Objective:To compare the pregnancy and neonatal outcomes of in vitro fertilization-embryo transfer(IVF-ET)with fresh or frozen embryos in spouses of patients with severely low sperm concentration and motility.Methods:A total of 2300 patients whose spouses have severely low sperm concentration and motility underwent IVT-ET in the Reproduction Medicine Center,Sir Run Run Shaw Hospital from April 2018 to April 2022.After applying the propensity score matching(PSM),473 fresh embryo transferred cycles and 473 frozen embryo transferred cycles were selected for the study,and the pregnancy and neonatal outcomes were compared between the two groups.Results:There were no significant differences in pregnancy outcomes and neonatal outcomes between fresh and frozen embryo groups(all P＞0.05).In the stratification analysis,the number of retrieved oocytes in the fresh good-quality embryo transfer group was significantly increased compared with the fresh poor-quality embryo group(P＜0.05),but the very early pregnancy loss rates were similar between the two groups(P＞0.05),while the rate in fresh good-quality embryo transfer group was significantly higher than that in the frozen good-quality embryo transfer group(P＜0.05).Among different age groups of women,the number of retrieved oocytes and the level of estrogen in the fresh embryo transfer group was significantly higher in the 20 to＜30 years old group than that in the 30 to＜35 years old group(both P＜0.05),but the clinical pregnancy rate was lower in the 20 to＜30 years old group than that in the 30 to＜35 years old group(P＞0.05).Additionally,the very early pregnancy loss was significantly increased in the fresh embryo group compared with the frozen embryo group in the 20 to＜30 years age group(P＜0.05).Conclusions:There were no significant differences in pregnancy and neonatal outcomes between fresh and frozen embryo transfer in spouses of patients with severely low sperm concentration and motility undergoing IVF-ET.Due to the shorter transfer times,less embryo freezing damage and reduced costs,fresh embryo transfer can be considered as the first choice.However,it is not necessary to pursue fresh embryo transfer if maternal oestrogen levels are too high and there is a tendency of overstimulation.

Objective:To investigate the current status of malnutrition and its influential factors among patients with stroke and dysphagia, and to develop and validate a malnutrition risk prediction model.Methods:Using a convenience sampling method, 150 patients with stroke and dysphagia admitted to Wenzhou Central Hospital from January 2019 to December 2023 were included in this study. Through a review of the literature and expert consultations, 15 influential factors were identified: age, gender, body mass index (BMI), history of smoking alcohol consumption , number of hospitalizations, education level, Barthel index, history of hypertension, history of diabetes, coronary heart disease, presence of limb disabilities, hemoglobin levels, Glasgow Coma Scale (GCS) score, and National Institutes of Health Stroke Scale score. Patients were categorized into malnutrition and normal groups based on the occurrence of malnutrition. The influential factors for malnutrition were analyzed, and a malnutrition risk prediction model was constructed using regression analysis. The model was presented using a nomogram and subsequently validated.Results:Among the 150 patients with stroke and dysphagia, the average age was (59.34 ± 6.46) years, with 83 females and 67 males. Of these patients, 66 (44.00%) were found to be malnourished. The following factors were identified as independent risk factors for malnutrition in patients with stroke and dysphagia: age (χ2 = 4.03, P = 0.045), BMI ( t = 6.33, P < 0.001), alcohol consumption (χ2 = 3.90, P = 0.048), number of hospitalizations (χ2 = 9.45, P = 0.024), Barthel index (χ2 = 7.78, P = 0.020), presence of limb disabilities (χ2 = 4.64, P = 0.031), hemoglobin levels (χ2 = 4.38, P = 0.036), and GCS score (χ2 = 9.83, P = 0.007) (all P < 0.05). Patients who were older, had a BMI < 18.5 kg/m2, consumed alcohol, had more than five hospitalizations, a Barthel index < 40, limb disabilities, abnormal hemoglobin levels, or a GCS score ≤ 11 were more likely to experience malnutrition (all P < 0.05). The C-index for predicting malnutrition was 0.851, with a 95% CI of (0.809, 0.892). The maximum Youden index was 0.562, with a sensitivity of 84.1% and specificity of 72.1%. Conclusion:The risk factors for malnutrition in patients with stroke and dysphagia include advanced age, alcohol consumption, more than five hospitalizations, limb disabilities, and abnormal hemoglobin levels. Protective factors against malnutrition in these patients are a BMI > 23.9 kg/m2, a Barthel index > 60, and a GCS score ≥ 14. The prediction model demonstrates a significant predictive value for the occurrence of malnutrition in patients with stroke and dysphagia.

Objective:To investigate the factors for serious complications within 30 days after surgery in elderly patients with advanced epithelial ovarian cancer(EOC)who undertook primary debulking surgery(PDS).Methods:The clinical data of International Federation of Gynecology and Obstetrics(FIGO)stage ⅢC/Ⅳ EOC patients aged≥60 years who received PDS in gynecological department of National Cancer Center and National Center of Gerontology between January 2014 and December 2018 were retrospectively analyzed.Clavien-Dindo scoring system was applied to grade the complications within 30 days after surgery.The serious early postoperative complications were those of grade Ⅲ or above occurred within 30 days after surgery.Multivariate Logistic regression analysis was used to screen the independent risk factors of serious complications within 30 days after surgery.Results:A total of 133 patients were included in this study and serious complications rated 11.3%(15/133). The mean age of patients in severe complication group was significantly higher than that in the control group[(69.80±6.56) vs.(65.87±5.14), t=2.699, P=0.008]. The proportion of patients with preoperative ECOG score≥2 was significantly higher in the severe complication group than that in the control group[26.7%(4/15) vs.5.9%(7/118), χ2=4.985, P=0.026], and the proportion of preoperative hypoalbuminemia(<35 g/L)was significantly higher in the severe complication group[20.0%(3/15) vs.3.4%(4/118), χ2=4.897, P=0.027]. However, there was no significant difference in intraoperative bleeding, R0 resection rate as well as surgical complexity( χ2=1.964, 0.330, 4.637, all P>0.05)between the two groups.Multivariate Logistic regression analysis showed that the independent factors for serious early postoperative complications were age≥70 years( OR=4.345, P=0.028), ECOG score≥2( OR=25.619, P=0.008)and preoperative albumin <35 g/L( OR=6.733, P=0.040). Conclusions:In the elderly ovarian cancer patients, individualized perioperative management should be strengthened for the patients with factors associated with serious early postoperative complications, in order to reduce severe complications and improve the prognosis.

OBJECTIVE To op timize the i ntegrated technology of producing area processing and decoction pieces processing of Curcuma longa （hereinafter refer to “integrated technology ”）. METHODS The content of ethanol-soluble extract in C. longa was determined by hot leaching method ；the contents of curcumin ，demethoxycurcumin and bisdemethoxycurcumin were determined by high performance liquid chromatography. On the basis of identification of producing area processing technology ， Using overall desirability （OD） value of the contents of ethanol-soluble extract ， curcumin， demethoxycurcumin and bisdemethoxycurcumin as evaluation indexes ，moisture content ，slice thickness and drying temperature as factors ，the integrated technology of C. longa was optimized by single factor tests combined with central composite design-response surface method ，and the validation tests were conducted. At the same time ，prepared product was compared with traditional decoction pieces prepared according to 2020 edition of Chinese Pharmacopoeia （part Ⅰ）. RESULTS The best integrated technology was that the fresh C. longa was boiled in boiling water for 5 min，dried at 50 ℃ to 40％ water content ，cut into 2 mm thin slices ，and dried at 50 ℃ until moisture content not exceeding 15.0％. After validation ，The deviation between the average OD value （0.811 3，RSD＝2.13％） and the predicted value （0.848 1）of the contents of ethanol-soluble extract ，curcumin，demethoxycurcumin and bisdemethoxycurcumin was 4.34％. OD value of the contents of ethanol-soluble extract ，curcumin，demethoxycurcumin and bisdemethoxycurcumin in decoction pieces prepared by integrated technology were all higher than those prepared by traditional technology. CONCLUSIONS The process optimized in this study is simple ，stable and feasible.

Objective:To design an oral methotrexate auxiliary device and explore the effect of methotrexate in patients with rheumatoid arthritis.Methods:Totally 30 patients with rheumatoid arthritis were selected and observed continuously for 12 months, from January to June in 2021, in the Affiliated Changzhou No. 2 People ′s Hospital of Naijing Medical University. The subjects took the medicine routinely in the first 6 months after entering the group, and the methotrexate oral drug assistant device was given in the latter 6 months to remind them to take the medicine correctly. Medication administration of patients before and after using the auxiliary device was compared, and the evaluation indexes such as disease activity, medication compliance and anxiety were observed. Results:Without the auxiliary device, there were 14 cases (46.67%) of medication error, 13 cases (43.33%) of medication time error, 9 cases (30.00%) of missed administration, while after the use of the auxiliary device, there were 4 cases (13.33%) of medication error, 2 cases (6.67%) of medication time error and 2 cases (6.67%) of missed administration, and the differences were statistically significant ( χ2=8.10, 9.09, 5.14, all P<0.05). Moreover, before using the auxiliary device, the scores of disease activity and medication compliance were 3.92 ± 0.95, 84.97 ± 6.49, respectively, while with the help of the auxiliary device, those scores changed to 3.29 ± 0.83, 92.40 ± 4.17 respectively. All the differences were statistically significant ( t=10.06, -10.37, both P<0.01). 16 cases (53.33%) were anxious after using the assistive device, which was also better than 26 cases (86.67%) before using the device. The difference was statistically significant ( χ2=8.10, P<0.01) . Conclusions:Oral administration aid for methotrexate can help rheumatoid arthritis patients to take methotrexate correctly and safely, reducing disease activity and anxiety, improving drug compliance. It is worthy to clinical promotion.

In recent years, antiangiogenic drugs based on VEGF and VEGFRs signaling pathway have been widely used in the treatment of malignant tumors. Apatinib is an orally bioavailable small-molecule antiangiogenic agent and can specifically inhibit the tyrosine kinase activity of VEGFR, thereby inhibiting tumor angiogenesis. Apatinib is the first-level recommendation of third-line treatment of gastric cancer in CSCO Guidelines for the Diagnosis and Treatment of Gastric Cancer published in 2018. Apatinib has been proved to be effective and safe in gastric, lung and breast cancers. In addition, the drug shows great potential in the treatment of a variety of solid tumors. This article reviews the recent progress on the mechanism, clinical efficacy, related efficacy predictors of apatinib and its combination with other antitumor drugs.

Objective? To develop a health care needs assessment tool for the elderly at home, which is in line with China's national conditions. Methods? Guided by Zuluaga-Raysmith model theory, a health care needs assessment tool for the elderly was developed through literature review, theoretical analysis, expert review, expert consultation and pre-survey. Results? An item pool of 10 first-level items and 72 second-level items, which were suitable for home-based elderly health care needs assessment tools was initially formed. Through three rounds of national expert consultation and pre-survey, an elderly health care needs assessment tool consisting of 7 first-level items, 10 second-level items and 61 third-level items was formed. The expert authority coefficient was 0.791, the expert positive coefficient was 100%, and the expert coordination coefficient was 0.935 (P＜ 0.05). Conclusions The pool of items for the assessment tool is reasonably formed, the results of Delphi expert consultation are reliable. The scale can be widely used after adjustment. It can help medical staff quickly and comprehensively understand the current situation of health care needs of the elderly, provide support for the accurate construction of long-term care service system for the elderly, and support the development of community/home care for the elderly.

ObjectiveTo analyze the literature related to nursing economy in China, so as to discover the current situation of nursing economic development in China. MethodsBibliometric analysis was conducted on 1 053 articles about nursing economy in the databases of CNKI, Wanfang Data Knowledge Service Platform and the VIP Database included from 2013 to 2017. ResultsFrom 2013 to 2017, the number of papers published in Beijing had been relatively stable, with 101 papers being the largest, 87.8%(925/1 053) of the first authors coming from hospitals and schools; the largest number of journal papers (90.3%,951/1 053) being published in 329 journals; the degree of literature cooperation was 2.24, with a co-authorship rate of 52.8%; 10 core authors were selected based on Price's law; and the subjects of study were mainly about the demand and supply of nursing services(33.5%); 21.1% of the literature was funded by scientific research fund. ConclusionsNursing economy research content is extensive, but lack of theoretical system, the development of this discipline is slow; nursing cost accounting and price deviate, it is urgent to build a reasonable cost accounting system; nursing service supply and demand is imbalanced, the establishment of a precise whole-process care system is needed; "the wave of silver hair" to promote long-term care insurance emerged; it is needed to appropriately plan human resources allocation to realize the career development of nursing staff.

?? [Abstract]? Objective? To investigate the current status of nursing care for patients with Alzheimer's disease(AD) in China in order to explore the reform of its care model. Methods? From January to April 2018, 12 medical staff, 19 patients with AD and their families from the Departments of Geriatrics and Neurology in a ClassⅢ Grade A hospital in Chengdu, psychiatric hospitals and community health service centers were selected as the research objects by purposive sampling. Semi-structured interviews were conducted, the data obtained was analyzed by Colaizzi phenomenological analysis method. Results? The results of the interview were divided into three themes: medical care, hierarchical care elements, and the needs of patients and their families. Medical and nursing services in different levels of medical institutions have different emphasis; patients' care needs vary in different periods of illness; care elements cover biological, psychological and social dimensions. Conclusions? Attention should be paid to early screening of AD diseases, early intervention in cognitive rehabilitation training, evidence-based construction of acute-medium-long-term care system for AD, and development of long-term care insurance for AD to serve patients accurately.

? Objective? To explore the tatus quo of geriatrics ward and nursing personnel allocation in medical institutions in Western China and to provide reference to construction planning of geriatrics wards. Methods? Nursing managers from medical institutions at different levels in 11 provinces, autonomous regions and municipalities in Western China between February and March 2018 were selected by convenient sampling. A cross-sectional study was conducted with the self-designed general information questionnaire for geriatrics ward construction. Results? Totally 327 questionnaires were distributed, and 289 valid questionnaires were collected, with a valid rate of 88.38%. Totally 142 of the 289 medical institutions (49.13%) set up geriatrics wards. The number of Class III Grade A hospitals accounted for 54.9%, and the number of general hospitals accounted for 88.7%. The proportion of geriatrics beds accounted for 7.1% of the total, and the bed-nurse ratio in geriatrics wards was 1:0.48. 5.7% (235/4 102) of nurses in geriatrics wards had senior titles, 23.5%(966/4 102) had intermediate titles, and 70.7%(2 901/4 102) had junior titles. Totally 0.8%(34/4 102) of them had a master's or doctoral degree, 49.2%(2 016/4 102) had a bachelor's degree, and 50.0%(2 052/4 102) had diploma from junior colleges. 6.9%(92/1 340) of nurses in specialized geriatrics wards had senior titles, 27.8%(372/1 340) had intermediate titles, and 65.4%(876/1 340) had junior titles. Totally 0.8%(11/1 340) of them had a master's or doctoral degree, 51.1%(685/1 340) had a bachelor's degree, and 48.1%(644/1 340) had diploma from junior colleges. Conclusions? The geriatrics ward construction and nursing personnel allocation in Western China have basically taken shape. However, they are imbalanced in different provinces, cities or medical institutions at different levels, indicating that Western China needs to pay attention to the construction of geriatrics wards in primary medical institutions, enhance the training for specialized geriatrics nurses, and ensure the nursing quality for elderly patients.