[Objective]To evaluate the efficacy of ureteral dilation versus ureteral reimplantation in treating pediatric primary obstructive megaureter(POM).[Methods]A retrospective analysis was conducted on clinical data of 53 pediatric patients with POM treated in the Department of Urology,Anhui Provincial Children's Hospital from April 2019 to September 2023.The cohort included 37 boys and 16 girls with 5 bilateral and 48 unilateral cases.The age ranged from 1 to 157 months,with a median age of 17.00(5.50-48.00)months.Patients were assigned to 3 groups based on the management of the ureteral stricture segment:dilation group(18 cases,19 sides),Cohen group(20 cases,24 sides),and Lich-Gregoir group(15 cases,15 sides).The duration of the operations,postoperative hospital stays,postoperative indwelling catheters,postoperative D-J stents;changes in renal pelvis anteroposterior diameter and ureteral diameter;and postoperative complications were compared to evaluate the therapeutic effects.[Results]All 53 patients successfully underwent surgery.The dilation group showed significantly shorter operative time,postoperative hospital stay,and postoperative catheterization duration compared to the Cohen and Lich-Gregoir groups(P＜0.05).However,the postoperative D-J stent time was longer in the dilation group than in the other 2 groups(P＜0.05).Upon follow-ups for 6-12 months after stent removal,all groups demonstrated statistically significant reductions in renal pelvis anteroposterior diameter and ureteral diameter compared to preoperative values(P＜0.05).No significant differences were observed among the 3 groups in hydronephrosis resolution rates(P＞0.05).Additionally,the incidence of postoperative complications(urinary tract infection,vesicoureteral reflux,and reoperation for restenosis)did not differ significantly among the groups(P＞0.05).[Conclusions]Ureteral dilation demonstrated non-inferior short-term clinical efficacy compared to ureteral reimplantation in managing POM in pediatric patients.With reduced operative time,minimal invasiveness,and technical simplicity,ureteral dilation may be considered a preferential treatment option for children with POM.

Objective:To explore the safety and effectiveness of ileal bypass with stent to prevent anastomotic leakage in Da Vinci robot anus-preserving surgery for low rectal cancer.Methods:From Dec 2021 to Sep 2024, the clinical data of 55 patients undergoing robot anus-preserving surgery and stent ileal bypass for low rectal cancer in the First Affiliated Hospital of Ningbo University was analyzed retrospectively.Results:All the 55 patients successfully completed the operation. Among them, 47 patients underwent low anterior resection and 8 patients did sphincter resection. The total operation time was (207±37)min, the operation time of ileal bypass was (24±3)min, and the intraoperative blood loss was (32±18)ml. After operation, the time of stent disintegration was (23.93± 2.87) days, and the time of catheter removal was (29.55 ± 3.21) days. By postoperative TNM staging, there were 12 cases in T1 stage, 26 cases in T2 and 17 cases in T3. The number of lymph node dissection was (16.84±4.50), 15 cases being positive for lymph node metastasis, 40 cases being negtive for lymph node metastasis, 36 cases were stage Ⅰ, 4 cases were stage Ⅱ and 15 cases were stage Ⅲ. The median follow-up time was 20 (2-35) months. Delayed anastomotic leakage occurred in 1 patient and anastomotic stenosis occurred in 2 patients.Conclusion:Stent ileal bypass is safe and effective to prevent anastomotic leakage in Da Vinci robot anus-preserving surgery for low rectal cancer.

Objective:To report the surveillance results of the distribution and antimicrobial resistance profile of clinical isolates in Anhui province.Methods:Surveillance data from 94 members of the Anhui Antimicrobial Resistance Surveillance Network（HuiNet）from October 2023 to September 2024 were collected，the major drug-resistant bacteria and the resistance to commonly used antibiotics were analyzed. WHONET 5.6 and SPSS 25.0 software were used for data analysis.Results:Among 240 339 clinical strains，Gram-negative bacteria accounted for 75.0%（180 153 strains）. The detected bacteria mainly include Escherichia coli（ n=53 587，22.3%）， Klebsiella pneumoniae（ n=39 774，16.5%）， Pseudomonas aeruginosa（ n=25 505，10.6%）， Staphylococus aureus（ n=19 438，8.1%）， Acinetobacter baumannii complex（ n=14 239，5.9%），and so on. The prevalence of methicillin-resistant Staphylococcus aureus（MRSA）and methicillin-resistant coagulase-negative Staphylococcus aureus（MRCNS）were 37.7%（7 112/18 853）and 73.9%（13 221/17 895），respectively. No vancomycin- and teicolanin-resistant Staphylococcus were detected. The prevalence of carbapenem-resistant Escherichia coli（CREC）and Klebsiella pneumoniae（CRKP）were 1.9%（971/51 991）and 12.3%（4 864/39 414），respectively. The resistance rate of CRKP to tigecycline and polycolistin B was 7.7% and 7.9%，respectively. The prevalence of carbapenem-resistant Acinetobacter baumannii（CRAB）complex and Pseudomonas aeruginosa（CRPA）were 57.9%（8 222/14 198）and 18.2%（4 569/25 052），respectively，with low resistance to polycolistin B（2.0% and 7.2%，respectively）. The detection rates of MRSA，MRCNS，CRAB complex，third-generation cephalosporin-resistant Escherichia coli（3GC-R-EC）and quinolone-resistant Escherichia coli（QREC）in northern Anhui were the highest（46.8%，77.1%，65.6%，57.6% and 55.5%，respectively），which were higher than those in central and southern Anhui（ χ2=107.858 and 566.202，5.950 and 142.223，39.254 and 289.137，135.402 and 449.114，39.142 and 185.114， P<0.05 or <0.01），and the detection rates in central Anhui were higher than those in southern Anhui（ χ2=272.031，102.717，162.409，118.891 and 66.889，all P<0.001）. The detection rates of CRKP，CRPA and thirdgeneration cephalosporinresistant Klebsiella pneumoniae（3GC-R-KP）in central Anhui were the highest（16.7%，21.7% and 32.0%，respectively），which were higher than those in northern and southern Anhui（ χ2=229.656 and 439.377，156.599 and 65.818，77.386 and 232.568，all P<0.001）. The detection rates of CREC，3GC-R-EC and QREC were the highest in the elderly（2.2%，54.0% and 56.4%，respectively），which were higher than those in children and adults（ χ2=8.034 and 13.150，17.032 and 103.437，438.353 and 183.099，all P<0.01）. The detection rates of CRKP and 3GC-R-KP in neonates were the highest（20.6% and 56.9%，respectively），which were significantly higher than those in children，adults and the elderly（ χ2=38.869，8.337 and 7.921；65.517，55.525 and 49.214，all P<0.01），and the detection rate of 3GC-R-KP in the elderly was higher than that in children and adults（ χ2=14.122 and 7.501，both P<0.01）. The detection rates of CRAB complex，CRPA，CREC，CRKP and 3GC-R-KP in tertiary hospitals were higher than those in secondary hospitals（ χ2=25.606，16.501，5.820，33.116 and 117.086， P<0.05 or <0.01）. Except for MRSA，vancomycin-resistant Enterococcus faecium and QREC，the detection rates of major drug-resistant bacteria in intensive care unit（ICU）were the highest（all P<0.001）. From 2019 to 2024，the detection rates of MRSA，MRCNS，CRKP，CRAB complex and CRPA all showed a slow decreasing trend（ χ2=42.319，122.779，340.381，83.512 and 81.668，all P<0.001）. Conclusions:The situation of antimicrobial resistance in Anhui province shows a downward trend，but it is still serious，especially in northern and central Anhui. It is necessary to pay attention to the bacterial resistance particularly for the elderly，newborns，children and ICU.

Objective:To explore the safety and effectiveness of ileal bypass with stent to prevent anastomotic leakage in Da Vinci robot anus-preserving surgery for low rectal cancer.Methods:From Dec 2021 to Sep 2024, the clinical data of 55 patients undergoing robot anus-preserving surgery and stent ileal bypass for low rectal cancer in the First Affiliated Hospital of Ningbo University was analyzed retrospectively.Results:All the 55 patients successfully completed the operation. Among them, 47 patients underwent low anterior resection and 8 patients did sphincter resection. The total operation time was (207±37)min, the operation time of ileal bypass was (24±3)min, and the intraoperative blood loss was (32±18)ml. After operation, the time of stent disintegration was (23.93± 2.87) days, and the time of catheter removal was (29.55 ± 3.21) days. By postoperative TNM staging, there were 12 cases in T1 stage, 26 cases in T2 and 17 cases in T3. The number of lymph node dissection was (16.84±4.50), 15 cases being positive for lymph node metastasis, 40 cases being negtive for lymph node metastasis, 36 cases were stage Ⅰ, 4 cases were stage Ⅱ and 15 cases were stage Ⅲ. The median follow-up time was 20 (2-35) months. Delayed anastomotic leakage occurred in 1 patient and anastomotic stenosis occurred in 2 patients.Conclusion:Stent ileal bypass is safe and effective to prevent anastomotic leakage in Da Vinci robot anus-preserving surgery for low rectal cancer.

Objective:To report the surveillance results of the distribution and antimicrobial resistance profile of clinical isolates in Anhui province.Methods:Surveillance data from 94 members of the Anhui Antimicrobial Resistance Surveillance Network（HuiNet）from October 2023 to September 2024 were collected，the major drug-resistant bacteria and the resistance to commonly used antibiotics were analyzed. WHONET 5.6 and SPSS 25.0 software were used for data analysis.Results:Among 240 339 clinical strains，Gram-negative bacteria accounted for 75.0%（180 153 strains）. The detected bacteria mainly include Escherichia coli（ n=53 587，22.3%）， Klebsiella pneumoniae（ n=39 774，16.5%）， Pseudomonas aeruginosa（ n=25 505，10.6%）， Staphylococus aureus（ n=19 438，8.1%）， Acinetobacter baumannii complex（ n=14 239，5.9%），and so on. The prevalence of methicillin-resistant Staphylococcus aureus（MRSA）and methicillin-resistant coagulase-negative Staphylococcus aureus（MRCNS）were 37.7%（7 112/18 853）and 73.9%（13 221/17 895），respectively. No vancomycin- and teicolanin-resistant Staphylococcus were detected. The prevalence of carbapenem-resistant Escherichia coli（CREC）and Klebsiella pneumoniae（CRKP）were 1.9%（971/51 991）and 12.3%（4 864/39 414），respectively. The resistance rate of CRKP to tigecycline and polycolistin B was 7.7% and 7.9%，respectively. The prevalence of carbapenem-resistant Acinetobacter baumannii（CRAB）complex and Pseudomonas aeruginosa（CRPA）were 57.9%（8 222/14 198）and 18.2%（4 569/25 052），respectively，with low resistance to polycolistin B（2.0% and 7.2%，respectively）. The detection rates of MRSA，MRCNS，CRAB complex，third-generation cephalosporin-resistant Escherichia coli（3GC-R-EC）and quinolone-resistant Escherichia coli（QREC）in northern Anhui were the highest（46.8%，77.1%，65.6%，57.6% and 55.5%，respectively），which were higher than those in central and southern Anhui（ χ2=107.858 and 566.202，5.950 and 142.223，39.254 and 289.137，135.402 and 449.114，39.142 and 185.114， P<0.05 or <0.01），and the detection rates in central Anhui were higher than those in southern Anhui（ χ2=272.031，102.717，162.409，118.891 and 66.889，all P<0.001）. The detection rates of CRKP，CRPA and thirdgeneration cephalosporinresistant Klebsiella pneumoniae（3GC-R-KP）in central Anhui were the highest（16.7%，21.7% and 32.0%，respectively），which were higher than those in northern and southern Anhui（ χ2=229.656 and 439.377，156.599 and 65.818，77.386 and 232.568，all P<0.001）. The detection rates of CREC，3GC-R-EC and QREC were the highest in the elderly（2.2%，54.0% and 56.4%，respectively），which were higher than those in children and adults（ χ2=8.034 and 13.150，17.032 and 103.437，438.353 and 183.099，all P<0.01）. The detection rates of CRKP and 3GC-R-KP in neonates were the highest（20.6% and 56.9%，respectively），which were significantly higher than those in children，adults and the elderly（ χ2=38.869，8.337 and 7.921；65.517，55.525 and 49.214，all P<0.01），and the detection rate of 3GC-R-KP in the elderly was higher than that in children and adults（ χ2=14.122 and 7.501，both P<0.01）. The detection rates of CRAB complex，CRPA，CREC，CRKP and 3GC-R-KP in tertiary hospitals were higher than those in secondary hospitals（ χ2=25.606，16.501，5.820，33.116 and 117.086， P<0.05 or <0.01）. Except for MRSA，vancomycin-resistant Enterococcus faecium and QREC，the detection rates of major drug-resistant bacteria in intensive care unit（ICU）were the highest（all P<0.001）. From 2019 to 2024，the detection rates of MRSA，MRCNS，CRKP，CRAB complex and CRPA all showed a slow decreasing trend（ χ2=42.319，122.779，340.381，83.512 and 81.668，all P<0.001）. Conclusions:The situation of antimicrobial resistance in Anhui province shows a downward trend，but it is still serious，especially in northern and central Anhui. It is necessary to pay attention to the bacterial resistance particularly for the elderly，newborns，children and ICU.

[Objective]To evaluate the efficacy of ureteral dilation versus ureteral reimplantation in treating pediatric primary obstructive megaureter(POM).[Methods]A retrospective analysis was conducted on clinical data of 53 pediatric patients with POM treated in the Department of Urology,Anhui Provincial Children's Hospital from April 2019 to September 2023.The cohort included 37 boys and 16 girls with 5 bilateral and 48 unilateral cases.The age ranged from 1 to 157 months,with a median age of 17.00(5.50-48.00)months.Patients were assigned to 3 groups based on the management of the ureteral stricture segment:dilation group(18 cases,19 sides),Cohen group(20 cases,24 sides),and Lich-Gregoir group(15 cases,15 sides).The duration of the operations,postoperative hospital stays,postoperative indwelling catheters,postoperative D-J stents;changes in renal pelvis anteroposterior diameter and ureteral diameter;and postoperative complications were compared to evaluate the therapeutic effects.[Results]All 53 patients successfully underwent surgery.The dilation group showed significantly shorter operative time,postoperative hospital stay,and postoperative catheterization duration compared to the Cohen and Lich-Gregoir groups(P＜0.05).However,the postoperative D-J stent time was longer in the dilation group than in the other 2 groups(P＜0.05).Upon follow-ups for 6-12 months after stent removal,all groups demonstrated statistically significant reductions in renal pelvis anteroposterior diameter and ureteral diameter compared to preoperative values(P＜0.05).No significant differences were observed among the 3 groups in hydronephrosis resolution rates(P＞0.05).Additionally,the incidence of postoperative complications(urinary tract infection,vesicoureteral reflux,and reoperation for restenosis)did not differ significantly among the groups(P＞0.05).[Conclusions]Ureteral dilation demonstrated non-inferior short-term clinical efficacy compared to ureteral reimplantation in managing POM in pediatric patients.With reduced operative time,minimal invasiveness,and technical simplicity,ureteral dilation may be considered a preferential treatment option for children with POM.

Objective:To evaluate the safety and feasibility of robot assisted total gastrectomy plus hand-sewn esophagojejunostomy.Methods:The clinical data of 72 patients diagnosed with gastric cancer and undergoing total gastrectomy at the First Affiliated Hospital of Ningbo University from Nov 2021 to May 2024 were retrospectively analyzed. They were divided into two groups: robot-assisted total gastrectomy (RATG) group, consisting of 30 patients, and laparoscopic assisted total gastrectomy (LATG) group, consisting of 42 patients . In the RATG group, the digestive tract was reconstructed by manual suture under the robot scope and Roux-Y reconstruction was performed . In LATG group, digestive tract reconstruction was performed using an in vitro stapler and Roux-Y. The clinicopathological data, perioperative indexes, and postoperative follow-up data of both groups were observed and analyzed.Results:All 72 patients successfully completed the operation without conversion to open laparotomy. The total operation time in RATG group was longer than that in LATG group [(235.2±25.8) min vs. (200.7±40.6) min, t=4.099, P<0.05)].RATG was superior to LATG group in terms of digestive tract reconstruction time, postoperative fluid intake time and hospitalization days,the difference was statistically significant [(36.9±3.0) min vs.(39.4±4.5) min, (4.2±0.5) d vs. (5.2±0.6) d、(9.5±1.6) d vs. (10.8±2.4)d, t=-2.554,-7.135,-2.595, all P<0.05]; In terms of postoperative pathology, the number of lymph node dissection in RATG group was higher than that in LATG group [(29.8±6.2) vs. (26.3±7.5), t=2.197, P<0.05]. Conclusion:The application of delayed disconnection hand-sewn esophagojejunostomy in Da Vinci robot total gastrectomy is safe and feasible for cure-intent total gastrectomy in patients of gastric carcinoma.

Objective:To analyse the distribution and antimicrobial resistance profile of clinical bacterial isolates in Anhui province.Methods:Surveillance data was collected from 83 members of the Anhui Antimicrobial Resistance Surveillance Network（HuiNet）during October 2022 to September 2023，to analyze the resistance of major bacteria to commonly used antibiotics and the detection of clinically common drug-resistant bacteria. The data was analyzed using WHONET 5.6 and SPSS 25.0 software.Results:A total of 201 647 clinical bacteria isolates were collected，with Gram-negative bacteria accounting for 74.8%（150 847/201 647）. The most prevalent Gram-positive bacterial strains were Staphylococus aureus（32.8%，16 648/50 800），followed by Staphylococcus epidermidis（14.0%，7 098/50 800）， Enterococcus faecalis（10.7%，5 458/50 800）， Enterococcus faecium（9.1%，4 613/50 800）and Staphylococcus hominis（7.4%，3 778/50 800）；the most prevalent Gram-negative bacterial strains were Escherichia coli（28.9%，43 577/150 847），followed by Klebsiella pneumoniae（22.5%，34 006/150 847）， Pseudomonas aeruginosa（14.7%，22 171/150 847）， Acinetobacter baumannii complex（9.4%，14 194/150 847）and Enterobacter cloacae（3.5%，5 235/150 847）. The prevalence of methicillin-resistant Staphylococcus aureus（MRSA）and methicillin-resistant coagulase-negative Staphylococcus aureus（MRCNS）were 39.5%（6 442/16 325）and 75.7%（12 343/16 312），respectively. No vancomycin- and teicolanin-resistant Staphylococcus were detected. The prevalence of vancomycin-resistant Enterococcus faecium and Enterococcus faecalis were 0.5% and 0.6%，respectively. The prevalence of carbapenem-resistant Escherichia coli and Klebsiella pneumoniae（CR-KPN）were 1.9%（805/42 956）and 11.7%（3 950/33 761），respectively. The resistance rate of CR-KPN to tigecycline was 3.9%. The prevalence of carbapenem-resistant Pseudomonas aeruginosa（CR-PAE）and Acinetobacter baumannii（CR-ABA）complex were 18.4%（3 936/21 447）and 62.9%（8 649/13 744），respectively，with low resistance rate to polycolistin B（6.9% and 1.7%，respectively）. The detection rates of MRSA，CR-ABA complex，third-generation cephalosporin-resistant Escherichia coli（CTX/CRO-R-ECO）and quinolone-resistant Escherichia coli（QNR-ECO）in northern Anhui were the highest（50.3%，72.9%，59.2% and 55.6%，respectively），which were higher than those in central and southern Anhui（ χ2=112.734 and 575.069，132.747 and 233.885，93.986 and 471.209，60.062 and 230.669，all P<0.001），and the detection rate in central Anhui was higher than that in southern Anhui（ χ2=278.671，29.219，207.395 and 80.267，all P<0.001）. The detection rates of CR-KPN and thirdgeneration cephalosporinresistant Klebsiella pneumoniae（CTX/CRO-R-KPN）in central Anhui were the highest（15.5% and 33.3%，respectively），which were higher than those in northern and southern Anhui（ χ2=156.237 and 325.533，76.928 and 180.686，all P<0.001），and the detection rate in northern Anhui was higher than that in southern Anhui（ χ2=32.202 and 25.539， P<0.001）. The detection rates of CTX/CRO-R-ECO and QNR-ECO were the highest in the elderly（55.2% and 55.8%，respectively），which were higher than those in children，and young and middle aged adults（ χ2=23.906 and 120.575，376.404 and 196.612， P<0.001）. The detection rate of CTX/CRO-R-KPN in neonates was the highest（57.1%），which was significantly higher than that in children，adults and the elderly（ χ2=46.141，38.843 and 32.093， P<0.001），and the detection rate in the elderly was higher than that in children and adults（ χ2=13.604 and 13.471， P<0.001）. The detection rates of MRSA and MRCNS were the highest in children（42.8% and 77.8%，respectively），which were higher than those in adults（ χ2=21.766 and 10.704， P<0.001）. Except MRSA and vancomycin-resistant Enterococcus faecium and faecalis，the detection rates of major drug-resistant bacteria in tertiary hospitals were higher than those in secondary hospitals（ P<0.05 or <0.01）. Conclusion:In 2023，the situation of antimicrobial resistance in Anhui province was serious，especially in northern and central Anhui，and targeted drug resistance control measures should be taken according to the monitoring results. At the same time，it is necessary to pay attention to the bacterial resistance in the elderly，newborns and children，and strengthen the rational use of antibiotics by clinicians to curb the spread of drug-resistant bacteria.

Circular RNA (circRNA) is widely expressed in eukaryotes. Abnormal expression of specific circRNA was found in both animal models with cognitive decline and patients with cognitive dysfunction.However, the role of circRNA in cognitive dysfunction related diseases is still unclear. By introducing the expression of circRNA in cognitive function related brain regions and its impact on brain structure and function, as well as the relevant research progress on the pathological mechanism of circRNA involvement in cognitive dysfunction related diseases, this review provides theoretical basis for revealing the pathological mechanism of circRNA in cognitive dysfunction related diseases and discovering specific circRNA targets for preventing and treating cognitive dysfunction.

Objective To investigate the anatomical features of aortic arch lesions in the Chinese population in order to provide anatomical reference for the development of domestic arch en-dografts.Methods Clinical data of 83 patients with aortic arch lesions were collected from a first prospective multi-center study of WeFlow-Arch stent system,which was carried out between June 1,2021 and January 1,2024 in 17 centers across China.According to their pathologic types,they were divided into an aneurysm group(67 patients)and an ulcer group(16 patients).Preoperative computed tomography angiography images were analyzed using three-dimensional reconstruction techniques to quantify the anatomical characteristics of the aorta.The resulting data were subse-quently compared to assess the anatomical suitability of the Zenith and Relay stents for use in Chinese patients.Results The anatomical feasibility of Zenith stent and Relay stent was 39.8％and 63.9％,respectively in this investigation.No significant differences were observed between the two groups in terms of anatomical features,including arch type,aortic diameter and length,di-mensions,orientation,and angulation of arch branch vessels,as well as diameters of the left and right femoral arteries,and proximal and total aortic tortuosity indices(P＞0.05).The tortuosity index of the ascending aorta was lower in the aneurysm group than the ulcer group(1.17±0.06 vs 1.22±0.08,P=0.010),but the index within the coverage region of the stent was higher in the aneurysm group than the ulcer group(2.97±0.46 vs 2.66±0.36,P=0.020).Conclusion There are significant variations in the tortuosity indexes of the ascending aorta and the coverage region of the stent among the patients with different aortic arch lesions,and thus,attention should be paid to the variations due to their prognostic implications.The anatomical suitability of foreign de-vices is not good enough for Chinese patients,so it is of great significance for developing en-dografts specifically designed for the patients of our own country.