One hundred and seventy one gastric biopsy specimens from the patients undergoing gastroscopic examination from March to November 2010 were reviewed . HE, sliver and immunohistochemistry stains were performed in the specimens; the correlation of histopatholigy and the density and distribution of Helicobacter pylori in gastric mucosa was analyzed .The results displayed that spiral H.pylori mainly appeared on the surface mucus and in the gland lumen of gastric small concave , some were attached to the epithelial cells; coccoid H.pylori appeared within the apical cytoplasmic part of the epithelial cells and in the mucous membrane stroma .The depth of H.pylori infection was correlated with mucosal erosion , inflammation activities and amount of interstitial lymphocytes .The results suggest that spiral H.pylori infection may facilitate the invasive depth of coccoid H.pylori in gastric mucous membrane and the density of H.pylori infection is correlated with the extent and severity of inflammation .

Objective To research Dengue virus type 2 (DENV-2) to human umbilical vein endothelial cells (HUVEC) permeability. Methods The titration of DENV-2 was detected and HUVEC infection DENV-2 layer of cells. At different time points after infection (30 min, 1 h, 3 h, 6 h, 12 h, 30 h,36 h, 24 h, 42 h, 48 h,72 h), the permeability in HUVEC were detected after Dengue virus infection. The virus load in HUVEC was detected by quantitative real-time PCR. And ultrastructure in HUVEC was observed by electron microscope. Results The permeability in HUVEC was changed after Dengue virus infection by time lasting. The most permeability in HUVEC was changed after Dengue virus infection at 30 min and 42 h. And at the same time the virus load were most value in all of time. The results of the cell membrane were changed by electron microscope. The deciduous cell microvillus and dissd endochylema were founded. And some of nuclear membrane blank was wided by Dengue virus. Even the leakage was founded in cell nucleus. The other change included that disappearance mitochondrial and vacuolization crista, elder pith change mitochondria. In addition, the complete of cell membrane were dissolved. Conclusion The permeability of HUVEC was changed by DENV-2. To explore the pathogenesis of Dengue virus provide certain theoretical basis.

Objective To explore the clinical result and complications of noncyclic-PPH surgery in treating internal hemorrhoids.Methods In this study,we evaluate the clinical outcome,such as clinical efficacy,operation time,length of hospital stay,postoperative pain degree and incidence of complications in 120 hemorrhoid patients,randomly divided into control group (60 cases) and observation group (60 cases)based on digital table method,receiving respectively noncyclic-PPH,or PPH (procedure for prolapse and hemorrhoids).Results Two groups were similar in average operation time and average length of hospital stay (P ＞ 0.05).The postoperative VAS score at each time point,was significantly lower in noncyclic-PPH group than the control group (P ＜ 0.05).Non-cyclic PPH group were also significantly lower in postoperative complications than the control group (P ＜ 0.05).Conclusion Compared with PPH surgery,patients with noncyclic-PPH have fewer pain complications or trauma.

Objective To assess the status of knowledge,attitude and behaviors on brucellosis among key population of Xinjiang Production and Construction Corps,so as to provide a basis for specially carrying out health education and behavioral intervention.Methods According to the geographical distribution in Xinjiang,using the method of multistage stratified sampling to select farm households,herdsman,veterinary,and meat processing personnel over 9 years old from eight divisions (South Xinjiang:1,2 division and Northern Xinjiang 6,7,8,9,10 division) and so on as the research object from March 2013 to December 2015.Adopt self-designed questionnaire to carry out a face to face and household investigation.Results Totally 11 098 brucellosis key persons of eight divisions were investigated,and the total awareness rate was 83.61％ (92 794/110 980),with the First Division (75.78％,10 769/14 210) and the Sixth Division (66.45％,10 154/15 280) lower than the total awareness rate (x2 =52.8,288.1,all P＜ 0.01).The knowledge of brucellosis increased with the education level of the participants (x2 linear =6 245.3,P ＜ 0.01).There were significant differences in the knowledge of brucellosis among different nationalities (x2 =6 912.8,P＜ 0.01),and the Uygur (56.73％,3 909/6 890) and Hui (57.93％,2 850/4 920) were obviously lower than that in the Han (87.27％,78 932/90450).The awareness of different age groups was different (x2 =407.1,P ＜ 0.01),the ＞ 60 age group (74.63％,3 515/4 710) was the lowest.Different occupations were also different (x2 =675.5,P ＜ 0.01),and the farm households (81227％,4 4228/54 420) were lower,the veterinary was the highest (94.86％,2 438/2 570).Conclusions The brucellosis awareness rate of Xinjiang Corps region has reached the level of the epidemic areas,but ethnic minorities,the elderly and occupational population are still relatively low.We should take further measures to strengthen health education so as to improve the protection consciousness of local residents.

Objective To evaluate the diagnosis and treatment of duodenal neuroendocrine tumors.Method We retrospectively analyzed data of 15 patients with duodenal neuroendocrine tumors admitted between August 1999 and July 2012.Result In all the 15 cases accurate and definitive diagnosis were achieved via pathological examination and immunohistochemistry.Clinical diagnostic methods included ultrasound,endoscopy,upper gastrointestinal imaging,abdominal CT,MRI,etc.7 cases underwent pancreaticoduodenectomy,2 cases were treated by local excision,4 cases by endoscopic excision,and total gastrectomy and distal gastrectomy was performed in one each case.Conclusions The diagnosis of duodenal neuroendocrine tumors is established mainly by endoscopy and diagnostic imaging.Surgical resection is the treatment of choice.Pancreatoduodenectomy and local excision is applicable for G2 and G3 patients while endoscopic excision can be used for G1 patients.

Objective The aim of this study was to investigate whether the addition of neoadjuvant chemoradiotherapy ( NACRT ) to surgery can improve outcomes better than neoadjuvant chemotherapy in terms of rate of R0 resection, pathological complete response ( pCR ) and side effects. Methods This exploratory study included primary gastric adenocarcinoma patients staged as clinical T4N0 or anyTN1-3. Intensity modulated radiotherapy was delivered of 40 to 50 Gy in 22 to 25 fractions,5 days/week.Concurrent chemotherapy regimens included S-1 or Capecitabine or a combination of Paclitaxel plus Carboplatin.Results Eleven eligible patients were enrolled. R0 and R2 resections were performed in 9 ( 9/11) and 1 patients, respectively.Peritoneal metastasis was found in 1 case during exploratory laparotomy.The pCR was observed in 1 patient with R0 resection ( 1/10 ) . Ten cases completed radiotherapy and 8 cases completed chemotherapy. Nausea ( 3/11 ) , vomit ( 2/11 ) and anorexia ( 2/11 ) were the most common Grade 3 toxicities. Conclusions NACRT showed an acceptable toxicity and promising activity in locally advanced gastric adenocarcinoma.

Objective Data from the HIV/AIDS surveillance sentinel sites was used to identify the recent HIV-1 infections and to estimate the HIV-1 incidence and epidemic trends among intravenous drug users (IDU),MSM,female sex workers and men attending the sexually transmitted disease clinics in Sichuan province.Methods Specimens collected from IDUs,MSM,female sex workers and men attending the sexually transmitted disease clinics sentinel sites were confirmed as HIV-I positive and tested with BED-CEIA.Annual HIV-1 prevalence and incidence rates were calculated and the incidence was adjusted by McNermar method.Results A total number of 194 223 serum specimens were collected and HIV antibody tested,with 5 297 HIV-1 positive.4 640 of the positives underwent BED-CEIA,with 749 identified as recent infections.During 2011-2015,HIV-1 incidence rates of the four types of population appeared as 5.16％ (95％CI:4.65-5.66),0.22％ (95％CI:0.16-0.28),0.57％(95％CI:0.45-0.69),7.53％ (95％CI:6.06-9.01) and 0.44％ (95％CI:0.36-0.53) respectively.Significant differences were seen in the HIV-1 incidence rates.Conclusions The HIV-1 incidence rates of IDUs from other sentinel sites in Sichuan province,female sex workers and men attending the sexually transmitted disease clinics appeared low,showing that the AIDS prevention and control activities worked effectively.However,the HIV-1 incidence of MSM was still at high level and even rising,suggesting that HIV-1 transmission between MSM and IDUs was possible.

OBJECTIVETo investigate the drug resistance of HIV patients to the HIV-1 CRF01_AE and CRF07_BC strains in Sichuan province during 2010 to 2013.

METHODS1.5 ml of plasma were collected from AIDS patients who had been receiving anti-retroviral treatment for over 6 months but still had a HIV-1 virus load of over 1 000 copies/ml from January 1, 2010 to December 31, 2013 in Sichuan province. Genetic analysis of the HIV-1 pol gene was performed using self-established method, and patients with a positive drug-resistant HIV-1 pol gene mutation were included. HIV-1 poly gene was successfully sequenced for a total of 1 213 patients. Drug resistance of different HIV-1 strains was compared with χ2 test or Fisher exact test.

RESULTS558 cases (46.0%) of the 1 213 successfully sequenced patients were infected by HIV-1-strains with drug-resistant mutations, including 327 cases (58.6%) infected by CRF01_AE strain, 126 (22.6%) by CRF07_BC strain, 46 (8.2%) by CRF08_BC strain, 33 (5.9%) by B strain, 4 (0.7%) by C strain, 1 (0.2%) by CRF02_AG strain, and 21 (3.8%) by unidentified strains. Drug-resistant mutation analysis revealed that L33, F116, L74, Q151, and T69 resistance mutations occurred only in the CRF01_AE strain, while A71, K43, and Q58 resistance mutations occurred only in the CRF07_BC strain; in nuclear nucleoside reverse transcriptase inhibitors (NRTIs) and non nucleoside reverse transcriptase inhibitors (NNRTIs), CRF01_AE subtype strains showed highly resistant rate were higher than CRF07_BC, CRF08_BC and B subtype strains, with the differences were statistically significant (P<0.05).

CONCLUSIONThe drug-resistant HIV-1 strains in Sichuan mainly included the CRF01_AE and CRF07_BC strains, which had different resistance mutations.

Base Sequence ; Drug Resistance, Viral ; Genes, pol ; HIV Infections ; HIV-1 ; Humans ; Mutation ; Reverse Transcriptase Inhibitors ; Viral Load

Objective:To investigate the application value of mesocolon approach in transanal total mesorectal excision (TaTME).Methods:The retrospective cohort study was conducted. The clinicopathological data of 61 patients with middle or low rectal cancer who were admitted to the Nanchong Central Hospital of North Sichuan Medical College from January to December in 2018 were collected. There were 41 males and 20 females, aged from 43 to 81 years, with an average age of 62 years. Of the 61 patients, 30 patients undergoing TaTME with the conventional approach were allocated into traditional approach group, and 31 patients undergoing TaTME with mesocolon approach were allocated into mesocolon approach group. Observation indicators: (1) surgical situations; (2) postoperative recovery; (3) follow-up. Follow-up was conducted by outpatient examination and telephone interview once every 3 months to detect local recurrence and metastasis of tumors in patients up to June 2019. Measurement data with normal distribution were expressed as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were expressed as M (range), and comparison between groups was conducted using the Mann-Whitney U test. Count data were expressed as absolute numbers or percentages, and comparison between groups were analyzed using the chi-square test or Fisher exact probability. Comparison of ordinal data between groups was analyzed using the Mann-Whitney U test. Results:(1) Surgical situations: patients in the two groups underwent TaTME successfully, without conversion to laparotomy. The transabdominal operation time, volume of intraoperative blood loss, length of distal margin from surgical specimen, length of proximal margin from surgical specimen, cases with complete mesentery or with nearly complete mesentery ( the integrity of mesentery ), positive rate of circumferential margin, positive rate of distal margin, and the number of lymph node dissected of the traditional approach group were (126±56)minutes, 41.0 mL (range, 17.5-71.4 mL), 1.3 cm (range, 0.8-2.0 cm), (10.0±5.0)cm, 10, 20, 3.3%(1/30), 0, 13.7 (range, 9.0-17.0), respectively, versus (101±30)minutes, 44.0 mL (range, 25.0-67.5 mL), 1.6 cm (range, 1.1-2.2 cm), (12.0±3.0)cm, 23, 8, 6.5%(2/31), 0, 13.0 (range, 10.9-17.3) of the mesocolon approach group. There were significant differences in the transabdominal operation time, length of proximal margin from surgical specimen, and the integrity of mesentery between the two groups ( t=2.133, -2.286, χ2=10.250, P<0.05). There was no significant difference in the volume of intraoperative blood loss, length of distal margin from surgical specimen, or the number of lymph node dissected between the two groups ( Z=-0.662, -1.107, 0.304, P>0.05). There was also no significant difference in the positive rate of circumferential margin or positive rate of distal margin between the two groups ( P>0.05). (2) Postoperative recovery: the time to first anal flatus of the traditional approach group was 51 hours (range, 48-64 hours). There were 3 patients with complications in the traditional approach group. One patient in the traditional approach group had postoperative anastomotic fistula of Clavien-Dindo classification Ⅱ, and was cured after conservative treatment including sufficient drainage, parenteral nutrition and anti-infective treatment. One patient had chylous fistula of Clavien-Dindo classification Ⅱ, and was cured after conservative treatment. One patient had pulmonary infection of Clavien-Dindo classification Ⅳa, and was cured after treatment in ICU. The duration of postoperative hospital stay of the traditional approach group was (11.3±4.5)days. The time to first anal flatus of the mesocolon approach group was 59 hours (range, 49-70 hours). One patient in the mesocolon approach group had paralytic ileus of Clavien-Dindo classification Ⅰ, and was cured after conservative treatment. The duration of postoperative hospital stay of the mesocolon approach group was (9.6±1.8)days. There was no significant difference in the time to first anal flatus or duration of postoperative hospital stay between the two groups ( Z=-0.554, t=1.884, P>0.05). There was no significant difference in the complications between the two groups ( P>0.05). (3) Follow-up: 61 patients were followed up for 6-18 months, with a median time of 12 months. There was no local recurrence or metastasis of tumors in patients during the follow-up. Conclusion:The mesocolon approach is safe and feasible in TaTME, which abides by the principle of radical resection, and can decrease the difficulty of mesocolon excision, shorten the time of transabdominal operation, increase the length of proximal margin from tumor specimen, improve the integrity of mesentery.

OBJECTIVETo study the detection method of coccoid helicobacter pylori (HP) and to investigate the significance of pure coccoid HP infection of gastric mucous membrane.

METHODSA total of 171 gastric biopsy specimens were reviewed by HE stain, and the presence, density and tissue distribution of HP were investigated by sliver stain and immunohistochemistry(S-P method).

RESULTSThe rates of mucosal erosion and active inflammation with the presence of pure coccoid HP infection were 36.0% (9/25) and 44.0% (11/25), respectively, both higher than those without HP infection (13.5%, 10/74; 24.3%, 18/74), while lower than those infected with spiral HP (72.1%, 49/68; 79.4%, 54/68). The quantity of interstitial lymphocyte and inflammation severity were also higher than those without HP infection, while lower than those with spiral HP infection.

CONCLUSIONSPure coccoid HP causes human gastritis, similar to that of spiral HP infection but at a lesser degree. Further studies are important to confirm its clinical significance.

Adult ; Aged ; Female ; Gastritis ; microbiology ; pathology ; Gastritis, Atrophic ; microbiology ; pathology ; Helicobacter Infections ; microbiology ; Helicobacter pylori ; classification ; isolation & purification ; Humans ; Lymphocyte Count ; Male ; Middle Aged