Objective To explore the effect and safety of magnetic resonance imaging and transrectal ultrasound (mpMRI-TRUS) image fusion targeted transperineal biopsy technique using electromagnetic needle tracking under local anesthesia. Methods We retrospectively analyzed the clinical and pathological data of 81 patients with mpMRI-TRUS image fusion targeted transperineal prostate biopsy using electromagnetic needle tracking under local anesthesia. Visual analog scale (VAS) and visual numeric scale (VNS) were used to evaluate the pain level and satisfaction of patients during prostate biopsy (VAS-1 and VNS-1), one hour after puncture (VAS-2 and VNS-2), and one day after surgery (VAS-3 and VNS-3). The perioperative clinical data and tumor positive rate of postoperative biopsy were recorded. Results The average prostate volume of 81 patients was 53.39±29.46 cm³. The PSA values of patients with PI-RADS scores of 2, 3, 4, and 5 were 9.14±2.31, 9.95±4.10, 14.77±6.36, and 32.17±24.39 ng/ml, respectively. The scores of VAS-1, VAS-2, and VAS-3 were 1.70±0.73, 1.16±0.58, and 0.53±0.55, respectively; the scores of VNS-1, VNS-2, and VNS-3 were 2.74±0.44, 3.69±0.46, and 3.84±0.37, respectively. The average surgical time was 17.47±3.44 minutes. Postoperative pathological results showed that the tumor positive rate of targeted prostate biopsy was 64.20%. According to the PI-RADS score for subgroup analysis, the tumor positive rates of patients with PI-RADS scores of 2, 3, 4, and 5 were 21.43%, 44.44%, 61.11%, and 96.77%, respectively. After transperineal prostate biopsy, gross hematuria occurred in 19.75% patients, and urinary retention occurred in 3.70%. The latter were relieved after symptomatic treatment. All patients did not experience complications, such as perineal puncture area hematoma, urinary tract infection, hematospermia, hematoma in perineal puncture area, urinary tract infection, hematospermia, vagus nerve reaction, or septic shock. Conclusion For suspected prostate cancer patients, mpMRI-TRUS image fusion targeted transperineal biopsy technique using electromagnetic needle tracking under local anesthesia is a feasible and easily tolerated surgical procedure. It has good safety and high tumor positive-detection rate, indicating that this technique is worthy of further clinical promotion and application.

Objective To explore the efficacy and safety of multi-parametric magnetic resonance imaging and transrectal ultrasonography(mpMRI-TRUS)fusion targeted transperineal biopsy(TPB)under local anesthesia(LA)with"one-plane three-point"dual probe ultrasound localization.Methods Clinical data of 134 suspected prostate cancer(PCa)patients treated with this method in our hospital during Jan.and Sep.2023 were retrospectively analyzed.The same doctor applied visual analog scale(VAS)and visual digital scale(VNS)to evaluate the pain level and satisfaction of patients during TPB(VAS-1 and VNS-1)and 1 hour after TPB(VAS-2 and VNS-2),and recorded the perioperative clinical data and detection rate of clinically significant prostate cancer(csPCa).Results VAS-1 score was(1.60±0.68)and VAS-2 score was(1.13±0.55);VNS-1 score was(2.84±0.41),and VNS-2 score was(3.74±0.44).The operation time was(16.12±3.35)minutes.The postoperative pathological results showed that the detection rate of csPCa was 65.67％(88/134).According to the PI-RADS score in subgroup analysis,the detection rates of patients with PI-RADS scores of 2,3,4,and 5 were 23.08％(6/26),52.94％(18/34),62.50％(15/24)and 98.00％(49/50),respectively.After TPB,gross hematuria occurred in 20.90％(28/134)patients,and urinary retention occurred in 4.00％(5/125)patients,which were relieved after symptomatic treatment.No complications such as perineal puncture area hematoma,urinary tract infection,hematospermia,vagal nerve reaction,and septic shock occurred.Conclusion The mpMRI-TRUS fusion targeted TPB under LA with"one-plane three-point"dual probe ultrasound localization provides a feasible and tolerable surgical procedure for suspected PCa patients with a high detection rate of csPCa,which is worthy of further clinical promotion and application.

Objective To explore the feasibility and accuracy of neutrophil-to-lymphocyte ratio(NLR)in the prediction of testicular torsion(TT)in children with acute scrotal pain.Methods A retrospective case-control study was performed on 158 pediatric patients with ultrasound suspicion of TT who underwent surgical testicular examination during Jan.2017 and Jan.2024.The patients were divided into TT group and non-TT group.Clinical data and laboratory data at admission were analyzed.Sensitivity and specificity of NLR to TT were determined with the area under the curve(AUC)represented on the receiver operating characteristic(ROC)curves.Results There were with no statistically significant differences in clinical data between the two groups(P＞0.05).The NLR was significantly higher in the TT group than in the non-TT group[(4.82±2.37)vs.(2.85±0.75),P＜0.05].The optimal cut-off value of TT predicted by NLR was 2.07,the AUC was 0.809(95％CI:0.709-0.909),and the sensitivity and specificity were 97.9％and 93.3％,respectively,which were significantly higher than other factors.Conclusion For suspicious ultrasound diagnosis of pediatric acute scrotal pain cases,NLR can be used to predict the possibility of TT and may help to evaluate the urgent surgical treatment in these patients.

Objective To explore the application value of mpMRI-TRUS multi-modal image fusion transperineal biopsy technique using electromagnetic needle tracking under local anesthesia combined with rapid paraffin-embedded section of small specimen in the diagnosis of prostate cancer.Methods The clinicopathological data of 138 patients with PI-RADS score≥3 who underwent mpMRI-TRUS image fusion transperineal biopsy using electromagnetic needle tracking under local anesthesia were retrospectively analyzed.AI technology was used to fuse mpMRI and TRUS multi-mode images,and two-core targeted biopsies were performed on suspicious lesions,followed by 12-core systematic biopsies.The specimens obtained from targeted biopsies were sent for rapid paraffin-embedded section pathological examination,and the detection rates of csPCa were compared.Results The detection rate of csPCa in 138 patients was 71.01% .The detection rates of csPCa in targeted biopsies and systematic biopsies were 62.32% and 70.29%,respectively(P=0.20).The detection rate of combined biopsies was higher than those of targeted biopsies and systematic biopsies,but the difference was not statistically significant(P>0.05).The detection rates of csPCa in targeted biopsies,systematic biopsies,and combined biopsies in patients with PI-RADS score 3 were 30.95%,38.10%,and 40.48%,respectively;and the percentages were 52.94%,61.76%,and 61.76% in patients with PI-RADS score 4,respectively;and the percentages were 90.32%,96.77%,and 96.77% in patients with PI-RADS score 5,respectively,without statistically significant difference(all P>0.05).In the subgroups with PI-RADS scores of 3,4,and 5,the missed diagnosis rates of csPCa by targeted biopsies were 23.53%,14.29%,and 6.67%,respectively.Conclusion For patients with suspected prostate cancer and PI-RADS v2.1 score≥3,transperineal biopsy using electromagnetic needle tracking combined with rapid paraffin-embedded section of small specimen can obtain pathological results rapidly and has good diagnostic accuracy.However,combined biopsy is still the most suitable method for the diagnosis of prostate cancer at present.

Objective To study the effects of pressure controlled ventilation(PCV)and volume controlled ventilation(VCV)on diaphragm function and the incidence of postoperative pulmonary complica-tions(PPCs)in patients undergoing laparoscopic surgery.Methods Sixty-six patients underwent laparo-scopic gynecological surgery under general anesthesia,aged 18-64 years,BMI 18-30 kg/m2,ASA physical status Ⅰ or Ⅱ were recruited.The patients were randomly divided into two groups:PCV group(group P)and VCV group(group V),33 cases in each group.All the patients were ventilated in VCV mode after induction.Group P was switched to PCV after pneumoperitoneum and group V maintained VCV until the end of operation after pneumoperitoneum.The diaphragm ultrasonic evaluation indexes including di-aphragmatic excursion(DE),diaphragm contraction velocity(DCV),and diaphragmatic rapid shallow breathing index(D-RSBI)were recorded before anesthesia induction,immediately after extubation,and 30 minutes after extubation.The mechanical ventilation time,artificial pneumoperitoneum time,the time from the end of artificial pneumoperitoneum to extubation,the cumulative dosage of cisatracuriumbesylate,and the patient's observer's assessment alert/sedation(OAA/S)immediately after extubation,the incidence of diaphragm dysfunction immediately after extubation and 30 minutes after extubation,and the cumulative in-cidence of PPCs in 1-3 days after operation.Results Compared with group V,DE in group P was in-creased significantly immediately after extubation(P＜0.05),but there was no significant difference in DE of 30 minutes between the two groups after extubation.Compared with group V,DCV in group P was in-creased significantly immediately after extubation and 30 minutes after extubation(P＜0.05),the inci-dence of PPCs in group P was significantly lower on the 1st day after operation(P＜0.05).There were no significant differences in D-RSBI,time of mechanical ventilation,time of artificial pneumoperitoneum,time from the end of pneumoperitoneum to extubation,cumulative dosage of atracurium besylate,OAA/S score immediately after extubation,and the incidence of diaphragm dysfunction immediately after extubation and 30 minutes after extubation,and the cumulative incidence of PPCs on the 2nd and 3rd day after operation.Conclusion In lower abdominal endoscopic gynecological surgery,compared with volume-controlled venti-lation mode,pressure-controlled ventilation mode dose not reduce the incidence of postoperative diaphragm dysfunction,but dose alleviate the weakening of diaphragm inspiratory force and reduce the incidence of pul-monary complications on the first day after operation.

Objective:To find out the variety, producing area, fluorine content of brick tea in Qinghai Province, and the drinking situation of brick tea among people, so as to provide basis for preventing and curing endemic fluorosis of drinking tea type.Methods:From April to November 2019, according to historical data, in 3 066 administrative villages in 39 counties (cities, districts, hereinafter referred to as counties) in Qinghai Province that had the habit of drinking brick tea, 10 families were randomly selected from each village to investigate the demographic data of each family and the drinking situation of brick tea, to collect brick tea samples to determine the fluorine content, and to calculate the daily average brick tea fluorine intake of the population > 16 years old.Results:A total of 31 067 brick tea samples were collected. The main brick tea consumed by the residents in the whole province was Fu brick tea, accounting for 89.97% (27 952/31 067), followed by Kang brick tea [5.12% (1 592/31 067)], Green brick tea [2.29% (710/31 067)], Black brick tea [1.85% (574/31 067)], and golden tip, mosaic, black wool and other brick tea [0.77% (239/31 067)]. There were 523 brands of brick tea in circulation in the province, among which there were 410 brands produced in Hunan Province, 26 brands in Sichuan Province, 11 brands in Hubei Province, and 76 brands in Henan Province and other provinces. The average content of fluorine in brick tea was 646.1 mg/kg, which ranged from 40.0 to 2 295.0 mg/kg. Brick tea with fluorine content ≤300 mg/kg accounted for 7.80% (2 422/31 067) of all samples. The annual average consumption of brick tea by population > 16 years old was 1.09 (0.35 - 7.40) kg, and the daily average brick tea fluorine intake was 1.93 (0.39 - 18.64) mg. There were 15 counties and 486 administrative villages in which the daily average brick tea fluorine intake exceeded the national standard (3.5 mg).Conclusion:The main brick tea in circulation in Qinghai Province is Fu brick tea, which has high fluorine content and is harmful to people, and prevention and control measures should be taken as soon as possible.

Objective:To understand the situation of drinking water-borne endemic fluorosis (short for drinking water fluorosis) in Huangzhong, Ping'an and Ledu districts of Qinghai Province and operation status of water improvement projects, and to evaluate the effect of control measures.Methods:In historical drinking water fluorosis villages of Huangzhong, Ping'an and Ledu districts of Qinghai Province in 2018, the status of water improvement, the operation of water improvement projects and the content of water fluoride were investigated; the dental fluorosis of 8-12 years old children in all investigated villages was checked; 3 villages from 3 districts were selected, X-ray examination for skeletal fluorosis and urinary fluoride detection of adults over 25 years old of age were performed.Results:Eight-two historical drinking water fluorosis villages in 3 districts were investigated and all the villages had water improvement projects, in addition, the water improvement projects were operating normally, and the water fluoride content ranged from 0.10 to 0.37 mg/L, which were in line with the drinking water fluoride content standard (< 1.2 mg/L). Totally 2 503 children aged 8-12 years old were examined, the detection rate of dental fluorosis was 6.03% (151/2 503), the index of dental fluorosis was 0.13, the epidemic intensity was negative; the detection rates of dental fluorosis in 3 districts were 6.24% (129/2 068), 4.05% (7/173), 5.73% (15/262), respectively, reaching the control standard (< 30%), and the detection rate of dental fluorosis in 81 villages was less than 30%; 198 adults over 25 years old were examined, the detection rate of skeletal fluorosis was 5.05% (10/198), the geometric mean of urinary fluoride was 0.81 mg/L, and skeletal fluorosis cases were mainly in the age group over 40 years old, all of them were mild cases.Conclusions:The fluoride content in drinking water and the detection rate of children's dental fluorosis are all up to the control standard, and the condition of skeletal fluorosis is significantly reduced after the implementation of water improvement measures in Huangzhong, Ping'an and Ledu districts. It can be seen that the prevention and control of drinking water fluorosis in Huangzhong, Ping'an and Ledu districts have achieved good results, but later management and condition monitoring of water improvement projects should be strengthened to prevent the disease from rebounding.

Objective:To investigate the dietary iodine intake of people in different areas of Qinghai Province, and to provide the basis for scientific iodine supplementation and continuous elimination of iodine deficiency hazards.Methods:From 2018 to 2019, according to administrative division, natural geographical regions, population distribution and economic development level of Qinghai Province, a total of 14 survey sites were selected. One village was selected from each survey site, and 20 households were selected from each village, the salt samples and 24 h urine samples of all family members were collected to detect salt iodine and urinary iodine. One drinking water sample was collected at the five directions of east, west, south, north and middle of each village to detect water iodine. Salt iodine was detected by direct titration, urinary iodine and water iodine were detected by arsenic-cerium catalytic spectrophotometry. At the same time, the 3-day weighing method was used to investigate the diet, the daily dietary iodine intake per capita (the result was expressed as average) and the proportion of dietary iodine in urinary iodine were calculated, the daily dietary iodine intake per capita of different production modes (agricultural region and pastoral region), different geographical environment (Hehuang Valley, Qaidam Basin, Qilian Mountain and Qingnan Plateau), different nationalities (Han, Tibetan, Hui, Mongolian, Tu, Salar) and different economic levels (< 8 000, 8 000 -, 10 000 -, ≥12 000 Yuan) were compared.Results:A total of 999 people from 280 families were surveyed, including 511 males and 488 females. The median water iodine of each survey site was less than 10 μg/L, all of which were environmentally iodine-deficient areas. A total of 280 salt samples were collected, the median salt iodine was 26.0 mg/kg, and the consumption rate of qualified iodized salt was 100% (280/280). A total of 999 urine samples were tested, and the median urinary iodine of people was 192.5 μg/L, which was at an appropriate level of iodine. There was no statistically significant difference ( t =-1.599, P > 0.05) in the daily dietary iodine intake per capita (28.53, 33.44 μg) of people in agricultural region ( n = 643) and pastoral region ( n = 356). The daily dietary iodine intake per capita (25.38, 33.30, 32.98, 34.79 μg) of people in Hehuang Valley ( n = 448), Qaidam Basin ( n = 125), Qilian Mountain ( n = 157), and Qingnan Plateau ( n = 269) were compared, the difference was statistically significant ( F = 2.883, P < 0.05); among them, the daily dietary iodine intake per capita in Hehuang Valley was lower than that in Qingnan Plateau ( P < 0.05). The daily dietary iodine intake per capita of different nationalities were compared, the difference was statistically significant ( F = 3.647, P < 0.05), Salar ( n = 68) and Tibetan ( n = 239) were higher (37.21 and 32.21 μg). The daily dietary iodine intake per capita (38.97, 17.01, 30.86, 33.14 μg) of annual per capita disposable income < 8 000 ( n = 194), 8 000-( n = 221), 10 000-( n = 302), ≥12 000 Yuan ( n = 282) were compared, the difference was statistically significant ( F = 9.407, P < 0.05). The proportions of dietary iodine in urinary iodine of various population ranged from 5.35% to 15.54%. Conclusions:The iodine nutrition of people in Qinghai Province is suitable, the dietary iodine intake of people is closely related to geographical environment, nationality and economic level. But the proportion of dietary iodine in urinary iodine is relatively low, the consumption of iodized salt is still the main way for people to intake iodine, and it is also the main measure to continuously eliminate the harm of iodine deficiency in Qinghai Province.

Objective:To understand the water iodine content in Qinghai Province and draw a distribution map of water iodine, so as to provide a basis for scientific supplementation of iodine and continuous elimination of iodine deficiency hazards.Methods:In 2017, in all counties (cities, districts) in Qinghai Province, with townships (towns, streets, referred to as townships) as the unit, the residents' drinking water samples were collected, water iodine content was tested, the median water iodine was calculated, and the water iodine distribution map of Qinghai Province was drew.Results:Totally 1 836 drinking water samples were collected in 392 townships, the median water iodine was 1.7 μg/L. Townships that had the median water iodine < 5 μg/L, in the range of 5 to 10 μg/L and > 10 μg/L accounted for 80.6% (316/392), 17.1% (67/392) and 2.3% (9/392), respectively. Among all townships, the highest of the median water iodine was 24.8 μg/L. Based on the results, water iodine distribution map of Qinghai Province, water iodine distribution map of Xining City and water iodine distribution map of Haidong City were compiled.Conclusions:Iodine deficiency is widespread throughout natural environment in Qinghai Province. Hence, salt iodization measures to prevent iodine deficiency disorders should be implemented continuously. According to the water iodine distribution map, the people should be guided to supplement iodine scientifically.

Objective:To observe and evaluate the effect of health education on drinking brick-tea type fluorosis in Zhiduo County, Qinghai Province, so as to provide basis for further formulating health education strategies.Methods:From April 2019 to April 2020, according to the historical prevalence of drinking brick-tea type fluorosis in Zhiduo County, Qinghai Province, 3 townships (towns) were selected to carry out the health education activities on drinking brick-tea type fluorosis for students of grade 4 - 6, village doctors, adults and monks in each township (town). We carried out a one-year publicity on the prevention and treatment of drinking brick-tea type fluorosis, distributed health education materials and organized health education activities. Before and after the intervention, we conducted a questionnaire survey on health education among the target population (grade 4 - 6 students, village doctors, adults and monks), to evaluate the awareness rate and behavior formation rate of fluorosis prevention and control, and to evaluate the intervention effect.Results:A total of 86 students of grade 4 - 6, 40 village doctors, 42 adults and 20 monks were investigated, after the intervention, the awareness rates of prevention and treatment of drinking brick-tea type fluorosis in grade 4 - 6 students, village doctors, adults and monks were 87.98% (227/258), 96.67% (116/120), 81.75% (103/126), 83.33% (50/60), respectively, which were significantly higher than those before the intervention [38.38% (76/198), 83.33% (100/120), 15.45% (19/123), 28.89% (13/45), P < 0.05]. After the intervention, the behavior formation rates of prevention and treatment of the drinking brick-tea type fluorosis in grade 4 - 6 students, village doctors, adults and monks were 74.42% (128/172), 72.50% (58/80), 52.38% (44/84), 60.00% (24/40), respectively, which were significantly higher than those before the intervention [14.39% (19/132), 38.75% (31/80), 3.66% (3/82), 0(0/28), P < 0.05]. Conclusion:The comprehensive intervention measures based on health education can significantly improve the knowledge of local residents, and improve their bad drinking habits of drinking tea, which is of great significance to the prevention and treatment of drinking brick-tea type fluorosis.