Objective:To investigate the distribution characteristics of urinary tract pathogens in patients with community-acquired urinary tract infection and their sensitivity to nenoxacin and levofloxacin.Methods:This prospective, multicenter clinical trial included patients with community-acquired urinary tract infection who were admitted to urological clinics at 9 clinical research centers from November 2021 to August 2022.Inclusion criteria: Patients aged 18-70 years with community-acquired acute uncomplicated cystitis(AUC), recurrent acute episodes of urinary tract infection(rUTI), and non-febrile complicated urinary tract infection(cUTI) with signs of urinary tract irritation and abnormal elevation of routine white blood cells in urine. Exclusion criteria: ①Patients who received effective antimicrobial therapy within 72 h before enrollment and lasted for more than 24 h. ②Fever (>37.3℃) or symptoms of upper urinary tract infection such as low back pain, tapping pain in the kidney area, etc. ③Indwelling urinary catheter. At the first visit, clean midstream urine samples were taken for bacterial culture, and the distribution characteristics of urinary pathogens of different types of urinary tract infections were analyzed. Extended spectrum β-lactamases (ESBLs) were measured for Gram-negative bacteria. The susceptibility of nenoxacin and levofloxacin to urinary tract pathogens was determined by disk diffusion method. Drug resistance rate, sensitivity rate were analyzed between different disease groups.Results:There were 404 enrolled patients from 9 hospitals, including 364 (90.1%) females and 40 (9.9%) males. A total of 177 strains of pathogenic bacteria were isolated, among which the highest proportion of Escherichia coli was 66.1% (117/177).Klebsiella pneumoniae was followed by 6.8% (12/177) and Streptococcus agalactis 5.1% (9/177). The bacterial spectrum distribution of AUC and rUTI were similar, and the proportions of Escherichia coli were 70.6% (85/119) and 65.9% (29/44), respectively. However, the proportions of Escherichia coli isolated from cUTI patients were only 28.6% (4/14) and Enterococcus faecalis 7.1%(1/14). The overall detection rate of ESBLs in Gram-negative bacteria was 30.9%(43/139). The sensitivity rate of nenoxacin was 74.6%(91/122), and the resistance rate was 25.4%(31/122). The overall sensitivity rate of levofloxacin was 44.9%(70/156) and the resistance rate was 36.5%(57/156). The rate of resistance of urinary tract pathogens to levofloxacin was 48.2% (27/56) in patients with previous urinary tract infection history, and 30.0% (30/100) in patients with no previous urinary tract infection history, the difference was statistically significant( P=0.023).The sensitivity rate of Gram-negative bacteria to nenofloxacin was 70.7% (65/92) and that to levofloxacin was 50.0% (46/92, P<0.001). The sensitivity of Gram-positive bacteria to nenofloxacin was 80.0% (16/20), and that to levofloxacin was 70.0% (14/20, P=0.009). Conclusions:The bacterial profile of out-patient community acquired urinary tract infection varies greatly according to different diseases. The proportion of Escherichia coli in AUC and rUTI patients is higher than that in cUTI. The detection rate of ESBLs in Gram-negative bacteria was lower than the domestic average.Patients with a history of urinary tract infection had a high risk of treatment failure with levofloxacin. The sensitivity of common urinary tract pathogens to nenofloxacin was higher than levofloxacin.

Alzheimer's disease(AD), the most common neurodegenerative disease, has shown an increasing incidence among younger people. With the onset of disease, most patients' cognitive function will show a progressive decline, bringing a heavy burden to the society and the family. Studies have shown that fibroblast growth factor (FGF) may be involved in the pathogenesis of AD through multiple mechanisms. This article reviews the mechanism of FGF in AD, with the hope of providing new ideas for elucidating the pathogenesis and early diagnosis of AD.

Objective To investigate the acoustic characteristics of monophthong vowels and compound vow-els articulation movement in patients with dysarthria.Methods A total of 24 patients aged 40～81 years old with dysarthria from hospitals,and 24 healthy adults aged 40～80 years old from communities in Shanghai were recrui-ted.The first and second formants(F1,F2)of monophthong vowels/a/,/i/,/u/were extracted from the speech samples,and mandibular distance,tongue distance,vowel space area(VSA)and vowel articulation index(VAI)were calculated.The slope of the second formant of compound vowels/ai/,/ua/,/uai/was extracted and calculat-ed.The acoustic parameters of two groups of subjects were compared under different tasks.Results Under the monophthong vowels task,F1 of/a/,F2 of/i/,mandibular distance,tongue distance,VSA and VAI in the pa-tients were significantly lower than those in the control group(P＜0.01).F2 of/u/was significantly higher than that in the control group(P＜0.01).F2 slope of/ai/,/ua/,/uai/was significantly lower than that of the control group(P＜0.05).Conclusion The space of monophthong vowels articulation movement was reduced in the pa-tients with dysarthria,presenting a state of aggregation.The speed of compound vowels articulation movement was decreased.

Objective:To establish the reference values of stimulation single fiber electromyography (SFEMG) in orbicularis oculi, and to explore its sensitivity in repetitive nerve stimulation (RNS) negative ocular myasthenia gravis (OMG) patients, and the relationship between jitter and various clinical parameters.Methods:Thirty-two healthy volunteers were included to establish the reference value of normal controls from January 2019 to December 2019. From December 2019 to January 2023, 36 OMG patients with negative RNS were collected. Quantitative MG score (QMGS) was performed, neostigmine test and antibody titers as well as thymus CT results were recorded. One side of the orbicularis oculi muscle was tested with a disposable concentric needle electrode in stimulation SFEMG, and the mean consecutive difference (MCD) value was calculated, which was compared with the average MCD value and upper limit of individual values in normal controls to evaluate whether the jitter was abnormal. Spearman correlation analysis of abnormal mean MCD values with QMGS and antibody titer was conducted.Results:Among the 32 healthy volunteers, there were 13 males and 19 females, the age was (46.8 ±18.7) years, and the MCD was (19.0 ±4.4) μs. The upper limit of the reference value was 27.7 μs for average MCD, and 37.4 μs for 10% individual values. Among 36 OMG patients negative at RNS tests, 20 were male and 16 were female, with a age of (37.2 ±17.0) years. The MCD was (29.9 ±14.7) μs, and Jitter was abnormal in 29 patients (81%). Among them, 20 (20/25) patients were antibody positive, 6 (6/26) patients had thymic hyperplasia, and 7 (7/26) patients had thymoma. The QMGS was 3(2, 4). There were 7 patients (19%) with normal jitter, whose QMGS was 3(2, 4). Among the patients with normal Jitter, 5 (5/5) patients were antibody positive, 2 (2/6) patients had thymic hyperplasia. There was no statistically significant difference in clinical indicators between the two groups of patients with abnormal or normal jitter. There was no significant correlation in antibody titer or QMGS with abnormal mean MCD value. Conclusions:The upper limit of the mean MCD value in the normal controls is 27.7 μs. The upper limit of a single value is 37.4 μs. Its sensitivity for OMG patients with RNS negative is 81%, and the abnormal mean MCD value does not show a significant correlation with various clinical indicators. Abnormal jitter indicates dysfunction of neuromuscular junction transmission, which is an important neuroelectrophysiological indicator for MG patients and is suitable for RNS negative patients. Orbicularis oculi muscle stimulation SFEMG provides a reliable and sensitive electrophysiological means for functional evaluation of neuromuscular junction.

Menopausal syndromes are mostly based on kidney deficiency， which could be expalined that kidney governing essence storage and controlling innateness， so when the kidney water was deficient and the liver fail to nourish， then led to liver depression and transform into fire； deficiency of the kidney， loss of warmth of the spleen， and inability to transport and transform the water and dampness will easily lead to phlegm and fire； the decline of the kidney yin and loss of water and fire will easily cause the exuberance of heart fire. Therefore， clinical symptoms of hot flashes， insomnia， and palpitations are common due to phlegm， depressions， and fire. Based on this， at the beginning of the treatment， we should treat the symptoms firstly by resolving phlegm， relieving depression and clearing fire， and commonly use Huanglian Wendan Decoction （黄连温胆汤）， Yigan Powder （抑肝散）， Chaihu plus Longgu Muli Decoction （柴胡加龙骨牡蛎汤）， and Qingxin Zishen Decoction （清心滋肾饮）， etc. After improving the symptoms of hot flashes and sweating， irritability， dreaming and frightening， then we should give the prescriptions to tonify kidney yang and nourish kidney yin， in order to eliminate the pathogens and reinforce healthy qi， and to treat both the manifestations and the root cause， so that the symptoms of the patients can be better alleviated.

Objective:To compare the pregnancy and perinatal outcomes following cleavage-stage embryo transfer and blastocyst-stage embryo transfer, and to explore the best strategy of embryo transfer for infertile patients.Methods:In this retrospective cohort study, data of patients who underwent in vitro fertilization/intracytoplasmic sperm injection from January 2021 to December 2022 in Reproductive Medicine Department of the Fifth Hospital and the First Hospital of Shanxi Medical University and Jinzhong Yingtai Women's and Children's Hospital were collected. Patients were divided into cleavage-stage embryo transfer group (named D3 group, n=2 827) and blastocyst-stage embryo transfer group (named D5 group, n=1 253). The main observation indicators were large for gestational age (LGA) and preterm birth (PTB). The secondary observation indicators were multiple pregnancy, gestational age, birth weight and newborn gender. Univariate and multivariate logistic regression were applied to analyze the correlation between embryo transfer type and adverse outcomes. Results:Clinical pregnancy rate [64.5% (808/1 253)], live birth rate [55.5% (696/1 253)], implantation rate [46.0% (1 026/2 230)], multiple pregnancy rate [22.6% (183/808)], male newborn rate [58.6% (515/879)], single LGA rate [19.8% (103/520)] and single PTB rate [21.7% (113/520)] in D5 group were significantly higher than those in D3 group [54.3% (1 535/2 827), P<0.001; 48.2% (1 362/2 827), P<0.001; 36.7% (1 962/5 346), P<0.001; 19.0% (291/1 535), P=0.026; 49.7% (822/1 653), P=0.001; 7.5% (80/1 071), P<0.001; 17.2% (184/1 071), P=0.029]. LGA rate [24.8% (72/290)] in the single frozen-embryo transfer and LGA rate [13.5% (31/230)] in the single fresh-embryo transfer of D5 group were significantly higher than those of D3 group [8.8% (36/409), P<0.001; 6.6% (44/662), P=0.002]. LGA in male newborns [24.8% (82/330)] and female newborns [11.1% (21/190)] of D5 group were significantly higher than those of D3 group [9.1% (54/592), a OR=2.95, 95% CI: 2.01-4.33, P<0.001; 5.4% (26/479), a OR=2.04, 95% CI: 1.10-3.77, P=0.024]. Conclusion:The risk of LGA and premature birth in blastocyst-stage embryo transfer is higher than that in cleavage-stage embryo transfer. In clinical practice, embryo transfer methods should be selected based on the condition of patient and embryo.

Objective:To investigate the efficacy and characteristics of levonorgestrel intrauterine system in in vitro fertilization (IVF) assisted pregnancy for infertility patients with atypical endometrial hyperplasia and adenomyosis. Methods:The clinical characteristics of 3 infertility patients with atypical endometrial hyperplasia and adenomyosis admitted to the Reproductive Medicine Center, the Fifth Clinical Medical College of Shanxi Medical University from 2019 to 2021 were retrospectively analyzed. All patients underwent IVF as soon as possible after the successful treatment of levonorgestrel intrauterine system. Using progestin-primed ovarian stimulation protocol and gonadotropin-releasing hormone antagonist protocol, the ring was removed before frozen-thawed transfer.Results:Two cases of atypical endometrial hyperplasia were completely relieved, one case received healthy singleton fetus, and one case received biochemical pregnancy. One case had complete remission of adenomyosis and received healthy singleton fetus.Conclusion:Levonorgestrel intrauterine system in the treatment of infertility caused by atypical endometrial hyperplasia and adenomyosis can not only achieve better therapeutic effect but also effectively improve endometrial receptivity.

Objective:To compare the pregnancy and perinatal outcomes following cleavage-stage embryo transfer and blastocyst-stage embryo transfer, and to explore the best strategy of embryo transfer for infertile patients.Methods:In this retrospective cohort study, data of patients who underwent in vitro fertilization/intracytoplasmic sperm injection from January 2021 to December 2022 in Reproductive Medicine Department of the Fifth Hospital and the First Hospital of Shanxi Medical University and Jinzhong Yingtai Women's and Children's Hospital were collected. Patients were divided into cleavage-stage embryo transfer group (named D3 group, n=2 827) and blastocyst-stage embryo transfer group (named D5 group, n=1 253). The main observation indicators were large for gestational age (LGA) and preterm birth (PTB). The secondary observation indicators were multiple pregnancy, gestational age, birth weight and newborn gender. Univariate and multivariate logistic regression were applied to analyze the correlation between embryo transfer type and adverse outcomes. Results:Clinical pregnancy rate [64.5% (808/1 253)], live birth rate [55.5% (696/1 253)], implantation rate [46.0% (1 026/2 230)], multiple pregnancy rate [22.6% (183/808)], male newborn rate [58.6% (515/879)], single LGA rate [19.8% (103/520)] and single PTB rate [21.7% (113/520)] in D5 group were significantly higher than those in D3 group [54.3% (1 535/2 827), P<0.001; 48.2% (1 362/2 827), P<0.001; 36.7% (1 962/5 346), P<0.001; 19.0% (291/1 535), P=0.026; 49.7% (822/1 653), P=0.001; 7.5% (80/1 071), P<0.001; 17.2% (184/1 071), P=0.029]. LGA rate [24.8% (72/290)] in the single frozen-embryo transfer and LGA rate [13.5% (31/230)] in the single fresh-embryo transfer of D5 group were significantly higher than those of D3 group [8.8% (36/409), P<0.001; 6.6% (44/662), P=0.002]. LGA in male newborns [24.8% (82/330)] and female newborns [11.1% (21/190)] of D5 group were significantly higher than those of D3 group [9.1% (54/592), a OR=2.95, 95% CI: 2.01-4.33, P<0.001; 5.4% (26/479), a OR=2.04, 95% CI: 1.10-3.77, P=0.024]. Conclusion:The risk of LGA and premature birth in blastocyst-stage embryo transfer is higher than that in cleavage-stage embryo transfer. In clinical practice, embryo transfer methods should be selected based on the condition of patient and embryo.

Objective:To investigate the efficacy and characteristics of levonorgestrel intrauterine system in in vitro fertilization (IVF) assisted pregnancy for infertility patients with atypical endometrial hyperplasia and adenomyosis. Methods:The clinical characteristics of 3 infertility patients with atypical endometrial hyperplasia and adenomyosis admitted to the Reproductive Medicine Center, the Fifth Clinical Medical College of Shanxi Medical University from 2019 to 2021 were retrospectively analyzed. All patients underwent IVF as soon as possible after the successful treatment of levonorgestrel intrauterine system. Using progestin-primed ovarian stimulation protocol and gonadotropin-releasing hormone antagonist protocol, the ring was removed before frozen-thawed transfer.Results:Two cases of atypical endometrial hyperplasia were completely relieved, one case received healthy singleton fetus, and one case received biochemical pregnancy. One case had complete remission of adenomyosis and received healthy singleton fetus.Conclusion:Levonorgestrel intrauterine system in the treatment of infertility caused by atypical endometrial hyperplasia and adenomyosis can not only achieve better therapeutic effect but also effectively improve endometrial receptivity.

Objective:To analyze the neutralization properties of different genotypes and mutants of severe fever with thrombocytopenia syndrome virus (SFTSV).Methods:Pseudoviruses of SFTSV of different genotypes and mutants were constructed using VSVΔG-Fluc*G backbone. Neutralization assays were established based on the pseudoviruses. DNA vaccines for different SFTSV genotypes were prepared. Serum samples were collected from guinea pigs immunized with the DNA vaccines. Neutralizing antibodies in serum samples from immunized guinea pigs and naturally infected patients were detected using neutralization assays and analyzed.Results:The pseudoviruses of five genotypes and 43 mutants were successfully constructed and the neutralization assays based the pseudoviruses were successfully established after optimizing the reaction parameters. The dilution multiple corresponding to the inhibition rate of neutralizing antibody to half of the pseudovirus infection was taken as the titer of neutralizing antibody by the reduction in pseudovirus reporter gene. The neutralization antibody titers in naturally infected patients and immunized guinea pigs were respectively in the ranges of 1∶100-1∶43 000 and 1∶100-1∶2 500 when detected with the reference HB29 pseudovirus. The neutralization antibody titers ranged from 1∶100-1∶2 500 after immunization with different genotypes of DNA vaccines. No significant statistical difference in neutralization antibody titer was observed among different genotypes or mutant strains.Conclusions:The neutralization properties of different genotypes and mutants showed no significant change, which would be very useful for developing vaccines.