Objective To investigate the MRI features of male urogenital diaphragm.Methods A total of 4 pelvic specimens of healthy male cadaver and 15 healthy male volunteers underwent pelvic MRI examination.All MRI scan images were analyzed to approach the urogenital diaphragm structure both in corpse and the MRI images.Results The normal urogenital diaphragm of cadavem connected to ramus inferior ossis pubis and ischiadic ramus.There were three layers inside the urogenital diaphragm,including superior fascia of urogenital diaphragm,inferior fascia of urogenital diaphragm and deep transverse muscle of perineum.MRI imaging showed the coronal was the best location to exhibit the urogenital diaphragm,and all of the structure appeared like sandwich.In the images of the diaphragm of the volunteers also exhibited like sandwich,and the three layers are moderate signal in MRI.Ten volunteers were given the fat-depresstion and high resolution scan of T2WI in small ROI,and the structure could be seen much clearly.Fat-depresstion and high resolution scan of T2WI in small ROI was the best sequence to exhibit the urogenital diaphragm.Coronal location of the structure appeared like sandwich.Conclusion MRI is a good way to show urogenital diaphragm,and high resolution scan of T2WI in small ROI can show the structure much clearer.

Objective To explore the clinical value of real -time ultrasound elastography in the diagnosis of thyroid nodules , and to provide reference for the clinical diagnosis and treatment of patients with thyroid nodular lesions.Methods The clinical data of 62 patients with thyroid nodule occupying lesions were retrospectively analyzed.The results of real-time ultrasound elastography imaging and pathological diagnosis were compared ,and the accuracy ,sensitivity and specificity of real -time ultrasound elasticity imaging in the diagnosis of thyroid nodular lesions were analyzed.Results The patients with elastic grade 0,pathological examination showed follicular adenoma cystic degeneration;The patients with elastic gradeⅠ,pathological examination showed follicular hyperplastic nodules ;The patients with elastic grade Ⅱ,pathological examination showed follicular gland tumor;The patients with elastic grade Ⅲ,pathological examination showed papillary adenocarcinoma;The patients with elastic grade Ⅳ,pathological examination showed papillary adenocarcinoma .In patients with elastic grade 0,3 patients had proliferative nodules , and 5 cases were follicular adenomas .Among the patients with grade Ⅰ,5 cases were proliferative nodules ,8 cases were follicular adenoma ,1 case of papillary adenocarcinoma;of gradeⅡpatients,6 cases of proliferative nodules ,14 cases of follicular adenoma ,2 cases of papillary adenocarcinoma .Among the patients with grade Ⅲ,4 cases were follicular adenomas,and 6 cases were papillary adenocarcinomas .Among the patients with grade Ⅳ,3 cases were follicular adenomas,7 cases were papillary adenocarcinomas .The diagnostic accuracy of real -time ultrasound elastography was 93.5%,and the difference was not statistically significant (P>0.05).The sensitivity and specificity of real -time ultrasound elastography were 100.0% and 72.6%.Conclusion Real -time ultrasound elastography has high accuracy in the diagnosis of benign and malignant lesions of thyroid nodules ,it is worthy of being widely promoted .

Objective To investigate the efficacy and safety of compound azintamide on dyspepsia symptoms. Methods One hundred and eighty dyspepsia patients were divided into two groups according to dyspepsia symptom related with gastrointestinal disease ( group A) or biliary system disease (group B),whose dyspepsia symptom were not improved by the Domperidone 10 mg tid for 2 weeks. Two tablets of compound azintamide were administered orally following a meal, tid for 2 weeks. The changes of symptoms score of upper abdominal distention, upper abdominal pain or discomfort anorexia and effective rate as well as adverse events were recorded. Results Compound azintamide greatly improved the symptoms of upper abdominal distention, upper abdominal pain or discomfort and anorexia. All symptoms scores were significantly decreased after 2 weeks of compound azintamide (P < 0.01). The effective rate of each symptom and total symptoms score were more than 84.9% and 92.5%. One patient reported mild rash at the fourteenth days, which disappeared 3 days later. Conclusion Compound azintamide showed effective and safety in treatment of patient with dyspepsia symptoms when Domperidone therapy is not satisfactory.

Objective To discuss the application of cystic cavity flushing technique in percutaneous ethanol sclerotherapy for the thyroid colloid cysts.Methods A total of 49 patients with thyroid colloid cysts were randomly divided into the study group (n=33) and the control group (n=16).Patients in the study group received cystic cavity flushing treatment by using saline together with α-chymotrypsin,which was followed by percutaneous ethanol injection (PEI).Patients in the control group underwent simple aspiration of cyst fluid followed by PEI.The residual cystic volume,the effective rate and the untoward effects were calculated at one,3 and 6 months after the treatment,and the results were compared between the two groups.Results Striking difference in the changes of postoperative residual cystic volume existed between the study group and the control group.The effective rate of PEI in the study group was 93.9％,which was obviously better than 68.8％ in the control group,the difference between the two groups was statistically significant (P＜0.05).No untoward effect was observed during the performance of aspiration of cyst fluid and flushing of cystic cavity.Nevertheless,bad side effect occurred in PEI procedure in both the study group (6.1％) and the control group (8.3％),but the difference was not statistically significant (P=0.75).Conclusion For the treatment of thyroid colloid cysts,the use of aspiration of cyst fluid together with cystic cavity flushing technique by using saline combined with α-chymotrypsin is safe and reliable,it can improve the curative effect of subsequent PEI.

Objective: To analyze the features of Norovirus outbreaks in schools and kindergartens and the associated factors in Chengdu, 2017, and to provide the scientific basis for Norovious outbreaks prevention and control. Methods: A total of 75 schools and kindergartens in Chengdu of 2017 participated in the study about Norovirus outbreaks. ANOVA and binary Logistic regression models were used to analyze the influencing factors and duration of Norovirus outbreaks. Results: Overall 710 cases were included. There was an average of 9.47 cases and 27.52 hours for each outbreak,decreasing by 1.06 cases and 10.56 hours compared with those of 2016. Most outbreaks happened in kindergartens and in the firstlevel economy regions from January to March, with GII type as the main outbreak. Compared with the first case of vomiting at home, vomiting in public area (OR=11.76, 95%CI=1.63-84.69) was much more serious, and compared with the active report of school/ community, being informed of the outbreak passively (OR=4.09，95%CI=1.04-16.03) was positively associated with outbreak severity. Conclusion To prevent Norovirus infection, specific development and training of dealing with vomiting and feces should be introduced, and measures to increase the ability to surveil and report Norovirus outbreaks should be enhanced.

Objective:To evaluate the clinical application of the SITA faster (SFR) visual field strategy in glaucoma patients.Methods:A diagnostic test was adopted.A total of 72 subjects who visited the Eye and ENT Hospital Affiliated to Fudan University during September 2018 to February 2019 were collected, including 28 normal subjects (56 eyes) and 44 glaucoma patients (86 eyes). The consistency and convenience of visual field tests were evaluated using SITA Standard (SS) and SITA Fast (SF), or SS and SITA Faster (SFR) in normal subjects and glaucoma patients.Test duration, visual field index (VFI), mean deviation (MD) and the number of defect points with probabilities of <5%, <2%, <1%, and <0.5% in the pattern deviation probability plots were recorded, and tested for difference, correlation and consistency.This study followed the Declaration of Helsinki.Written informed consent was obtained from all subjects prior to their entering the study cohort.The study protocol was approved by the Ethics Committee of the Eye and ENT Hospital of Fudan University.Results:For all of the included subjects, the mean test durations of SF and SFR were (64±13)% and (44±10)% compared to that of SS, respectively.MD and VFI evaluated by SS and SF, or by SS and SFR, showed no significant difference in either the normal subjects or the glaucoma patients (all at P>0.05). Across all included subjects, the positive correlation and consistency of MD and VFI were good ( r=0.99, P<0.01). However, for the results of the probability points in the pattern deviation probability blot, there was no difference among normal subjects, but the correlation and consistency were not good.In the deviation probability blot, there was a greater number of defect points of P<0.5% in glaucoma patients evaluated via SS compared to those evaluated by SFR, and the difference was statistically significant ( Z=-2.28, P=0.02). Apart from this, the number of defect points in glaucoma patients showed no difference between SS and SF, or between SS and SFR, and the correlation and consistency were higher in glaucoma patients than those in the normal subjects. Conclusions:Compared with SF and SS, SFR saves more test time.Except for partial variances in the pattern deviation probability blot, the difference between visual field strategies is relatively small and the results are basically consistent.

Objective To investigate the effect of intrarectal local anesthesia (IRLA) with heated oxybuprocaine gel on pain during transrectal ultrasound guided prostate biopsy (TRUSPB).Methods A total of 150 cases patients who underwent TRUSPB in Huzhou Central Hospital from January to June 2023 were prospectively taken into.The patients were randomly divided into group A (routine group),group B (oxybuprocaine gel for IRLA at room temperature) and group C (oxybuprocaine gel for IRLA at 40℃),with 50 cases in each group.Nurses who were unaware of the anesthesia type used visual analog scale (VAS) to score the pain level of patients at each stage (VAS Ⅰ:when the ultrasound probe was inserted into the rectum;VAS Ⅱ:during the biopsy;VAS Ⅲ:30 minutes after biopsy),and the incidence of complications after biopsy were compared.Results The VAS Ⅱ score of group C was lower than that of group A and group B,and the difference was statistically significant (P<0.05).There was no statistically significant difference (P>0.05) in the VAS Ⅰ,VAS Ⅲ scores,and incidence of complications after biopsy among the three groups.There was no allergic reaction to oxybuprocaine gel.Conclusion In TRUSPB,IRLA with heated oxybuprocaine gel can effectively control pain without increasing incidence of complications.

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.