Objective To understand the mycoplasma infection situation and resitance to clinical drugs among the patients with urogenital tract infection in Danzhou area .Methods A total of 1 828 patients with urogenital tract infection were selected from this area .The mycoplasma culture ,identification and drug susceptibility integration reagent kit was used for conducting the culture ,i‐dentification and drug susceptibility test of ureaplasma urealyticum (Uu) and mycoplasma hominis (Mh) .And the obtained results were statistically analyzed .Results Among 1 828 cases of urogenital tract infection ,the total positive rate of mycoplasma culture was 35 .01% (640/1 828) ,in which the male mycoplasma infection rate was 25 .94% ,while the female mycoplasma infection rate was 42 .04% .The annual mycoplasma infection rate was 30 .98% in 2014 and 38 .87% in 2015 .Mycoplasma isolated from Danzhou area still maintained a high sensitivity to doxycycline ,minocycline and josamycin .However ,it generated different levels of drug re‐sistance to quinolones antibacterial drugs .Conclusion Mycoplasma infection is common among the patients with urogenital tract in‐fection in this area ,and gradually generates drug resistance .Therefore clinical doctors should rationally select antibacterial drugs ac‐cording to the patient′s condition .

ObjectiveTo compare the effects between laparoscopic cholecystectomy (LC) +laparoscopic common bile duct exploration(LCBDE) and endoscopic sphincterotomy(EST) + laparoscopic cholecystectomy( LC ) for secondary choledocholithiasis.MethodsThe clinical data of patients with secondary choledocholithiasis receiving LC + LCBDE or EST + LC from January 2008 to December 2009 were retrospectively compared. Parameters included operation time, postoperative complication, length of stay,cost of hospitalization. All patients received follow up of 1 year. Enumeration data was analyzed by chisquare test and measurement data was analyzed by t test.ResultsIn this study 87 patients received LC +LCBDE,76 patients received EST + LC.Patients in LC + LCBDE group had shorter hospital stay, less hospital charges and less complications. There was not difference in the procedure success rate and stone remanent rate between the two groups.ConclusionsLC + LCBDE could be used as the first choice for patients with gallstones and secondary choledocholithiasis.

Objective:To investigate the effect of serum cystatin C level on the occurrence and its long-term prognosis of contrast agent-induced acute kidney injury(CI-AKI)after percutaneous coronary intervention(PCI)in elderly patients.Methods:A total of 848 elderly patients(≥60 years)undergoing PCI in our department between Mar 2015 and Dec 2017 were enrolled in a prospective cohort.The CI-AKI was defined as the increase of serum creatinine ≥44.2 μmol/L within 48-72 h after using iodine contrast agent or more than 25 % higher than base level within 48-72 h after PCI.A receiver operating characteristic curve was used to analyze the optimal cut-off value of Cystatin C for predicting CI-AKI after PCI.Patients were divided into 2 groups based on the optimal cut-off value of Cystatin C: the high Cystatin C group(Cystatin C ≥1.3 mg/L, n=178)and the control group(Cystatin C<1.3 mg/L, n=670). The differences in the incidence of CI-AKI after PCI and major adverse cardiac events(MACE)at 1 year follow-up were compared between the two groups.The Cox regression model was further used to analyze the predictors of the long-term prognosis after PCI.Results:Of 848 patients receiving PCI, the incidence of CI-AKI was 9.4%.The incidence of MACE at 1 year after PCI was higher in the high Cystatin C group than in the control group(15.7% vs.9.3%, χ2=6.524, P=0.011). Cox regression analysis confirmed that the high baseline level of Cystatin C was the most independent predictive factor for MACE at 1 year of follow-up( HR=16.244, P<0.001). Conclusions:The high baseline level of Cystatin C(≥1.3 mg/L)is an independent risk factor for CI-AKI and is also the most important predictor for the occurrence of long-term MACE in elderly patients undergoing PCI.

Objective To explore the impact of Enalapril-folic acid tablet on development of contrast-induced nephropathy (CIN) after percutaneous coronary intervention (PCI) in elderly patients with coronary heart diseases(CHD) complicated with mild renal insufficiency. Methods A total of 935 old patients (≥60 years) undergoing selective PCI at our hospital from January 2013 to June 2016 were enrolled in this retrospective study.Based on treatments during the perioperative phase ,the 935 patients were divided into Enalapril-folic acid tablet intervention group (n= 296 ,31.7％ ) ,and other RAS blocker control group with Angiotensin eonverting-enzyme inhibitor (ACEI) or Angiotensin Ⅱreceptor blocker (ARB) (n=639 ,68.3％ ). The levels of serum creatinine for 72 hours after operation were monitored and evaluated.Baseline data and CIN incidence were compared between two groups.The clinical events within 1 month after contrast media application were recorded.Multivariate Logistic regression analysis was used to analyze independent risk factors for CIN after PCI. Results The incidence of CIN after PCI was lower in the intervention group than in the control group with no statistical significance[7.1％ (21/296) vs.11.1％ (71/639) ,χ2 = 3.679 ,P= 0.059].Multivariate regression analysis showed that age (OR=1.103 ,P=0.001) ,hypertension (OR=3.362 ,P=0.017) , and hyper-homocysteinemia (OR=3.528 ,P=0.003) were independent risk factors ,but the treatment with Enalapril-folic acid tablet might be a protective factor for development of CIN after PCI (OR=0.443 ,P=0.042).During the 1-month follow-up ,the rate of recurrent angina pectoris was lower in the intervention group than in the control group ( P < 0.05 ) ,while there were no statistically significant differences between two groups in the rates of rehospitalization due to worsening renal dysfunction ,dialysis/hemofiltration ,acute heart failure ,and new myocardial infarction (all P>0.05). Conclusions The treatment with enalapril-folic acid tablet may prevent the occurrence of CIN after PCI in elderly patients with coronary heart disease and mild renal insufficiency.

Objective:To analyze the factors affecting delayed chemotherapy in children with Burkitt lymphoma (BL) and their influence on prognosis.Methods:Retrospective cohort study. Clinical data of 591 children aged ≤18 years with BL from May 2017 to December 2022 in China Net Childhood Lymphoma (CNCL) was collected. The patients were treated according to the protocol CNCL-BL-2017. According to the clinical characteristics, therapeutic regimen was divided into group A, group B and group C .Based on whether the total chemotherapy time was delayed, patients were divided into two groups: the delayed chemotherapy group and the non-delayed chemotherapy group. Based on the total delayed time of chemotherapy, patients in group C were divided into non-delayed chemotherapy group, 1-7 days delayed group and more than 7 days delayed group. Relationships between delayed chemotherapy and gender, age, tumor lysis syndrome before chemotherapy, bone marrow involvement, disease group (B/C group), serum lactate dehydrogenase (LDH) > 4 times than normal, grade Ⅲ-Ⅳ myelosuppression after chemotherapy, minimal residual disease in the interim assessment, and severe infection (including severe pneumonia, sepsis, meningitis, chickenpox, etc.) were analyzed. Logistic analysis was used to identify the relevant factors. Kaplan-Meier method was used to analyze the patients' survival information. Log-Rank was used for comparison between groups.Results:Among 591 patients, 504 were males and 87 were females, the follow-up time was 34.8 (18.6,50.1) months. The 3-year overall survival (OS) rate was (92.5±1.1)%,and the 3-year event-free survival (EFS) rate was (90.5±1.2)%. Seventy-three (12.4%) patients were in delayed chemotherapy group and 518 (87.6%) patients were in non-delayed chemotherapy group. The reasons for chemotherapy delay included 72 cases (98.6%) of severe infection, 65 cases (89.0%) of bone marrow suppression, 35 cases (47.9%) of organ dysfunction, 22 cases (30.1%) of tumor lysis syndrome,etc. There were 7 cases of chemotherapy delay in group B, which were seen in COPADM (vincristine+cyclophosphamide+prednisone+daunorubicin+methotrexate+intrathecal injection,4 cases) and CYM (methotrexate+cytarabine+intrathecal injection,3 cases) stages. There were 66 cases of chemotherapy delay in group C, which were common in COPADM (28 cases) and CYVE 1 (low dose cytarabine+high dose cytarabine+etoposide+methotrexate, 12 cases) stages. Multinomial Logistic regression analysis showed that the age over 10 years old ( OR=0.54,95% CI 0.30-0.93), tumor lysis syndrome before chemotherapy ( OR=0.48,95% CI 0.27-0.84) and grade Ⅲ-Ⅳ myelosuppression after chemotherapy ( OR=0.55,95% CI 0.33-0.91)were independent risk factors for chemotherapy delay.The 3-year OS rate and the 3-year EFS rate of children with Burkitt lymphoma in the delayed chemotherapy group were lower than those in the non-delayed chemotherapy group ((79.4±4.9)% vs. (94.2±1.1)%, (80.2±4.8)% vs. (92.0±1.2)%,both P<0.05). The 3-year OS rate of the group C with chemotherapy delay >7 days (42 cases) was lower than that of the group with chemotherapy delay of 1-7 days (22 cases) and the non-delay group (399 cases) ((76.7±6.9)% vs. (81.8±8.2)% vs. (92.7±1.3)%, P=0.002).The 3-year OS rate of the chemotherapy delay group (9 cases) in the COP (vincristine+cyclophosphamide+prednisone) phase was lower than that of the non-chemotherapy delay group (454 cases) ((66.7±15.7)% vs. (91.3±1.4)%, P=0.005). Similarly, the 3-year OS rate of the chemotherapy delay group (11 cases) in the COPADM1 phase was lower than that of the non-chemotherapy delay group (452 cases) ((63.6±14.5)% vs. (91.5±1.3)%, P=0.001). Conclusions:The delayed chemotherapy was related to the age over 10 years old, tumor lysis syndrome before chemotherapy and grade Ⅲ-Ⅳ myelosuppression after chemotherapy in pediatric BL. There is a significant relationship between delayed chemotherapy and prognosis of BL in children.