Objective  To analyze differences in brain structure volumes among patients with Alzheimer's disease(AD), mild cognitive impairment(MCI), and cognitively normal older adults using structural magnetic resonance imaging(sMRI) technology.  Methods  A total of 67 AD patients, 77 MCI patients and 174 normal controls(NC) were included. All participants underwent 3D T1-weighted images (T1WI) scanning, Mini-Mental State Examination (MMSE), and Montreal Cognitive Assessment (MoCA). The T1WI of all subjects were processed using MR brain structure automatic segmentation software to obtain the volume and volume percentage of each brain region. SPSS v25.0 was used for statistical analysis, and covariates included age, gender, years of education and whole brain volume.  Results  There were significant differences in the volume of multiple brain regions among the three groups (P＜0.05). Compared with the NC group, the volume of the ventricular system-related regions in the MCI group increased significantly, while the volume of the middle part of the corpus callosum decreased significantly. Compared with the NC group, the volume of the whole brain gray matter and multiple brain regions in the AD group decreased significantly, and the volume of the ventricular system-related regions increased significantly. Compared with the MCI group, the volume of the ventricular system-related regions in the AD group increased significantly, and the volume of some brain regions decreased significantly. There were significant differences in the volume percentages of multiple brain regions among the three groups. Compared with the NC group, the volume percentages of the ventricular system-related regions in the MCI group increased significantly, and the volume of the middle part of the corpus callosum decreased significantly. Compared with the NC group, the volume percentages of the whole brain gray matter and multiple brain regions in the AD group decreased significantly, and the volume percentages of the ventricular system-related regions increased significantly. Compared with the MCI group, the volume percentage of the ventricular system-related areas in the AD group increased significantly, and the volume percentage of some brain regions decreased significantly.  Conclusion  The segmentation and measurement of brain volumes can assist in the clinical diagnosis of AD. Ventricular system dilatation and atrophy of the middle corpus callosum may facilitate the early identification of MCI.

家族性致死性失眠症(familial fatal insomnia, FFI)是一種少見的常染色體顯性遺傳性朊蛋白疾病，臨床常表現為頑 固性失眠、自主神經功能及運動障礙。自1986年Lugaresi 在意大利發現全球第一例後，國內外也有不少病例報導。目前基因檢測是唯一診斷“金標準”，PRNP基因發生變異是其主要特點。該病進展迅速、致死率高、預後差、起病樣式多樣化。本病例為本院確診的首例。

較長時間的術後禁飲禁食導致患者出現口渴、焦慮、煩躁等負面情緒，不僅增加了患者躁動、導管脫出、墜床、切口出血的風險，甚至發生血流動力學紊亂、血糖波 動、譫妄，延緩患者康復。隨着禁飲時間的持續，患者口渴難受程度甚至超過了疼痛。加速康復外科(enhanced recovery after surgery, ERAS)是以患者為中心，核心是減輕手術患者心理和生理創傷的應激反應，促進術後康復。術後早期經口飲食(early oral feeding, EOF)已成為ERAS的重要環節之一。目前，術後飲食的具體時間、種類、數量，尚缺乏統一標準。為進一步提高術後患者滿意度，本文就術後早期少量飲食的研究進行綜述。

Objective To investigate the clinical characteristics of juvenile idiopathic arthritis (JIA) through retrospective analysis of pediatric cases, providing references for early diagnosis and treatment.  Methods Clinical data of diagnosed case between 2019 to 2024 were analyzed retrospectively, focusing on age, gender, subtypes, clinical features, and disease progression.  Results The mean age of onset of the 8 patients was 9 years and 1 month (male-to-female ratio 1:1). Subtype distribution included systemic JIA (1 case), polyarticular JIA (1 case), oligoarticular JIA with iridocyclitis (2 cases), andenthesitis-related JIA (4 cases). Systemic JIA was treated with ibuprofen and corticosteroids, while other subtypes received methotrexate combined with etanercept or adalimumab, supplemented by rehabilitation. All cases showed clinical improvement.  Conclusion JIA exhibits heterogeneous manifestations requiring differential diagnosis from other systemic disorders. Common complications include joint dysfunction and uveitis-induced visual impairment, highlighting the necessity of early recognition and aggressive therapeutic intervention.

Objective To explore the influencing factors of hemorrhagic transformation after cerebral infarction in patients with non-valvular atrial fibrillation.  Methods A retrospective analysis was conducted on 91 inpatients with non-valvular atrial fibrillation and cerebral infarction admitted to Kiang Wu Hospital in Macau from January 2020 to December 2022. They were divided into a non-hemorrhagic transformation group (n=64) and a hemorrhagic transformation group (n=27) based on imaging changes. Collect clinical data and imaging results of patients, explore risk factors for hemorrhagic transformation.  Results (1) Comparing the NIHSS score, cortical cerebral infarction and large-area cerebral infarction between the non- hemorrhagic transformation group and the hemorrhagic transformation group, the difference was statistically significant (P<0.05); (2)NIHSS score, cortical cerebral infarction and large-area cerebral infarction are independent influencing factors of hemorrhagic transformation (P<0.05).  Conclusion NIHSS score, cortical cerebral infarction and large-area cerebral infarction are related to hemorrhagic transformation after cerebral infarction in patients with non-valvular atrial fibrillation and are independent high-risk factors.

Objective To establish a localized adult CT localized Diagnostic Reference Level (DRL) by using the Radimetrics platform and apply it in Continuous Quality Improvement (CQI), to provide baseline data for regional radiation protection.  Methods Retrospective analysis of CT plain scan dose data in adults (head, neck, chest, abdominopelvic regions) from 2020 to 2024 at Kiang Wu Hospital. Key metrics (CTDIvol, DLP) were extracted and analyzed statistically, including mean, standard deviation, median, and 75th percentile (P75). The baseline 2020 P75 data were compared horizontally with US ACR and Chinese DRLs. Annual data from 2021-2024 were analyzed longitudinally for mean value trends, and the mean reduction ratios of CTDIvol and DLP after optimization were calculated.  Results Cross-sectional Comparison: The 2020 baseline P75-CTDIvol values(55.4, 12.3, 4.73, and 12.2 mGy, respectively) were all better than ACR data(a decrease of 1.1% to 63.6%); except for the head, the other three parts were also better than the Chinese data(a decrease of 23.1%-64.1%). P75-DLP values showed a similar trend. Longitudinal Comparison: From 2021 to 2024, the mean CTDIvol and DLP of each part were significantly lower than the baseline data, among the mean CTDIvole of the head and chest decreased by 6.0%-12.1%, and the mean DLP decreased by 11.2%- 13.7%; and the annual reduction rate of the mean CTDIvol after optimization tended to be stable.  Conclusion By establishing our hospital's DRL and implementing CQI measures through the Radimetrics platform, the CT radiation dose was effectively reduced, and providing a scientific basis for localized DRL.

Objective This study is based on the BEERS and STOPP criteria, combined with the actual medication usage at Kiang Wu Hospital (KWH), Macao, to develop a comprehensive list of potentially inappropriate medication (PIM) screening items. It analyzes the PIM use in hospitalized elderly patients aged 80 or above in the internal medicine department of KWH and explores the associated risk factors.  Methods A retrospective cohort study design was adopted, collecting data from hospitalized internal medicine patients aged 80 years or older in KWH between January 1, 2023, and December 31, 2023. Data included demographics, comorbidities, physiological factors, and medication use. PIM screening was performed based on the 2023 version of the BEERS and STOPP criteria, and the risk factors for PIM use were explored using multivariate logistic regression analysis.  Results The screening rates based on STOPP and BEERS criteria were 96.93% and 91.73%, respectively, and the mean number of PIMs per capita was 3.53±1.95 and 3.16±1.86, respectively (P＜0.001). The most common reasons for PIM were the use of medications requiring caution, central nervous system drugs, and drugs that increase the risk of falls. Multivariate regression analysis revealed that, compared to mild PIM, the risk factors for moderate PIM based on the BEERS criteria were diabetes, gout, and hyperuricemia; the risk factor for severe PIM was peripheral vascular embolism; and the common risk factors for moderate and severe PIM were depression and anxiety, as well as a hospital stay longer than 20 days. Based on the STOPP criteria, the risk factors for moderate PIM compared to mild PIM were having more than five chronic diseases, peripheral vascular embolism, and a hospital stay longer than 20 days; the common risk factors for moderate and severe PIM were heart failure, osteoporosis, and a history of fractures.  Conclusion Managing medications in elderly patients presents unique challenges, with PIMs being particularly prevalent. Effective clinical management requires a comprehensive approach that considers individual variations, comorbid conditions, and drug-specific factors. Priority should be given to addressing modifiable risk factors (e.g., extended hospital stays) while maintaining vigilant monitoring of non-modifiable factors (e.g., multiple comorbidities). A three-tiered intervention strategy is recommended: (1) regular medication regimen reviews, (2) selection of safer therapeutic alternatives when available, and (3) implementation of personalized monitoring protocols for high-risk medications. Successful implementation requires close collaboration between physicians and pharmacists, coupled with the integration of a severity-based PIM classification system into electronic health records to systematically enhance medication safety.

Objective To compare analgesic effect, side effect and quality of recovery score between Opioid-free anesthesia(OFA) method and traditional opioid-based anesthesia(OA) in gynecology laparoscopic surgery.  Methods From January 2022 to December 2023, female patients undergoing gynecology laparoscopic surgery under general anesthesia, were divided randomly into two groups, OFA group and OA group. We analyzed the differences between the two groups in terms of analgesic effect, side effect and quality of recovery score.  Results Tracheal extubation time and Qor-40 score in OFA group are superior to control group, with statistically significant difference. There is no statistical difference in postoperative Numerical Rating Scale(NRS) in 1,6,12,24hand side effects such as nausea, vomiting and instability of blood pressure. Fluctuation of heart rate is more obvious in OFA group, with statistical significance.  Conclusion Qor-40 score and extubation time are better in OFA, which is competitive to OA in analgesic effect, and improve the perioperative experience in female patients.

Objective To detect and compare of EGFR mutation by immunohistochemistry and ARMS PCR, explore the possibility of substitution for EGFR gene mutation detection by ARMS PCRin lung adenocarcinoma.  Methods Cell smears, histological and cell blocks were used to detect EGFR mutation by ARMS PCR and delE746-A750 and L858R mutant proteins by immunohistochemistry, and the detection results of both methods were relatively analyzed.  Results EGFRmutant proteins in 116 cases of lung adenocarcinomaare detected by immunohistochemistry. In 39 cases of immunohistochemical score of 0, 29 cases (74.4%) had ARMS PCR mutations. In 5 cases of immunohistochemical score of 1, 4 cases (80.0%) had ARMS PCR mutations. In 14 cases of immunohistochemical score of 2, 14 cases (100%) had ARMS PCR mutations.In58 cases of immunohistochemical score of 3, 58 cases (100%) had ARMS PCR mutations. With an immunohistochemical score of <1+ as negative and >2+ as positive, the sensitivity of immunohistochemistry was 69.2%, the specificity was 100%, the positive predictive value was 100%, and the negative predictive value was 25.6%.  Conclusion The immunohistochemical detection for EGFR delE746-A750 and L858R mutant protein is a simple, fast and easy to interpret method, and this method can be used as a substitution for EGFR ARMS PCR mutation detection, or a primary screen protocol.

神經源性膀胱(Neurological Bladder, NB)是腦卒中後預後不良的重要預測因子，反映未來功能恢復不佳及死亡率較高。報導顯示卒中後急性期有40.5%患者需要留置尿管，當中26.3%出現拔管失敗情況，長期留置尿管亦增加尿路感染風險，因此改善排尿功能，早期拔除尿管對促進患者功能恢復、降低致殘率具有重要的臨床意義。提供更精準刺激的重覆外周磁刺激(repetitive Peripheral Magnetic Stimulation, rPMS)，近年亦初步應用於NB治療中。本文介紹應用rPMS成功治療卒中後尿管拔除困難患者2例。

心室遊離壁破裂、室間隔破裂和乳頭肌斷裂是急性 心肌梗死三種潛在致命的機械併發症。病理機制是廣泛整層心肌細胞壞死導致組織破裂，從而導致心源性休克和心臟衰竭等嚴重致命後果。病情發展危急，需要積極使用血管活性藥物、主動脈內球囊反摶、體外循環支持過渡。若併發室間隔破裂需審慎評估手術修補時機和過渡期技術支持。現報導一例本院icu急性心肌梗死併發室間隔破裂 ECMO (V-A)支持個案。

Objective Review and analyze the clinical characteristics of patients with liver abscess in Kiang Wu Hospital from 2022 to 2024, providing reference for diagnosis and treatment evaluation in Emergency Department.  Methods Patients diagnosed with bacterial liver abscess in Kiang Wu Hospital from January 1, 2022 to December 31, 2024 were collected and registered and statistically analyzed according to detailed information such as gender, age, clinical symptoms, laboratory tests, pathogens, and treatment methods.  Results Total of 51 cases were enrolled, including 33 males (65%) and 18 females (35%), with a mean age of 57.8±14.1 years. Fever was the most common symptom, accounting for 96%, followed by abdominal pain (accounting for 51%), and Klebsiella pneumoniae was the main pathogen (78%). Compared with non-diabetic patients, diabetic patients had poor control of glycosylated hemoglobin, higher proportion of patients with hypertension and infection in other organ , lower proportion of patients with abdominal pain, the difference was statistically significant (P<0.05). Among the treatment methods, the number of hospital stays in the percutaneous puncture group was higher, the alanine aminotransferase was elevated, and the proportion of patients with pathogen of Klebsiella pneumoniae was higher, the difference was statistically significant (P<0.05). The patient group with Klebsiella pneumoniae were younger, and the proportion of patients with elevated aspartate aminotransferase was higher, the difference was statistically significant (P<0.05).  Conclusion Bacterial liver abscess should be considered in diabetic patients with unknown cause fever in Emergency Department. Empirical antibiotic therapy for bacterial liver abscess should be directed primarily against Klebsiella pneumoniae .Detection of highly virulent Klebsiella pneumoniae can guide treatment and assessment of prognosis.

Objective To evaluate the clinical effectiveness of vital pulp therapy for carious pulp-exposed mature permanent teeth.  Methods A retrospective analysis was conducted on mature permanent teeth with pulp exposure caused by caries. In the experimental group, Iroot-bp plus was used as a pulp capping material for vital pulp therapy, while the control group received root canal treatment. Follow-up observations were conducted at 3 months, 6 months, and 12 months after the procedure to compare the clinical outcomes between the two groups. Furthermore, the differences in success rates among different age groups in the experimental group were analyzed.  Results A total of 96mature permanent teeth with pulp exposure caused by caries the overall success rate in the vital pulp therapy group was 95.24%, while that in the root canal treatment group was 96.30%. There was no statistically significant difference between the two groups (P>0.05). In the vital pulp therapy group, the pulp preservation success rates for patients aged <40 years, 40-60 years, and >60 years were 93.33%, 93.75%, and 100%, respectively, with no statistically significant differences among these three age groups (P>0.05).  Conclusion For carious pulp-exposed mature permanent teeth, vital pulp therapy demonstrates good short-term effectiveness, with a success rate comparable to that of root canal treatment. Age is not a limiting factor for vital pulp therapy, however, strictly mastering the indications is the key to ensuring the success of the treatment.

Objective To compare the bone mineral density in postmenopausal patients with severe osteoporosis after 12 months of subcutaneous injection of romosozumab or teriparatide.　 Methods A total of 49 patients with severe postmenopausal osteoporosis were divided into two groups: romosozumab R group (25 cases) and teriparatide T group (24 cases). The R group received subcutaneous injection of romosozumab, while the T group received subcutaneous injection of teriparatide. The bone mineral density (lumbar spine bone mineral density, femoral neck and hip joint bone mineral density) and adverse reactions were compared between the two groups before and after treatment.　 Results The lumbar vertebrae bone mineral density values increased in both groups after treatment (P<0.05), and the lumbar vertebrae bone mineral density value in group R was sig-nificantly higher than that in group T after 12 months of treatment (P<0.05). There was no statistically significant difference in the bone mineral density of the femoral neck and hip joint between the two groups after treatment, and no adverse reactions were observed in either group. 　Conclusion Romosozumab and teriparatide can achieve satisfactory therapeutic effects on lumbar spine bone mineral density in postmenopausal patients with severe osteoporosis 12 months later, but romosozumab has more advantages in reducing bone metabolism indicators and increasing bone mineral density.

Objective Urine metabolomics analysis was performed to identify metabolite markers for glomerular filtration rate.  Methods A total of 145 volunteers who were tested in Kiang Wu Hospital in Macau from June 2019 to June 2020 were recruited. The urine of 145 subjects with different degrees of renal function was analyzed using non-targeted metabolomics technology.  Results The study found potential markers and related metabolic pathways related to renal filtration function. Significant metabolites include 398 metabolites. The top 10 were glycine, N6-acetyl-L-lysine, 17 β-estradiol 3-β-D-glucuronic acid, N -Acetyl-L-2-amino-6-oxopimelate, N-acetyldesmethylphosphinothricin, citric acid, L-cysteine, androsterone glucuronide), N6-acetyl-LL -2,6-diaminopimelic acid, aminoadipic acid. Metabolic pathways included the ABC transporter pathway, the protein digestion and absorption pathway, the tryptophan pathway, the amide-tRNA synthesis pathway, the steroid hormone biosynthesis pathway, and the arginine-proline metabolic pathway.  Conclusion These urinary metabolites are associated with renal function. It provides a reliable basis for the targeted development of metabolites related to renal function, and becomes possible for renal function evaluation with urine samples in the future.

"病人腰痛，醫生頭痛"這句俗語在社會和醫療界廣為流傳。腰痛作為一種常見的臨床症狀，不僅給病人帶來身心上的痛苦，也給醫生帶來了診斷和治療上的挑戰。本文以骨科醫生的角度，從腰痛的複雜性和治療困境，分析這一現象的底層邏輯，並探討其背後的醫學人文意義。病人需要得到社會各方的信任、尊重和支持，而不是受到指責和邊緣化。醫生要理解尊重腰痛病人，“有時去治癒，常常去幫助，總是去安慰”。

Objective To analyze the development and research hotspots in bariatric and metabolic care by nursing professionals using bibliometric methods. 　Methods A bibliometric analysis was conducted based on publications from 2001 to 2024 retrieved from the Web of Science Core Collection. Scientific mapping and visual analyses were performed using VOSviewer, CiteSpace, and R software.　 Results We conducted a comprehensive search of 764 articles authored by 3,501 researchers from 1,339 institutions across 58 countries and regions, published in 332 journals. Both the number of published papers and citations exhibit a consistent annual increase. The United States and China accounted for the majority of the contributions. Leading research institutions include the Pennsylvania State System of Higher Education (n=48, 6.28%), University of Pittsburgh (n=41, 5.37%), and Duquesne University (n=34, 4.45%), all based in the United States. Among the most prolific authors are LEE WJ (34 papers), KALARCHIAN MA (31 papers), and CHEN SC (23 papers), with KALARCHIAN MA having the highest citation count (100 citations). The journal "OBESITY SURGERY" ranks highest in both publication volume and citation frequency. Key research hotspots in this field include morbid obesity, metabolic syndrome, and mortality ratesn. 　Conclusion The findings indicate a steady increase in research output led or co-authored by nursing professionals, with particular emphasis on outcome prediction following bariatric surgery, associations with malignancy, enhanced recovery protocols, and postoperative pain management.

Aortic arch anomalies are congenital malformations of the position or branching of the aortic arch, or both. Double aortic arch (DAA) is a very rare malformation, affecting approximately 0.005% ~0.007% of fetuses, and there has been no relevant literature mentioning the prenatal finding DAA in Macau till now.

The vascular ring formed by the DAA that encircles the trachea and esophagus can lead to important symptoms such as dyspnea, wheezing, stridor, cough, respiratory tract infections, and dysphagia. Fetal DAA is generally diagnosed based on the characteristic complete vascular ring in the three-vessel tracheal view on prenatal ultrasound, and postnatal diagnosis can be confirmed by computed tomography angiography (CTA) as our case.

Russell小體胃炎是一個罕見的病變，鏡下表現為胃 黏膜固有層內可見體積增大的漿細胞，漿細胞胞漿內見紅染的Russell小體。多數病例伴有幽門螺桿菌感染。現報導兩例Russell小體胃炎。

疼痛是機體受到損傷或潛在損傷時所引起的不愉快的情感體驗，是一種複雜的生理和心理活動。胎兒22週~29週胎齡時，身體表面已出現感覺神經末梢，胎兒可感覺疼痛刺激。新生兒，尤其早產兒及NICU患兒曾經歷反復多次的診療操作，而侵襲性操作、疾病、外科手術及 NICU中慢性長期疼痛可導致腦血流出現變化，外周神經、脊髓神經通路、內分泌和神經發育發生改變，腦部多區域如額葉、顳葉皮質變薄，肢體系統及基底節容量減少，後期可出現痛閾升高、神經系統重塑、內分泌系統改變、免疫應答失衡、情感認知及行為障礙，可能導致遠期神經發育不良結局。疼痛也可影響新生兒的疾病狀況，如出現缺氧、高碳酸血症、高血糖、人機對抗、氣胸等。目前，疼痛已逐漸成為繼體溫、呼吸、脈搏、血壓之後的第五大生命體徵，新生兒疼痛管理問題也越來越受到臨床醫生的重視。

重度三尖瓣病變患者多數合併頑固的右心衰竭，從而導致肝腎淤血，凝血功能障礙，貧血等併發症。對於此類患者，指南推薦瓣膜成形或置換手術。因三尖瓣置 換圍手術期嚴重併發症的發生及死亡率較成形術高，外科醫生對三尖瓣置換術的選擇非常慎重。據統計，三尖瓣置換約佔心外科手術2%，再次三尖瓣置換術則只有少數的案例報導。臨床上對於再次三尖瓣置換術的手術經驗缺乏，長期預後瞭解不足，且再次心臟手術本身具有諸多不確定因素及風險。所以開展再次三尖瓣置換需要術者嚴格把控手術指徵，時機及手術方式。本院最近收 治一名三尖瓣生物瓣置換術後瓣膜衰敗梗阻的患者，採取低溫誘導室顫性停搏的方式腔鏡下行再次行三尖瓣置換手術，手術效果滿意，患者順利康復出院，為澳門地區首例個案。

Objective Investigated the seroepidemiological characteristics of herpes simplex virus (HSV) types 1 and 2 before and after the COVID-19 pandemic.  Methods Serological data from 2018 to 2024 (IgM:1,942 cases; IgG:1,483 cases) were analyzed using ELISA for HSV-1/2-specific IgM and IgG antibodies. Chi-square tests assessed differences by gender, age, and year.  Results The positive rates of HSV-1 IgM/IgG were 9.32% and 67.23% respectively; the positive rates of HSV-2 IgM/IgG were 13.18% and 27.85% respectively. The HSV-1/2 IgM positivity rate in females (11.86%/16.96%) was significantly higher than that in males (6.83%/9.48%), and the HSV-1 IgG positivity rate in females (70.70%) was higher than that in males (63.40%), while there was no significant gender difference in HSV-2 IgG. The IgM peak appeared in the age group of 10-20 years (HSV-1 16.67%, HSV-2 21.43%), indicating that adolescents are at high risk of infection. The IgG positivity rate continued to increase with age, reaching 92.11% for HSV-1 and 55.26% for HSV-2 in the group aged >60 years, showing a cumulative infection characteristic.  Conclusion Macao's strict COVID-19 measures indirectly affected the transmission patterns of herpes simplex virus, with increased household contact leading to an increased risk of HSV-1 and changes in behavioral patterns leading to a decreased risk of HSV-2. Gender- and age-specific strategies and post-pandemic surveillance are critical to reducing HSV infections.

Objective To investigate the correlation between pain control outcome and quality of life of cancer patients in a hospital in Macau.  Methods A convenient sampling method was adapted to recruit cancer patients from a hospital in Macau for the questionnaire survey. Patient general information and clinical data were collected. The Chinese version of Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R) and the Chinese version of European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) were used to evaluate cancer patients'pain control and quality of life respectively.  Results A total of 104 cancer patients were recruited in the survey. The pain control outcome for cancer patients with a pain intensity dimension score was 2.49±1.38, which included two aspects: the pain severity score experienced most of the past 24 hours was 3.65±2.39 and the score of episodes number of pain in the past 24 hours was 1.32±0.49, which were rated at a lower middle level. Financial resource, history of chemotherapy, and history of other treatments were the influencing factors of pain control in cancer patients. The score of quality of life of patients with cancer pain were 54.41±20.61 points in overall health level. Hospitalizational department and other treatments were the factors influencing quality of life of cancer pain.  Conclusion Pain control of cancer patients has been effectively relieved. Pain control outcomes are generally good and pain control satisfaction is at a satisfactory level in the studied hospital. The quality of life of the patients with cancer pain is at a moderate level. Pain control outcomes in cancer patients were positively correlated to quality of life. The better the outcomes of pain control, the better the quality of life.

Objective To analyze and compare the correlation and acceptability of bias in the determination of glycated hemoglobin by high performance liquid chromatography and immunoturbidimetry, and to evaluate the imprecision, accuracy and contamination rate of the two principles.  Methods Uses Japan's Tosoh HLC-723 G11 instrument as the comparison method (set as X machine), Roche Cobas c 503 instrument as the experimental method (set as Y machine), and adopts EP9-A2, EP5-A2, EP15-A3 and other experimental plans, comparatively analyze the correlation, precision, accuracy and contamination rate of the measurement results of the two instruments.  Results Comparison of the correlation between the measurement results of the two instruments: r=0.997, average relative bias 1.83%, expected bias 0.17; imprecision CV (Coefficient variation, CV) value: the high and low intra-batch CV values of the X machine are respectively 0.48%, 0.89%, the day-to-day CV values are 0.80%, 0.36%, respectively, and the total CV values are 0.97%, 0.73% respectively; the high-value and low-value intra-batch CV values of the Y machine are 0.82%, 1.17%, respectively, and the day-to-day CV values are 0.82% and 1.17% respectively. The inter-CV values were 0.34% and 0.48% respectively, and the total CV values were 0.67% and 0.86% respectively. Accuracy experiment: The relative bias of X machine is -3.95%~-0.58%; the relative bias of Y machine is -2.63%~0.39%. The deviation coincidence rate of both machines is 100%.  Conclusion The imprecision of the two principles for measuring glycated hemoglobin is good, and the bias between the measurement results and the "target value" of the accuracy experiment is within the acceptable range; the correlation between the results of the two principles is good, the bias is acceptable, and the test can be realized Comparability of results.

巴德-吉亞利綜合征(Budd-Chiari syndrome, BCS)是一種 因肝靜脈流出道梗阻引起的血管源性疾病。本文報告1例 BCS患者，經球囊擴張支架植入術聯合中藥活血通脈湯治療，症狀顯著緩解。近年BCS治療方法之相關研究，均集中在球囊擴張支架植入術方面，中西醫結合治療或能為BCS提供新思路。

Objective To investigate the diagnostic value of fractional exhaled nitric oxide (FeNO) combined with bronchial provocation test (BPT) in adults with bronchial asthma.  Methods From Janurary 2021 to December 2022, patients performed both BPT and FeNO test with coughing, chest tightness and shortness of breath admitted to inpatient and outpatient department of Kiang Wu Hospital were selected. The relativity of FeNO and BPT PD20 were evaluated.  Results A total of 101 patients were included. According to PD20, patients were divided into three groups, including non-asthmatic group (n=34), mild group (n=32) and moderate to severe group (n=35). MEF75 was significantly lower in the moderate to severe group when compared with the non-asthmatic group (P<0.05). The value of FeNO in the moderate to severe group was significantly higher than that in the non-asthmatic and mild group (P<0.00). The detection rate of asthma was higher in the mild group and the moderate to severe group than that in the non-asthmatic group. The sensitivity of BPT was higher than FENO>30ppb and >50ppb group. The specificity of FENOn50ppb was higher than BPT and FENO>30ppb. The Youden index was highest when BPT was combined with FENO>50ppb. Application of inhaled steroid was significently higher in the mild group and the moderate to severe group than that in the non-asthmatic group.  Conclusion FeNO test can be used as a supplementary test in the diagnosis of asthma. The diagnostic efficacy was highest when BPT was combined with FENO>50ppb.

睾丸纖維性假瘤是一種臨床上較為少見的良性腫瘤，Balloch於1904年首先描述，此後有許多病例報導。由於其來源不明、廣泛變異的局部解剖學和形態學結構，炎性假瘤對臨床病理具有很大的挑戰，術前常難以診斷。該病主要來源於睾丸實質，很少在附睾和精索生長。本文報告本院於2020年收治的1例睾丸纖維性假瘤患者，並複習文獻，探討其臨床病理特點，以提高對該病的認識。

Objective This study systematically evaluated the clinical efficacy of laparoscopic sacral colpopexy (LSC) in restoring pelvic floor function and improving health-related quality of life in patients with uterine prolapse.  Methods A retrospective analysis was conducted on the clinical data of patients diagnosed with stage II—IV pelvic organ prolapse according to the Pelvic Organ Prolapse Quantification (POP-Q) system, who underwent LSC treatment between February 2022 and August 2024. Multidimensional efficacy assessments were performed preoperatively, and at 3 and 6 months postoperatively using anatomical indicators (POP-Q staging), the Pelvic Floor Distress Inventory (PFDI-20), and the Pelvic Floor Impact Questionnaire (PFIQ-7).  Results All 17 procedures were completed successfully, with a surgical success rate of 100%. The mean operative time was 226.65±35.14 minutes, and no severe postoperative complications occurred. Significant anatomical improvements were observed 6 months postoperatively, with the greatest improvement noted at point Aa, reaching 4.38 cm (P<0.05). Additionally, the mean PFDI-20 score significantly decreased to 21.09 points at 6 months postoperatively(P<0.05), and the PFIQ-7 score was reduced by 91.2% compared to baseline (P<0.05).  Conclusion LSC significantly improves anatomical outcomes, alleviates clinical symptoms, and enhances quality of life for patients with uterine prolapse, demonstrating a safe and effective therapeutic approach.

Objective To investigate the relationship between coping style, perceived social support and psychological resilience of hospital nurses during COVID-19 and the relationship between.  Methods A questionnaire survey using the demographic characteristics survey, the simple coping style scale (SCSS), the perceived social support scale (PSSS) and the Connor-Davidson resilience scale (CD-RISC).  Results In this study, 270 nurses were recruited. The score of positive response in SCSS during COVID-19 was 2.05±0.42and negative response was 1.31±0.49respectively. The total score of PSSS was 64.43±8.97and rated as medium to high leval. The total score of CD-RISC was 57.52±9.34and rated as medium to low level. There was a significant positive correlation between positive coping style, perceived social support and psychological resilience (P<0.001). Years of working and monthly income are the influencing factors of positive response of SCSS. Gender is an influencing factor of the PSSS. Educational level is an influencing factor of psychological resilience.  Conclusion Hospitals can hold targeted and systematic basic training course and practical training courses on psychological resilience organized by hospital may help nurses effectively to relieve workingstress, facilitate self development and improve psychological resilience in the future with unknown epidemics.

Objective To explore the impact of uremic itching on the quality of life of hemodialysis patients. Methods this cross-sectional study, 5-D Itching Scale and the Quality of Life Scale for Kidney Disease Patients (KDQOL-36) were adopted to evaluate the prevalence of uremic pruritus and the quality of lifeamoung maintenance hemodialysis patients at a hospital hemodialysis center in Macau. Results The study enrolled 158 maintenance hemodialysis patients and all participants were divided into two groups according to the scoring of 5-D itch scale: 113 cases (71.5%) for the itch group and 45 cases (28.5%) for the non-itch group. The degree of itching is classified as mild itching (20.2%), moderate itching (26.6%), severe itching (17.7%), and serious itching (6.9%). There were statistically significant differences in the factors related to itching between the two groups of patients in terms of educational level (P=0.032), dialysis age (P=0.029), urea clearance index (Kt/v) (P=0.042), and blood phosphorus (P=0.048). In regardto quality of life, non-itching patients scored higher than those with itching, and the severer the itching, the lower the score of quality of life. Conclusion The incidence of uremia among maintenance hemodialysis patients in the study hospital is 71.5%. Educational level, dialysis age, urea clearance index,and blood phosphorus are factors related to uremic itching. Uremic itching is negatively correlated with quality of life.

Objective To systematically review the clinical application status, toxicity profiles, safety research advancements, and risk control strategies of topical formulations containing toxic Chinese herbal medicines (CHMs) over the past five years, providing evidence for their rational utilization and enhanced safety. Methods Relevant literature published within the last five years on topical formulations of toxic CHMs was retrieved from major Chinese databases (CNKI, Wanfang, and VIP). Studies were screened and synthesized, with analysis focusing on formulation types, administration routes, clinical applications, adverse reactions, and detoxification methods. Results Topical formulations of toxic CHMs exhibit diverse forms and broad clinical utility, demonstrating significant efficacy in treating conditions such as periarthritis of the shoulder, arthritis, and dermatological disorders. Adverse reactions are predominantly localized irritation and allergic responses, with systemic toxicity incidence rates remaining below 1%. Risk mitigation can be effectively achieved through measures including precise dosage control, optimized treatment duration, pharmaceutical processing for detoxification, formulation refinement, and technological improvements. Nevertheless, current research is limited by insufficient long-term toxicity data, inadequately defined protocols for special populations, and the absence of an established toxicity biomarker monitoring system. Conclusion Topical formulations of toxic CHMs present an overall controllable safety profile when used according to established guidelines, holding substantial clinical value. Future efforts should integrate multidisciplinary approaches-such as transdermal pharmacokinetics and metabolomics-to elucidate the mechanisms of dermal penetration by toxic constituents, establish comprehensive toxicity surveillance systems, and advance the development and implementation of technical standards. This integrated strategy is essential for achieving the precision dosing goal of optimal efficacy-toxicity balance.

The occurrence of right bundle branch block (RBBB) on electrocardiography in patients with acute myocardial infarction is relatively uncommon and may interfere with ECG interpretation, increasing the risk of delayed diagnosis and treatment. This article reports a case of such a patient.

Primary hepatic angiosarcoma (PHA) is an extremely rare malignancy, accounting for approximately 2% of primary hepatic cancers and representing the most common primary malignant mesenchymal tumor of the liver. The imaging features of PHA lack specificity, and definitive diagnosis relies on pathological confirmation; biopsy should be performed with caution due to the risk of bleeding. This article presents a retrospective analysis of the imaging characteristics of a case of multifocal PHA treated at our hospital, providing a reference for future diagnostic practice.

X‑linked agammaglobulinemia (XLA) is the most common form of antibody immunodeficiency, accounting for approximately 85% of congenital agammaglobulinemia cases. Patients typically present with persistently low serum immunoglobulin levels and recurrent bacterial infections, with onset most often occurring during infancy. Here, we report one case of XLA diagnosed and treated in our hospital, accompanied by a review of the relevant literature, in order to enhance clinicians’ understanding of this condition.

Fetomaternal hemorrhage (FMH) is a rare pregnancy-related condition in which various causes lead to disruption of the placental barrier, allowing fetal blood to enter the maternal circulation. This results in a spectrum of clinical manifestations, including fetal anemia and hemolytic transfusion reactions in the mother. In 1955, Chown and colleagues first confirmed the presence of fetal red blood cells in the maternal circulation. The exact pathogenesis of FMH remains unclear, and there is currently no specific diagnostic standard. The incidence of FMH with typical clinical symptoms is estimated to be approximately 1 in 1,000 to 1 in 3,000 pregnancies.