Objective:To analyze the symptoms,diagnosis and treatment of upper urinary tract calculi patients combined with mild and moderate benign prostatic hyperplasia(BPH)after ureteral stent implantation.Methods:One hundred and six BPH pa-tients who were hospitalized for upper urinary tract calculi and had ureteral stents retained from January 2019 to December 2022 were selected and divided into 2 weeks group and 4 weeks group according to the time of removal of ureteral stents after surgery.Their gener-al clinical data were analyzed and compared.International Prostatic Symptom Scale(IPSS),postoperative ureteral Stent Symptom Questionnaire(USSQ),and incidence of adverse events after ureteral stent removal were recorded before and after removal.Results:The scores of IPSS were significantly increased in all patients,and symptoms in urinary tract had improved significantly after discharge(P＜0.05).Compared with the 2 weeks group,the USSQ score of the 4 weeks group was significantly increased(P＜0.05).And no significant adverse event was observed in the 2 weeks group after the removal of ureteral sten.Conclusion:IPSS score and USSQ score increased significantly during stent implantation in BPH patients with lithiasis.And complications increased sig-nificantly over time.Following thorough clinical assessment,early ureteral stent removal demonstrates both safety and efficacy,repre-senting an optimal therapeutic approach in selected cases.

Objective To investigate the changing antibiotic resistance profiles of E.coli isolated from patients in the 52 hospitals participating in the CHINET program from 2015 to 2021.Methods Antimicrobial susceptibility was tested for clinical isolates of E.coli according to the unified protocol of CHINET program.WHONET 5.6 and SPSS 20.0 software were used for data analysis.Results Atotal of 289 760 nonduplicate clinical strains ofE.coli were isolated from 2015 to 2021,mainly from urine samples(44.7±3.2)％.The proportion of E.coli strains isolated from urine samples was higher in females than in males(59.0％vs 29.5％).The proportion of E.coli strains isolated from respiratory tract and cerebrospinal fluid samples was significantly higher in children than in adults(16.7％vs 7.8％,0.8％vs 0.1％,both P＜0.05).The isolates from internal medicine department accounted for the largest proportion(28.9±2.8)％with an increasing trend over years.Overall,the prevalence of ESBLs-producing E.coli and carbapenem resistant E.coli(CREco)was 55.9％and 1.8％,respectively during the 7-year period.The prevalence of ESBLs-producing E.coli was the highest in tertiary hospitals each year from 2015 to 2021 compared to secondary hospitals.The prevalence of CREco was higher in children's hospitals compared to secondary and tertiary hospitals each year from 2015 to 2021.The prevalence of ESBLs-producing E.coli in tertiary hospitals and children's hospitals and the prevalence of CREco in children's hospitals showed a decreasing trend over the 7-year period.The prevalence of CREco in secondary and tertiary hospitals increased slowly.Antibiotic resistance rates changed slowly from 2015 to 2021.Carbapenem drugs(imipenem,meropenem)were the most active drugs amongβ-lactams against E.coli(resistance rate≤2.1％).The resistance rates of E.coli to β-lactam/β-lactam inhibitor combinations(piperacillin-tazobactam,cefoperazone-sulbactam),aminoglycosides(amikacin),nitrofurantoin and fosfomycin(for urinary isolates only)were all less than 10％.The resistance rate of E.coli strains to antibiotics varied with the level of hospitals and the departments where the strains were isolated,especially for cefazolin and ciprofloxacin,to which the resistance rate of E.coli strains from children in non-ICU departments was significantly lower than that of the strains isolated from other departments(P＜0.05).The E.coli isolates from ICU showed higher resistance rate to most antimicrobial agents tested(excluding tigecycline)than the strains isolated from other departments.The E.coli strains isolated from tertiary hospitals showed higher resistance rates to the antimicrobial agents tested(excluding tigecycline,polymyxin B,cefepime and carbapenems)than the strains from secondary hospitals and children's hospitals.Conclusions E.coli is an important pathogen causing clinical infection.More than half of the clinical isolates produced ESBL.The prevalence of CREco is increasing in secondary and tertiary hospitals over the 7-year period even though the overall prevalence is still low.This is an issue of concern.

Objective:To investigate the current status of postoperative Day 1 ambulation in patients undergoing posterior lumbar interbody fusion (PLIF) surgery under an enhanced recovery after surgery (ERAS) protocol, analyze the influencing factors of successful ambulation on postoperative Day 1, and explore the impact of early ambulation on postoperative recovery.Methods:Data from 397 patients who underwent PLIF surgery at Beijing Jishuitan Hospital, Capital Medical University, from September 2023 to July 2024 were retrospectively collected. Patients were divided into two groups based on whether they successfully ambulated on postoperative Day 1: the successful ambulation on Day 1 group and the delayed ambulation group. Binary Logistic regression was used to analyze the factors influencing successful ambulation on postoperative Day 1. Postoperative recovery indicators, including catheter removal time, hospital length of stay, drainage volume on postoperative Day 3, and pain scores for the low back and legs, were compared between the two groups.Results:A total of 378 patients were included in the analysis. Among them, 316 patients (83.6%) successfully ambulated on postoperative Day 1, while 62 patients (16.4%) had delayed ambulation. Logistic regression analysis indicated that postoperative Day 1 hemoglobin classification and pre-ambulation low back pain score in the supine position were independent factors influencing successful ambulation on Day 1 ( P<0.05). The successful ambulation group had a shorter catheter removal time and hospital stay compared to the delayed ambulation group, with statistically significant differences ( P<0.05). There were no significant differences between the two groups in postoperative drainage volume, low back pain scores, leg pain scores, or Oswestry Disability Index scores before discharge (all P>0.05) . Conclusions:Postoperative Day 1 hemoglobin levels and pre-ambulation low back pain scores are independent factors influencing the success of ambulation on postoperative Day 1 in patients undergoing PLIF surgery. Early ambulation on postoperative Day 1 helps reduce catheter removal time and length of hospital stay without increasing postoperative drainage or pain levels.

Objective:To explore the current status of lumbar paraspinal muscle functional exercise in patients undergoing lumbar fusion surgery, and to analyze the facilitators and barriers affecting these exercises in order to provide a theoretical basis for developing targeted interventions.Methods:This qualitative study was guided by the Information-Motivation-Behavioral Skills (IMB) model. Semi-structured interviews were conducted between September and November 2024 with 13 postoperative patients, 13 medical staff from the spine surgery ward, and four family caregivers at Beijing Jishuitan Hospital, Capital Medical University. Data were orgznized, analyzed and coded using Colaizzi's seven-step method.Results:A total of three major themes and 14 subthemes were identified. The first major theme highlighted various facilitating factors, including perceived benefits of rehabilitation, a trusting physician-patient relationship, strong motivation for recovery, and patient preference in exercise choices. The second major theme revealed several barriers, including residual postoperative symptoms, psychological burden, lack of awareness, limited access to information, uncomfortable experiences during exercise, and negative family support. The third major theme described the current issues of clinical implementation, including unclear role definitions among healthcare staff, inefficient exercise models, lack of standardized protocols and guidelines, and the need to establish a support and follow-up system.Conclusions:The implementation of lumbar paraspinal muscle functional exercises post-lumbar fusion surgery is influenced by multiple facilitating and hindering factors. Healthcare professionals should leverage facilitators and overcome barriers by adopting targeted strategies to optimize postoperative rehabilitation care practices.

Given the lack of annotations for key lung organs and tissues in existing public datasets,this study collected 863 cases of chest CT scan images and constructed the first comprehensive dataset containing annotations of pulmonary vessels,airways,and nodules using a semi-automated method that combines computer vision algorithms with manual corrections by radiologists.On this basis,a lung nodule segmentation model based on multi-task learning is proposed.By incorporating annotations of pulmonary vessels(pulmonary arteries and veins)and the trachea to enhance model's ability to learn lung features,the proposed model reduces the false discovery rate in lung nodule detection,and improves generalization ability.Additionally,the use of larger image patches further optimizes model performance.The trained VAAN_128 model achieves the best performance,with a Dice coefficient of 0.694 and a false discovery rate of 0.210 for lung nodule segmentation.Moreover,it simultaneously provides accurate segmentation results of pulmonary vessels and the trachea,assisting in the formulation of more precise diagnosis and treatment plans.Based on the VAAN_128 model,a software system for navigation and localization in biopsy procedures is developed.In clinical practice,this system can assist physicians in accurately locating lung nodules,distinguishing critical tissues,and improving preoperative planning efficiency.This provides precise and efficient technical support for early diagnosis and disease monitoring of lung diseases,and is of great significance for path planning in clinical navigation system and future lung imaging research.

Objective To construct a predictive model for patients with verte-brobasilar dolichoectasia(VBD)complicated by posterior circulation acute cerebral infarction(ACI)based on the characteristics of verte-brobasilar artery magnetic resonance vascular wall imaging(MR-VWI),thereby providing a reference for clinical prevention.Methods A total of 102 patients with VBD complicated by posterior circulation ACI who were admitted to our hospital between March 2016 and January 2023 were selected as the concurrent group.An addi-tional 102 patients with VBD without concurrent posterior circulation ACI were selected as the non-concurrent group at a 1∶1 ratio.The MR-VWI characteristics(basilar artery[BA]diameter,BA length,vertebral artery[VA]intracranial segment length,BA deviation grade,and BA bifurcation height grade)and clinical data of the two groups were compared,and the factors influencing posterior circulation ACI in patients with VBD were analyzed.Based on the MR-VWI features and related influencing factors,a nomogram prediction model of pos-terior circulation ACI in patients with VBD was constructed,and the clinical significance of the nomogram prediction model was evaluated using receiver operating characteristic(ROC)and calibration curves.Results A significant difference were observed in the D-dimer levels between the two groups(P＜0.05).BA diameter,BA length,and VA intracranial length were greater in the concurrent group than in the non-concurrent group.The proportion of BA bifurcation height grade ≥ 2 and BA deviation grade≥2 in the concurrent group was higher than that in the non-concurrent group(P＜0.05).BA diameter,BA length,BA bifurcation height classification,BA deviation classi-fication,and D-dimer level were all independent risk factors for posterior circulation ACI in patients with VBD(P＜0.05).The area under the curve of the posterior circulation ACI predicted using the nomogram model was 0.900(95％CI:0.858-0.943),and good calibration was noted.Conclusion BA diameter,BA length,BA bifurcation height classification,BA offset classification,and D-dimer level were inde-pendent influencing factors of posterior circulation ACI in patients with VBD.Based on these factors,a nomogram prediction model was constructed with high prediction efficiency and good calibration.

Objective To investigate the changing antibiotic resistance profiles of E.coli isolated from patients in the 52 hospitals participating in the CHINET program from 2015 to 2021.Methods Antimicrobial susceptibility was tested for clinical isolates of E.coli according to the unified protocol of CHINET program.WHONET 5.6 and SPSS 20.0 software were used for data analysis.Results Atotal of 289 760 nonduplicate clinical strains ofE.coli were isolated from 2015 to 2021,mainly from urine samples(44.7±3.2)％.The proportion of E.coli strains isolated from urine samples was higher in females than in males(59.0％vs 29.5％).The proportion of E.coli strains isolated from respiratory tract and cerebrospinal fluid samples was significantly higher in children than in adults(16.7％vs 7.8％,0.8％vs 0.1％,both P＜0.05).The isolates from internal medicine department accounted for the largest proportion(28.9±2.8)％with an increasing trend over years.Overall,the prevalence of ESBLs-producing E.coli and carbapenem resistant E.coli(CREco)was 55.9％and 1.8％,respectively during the 7-year period.The prevalence of ESBLs-producing E.coli was the highest in tertiary hospitals each year from 2015 to 2021 compared to secondary hospitals.The prevalence of CREco was higher in children's hospitals compared to secondary and tertiary hospitals each year from 2015 to 2021.The prevalence of ESBLs-producing E.coli in tertiary hospitals and children's hospitals and the prevalence of CREco in children's hospitals showed a decreasing trend over the 7-year period.The prevalence of CREco in secondary and tertiary hospitals increased slowly.Antibiotic resistance rates changed slowly from 2015 to 2021.Carbapenem drugs(imipenem,meropenem)were the most active drugs amongβ-lactams against E.coli(resistance rate≤2.1％).The resistance rates of E.coli to β-lactam/β-lactam inhibitor combinations(piperacillin-tazobactam,cefoperazone-sulbactam),aminoglycosides(amikacin),nitrofurantoin and fosfomycin(for urinary isolates only)were all less than 10％.The resistance rate of E.coli strains to antibiotics varied with the level of hospitals and the departments where the strains were isolated,especially for cefazolin and ciprofloxacin,to which the resistance rate of E.coli strains from children in non-ICU departments was significantly lower than that of the strains isolated from other departments(P＜0.05).The E.coli isolates from ICU showed higher resistance rate to most antimicrobial agents tested(excluding tigecycline)than the strains isolated from other departments.The E.coli strains isolated from tertiary hospitals showed higher resistance rates to the antimicrobial agents tested(excluding tigecycline,polymyxin B,cefepime and carbapenems)than the strains from secondary hospitals and children's hospitals.Conclusions E.coli is an important pathogen causing clinical infection.More than half of the clinical isolates produced ESBL.The prevalence of CREco is increasing in secondary and tertiary hospitals over the 7-year period even though the overall prevalence is still low.This is an issue of concern.

To formulate an expert consensus on the principles of preoperative hair removal and provide scientific guidance for standardized removal of hair before surgical procedures so as to reduce the incidence of surgical site infections.METHODS Led by the Hospital Management Institute of National Health Commission of the People's Republic of China,this consensus was reached with the joint efforts from the expects of relevant fields such as surgeries,interventional therapies,nursing,and infection prevention and control.The consensus facilitates the classification and evaluation of literatures by following the evidence grade formulated by Oxford Evidence-based Medicine Center and focuses on the association of preoperative hair removal with surgical site infection,it reaches the evidence grade of expert consensus and recommendation intensity by integrating with discussions on meetings and clinical experience of the expects from relevant fields.RESULTS A total of 6 items of consensus were reached by summarizing the latest evidence on the aspects including the indications for preoperative hair removal,tools,range,timing and places.CONCLUSION The consensus,to some extent,make supplements to and complete the exiting regulations and standards.It provides guidance for the medical institutions to carry out the preoperative hair removal.

To formulate an expert consensus on the principles of preoperative hair removal and provide scientific guidance for standardized removal of hair before surgical procedures so as to reduce the incidence of surgical site infections.METHODS Led by the Hospital Management Institute of National Health Commission of the People's Republic of China,this consensus was reached with the joint efforts from the expects of relevant fields such as surgeries,interventional therapies,nursing,and infection prevention and control.The consensus facilitates the classification and evaluation of literatures by following the evidence grade formulated by Oxford Evidence-based Medicine Center and focuses on the association of preoperative hair removal with surgical site infection,it reaches the evidence grade of expert consensus and recommendation intensity by integrating with discussions on meetings and clinical experience of the expects from relevant fields.RESULTS A total of 6 items of consensus were reached by summarizing the latest evidence on the aspects including the indications for preoperative hair removal,tools,range,timing and places.CONCLUSION The consensus,to some extent,make supplements to and complete the exiting regulations and standards.It provides guidance for the medical institutions to carry out the preoperative hair removal.

Objective To explore the predictive value of MRI parameters of carotid artery plaque combined with low density lipoprotein cholesterol/high density lipoprotein cholesterol(LDL-C/HDL-C)ratio for predicting ischemic stroke in young patients with carotid atherosclerosis.Methods Totally 125 young patients with carotid atherosclerosis were prospectively included and divided into stroke group and non-stroke group based on whether ischemic stroke occurred within 3 months.Clinical data,laboratory indicators and carotid plaque-related MRI parameters were compared between groups.Based on carotid plaque-related MRI parameters being statistically different between groups,combined model 1 was constructed using multivariable logistic regression analysis,while combined model 2 was constructed combined with LDL-C/HDL-C ratio.The efficacy of each parameter and model for predicting ischemic stroke in young adults was analyzed.Results There were 48 cases in stroke group and 77 cases in non-stroke group.The levels of glycosylated hemoglobin,LDL-C,LDL-C/HDL-C ratio,carotid artery stenosis rate,plaque eccentricity index and plaque enhancement rate in stroke group were all higher than those in non-stroke group(all P＜0.05).The area under the curve(AUC)of LDL-C/HDL-C ratio,carotid artery stenosis rate,plaque eccentricity index,plaque enhancement rate,combined model 1 and 2 for predicting ischemic stroke in young adults was 0.816,0.757,0.768,0.805,0.883 and 0.936,respectively,of combined model 1 was higher than those of single parameter(all P＜0.05),while of combined model 2 was higher than that of combined model 1(Z=2.336,P=0.020).Conclusion MRI parameters of carotid artery plaque combined with LDL-C/HDL-C ratio could effectively predict ischemic stroke in young patients with carotid atherosclerosis.