Objective To select the ultrasonic appearances which effect the benign and malignant of thyroid lesions,and to explore the establishment and applications of supersonic evaluation system for thyroid imaging reporting and data system (TI-RADS) classification.Methods The ultrasound images of 1 080 thyroid nodule cases were retrospectively analyzed by Logistic equation,and the ultrasonic appearances were screened to identify benign and malignant of thyroid lesions.All appearances were obtained weights.The TI-RADS classification analysis software was assigned,which was used to analyze 332 patients with thyroid diseases and to verify the diagnostic performance of the TI-RADS classification system.Results Five ultrasonic features were selected into the regression model,including aspect ratio (odds ratio [OR]=3.61),margins (OR=3.83),composition (OR=11.46),echogenicity (OR=14.12),microcalcification foci (OR =48.82).Using objective evaluation system for TI-RADS classification in ultrasound in diagnosing 332 cases,the area under the ROC curve was 0.91 (P＜0.05).Conclusion Relatively the weight and formation of malignant indicators should be more concern than the number of ultrasonic malignant thyroid lesions indicators.The objective evaluation system for TI-RADS classification in ultrasound has relatively high diagnosis capability which established by the methods of Logistic equation.

Objective To study the radiation-protective effect of diallyl disulfide(DADS)in germ cells of male mice. Methods Male mice were whole-body exposured to 4 Gy X-ray irradiation to establish a animal radiation damage model. Testicular histology, sperm motility and sperm deformity rate were observed, protein carbonyl content, malondialdehyde(MDA)and 8-hydroxy deoxyguanosine(8-OHdG)content were tested to assess the degrees of radiation damages of sperm cells and protective effect of DADS. Testicular tissue antioxidant enzymes such as superoxide dismutase (SOD),catalase(CAT),glutathione peroxidase(GSH-px)activity and glutathione(GSH)content were examined. The expression of Nrf2 signal protein was detected to explore the radiation-protective mechanism of DADS. Results Compared with the pure exposure group, the testicular tissue damages in the DADS pretreatment group were milder, sperm motility increased significantly(P< 0.05)and sperm deformity rate decreased(P< 0.05), and the protein carbonyl content, MDA and 8-OHdG levels significantly reduced(P< 0.05). The antioxidant indexes of SOD, CAT, GSH-px and GSH were markedly improved(P< 0.05),and the expression of Nrf2 was dramatically enhanced. Conclusions DADS has a protective effect on acute radiation injury in germ cells of male mice by means of anti-oxidative ability.

Objective To investigate the effect of anti-inlammation and antiulcer in rats of Erkou powder and Erkou film.Methods The rats were divided into six groups according to random number table:control group,Guilin watermelon frost group,Erkou powder low dose group,Erkou powder high dose group,Erkou film low dose group and Erkou film high dose group,each with 12.Guilin watermelon frost group was given 0.7 g/kg,Ekou powder low dose group and high dose group were respectively given 14.56,29.12 mg/kg,Erkou film low dose group and high dose group were given 19.25,38.5 mg/kg by intragastric administration.Control group was given the same volume of normal sodium by intragastric administration.To observe the inhibitory actions of paw edema induced by carrageenan of big rats,the increase of abdominal cavity capillary permeability in rats due to acetic acid and effect of oral ulcer healing on aceti acid-cautery type oral ulcer rats.Results Compared with the control group,1 h and 3 h after injection of 1％ carrageenan,the paw edema of rats were significantly reduced in Guilin watermelon frost group,Erkou powder high dose group and Erkou film high dose group (P＜0.01 or P＜0.05).Compared with the control group,the absorbance (0.62 ± 0.08,0.62 ± 0.17,0.64 ± 0.15 vs.0.82 ± 0.24) of peritoneal lavage fluid in Guilin watermelon frost group,Erkou powder high dose group and Erkou film high dose group were significantly decreased (P＜0.05).Compared with the control group,the diameter of ulcer area (3.16 ± 0.68 mm,3.12 ± 0.45 mm,3.22 ± 0.59 mm,3.23 ± 0.70 mm vs.3.90 ± 0.72 mm) of rat in Guilin watermelon frost group,Erkou powder low dose group,Erkou powder high dose group and Erkou film high dose group were significantly decreased (P＜0.01 or P＜0.05) in the third day.Compared with the control group,the diameter of ulcer area (1.93 ± 0.49 mm,1.39 ± 0.42 mm,2.01 ± 0.45 mm,1.98 ± 0.61 mm vs.2.69 ± 0.74 mm) of rat in Guilin watermelon frost group,Erkou powder low dose group,Erkou powder high dose group and Erkou film high dose group were significantly decreased (P＜0.01 or P＜0.05) in the fifth day.Compared with the control group,the healing time of oral ulcer (7.20 ± 0.67 d,6.64 ± 0.67 d,7.27 ± 0.90 d,7.27 ± 0.90 d vs.8.37 ± 1.12 d) of rat in Guilin watermelon frost group,Erkou powder low dose group,Erkou powder high dose group and Erkou film high dose group were significantly shortened.Conclusions Both Erkou plastics and Erkou powder have the effects of resisting inflammation and promoting the healing of oral ulcers.

Objective:To evaluate the efficacy of quantitative fecal immunochemical test (fecal immunochemical test, FIT) in the screening of colorectal cancer and precancerous lesions.Methods:47 243 patients who underwent quantitative FIT screening for colorectal cancer in the Health Management Department of Shenzhen People′s Hospital from January 2019 to October 2020 were enrolled as subjects. Colonoscopy was recommended for patients with positive quantitative FIT. A follow-up was done after one year to compare the results of the quantitative FIT positive group and the negative group after colonoscopy. Data were adjusted by propensity score matching method and a receiver operating characteristic curve ( ROC) was established to evaluate the diagnostic effect of quantitative FIT combined with colonoscopy on colorectal cancer and precancerous lesions. Results:A hemoglobin concentration>100 μg/L was set as a positive threshold. There were 2 472 positive cases of quantitative FIT, and the positive rate was 5.23%. After one-year follow-up, 284 patients had completed colonoscopy; the colonoscopy compliance was 11.49%. Of the negative population, 1 493 patients selected colonoscopy within one year. Compared with the results of gold standard colonoscopy, the sensitivity and specificity of quantitative FIT for screening for advanced adenoma and cancer were 26.53% and 86.54%, respectively. The sensitivity for colorectal cancer screening was 94.44% and screening for advanced adenoma was 22.77%. After propensity score matching, there were 256 FIT positive patients and 705 FIT negative patients. Colorectal cancer was the outcome variable, while FIT combined with colonoscopy, age combined with colonoscopy, and FIT combined with age combined with colonoscopy were the diagnostic indicators. The areas under the curve were 0.841(95% CI:0.778-0.904), 0.677(95% CI: 0.535-0.820), and 0.882(95% CI:0.807-0.958), respectively. Conclusion:Quantitative FIT has a high susceptibility to opportunistic screening for colorectal cancer, and a low sensitivity to advanced adenoma. At the same time, quantitative FIT combined with colonoscopy has a good diagnostic accuracy for colorectal cancer, which is better than the effect of using age as a cut-off point for colonoscopy. Quantitative FIT combined with age and colonoscopy has the best effect on screening for colorectal cancer. Quantitative FIT has a high sensitivity to colorectal cancer and a low sensitivity to advanced adenoma.

Objective:To determine the effect of short-term high protein and low carbohydrate diet interventions on weight-related metabolic indexes in obese patients with hypertension.Methods:A retrospective study was conducted on 200 obese patients with hypertension who underwent physical examination and weight management in Shenzhen People′s Hospital from May 2015 to December 2019. Among them, 100 patients were given routine diet education (control group), and 100 patients were given high protein and low carbohydrate diet interventions (experimental group). After eight weeks, changes in body weight, body mass index, blood pressure, fasting blood glucose, blood lipid, and medical expenses were compared. T-test and Wilcoxon rank sum test were used to compare the differences between the two groups before and after the interventions. When P<0.05, it was considered significantly different. Results:After the intervention, body weight, body mass index, systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol, triglycerides, and medical expenses of the experimental group decreased [79.0 (74.0, 85.0) vs 70.0 (66.0, 72.0) kg; 28.5 (26.8, 29.5) vs 26.1 (25.4, 27.7) kg/m 2; 168.0 (162.0, 178.0) vs 160.0 (154.0, 166.0) mmHg(1 mmHg=0.133 kPa); 101.0 (98.0, 108.0) vs 97.0 (90.5, 98.0) mmHg; 5.25 (4.80, 5.52) vs 4.95 (4.70, 5.20) mmol/L; 5.80 (5.27, 6.40) vs 5.40 (5.00, 5.80) mmol/L; 1.25 (0.90, 1.50) vs 1.10 (0.90, 1.20) mmol/L;(669.6±21.6) vs (646.4±21.3) CNY, respectively] (all P<0.05). The body weight of the control group decreased [78.0(73.3, 83.0) vs 79.5(74.5, 85.0) kg] ( P<0.05). The control group′s body mass index, systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol, triglycerides, and medical expenses had no significant changes (all P>0.05). Conclusion:Short-term, high protein, low carbohydrate diet intervention can effectively reduce weight, hypertension, fasting blood glucose, total cholesterol, triglycerides, and medical expenses in obese patients with hypertension.

Objective To evaluate the efficacy of the combination of gynecologic imaging reporting and data system (GI-RADS) uhrasonographic stratification and 3D contrast-enhanced ultrasonography (3D-CEUS) in identifying malignant lesions from benign ovarian masses.Methods Both of 2D ultrasound (2D-US) and 3D-CEUS were performed on 102 patients with ovarian masses.The perfusion characteristics of ovarian masses were observed with 3D-CEUS,and the 2D-US features of ovarian masses were analyzed based on GI-RADS.Simple and multiple Logistic regression analysis were used to investigate whether the independent risk predictors in differential diagnosis of benign and malignant ovarian could be confirmed.In addition,ROC curves were drawn.The diagnostic efficacy of GI-RADS combined with 3D-CEUS scoring system was evaluated and compared with that of only GI-RADS.Results Simple and multiple Logistic regression analysis confirmed that there were 8 independent predictors of malignant masses,including large papillary projections (≥7 mm),separated or wall thickness ≥3 mm,central blood flow,the proportion of solid part ≥50％,combination of ascites,high level enhancement,uneven distribution of contrast media in enhanced solid part and the vascular with characteristics as dense,tortuous and anfractuous.When using 4 points as the cut-off,the area under the curve (AUC) of GI-RADS combined with 3D-CEUS scoring system in identifying malignant ovarian masses was 0.969,higher than that of only GI-RADS (0.839;Z=1.64,P=0.029).Furthermore,the scoring system showed higher sensitivity,specificity,positive predictive value,negative predictive value and accuracy (all P＜0.001).Conclusion The combination of GI-RADS with 3D-CEUS can be more effective to distinguish malignant lesions from benign ovarian masses.

Objective To investigate the distribution and antimicrobial resistance profiles of the common pathogens isolated from urine from 2015 to 2021 in the CHINET Antimicrobial Resistance Surveillance Program.Methods The bacterial strains were isolated from urine and identified routinely in 51 hospitals across China in the CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021.Antimicrobial susceptibility was determined by Kirby-Bauer method,automatic microbiological analysis system and E-test according to the unified protocol.Results A total of 261 893 nonduplicate strains were isolated from urine specimen from 2015 to 2021,of which gram-positive bacteria accounted for 23.8％(62 219/261 893),and gram-negative bacteria 76.2％(199 674/261 893).The most common species were E.coli(46.7％),E.faecium(10.4％),K.pneumoniae(9.8％),E.faecalis(8.7％),P.mirabilis(3.5％),P.aeruginosa(3.4％),SS.agalactiae(2.6％),and E.cloacae(2.1％).The strains were more frequently isolated from inpatients versus outpatients and emergency patients,from females versus males,and from adults versus children.The prevalence of ESBLs-producing strains in E.coli,K.pneumoniae and P.mirabilis was 53.2％,52.8％and 37.0％,respectively.The prevalence of carbapenem-resistant strains in E.coli,K.pneumoniae,P.aeruginosa and A.baumannii was 1.7％,18.5％,16.4％,and 40.3％,respectively.Lower than 10％of the E.faecalis isolates were resistant to ampicillin,nitrofurantoin,linezolid,vancomycin,teicoplanin and fosfomycin.More than 90％of the E.faecium isolates were ressitant to ampicillin,levofloxacin and erythromycin.The percentage of strains resistant to vancomycin,linezolid or teicoplanin was＜2％.The E.coli,K.pneumoniae,P.aeruginosa and A.baumannii strains isolated from ICU inpatients showed significantly higher resistance rates than the corresponding strains isolated from outpatients and non-ICU inpatients.Conclusions E.coli,Enterococcus and K.pneumoniae are the most common pathogens in urinary tract infection.The bacterial species and antimicrobial resistance of urinary isolates vary with different populations.More attention should be paid to antimicrobial resistance surveillance and reduce the irrational use of antimicrobial agents.

Objective To understand the distribution and changing resistance profiles of clinical isolates of Enterococcus in hospitals across China from 2015 to 2021.Methods Antimicrobial susceptibility testing was conducted for the clinical isolates of Enterococcus according to the unified protocol of CHINET program by automated systems,Kirby-Bauer method,or E-test strip.The results were interpreted according to the Clinical & Laboratory Standards Institute(CLSI)breakpoints in 2021.WHONET 5.6 software was used for statistical analysis.Results A total of 124 565 strains of Enterococcus were isolated during the 7-year period,mainly including Enterococcus faecalis(50.7％)and Enterococcus faecalis(41.5％).The strains were mainly isolated from urinary tract specimens(46.9％±2.6％),and primarily from the patients in the department of internal medicine,surgery and ICU.E.faecium and E.faecalis strains showed low level resistance rate to vancomycin,teicoplanin and linezolid(≤3.6％).The prevalence of vancomycin-resistant E.faecalis and E.faecium was 0.1％and 1.3％,respectively.The prevalence of linezolid-resistant E.faecalis increased from 0.7％in 2015 to 3.4％in 2021,while the prevalence of linezolid-resistant E.faecium was 0.3％.Conclusions The clinical isolates of Enterococcus were still highly susceptible to vancomycin,teicoplanin,and linezolid,evidenced by a low resistance rate.However,the prevalence of linezolid-resistant E.faecalis was increasing during the 7-year period.It is necessary to strengthen antimicrobial resistance surveillance to effectively identify the emergence of antibiotic-resistant bacteria and curb the spread of resistant pathogens.

Objective To examine the changing antimicrobial resistance profile of Enterobacter spp.isolates in 53 hospitals across China from 2015 t0 2021.Methods The clinical isolates of Enterobacter spp.were collected from 53 hospitals across China during 2015-2021 and tested for antimicrobial susceptibility using Kirby-Bauer method or automated testing systems according to the CHINET unified protocol.The results were interpreted according to the breakpoints issued by the Clinical & Laboratory Standards Institute(CLSI)in 2021(M100 31st edition)and analyzed with WHONET 5.6 software.Results A total of 37 966 Enterobacter strains were isolated from 2015 to 2021.The proportion of Enterobacter isolates among all clinical isolates showed a fluctuating trend over the 7-year period,overall 2.5％in all clinical isolates amd 5.7％in Enterobacterale strains.The most frequently isolated Enterobacter species was Enterobacter cloacae,accounting for 93.7％(35 571/37 966).The strains were mainly isolated from respiratory specimens(44.4±4.6)％,followed by secretions/pus(16.4±2.3)％and urine(16.0±0.9)％.The strains from respiratory samples decreased slightly,while those from sterile body fluids increased over the 7-year period.The Enterobacter strains were mainly isolated from inpatients(92.9％),and only(7.1±0.8)％of the strains were isolated from outpatients and emergency patients.The patients in surgical wards contributed the highest number of isolates(24.4±2.9)％compared to the inpatients in any other departement.Overall,≤ 7.9％of the E.cloacae strains were resistant to amikacin,tigecycline,polymyxin B,imipenem or meropenem,while ≤5.6％of the Enterobacter asburiae strains were resistant to these antimicrobial agents.E.asburiae showed higher resistance rate to polymyxin B than E.cloacae(19.7％vs 3.9％).Overall,≤8.1％of the Enterobacter gergoviae strains were resistant to tigecycline,amikacin,meropenem,or imipenem,while 10.5％of these strains were resistant to polycolistin B.The overall prevalence of carbapenem-resistant Enterobacter was 10.0％over the 7-year period,but showing an upward trend.The resistance profiles of Enterobacter isolates varied with the department from which they were isolated and whether the patient is an adult or a child.The prevalence of carbapenem-resistant E.cloacae was the highest in the E.cloacae isolates from ICU patients.Conclusions The results of the CHINET Antimicrobial Resistance Surveillance Program indicate that the proportion of Enterobacter strains in all clinical isolates fluctuates slightly over the 7-year period from 2015 to 2021.The Enterobacter strains showed increasing resistance to multiple antimicrobial drugs,especially carbapenems over the 7-year period.

Objective To understand the changing distribution and antimicrobial resistance profiles of Proteus,Morganella and Providencia in hospitals across China from January 1,2015 to December 31,2021 in the CHINET Antimicrobial Resistance Surveillance Program.Methods Antimicrobial susceptibility testing was carried out following the unified CHINET protocol.The results were interpreted in accordance with the breakpoints in the 2021 Clinical & Laboratory Standards Institute(CLSI)M100(31 st Edition).Results A total of 32 433 Enterobacterales strains were isolated during the 7-year period,including 24 160 strains of Proteus,6 704 strains of Morganella,and 1 569 strains of Providencia.The overall number of these Enterobacterales isolates increased significantly over the 7-year period.The top 3 specimen source of these strains were urine,lower respiratory tract specimens,and wound secretions.Proteus,Morganella,and Providencia isolates showed lower resistance rates to amikacin,meropenem,cefoxitin,cefepime,cefoperazone-sulbactam,and piperacillin-tazobactam.For most of the antibiotics tested,less than 10％of the Proteus and Morganella strains were resistant,while less than 20％of the Providencia strains were resistant.The prevalence of carbapenem-resistant Enterobacterales(CRE)was 1.4％in Proteus isolates,1.9％in Morganella isolates,and 15.6％in Providencia isolates.Conclusions The overall number of clinical isolates of Proteus,Morganella and Providencia increased significantly in the 7-year period from 2015 to 2021.The prevalence of CRE strains also increased.More attention should be paid to antimicrobial resistance surveillance and rational antibiotic use so as to prevent the emergence and increase of antimicrobial resistance.