Objective To observe and compare the effects of high-intensity interval training (HIIT) and continuous aerobic training (CAT) on the exercise performance and habits of patients with chronic obstructive pulmonary disease (COPD) during hospitalization. Additionally, the study compared the differences in the effectiveness of the two training modes. Methods Inpatients diagnosed with COPD in our patients who were hospitalized between September 2020 and December 2022 were selected as the study population. A total of 46 samples were collected for this study using a randomized case‒control method. Results Increased frequencies of rehabilitation exercise during hospitalization were associated with significant improvements in the 6MWT, MIP and daily exercise time. HIIT had better results than CAT in the 6MWT. Conclusion Therefore, instead of CAT, HIITeasier can improve patients’ exercise tolerance and mobility.

Objective  To analyze the lifestyle habits of bus drivers in Macau, collect and analyze physiological and biochemical indicators, assess the risk of cardiovascular disease, and establish a protocol for periodic health checkups. Methods  Through medical history collection and related physical examination results, bus drivers were assessed according to the risk prediction model, and the risk of cardiovascular disease was analyzed. Results  We studied a total of 398 male bus drivers whose overweight and obesity status were 60.6%, smoking status was 33.7%, and drinking status was 34.4%. The prevalence of hypertension, diabetes and metabolic syndrome was 22.9%, 9.1% and 23.4%, respectively. The incidences of hypertension and diabetes, smoking and drinking rate, weight and triglyceride levels were significantly different among the different age groups. 3. The risk prediction of cardiovascular disease was analyzed in 102 bus drivers who underwent highdensity lipoprotein (HDL) cholesterol testing. The risk prediction of cardiovascular disease in different age groups was statistically significant. Conclusion  The high prevalence of overweight and obesity should be considered in local drivers. The overall health management of patients with hypertension and diabetes was not satisfactory, and active intervention was needed. This study showed that the health of bus drivers is closely related to their age. It is very important to receive appropriate health checkups regularly. Additionally, HDL-C should be tested during periodical health checkups on bus drivers older than 50 years to optimally utilize the China-PAR model and to predict the risk of cardiovascular disease.

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Objective  To analyze the therapeutic effects and prognostic factors of hyperbaric oxygen in patients with sudden hearing loss. Methods  Patients with sudden hearing loss treated with hyperbaric oxygen were retrospectively analyzed and divided into an effective group and an ineffective group according to differences in therapeutic efficacy. The general data of the two groups were compared. Logistic regression analysis was used to evaluate the associations between therapeutic efficacy and factors. Results  There were significant differences between the effective group and the invalid group in age, onset time to start hyperbaric oxygen therapy, degree of hearing loss, type of hearing loss and vertigo (P<0.05). Logistic regression equation analysis revealed that age >60 years and >14 days from onset to the start. Conclusion  The effect of hyperbaric oxygen in the treatment of sudden hearing loss is important because it can improve hearing function and is worthy of clinical promotion. However, advanced age and the time from onset to initiation of hyperbaric oxygen therapy are important factors affecting patient prognosis.

Objective To investigate the prevalence of chronic obstructive pulmonary disease (COPD) and preserved ratio impaired spirometry (PRISm) among smokers in Macao and its relationship with lung cancer detection rates. Methods This single-arm study involved recruiting current or former smokers aged 50-75 years who were at risk of lung cancer. A baseline health questionnaire, spirometry, and low-dose CT scan were performed. CT scans were assessed by a radiologist for emphysema and lung nodules. As the spirometry technique is the gold standard, subjects were divided into three groups: the normal lung function group, the PRISm group and the COPD group. We analyzed the different characteristics of the three groups and their relationships with lung cancer detection rates. Results Among the 291 recruited subjects, 32 (11.0%) met the spirometry criteria for PRISm, 98 (33.7%) met the spirometry criteria for COPD, and 161 (55.3%) had normal lung function. Ten patients had lung cancer. The lung cancer detection rates were 0.63%, 12.50%, and 5.10% (X2=15.79, P<0.00) in the normal group, the PRISm group and the COPD group, respectively. The odds of lung cancer occurring in patients with PRISm syndrome and abnormal lung function (the PRISm and COPD groups) were 20-fold (20.13, 95% CI=2.33-174.20) and 11-fold (11.08, 95% CI=1.39-88.57), respectively (normal). lung function group, respectively. The consistency rate of LDCT and spirometry for COPD patients was low (Kappa=0.24, P<0.05). Conclusion The COPD and PRISm detection rates are high in the smoker population. COPD and PRISm are risk factors for lung cancer. There are few correlations between spirometry and LDCT in the diagnosis of COPD. Spirometry could be considered an additional test in lung cancer screening programs for heavy smokers.

Objective To observe the clinical effects of traumatic recurrent corneal epithelial erosion caused by alcohol-assisted exfoliation and PTKs. Methods This was a retrospective series of case studies. A total of 78 eyes with traumatic recurrent corneal epithelial erosion diagnosed in our hospital between March 2019 and October 2022 were selected, and their clinical manifestations, treatment methods, recurrence rate, and recurrence interval were observed. Fourteen eyes were treated with alcohol-assisted epithelial PTK (A-PTK) and observed for 6 months to determine whether there were complications, especially corneal subepithelial haze (HAZE), or if the BCVA decreased postoperatively. Correlations between the duration of corneal epithelium soaking in alcohol or cutting depth and the recurrence rate during A-PTK surgery was also analyzed. Results A total of 78 participants were included in this study; 32 were male (41%), and 46 were female (59%). Similarly, the average interval seizures were significantly shorter for males than for females (P <0.05). In this study, the recurrence rate was 48.4% in the medical treatment group and 28.6% in the A-PTK group. After the 6-month follow-up, all the BCVA returned to the preoperative level at the end of the 6-month follow-up. One patient had -0.50DS myopia after TPTK, which was corrected by wearing glasses to 20/20. No complications, such as HAZE, occurred during observation. In the A-PTK group, the number of days between attacks after treatment (144.36±66.03 days) was significantly greater than that before treatment (52.43±41.98 days) (P =0.004). Conclusion This group of observation objects was used. With traumatic recurrent corneal epithelial erosion, males have more frequent attacks than females. A-PTK is safe and effective in the treatment of traumatic recurrent corneal epithelial erosion and can reduce the frequency of recurrence.

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Objective To use the PDCA (Plan Do Check Act) management cycle to establish a reasonable blood component management system for reducing component waste after it is released from the blood bank. Methods Blood component waste data were collected from April to December 2019 to determine the basic conditions of the participants. After analyzing the underlying reasons, we applied several improvements in waste management and performed the second period of data collection, from January to December 2020, 2021 and 2022, annually. The chi-square distribution method was used to assess differences. Results After improvement, a comparison of the blood component wastage, and the difference between the first and second periods by year was significant (P<0.05). Conclusion The introduction of a PDCA management cycle is a useful tool for reinforcing blood component management after the blood component is released to the ward and effectively decreasing waste.

Objective To explore the differences between lung algorithms and standard algorithms in terms of the artificial intelligence (AI) detection rate and natural judgment of pulmonary nodules. Methods Analysis of lung CT images from August 1, 2022, to December 31, 2022, was performed at the Imaging Department of Kiang Wu Hospital in Macau. The AI lung algorithm and standard algorithm are used to analyze and compare the detected pulmonary nodules. The impact of two algorithms on the detection rate and natural judgment of pulmonary nodules. Results A total of 216 patients with low-dose chest CT scans of the lungs were randomly collected.A total of 922 nodules were detected. Moreover, there was no significant difference in the detection rate of pulmonary solid nodules between the AI system lung algorithm and the standard algorithm (P=0.106). The detection rate of pulmonary ground-glass opacities was significantly different between the lung algorithm and the standard method algorithm (P=0.00). Conclusion The lung algorithm and the standard algorithm have a great impact on the detection of pulmonary nodules via the AI system and should be used together in practical work. 

Objective To explore the role of the endometrial sampler SAP-1 as a sample-collecting tool for screening for endometrial cancer (EC) in patients with general risk. Methods Patients who were hospitalized and underwent hysteroscopy examination between August 2018 and December 2022 were enrolled in this study and were confirmed to be at general risk of EC. Before the procedure, endometrial samples were first collected by SAP-1, after which hysteroscopy curettage or electrotomy was performed to obtain the endometrial samples. With the pathological results of the hysteroscopy samples as the "gold standard", the diagnostic efficacy of SAP-1 sampling was analyzed. Results The sample satisfaction rate of SAP-1-treated patients was 91.5%, which was slightly lower than that of hysteroscopic patients (95.6%), but the difference was not significant. A total of 245 patients were subjected to both methods. The sensitivity, specificity and accuracy of SAP-1 in diagnosing EC and precancerous lesions were 86.7%, 100% and 99.2%, respectively. Conclusion Applying an endometrial sampler SAP-1 for screening for EC among women with general risk of EC, which has high diagnostic efficiency, simple operation, high safety and an outstanding cost-to-performance ratio, is worthy of clinical promotion.

Objective To assess the current status of knowledge, attitudes, practices and related factors related to medical waste classification among nurses at a hospital in Macau. Methods The participants in this study were nurses who were enrolled in stratified random sampling. Self-developed and structured questionnaires assessing participants’ knowledge, attitudes, practices and related factors concerning medical waste classification were used. Results A total of 325 patients were recruited. The participants received a high score in the medical waste classification knowledge survey, as well as in the attitude and practices survey. There were significant positive correlations between participants' knowledge and attitudes toward medical waste classification and between their knowledge and their attitudes and practices (P <0.01). The background variables and attitudes toward medical waste classification of the participants could predict their medical waste practices and explained 26.1% of the total variation, among which "medical waste classification attitude" had the greatest impact (P <0.01). Conclusion The participants had an insufficient level of knowledge of medical waste.classification, as well as attitudes and practices. The greater their knowledge about medical waste classification is, the better their attitude toward medical waste classification, and the better their attitude toward medical waste classification is, the better their medical waste classification practices. An attitude toward medical waste classification was the main factor impacting medical waste classification practices. Hence, education and training are proposed to improve medical waste classification among nursing staff, especially for improving their attitudes toward medical waste classification.

Objective The aim of this study was to examine the significance of umbilical artery (UA) and middle cerebral artery (MCA) blood flow indices in the diagnosis of fetal growth restriction. Methods We selected 26 fetuses with IUGR and 30 fetuses with healthy fetuses as the control group from January 2020 to December 2022 at our hospital. The age of the pregnant women ranged from 27-43 years, with an average of 31±3.2 years. The gestational age ranged from 32-39 weeks, with an average of 35.16±2.74 weeks. We measured UA-PIs.UA-RI, MCA-PI, and MCA-RI in both groups of pregnant women. We also recorded the Apgar score of the newborns at 5 minutes and calculated the sensitivity and specificity of each indicator for diagnosing intrauterine growth restriction (IUGR). Results In the IUGR group, there were 16 cases of abnormal UA-PIs, 12 cases of abnormal UA-RIs, 6 cases of abnormal MCA-PIs, and 5 cases of abnormal MCA-RIs. In the normal control group, there were four patients with abnormal UA-PIs, 2 patients with abnormal UA-RIs, 2 patients with abnormal MCA-PIs, and 2 patients with abnormal MCA-RIs. The Apgar scores at 5 minutes after birth were as follows: in the IUGR group, among the newborns with abnormal UA-PIs, one had a score of 0-3, two had a score of 4-6, and twenty-three had a score of 7-10; among the newborns with abnormal UA-RIs, two had a score of 4-6, and twenty-four had a score of 7-10; among the newborns with abnormal MCA-PIs, one had a score of 4-6, and twenty-five had a score of 7-10. All Newborns with abnormal MCA-RIs had a score of 7-10. In the normal control group, among the newborns with abnormal UA-PIs during the fetal period, the Apgar scores at 5 minutes after birth were as follows: one had a score of 4-6, and 29 had a score of 7-10. The Apgar scores of the other newborns in the normal control group were within the normal range. The UA-PI had the highest sensitivity for the early diagnosis of IUGR, but its specificity was the lowest among all the indicators. The specificity of the UA-RI, MCA-PI, and MCA-RI was as high as 93.3%. Conclusion Fetal UA and MCA blood flow monitoring have significant clinical value for the early diagnosis of IUGR, and the fetal UA index is more sensitive for detecting IUGR than the fetal MCA index.

Objective The aim of this study was to explore the clinical pathological characteristics of multiple primary tumor patients and optimize the diagnosis and treatment of these patients. Methods We retrospectively analyzed the clinical data of patients who were diagnosed with multiple primary tumors between 2001 and 2023 at our center, including diagnosis, primary and secondary tumor site, pathology subtype, treatment type and survival data. The prognostic factors were calculated. Results In total, 67 patients were diagnosed with multiple primary tumors were included. There was a male predominance. There were 31 and 36 synchronous and metachronous multiple primary tumors, respectively. The most common site of primary tumor was the breast. The most common site in the second cohort was the lung. The overall survival rate was 66%. The unfavorable factors were age at diagnosis and site of the primary site. Conclusion Multiple primary tumors presented with a predominant incidence of breast cancer at our center, followed by GI cancer. A multidisciplinary team discussion is recommended for this kind of disease.

Objective To investigate the effects of long-term smoking on lung function, and the early detection of chronic obstructive pulmonary disease. Methods From May 2017 to December 2019, pulmonary function was examined, and the detection rates of COPD and lung function abnormalities were analyzed. Results A total of199 patientsin the smoking group and 73patients in the nonsmoking group completed lung function tests. The 1second rate (FEV 1 / FVC) and FEV 1% Pred were lower in the smoking group than in the nonsmoking group. The detection rates of abnormal lung function in two groups were 46.2% and 15.1%, respectively, and those in the smoking group were higher than those inthe non-smoking group (χ²=22.04, P <0.01). In thesmoking group, the detection rate of possible COPD was 36.2% (95%CI: 29.5%~42.9%), and that of PRISm was 10.1% (95%CI: 5.8%~14.2%). In the nonsmoking group,the detection rate of possibleCOPD was 6.8% (95%CI:1.1%~12.6% )and that of PRISmwas 8.2% (95%CI: 5.2%~14.5%). The detection rate of possible COPD was significantly greater in the smoking group than in nonsmoking group. Conclusion Long-term smokers have a high detection rate of pulmonary function impairment and possible COPD. Pulmonary function examination may help to detect early COPD and pulmonary function impairment in the population,providing a basis for the early prevention and treatment of COPD.

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Objective To observe the clinical effect of traditional Chinese medicine (TCM) on postpartum retained products of conception (RCPs). Methods This was a retrospective analysis of 38 patients who had retained products of conception after a pregnancy in the TCM outpatient clinic of Kiang Wu Hospital and who were orally administered the TCM Jiawei Tuohua Decoction. The clinical curative effect was evaluated by comparing ultrasonography before and after treatment. Results After treatment, 30 cases were cured, 1 case was improved, 7 cases were ineffective, the cure rate was 79.94%, the total effective rate was 81.57%. The mean diameter of uterine tissue residues measured by B-ultrasound before treatment was (1.33±0.91) cm, and that after treatment was (0.31±0.74) cm, which was significantly reduced compared with that before treatment, and the difference was statistically significant (P < 0.05). Conclusion The preliminary results show that traditional Chinese medicine in the treatment of postpartum uterine residue has good efficacy, fewer side effects, favorable dischargeuterine residue, promote uterine involution, reduce the rate of second uterine clearance operation, worthy of clinical application.

Objective This study investigated and analyzed the influencing factors of nurses' self-efficacy and clinical communication skills in a local hospital in Macau. Methods A cross-sectional survey was conducted in a hospital in Macau. The questionnaires included a demographic survey form, the General Self-Efficacy Scale (GSES), and the Clinical Communication Competence Scale (CCCS). Results There were 400 clinical nurses participated in this study. The self-efficacy score was 24.39±5.03 points. Nurses' self-efficacy and clinical communication skill scores varied according to their working department (F =3.307, P <0.05). The total average score for nurses’ clinical communication skills was 3.95±0.48 points. The relationship between self-efficacy Clinical communication skills were positively correlated with the coefficients (r =0.357, P =0.01). Conclusion The self-efficacy score ranged from medium to low and was positively correlated with the clinical communication skill score. It was recommended that nurses be encouraged to participate in management training to improve their professional identity and self-efficacy. Communication skills training can be strengthened through nurses' participation, such as focused discussion and role-playing, to improve their job satisfaction and clinical communication skills.

Objective To explore the academic characteristics and development trends of the Medical Journal of Kiang Wu, as well as the development level of various disciplines at Kiang Wu hospital in different periods through statistical analysis of medical literature information and author information from the Medical Journal of Kiang Wu for thirty years after its resumption. Methods All the journals published in the Medical Journal of Kiang Wu over the past 30 years since its resumption. Medical literature was selected from the titles of each issue, and data on the number, classification, authors, and author affiliations were collected. Background data of the first author, including education level, graduation year, work experience, and professional and technical title, were also collected. Using descriptive statistics and chi-square test methods, we calculated and analyzed the annual and cumulative publication volume, the distribution and change in publication types, the composition of authors and publication units, and the relationship between the first author's different backgrounds and the publication volume of different literature types and the characteristics of the core authors. Results Between 1993 and 2022, the Medical Journal of Kiang Wu published a total of 40 issues, with a total of 1516 articles of various types, including 1248 medical studies (1216 in Chinese and 32 in English). The annual publication volume increased from 25 articles at the beginning to 72 articles in the later period, and the publication cycle was changed from annual to semiannual. The proportions of various articles were 23% for clinical study, 34% for clinical experience, 23% for case report, 6% for medical humanities, 11% for reviews, and 3% for technical introduction. The proportions of case reports and medical humanities articles showed an increasing trend, while the proportions of reviews and technical introductions articles showed a decreasing trend. The departments that contributed to more than 5% of the total literature were Imaging, Pediatrics, Cardiology, Pathology, Orthopedics, Emergency and Critical Care Medicine, and Nursing. There were a total of 743 signed authors, including 476 first authors (12 of whom were from outside the hospital). Of the authors, 46.1% published one article, while 20.5% published two articles. Authors with a publication volume of 5 or more were defined as core authors, with a total of 69 people, accounting for 14.5%, and 42.1% of all the publications. The highest number of publications by an author is 36. A total of 251 papers (20.1%) had independent authorship, while 997 papers (79.9%) were authored collaboratively. 1144 articles (91.7%) were signed by a single department, while 104 articles (8.3%) were signed in collaboration with multiple departments. 64 were signed in collaboration with internal departments, and 40 were signed in collaboration with internal and external institutions. Another 118 articles (9.5%) were signed with 6 or more signed authors. The first author had a bachelor's degree or above, and the number of papers published was significantly greater than that of the authors with a technical secondary school or college degree (P=0.000). Authors with a bachelor's degree tend to publish articles in the clinical research category, authors with a master's degree tend to publish articles in the case report category rather than in the medical humanities category, and authors with a vocational school or college degree tend to publish articles in the clinical experience and medical humanities categories rather than in the clinical research and case report categories. There was a positive correlation between the author's publication year and the number of publications. There are significant differences between the publication years ≤ 5 years group and the 16-20 years group, as well as between the ≤ 5 years group and the ≥ 26 years group (P=0.04 and P =0.000); Authors with a publication period of ≤ 5 years tend to publish articles of the review type, rather than articles of the technical introduction type; Authors with a publication period of 6-10 years tend to publish articles of the review type, rather than articles of the clinical experience or medical humanities type; Authors with a publication period of 11-15 years tend to publish articles in the category of case report, but are not inclined to publish articles in the categories of clinical studies, medical humanities, and reviews; Authors with a publication period of 16-20 years tend to publish articles of clinical experience type, and are not inclined to publish articles of medical humanities, review, and technical introduction type; Authors with a publication period of 21-25 years tend to publish articles of clinical experience type, and do not prefer articles of case report type; Authors with a publication period of more than 26 years tend to publish articles in the field of medical humanities, and are less inclined to publish articles in the fields of clinical experience and case reports. The number of articles published by authors with work experience in more than one hospital was significantly higher than that of authors who worked in only one hospital (P =0.003). Analysis of professional and technical titles showed that the number of papers published by the first author in the current register exhibited a positive correlation with technical title (P <0.001). The average number of papers published per technical title was as follows: 5.5 papers for senior titles, 4.8 papers for deputy senior titles, 2.3 papers for intermediate titles, and 1.5 papers for junior titles. Only 4.9% of the total literature was published in the field of nursing. Conclusion Over the 30 years since the resumption of the Medical Journal of Kiang Wu, with the hard work of a generation, the amount of editing, publishing and distribution work has become increasingly standardized, the amount of information published has increased, and the columns and contents set up have become increasingly mature, which also reflects the development level of various disciplines at Kiang Wu hospital. The core author group has been the backbone of the continuous development of the Medical Journal of Kiang Wu in the past 30 years. Overall, the future prospects of the journal are promising.

Objective To investigate the correlation between antimicrobial resistance and the use of antibiotics against common gram-negative bacteria at Kiang Wu Hospital (KWH), Macau, with the goal of providing a reference for the standardization of antibiotic use. Methods Antimicrobial resistance rates of common gram-negative bacteria were assessed from January 2018 to December 2021 (4 years) and were analyzed in correlation with the frequency and antimicrobial use density (AUD) of antibiotics used by hospitalized patients during the same period. Results The antimicrobial resistance rate of Klebsiella pneumoniae to imipenem was positively correlated with the AUD of this antibiotic, with a correlation coefficient of r =0.997 (P=0.003). The antimicrobial resistance rate of Acinetobacter baumannii to levofloxacin was also positively correlated with the AUD caused by this antibiotic, with a correlation coefficient of r =0.963 (P=0.037). Conclusion The results indicate a positive correlation between the resistance of certain gram-negative bacteria (Klebsiella pneumoniae and Acinetobacter baumannii) and the intensity of antibiotic use, suggesting the need for a standardized approach to the use of antibiotics in KWH.

Objective To evaluate the effectiveness of medication reconciliation by analyzing and comparing the average number of drug-related problems (DRPs) that occur in elderly patients in the geriatrics department before and after the implementation of medication integration. Methods Patients who were admitted to the geriatric departments between November 1, 2021, and July 31, 2021, were included in the study. General information, chronic underlying diseases, laboratory indicators such as liver and kidney function, and clinical medication usage were collected. The time period was divided into three phases: Pre-stage, Stage 1, and Stage 2. Each phase lasted three months, and February 1st, 2022, was used as the time point for medication reconciliation. DRPs were recorded by the same pharmacist before and after medication reconciliation, and the changes in DRPs were compared. Results A total of 259 patients were included in the study; the mean age was 86.59±9.33 years, 80.69% of the patients had more than three chronic underlying diseases, and 88.88% of the patients were taking more than five medications. The most common type of DRP was related to medication dosage, accounting for 40.44%. After medication reconciliation, the number of DRPs decreased significantly both at admission and at discharge (P <0.001). At admission, the average number of DRPs in Stage 2 was 0.45 (P <0.001) and 0.38 (P =0.013) lower than that in Pre-stage and Stage 1, respectively. At discharge, compared with those in Pre-stage, the average number of DRPs in Stages 1 and 2 was 0.48 (P <0.001) and 0.44 (P <0.001), respectively. Conclusion DRPs are common in elderly patients during hospitalization, and pharmacist-led medication integration can significantly reduce the incidence of DRPs, improving medication safety in elderly patients.

Objective To provide a reference for the balance between the effective management and antibiotic requirement in neonatal early-onset sepsis (EOS). Methods A retrospective analysis was performed on our 157 EOS patients from January 2021 to December 2021.Clinical manifestations, laboratory data, and maternal high-risk factors were collected. The data were analyzed using the Neonatal Early-Onset Sepsis Calculator, and compare the antibiotics requirement between two management protocol. Results Compared with two management protocol, there were statistical differences in antibiotics requirement and treatment days (P < 0.05) for these 157 case. In terms of safety, a child who was graded to be clinically observed experienced deterioration during progress. Conclusion Both potocol have advantages and disadvantages for our EOS management.

Secretory carcinoma is a rare breast cancer. We report a case of secretory carcinoma occurred in childhood. A 7-year-old girl had a history of a mass in the breast for 4 years. The tumor grew slowly and well circumscribed, mimicking benign lesions on imaging. After breast lumpectomy, a diagnosis of secretory carcinoma was made based on its histological morphology, immunohistochemical reaction, and molecular profile. Herein, we report the process of diagnosis, and treatment of this rare case.

Objective To observe the clinical effect of acupuncture combined with the Chinese patent medicine "Dieda Pill" in the treatment of trigger fingers. Methods The 60 trigger finger muscles were divided into 30 cases in the observation group and 30 cases in the control group by the random numbering table method. The VAS and Quinnell scores at 7 days and 3 months postsurgery were recorded for both groups to assess clinical outcomes. Results There was a significant difference in VAS score between the observation group and the control group at 7 days postsurgery (P <0.05); moreover, there was no difference in VAS score between the observation group and the control group at 3 months postsurgery (P >0.05). There was no difference between the Quinnell ratings of the observation group and the control group at 7 days or 3 months postsurgery (P >0.05). The total efficiency in both groups was 100%. Conclusion The combination of acupuncture with the oral Chinese medicine "Dieda Pill" for the treatment of trigger finger pain can relieve early pain in the affected finger after surgery, but there was no difference in clinical efficacy between the two groups.

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Objective To analyze and summarize the clinical data of 60 lesions in 26 patients with MPLC, aiming to discuss the diagnosis and treatment strategies for MPLC. Methods The clinical data of 26 patients with MPLC (including 60 lesions) diagnosed and treated by thoracoscopic minimally invasive surgery in our hospital between March 2016 and January 2023 were collected, and imaging, surgical method and postoperative pathology data were retrospectively analyzed. Results Thin-slice CT (computed tomography, CT) was used to detect multiple pulmonary nodules, and all the patients underwent thoracoscopic surgery. The majority (16/19) of patients with lesions located on the same side underwent surgical treatment at the same time, mainly thoracoscopic lobectomy + sublobectomy. All patients with bilateral lesions underwent surgery at various stages. The pathological manifestations of ground-glass opacity (GGO) were mainly minimally invasive adenocarcinoma (MIA), while the mixed ground-glass opacity and solid nodules were mainly invasive adenocarcinoma. The focus of gene detection for multiple primary lung cancers mostly showed gene mutations. In this cohort, 18/26 patients had gene mutations, all of which were EGFR gene mutations. Conclusion CT is considered to be the best method for diagnosing MPLC. Thoracoscopic lobectomy or sublobectomy of the lesion is the most commonly used procedure. For multiple lesions, the size and solid component of the nodule significantly impact the independent staging of the nodule. Gene mutations are common in MPLC, and genetic testing may be helpful for tumor follow-up and further treatment.

Objective This was a retrospective analysis of sonographic characteristics to evaluate the value of sonography in the differential diagnosis of phyllodes tumors(PT) and breast fibroadenomas(BF). Methods The sonographic characteristics of PT patients and BF patients confirmed by histopathology at Kiang Wu Hospital from 2009 to 2020 were retrospectively studied. Results Pathological analysis revealed that of the 40 PT patients, 29 (72.5%) were benign PT, 9 (22.5%) were borderline PT, and 2 (5.0%) were malignant PT. The accuracy rate of diagnosis was 15%. Twenty-five patients (62.5%) were misdiagnosed with BF. In addition, 81 cases of BF were confirmed by postoperative pathology, 65 cases were diagnosed preoperatively, and the accuracy rate of diagnosis was 80.2%. The ultrasonic images of benign PTs and BFs showed significant differences only in lesion size (P<0.05), while nonbenign PTs and BFs showed significant differences in shape, size, boundary, internal cystic degeneration and calcification (P<0.05). Conclusion It was difficult to distinguish between PTs and BFs. However, familiarity with their sonographic characteristics could improve the accuracy of diagnosis and has certain value in differential diagnosis.

"MEDICAL JOURNAL OF KIANG WU" chronicle of events

Objective The aim of the present study was to assess the clinical profile of children who presented with nocturnal enuresis (NE) and follow-up outcomes. Methods This was a retrospective analysis of the clinical data of children with NE from January 2018 to June 2022. Results This study included 66 clinical types of young children, including mild NE (n=43, 65.2%), moderate-to-severe NE (n=23, 34.8%), a family history of NE (n=7, 10.6%), monosymptomatic enuresis (n=51, 77.3%), nonmonosymptomatic enuresis (n=15, 22.7%), difficulty awaking at night (n=42, 63.6%), and constipation (n=19, 28.8%). A voiding diary was used for 34 (77.3%) NE children; functional bladder volume reduction accounted for 23.5% (n=8), nocturia polyuria accounted for 32.4% (n=11), nocturia polyuria with reduced functional bladder capacity accounted for 8.8% (n=3), and normal nocturnal urine volume and bladder capacity accounted for 35.3% (n=12). Forty-three patients with NE received only desmopressin therapy; 69.8% had a complete response (n=30), 23.3% had a partial response (n=10), and 7% had no response (n=3). Eight NE children received desmopressin plus oxybutynin combination therapy; 75% had a complete response (n=6), 12.5% had a partial response (n=1), 12.5% had no response (n=1), and 15 had refused treatment. The relapse rates were 47.4% (n=9) in 19 patients with NE due to immediate cessation of desmopressin and 16.7% (n=4) in 24 patients with NE due to structured withdrawal of desmopressin between 3 and 6 months; these patients received only desmopressin therapy. Conclusion Studies attempting to establish bladder dysfunction, difficulty awaking, and constipation as the causes of NE have been the focus of interest. A voiding diary was recommended for the individual therapy of NE. Desmopressin plus oxybutynin combination therapy was a satisfactory response in NE patients with reduced functional bladder capacity. Compared with children treated with immediate cessation, those treated with structured withdrawal of desmopressin had a significantly lower relapse rate. We suggest exploring the general profiles and clinical characteristics of NE parents to improve compliance with medication.

Objective To explore the relationship between PD-L1(SP142) and CTLA-4, PTEN expression in triple-negative breast cancer (TNBC). Methods One hundred and thirty six cases of breast cancer were collected in Kiang Wu Hospital of Macau from January 2008 to June 2018, and divided into 4 groups according to molecular classification,including TNBC, Luminal A, Luminal B and HER2-enriched. Expressions of PD-L1(SP142), CTLA-4 and PTEN were detected by immunohistochemical staining in the breast cancers. The relationship between PD-L1(SP142) expression and CTLA-4, PTEN expression were analyzed in TNBC and other molecular types of breast cancer. Results Among the 136 cases of breast cancer, 32.4% of cases were PD-L1(SP142) positive, in which, 48% (24/50) TNBC, 11.9% (5/42) Luminal A , 20% (3/15) Luminal B and 41.4% (12/29) HER2-enriched were PD-L1(SP142) positive. Among the 136 cases of breast cancer, 43.4% of cases were CTLA-4 positive, in which, 52.0% (26/50) TNBC, 31.0% (13/42) Luminal A, 33.3% (5/15) Luminal B and 50.9% (15/29) HER2-enriched were CTLA-4 positive. Among the 136 cases of breast cancer, 28.0% of cases were PTEN positive, in which, 52.0% (26/50) TNBC, 31.0% (13/42) Luminal A , 33.3% (5/15) Luminal B and 50.9% (15/29) HER2-enriched were PTEN positive. The expression of PD- L1(SP142) was positively correlated with the expression of CTLA-4in TNBC (Spearman=0.409, P<0.05), but negatively correlated with the expression of PTEN (Spearman=-0.318, P<0.05). Conclusion The positively correlation betweenPD-L1(SP142)and CTLA-4 in TNBC suggests that combined immunotherapy may benefit TNBC patients, the negative correlation between PD-L1(SP142) andPTEN suggests that TNBC may suffer from double hits(immune escape and gene mutation), so TNBC is suitable for combining immunotherapy and targeted PTEN therapy.

Objective To analyze the effect of hyperbaric oxygen therapy for long-COVID-19. Methods A retrospective research method was used to analyze the basic information, clinical symptoms, and effect of patients with long-COVID-19 treated with hyperbaric oxygen in Kiang Wu Hospital from January 2023 to March 2023. Results Among the 21 patients, 1 patient could not continue hyperbaric oxygen therapy due to acute secretory otitis media and 1 patient due to high blood pressure. The remaining 19 patients completed 6 to 10 rounds of hyperbaric oxygen therapy, 18 cases were effective, and 1 case was ineffective, about 94.7% patients were effective. Conclusion Hyperbaric oxygen an effective and safe non-drug treatment for long-COVID-19, and it is worthy of clinical promotion.

Objective To survey the carrier status of HLA-B*58:01 allele in patients in Kiang Wu Hospital (hereinafter referred to as our hospital) and its correlation with Allopurinol-induced skin adverse reactions. Methods A retrospective analysis method was used to investigate the drug allergy history and medication history of patients who were prescribed the HLA-B*58:01genetic test item from November 2021 to June 2022.The basic data and HLA-B*58:01 gene of the above patients were analyzed by statistical software. Results During the period, 131 patients were tested, and 21 patients (16%) had positive test results. Among patients who had taken allopurinol, there were 3 cases (50%) of adverse skin reactions in HLA-B*58:01 gene positive group, and only 2 cases (3.6%) in HLA-B*58:01 negative group. Conclusion In view of 16% of HLA-B*58:01 allele in our hospital, and the results of the study showed a significant correlation between HLA-B*58:01 gene and Allopurinol-induced skin adverse reactions. It is suggested that detection should be performed before starting Allopurinol use. With a lower initial dose of Allopurinol, renal function should be assessed during treatment to minimize the risk of serious skin adverse reactions.

Objective To investigate the relationship between the expression of estrogen receptor (ER) and progesterone receptor (PR) in endometrial tissues of patients with endometrial cancer and their clinicopathological characteristics. Methods Clinical data and pathological data from endometrial cancer patients who underwent surgery at the Department of Obstetrics and Gynecology of Macau Kiang Wu hospital from January 2016 to August 2022 were collected. Immunohistochemical methods were used to detect the expression of ER and PR in their endometrial tissues. Results The positive rates of ER and PR expression in endometrioid carcinoma tissues were 97.2% and 94.4%respectively, which were significantlygreater than those in non-endometrioid carcinoma tissues; The expression of ER and PR in endometrioid carcinoma tissue decreased with the increasing of clinical stage, and the expression of ER and PR in cancer tissue of clinical stage II and III patients was significantly lower than that in cancer tissue fromstage I patients. The expression of ER and PR in endometrial tissue of patients with lymph node metastasis waslower than that in patients without lymph node metastasis, but only PR expression was significantly different; The expression of ER and PR was not related to the depth of myometrium invasion. The expression of ER and PR in patients with lymphovascular space invasion was lower than that in patients without invasion, but the difference was not statistically significant. Conclusion The decreased expression of ER and PR is related to the degree of tumor cell differentiation, clinical stage, and lymph node metastasis in EC patients, which may help to determine the severity of the disease.

Objective To observe the effect of Bio-Oss®bone powder and Bio-Oss®Collagen on site preservation during implantology. Methods From August 2020 to December 2022, 20 patients from the Department of Stomatology of Kiang Wu Hospital, Macau, who needed tooth extraction and alveolar ridge preservation were chosen. The patients were randomly assigned into two groups: the Bone powder group (n=10) and the Collagen group (n=10). The Bone powder group received Bio-Oss®for socket filling, while the Collagen group received Bio-Oss®Collagen. All patients underwent a wound healing evaluation two weeks after the surgery. After six months, we assessed the alveolar bone mass and treatment efficacy. Results Two weeks after surgery, both groups showed good wound healing. The Bio-Oss® Collagen group exhibited a marginal increase in alveolar bone height of 0.121±0.98mm (t= -0.389, P >0.05) and a slight width decrease of -0.894±2.71mm(t= 1.044, P >0.05), but there was no significant difference observed. The Bio-Oss® group, on the other hand, demonstrated a decrease in alveolar bone height of -1.307±1.94mm (t= 2.135, P >0.05) and a width decrease of 0.753±1.14mm (t= -2.088, P >0.05). There was no significant difference in the effectiveness of the two materials for alveolar ridge preservation (P >0.05). Conclusion There is no significant difference in the efficacy of site preservation between the two materials.

Objective To retrospectively analyze the treatment interruption and dose compensatory delivery of RT patients in our center during the second phase of the transition period for epidemic prevention and control in Macao. Methods Data of radiotherapy patients were collected from Dec 14th 2022 to Jan 8th 2023,including diagnosis, pathological type, treatment purpose, number of radiotherapy interruptions, radiotherapy interruption time, dose compensation and treatment course extension time and analyze the patient's tumor and treatment-related characteristics. Results From Dec 14th 2022 to Jan 8th 2023, a total of 74 patients received radiotherapy in our center, of which 41 patients had unplanned radiotherapy interruptions, accounting for 55%. Among the interrupted patients, 20 received dose compensation, accounting for 51%. After compensation, the treatment extension time is 7±4 (-2-14) days. One patient completed treatment 2 days in advance, 1 patient completed treatment on time, 3 patients' treatment extension time were controlled within 3 days, 11 patients' treatment extension time were controlled within 1 week, and all compensated patients' treatment extension time were controlled within 2 weeks. Conclusion The epidemic has heightened medical staff's caution on treatment interruption and dose compensation. Dose compensation is an effective method to reduce the prolongation of radiotherapy courses.

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Objective To analyze the application value of high-flow nasalcannula (HFNC) oxygen therapy compared with noninvasive ventilation (NIV) in patients with type I respiratory failure. Methods Patients with type I respiratory failure who were treated with HFNC and NIV in the emergency department of Kiang Wu Hospital from May 2022 to April 2023, were selected to retrospectively analyze basic data, treatment outcomes, dyspnea scores, and comfort scores. Results There were 41 cases in the HFNC group and 26 cases in the NIV group.There was no statistically significant difference in dyspnea score (VAS), and respiratory rate (RR) after treatment. Oxygenation index (PaO2/FiO2) become better in NIV group more than HFNC group, there was statistically significant difference.The failure rate within 2 hours of treatment with HFNC or NIV in the emergency department, the rate of intubation within 6 hours after admission with HFNC or NIV, 28-day mortality rate, all of that the difference was not statistically significant. The comfort score was better in the HFNC group and the difference was statistically significant. Conclusion For patients with type I respiratory failure, HFNC is better tolerated than NIV, and that is more conducive to clinical treatment.

Objective To observe the Influence of age on efficacy of lumbar spinal root radiofrequency. Methods The clincal data of 68 patients who suffered from lower limb radicular pain and had been treated with spinal root pulsed radiofrequencyin our hospital from January 2020 to December 2022 were retrospectively analyzed. Between 42-92 years of age (median 69.5years), 34 patients ages 42-69 were allocated into younger group, and 34 patients ages 70-92 were allocated into elder group. Data of visual analogue scale (VAS) was recorded before treatment, and at1 week, 1 month, 2 months, 3 months after treatment to analyze and evaluate the efficacy with modified MacNab criteria at 3 months after treatment. Results The VAS scores at1 week, 1 month, 2 months, and 3 months after treatment had significantly decreased in the two groups compared with those before treatment (P < 0.001). The VAS scores has no significant different between the two groups before treatment (P >0.05). During the follow-up period after treatment, the VAS scores at 1 week were no significant different between the two groups (P >0.05). The elder group patients showed significant relief of lower limb radicular pain VAS scores as compared with the patients in younger group at 1 month, 2months, and 3 months after treatment (P <0.05). The percentage of excellent and good recovery according to the modified MacNab criteria at 3 months after treatment has significant different between the two groups, the elder group 85.2%, and younger group 50% (P <0.05). Conclusion Pulsed radiofrequency is effective for treatment of lower limb radicular pain and can produce good short-term effects of pain relief and decrease the rate of back surgery in elder patients. It can improve the patients life quality and have clinical utility.

Objective Objective: Patients often develop moderate to severe pain after total knee arthroplasty (TKA). This study compared the analgesic effect of single-dose epidural morphine with that of the control group in patients following TKA surgery. Methods This randomized, double-blinded, controlled trial was conducted between April 2021 and August 2012. Sixty patients were randomized to receive either combined spinal epidural anesthesia (spinal anesthesia with 0.5% bupivacaine 2-3ml followed by epidural injection of 2 mg morphine, the experimental group) or spinal anesthesia (spinal anesthesia with 0.5% bupivacaine 2-3 ml, the control group). For all patients, periarticular infiltration with local anesthetic was performed. The severity of pain was assessed with the numerical rating scale (NRS) at 0-6, 6-12, 12-24, 24-36, and 36-48 hours after surgery. The presence of pruritus, urinary retention, nausea, vomiting, and respiratory depression was recorded. Results The incidence of moderate to severe pain (NRS≥4) within 48 hours was lower in the experimental group than in the control group (20.0% [6/30] vs. 46.7% [14/30] P=0.028). The incidence of urinary retention was greater in the experimental group than in the control group (36.7% [11/30] vs. 6.7% [2/30] P=0.005). Conclusion For patients following TKA, single-dose epidural morphine decreases the incidence of moderate to severe pain within 48 hours, but it increases the incidence of urinary retention.

Objective To analyze the effectiveness and safety of high-power short-duration (HPSD) radiofrequency ablation for the treatment of atrial fibrillation (AF). Methods Clinical data of the patients who underwent HPSD ablation for AF in our hospital from March 2022 to March 2023 were analyzed. Patients' basic clinical data, immediate pulmonary vein isolation (PVI) success rate, single-loop isolation rate, ablation gap positions, ablation parameters (power, pressure, ablation time, ablation index, ablation catheter type, etc.), and perioperative complications were recorded. Follow-up was conducted from 1 to 12 months after surgery to determine AF recurrence. Results A total of 20 patients were included in the analysis, including 9 males and 11 females. There were 19 cases of paroxysmal AF and 1 case of persistent AF. All patients completed pulmonary vein isolation with a success rate of 100%. Single-loop isolation was achieved in 18 cases (90%) of the right pulmonary vein and 16 cases (80%) of the left pulmonary vein. The additional ablation points for isolation of the right pulmonary veins were located at the superior and inferior walls, while for the left pulmonary veins they were located at the superior, inferior, anterior and posterior walls between the two left pulmonary vein.The mean surgery time was (158±47.2) minutes. Follow-up was conducted for more than 3 months in 17 patients, and 2 cases of AF recurrence were observed, while the rest maintained sinus rhythm. Three patients were followed up for 1 month and all maintained sinus rhythm. Only 1 patient developed an arteriovenous aneurysm, which was treated with conservative therapy and required surgical intervention before discharge, and no cases of cardiac tamponade, thromboembolism, severe bleeding, or atrio-esophageal fistula were observed. Conclusion HPSD is an effective and safe treatment for AF.