Objective To understand the situation of prevention and control knowledge of echinococcosis in students in Qin?ghai Province,so as to provide an evidence for effective prevention and control of echinococcosis. Methods The students of Grade Four or above were randomly selected with the multi?stage stratified cluster sampling method and investigated with the questionnaire about echinococcosis in Qinghai Province. Results Totally 23 600 students were selected and surveyed,with the pass rate of 66.0%(15 566 cases). The pass rates of the male and female students were 65.1%(7 947 cases)and 66.9%(7 619 cases)respectively,and the difference was significant(χ2=8.454,P<0.01). The difference of pass rates among different dis?tricts of Qinghai Province was statistically significant(χ2=3 848.619,P<0.01). Conclusion The general aware rate of echino?coccosis knowledge in students is not high in Qinghai Province,and therefore,it is necessary to enhance the health education, especially for students in pasturing areas.

Objective To understand the epidemic status of alveolar echinococcosis in Tibetan children in south Qinghai Province. Methods The imageology and serology methods were applied to investigate the epidemic status of alveolar echinococ?cosis of elementary school students in Yushu and Guoluo prefectures. Results Totally 19 629 children were investigated by the portable B ultrasound and 221 children were diagnosed as alveolar echinococcosis with the morbidity of 1.13%. Totally 9 888 were investigated by the indirect ELISA,and the positive rate of serum tests was 12.59%(190/9 888). The total morbidity of al?veolar echinococcosis of children in Yushu Prefecture was 0.42%(31/7 454)and it was 1.57%(190/12 175)in Guoluo Prefec?ture and there was a significant difference between them(χ2=53.42,P<0.005). The sero?positive rates of children in Yushu and Guoluo were 4.26%(302/7 081)and 18.56%(1 835/9 888),respectively(χ2 =765.77,P<0.005). The counties with the highest prevalence of alveolar echinococcosis in children were Dari County (4.31%,106/2 461) and Banma County (1.92%,26/1 351)of Guoluo Prefecture ,and Chengduo County(1.11%,18/1 612)of Yushu Prefecture. The total morbid?ity rates of alveolar echinococcosis of male and female children were 0.91%(91/9 954)and 1.34%(130/12 175)respective?ly(χ2=7.35,P<0.005). The total sero?positive rates of alveolar echinococcosis of male and female children were 12.10%(1 037/8 568)and 13.09%(1 100/8 406)respectively(χ2=3.63,P>0.05). The total morbidity of alveolar echinococcosis of children in different age groups was from 1.00%to 1.13%,and there was no significant difference among the age groups(χ2=2.73,P>0.05). The P1a type,P1b type and P2 type accounted for 67.76%(145/214),10.75%(23/214)and 16.36%(35/214)respectively among the alveolar echinococcosis patients. The diameters of nidus of 87.38%(187/214)patients were less than 5 cm,and 2.80%(6/214)were more than 10 cm. Conclusions The epidemic status of alveolar echinococcosis of Tibetan children in south Qinghai Province is serious,but most of the patients were at early stage of the disease. The screening work of al?veolar echinococcosis should be strengthened in Tibetan children,so as to perform the early diagnosis and treatment.

Objective To understand the situation of prevention and control knowledge of echinococcosis in people,and analyze the influencing factors of prevention and control knowledge of echinococcosis,so as to provide efficient and targeted evidence for taking intervention measures against echinococcosis.Methods All the districts (counties) in agricultural and pastoral area-based cities (zhous) in Qinghai Province were selected,3 townships were selected in each district (county),and 100 residents were randomly selected in each township via the stratified random sampling method.In each district (county),students of Grade Four or higher were randomly selected via the multi-stage stratified cluster sampling method,they were all investigated through a questionnaire survey about echinococcosis in Qinghai Province in 2012-2014.The influencing factors of prevention and control knowledge of echinococcosis were analyzed using Logistic regression analysis,including age,gender and district.Results Totally 11 959 residents and 23 600 students were selected and surveyed,and the qualified rate of residents and students in prevention and control knowledge of echinococcosis was 62.4％ (7 464 cases) and 66.0％(15 566 cases),respectively,and the difference was statistically significant (x2 =43.695,P ＜ 0.01).The aware rate of echinococcosis knowledge between residents and students was significantly different (x2 =113.680,60.712,1 204.943,273.296,P ＜ 0.01) except the question "washing hands before eating".Logisitic regression analysis showed that the main factors influencing the qualified rate of echinococcosis of residents were age (OR =0.989,95％CI:0.986-0.991) and district (compared with Huangnan Zhou,Haidong City OR =3.478,95％CI:2.978-4.063;Haixi Zhou OR =10.284,95％CI:8.578-12.330;Hainan Zhou OR =7.750,95％CI:6.468-9.286;Haibei Zhou OR =11.056,95％CI:9.089-13.448;Guoluo Zhou OR =7.309,95％CI:6.132-8.713;and Yushu Zhou OR =0.319,95％CI:0.258-0.393);and the main factors influencing the qualified rate of echinococcosis of students were age (OR =0.981,95％CI:0.964-0.998),gender (OR =1.103,95％CI:1.040-1.170) and district (compared with Huangnan Zhou,Xi'ning City OR =5.428,95％CI:4.823-6.109;Haidong City OR =3.860,95％CI:3.437-4.334;Haixi Zhou OR =6.557,95％CI:5.750-7.477;Hainan Zhou OR =2.757,95％CI:2.444-3.112;Haibei Zhou OR =9.968,95％CI:8.498-11.692;Guoluo Zhou OR =4.306,95％CI:3.653-5.075;and Yushu Zhou OR =0.616,95％CI:0.545-0.695).Conclusions The general aware rate of echinococcosis knowledge in people is not high in Qinghai Province.The main factors that have influenced the qualified rate of echinococcosis knowledge of residents are age and district,and of students are age,gender and district.It is necessary to implement the targeted intervention measures to improve mastering level of prevention and control knowledge of echinococcosis of people in Qinghai Province.

Objective:To investigate the treatment, safety and prognosis of advanced non-small cell lung cancer patients with leptomeningeal metastasis and performance status score more than 3.Methods:The clinical data of 6 NSCLC patients with leptomeningeal metastasis admitted to the People's Hospital of Wuhan University from November 2016 to September 2018 were analyzed retrospectively. The curative effect and adverse reactions were observed, and the prognosis was analyzed.Results:There were 5 females and 1 male among 6 patients. The median age was 57 years old (46-74 years old). All 6 patients were diagnosed as stage Ⅳ lung adenocarcinoma. There were 3 patients with epidermal growth factor receptor (EGFR) exon 21 mutation, 2 patients with exon 19 mutation and one with anaplastic lymphoma kinase (ALK) fusion mutation. The time window of leptomeningeal metastasis occurred after the progression of adenocarcinoma of lung: 3 cases was more than 12 months, the other 3 cases was less than 12 months, and the average was 20.3 month. Performance status score was more than 3 when leptomeningeal metastasis occurred. The brain magnetic resonance imaging of 6 patients showed linear enhancement of leptomeningeal, cancer cells were found in cerebrospinal fluid in one case, 4 cases were treated with a combination of bevacizumab and EGFR-tyrosine kinase inhibitor (EGFR-TKI), 1 case was treated with oral administration of EGFR-TKI, 1 case was treated with oral administration of EGFR-TKI combined with temozolomide. The median overall survival (mOS) was 9 months (2-13 months), and the median progression free survival was 6 months (2-11 months).Conclusion:Lung adenocarcinoma may be prone to leptomeningeal metastasis; for NSCLC patients with leptomeningeal metastasis and performance status score more than 3, a combination of EGFR-TKI and bevacizumab has good tolerance, high safety and considerable curative effect.

Objective:To explore the clinical value of 16-slice spiral CT in diagnosing bony lacrimal passage fracture.Methods:16-slice spiral CT images of 65 patients,which were clinically proved as bony lacrimal passage fractures,were analyzed retro-spectively.Postprocessing of images was performed by GE AW 4.1.Multi planar reconstruction(MPR).The thin-thick axial images were compared with the MPR.Results:16-slice spiral CT showed clearly the fractures of lacrimal sac fossa and nasolac-rimal duct.All the 65 cases were compound fracture,most of which were naso-orbital-ethmoid fracture,including 45 cases of fractures of the frontal process of the maxilla,30 cases of the lacrimal bone fractures,40 cases of ethmoid bone fractures on the medial orbital wall,32 cases of nasal bone fractures,13 cases of the nasal process fractures of frontal bone,23 cases with naso-maxillary suture separations,17 cases with naso-frontal suture separations,20 cases with frontal-maxillary suture separations, 50 cases with lacrimo-maxillary suture separations,26 cases with internasal suture separations.There was no significant difference between the thin-thick axial images and the MPR in diagnosing bony lacrimal passage fracture.Conclusions:16-slice spiral CT can accurately display the location,extent and secondary changes of bony lacrimal passage fracture in detail.

Objective·To investigate the imaging features of computed tomography(CT)and magnetic resonance imaging(MRI)in the patients with Kimura disease(KD)in the head and neck.Methods·Sixty-four cases of KD in the head and neck comfirmed by histopathology were retrospectively collected from 2009 to 2023 in Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine.All patients completed CT and/or MRI enhancement imaging before surgery.Clinical and imaging characteristics were collected,recorded and analyzed,including age,gender,peripheral blood eosinophilic ratio,serum IgE level,the lesion location,shape,size,CT density and degree of enhancement,MRI signal intensity and degree of enhancement,apparent diffusion coefficient(ADC),time-signal intensity curve(TIC)patterns,wash-in rate,and time to peak(TTP).Results·The average age of the 64 KD patients was(40±19)years,and 92.2%were males.A total of 73.5%of the patients showed an elevated ratio of peripheral blood eosinophil,and all 10 tested patients exhibited increased serum IgE levels.There were 82 extranodal(subcutaneous and glandular)lesions and 144 lymph node lesions detected by CT and MRI.Among the extranodal lesions,80.5%were subcutaneous or glandular patchy lesions with unclear boundaries,and the rest were nodular lesions with clear boundaries.All lesions exhibited isodensity on CT scans and showed isointensity on T1-weighted imaging(T1WI)and hyperintensity on T2-weighted imaging(T2WI)in MRI.Most extranodal lesions tended to show heterogeneous enhancement,while most lymph node lesions showed homogeneous enhancement.The median ADCs of the extranodal lesions and the lymph node lesions were 1.04×10-3 mm2/s and 0.67×10-3 mm2/s,respectively,which were significantly different(P=0.000).The dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)results showed that the TIC patterns of extranodal lesions were predominantly type Ⅰ andⅡ,accounting for 57.5%and 42.5%,respectively;while the TIC patterns of lymph node lesions were predominantly type Ⅱ(96.6%).The difference in the TTP and the wash-in rate between the extranodal lesions and the lymph node lesions were both statistically significant(P=0.000).Conclusion·Extranodal lesions and lymph node lesions of KD both show isodensity on CT,and isointensity on T1WI and hyperintensity on T2WI in MRI.Extranodal lesions often show high ADC,TIC type Ⅰ or Ⅱ,and mostly heterogeneous enhancement;lymph node lesions often show low ADC,TIC type Ⅱ,and mostly homogenous enhancement.

Objective:Surgical site infection (SSI) is the most common infectious complication after emergency abdominal surgery (EAS). To a large extent, most SSI can be prevented, but there are few relevant studies in China. This study mainly investigated the current situation of SSI occurrence after EAS in China, and further explored risk factors for SSI occurrence.Methods:Multi-center cross-sectional study was conducted. Clinical data of patients undergoing EAS in 33 hospitals across China between May 1, 2019 and June 7, 2019 were prospectively collected, including perioperative data and microbial culture results from infected incisions. The primary outcome was the incidence of SSI after EAS, while the secondary outcomes were postoperative hospital stay, ICU occupancy rate, length of ICU stay, hospitalization cost, and mortality within postoperative 30 days. Univariate and multivariate logistic regression models were used to analyze the risk factors of SSI after EAS.Results:A total of 660 EAS patients aged (47.9±18.3) years were enrolled in this study, including 56.5% of males (373/660). Forty-nine (7.4%) patients developed postoperative SSI. The main pathogen of SSI was Escherichia coli [culture positive rate was 32.7% (16/49)]. As compared to patients without SSI, those with SSI were more likely to be older (median 56 years vs. 46 years, U=19 973.5, P<0.001), male [71.4% (35/49) vs. 56.1% (343/611), χ 2=4.334, P=0.037] and diabetes [14.3% (7/49) vs. 5.1% (31/611), χ 2=5.498, P=0.015]; with-lower preoperative hemoglobin (median: 122.0 g/L vs. 143.5 g/L, U=11 471.5, P=0.006) and albumin (median: 35.5 g/L vs. 40.8 g/L, U=9452.0, P<0.001), with higher blood glucose (median: 6.9 mmol/L vs. 6.0 mmol/L, U=17 754.5, P<0.001); with intestinal obstruction [32.7% (16/49) vs. 9.2% (56/611), χ 2=25.749, P<0.001], with ASA score 3-4 [42.9% (21/49) vs. 13.9% (85/611), χ 2=25.563, P<0.001] and with high surgical risk [49.0% (24/49) vs. 7.0% (43/611), χ 2=105.301, P<0.001]. The main operative procedure resulting in SSI was laparotomy [81.6%(40/49) vs. 35.7%(218/611), χ 2=40.232, P<0.001]. Patients with SSI experienced significantly longer operation time (median: 150 minutes vs. 75 minutes, U=25 183.5, P<0.001). In terms of clinical outcome, higher ICU occupancy rate [51.0% (25/49) vs. 19.5% (119/611), χ 2=26.461, P<0.001], more hospitalization costs (median: 44 000 yuan vs. 15 000 yuan, U=24 660.0, P<0.001), longer postoperative hospital stay (median: 10 days vs. 5 days, U=23 100.0, P<0.001) and longer ICU occupancy time (median: 0 days vs. 0 days, U=19 541.5, P<0.001) were found in the SSI group. Multivariate logistic regression analysis showed that the elderly (OR=3.253, 95% CI: 1.178-8.985, P=0.023), colorectal surgery (OR=9.156, 95% CI: 3.655-22.937, P<0.001) and longer operation time (OR=15.912, 95% CI:6.858-36.916, P<0.001) were independent risk factors of SSI, while the laparoscopic surgery (OR=0.288, 95% CI: 0.119-0.694, P=0.006) was an independent protective factor for SSI. Conclusions:For patients undergoing EAS, attention should be paid to middle-aged and elderly patients and those of colorectal surgery. Laparoscopic surgery should be adopted when feasible and the operation time should be minimized, so as to reduce the incidence of SSI and to reduce the burden on patients and medical institutions.

Objective:Surgical site infection (SSI) is the most common infectious complication after emergency abdominal surgery (EAS). To a large extent, most SSI can be prevented, but there are few relevant studies in China. This study mainly investigated the current situation of SSI occurrence after EAS in China, and further explored risk factors for SSI occurrence.Methods:Multi-center cross-sectional study was conducted. Clinical data of patients undergoing EAS in 33 hospitals across China between May 1, 2019 and June 7, 2019 were prospectively collected, including perioperative data and microbial culture results from infected incisions. The primary outcome was the incidence of SSI after EAS, while the secondary outcomes were postoperative hospital stay, ICU occupancy rate, length of ICU stay, hospitalization cost, and mortality within postoperative 30 days. Univariate and multivariate logistic regression models were used to analyze the risk factors of SSI after EAS.Results:A total of 660 EAS patients aged (47.9±18.3) years were enrolled in this study, including 56.5% of males (373/660). Forty-nine (7.4%) patients developed postoperative SSI. The main pathogen of SSI was Escherichia coli [culture positive rate was 32.7% (16/49)]. As compared to patients without SSI, those with SSI were more likely to be older (median 56 years vs. 46 years, U=19 973.5, P<0.001), male [71.4% (35/49) vs. 56.1% (343/611), χ 2=4.334, P=0.037] and diabetes [14.3% (7/49) vs. 5.1% (31/611), χ 2=5.498, P=0.015]; with-lower preoperative hemoglobin (median: 122.0 g/L vs. 143.5 g/L, U=11 471.5, P=0.006) and albumin (median: 35.5 g/L vs. 40.8 g/L, U=9452.0, P<0.001), with higher blood glucose (median: 6.9 mmol/L vs. 6.0 mmol/L, U=17 754.5, P<0.001); with intestinal obstruction [32.7% (16/49) vs. 9.2% (56/611), χ 2=25.749, P<0.001], with ASA score 3-4 [42.9% (21/49) vs. 13.9% (85/611), χ 2=25.563, P<0.001] and with high surgical risk [49.0% (24/49) vs. 7.0% (43/611), χ 2=105.301, P<0.001]. The main operative procedure resulting in SSI was laparotomy [81.6%(40/49) vs. 35.7%(218/611), χ 2=40.232, P<0.001]. Patients with SSI experienced significantly longer operation time (median: 150 minutes vs. 75 minutes, U=25 183.5, P<0.001). In terms of clinical outcome, higher ICU occupancy rate [51.0% (25/49) vs. 19.5% (119/611), χ 2=26.461, P<0.001], more hospitalization costs (median: 44 000 yuan vs. 15 000 yuan, U=24 660.0, P<0.001), longer postoperative hospital stay (median: 10 days vs. 5 days, U=23 100.0, P<0.001) and longer ICU occupancy time (median: 0 days vs. 0 days, U=19 541.5, P<0.001) were found in the SSI group. Multivariate logistic regression analysis showed that the elderly (OR=3.253, 95% CI: 1.178-8.985, P=0.023), colorectal surgery (OR=9.156, 95% CI: 3.655-22.937, P<0.001) and longer operation time (OR=15.912, 95% CI:6.858-36.916, P<0.001) were independent risk factors of SSI, while the laparoscopic surgery (OR=0.288, 95% CI: 0.119-0.694, P=0.006) was an independent protective factor for SSI. Conclusions:For patients undergoing EAS, attention should be paid to middle-aged and elderly patients and those of colorectal surgery. Laparoscopic surgery should be adopted when feasible and the operation time should be minimized, so as to reduce the incidence of SSI and to reduce the burden on patients and medical institutions.