Objective  To investigate the effects of speech training on improving basic concepts in children with developmental language delay. Methods  Forty-four children with developmental language disorder were selected and given 8 sections of speech trainingwho were trected in the rehabilitation department form Sep 2021 to Sep 2022. Before and after training, they were tested on the language concepts of big/small, color, number and direction. Results  The total scores of basic concepts before and after training were significantly different (P<0.01). The effective rate of speech training was 68.2% in the concept of big/small, 86.4% in the concept of color, 54.5% in the concept of number and 52.2% in the concept of direction. A significant difference in the total healing rate between the four concepts of language was found (P<0.01). There were significant differences between the healing rate of color and number, as well as direction (P<0.01). Conclusion  Speech training showed a significant effect on the development of language delay in children with language basic concept impairment.

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During the peak of the COVID-19 pandemic outbreak at the end of December 2022, a large number of medical staff in the emergency department became infected, putting unprecedented pressure on the functioning of the department. To cope with the significant increase in emergency patients within a short period of time, the Department of Family Medicine launched the "Online Outpatient Service" by conducting phone consultations to treat mild COVID-19 patients. This effectively relieved the pressure on the emergency department and gained widespread recognition in the Macao community. However, although standardized questioning and prescribing protocols were used in the "Online Outpatient Service" for COVID-19 patients, there may be discrepancies when compared to the standards of existing "telemedicine" practices both domestically and internationally. This highlights the need for us to summarize and improve these practices.

Objective  To identify retained placenta (RP) risk factors by comparing and screening medical history and laboring data of patients with and without RP. Methods  A total of 1865 pregnant patients with vaginal delivery, singleton pregnancy and no major fetal anomaly were recruited and divided into the RP group and the control group. Medical history and laboratory data were compared between the two groups, and multivariable logistic regression analyses were applied to estimate the adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for potential RP risk factors. Results  The number of pregnancy times, the number of delivery times, the percentage of ≥2 manual abortions, the percentage of patients with intrauterine procedures and with RP history, the amount of postpartum hemorrhage blood and the percentage of patients with postpartum hemorrhage were significantly higher in the RP group than in the control group. Multivariable logistic regression analyses showed that multiple deliveries, previous intrauterine procedures, RP history and ≥600 min oxytocin application were independent risk factors for RP. Conclusion  Intrauterine procedures should be reduced as few times as possible before pregnancy. During labor, oxytocin application time should be minimized. In the meantime, during the third stage of labor, the RP alert should be set up immediately as the abovementioned RP risk factors are noticed

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Objective  Investigate perinatal clinical procedures to reduce the negative effects of placental abruption (PA) on pregnant women and newborns' clinical results. Methods  A retrospective analysis was conducted in women with singleton pregnancies who delivered at Kiang Wu Hospital from October 2018 to October 2021. According to the consistency of prenatal and postnatal diagnoses, the patients were divided into 2 groups. The diagnosis group (D group) and the missed diagnosis and misdiagnosis group (MM group). Results  The incidence of PA was 1.33%. The missed diagnosis and misdiagnosis ratios were 56.56% and 0.82%, respectively. The incidences of 0-degree and I-degree PA in the D group were significantly lower and higher than those in the MM group, respectively. The incidences of premature rupture of membranes (PROM) and induced labor were significantly higher and lower than those in the MM group, respectively. The incidences of prelabor vaginal bleeding, persistent abdominal pain and uterine tenderness in the D group were significantly higher than those in the MM group. However, the incidences of uterine contraction and bloody amniotic fluid were similar between the two groups. The abnormal rate of fetal heart rate monitoring and the rate of cesarean section and induced labor were significantly higher in the D group than in the MM group. There was no significant difference in the rate of abnormal ultrasound findings, postpartum hemorrhage, blood loss or neonatal asphyxia between the 2 groups. Conclusion  It is important to take both the PA risk factors and the clinical manifestations/lab results into account when making a diagnosis. Clinicians should pay close attention to the patient’s clinical symptoms to diagnose PA as early as possible to improve the prognosis of PA during induced labor.

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Objective Lung cancer has been a challenging problem in Macaufor the last 10 years, and at least half of patients are at an advanced stage when they are diagnosed. Target therapy worked as a new direction to advance stage lung cancer patients. This article intended to realize its effect of target therapy in the Macau area. Methods Lung cancer has been a challenging problem in Macau for the last 10 years, and at least half of patients are at an advanced stage when they are diagnosed. Target therapy worked as a new direction to advance stage lung cancer patients. This article intends to realize the effect of target therapy in the Macau area. Results In the final analysis, annual new lung cancer cases increased and ranked as the top cause of death among tumor patients in the past ten years in Macau. Half of the Macau lung cancer cases were smokers. In addition, nonsmoking female lung cancer patients grow up rapidly. Lung adenocarcinoma was the main histological type in Macau in recent decades. EGFR and ALK gene mutations are common genetic types, and approximately 40% of lung adenocarcinoma patients benefit from targeted therapy because of molecular test implementation. Overall survival and the 5-year survival rate clinically increased in the targeted therapy and chemo-targeted therapy groups. Better drug compliance was observed after target therapy was introduced in Macau. We are looking forward to the development of molecular biology and the corresponding drugs. Conclusion Smoking cessation should be continuously promoted in Macau. Molecular testingworked as a routine examination of lung adenocarcinoma patients to improve the survival rate. The effect of targeted therapy in lung cancer patients is encouraging, and it is worth expecting more genotype-based or phenotype-based treatments to improve the survival rate of lung cancer patients in Macau.

Objective  It is hoped that analyzing the risk factors related to the death of COVID-19-infected patients in our hospital can be used to develop a prevention and treatment strategy for COVID-19. Methods  In this retrospective study, we included patients with COVID-19 from Kiang Wu Hospital. Clinical data were collected from medical records from 15 December 2022 to 31 January 2023. A total of 1,005 COVID-19-infected patients were analyzed. Results  The deaths of COVID-19-infected patients with hypertension, type 2 diabetes, coronary heart disease, chronic kidney failure, cancer, dementia and COPD were 65.49%, 33.10%, 15.49%, 12.68%, 7.75% and 4.23%, respectively. In multiple logistic regression, male sex was associated with an increased risk of death from COVID-19 (OR = 1.65, 95% C.I. 1.11-2.44). Older age (60-69, 70-79, ≥80) was associated with an increased risk of death from COVID-19 (ORs are 14.31, 26.98 and 54.77, respectively, and 95% C.I. are 3.03-67.49, 6.17-117.93 and 12.85-233.43, respectively). Patients with chronic kidney failure or cancer had an increased risk of death from COVID-19 [ORs were 1.77 and 3.43, 95% C.I. were 1.01-3.10 and 1.76-6.69, respectively]. Patients who received 3 or more doses of COVID-19 vaccine effectively had a reduced risk of death from COVID-19 [OR=0.49, 95% C.I. 0.28-0.85]. Conclusion  Men, older age, and patients with chronic diseases (chronic kidney failure or cancer) have an increased risk of death from COVID-19. It is recommended that patients with relevant risk factors be vaccinated in time, which can effectively prevent severe events and death.

Objective  To analyze the clinical features and outcomes of COVID-19 infection in elderly patients during the 5th wave COVID-19 subtype Omicron epidemic period in Macao in order to improve the ability of diagnosis and treatment. Methods  The clinical data of omicron infected patientsfrom December-18-2022 to February-02-2023 were collected. A retrospective study was used to compare the elderly patients and young to middle-aged patients. The cases were confirmed based on the clinical features, positive result in rapid COVID -19 antigen test or real time reverse-transcriptase polymerase chain. Results  The mean age of the total 939 patients was (76.18±18.14) years old, and the age range was 18 to 109 years old. A total of 22.6% were older than 90 years, 94.5% of them were severe or critical patients, and 95.3% had at least combined with one pre-existing disease. The improved discharge rate in the very old group was 76.5%, lower than that of 96.4% in young to middle-aged group (χ²=33.9, P<0.05). Conclusion  The elderly patients infected with Omicron, especially very old patients, have a higher rate of severe or critical illness and a lower rate of improved discharge. They are still the key population for the elderly prevention and treatment in the future.

Objective  Discuss the impacts of labor epidural analgesia (LEA) on the delivery consequences of primiparae with different gestational weight gain (GWG). Methods  To analyze retrospectively the delivery records of 801 pregnants who had undergone transvaginal delivery. In accordance with primiparae with normal GWG, primiparae with over - GWG and whether they had accepted LEA, the samples were divided into 4 groups. Group I: Normal GWG primiparae who didn’t accept LEA; Group II : Normal GWG primiparae who accepted LEA; Group III : Over GWG primiparae who didn’t accept LEA; Group IV : Over GWG primiparae who accepted LEA. The delivery approaches, time consumption of delivery, blood loss, weight of neonates, Apgar Scores of neonates, time consumption of LEA, natural birth rates of primiparae etc, were recorded respectively. Results  Time consumptions of both Group II and Group IV primiparae were longer than Group I and Group III. The 2nd gestational stage of Group IV primiparae is obviously longer than Group III. The natural birth rate of Group IV primiparae is higher than Group III. The 5 minutes Apgar score of neonates from Group II is obviously lower than the other groups. Conclusion  There is no correlation between GWG and natural birth rate. Although the delivery time consumption of primiparae who accepted LEA is elongated, the natural birth rate is obviously higher than those who didn’t accept LEA. Hence, LEA is worthy to be promoted for all primiparae especially for those over-GWG primiparae.

Objective  To compare the clinical effects of rotator cuff injury between endoscope repair and medication plus physiotherapy. Methods  From January 2019 to December 2020, a retrospective analysis of 36 inpatients with rotator cuff injuries who received treatment at Kiang Wu Hospital were included. Eighteen patients who underwent arthroscopic anchor repair surgery were enrolled in the study group, and 18 patients with medication plus physiotherapy were included in the control group. The pain degrees, shoulder joint scores and prognosis of the two groups were compared. Results  Compared with the results of Constant score, VAS score, and the excellent rate of UCLA, the surgical treatment group had a statistically significant advantage over the control group (P<0.05). Conclusion  Patients with rotator cuff injuries who underwent microscopic repair compared with medication plus physiotherapy had less pain, a higher shoulder scores and a better functional recovery

Objective  This cross-sectional study aimed to investigate the clinical characteristics of elderly patients on maintenance hemodialysis (MHD) and to try to improve management skills. Methods  Patients who underwent MHD at Kiang Wu Hospital at the end of 2020.12.31 were enrolled and divided into elderly (age≥ 65 years) and nonelderly groups (<65 years) according to age. Data including patients’ general information (age, sex, primary disease, dialysis modality, dialysis age, blood access), laboratory examinations (hemoglobin, transferrin saturation, ferritin, calcium, phosphate, urea) and dialysis adequacy index were collected and compared. Results  Finally, 512 patients were enrolled, while 322 patients (62.9%) were in the elderly group and 190 patients (37.1%) were in the nonelderly group. Compared to the nonelderly group, the elderly group obviously had a higher female ratio (43.8% vs 31.1%, P=0.004), lower average weight (57.61±12.95kg vs 61.45±12.82kg, P=0.001), lower glomerular disease percentage (18.3% vs 26.3%, P=0.033) among primary diseases, lower proportion in high flux dialysis (75.5% vs 86.8%, P=0.002), less AVF and more permanent catheter usage in blood access. There was no significant difference between the two groups in terms of the hemoglobin and calcium levels (P>0.05). The serum transferrin saturation (TSAT), ferritin and phosphate levels of the elderly group were significantly higher. In contrast, albumin and urea levels before and after dialysis were significantly lower than those of the nonelderly group. Conclusion  The population of elderly MHD patients is getting increasingly older from diabeticcomplications with poor vascular and nutritional conditions. More efforts should be put on comprehensive evaluations for elderly MHD patients to assist in choosing proper blood access and dialysis modality. Timely correction of anemia and malnutrition might lower the risk of mortality.

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.

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Objective  To explore the effect of the International Dysphagia Diet Standardization Initiative (IDDSI) application for standard texture foods on the swallowing function of patients with oropharyngeal dysphagia. Methods  Patients with oropharyngeal dysphagia who were hospitalized in Macau Kiang Wu Hospital from January 2018 to November 2020 were included. They were allocated to either the experimental group (the volume viscosity swallow test (V-VST) assessment for dietary guidance and IDDSI standardized foods recommendation) or the control group (regular diet recommendation). The improvement in swallowing function between the two groups was compared. Results  The within-group comparison for swallowing function of pre- and postimplementation was improved (P<0.01). The extubation rate of the nasogastric tube and the improvement in swallowing function in the experimental group were significantly better than those in the control group (P<0.05). Conclusion  Standard texture foods can significantly promote the swallowing function, extubation rate of nasogastric tube and feeding function

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Objective To sum up diagnosis and treatment experiences of neonatal congenital gastrointestinal malformation, and to improve clinical level. Methods To review and analyze the clinical data of 24 neonatal congenital gastrointestinal malformations who were admitted to Kiang Wu Hospital from Jan 2009 to Dec 2021. Results Most cases of neonatal congenital gastrointestinal malformations in our hospital were male, full term babies with normal birth weight, mainly disease types were intestine malrotation, megacolon and anus atresia, less cases included two types of malformation. Clinical manifestations were vomit, abdominal distension, and abnormal bowel movement. Most cases were cured after surgery. Conclusion Early recognition of sign and specific check help to quick diagnosis and treatment, it was key for better prognosis, low mortality and less complication. Active coordination and complex treatment during perioperation raised total management level.

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Objective  This analysis aimed to assess the impact of the updated 2014 Atrial fibrilla[1]tion(AF) diagnosis and management guidelines on the anticoagulation therapy rate and treatment plans for high-risk thromboembolism non-valvular atrial fibrillation(NVAF) patients. The results of this study can provide evidence-based guidance for clinical anticoagulation management. Methods  This study included high-risk thromboembolism NVAF patients at Kiang Wu Hospital between January 1, 2010, and December 31, 2018. Clinical data and anticoagulation therapy information were collected. The study population was divided into two groups based on the publication of the 2014 AF diagnosis and management guidelines: the study group (after publication) and the control group (before publication). The anticoagulation therapy rate and medication changes between the two groups were compared. Results  The average anticoagulation therapy rate for the study population was 26.69 ± 11.27%, and there was an increasing trend observed annually during the study period. In 2018, the anticoagulation therapy rate increased more than three-fold compared to that in 2010 (43.62% vs. 12.73%). The study group had a significantly higher anticoagulation therapy rate than the control group (37.37% vs. 18.05%, P = 0.023). With regard to anticoagulant drugs, the proportion of patients in the study group treated with non-vitamin K antagonist anticoagulants (NOACs) increased nearly 10-fold compared to that in the control group (20.72% vs. 2.27%, P = 0.014), while the proportion of patients receiving warfarin therapy showed no significant change between the two groups (16.65% vs. 15.78%, P = 0.624). Conclusion  The updated guidelines for treating atrial fibrillation have helped improve the rate of anticoagulation therapy for high-risk thromboembolism in patients with non-valvular atrial fibrillation. This promotes a more standardized and efficient approach to anticoagulation management for NVAF patients among clinical physicians.

Objective  To investigate the association between viral load, C reactive protein, ferritin and interleukin-6 in COVID-19 (coronavirus disease 2019) patients with different clinical types. Methods  46 patients admitted with COVID-19 in Kiang Wu Hospital from January 2023 to April 2023 were divided into mild group (25 cases) and severe group (21 cases) according to their clinical classification. The SARS-CoV-2 nucleic acid Ct (cycle threshold) value, CRP, ferritin and IL-6 levels of the patients were measured, and statistical analysis was performed to analyze the association between the biomarkers and the severity of disease. Results  Among 46 patients with COVID-19, the results showed that the viral load (28.83±5.63), CRP [76.40 (23.08, 115.00)] and IL-6 [43.10 (26.60, 86.10)] in the severe group were significantly higher than the viral load (33.88±2.03), CRP [13.70 (6.56, 50.60)] and IL-6[13.60 (5.97, 26.20)] in the mild group (P<0.001). Receiver Operating Characteristic curve (ROC) analysis results showed that CRP and IL-6 can be used as indicators to predict the severity of the COVID-19 (AUC were 0.75 and 0.76, respectively). Correlation analysis found that CRP and IL-6 were negatively correlated with Ct values (rs=-0.419, P=0.004; rs=-0.373, P=0.011); CRP was significantly correlated with IL-6 (rs=0.706, P=0.000); and no association of ferritin was found between the two groups. Conclusion  Patients with higher viral load should continue to measure the levels of CRP and IL-6 to assess the severity of COVID-19.

Objective  To analyze the general condition and characteristics of traditional Chinese medicine (TCM) syndromes in patients during the COVID-19 recovery period in Macau. Methods  A retrospective study was conducted on 980 patients with COVID-19 recovery period who visited the TCM simple outpatient clinic of Kiang Wu Hospital in Macau from January 2 to February 18, 2023. The basic characteristics, TCM syndrome features, and medication information of the patients were collected and analyzed. Results  The patients with COVID-19 recovery period were approximately 47 years old, and most of them were female. Common symptoms were cough (83.84%), dyspnea (48.98%), fatigue (45.71%), throat itching (34.46%), dry mouth (23.62%), etc.; the tongue appearance was mainly pale red tongue (45.8%), and the tongue coating was commonly thin coating (27%) and greasy coating (19.1%). The main TCM syndrome type was wind evil invading lung syndrome (33.1%); phlegm heat obstructing lung syndrome was most common in young patients; depression of evil in shaoyang syndrome was more common in patients over 45 years old; wind heat attacking surface syndrome was mainly seen in young and middle-aged patients. The distribution of TCM syndrome types in different age groups was significantly different (P<0.05). Conclusion  Patients in the COVID-19 recovery period may have residual symptoms in respiratory tract and other symptoms. The TCM syndromes show the characteristics of a mixture of deficiency and excess, deficiency of root and excess of branch, with wind evil as the main excess evil, and qi deficiency and yin deficiency as the main deficiency of vital energy. The treatment should focus on strengthening vital energy and expelling evil, protecting the qi of lung and spleen, and the yin of lung and stomach, and expelling wind, phlegm, heat and other residual evils.

Objective The aim of this study was to compare the outcomes of laparoscopic colorectal cancer surgery in combination with ERAS protocol in patients aged above 65 and below 65. Methods The analysis included 45 patients from March 2018 to October 2019 who underwent laparoscopic colorectal cancer surgery in combination with the ERAS protocol. They were divided into two groups according to the age, <65 years of age, categorized into group I, including a total of 25 cases; >65 years of age, categorized into group II, including a total of 20 cases. Both anesthesiologists and surgeons were well trained to use the ERAS protocol. All patients were treated with anesthesia management measures designed according to the Expert Consensus on Enhanced Recovery after Surgery and Clinical Practice of Lingnan Colorectal Surgery Anesthesia(2016 edition). Both groups were compared with the outcomes of the surgery: length PACU stay, hospital stay, postoperative blood sugar and body temperature, perioperative infusion volume, restore gastrointestinal function, tolerance of oral nutrition, mobilization, etc. Results No significant differences were found regarding the postoperative sugar, body temperature, length of PACU stay and length of hospital stay following surgery, restore gastrointestinal function, oral nutrition, etc. Old patients had higher ASA scores, more extended hospital stays before operation(P<0.05), and higher perioperative infusion volumes (P<0.05). Conclusion Laparoscopic colorectal cancer surgery in combination with ERAS protocol for the old patient is safe and effective.

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Objective To evaluate the causes of postpartum hemorrhage (PPH), high risk factors and the relationship with delivery methods. Methods Retrospective analysis of the cases in which blood lost ≥500ml after vaginal birth or ≥1000ml after cesarean deliveries from January 2016 to December 2018 in Kiang Wu Hospital. Results 359 cases of postpartum hemorrhage were reviewed. The incidence of postpartum hemorrhage was 3.51% (359/10223). The major cause for postpartum hemorrhage was uterine atony, taking up 70.75% (254/359). The most common risk factor of postpartum hemorrhage was advanced maternal age. Among all PPH, the incidence of minor, moderate and severe PPH was 76.88%, 18.94% and 4.18% respectively. There were more PPH after vaginal birth than after cesarean deliveries (P>0.05). Conclusion Preventions of uterus atony, management of high-risk pregnancy, close monitoring during labor and use of uterotonic drugs could reduce the occurrence of PPH.

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Objective  We reviewed and analyzed the clinical characteristics of patients with COVID-19 vaccine adverse reactions in the Emergency Department of Kiang Wu Hospital in Macau from 2021 to 2022, providing information for the safety assessment of locally used COVID-19 vaccines. Methods  Cases with adverse reactions to the COVID-19 vaccine reported to the Macao Health Bureau from the emergency department of Kiang Wu Hospital were collected, and the type of COVID-19 vaccine inoculated, number of inoculation doses, sex of the vaccinator, age, adverse reaction symptoms, outcome and other detailed information were registered and statistically analyzed from June 1, 2021, to May 31, 2022. Results  A total of 1430 patients were selected; 35 patients were hospitalized, accounting for 2.4%, and 1395 patients were discharged after treatment, accounting for 97.6%. There were 594 males (41.5%) and 836 females (58.5%), with an average age of 36.1±16.5 years. There were 907 cases of inactivated vaccine, accounting for 63.4%, and 523 cases of mRNA vaccine, accounting for 36.6%. Among patients with adverse reactions to the two vaccines, there were statistically significant differences in the age of onset, days of onset, and the composition ratio of common systemic symptoms and allergic symptoms (P<0.05). There were statistically significant differences in the composition ratios of common systemic symptoms and allergic symptoms among the adverse reactions of two complete doses of mRNA vaccine and inactivated vaccine and booster injections of mRNA vaccines (P<0.05). Conclusion  Most of the adverse reactions of the two vaccines are expected, Emergency department needs to continuously identify, treat and monitor various adverse reactions of COVID-19 vaccines, provide information for the management agency, and promote the implementation of the vaccination plan.

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Objective  To analyze the anxiety status of cardiac catheterization patients in our hospital. Methods  Patients undergone cardiac catheterization with local anesthesia were enrolled from January to March in 2022 in our hospital. General demographic data, anxiety level, blood pressure, heart rate, and complications were investigated and the relationship between anxiety and operation was discussed. Results  This survey recruited 100 patients and 86% of them had anxiety before operation. Most of the patients were male, over 65 years-old, receiving their first cardiac catheterization or percutaneous coronary angioplasty. 71% of the patients had elevated systolic blood pressure ≥140mmHg during intraoperative peroid. There was statistically significant differences between age and anxiety level (P <0.05), while no significant difference was found between other demographic data and preoperative, intraoperative, and postoperative blood pressure and heart rate (P >0.05). Conclusion  Patients over 65 years old undergone cardiac catheterization have a high incidence of anxiety. Appropriate nursing intervention is suggested seriously for patient anxiety reduction during cardiac catheterization.

Objective  To investigate Nicotine dependence level and affecting factors in long-term smokers in Macau. Methods  Use of clinical recruitment in adult smokers who work from different careers. The Fagerstrom test for Nicotine Dependence (FTND) was used to assess the Nicotine dependence level in this Lung Cancer Screening research. Results  Were analysed to investigate the affecting factors of Nicotine dependence level in adult smoker in Macau. Results: there were a total of 257 adult smokers whose smoking age was ≥20 years in average, in which 65.8% first started smoking at the age of 11 to 20 years old, the average score of their Nicotine dependence level was 4.38 (±2.162). Conclusion  In this research, 66.1% of the smokers showed medium to high Nicotine dependency (in which 35.4% were medium and 30.7% were high dependency); the amount of smoking was related to Nicotine dependence level. In addition, adolescents should be mainly targeted in tobacco control, corresponding policies and interventions should be formulated according to the characteristics of Nicotine dependence level in different smoking age.

Objective  To explore the application value of chest radiography in patient triage during the outbreak of novel coronavirus pneumonia (COVID-19 pneumonia). Methods  A retrospective study of the first chest X-ray of 106 COVID-19 patients from December 15, 2022, to January 31, 2023, was performed. A severity score was determined to quantify the extent of pulmonary exudation on chest X-ray. The correlation between severity scores on chest X-ray and the severity of clinical features of infection was statistically analyzed. Results  On chest radiography, the distribution of lesions was mainly in the lower lung fields (χ²=116.0, P <0.00), and there was no significant difference in the distribution of lesions in the left and right lungs (χ²=1.66, P =0.79, χ²=0.73, P =0.39). The lesions mainly demonstrated a mixture of consolidation and interstitial changes. Patients with symptoms of dyspnea and decreased fingertip oxygen saturation (SpO₂) had higher chest X-ray scores than those without symptoms of dyspnea and with normal SpO₂ (t=14.81, P <0.00, t=8.69, P <0.00). The chest X-ray scores of outpatients were mostly lower than those of inpatients (χ²=9.25, P <0.05), and the scores were lower in the improved patients than in the deceased patients (χ²=7.00, P <0.05). The patients with higher chest X-ray scores had a relatively longer hospital stay (H=6.45, P <0.05). The chest radiography severity scores were positively correlated with the clinical severity of COVID-19 (r=0.59, P <0.05). Conclusion  Chest radiography has certain application value in assessing the severity of infection which is helpful in the patient triage during the outbreak of COVID-19 infection

Objective   To investigate the clinical impact of cardiac rehabilitation in patients after percutaneous coronary intervention (PCI). Methods PCI patients with coronary artery disease were retrospectively collected from April 2017 to March 2019. 84 received cardiac rehabilitation. Routine medicine therapy for CHD and health education were given to all patients. In cardiac rehabilitation group, additional 12 times exercise rehabilitation were given for 6 weeks. The cardiac function, MACE, 6MWT, BMI and blood tests were compared before and after treatment. Results  After cardiac rehabilitation for 3 months, the patients in cardiac rehabilitation group had significantly lower levels of BMI, LDL, FPG andLVDdcompared to the values before discharge from hospital (P<0.05), and had significant improvements in LVEF and 6MWT as well. Treatment group patients showedsignificantly more lowering in LDL, FPG and LVDd than the control group patients.The increase inLVEF was also more prominent in treatment group than control group (P<0.05), although both groups showed increase in value. No MACE occurred in either group. Conclusion     Cardiac rehabilitation could reduce the risk factors and improve the cardiac function and activity tolerance inpatients after PCI.

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Objective To compare the clinical effect of acupuncture interventional therapy in acute phase and non-acute phase of facial paralysis. Methods A total of 110 cases of peripheral facial paralysis diagnosed in the Acupuncture Department of KiangWu Hospital from January 2017 to December 2018 were collected. According to the course of the first acupuncture treatment, they were divided into two groups: acute phase and non-acute phase. The acute phase group included acupuncture interventional treatment cases within 7 days of onset, and the non-acute phase group included acupuncture interventional treatment cases within 8 to 30 days of onset. Both groups were treated with acupuncture and flash cupping methods, once a day, 6 times a week as a course of treatment. After 3 consecutive courses of treatment, the recovery rates of the two groups were compared. Results In the acute phase group, 35 cases were cured, 30 cases were markedly effective, 9 cases were effective, and the total effective rate was 100%. In the non-acute phase group, 11 cases were cured, 14 cases were markedly effective, 9 cases were effective, and the total effective rate was 94.44%. The recovery rate and apparent efficiency were significantly better than those in the non-acute phase group, which was statistically significant. Conclusion The curative effect of acupuncture combined with flash cup intervention in the acute phase of peripheral facial paralysis is better than that in the non-acute phase.

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.

在社區的綜合性醫院要做好醫學教育的工作，需要多管齊下的管理，包括建立“分層管理，分類負責”的橫向教學培訓管理架構；完善導師團隊建設；妥善保存個人培訓記錄；不斷更新部門教學檔案等。同時教育也要考慮部門和個人的發展需要而與時地作調整。