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.

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.

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.

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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.

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 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 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.

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.

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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.

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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 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.

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.

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Objective To compare and analyse the advantages and disadvantages of carpal arthroscopy and small incision surgery in the treatment of carpal tunnel syndrome (CTS). Methods 48 patients with unilateral carpal tunnel syndrome (CTS) who fulfilled the inclusion criteria in the Department of Orthopedics of Kiang Wu Hospital in the two-year period from November 2020 to October 2022 were analyzed in a retrospective study, and were divided into a carpal arthroscopy group and a small incision group according to the treatment modality, and were followed up for at least 13 weeks after surgery. The incision length, duration of surgery, hospital stay, postoperative recovery time, surgical complications, pain scores at 2 weeks, 6 weeks, and 13 weeks after surgery, and two-point discrimination sensation data were recorded for statistical analysis to assess the efficacy and safety of the treatment. Results The carpal arthroscopy group was significantly better than the small incision group in terms of incision length, duration of surgery, hospital stay, and postoperative recovery time, and there was no postoperative bleeding, hematoma, neurological injury, recurrence, and other problems in either group. There were no postoperative complications such as bleeding, hematoma, nerve injury, recurrence, neuroma, muscle abnormality of the hand or wrist, etc. The pain scores at 2 weeks after surgery suggested that the carpal arthroscopy group was better than the small incision group, and there was no significant difference in the pain scores of the two groups at 6 weeks and 13 weeks after surgery, and the two-point discrimination sensation at 2 weeks, 6 weeks, and 13 weeks after surgery. Conclusion Carpal arthroscopy treatment of carpal tunnel syndrome has the advantages of effective treatment, being less invasive, resulting in fewer complications and a shorter recovery time, which is worthy of promotion.However, it requires a higher level of surgical skills and still has some therapeutic limitations

Objective To investigate the significance of eosinophils in colorectal polyp and tumor tissues. Methods The distribution and number of eosinophils in colorectal polyps were observed by light microscope. Results A total of 860 patients underwent colonoscopy and colorectal polyp removal in KiangWu Hospital from June 2022 to June 2023 were collected, including 52 cases of colorectal carcinoma, 78 cases of high- grade dysplastic adenoma, 481cases of low-grade dysplastic adenoma, and 249 cases of hyperplastic polyp. Eosinophils were diffusely infiltratein the stroma of the polyps. 81 cases of >20/HPF eosinophils were found in 249 cases (32.5%) of non-tumor group (hyperplastic polyp), while 600/611 (98.2%) cases in tumor group (including colorectal carcinoma, high-grade and low-grade dysplastic adenoma). The difference of eosinophil number between non-tumor group and tumor group was statistically significant (P <0.01). >20/HPF eosinophils were found in 96.2% (50/52), 98.7% (77/78) and 98.3% (473/481) of colorectal cancer, high-grade dysplastic adenoma, and low-grade dysplastic adenomarespectively. The difference of eosinophil number betweendifferent grade tumor groups wasnot statistically significant (P >0.05). Conclusion The presence of eosinophils was significantly correlated with formation of colorectal tumors.The mechanism of promoting tumor growth needs further explore.

Objective To explore the risk factors and outcomes of trial of labor after cesarean delivery (TOLAC). Methods The clinical data of 66 patients attempted TOLAC were included from December 2019 to December 2020. Patients who successfully delivered were classified into the TOLAC success group. Patients who attempted TOLAC but had a repeat Cesarean delivery due to medical issues were classified into the TOLAC failure group.Clinical data including age, height, BMI, gestational weight gain, gestational age, complications of pregnancy, duration of hospital stay after delivery, postpartum hemorrhage, weight of newborns and 5 min Apgar score were compared between the 2 groups. Logistic regression analysis was used to analyze the risk factors of vaginal delivery and the pregnancy outcomes in both groups were observed. Results The success rate of TOLAC was 80.3% (53/66). The total duration of hospital stay after delivery in TOLAC success group is shorter than that of TOLAC failure group (P <0.05). Logistic regression analysis showed that premature rupture of membranes (PROM)(OR=0.076, 95% CI: 0.015-0.374, P <0.05) was positively associated with TOLAC failure. Conclusion TOLAC is safe and feasible on the basis of strict grasp of the indications and close monitoring. PROM may be a risk factor for TOLAC failure.

Objective To investigate the practical value of soluble fms-like tyrosine kinase 1 (sFlt-1) and placental growth factor (PlGF) ratio in proteinuria pregnant women for predicting preeclampsia and other adverse pregnancy outcomes. Methods A total of 80 proteinuria pregnant women from October 2019 to November 2022 were selected as the observation group, and 40 healthy pregnant women during the same period were selected as the control group. The serum levels of sFlt-1 and PlGF in each group were analyzed and compared the difference of sFlt-1/PlGF ratio >38, receiver operating characteristic curve(ROC) was used to analyze predictive value of sFlt-1/PlGF ratio for adverse pregnancy outcomes and preeclampsia. Results The median values of the serum sFlt-1/PlGF ratios of the observation group and the control group were 14.66 and 5.06 respectively, the sFlt-1/PlGFratio in the observation groupwas significantly higher than that in the control group, (P<0.05); Adverse pregnancy outcome and preeclampsia were analyzed by ROC curve, and the Area under the Curve(AUC) were 0.90 and 0.77, respectively. Conclusion The serum sFlt-1/PlGF ratio of proteinuria pregnant women can be used for prediction of preeclampsia and other adverse pregnancy outcomes.

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Objective To use musical therapy as a way of relaxation to relieve the discomfort of patients during colonoscopy operation, so as to promote the progress and comfort level of colonoscopy. Methods From April 12 to May 18 in 2021, a study was conducted with104 colonoscopy examine esin a Macau hospital. The study participants were divided into study group and control group with 52 participants for each group. Musical therapy was used, and the differences in pain level were evaluated by numerical rating scale (NRS), systolic blood pressure, diastolic blood pressure, heart rate and mirroring time of colonoscopy were compared between the two groups. Results There was no difference in NRS score, intra and post operative blood pressure and heart rate between the two groups. There was no significant difference in the time of mirroring between the two groups. However, the mirroring time less than or equal to 10 minutes (non-difficult colonoscopy group) found a significant difference between mirroring time more than 10 minutes (difficult colonoscopy group) with study group reaching 6.2±1.6 min and control group in 7.2±1.6 min (T=-2.075, P<0.05). There was no difference found in the difficult colonoscopy group. Conclusion Musical relaxation therapy has no significant effect on the pain relief and blood pressure stabilization of colonoscopy patients, but it can still shorten the time for colonoscopist. However, it has no significant effect on difficult colonoscopy music therapy.

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Objective To compare the efficacy of low-concentration atropine, defocus-incorporated multiple segment spectacle lenses (DIMS) and low-concentration atropine combined with DIMS in the treatment of myopia in children. Methods A total of 85 children (166 eyes) with myopia aged 5-12 years old who were treated in Kiang Wu Hospital from April 2019 to April 2022 were included. The eyes were allocated into three groups: low-concentration atropine (54 eyes), DIMS (56 eyes), and the combined group (56 eyes). The spherical equivalent power (SE) and axial length were followed up for 1 year. Results At baseline, there were no significant differences in sex, age, or axial length, but there were significant differences in equivalent spherical power (F=7.268, P <0.001). The combined treatment group (-3.9±1.61 D) was more myopic than the other groups. SE increased significantly over 1 year in the atropine group (-0.41±0.47 D), DIMS group (-0.39±0.44 D), and combined treatment group (-0.38±0.44 D); however, there were no significant differences ( P >0.05). Axial length increased significantly over 1 year in the atropine group (0.24±0.19 mm), DIMS group (0.21±0.29 mm), and combined treatment group (0.17±0.16 mm); there were no significant differences between the groups ( P >0.05). Conclusion There was no significant difference between low-concentration atropine, DIMS and low-concentration atropine combined with DIMS in the treatment of myopia in children. Compared with wearing single-vision glasses which was investigated in other epidemiological investigations, the three myopia treatment methods examined herein can control the progression of myopia.

Objective This study aims to understand the current situation of nurses’ knowledge, attitudes, and behaviours on the prevention of pressure injury in a hospital in Macao. Explore the differences between the socio-demographic characteristics of nurses and the perceived factors of work environment on the behaviour of pressure injury prevention,the correlation between the knowledge, attitudes, and behaviours of pressure injury prevention. Methods Through cross-sectional surveys and studies, using convenient sampling methods, structured questionnaires are used to collect data. Results Finally, 213 valid questionnaires were collected. The overall average score of nurses in a hospital in Macao on the knowledgeof pressure injury prevention is 70%, and the overall average scores of attitudes and behaviours ofpressure injury prevention are 77.20% and 76.80% respectively. There are significant differences between the work department, whether the subjects have read related literatures about pressure injury in recent one year and nurses’ behaviours on pressure injury prevention. There is a significant positive correlation between nurses’ knowledge, attitudes, and behaviours about the prevention of pressure injuries. Conclusion The nurses of a hospital in Macao have slightly poor knowledge of the prevention of pressure injury injuries; their attitudes and behaviours regarding the prevention of pressure injuries are acceptable. Therefore, it is recommended to comprehensively strengthen the on-the-job training of nurses for pressure injury, formulate a pressure injury assessment mechanism, and increase related resources, to strengthen nurses' knowledge, attitudes, and behaviours about pressure injury prevention and improve the quality of care for pressure injury.

Objective To investigate the effects ofspeech and languageintervention to improve the communication temptation in developmental language delay(DLD) children. Methods Twenty-six children were divided in DLD group(14) and ASD group(12). Two groups were given 10 sections of speech and languageintervention. Before and after intervention, they were tested by the13-item scale of communication skills. Results In DLD group the scores of naming, request for object, request for action, refusal, protest/ reject, directing/showing, responding, greet/farewell, showing off, express affection and total scores before and after intervention were statistically different (P<0.05), but in ASD group, only request for object, request for action, refusal, protest/reject, directing/showing, responding, greet/farewell and total scores were statistically different(P<0.05). The difference before and after interventionin two groups was statistically different(P<0.05). Conclusion Speech and language in tervention shows significant effects in DLD with communication temptation impairment. Compared with ASD children, interventions have significant effects in DLD children. This research considered that the speech trainings should not only focus on communication temptation, but also on oral expression for the DLD children; For ASD children with no languages, communication device can be used in training.

Objective To observe the effects of individualized low phosphorus diet nutrition education by dietitians on the dietary behavior and serum phosphorus levels of patients with hyperphosphatemia on hemodialysis (HD). Methods Patients with average serum phosphorus levels greater than 1.78mmol/L after 3 months of adequate HD and oral phosphate lowering drug treatment were selected and randomly divided into a study group and a control group. Dietitians provided two sessions of one-by-one hyperphosphatemia dietary nutrition education to the study group patients at the 2nd and 4th months, respectively. The knowledge, attitude, and behavior questionnaire (KAP) scores, serum phosphorus levels, and serum phosphorus compliance rate were analyzed and compared before and after nutrition health education. Results Forty participants completed the study, with an average age of 64.6±12.1 years old and their averagedining out per person was six times per week; 75% of the participants frequently drank coffee, milk tea or tea. After low phosphorus diet education intervention, the proportion of participants in the study group who recognized processed foods as high phosphorus foods significantly increased from 66.7% to 90.5% (P<0.05). After diet education intervention, the knowledge of low phosphorus diet(P=0.014) and behaviorscores were significantly improved compared to before intervention. However, there was no statistically significant difference.After diet education intervention, the serum phosphorus levels of the study group participants showed a downward trend, whereas the serum phosphorus compliance rate showed an upward trend, but there was no statistically significant difference. Conclusion Nutritional education is effectivein improving patients' understanding of high phosphorus foods and their attitudes towards low phosphorus diets, but it has not been able to show improvements in theirserum phosphorus levels.

Objective To evaluate the accuracy of free end dental implants guided by digital surgical guides. Methods This study collected 16 patients (16 implants) who underwent free end implantation guided by digital guide during Dec 2021 to Dec 2022 in the Department of Stomatology, Kiang Wu Hospital, Macau. A total of 16 patients (16 implants) with non-free end dental implants were collected during the same period. The Blue-Sky Plan software was used to cross-compare the preoperative design data and postoperative implant scan data of patients, measure the difference between the preoperative design position and the actual postoperative position, and statistically analyze the difference in implant accuracy between the free end and the non-free end implantation. Results Compared with the preoperative design of the implant location, the implant accuracy of the free end of the dentition was similar to that of the non-free end of the dentition (P >0.05). Conclusion Even at the free end of the dentition, the digital guide can guide the operation to achieve accurate implant implantation, which is worthy of clinical application.

Objective To analyze semen examination reports from November 2018 to November 2022 in Kiang Wu Hospital. We aimed to explore the results of routine semen analysis and sperm quality, in order to provide guidance of suitable assisted reproductive techniques for infertile men. Methods Patients' semen samples were evaluated according to the World Health Organization (WHO) criteria for routine semen analysis, dividing patients into groups meeting the standard for semen quality and not meeting it, respectively. Additionally, the study analyzed the in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) outcomes for patients with normal and abnormal sperm analysis results. Results Out of 3090 semen routine analysis, 1972 individuals (63.82%) met the standard criteria. The average age was 37.35 years, with an average total sperm count of 314.61×10 6, a forward motility rate of 45%, and an immotile sperm proportion of 35%. In contrast, 1118 individuals (36.18%) did not meet the standard criteria, with an average age of 31.33 years, an average total sperm count of 136.30×10 6, a forward motility rate of 18%, and an immotile sperm proportion of 55%. Sperm morphology analysis (SMA) was performed on 750 samples, with 333 meeting the standard, accounting for 44.40%, with an average age of 35.11 years. Additionally, 228 patientshad mild abnormalities, accounting for 30.40% with an average age of 35.09 years, whereas 189 cases had severe abnormalities, accounting for 25.2% with an average age of 36.48 years. The total fertilization rate innormal SMAgroup showed no significant difference comparing to that ofmild abnormal group, however ,significantly higher than that of severeabnomal group. Moreover, the IVF normal fertilization rate was significantly higher in the SMA normal group comparing to the SMA mild abnormal group. There were no significant differences in total fertilization rates and normal fertilization rates among the groups receiving ICSI treatment. Conclusion Routine semen analysis and sperm quality analysis are crucial indicators for assessing male fertility. Abnormal sperm morphology is a primary cause of male infertility. Semen routine analysis can enhance the diagnostic accuracy of male infertility, and the results of sperm quality analysis can assist in the selection of appropriate assisted reproductive techniques.

The incidence rate of cervical spondylotic radiculopathy (CSR) is relatively high, with a wide range of patients and a tendency to become younger, which makes the clinical treatment of this disease of great importance. As an important part of conservative treatment, the external therapeutic methods of Chinese medicine mainly include acupuncture, moxibustion, acupuncture plus moxibustion, tuina and other special methods such as fire needle and acupotomy. Acupuncture and moxibustion in particular are widely used in clinical practice and have proven efficacy. The clinical reports on acupuncture and moxibustion for CSR in the last 10 years are summarised here.

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Objective To evaluate the role of preoperative magnetic resonance imaging (MRI) in decision-making for pelvic lymph node dissection (PLND) in patients with endometrial cancer. Methods From January 2016 to March 2024, patients with endometrial cancer who underwent surgical treatment in the Obstetrics and Gynecology Ddepartment of Kiang Wwu Hospital were enrolled in this study. Clinical materials were collected and postoperative pathological results were used as the gold standard to evaluate the diagnostic efficacy of preoperative MRI examination for uterine myometrial infiltration and pelvic lymph node metastasis. Results 84 patients with endometrial cancer were adopted for final analysis. The sensitivity, specificity, and accuracy of MRI in evaluating deep uterine myometrial infiltration (MI≥50%) were 60.7%, 91.1%, and 81.0%, respectively. The sensitivity, specificity, and accuracy of MRI in evaluating pelvic lymph node metastasis were 27.3%, 89.3%, and 79.1%, respectively. When MRI indicating deep myometrial infiltration, pelvic lymph node metastasis, or a combination of both were applied to predict pathological diagnosis of pelvic lymph node metastasis, the Youden index of MRI indicating deep myometrial infiltration as the predictive indicator is the highest, at 0.495. Conclusion In our hospital, compared with MRI diagnosis of pelvic lymph node metastasis, selective PLND based on MRI diagnosis of deep myometrial infiltration is a more reasonable preoperative evaluation plan.

Objective To analyze the admission rate of patients at Kiang Wu Hospital, Macau (hereinafter referred to as 'our hospital') due to ADRs and related factors. Methods A retrospective studywas performed, and data were collected from unintentional admissions of adult patients who met the inclusion criteria from April 2023 to September 2023. Two clinical pharmacists gathered patients' basic information and assessed the causality, type, severity, and avoidability of all suspected ADRs. Logistic regression analysis was used to evaluate the related factors associated with the occurrence of ADRs at the time of admission. Results A total of 4,919 patients were included in the study, 54.7% were female, with a mean age of 64.8±19.3 years. 228 patients experienced ADRs at the time of admission, resulting in an incidence rate of 4.6%, while 151 patients were admitted due to ADRs, with an incidence rate of 3.1%. A total of 242 ADR events were identified, with 278 instances of drug involvement. The number of medications taken (five or more) and the presence of diabetes were identified as key factors in the multifactorial analysis of ADRs. 211 patients were admitted to the internal medicine wards, accounting for 92.5% of those who experienced ADRs at the time of admission. The most common ADRs were bleeding/INR abnormalities (29.8%) and electrolyte disturbance (13.6%), with the most frequently involved drug classes being cardiovascular drugs (29.5%) and drugs affecting the blood and blood forming organs (27.0%). Conclusion This study fills a gap in local ADR data and highlights the need for targeted interventions for high-risk populations and high-risk medications to reduce the occurrence of ADRs.

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Objective To investigate the distribution of allergens in Macau children to provide a scientific basis for the prevention of allergic diseases. Methods The laboratory results of allergens detection in children from the year 2022 were selected to study the distribution of allergens, with a total of 173 cases related to food allergens and 239 cases related to inhaled allergens. Statistical analysis was performed to find out the relationship between the distribution of allergens and factors such as sex, gender, and season. Results Positive rate of food allergies was 56.65% and inhaled allergies were 70.29%. Among the food allergens, for the panel related to seafood and meat, the top 3 most detected allergens were egg white , milk and salmon, for fruit and nuts panel, the oat , kiwi and peanuts were thetop 3 most detected allergens. For inhaled allergies, the top 3 most detected allergens were dermatophagoidespteronyssinus, cat danderand dog dander. From the statistical analysis, the positive rate of inhaled allergens increasedwithage, but positive rate of food allergens decreasedand the differences between the findings were statistically significant. Conclusion There are differences in allergen positivity rates among different age groups, therefore, understanding the distribution of allergens among children in an early stage is important to promote early intervention and prevention of allergic diseases, and also facilitate the diagnosis and treatment of allergic diseases.

AIH is a chronic disease of unknown origin characterized by persistent inflammation and necrosis in the liver, which can progress to liver cirrhosis. The disease's progression can be slow, and patients may present with a wide range of symptoms, from no symptoms at all to sudden, severe hepatic failure. The diagnosis of AIH can be easily made using the IAH scoring system. In patients with impaired liver function, it is important to investigate for AIH by ruling out viral hepatitis, drug-induced hepatitis, and alcoholic hepatitis, and by conducting tests for autoimmune markers. The standard treatment for AIH is immunosuppressive therapy. Although AIH is relatively uncommon, it can be fatal if left untreated; however, early diagnosis and treatment often result in a favorable response. Our objective is to bring attention to AIH and emphasize the importance of increased awareness of this disease in patients with unexplained liver impairment.