Objective:To investigate the diagnostic value of hydrocolonic sonography combined with shear-wave elastography(SWE)for benign and malignant tumors of colon.Methods:A total of sixty-three patients with tumor,who were confirmed by hydrocolonic sonography in the Second Affiliated Hospital of Shantou University Medical College from February 2021 to August 2022,were selected.The point-type SWE(pSWE)and two-dimensional SWE(2D-SWE)were performed on the tumors by SWE technique,respectively,to obtain shear wave velocity(SWV).And then,they were divided into benign group(N=20)and malignant group(N=43)according to pathological results.Receiver operating characteristic(ROC)curve was constructed to predict the SWV critical value of malignantly colonic lesions.In addition,the mean(Emean),the minimum value(Emin)and the maximum value(Emax)of Young's modulus between two groups were compared.Results:The SWV value of malignant group was significantly higher than that of benign group.The results of ROC curve of 2D-SWE indicated that the values of area under curve(AUC)of Emean,Emin and Emax were maximum when the SWV cutoff values were respectively 1.945 m/s,1.485 m/s and 2.445 m/s.Among of them,the sensitivity and specificity of Emax were the best,which were respectively 95.3%and 95%.However,the pSWE only had mean,which AUC was the biggest when SWV cutoff value was 1.885 m/s.There were correlations in both two groups between Emean and pSWE,and the correlation coefficients of benign and malignant groups were respectively 0.725 and 0.803.Conclusion:Hydrocolonic sonography combined with SWE technique is an objective and quantitative index,which has higher reference value for differentiating benign and malignant intestinal lesions.It is non-invasive and it has good compliance,which is worthy in clinical application.

Objective To monitor the antifungal resistance of clinical isolates of Candida spp.in the East China region.Methods MALDI-TOF MS or molecular methods were used to re-identify the strains collected from January 2018 to December 2022.Antifungal susceptibility testing was performed using the broth microdilution method.The susceptibility test results were interpreted according to the breakpoints of 2022 Clinical and Laboratory Standards Institute(CLSI)documents M27 M44s-Ed3 and M57s-Ed4.Results A total of 3 026 strains of Candida were collected,65.33％of which were isolated from sterile body sites,mainly from blood(38.86％)and pleural effusion/ascites(10.21％).The predominant species of Candida were Candida albicans(44.51％),followed by Candida parapsilosis complex(19.46％),Candida tropicalis(13.98％),Candida glabrata(10.34％),and other Candida species(0.79％).Candida albicans showed overall high susceptibility rates to the 10 antifungal drugs tested(the lowest rate being 93.62％).Only 2.97％of the strains showed dose-dependent susceptibility(SDD)to fluconazole.Candida parapsilosis complex had a SDD rate of 2.61％and a resistance rate of 9.42％to fluconazole,and susceptibility rates above 90％to other drugs.Candida glabrata had a SDD rate of 92.01％and a resistance rate of 7.99％to fluconazole,resistance rates of 32.27％and 48.24％to posaconazole and voriconazole non-wild-type strains(NWT),respectively,and susceptibility rates above 90％to other drugs.Candida tropicalis had resistance rates of 29.55％and 26.24％to fluconazole and voriconazole,respectively,resistance rates of 76.60％and 21.99％to posaconazole and echinocandins non-wild-type strains(NWT),and a resistance rate of 2.36％to echinocandins.Conclusions The prevalence and species distribution of Candida spp.in the East China region are consistent with previous domestic and international reports.Candida glabrata exhibits certain degree of resistance to fluconazole,while Candida tropicalis demonstrates higher resistance to triazole drugs.Additionally,echinocandins resistance has emerged in Candida albicans,Candida glabrata,Candida tropicalis,and Candida parapsilosis.

Objective: To understand the sex related knowledge, attitude and practice of senior kindergarten children in Luzhou and its influencing factors, and to provide a scientific basis for comprehensive early childhood sexuality education. Methods: In January 2022, the stratified cluster sampling method was used to select 1 438 large class children and their parents in 24 kindergartens in Luzhou. Results: The eligible rate of sex related knowledge, attitude and practice of senior kindergarten children was 27.2% . About 91.0% of children knew that they should not let others see/touch their private parts, 88.0% of children could correctly name the source of life, 35.1% of children could correctly and completely point out the location of male/female private parts and 11.5% of children believed that girls could not play with toy pistols and 1.2% of children thought boys should not wear skirts. The results of multivariate analysis showed that public kindergarten, girls, ≥6 years old, high maternal education (college/undergraduate or above), parental sexuality education with positive attitude/good behavior were associated with high sex related knowledge, attitude and practice( OR =1.69, 1.74, 1.86, 1.37, 1.32, 1.48, P <0.05). Conclusion Sex related knowledge, attitude, and practice among senior kindergarten children is insufficient, however, knowledge regarding sexual assault prevention and life education is sufficient. It is necessary to pay attention to the role of parents attitudes and behaviors in child sexuality education, especially among boys, children from private kindergartens, as well as those with young age or low maternal education.

Objective:To evaluate the microstructural changes of brain parenchyma in patients with essential hypertension by diffuse kurtosis imaging (DKI) and enhanced T2 star weighted angiography (ESWAN).Methods:A prospective study was performed; 27 patients with essential hypertension, admitted to our hospital from April 2019 to September 2019, and 16 healthy subjects matched with gender, age and education level were enrolled in our study. According to the presence or absence of cerebral microbleeds (CMBs), patients with essential hypertension were divided into essential hypertension with CMBs group ( n=8) and essential hypertension without CMBs group ( n=19). MRI, DKI and ESWAN were performed on all subjects. The mean kurtosis (MK), mean diffusivity (MD) and fractional anisotropy (FA) of bilateral hippocampal gyrus, centrum semiovale, caudate head, posterior limb of internal capsule, thalamus, red nucleus, substantia nigra, pons, and cerebellum were measured. Results:As compared with the healthy subjects, the patients with essential hypertension had significantly lower MK values in the left semioval center, bilateral caudate head, left posterior limb of internal capsule, and bilateral thalamus, significantly higher MD value in the right thalamus, and statistically lower FA value in the left posterior limb of internal capsule ( P<0.05). The essential hypertension with CMBs group had significantly lower MK values in left hippocampus gyrus, left centrum semiovale, bilateral caudate head, left posterior limb of internal capsule, bilateral thalamus, and left substantia nigra, significantly higher MD value in right thalamus, and significantly lower FA value in left posterior limb of internal capsule as compared with essential hypertension without CMBs group and healthy control group ( P<0.05). Conclusion:In patients with essential hypertension, the brain microstructural changes are found in the hippocampus, centrum semiovale, caudate head, posterior limb of internal capsule, thalamus and substantia nigra; these changes are more obvious in essential hypertension patients with CMBs; DKI and ESWAN can effectively assess the early brain microstructure changes in patients with essential hypertension.

Objective:To explore the relationship between serum cytokine levels and cognitive impairment in patients with bipolar I manic episode.Methods:Forty-four patients with bipolar I manic episode (BDI group) and 42 healthy volunteers (HC group) matched with demographic data were included.Peripheral serum interleukin-6 (IL-6), interleukin-10 (IL-10), interleukin-23 (IL-23), and tumor necrosis factor-α (TNF-α) levels were detected by enzyme-linked immunosorbent assay (ELISA). The repeatable battery for the assessment of neuropsychological status (RSPM) was used to evaluate the cognitive function of the two groups.Young manic rating scale (YMRS) was used to evaluate the clinical manic symptoms of patients.Hypothesis testing and correlation analysis were processed by SPSS 22.0.Results:(1) The expression levels of serum cytokines IL-6, IL-10, IL-23 and TNF-α in BDI group ((38.872±7.803), (33.259±7.260), 42.350(33.600, 55.390), (108.309±19.398)) were significantly different with those in HC group ((24.664±6.083), (29.257±5.208), 17.360(12.870, 30.690), (68.674±13.610)), and the differences were statistically significant (( t=9.387, t=2.947, Z=-5.477, t=10.921, all P<0.01)). (2) In the RBANS cognitive test, the visual span, attention, delayed memory and total scale scores of the BP group ((92.909±16.126). (83.091±8.529), (80.636±9.592), (416.318±33.438)) were significantly different with those of the HC group ((82.905±10.958), (92.381±14.850), (93.714±7.613), (436.905±37.228), t=3.378, t=-3.538, t=-6.982, t=-2.700, all P<0.05). (3)Correlation analysis showed that in the BDI group, the course of disease was positively correlated with IL-6 and IL-23( r=0.509, r=0.298, P<0.05), the visual breadth was positively correlated with IL-10 and TNF-α ( r=0.426, r=0.647, P<0.05), language was negatively correlated with IL-23 level ( r=-0.372, P<0.05), attention was significantly negatively correlated with IL-6, IL-10, and TNF-α ( r=-0.315, r=-0.318, r=-0.498, all P<0.05), delayed memory was positively correlated with IL-10 and TNF-α ( r=-0.360, r=-0.621, P<0.05). No significant correlation was found between YRMS score, immediate memory score and cytokines ( P>0.05). Conclusion:Patients with bipolar I disorder manic have changes in serum levels of cytokines and cognitive dysfunction. The course of disease and cognitive function are related with serum cytokine level.

Objective:To compare the clinical outcomes between modified percutaneous kyphoplasty (PKP) and conventional PKP in the treatment of Kümmell disease.Methods:A retrospective cohort study was conducted of the 57 patients with single level kummell disease who had undergone PKP between January 2015 and December 2017 at Department of Spinal Surgery, Jiangmen Hospital Affiliated to Sun Yat-sen Uni-versity.Of them, 36 received modified PKP and 21 conventional PKP.In the modified PKP group, there were 24 males and 12 females with an age of 73.9 years±9.4 years and a course of disease of 2.2 months±1.5 months; the disease was located at a thorocic vertebra in 20 cases and at a lumbar vertebra in 16.In the conventional PKP group, there were 15 males and 6 females with an age of 72.6 years±11.9 years and a course of disease of 1.8 months±1.1 months; the disease was located at a thorocic vertebra in 10 cases and at a lumbar vertebra in 11.The 2 groups were compared in terms of operation time, bone cement volume, cement leakage, visual analogue scale (VAS), Oswestry disability index (ODI), anterior and middle heights and cobb angle of injured vertebra at postoperative 3 days, 1 and 3 months, and final follow-up.Results:There were no significant differences in the general clinical data between the 2 groups, showing compatibility between groups ( P>0.05).All the operations were accomplished uneventfully with no such serious complications as spinal cord nerve injury, wound infection, pulmonary embolism, bone cement poisoning reaction or death. There was no significant difference between the 2 groups in operation time or bone cement volume ( P>0.05).The rate of cement leakage in the modified PKP group [33.3%(9/27)] was significantly lower than that [52.4%(11/21)] in the conventional PKP group ( P<0.05).There were no significant differences be-tween the 2 groups in VAS, ODI, anterior or middle height of injured vertebra or cobb angle at postoperative 3 days or one month ( P>0.05), but the postoperative values were improved compared to the preoperative ones.At postoperative 3 months and final follow-up, the modified PKP group was significantly better in all the indexes than the conventional PKP group ( P<0.05). Conclusion:Compared with conventional PKP, the modified PKP may lead to better outcomes for Kümmell disease.

Objective To study the pathogens associated with infectious keratitis for early diagnosis and treatment.Methods This study was conducted with the patients with confirmed diagnosis of infectious keratitis in our hospital during the period from January 2011 through December 2015.The specimens from corneal ulcer were subject to bacterial and fungal culture.The pathogens and associated risk factors of infectious keratitis were analyzed retrospectively.Results Of the 1 046 corneal specimens,369 (35.3％) were positive for microorganisms.The most frequently isolated microorganism was fungal species (53.1％),followed by grampositive cocci (31.2％),gram-negative bacilli (11.1％),and gram-positive bacilli (4.6％).Of the fungal strains,most were Fusarium (69.4％),followed by Aspergillus species (21.9％).Coagulase negative Staphylococcus accounted for more than half (50.4％) of the gram positive cocci.Conclusions Infectious keratitis is primarily associated with fungal infection,especially filamentous fungus such as Fusarium.

Objective To investigate the effect of the combination therapy of tirofiban and reteplase on endothelial function,coagulation function and plaque inflammation in elderly patients with ST-elevation acute myocardial infarction (STEMI).Methods 100 patients with STEMI were treated with percutaneous transluminal coronary intervention (PCI) from January 2014 to June 2016 in our hospital.39 cases in the control group used conventional oral aspirin,clopidogrel and statins and other treatment.61 cases in the observation group received tirofiban and reteplase on the basis of the control group.The expression of endothelial microparticles (EMP) was detected by flow cytometry (FCM),and the ICAM-1,high sensitivity C-reactive protein (hs-CRP),tumor necrosis factor α(TNF-α) and interleukin-6 (IL-6),endothelin-1(ET-1) were measured by enzyme-linked immunosorbent assay (ELISA).The thrombin time (TT),activated partial thrombin time (APTT),prothrombin time (PT) and other indicators were measured by PUN-2048A coagulation instrument,then statistical analysis was performed.Results The postoperative levels of EMP,ICAM-1 and ET-1 of control group were (693.46±90.72),(768.58±20.46)μg/L and (31.27±8.18)ng/L,which were significantly higher than those in the observation group [(652.36±67.39),(752.37±25.0)μg/L,(28.22±5.05)ng/L],the differences were statistically significant (t=2.41,2.67,2.68,all P<0.05).After operation,the hs-CRP,TNF-α,IL-6 levels in the control group were (4.16±2.35)mg/L,(4.32±2.02)ng/L,(10.59±3.16)ng/mL,which were significantly higher than those in the observation group [(2.22±1.47)mg/L,(2.74±1.52)ng/L,(6.33±2.24)ng/mL],the differences were statistically significant(t=2.65,2.67,3.42,all P<0.05).The postoperative TT,PT,APTT in the observation group were (26.31±3.18)s,(14.34±1.67)s,(27.20±4.12)s,which were significantly longer than those in the control group [(24.03±2.84)s,(12.56±1.43)s,(24.55±3.62)s],the differences were statistically significant(t=2.15,2.31,2.65,all P<0.05).Conclusion Tirofiban combined with reteplase can improve endothelial function,inhibit inflammatory reaction and regulate coagulation function.

Objective To investigate the metabolite changes in systemic lupus erythematosus (SLE) patients with and without neuropsychiatric symptoms using magnetic resonance spectroscopy (MRS) and explore the associations between image findings and clinical variables. Methods Twenty-two SLE patients with neuropsychiatric symptoms (NPSLE), twenty-one SLE patients without neuropsychiatric symptoms (non-NPSLE) and twenty healthy controls (HCs) underwent routine MRI scan and multivoxel magnetic reson-ance spectroscopy (MVS). The absolute metabolite concentrations were measured bilaterally in the posterior cingulate gyrus (PCG), dorsal thalamus (DT), lentiform nucleus (LN) and posterior paratrigonal white matter (PWM) using LCModel and SAGE software. The relationships between metabolite con-centrations and cognitive function scores were analyzed by Spearman rank correlation. Single-factor Chi-square analysis and t-test were used for analysis. Results ① Compared to control subjects, NPSLE patients had significantly lower N-acetylaspartate (NAA) values in bilateral PCG and DT, with the mean differences of -1.504 [95% confidence interval ( CI) (-2.335, -0.672), P=0.001], -1.460 [95%CI (-2.349, -0.570), P=0.002], -1.259 [95%CI (-1.894, -0.625), P=0.000] and -1.022[95%CI (-1.688, -0.356), P=0.003] for RPCG, LPCG, RDT and LDT, respectively. The concentration of total creatinine were observed to decline in RPCG and RDT, with the mean differences of-1.094 [95%CI (-1.845, -0.342), P=0.003], -0.955 [95%CI (-1.630, -0.280), P=0.006], -1.259 [95%CI (-1.894,-0.625), P=0.006] respectively. Glutamine and glutamate-values decreased significantly in RDT [mean difference=-2.586, 95%CI (-4.139, -1.033), P=0.002]. ② Compared to non-NPSLE patients, NPSLE patients had a lower NAA level in LPCG [mean difference=-1.256, 95%CI (-2.146, -0.367), P=0.006]. Positive correlations between mini-mental state examination scores [RPCG: rs=0.312, P<0.05; LPCG: rs=0.355, P<0.01], Montreal cognitive assessment scores (RPCG: rs=0.362, P<0.01; LPCG: rs=0.285, P<0.05) and NAA values in bilateral PCG were detected. Conclusion Both NPSLE and non-NPSLE patients may have metabolite dysfun-ctions in different brain regions. The cognitive disorder in SLE patients may be interpreted by neuronic damage of PCG.

With the advances in surgical technique,increasingly complicated and knotty surgeries were performed on neonatal and pediatric patients,and the success of many of these surgeries are ensured by an adequate and safe blood supply.Autologous and/or allogeneic blood may be used,depending upon the anticipated blood loss,types of components required,and urgency of surgery.However,in all cases,every attempt should be made to minimize the number of donor exposures to reduce the risk of transfusion,for dangers of transfusion having been payed more attention.The strategy and practice of blood support for pediatric surgery show very important.