Objective:To analyze the epidemiological and clinical features of infectious diseases of the central nervous system (CNS).Methods:A cross-sectional study and analysis were conducted to summarize the epidemiological and clinical characteristics of 9 918 patients with CNS infectious diseases, who were diagnosed and treated at 29 hospitals across China from January 1, 2001 to December 31, 2020. Data collected included demographic data, clinical manifestations, health economic indicators, and prognostic outcomes.Results:Among the 9 918 collected cases of CNS infectious diseases, 5 559 were male (56.0%) and 4 359 were female (44.0%), with an onset age of 38 (25, 53) years. Education level: slightly more junior high school education (2 651 cases, 26.7%), and less elementary school education and below (2 181 cases, 22.0%) were found. Occupational distribution: farmers were found predominant (3 215 cases, 32.4%), followed by workers (1 826 cases, 18.4%) and students (1 633 cases, 16.5%). Clinical manifestations: headache (6 074 cases, 61.2%), fever (5 869 cases, 59.2%) and positive meningeal irritation signs (2 273 cases, 22.9%) were the 3 most common clinical manifestations, followed by nausea and (or) vomiting (2 095 cases, 21.1%), impaired consciousness (2 077 cases, 20.9%), psychiatric symptom (1 866 cases, 18.8%) and epilepsy (1 627 cases, 16.4%), etc., and cranial nerve involvement was found in 669 cases (6.7%). Major pathogens included viruses in 6 814 cases (68.7%), Mycobacterium tuberculosis in 1 677 cases (16.9%), common bacteria in 864 cases (8.7%), fungi in 254 cases (2.6%), spirochetes of syphilis in 183 cases (1.8%), parasites in 121 cases (1.2%), and rickettsiae in 5 cases (0.1%). Urban-rural distribution: slightly more cases were found in the countryside (5 418 cases, 54.6%) than in the towns (4 500 cases, 45.4%). Distribution of onset by season: 2 412 cases (24.3%) fell ill in spring, 2 835 cases (28.6%) in summer, 2 187 cases (22.1%) in fall, and 2 484 cases (25.0%) in winter. Health economics: the duration of hospitalization was 15 (8, 27) days, and the cost of hospitalization was 1.53 (0.91, 3.02)×10 000 yuan. Prognosis: 9 531 cases (96.1%) were cured or improved, and 92 cases (0.9%) died. Conclusions:The pathogens responsible for CNS infectious diseases are predominantly viruses. Although the incidence is slightly higher during the summer months, the overall seasonal pattern is not particularly pronounced. These infections are more commonly observed in young and middle-aged males and present with a diverse range of clinical manifestations, contributing to a significant disease burden.

Objective:To analyze the epidemiological and clinical features of infectious diseases of the central nervous system (CNS).Methods:A cross-sectional study and analysis were conducted to summarize the epidemiological and clinical characteristics of 9 918 patients with CNS infectious diseases, who were diagnosed and treated at 29 hospitals across China from January 1, 2001 to December 31, 2020. Data collected included demographic data, clinical manifestations, health economic indicators, and prognostic outcomes.Results:Among the 9 918 collected cases of CNS infectious diseases, 5 559 were male (56.0%) and 4 359 were female (44.0%), with an onset age of 38 (25, 53) years. Education level: slightly more junior high school education (2 651 cases, 26.7%), and less elementary school education and below (2 181 cases, 22.0%) were found. Occupational distribution: farmers were found predominant (3 215 cases, 32.4%), followed by workers (1 826 cases, 18.4%) and students (1 633 cases, 16.5%). Clinical manifestations: headache (6 074 cases, 61.2%), fever (5 869 cases, 59.2%) and positive meningeal irritation signs (2 273 cases, 22.9%) were the 3 most common clinical manifestations, followed by nausea and (or) vomiting (2 095 cases, 21.1%), impaired consciousness (2 077 cases, 20.9%), psychiatric symptom (1 866 cases, 18.8%) and epilepsy (1 627 cases, 16.4%), etc., and cranial nerve involvement was found in 669 cases (6.7%). Major pathogens included viruses in 6 814 cases (68.7%), Mycobacterium tuberculosis in 1 677 cases (16.9%), common bacteria in 864 cases (8.7%), fungi in 254 cases (2.6%), spirochetes of syphilis in 183 cases (1.8%), parasites in 121 cases (1.2%), and rickettsiae in 5 cases (0.1%). Urban-rural distribution: slightly more cases were found in the countryside (5 418 cases, 54.6%) than in the towns (4 500 cases, 45.4%). Distribution of onset by season: 2 412 cases (24.3%) fell ill in spring, 2 835 cases (28.6%) in summer, 2 187 cases (22.1%) in fall, and 2 484 cases (25.0%) in winter. Health economics: the duration of hospitalization was 15 (8, 27) days, and the cost of hospitalization was 1.53 (0.91, 3.02)×10 000 yuan. Prognosis: 9 531 cases (96.1%) were cured or improved, and 92 cases (0.9%) died. Conclusions:The pathogens responsible for CNS infectious diseases are predominantly viruses. Although the incidence is slightly higher during the summer months, the overall seasonal pattern is not particularly pronounced. These infections are more commonly observed in young and middle-aged males and present with a diverse range of clinical manifestations, contributing to a significant disease burden.

Objective To investigate the relationship between the morphology and elasticity of the levator ani muscle(LAM)and stress urinary incontinence(SUI),and to develop a multimodal diagnostic model for SUI based on LAM morphology and elasticity parameters,while evaluating the diagnostic performance of this model.Methods From September 2020 to September 2022,147 female patients with SUI from the Affiliated Hospital of North China University of Science and Technology were enrolled as the SUI group(case group),while 144 women without SUI during the same period were selected as the non-SUI group(control group).Transperineal ultrasonography was conducted to measure the anteroposterior diameter(LH-A1)and transverse diameter(LH-D1)of the levator hiatus at rest,the resting area of the levator hiatus(LA1),as well as the anteroposterior diameter(LH-A2),transverse diameter(LH-D2),and area(LA2)of the levator hiatus during the maximum Valsalva maneuver.Addi-tionally,ultrasonography was used to observe LAM injury(LA-MI)during pelvic muscle contraction.Shear wave elastography(SWE)was also performed transperineally to record the elastic modulus values of the puborectalis muscle at rest(E1)and during pelvic muscle contraction(E3).The differences in ultrasound parameters between the two groups were compared,and a logistic regression model was constructed for multivariate analysis to establish a diagnostic model for SUI.The goodness of fit of the logistic regression model was assessed using the Hosmer-Lemeshow test.The diagnostic performance of individual indicators and the diagnostic model for SUI was evaluated using the receiver operating characteristic(ROC)curve.Finally,the clinical utility of the model was assessed using decision curve analysis.Results There were statistically significant differences in age,BMI,LH-A1,LH-D1,LA1,LH-A2,LH-D2,LA2,LA-MI,E1,and E3 between the two groups(P<0.05).Multivariate logistic regression analysis revealed that age,BMI,LH-A1,LA2,LA-MI,E1,and E3 were significantly associated with SUI(P<0.05).Based on these findings,a diagnostic model for SUI was established:PRESUI=0.261×age+0.904×BMI-4.300×LH-A1+1.166×LA2-2.815×LA-MI+0.587×E1-0.631×E3-1.258.The model demon-strated excellent goodness-of-fit(P=0.983).The ROC curve analysis indicated that age,BMI,LH-A1,LA2,LA-MI,E1,and E3 all exhibited diagnostic efficacy for SUI(AUC>0.500,P<0.05).Notably,the AUC of the constructed diagnostic model for SUI was 0.996(95%CI:0.992～1.000),suggesting that the diagnostic accuracy of the model surpassed that of individual indicators.When the cut-off value of the diagnostic model was set at 0.437,the sensitivity reached 98.0%,and the specificity was 97.2%.Furthermore,the decision curve analysis demon-strated that the diagnostic model provided substantial net clinical benefit within the threshold probability range of 0.1 to 1.0.Conclusions The morphology and elasticity of the LAM are significantly altered in women with SUI.The SWE technique demonstrates potential application value for quantitatively assessing the elasticity of the LAM.Furthermore,the diagnostic model constructed based on age,BMI,LH-A1,LA2,LA-MI,E1,and E3 exhibits high clinical application value.

Objective To investigate the relationship between the morphology and elasticity of the levator ani muscle(LAM)and stress urinary incontinence(SUI),and to develop a multimodal diagnostic model for SUI based on LAM morphology and elasticity parameters,while evaluating the diagnostic performance of this model.Methods From September 2020 to September 2022,147 female patients with SUI from the Affiliated Hospital of North China University of Science and Technology were enrolled as the SUI group(case group),while 144 women without SUI during the same period were selected as the non-SUI group(control group).Transperineal ultrasonography was conducted to measure the anteroposterior diameter(LH-A1)and transverse diameter(LH-D1)of the levator hiatus at rest,the resting area of the levator hiatus(LA1),as well as the anteroposterior diameter(LH-A2),transverse diameter(LH-D2),and area(LA2)of the levator hiatus during the maximum Valsalva maneuver.Addi-tionally,ultrasonography was used to observe LAM injury(LA-MI)during pelvic muscle contraction.Shear wave elastography(SWE)was also performed transperineally to record the elastic modulus values of the puborectalis muscle at rest(E1)and during pelvic muscle contraction(E3).The differences in ultrasound parameters between the two groups were compared,and a logistic regression model was constructed for multivariate analysis to establish a diagnostic model for SUI.The goodness of fit of the logistic regression model was assessed using the Hosmer-Lemeshow test.The diagnostic performance of individual indicators and the diagnostic model for SUI was evaluated using the receiver operating characteristic(ROC)curve.Finally,the clinical utility of the model was assessed using decision curve analysis.Results There were statistically significant differences in age,BMI,LH-A1,LH-D1,LA1,LH-A2,LH-D2,LA2,LA-MI,E1,and E3 between the two groups(P<0.05).Multivariate logistic regression analysis revealed that age,BMI,LH-A1,LA2,LA-MI,E1,and E3 were significantly associated with SUI(P<0.05).Based on these findings,a diagnostic model for SUI was established:PRESUI=0.261×age+0.904×BMI-4.300×LH-A1+1.166×LA2-2.815×LA-MI+0.587×E1-0.631×E3-1.258.The model demon-strated excellent goodness-of-fit(P=0.983).The ROC curve analysis indicated that age,BMI,LH-A1,LA2,LA-MI,E1,and E3 all exhibited diagnostic efficacy for SUI(AUC>0.500,P<0.05).Notably,the AUC of the constructed diagnostic model for SUI was 0.996(95%CI:0.992～1.000),suggesting that the diagnostic accuracy of the model surpassed that of individual indicators.When the cut-off value of the diagnostic model was set at 0.437,the sensitivity reached 98.0%,and the specificity was 97.2%.Furthermore,the decision curve analysis demon-strated that the diagnostic model provided substantial net clinical benefit within the threshold probability range of 0.1 to 1.0.Conclusions The morphology and elasticity of the LAM are significantly altered in women with SUI.The SWE technique demonstrates potential application value for quantitatively assessing the elasticity of the LAM.Furthermore,the diagnostic model constructed based on age,BMI,LH-A1,LA2,LA-MI,E1,and E3 exhibits high clinical application value.

BACKGROUND: The morbidity of lung cancer has long been the highest in cancer. Stage I, stage II and partly of stage III non-small cell lung cancer (NSCLC) are mainly treated by surgery. Lobectomy and segmentectomy both are common lung resection methods. Video-assisted thoracoscopic surgery (VATS) has been widely used in clinical, and the application of single-portvideo-assisted thoracoscopic surgery (SP VATS) has gradually been recognized and accepted by professors. With increasing degree of eldly in society, eldly patients already have become inceasingly difficulties in the diagnosis and treatment of NSCLC. The aim of this study is to explore and analyze clinical value of SP VATS lobectomy and segmentectomy in elderly patients with NSCLC. METHODS: In this retrospective observational study, the outcomes of 417 consecutive patients who had undergone SP VATS anatomic segmentectomy or lobectomy for NSCLC from May 2014 to December 2016 on department of thoracic surgery in Fujian Medical University Affiliated Union Hospital were examined, including 139 elderly-case (lobectomy vs segmentectomy: 124 vs 15) and 278 nonelderly-case (lobectomy vs segmentectomy: 248 vs 30). The condition of perioperative period and postoperative short-time recovery could be compared with lobectomy and segmentectomy between elderly and nonelderly cases and lobectomy and segmentectomy in elderly cases. RESULTS: The morbidty of preoperative complications was significant difference (P<0.05) in comparing with elderly and non-elderly patients with NSCLC either in SP VATS anatomic segmentectomy orlobectomy, except others is no significant difference (P>0.05). Numbers of dissected lymph nodes and mediastinal nodal stations of SP VATS lobectomy in elderly patients with NSCLC were more than segmentectomy (P<0.05), which were (7.61±0.21) vs (20.39±0.97) and (5.60±0.35) vs (15.40±2.64). But there was not significant difference between two elderly groups of SP VATS lobectomy and anatomic segmentectomy in age, morbidty of preoperative complications, average operation time and intraoperative blood loss (P>0.05). Postoperative drainage volume [(1,150.15±140.02) mL vs (853.53±177.04) mL] and duration [(7.00±1.31) d vs (5.00±0.74) d], duration of postoperative hospital stay [(3.18±1.32) d vs (5.04±1.30) d], costs [(70.06±5.23) thousands yuan vs (61.20±5.22) thousands yuan ] or postoperative complications (5.97% vs 20.00%)(P>0.05). Notwithstanding, group of SP VATS anatomic segmentectomy found more postoperative atrialfibrillation and the vein thrombosis of lower limbs (P<0.05). CONCLUSIONS Elderly patients having more basic diseases and taking increasely risk of postoperative complications. SP VATS anatomic segmentectomy andlobectomy do not increase the risk of elderly patients with surgery. SP VATS segmentectomy is as safe and effective as SP VATS lobectomy in elderly patients, who fit to undergo SP VATS segmentectomy seem to get as same short-time effect as SP VATS lobectomy.
Aged ; Carcinoma, Non-Small-Cell Lung ; pathology ; surgery ; Female ; Humans ; Length of Stay ; Lung Neoplasms ; pathology ; surgery ; Lymph Node Excision ; Male ; Mastectomy, Segmental ; methods ; Middle Aged ; Pneumonectomy ; methods ; Postoperative Complications ; etiology ; Retrospective Studies ; Thoracic Surgery, Video-Assisted ; methods

Objective To discuss the safety and efficacy of inserting ureterovesical reimplantation by means of laparoscopy associated with six-stitch suture.Methods There was an retrospective analysis on operation videos and clinical data for 16 participants of inserting ureterovesical reimplantation by means of laparoscopy associated with six-stitch suture with the period from March in 2012 to September in 2015. And these were statistically analyzed including the operation time, intraoperative bleeding volume, postoperative drainage volume, removal time of drainage tube, admission time after operation and the incidence of postoperative complications of vesicoureteric reflux and stenosis.Results The operations of 16 participants were completed successfully without converting to open surgery. The operation time was 60 ~ 125 min (Mean time: 85 min); intraoperative bleeding volume was 20 ~ 50 ml (Mean volume: 32 ml); postoperative drainage volume was 60 ~ 400 ml (Mean volume: 106 ml); removal time of drainage tube was 3 ~ 6 d (Mean time: 4.2 d) and admission time after operation was 7 ~ 10 d (Mean time: 8.5 d). There was the follow-up with 6 ~ 18 months (Mean time: 12 months) for participants. No anastomotic stenosis was present. In addition, one participant was suffered from mild vesicoureteric relfux. And there was no aggravation during 18 months.Conclusions The inserting ureterovesical reimplantation by means of laparoscopy associated with six-stitch suture was safe and effective. It was found that the operation time was significantly shortened and the incidence of postoperative complications of vesicoureteric relfux and anastomotic stenosis was not increased. By contrast, the six-stitch suture could reduce the incidence of anastomotic stenosis.

OBJECTIVE:To prepare dexibuprofen sustained-release pellets,and to analyze the drug release behavior in vitro. METHODS:Centrifugal granulation powder layering-eudragit dispersion coating method was used to prepare dexibuprofen sus-tained-release pellets using 3%HPMC as adhesive agent. The formula of the pellets was optimized by orthogonal test with weight ra-tio of sucrose to dexibuprofen,weight ratio of HPMC to Eudragit NE30D and coating weight as factors,using 1,4 and 10 h accu-mulated release rate (Q) as index. The release of the drug from the pellets was analyzed. RESULTS:The optimized formulation was that the proportion of sucrose to drug was 1:10,the weight ratio of HPMC to Eudragit NE30D was 1.5:1,the increased weight of coating material was 8%. Q1 h,Q4 h and Q10 h of prepared pellets were 21%,57% and 89%,respectively(n=3). The co-rrelation coefficient of zero-order,one-order and Higuchi equation release model were 0.956 6,0.989 9,0.996 5. CONCLUSIONS:Prepared pellets show good sustained-release effect in vitro. Drug release of pellets is more in accordance with Higuchi equation.

Objective To study the clinicopathologic classification,and methods of individualized treatment of Budd-Chiari syndrome (B-CS).Methods Analysed the clinical data of 42 cases of B-CS in our hospital from March 2006 to August 2010.Results The 42 patients were divided into three types,including 5 subtypes,which of them underwent operation or the interventional therapy,All kinds of bypass,a total of 20 cases.After operation,1 case appeared hepatic encephalopathy and die from it,the others all recovered well.Radical lesion resection and thrombosis was taken out in 7 cases; a balloon catheter in 5 cases and postoperative recovered well.The spleen-lung fixation in 6 cases were cured after operation.The three cavity two capsule tube was used oppression hemostasis for 4 patients with emergency bleeding,three cases was cured of joint spleen cut + cutoff,1 case with conservative treatment is invalid,died.The 41 cases received follow-up,during the follow up period of 3 months to 3 years,2 patients had recurrence (4.9％),and the other patients recovered satisfactorily.Conclutions According to different the clinicopathologic classification of B-CS,Taking individualized treatment may further improve the clinical curative effect.

Objective To compare the results of stroke risk assessment system in patients with non-valvular atrial fibrillation u-sing CHADS2 and CHA2 DS2-VASc .Methods A total of 420 patients with non-valvular atrial fibrillation were evaluated using CHADS2 and CHA2DS2-VASc ,they were divided into three groups according scores :low risk group(scores 0) ,intermediate risk group(scores 1) ,high risk group(scores≥2) .Compare the average scores and the proportions of three groups of two stroke risk as-sessment system .Results The average score of CHA2DS2-VASc was significantly higher than that′s of CHADS2 (2 .41 ± 1 .93 vs . 1 .39 ± 1 .39 ,P<0 .05) .According to scores of CHADS2 ,the proportions of low risk groups were 34 .5% (145/420) ,intermediate risk group were 28 .8% (121/420) ,high risk group were 36 .7% (154/420) .According to scores of CHA2DS2-VASc ,the propor-tions of low risk group were 16 .2% (68/420) ,intermediate risk group were 23 .3% (98/420) ,high risk group were 60 .5% (254/420) .CHA2 DS2-VASc compared with CHADS2 ,the proportion of low-risk group significantly lower than the latter ,the proportion of high-risk groups significantly higher than the latter(P<0 .05) .Conclusion The scores of CHA2DS2-VASc is significantly high-er than that′s of CHADS2 in patients with non-valvular atrial fibrillation ,there are more patients needs anticoagulation using stroke risk assessment system CHA2 DS2-VASc .

Objective To investigate Fascin expression in human lung cancer tissues and its clinical significance.Methods Immunohistochemistry was performed in 62 patients with different histological types and clinical stages of lung cancer and 92 cases with other malignant tumors.Fascin positive rate in each group was calculated and the differences of pathological characters between the two groups were analyzed.Results Fascin expression in lung cancer tissues was significantly higher than that in normal lung tissues(P ＜ 0.05),its expression varied by different clinical stage of lung cancer tissue differentiation.As differentiation degree decreased,Fascin positive rate increased.Fascin expression was independent with age,sex,smoking history(P ＞ 0.05).Fascin expression had no significant difference between lung cancer group and other tumor group(P ＞ 0.05).Conclusions Fascin expression raising might be common in malignant tumors.Fascin expression in lung tissues indicated the possibility of lung cancer.In lung tissue,high expression of Fasein was a sign of poor differentiation and malignant status of lung cancer.