Metastasis is the essential character of biological behaviors in malignancies,which is also the main reason for the death of patients with tumor. So it is very important to research the metastasis for the pre-vention and treatment of carcinomas. Rectal cancer is one of the most common gastrointestinal cancer,and its prognosis is bad. lymphatic metastasis is one important factor in the determination of colon cancer' s progno-sis. More than 50% patients are found lymphatic metastasis when taking operation. The ralationship of lym-phatic metastasis and prognosis is more important than the original tumor's invasiving. So it is meaningful to study the mechanism of tumor metastasis, and to provide a scientific approach to the prediction of tumor me-tastasis, the precise assessment of prognosis and the treatment of tumor metastasis.

OBJECTIVETo determine the influence of Helicobacter pylori (H. pylori) on gastric cancer-related antigen MG7 expression.

METHODSThe H. pylori infection and the expression level of antigen MG7 in gastric mucosa were determined by HE stain, PCR, ELISA and immunohistochemistry in 291 patients with H. pylori-related conditions, among whom 34 were followed-up.

RESULTSNo significant difference was found between H. pylori-negative and H. pylori-positive intestinal metaplasia, atrophic gastritis and dysplasia of gastric epithelium in positive rate of antigen MG7 expression. There was significant difference between H. pylori-negative and H. pylori-positive superficial gastritis in the positive rate of MG7 expression (P < 0.05). During follow-up, one of 3 H. pylori-negative cases turned to be H. pylori-positive, and its MG7 expression turned to be higher at the same time. Three of 31 H. pylori-positive patients were discovered as having early gastric cancer, among whom one with antigen MG7 expression (+ + +) was found to have a reduced Mg7 expression accompanied with H. pylori eliminutied after operation.

CONCLUSIONThere is correlationship between H. pylori infection and MG7 expression in superficial gastritis. Although the MG7-positive lesions with H. pylori infection shows a benign nature in morphology, they also have the potential risk of developing into gastric cancer. Therefore, they should be followed up, during which special attention should be paid to patients with increased MG7 expression.

Antibodies, Bacterial ; blood ; Antigens, Neoplasm ; biosynthesis ; DNA, Bacterial ; genetics ; Enzyme-Linked Immunosorbent Assay ; Gastric Mucosa ; metabolism ; microbiology ; pathology ; Gastritis ; metabolism ; microbiology ; Helicobacter Infections ; metabolism ; microbiology ; Helicobacter pylori ; genetics ; growth & development ; immunology ; Humans ; Immunohistochemistry ; Polymerase Chain Reaction ; Stomach Diseases ; metabolism ; microbiology ; Stomach Ulcer ; metabolism ; microbiology

ObjectiveTo investigate the features and methods of clinical diagnosis and treatment of elderly patients with acute calculous cholecystitis. MethodsA retrospective analysis was performed for the clinical data of elderly patients who were diagnosed with acute calculous cholecystitis in 451 Hospital of PLA from June 2012 to June 2015. After admission, all patients received fasting treatment, electrocardiographic monitoring, anti-infective therapy, and maintenance of body fluid balance and stable blood pressure and glucose. According to patients condition choose laparoscopic cholecystectomy open cholecystectomy, open cholecystectomy and common bile duct exploration. ResultsA total of 129 patients were enrolled; among these patients, 119 had acute calculous cholecystitis, 2 had gallstones with adenomatous hyperplasia of the gallbladder mucosa, 6 had pyogenic cholecystitis, and 2 had gallbladder gangrene. Among the patients enrolled, 52 were complicated by at least one internal disease. Among them, 67 underwent emergency surgery since there were no significant improvements in symptoms, and 62 showed relief of symptoms and underwent surgical treatment at other times. Of all patients, 108 underwent laparoscopic cholecystectomy, 9 underwent laparoscopy and were converted to open cholecystectomy, and 9 underwent open cholecystectomy and common bile duct exploration. All the surgeries were successful and all the patients were cured and discharged. There were no deaths. ConclusionElderly patients with acute calculous cholecystitis are in a critical condition and often complicated by various internal diseases. Laparoscopic cholecystectomy is the most commonly used therapeutic method. Clinicians should be fully prepared before surgery, take the perioperative management seriously, and accurately judge the surgical indications and timing.

Objective To access the influence factors of diagnostic delay of endometriosis. Methods We designed a questionnaire of diagnostic delay of endometriosis. From February 2014 to February 2016,400 patients who had dysmenorrhea and diagnosed with endometriosis by surgery in Peking University Third Hospital were surveyed retrospectively. Time and risk factors of diagnostic delay were analyzed.Results The diagnostic delay of 400 patients was 13.0 years(0.2-43.0 years),78.5%(314/400) patients thought pain was a normal phenomenon and didn′ t see the doctor. Patients who suffered dysmenorrhea at menarche experienced longer diagnostic delay than those who had dysmenorrhea after menarche(18.0 vs 4.5 years;Z=191.800,P<0.01).Patients who suffered aggravating dysmenorrhea experienced shorter delay time than those who suffered stable or relieving dysmenorrhea(11.0 vs 12.5 vs 18.0 years;Z=8.270, P<0.05), with the difference statistically significant, single factor analysis shows. Severe dysmenorrhea, deep infiltration endometriosis(DIE), family history of dysmenorrhea or endometriosis, previous surgical history of endometriosis,high stage,with infertility,adenomyoma or other symptoms,could help to shorten diagnostic delay with no significant difference(P>0.05). By multiple logistic regression analysis,the results shown that whether have dysmenorrhea at menarche and clinical diagnosis time were the independent factors affecting delayed diagnosis(P<0.01).Conclusions Diagnostic delay of endometriosis is common and the mean delay time is 13.0 years mainly due to the unawareness of dysmenorrhea. Dysmenorrhea at menarche,clinical diagnosis time and dysmenorrhea intensity are the factors affecting time of diagnostic delay.

Breast cancer is the most common cancer in women all over the world, and it is also the main cause of cancer death in women. In 2018, there were about 2.09 million of new breast cancer cases and 630 thousand of death cases worldwide. The incidence rate of breast cancer varies in different regions of the world, but all of them were on the rise. Although the incidence (36.1/10⁵) and mortality (8.8/10⁵) of female breast cancer in China were relatively low worldwide, the number of female breast cancer cases and deaths in China ranks first in the world. Moreover, the incidence and mortality of female breast cancer in China are increasing in recent year. Breast cancer is a multifactorial disease, mainly including genetic factors, environmental factors and behavioral lifestyle factors, etc. This review aims to explore the epidemiology and related risk factors of breast cancer in the world, so as to understand the prevalence of breast cancer and provide help for the prevention, intervention and early detection of breast cancer.

OBJECTIVETo study the effects of educational background of men who have sex with men (MSM) on their high risk sexual behaviors and the HIV/STI infection rates.

METHODSDuring July to November of 2009 and March to October of 2010, snowball and convenience sampling methods were adopted to recruit MSM from MSM venues and via the internet in Changzhou city of Jiangsu province, and finally 659 MSM were conducted a questionnaire survey and serological testing. According to the educational background of MSM, they were divided into 3 groups, that is, junior high school group (206 cases), high school group (254 cases), and university group (199 cases). The questionnaire mainly includes information on social demography, sexual behaviors, condom use, etc. Blood samples were collected for HIV and syphilis spirochete detection, and urine samples were also collected in 291 MSM who were recruited during July to November of 2009 for neisseria gonorrhoeae and chlamydia trachomatis nucleic acid detection. χ(2) test and other statistical analysis methods were used to compare the characteristics of sexual behaviors and HIV/STI infections in 3 groups.

RESULTSOf the 659 valid questionnaires returned, junior high school group, high school group, and university group accounted for 31.3% (206 cases), 38.5% (254 cases) and 30.2% (199 cases). Places where MSM of different education levels most often to seek sexual partners, were significantly different. Junior high school group and high school group mostly went to bath house/sauna club (56.3%, 116 cases) and bar (34.8%, 88 cases) for partners, respectively, while the university group sought partners mainly through the internet (41.1%, 81 cases) (χ(2) = 99.35, P < 0.05). 53.4% (109/204) of the junior high school group had anal sex with men in the last 6 months, which was higher than that of high school group (67.7%, 172/254) (χ(2) = 9.74, P < 0.05) and university group (72.7%, 144/198) (χ(2) = 16.04, P < 0.05) . A total of 54.4% (111/204) of the junior high school group had sex with women in the last 6 months, which was higher than that of university group (38.6%, 76/197) (χ(2) = 10.10, P < 0.05) , but was not statistically significantly different from that of high school group (46.9%, 119/254) (χ(2) = 2.59, P = 0.11) . The rates of condom use with men at the last anal sex in junior high school group (73.4%, 80/109) , high school group (78.0%, 131/168) and university group (73.9%, 105/142) were similar. The rates of condom use with women in the last intercourse in junior high school group, high school group and university group were 51.8% (57/110), 54.6% (65/119) and 61.8% (47/76), respectively(χ(2) = 1.88, P = 0.39) . In junior high school group, high school group and university group, the infection rates of HIV were 9.2% (19/206), 10.6% (27/254) and 5.6% (11/197) (χ(2) = 3.68, P = 0.16), the positive rates of neisseria gonorrhoeae were 3.8% (3/79), 3.4% (4/117) and 0.0% (0/95) (χ(2) = 3.85, P = 0.14), the positive rates of chlamydia trachomatis were 5.1% (4/79), 9.4% (11/117) and 4.2% (4/95) (χ(2) = 2.70, P = 0.26). The infection rate of syphilis in junior high school group was 19.9% (41/206), which was higher than high school group (12.2%, 31/254) (χ(2) = 5.11, P < 0.05) and university group (10.2%, 20/197) (χ(2) = 7.45, P < 0.05 ).

CONCLUSIONThere was no obvious correlation between education level and high risk sexual behaviors;MSM with lower education level were at higher risk of infection of syphilis.

Adult ; Cross-Sectional Studies ; Cultural Characteristics ; Educational Status ; HIV Infections ; epidemiology ; Homosexuality, Male ; Humans ; Male ; Middle Aged ; Schools ; Surveys and Questionnaires ; Syphilis ; epidemiology ; Universities ; Unsafe Sex ; Young Adult

Conversion therapy has become the core in the treatment of borderline resectable or unresectable liver cancer, which provides resectable opportunities for more advanced liver cancer patients. In accordance with the first-choice treatment regimen recommended by the guidelines, the authors reported a successful case of Atezolizumab and Bevacizumab (T+A regimen) conversion therapy. The patient with initially borderline resectable advanced liver cancer was performed liver segment resection sucessfully after conversion therapy, and non-tumor recurrence was observed at postoperative 9 months. Postoperative pathological examination showed combined hepatocellular-cholangiocarcinoma, which also indicated the important value of T+A regimen in the conversion therapy of combined hepatocellular-cholangiocarcinoma.

Lung cancer is the most common malignant tumor in the world. The five-year survival rate is 19.7%, which seriously threatens human health. Lung cancer screening is an effective measure to reduce lung cancer mortality. Existing studies have shown that screening with low-dose computed tomography (LDCT) can reduce lung cancer deaths by 20%. Currently, lung cancer screening is recommended internationally and nationally. Studying the development status of lung cancer screening helps us to identify the high-risk groups of lung cancer, explore reasonable screening programs, improve the cost-effectiveness of screening and reduce the economic burden. Therefore, this article summarizes the current status of lung cancer screening, the cost-effectiveness of lung cancer screening and the existing problems as follows.
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AIM: To investigate the differences in varying stages of non-proliferative diabetic retinopathy(NPDR)using optical coherence tomography angiography(OCTA).METHODS: Cross-sectional study. A total of 77 cases(77 eyes)of diabetic patients were included, and they were divided into non-diabetic retinopathy(NDR; 23 eyes)and non-proliferative diabetic retinopathy(NPDR; 54 eyes)groups, further subdivided into mild NPDR(20 eyes), moderate NPDR(20 eyes), and severe NPDR(14 eyes). Foveal avascular zone(FAZ)area, superficial and deep capillary plexus densities(SSP and DSP), and visual acuity(LogMAR)were compared between NDR and NPDR groups. Furthermore, the visual acuity, FAZ area and levels of SSP and DSP were compared in different degrees of NPDR. Correlation analysis were conducted to elucidate relationships between FAZ area, visual acuity, SSP, DSP, and severity of the disease.RESULTS: Compared with the NDR group, the visual acuity(LogMAR)and macular FAZ area increased, while SSP and DSP were decreased in the NPDR group(P<0.05); there were significant differences in visual acuity, FAZ area and SSP and DSP levels in different degrees of NPDR(P<0.05). Visual acuity(LogMAR)and FAZ area displayed a positive correlation with the severity of disease, while SSP and DSP showed a negative correlation.CONCLUSION: With the progression of NPDR, the visual acuity(LogMAR)and FAZ area increased, and the SSP and DSP decreased.