented by 177Lu-prostate specific membrane antigen (PSMA)-RLT, effectively solves the problem of poor efficacy in advanced hormone-resistant prostate cancer, and has been widely recognized in the world. In this paper, the clinical practice of 177Lu-PSMA-RLT in the treatment of prostate cancer and its common adverse reactions are described in order to better understand and master its methods and lay the foundation for better clinical application and follow-up research.

Objective To fully assess the status of cancer chemotherapy quality of secondary and tertiary hospitals in Shanghai City in order to improve the quality control system of cancer chemotherapy.Method According to the supervision plan of Shanghai Cancer Chemotherapy Quality Control Center,all of the 103 secondary and tertiary hospitals in Shanghai City which administrated chemotherapy to cancer patients have been inspected in 2015.SPSS13.0 was used for data aggregation and analysis.Result The cancer chemotherapy quality was significantly different between the secondary and tertiary hospitals,as well as between the oncoiogy and non-oncology departments,the main problems were as follow.:the informed consent content was incomplete (33.04％);pathological diagnosis was incomplete or missing (15.50％);tumor stage was not standardized or no staging (56.27％);the chemotherapy purposes (42.44％) and the chemotherapy indications (37.47％) and contraindications (12.21％) were incomplete or missing;the evaluation of chemotherapy efficacy was incomplete or not evaluated (24.10％);the mid-term assessment was incomplete or not evaluated (27.72％);admission history (16.28％) and records of the chemotherapy day (32.04％) were incomplete or missing.Conclusion The quality of medical records of cancer chem0therapy in Shanghai City is significantly related to hospital level and specialty.The hospital authorities should learn the quality control standards based on their own problems.

Objective To investigate the correlations between the soluble form of B7-H3 ( sB7-H3) and the cytokines of IL-17 and IL-8 in serum samples from patients with primary hepatocellular carcino-ma ( HCC) and to evaluate their clinical values for early diagnosis of HCC.Methods Serum samples were collected from 63 patients with HCC and 50 healthy subjects.The expression of sB7-H3, IL-17 and IL-8 in serum samples were detected by ELISA.Receiver operating characteristic ( ROC) curve was generated to an-alyze the diagnostic values of sB7-H3, IL-17 and IL-8 for hepatoma.The logistic regression model was used to predict the probability of hepatoma by using sB7-H3, IL-17 and IL-8 in combination.Results The levels of sB7-H3, IL-17 and IL-8 in serum samples collected from the patients with HCC were significantly higher than those from healthy subjects.A positive correlation was found between the levels of sB7-H3 and IL-17 in serum samples from patients with HCC.No correlation was found between sB7-H3 and IL-8.A negative cor-relation was found between the levels of IL-17 and IL-8 in serum samples from patients with HCC.ROC curve analysis showed that the area under the curve (AUC) of sB7-H3, IL-17 and IL-8 were 0.832, 0.657 and 0.953, respectively, indicating the statistical significance of them for the diagnosis of HCC.The logistic regression showed that the AUC, diagnostic sensitivity and specificity of the regression model PRE in the pre-diction of HCC were 0.960, 91.30% and 94.29%, respectively, which was much better than using the three indicators alone.Conclusion The levels of sB7-H3 were positively correlated to the levels of IL-17 in serum samples from patient with HCC.The logistic regression model of combination of sB7-H3, IL-17 and IL-8 obtained in this study could be used for early clinical diagnosis of HCC in the future.

To study performance problems found in China's essential medicine system.The SmithModel of system implementation was called into play in a systematic collation and analysis for the ideal policies,system implementation agencies,target groups and policy environment in its performance,along with relationships among the four factors.The system is found with a number of loopholes as the system itself is highly idealized,its system objectives set inappropriately,problems found with the four factors,and tension and conflicts among these factors.Given these problems found in its performance,it is inappropriate to make drastic changes to avoid instability of the system at its early stage.Government departments in question are advised to comprehensively analyze the four factors and their relationships then taking effective measures to deal with them and the tension,conflict among them.This can ensure effectively implementation of the essential medicine system.

Objective To evaluate the township hospitals'medical service efficiency in Shandong province,and to provide references for the development in township hospitals under the background of the essential medicine system.Methods The method of data envelopment analysis(DEA)was used to analyze the township hospitals' medical service efficiency in Shandong province before and since the implementation of the essential medicine system.Results For the township hospitals in Shandong province in general,their relative efficiency ratio of the medical service efficiency dropped from 66.67% to 53.33% since the implementation of the essential medicine system.In terms of the input and output,the non-DEA effective township hospitals are found with insufficient output as measured by the output indicator,while some input indicators input were found as excessive.Conclusion The low scale efficiency has become the main factor for the low service efficiency of such hospitals since the implementation of the essential medicine system in Shandong province.In order to improve the medical service efficiency,it is important to continue to improve the essential medicine system,increase the medical staff's incentives, improve the fiscal compensation policy,and keep the policy continuity.

Objective To explore the effect of caregiver reaction on coping styles in cerebral infarction patients with the treatment of rehabilitation. Methods A total of 352 patients with cerebral infarction and their caregiver were valued by the Chinese version caregiver reaction assessment scale and Chinese version medical coping questionnaire. Pearson correlation analysis and multiple linear regression analysis were used to explore the effect of caregiver reaction on coping styles in patients with cerebral infarction. Results The scores of health problems, time arrangements disturbed, economic problems and lack of family support and self-esteem were respectively (2. 80 ± 0. 61), (3. 51 ± 0. 82), (3. 19 ± 0. 63), (2. 61 ± 0. 51) and (4. 08 ± 0. 90). For the coping styles, the scores of confrontation, surrender and avoidance were respectively (17. 85 ± 1. 64), (9. 61 ± 1. 34) and (17. 10 ± 1. 74). Pearson correlation analysis showed that the score of confrontation was significantly negatively correlated with health problems, time arrangements disturbed, economic problems and lack of family support (P<0. 05), but significantly positive correlated with self-esteem (P <0. 05); and the scores of surrender and avoidance were significantly positive correlated with health problems, time arrangements disturbed, economic problems and lack of family support (P <0. 05), but it negatively correlated with self-esteem (P<0. 05). There were significant difference of the score of confrontation, surrender, avoidance in the patients with different sex, age, educational level, marital status, family income, payment method, course of disease, NIHSS, frequency of attack and the the main caregivers with different sex, age and relationships with patients (P<0. 05). Multiple linear regression analysis showed that family income, course of disease, NIHSS and caregiver reaction were the influence factors of coping styles in patients with cerebral infarction (P<0. 05). Conclusions The caregiver reaction is an important influence factor of coping styles in patients with cerebral infarction.

Objective To identify the impact factors for community doctors with the essential medicine system in place,in support of mobilizing them and successful implementation of the essential medicine system in the community.Methods Based on the theory of ERG hierarchy of needs,the pathway analysis method was called into play to identify the three factors affecting community doctors,namely personal survival,interpersonal relations and self-development.Results Major factor of which is the interpersonal factor,with a score of 0.549,while the latter two factors do not directly affect the survival and development.The two however work on each other,and work on the interpersonal factor as well,with the impact coefficients of 0.320 and 0.402 respectively.Conclusion With the essential medicine system in place,the largest impact factor for community doctors'enthusiasm is the interpersonal one,involving the doctor-patient communications among others.This serving as the breakthrough point may improve the enthusiasm of the community doctors,paving the way for the system in the communities.