It is believed that retention due to deficient qi is an important pathogenesis of endometriosis （EMs）. Deficient qi is the root of the disease， mainly manifested as spleen deficiency， while retention is the branch pathogenesis of the disease， mainly with blood stasis， complicated with constraint， phlegm， heat， toxin and other pathological factors. Therefore， it is proposed to follow the treatment principle of supplementing deficiency and unblocking stagnation， and take the methods of replenishing qi and fortifying the spleen， removing stasis and eliminating concretions. Self-made Fuzheng Huayu Formula （扶正化瘀方） is taken as the basic formula， and can be modified with the symptoms in menstrual and non-menstrual periods. Additionally， the methods of moving qi， dispelling phlegm， clearing heat， relieving toxin and others can be combined， and it is recommended to treat the root and the branch simultaneously.

Background::Breast cancer (BC) risk-stratification tools for Asian women that are highly accurate and can provide improved interpretation ability are lacking. We aimed to develop risk-stratification models to predict long- and short-term BC risk among Chinese women and to simultaneously rank potential non-experimental risk factors.Methods::The Breast Cancer Cohort Study in Chinese Women, a large ongoing prospective dynamic cohort study, includes 122,058 women aged 25-70 years old from the eastern part of China. We developed multiple machine-learning risk prediction models using parametric models (penalized logistic regression, bootstrap, and ensemble learning), which were the short-term ensemble penalized logistic regression (EPLR) risk prediction model and the ensemble penalized long-term (EPLT) risk prediction model to estimate BC risk. The models were assessed based on calibration and discrimination, and following this assessment, they were externally validated in new study participants from 2017 to 2020.Results::The AUC values of the short-term EPLR risk prediction model were 0.800 for the internal validation and 0.751 for the external validation set. For the long-term EPLT risk prediction model, the area under the receiver operating characteristic curve was 0.692 and 0.760 in internal and external validations, respectively. The net reclassification improvement index of the EPLT relative to the Gail and the Han Chinese Breast Cancer Prediction Model (HCBCP) models for external validation was 0.193 and 0.233, respectively, indicating that the EPLT model has higher classification accuracy.Conclusions::We developed the EPLR and EPLT models to screen populations with a high risk of developing BC. These can serve as useful tools to aid in risk-stratified screening and BC prevention.

Objective: To understand the coincidence rate of adjustable and non adjustable desks and chairs in primary and secondary schools in Shanghai, so as to provide a reference for the effective management of desks and chairs in schools. Methods: Stratified random cluster sampling was applied to measure 1 091 sets of desks and chairs in 33 classrooms of 7 primary and secondary schools in 4 districts of Shanghai including Huangpu, Hongkou, Yangpu and Jiading districts. The height examination data of seated students in the same semester were also collected to evaluate the matching type of functional size of desks and chairs and students height according to Functional Sizes and Technical Requirements of Chairs and Tables for Educational Institutions. Results: The matching coincidence rate of desk and chair distribution in primary and secondary schools was 22.5%, and the matching coincidence rates of primary, middle and high schools were 11.7%, 27.1% and 40.9% respectively ( χ 2=83.23, P <0.01); the matching coincidence rate of adjustable desks and chairs (28.2%) was significantly higher than that of fixed (18.2%) ( χ 2=14.49, P <0.01). The type of distribution of desks and chairs that do not correspond to national standards, from elementary school to high school, showing a trend of high desks with high chairs, low desks with high chairs to high desks with low chairs. Conclusion The coincidence rate of desk and chair distribution in primary and secondary schools is low, and the adjustable desks and chairs has improved the problems to a certain extent, but has not significantly improved the coincidence rate. It is necessary to further explore the effective management mode in the use of adjustable desks and chairs and improve the current situation of the use of desks and chairs in schools.

Objective:To explore the effect of high intensity interval training (HIIT) on cardiac rehabilitation in patients after heart transplantation.Methods:According to the search terms, the search was conducted on China National Knowledge Infrastructure, VIP, WanFang Data, China Biology Medicine disc, Web of Science, PubMed, Cochrane Library, Embase, and EBSCO. The search time limit was from the establishment of the database to January 31, 2022. After 2 researchers screened the article, extracted information, and evaluated the quality, a Meta-analysis was conducted using RevMan 5.4 software.Results:According to the inclusion and exclusion criteria, 10 English articles were selected, including 191 patients in the intervention group and 212 patients in the control group, with a total of 403 patients. Meta-analysis showed that during cardiac rehabilitation exercise in patients after heart transplantation, HIIT could improve peak oxygen uptake in cardiopulmonary function exercise testing [ MD=1.98, 95% confidence interval ( CI) (0.55, 3.41), P=0.007], peak heart rate in chronotropic responses [ MD=6.93, 95% CI (2.62, 11.24), P=0.002], and muscle exercise ability [ MD=337.18, 95% CI (12.02, 62.35), P=0.04]. There was no statistically significant difference in systolic blood pressure, diastolic blood pressure, peak systolic blood pressure, peak diastolic blood pressure, resting heart rate and respiratory exchange rate between the two groups ( P>0.05). A subgroup analysis of peak oxygen uptake was conducted based on the intervention period and the start time of rehabilitation exercise after heart transplantation. The results showed that there were statistically significant differences in peak oxygen uptake between the intervention group and the control group when the intervention period was ≤ 12 weeks or the start time was > 6 weeks ( P<0.01) . Conclusions:HIIT effectively improves the peak oxygen uptake, peak heart rate, and muscle exercise activity of patients after heart transplantation. HIIT has a significant impact on peak oxygen uptake when the rehabilitation exercise start time after heart transplantation is > 6 weeks or the intervention period is ≤ 12 weeks.

Objective To evaluate the effect of applying sitting posture corrector on improving reading and writing posture of elementary school students， and provide scientific evidence for prevention and control of myopia in children and adolescents. Methods One elementary school each in urban and suburban areas of Shanghai was selected using a convenience sampling strategy. Furthermore， two classes each in Grade 3 and 4 were selected as the intervention group （282 students were included in the study）， and the other two classes each in Grades 3 and 4 were selected as the control group （294 students were included in the study）. Students in the intervention group used the sitting posture corrector in the classrooms for 4 months （from September 2020 to January 2021）， while those in the control group did not use the sitting posture corrector. Relevant data were collected before and after the intervention through a self-administered questionnaire and visual examination. Statistical analysis was performed using chi-square test and generalized estimating equation. Results Before the intervention， 13.5% （38/282） of students in the intervention group and 12.2% （36/294） in the control group had good reading and writing posture （ χ ² = 0.195， P >0.659）. After the intervention， 18.4% （52/282） of students in the intervention group had good reading and writing posture， which was higher than that （11.2%， 33/294） in the control group （ χ ²=5.957， P =0.015）. Before and after the intervention， there was no significant differences in the prevalence of myopia between students in the intervention and control groups （all P >0.05）. Generalized estimating equation analysis showed that students in the intervention group were 1.502 times more likely to have good reading and writing posture than those in the control group after the intervention （ P =0.043）. Conclusion Applying sitting posture corrector in schools could improve students' reading and writing posture.

Objective: To analyze the urinary iodine status of urban and rural residents in some areas of Gansu Province and its related influencing factors, and to provide certain references for scientific iodine intake of urban and rural residents in Gansu Province. Methods: Subjects in Gansu Province with normal thyroid function were recruited in the investigation of thyroid diseases and iodine nutritional status, conducted a questionnaire survey and measured height, weight, waist circumference, collected 1 urine sample, and tested their urinary iodine levels. The urinary iodine levels of different groups were compared based on different gender, region, age, body weight, the waist, and salt intaking. The affecting factors of urinary iodine levels were analyzed by multiple linear regression models. Results: Totally 1 964 subjects were recruited, including 1 099 males, and 865 females. The age was (41.23 ± 14.75) years old. The median urinary iodine of the selected group was 225.60 (158.80, 311.58) μg/L. The urinary iodine level of rural residents was significantly higher than that of urban residents [μg/L: 249.80 (180.58, 336.88) vs 206.25 (148.03, 280.33), Z=-8.015, P < 0.05], and there was no significant difference between the urinary iodine levels of male and female [μg/L: 222.40 (161.60, 298.90) vs 230.60 (158.00, 326.40), P > 0.05]. The composition ratio of < 100 μg/L group in rural areas was lower than that in urban areas (5.14% vs 8.27%, χ²= 7.45, P < 0.05), and the composition ratio of ≥300 μg/L group was higher than that in urban areas (34.93% vs 21.51%, χ²= 43.87, P < 0.05). The composition ratio of ≥300 μg/L group in male was lower than that in female (24.57% vs 31.21%, χ²= 10.73, P < 0.05). The multiple linear regression analysis showed that lived in rural areas, age, moderate and severe salt intaking, student, and weight were independently correlated with urinary iodine levels (β= 0.074, -0.001, 0.059, 0.034, 0.096, -0.003, P < 0.05). And the urinary iodine levels were decreased with age and weight increased (P < 0.05). Conclusions At present, the iodine nutrition level of urban and rural residents in some areas of Gansu Province is generally over the adequate level. The urinary iodine level of rural residents is higher than that of urban residents. In the future, we should pay attention to the impact of different living areas, salt intaking and body weight on urinary iodine levels to prevent thyroid diseases.

Objective To analyze the clinical value of Guizhi Fuling capsules combined with fosfomycin trometamol power in the treatment of pelvic inflammatory disease and pelvic effusion.Methods A total of 60 patients with pelvic inflammatory disease and pelvic effusion from February 2013 to March 2016 in our hospital were selected and divided into the control group and the observation group , 30 cases in each group.The control group were treated with fosfomycin trometamol power, and the observation group were additionally treated with Guizhi Fuling capsules.The therapeutic effects and changes of TCM syndrome scores were compared between the two groups.The levels of serum C reactive protein ( CRP ) in the two groups were determined before and after treatment and the ultrasound examination was performed and changes of pelvic effusion diameter was determined before and after treatment.Results The total effective rate of the observation group was higher than that of the control group, the difference was statistically significant (P<0.05).There was no significant difference in TCM syndrome scores between the two groups before treatment .After treatment, the TCM symptom scores of both groups were decreased, the difference was statistically significant ( P<0.05 ) .The scores of lumbosacral swelling pain, abdominal pain, morbid leucorrhoea increase, fatigue, low-grade fever and soreness of waist in the observation group were lower than those in the control group, the difference was statistically significant (P<0.05).Before treatment, there was no statistically significant difference in pelvic effusion and CRP levels between the two groups.After treatment, the pelvic effusion diameter and CRP levels were decreased, the difference was statistically significant (P<0.05), and those in the observation group were lower than the control group, the difference was statistically significant (P<0.05). Conclusion Guizhi Fuling capsules combined with the fosfomycin trometamol power is significantly effective in the treatment of pelvic inflammatory disease and pelvic effusion.It can significantly reduce the inflammatory reactions of patients, and improve the TCM syndrome scores.

Objective To observe the therapeutic effect of clarithromycin combined with Cassia Twig-Poria Cocos capsule on patients with chronic pelvic inflammatory disease and its influence on high sensitivity C - reactive protein (hs-CRP). Methods 106 cases of patients with chronic pelvic inflammatory disease were selected to be divided into the observation group and control group with each group of 53 patients. The patients in control group were only given clarithromycin, on the base of control group, patients in observation group were given Cassia Twig-Poria Cocos. Both group were treated for three courses of 7-14 days. Then the therapeutic effect, adverse reactions, hs-CRP, erythrocyte sedimentation rate and hematocrit of patients were investigated. Results The total effective rate of patients in observation group was 90.57%, and the control group was 75.47%. The total effective rate of observation group was higher than control group with statistically significant difference (P<0.05). The hs-CRP, erythrocyte sedimentation rate and hematocrit of two groups both decreased after treatment (P<0.05) and these indexes of observation group was much less than control group (P<0.05). Besides, there was no difference of incidence of adverse reactions between two groups during the treatment. Conclusion Treatment of clarithromycin combined with Cassia Twig-Poria Cocos capsule on patients with chronic pelvic inflammatory disease not only can lessen inflammatory reaction, but also can improve the therapeutic effect effectively.

Objective To conduct a retrospective study about drug-induced hyperthermia (DIH) based on DIH data obtained in medical practice,and elucidate the relationship between DIH incidence and antibacterials overuse.Methods To investigate successively the medical records of inpatients from orthopaedics department in Fudan university affiliated Jinshan hospital at two different periods,and data of DIH cases were extracted to perform a comparative study.The period for 229 effective cases of group Ⅰ was from Feb.1 to Apr.30,2011,before significant improvement on antibacterials use.The period for 342 effective cases of group Ⅱ was from Jul.1 to Sep.30,2012,after the effective enforcements of regulation on antibacterials use.Inclusion criteria for DIH were:①an oral temperature ≥37.6 ℃ since postoperative day 4,②no evidence of infection,③a time relationship between fever and the administration of causative drugs:a fever occurring with drug administration and disappearing after drug cessation within 3 days,④no other causes for the fever,⑤oral temperature ≤ 37.6 ℃ until leaving hospital.Exclusion criteria for DIH were listed below:①possible pathological fever,e.g.,in cancer,②hospitalization within 3 days,③no surgery,④severe trauma,for example,visceral or central nervous system injury.Results All causative drugs were for injection.By comparison,duration of antibacterial administration is significantly shorter in group Ⅱ than in group Ⅰ (1.7 ± 1.7 vs.4.6-± 1.8days,P ＜ 0.01),and total DIH incidence and antibacterials related DIH incidence were significantly lower in group Ⅱ than in group Ⅰ (7.3％ vs.30.1％,1.5％ vs.25.3％,both P ＜0.01).Conclusion DIH incidence is related with drug type especially with antibacterials overuse,and changed with drug program.DIH was more serious for injection of antibacterials than injection of traditional Chinese medicine.Decrease of antibacterials usage is positively associated with the decreased DIH incidence.Safe medication should begin from safe usage of antibacterials.

ObjectiveTo explore the application effects of type 2 diabetes mellitus (T2DM) clinical nursing pathway in clinical nursing education.Methods A total of 24 nursing students practiced in endocrine department of Beijing Electric Power Hospital of Capital Medical University from July 2014 to May 2015 were selected by purpose sampling method as the control group and they received the traditional clinical teaching method. 22 nursing students practiced in endocrine department of our hospital from July 2015 to May 2016 were selected as the observation group and they received clinical nursing teaching plan which was designed based on the clinical nursing pathway. The clinical nursing pathway was established based on T2DM clinical pathway issued by the Ministry of Health of PRC and refined according to the characteristics of nursing work. Test scores of students′ theory and operation were compared between two groups. The questionnaire of patients′ diabetes knowledge was self-designed and was used to investigate the knowledge of patients on diabetes.Results The scores of students′ theory and operation in the observation group were (90.91±3.13) and (92.36±2.59),which were higher than those in the control group [(84.63±3.79),(90.42±3.28)]. The differences were statistically significant (t= -6.103,-2.219;P<0.05). The score of knowledge on diabetes of patients in the observation group (86.23±4.98) was significantly higher than that in the control group (80.13±5.35) (t= -8.568,P<0.01). Conclusions The clinical teaching method based on clinical nursing pathway could guide nursing students to improve clinical practice and comprehensive ability as well as promoting knowledge of patients on diseases.