Objective To investigate the pathotypes,epidemiological characteristics and antimicrobial resistance of diarrheagenic Escherichia coli (DEC) in children with acute bacterial diarrhea in Shanghai.Methods A total of 2 071 outpatient children with probable acute bacterial diarrhea referred to the enteric clinic of Children's Hospital of Fudan University during June 2012 to June 2014 were enrolled in our study.The stool samples were processed for routine microbiologic and biochemistry tests to identify enteric bacteria,including enteropathogenic Escherichia coli (EPEC),enterotoxigenic Escherichia coli (ETEC),enteroinvasive Escherichia coli (EIEC) and enterohemorrhagic Escherichia coli (EHEC).Kirby-Bauer method was used to identify the antibiotic sensitivity.Difference of means between groups was compared by chi-square test.Results Of 2 071 enrolled children,DEC were identified in 145 (7.0 ％)cases.148 strains were isolated with three of mix infection strains.All DEC isolates in this study included 106 (71.6％) EPEC,24 (16.2％) ETEC,16(10.8％) EIEC and 2(1.4％) EHEC.The median ages of diarrheal children with DEC infections were 14 months (range:3 months to 13 years) and 62.8％ of them were ＜2 years.Among 125 DEC isolates tested for antimicrobial susceptibility,the rates of resistance to ampicillin,trimethoprim-sulfamethoxazole,cefotaxime,cefepime,gentamicin,ceftazidime,amoxicillinclavulanate,ciprofloxacin,and ofloxacin in a descending order were 55.2％,35.2％,28.0％,27.2％,23.2％,8.8％,5.6％,4.0％ and 4.0％,respectively.Resistance rates of EIEC to cefotaxime,cefepime and ceftazidime were 50.0％,43.8％ and 25.0％,respectively,which were higher than those of EPEC,ETEC and EHEC.Conclusion DEC is the important enteric bacteria that causes bacterial diarrhea in children in this study.

Objective To analyze the diseases responsible for ophthalmoplegia and determine the optimal technique identifying the lesions. Methods CT and MR imaging findings of 1376 patients with ophthalmoplegia were analyzed. The total positive rate and ratio of the diseases causing ophthalmoplegia were calculated. The efficiency of various methods and sequences was compared in the evaluation of cavernous sinus inflammation and other lesions. Multi-paired samples Friedman test was used to compare five kinds of images from different methods and sequences, and Wilcoxon test was used to compare between every two kinds of images. Results The total positive rate was 91.9% (1264/1376). In 50 patients who underwent both CT and MRI, the positive rate of MRI (92. 0% ,46/50) was higher than that of CT (48.0% ,24/50)(Z = -4. 8, P ＜ 0. 01). There were 552 cases (43.7%) of cavernous sinus lesions, 518 cases (41.0%)of extraocular muscle diseases, 108 cases (8. 5%) of cranio-orbital communicating lesions and 86 patients (6. 8%) of other lesions. The five kinds of images from various methods and sequences had significant difference in the detection of 283 cavernous sinus inflammation (χ2 = 1047. 1, P ＜ 0. 01) cases. Transverse T1WI with thin slice thickness[(2. 71 ± 0. 69)scores]was better than that with thick slice thickness [(1.67 ± 0. 64) scores], contrast transverse T1 WI with thin slice thickness[(3.92 ± 0. 27) scores]was better than transverse T2WI with thick slice thickness, transverse T1WI and coronal T1 WI with thin slice thickness[(3. 10 ± 0. 39) scores]. Coronal T1 WI with thin slice thickness was better than transverse T1 WI with thin slice thickness and transverse T2WI, and the contrast coronal T1WI with thin slice thickness [(3.95 ± 0. 22) scores]was better than transverse T, WI with thin slice thickness, transverse T2 WI and coronal T1WI (P ＜0. 01 separately). The positive rate of enhanced MRI (100% ,39/39) was higher than that of nonenhanced MRI (82. 1% ,32/39) (Z = - 2. 1, P ＜ 0. 05). Conclusion CT and MRI can show the lesions responsible for ophthalmoplegia. MRI is the best examination method in displaying these lesions.

Volume loss caused by aging process, diseases, trauma and surgical treatments, could lead to facial depressions, profoundly affecting appearance. Injectable fillers could help to correct this type of disfigurements and are preferred by plastic surgeons and patients due to their quality of minimal invasiveness and better delicateness. Among these fillers, collagen stimulators such as poly-L-lactic acid(PLLA) and polycaprolactone(PCL) are biodegradable synthetic polymers that can stimulate collagen formation and thus gradually restore tissue volume. These polymers have been used worldwide to treat facial aging changes and human immunodeficiency virus-associated facial fat lipoatrophy, demonstrating ideal results in volume enhancement and facial rejuvenation. The progress and clinical applications of compound injectables based on biodegradable collagen stimulators are summarized.

Volume loss caused by aging process, diseases, trauma and surgical treatments, could lead to facial depressions, profoundly affecting appearance. Injectable fillers could help to correct this type of disfigurements and are preferred by plastic surgeons and patients due to their quality of minimal invasiveness and better delicateness. Among these fillers, collagen stimulators such as poly-L-lactic acid(PLLA) and polycaprolactone(PCL) are biodegradable synthetic polymers that can stimulate collagen formation and thus gradually restore tissue volume. These polymers have been used worldwide to treat facial aging changes and human immunodeficiency virus-associated facial fat lipoatrophy, demonstrating ideal results in volume enhancement and facial rejuvenation. The progress and clinical applications of compound injectables based on biodegradable collagen stimulators are summarized.

Objective To investigate the correlation between pericarotid fat density(PFD)and carotid plaque CT vulnerability characteristics.Methods The clinical and imaging data of 78 patients were analyzed retrospectively.PFD and subcutaneous neck fat density(SNFD),as well as plaque density,degree of lumen stenosis,and maximum plaque thickness were measured on picture archiving and communication system(PACS),and PFD/SNFD ratio was calculated.The plaques were divided into 4 subgroups according to their composition,namely fatty plaque group,fibrous plaque group,calcified plaque group and mixed plaque group.The groups were divided into no/mild-to-moderate stenosis group and severe stenosis/complete occlusion group according to the degree of stenosis,and the differences between groups were compared for clinical indices,PFD,SNFD and PFD/SNFD ratio,respectively.Results The PFD/SNFD ratio[0.54(0.32,0.72)]in the fatty plaque group was lower than that in the calcified plaque group[0.74(0.56,0.96)],with a statistically significant difference(P=0.005).The PFD/SNFD ratio in the severe stenosis/complete occlusion group(0.51±0.29)was lower than that in the no/mild-to-moderate stenosis group(0.67±0.27)(P=0.001),and the PFD in the severe stenosis/complete occlusion group[-39.75(-61.13,-24.00)]was higher than that in the no/mild-to-moderate stenosis group[-61.75(-72.00,-45.38)](P＜0.001).Conclusion PFD,PFD/SNFD ratio are correlated with carotid plaque vulnerability.

[Objective] To compare the clinical efficacy of super pulse thulium laser enucleation of the prostate (SPThuLEP) with "open tunnel" and transurethral holmium laser enucleation of the prostate (HoLEP) in the treatment of benign prostatic hyperplasia (BPH), in order to provide reference for the treatment options of BPH. [Methods] The clinical data of 112 BPH patients treated in our hospital during Jan.2023 and Jul.2023 were retrospectively analyzed, including 65 treated with SPThuLEP with "open tunnel" and 57 with HoLEP.The operation time, postoperative hemoglobin decrease, postoperative bladder irrigation, catheter indwelling time, hospitalization time and complications were compared between the two groups.The changes of maximum urine flow rate (Qmax), international prostate symptom score (IPSS), quality of life score (QoL), postvoid residual (PVR) and prostate-specific antigen (PSA) were compared between the two groups before operation and one month after operation. [Results] All operations were successful without conversion to open or transurethral plasmakinetic resection.The postoperative decrease of hemoglobin in SPThuLEP group was lower than that in HoLEP group [(13.12±6.72) g/L vs. (21.02±6.51) g/L], with statistical difference (P<0.05). There were no significant differences in the operation time [(63.35±15.73) min vs.(61.02±17.55) min], postoperative bladder irrigation time [(1.07±0.45) d vs. (1.06±0.36) d], catheter indwelling time [(2.98±0.56) d vs. (3.01±0.63) d] and hospitalization time [(3.63±0.61) d vs.(3.79±0.76) d] between the two groups (P>0.05). No blood transfusion, secondary bleeding or unplanned hospitalization occurred, and there were no serious complications such as transurethral electroresection syndrome (TURS), urethral stricture and urinary incontinence.One month after operation, the Qmax, IPSS, QoL, PVR and PSA of the two groups were significantly improved compared with those before operation (P<0.05), but with no statistical difference between the two groups (P>0.05). [Conclusion] SPThuLEP with "open tunnel" has comparable efficacy as HoLEP in the treatment of BPH.With advantages of small amount of bleeding and high safety, this minimally invasive technique can be widely popularized in clinical practice.