Objective To investigate the efficiency of interventional treatment and intramuscular injection of methotrexate for the treatment uterine scar pregnancy.Methods 22 patients with uterine scar pregnancy were divided into two groups,group A (n =12),transvaginal color Doppler ultrasound to guide percutaneous interventional treatment;group B( n =10) intramuscular injection of methotrexate treatment.Mass size and β-HCG preoperation and 4 days,7 days,1 month postoperation were evalutaed respectively.Results The cure rate of interventional treatment and intramuscular injection of methotrexate for the treatment uterine scar pregnancy were 83.3％ and 40.0％ respectively.And the difference was statistically significant ( P ＜ 0.05 ).Conclusion Compared with intramuscular methotrexate treatment of uterine scar pregnancy,guided by vaginal ultrasonography involved the injection of methotrexate is more effective and have important clinical significance.

Objective The purpose of this study was to assess the value of prenatal ultrasound diagnosis for fetal ear auricle malformations.Methods The coronal and sagittal planes of fetuses ears were obtained prospectively in 6239 singleton fetuses in the First Affiliated Hospital of Shantou University Medical College for the period from 2012 February to 2015 December,the ultrasound images and pregnancy outcomes were analyzed in 11 cases of fetuses ear auricle malformations diagnosed prenatally.Results Eleven Cases of fetuses ear auricle malformations include with 7 cases of microtia,3 cases of low-set ears and 1 case of anotia.Eleven cases were combined with other structural malformations were as followings,3cases with craniocerebral congenital malformation,5 cases with dentofacial deformity,5 cases with malformation of heart,3 cases with limb deformity.Cordocentesis was performed in 7 cases among which 6 with abnormal karyotype,including 2 cases of trisomy 21,2 cases of trisomy 13,2 cases of trisomy 18,1 case of 22ql 1 abnormalities.Compared with the postpartum facial examination,prenatal ultrasound correctly diagnosed 10 cases of fetal ear auricle malformations,missed diagnosis 1 case of microtia.Conlusions Fetus with ear auricle abnormalities have characteristic prenatal ultrasound imaging;prenatal ultrasonography can provide reliable information in the diagnosis of this disease.This study suggests that antenatal ear auricle length measurements might be a promising sonographic screening method for the detection of abnormal karyotype in pregnancy.

Objective To summarize the clinical experience of interspineter resection in treating ultra-lower rectal tumor. Methods Twenty-six ultra-lower rectal tumor cases (24 cases of rectal cancer, 2 cases of giant villous adenoma) without extrasphincter involvement underwent total mesoreetal excision and interspineter resection. Partial, subtotal or total innerspineter resection was performed respectively for patients in which the tumor lower margin was over 2 cm, between 1 -2 cm, and less than 1.0 cm above thedentate line respectively. Alimentary tract continuity was constructed by end to end anastomsis of the colon and anus. Results The lower margin of tumor in 26 patients was within 0 - 3 cm above the dentate line.The pathology was highly differentiated in 6 cases and medium differentiated in 16 cases, papillary carcinoma in 2 cases, giant villous adenoma in 2 cases. There were 11 cases of stage Ⅰ , 8 of stage Ⅱ A, 4 of stage Ⅲ A, and 1 of stage Ⅲ B according to pTNM system; 8 cases of T1, 15 of T2, and 1 of T3 according to T stage criteria. There was no mortality nor major complications. Two cases suffered from anastomotic stricture. The stool seepage was common at early stage after surgery, with immediately postoperative daily defecation of 3 -10, and one year later, most patients were able to hold back the defecation impulse for more than 5 min, and have daily defecation of 0. 5 to 4 times. Occasional seepage was reported in one patient with total innersphincter resection. The average postoperative follow up was 28 months. One recurrence was found on the 5th month, one suffered from liver metastasis in the 10 month, and one died of cardiac arrest in 26 month. Conclusion To those patients with very lower rectal cancer restricted within rectal wall,interspincter resection fulfils curative purpose while preserving the anal function.

Objective To evaluate combined posterior excision of anus and modified Block′s repair for the treatment of constipation of anterior rectocele. MethodsClinical data of 82 patients treated by combined posterior resection of anus and modified Block′s technique in our hospital between Oct 2002 and May 2004 were retrospectively analyzed.ResultsThe overall effective rate was 96%, cure rate of 67%, significant improvement of 18%, and improvement of 11%. The mean hospital stay was 18.8?4.8 days, and no postoperative complication. Follow-up from 1 to 4 years found no recurrence of constipation and loss of control of evacuation.Conclusions This procedure is effective for the treatment of constipation of anterior rectocele type, and it prevents stricture of anus in patients with a relative narrow lumen of the anus.

Objective: To investigate risk factors and epidemiological characteristics of bacillary dysentery outbreaks in three schools, and to provide scientific basis for the prevention and control of the epidemic in the future. Methods: Case definition was established. All suspected, possible and confirmed cases of all students and faculty members from 3 schools (A, B, C) were selected for epidemiological investigation. Control group was used for case-control analysis, and relevant samples were collected for laboratory testing. Results: A total of 132 cases were found in 3 schools, all of which were from students, with the incidence rate of 17.74%. The morbidity in kindergarten A was 20.00%, in center primary school B it was 21.74%, and in junior middle school C it was 11.61%. Cohort studies and casecontrol studies suggested that schools are exposed places and that washing hands with raw water in schools was possible risk factor [OR(95%CI) =4.50(1.01-20.11)]. Nine stool samples were tested in laboratory, among which 8 were positive for Shigella(88.99%), and Shigella was detected in the end nodes of school s pipeline network, the water samples from canteen bucket, and the floor drains of sewer pipe. Conclusion The bacillary dysentery outbreaks in 3 schools was caused by Shigella, which may be due to fecal contamination of domestic water in 3 schools before the start of the school year. It is suggested to strengthen the management of centralized water supply and construction in rural areas, intensify the supervision at all levels, and sanitation and disinfection before school opens at all levels.

Objective To assess the clinical value of lung ultrasound (LUS) B-lines in diagnosis of rheumatoid arthritis (RA) associated interstitial lung diseases (RA-ILD).Methods Forty-five consecutive patients with RA who underwent a high resolution computed tomography (HRCT) scan of the chest,were also examined by LUS for detection of B-lines(within 1 month independently in all patients).The B-lines score was obtained by summing the number of total 50 inter-costal spaces (ICSs) of chest wall.Pulmonary fibrosis was quantified by HRCT as previously described by the 30-point Warrick score.Results B-lines score significantly correlated with the Warrick score [(r=0.778,95％CI(0.627,0.872),P＜0.05].Receiver operating characteristic (ROC) curve confirmed that B-lines cut-off point 77[sensitivity of 100％,specificity of 64.3％ respectively,area under curve [AUC] =0.86,95％CI(0.724,0.945)] and 108[sensitivity of 90％,specificity of 88.6％ respectively,AUC=0.879,95％CI(0.747,0.957)] had an optimal power to discriminate mild (Warrick score＜8) and severe fibrosis (Warrick score＞15):Conclusion The data confirm that LUS is a useful technique to identify ILD in RA.In RA-ILD,B-lines correlate significantly with HRCT and are able to identify mild and severe degree of fibrosis.LUS is a promising non-invasive and non-ionizing strategy for screening RA-ILD.

Objective To learn the diagnosis and treatment of brucellosis patients in Suide County of Shaanxi Province in 2015,and to provide a scientific basis for making accurate prevention and control measures.Methods All the cases diagnosed as brucellosis in Suide County from January 1 to December 31 in 2015 and lived in this county were retrospectively investigated by case questionnaire survey,including basic information,medical procedures,and epidemiological contacts.Descriptive statistical analysis was performed using SPSS 18.0 software.Results In 2015,75 cases of brucellosis were diagnosed in Suide County,75 questionnaires were distributed,with 53 completed questionnaires returned.The average age of respondents was (49 ± 14) years old,of which 84.9％ (45/53) were male and 94.3％ (50/53) were farmers,except one case was actively monitored by Suide County Centre for Disease Control and Prevention then treated,the rest of the patients were treated after the onset of the disease.Of the 52 patients,one patient was diagnosed after one visit,accounting for 25.0％ (13/52);one patient was diagnosed after at least 4 visits,accounting for 3.8％ (2/52).The cumulative diagnosis rate at provincial-level hospitals was 1/3 and that at disease prevention and control institutions was 92.7％ (51/55),there were no confirmed cases in municipal hospitals,county hospitals,township hospitals,village clinics and individual clinics.For the first reason to see a doctor,65.4％ (34/52) of the patients were fever or accompanied by sweating,fatigue,arthralgia and waist and leg pain.The medians from onset to treatment between the first diagnosis,and 2,3,4 visits were 15,18,27,45 days,respectively;the median from onset to diagnosis was 21 days,ranging from 2 to 182 days.Totally 84.9％ (45/53) patients had a history of exposure to animals,of which 97.8％ (44/45) had contacted the sheep.Conclusions The cases in Suide County are mainly adult male farmers,and the diagnosis rate at hospitals below municipal level is low.It is recommended to strengthen the health intervention of high-risk groups and improve the level of diagnosis and treatment of primary medical staff.

Objective:To investigate the diagnostic performance of a new artificial intelligence (AI) model incorporating SAM-YOLOV 5 deep learning network and image processing techniques for Breast Imaging Reporting and Data System (BI-RADS) 4 category breast masses in dynamic ultrasound classification.Methods:A total of 530 pathologically proven breast lesions of BI-RADS category 4 in 458 patients were retrospectively collected from May 2019 to June 2023 at the First Affiliated Hospital of Shantou University Medical College. The model was trained and tested at ratio of 7∶3, the area under the ROC curve (AUC), sensitivity, specificity, positive predictive value and negative predictive value of the model were determined. Firstly, the test results of the model were compared with a single static image, then, compared with the three conventional deep learning networks as well as senior and junior radiologists. The diagnostic efficiency of the new model in BI-RADS categories 4a, 4b, and 4c masses were analyzed.Results:The AUC, sensitivity, specificity, positive predictive value and negative predictive value of the new model based on dynamic ultrasound video were higher than those using a single ultrasound static imaging (all P<0.05). Based on dynamic ultrasound video, the AUC, sensitivity, specificity, positive predictive value and negative predictive value of the new model were significantly higher than those of YOLOV 5, VGG 16, Resnet 50 and the junior group (all P<0.05), lower than the senior group (just specificity and negative predictive value, P<0.05). The diagnostic efficiency of new model for BI-RADS category 4b masses was the lowest. Conclusions:Based on the SAM-YOLOV 5 deep learning network and image processing techniques, the new model has a high diagnostic value for breast mass dynamic ultrasound classification and is expected to be used in assisting clinical diagnosis.

Objective: To understand the dynamics and epidemiological characteristics of hand, foot and mouth disease (HFMD) in Shaanxi province during 2009-2018 and provide evidence for prevention and control of HFMD. Methods: Information on HFMD was collected from the Chinese Disease Prevention and Control Information System in Shaanxi Province during 2009-2018 and was analyzed by descriptive, dynamic geometric series averaging and circular distribution methods. Results: The annual average incidence rate of HFMD was 140.04/100 000 in Shaanxi province during 2009-2018. The highest incidence rates were seen in age groups as 1-year olds (3 494.24/100 000), 2-year olds (2 734.79/100 000) and 3-year olds (2 608.58/100 000). The highest reported mortality rates appeared in: 1-year olds as 1.42/100 000, 2-year olds as 0.77/100 000) and 0-year olds (0.53/100 000). The incidence rate increased most rapidly in the 1-year olds and the 0-year olds groups. The top three incidence rates were reported in Xi’an (251.34/100 000), Weinan (161.21/100 000) and Xianyang (123.73/100 000) cities in Guanzhong area of Shaanxi province. In the whole province, incidence rate was on the rise, and the average increases of incidence rates were all greater than zero in these cities. The proportion of severe cases in most cities somehow declined. Results from the circular distribution method estimated that the peak incidence would appear in April 10-11 each year, and the high incidence season was from April to July. In 2018, the composition of enterviruses (EV) 71 was 26.47% (1 303/4 922). In 2014 to 2018, the proportion of Coxsackie virus A16 (Cox A16) was between 20.06%(753/3 753) and 23.08% (855/3 705). The proportions of other EVs increased from 6.09% (14/230) to 51.91% (2 555/4 922) during 2009-2018. Conclusions The overall incidence rate of HFMD was increasing, with high risk population appeared in children under 3 year olds, in Shaanxi province during 2009-2018. However, both mortality and fatality rates were declining, with severe cases also showing a downward trend in most of the areas. Composition of pathogens was changing over time.

Objective:By analyzed the transmission patterns of 4 out of the 51 COVID-19 cluster cases in Shaanxi province to provide evidences for the COVID-19 control and prevention.Methods:The epidemiological data of RT-PCR test-confirmed COVID-19 cases were collected. Transmission chain was drawn and the transmission process was analyzed.Results:Cluster case 1 contained 13 cases and was caused by a family of 5 who traveled by car to Wuhan and returned to Shaanxi. Cluster case 2 had 5cases and caused by initial patient who participated family get-together right after back from Wuhan while under incubation period. Cluster case 3 contained 10 cases and could be defined as nosocomial infection. Cluster case 4 contained 4 cases and occurred in work place.Conclusion:Higher contact frequency and smaller places were more likely to cause a small-scale COVID-19 cluster outbreak, with potential longer incubation period. COVID-19 control strategies should turn the attention to infection prevention and control in crowded places, management of enterprise resumption and prevention of nosocomial infection.