Objective The gross appearance and histopathology as well a s the treatment of early colorectal carcinoma were investigated. Methods The clinical documents and histopathology of 105 cases(106 lesions) with early color ectal carcinoma detected by colonoscopy and proved pathologically after operatio n in past 16 years were retrospectively reviewed and analysed. Results 91.5％ of the early colorectal carcinoma were located distal to the sigmoid.The macro scopic type of these lesions under colonoscopy was classified as Ip type in 34 l esions,Ips type in 13,Is type in 26,Ⅱ a type in 11,Ⅱ a＋Ⅱ c type in 22(in whi ch 21 lesions are Sm carcinoma).Lymph node involvement was observed in 3 cases o f the 25 with Sm carcinoma (accounting for 12％ ).13 lesions(in 12 cases)were re moved under the colonoscopy,local recurrence was found in one case of Sm carcino ma during the follow up period and treated with radical operation.93 lesions(in 93 cases)were treated by local resection or radical surgery. Conclusions Most of the carcinomas withⅡ a＋Ⅱ c type were sm carcinoma.Histopathologically mos t of Sm carcinomas were poorly or moderately differentiated adenocarcinomas.Lymp h node involvement only appeared in Sm carcinoma.Radical operation should be per formed in the following conditions (1)the macroscopic type isⅡ a＋Ⅱ c type,(2) the histopathologic type is poorly differentiated adenocarcinoma,(3)involvement of submucosa or lymph node metastasis

Objective To investigate the epidemiological characteristics of renal transplantation recipients, effective prevention and control measures. Methods A total of 456 renal transplant recipients were monitored from January 2014 to December 2017. Postoperative infection including baseline data, infection site and infectious pathogen type was analyzed. Results Among 456 renal transplant recipients, 78 cases (17.1%) developed nosocomial infection. Postoperative infection time was 9(3-21) d. Infection sites mainly included the lower respiratory tract, urinary system and blood infection. Infection pathogens consisted of Staphylococci (n=13), Enterococcus faecium (n=6), fungi (n=6), Stenotrophomonas maltophilia (n=4), Acinetobacter baumannii (n=4), Pseudomonas aeruginosa (n=4), Staphylococcus epidermidis (n=4), Klebsiella pneumoniae (n=1), Escherichia coli (n=1) and other negative bacteria (n=9). Among them, 11 cases (14%) were infected with multi-drug resistant bacteria, and 4 cases died. Conclusions In renal transplant recipients, the incidence of nosocomial infection is relatively high, with early postoperative onset, common multiple drug-resistant bacterial infection and high mortality. Preoperative preparations should be fully implemented, postoperative lower respiratory tract infection should be actively prevented and prevention and treatment measures for multidrug-resistant bacteria should be standardized.

Objective To investigate the epidemiological characteristics of nosocomial infection after liver transplantation from organ donation after death of citizens,and to provide evidence for the development of effective prevention and control strategies.Methods Targeted monitoring was conducted on liver transplantation patients in a hospital from January 1,2014 to December 31,2017,and then descriptive statistical analyses were carried out on postoperative infection after liver transplantation.Results The nosocomial infection occurred in 118 cases (55.40％) among 213 cases of liver transplantation.The infection sites were lower respiratory tract,blood system,and intraabdominal infection,accounting for 40.30％,22.39％,and 19.40％,respectively.186 strains of pathogens were isolated,mainly including gram-positive cocci (including 113 strains,60.75％),followed by gram-negative bacilli (56 strains,30.11％) and fungi (17 strains,9.14％).There was significant difference in the infection of the respiratory tract,post-operative wounds and other part s (P＜(0.05).The most common pathogens were Enterococcus faecium,Staphylococcus,Klebsiella Pneumoniae,and Stenotrophomonas maltophilia,accounting for 15.05％,15.05％,10.22％ and 9.69％,respectively.There was significant difference in Gram-negative Bacillus,fungi strains,Acinetobacter strains,Enterococcus faecium strains,Pseudomonas aeruginosa strains,Stenotrophomonas maltophilia and staphylococcus (P ＜ 0.05).Conclusion The patients after liver transplantation from organ donation after death have a high incidence of nosocomial infection.The infection was mainly distributed in the lower respiratory tract and blood system,and predominantly caused by bacteria and fungi.Infection surveillance of liver transplant patients should be strengthened and comprehensively effective prevention and control measures for nosocomial infection should be developed.

Objective:To compare the population characteristics, the positive rate of screening, the detection rate of breast cancer, early diagnosis rate and the cost between the mass screening group and opportunistic screening group of breast cancer.Methods:This study is a prospective multicenter cohort study conducted from January 1, 2014 to December 31, 2016. The participants were enrolled for mass screening or opportunistic screening of breast cancer. After completing the questionnaire, all the participants received breast physical examination and breast ultrasound examination every year for 3 rounds by year. The participants′ characteristics and screening results of the two groups were compared by χ 2 test, Fisher exact test or Wilcoxon rank-sum test. Results:A total of 20 080 subjects were enrolled. In the mass screening group, 9 434 (100%), 8 111 (85.98%) and 3 940 (41.76%) cases completed the 3 rounds of screening, and 10 646 (100%), 6 209 (58.32%) and 2 988 (28.07%) cases in the opportunistic screening group, respectively. In the opportunistic screening group, the proportions of less than 3 months lactation (1 275/9 796 vs. 1 061/8 860, χ2=4.597, P=0.032), non-fertility (850/10 646 vs. 574/9 434, χ2=27.400, P<0.01), abortion history (6 384/10 646 vs. 5 062/9 434, χ2=81.232, P<0.01), postmenopausal (2 776/10 646 vs. 2 217/9 434, χ2=17.757, P<0.01), long-term oral contraceptives(>6 months) (171/10 646 vs. 77/9 434, χ2=25.593, P<0.01) and family history of breast cancer in first-degree relatives (464/10 646 vs. 236/9 434, χ2=51.257, P<0.01) were significantly higher than those in mass screening group. The positive rate of screening (514/10 646 vs. 128/9 434, χ2=194.736, P<0.01), the detection rate of breast cancer (158/10 646 vs. 13/9 434, χ2=107.374, P<0.01), and positive rate of biopsy (158/452 vs. 13/87, χ2=13.491, P<0.01) in the opportunistic screening group were significantly higher than those of the mass screening group. The early diagnosis rate of the mass screening group was significantly higher than the opportunistic screening group (10/12 vs. 66/141, χ2=5.902, P=0.015). The average cost for detecting each breast cancer case of the mass screening group was 215 038 CNY, which was 13.6 times of the opportunistic screening group (15 799 CNY/case). In the opportunistic screening group, the positive rate of biopsy in primary hospitals was significantly lower than that in large-volume hospitals (79/267 vs. 79/185, χ2=8.267, P=0.004), but there was no significant difference in the mass screening group (6/37 vs. 7/50, χ2=0.082, P=0.774). Conclusions:Breast cancer screening can improve early detection rate. Compared with the mass screening mode, the opportunistic screening mode has the advantages of higher proportion of high-risk factors, higher positive rate of screening, higher detection rate of breast cancer, higher positive rate of biopsy, and lower cost of screening. However, the early diagnosis rate of breast cancer of opportunistic screening is lower than that of mass screening. The positive rate of opportunistic screening in primary hospitals is lower than that of large-volume hospitals. The two screening modes have their own advantages and should be chosen according to local conditions of different regions in China.

Objective:To compare the population characteristics, the positive rate of screening, the detection rate of breast cancer, early diagnosis rate and the cost between the mass screening group and opportunistic screening group of breast cancer.Methods:This study is a prospective multicenter cohort study conducted from January 1, 2014 to December 31, 2016. The participants were enrolled for mass screening or opportunistic screening of breast cancer. After completing the questionnaire, all the participants received breast physical examination and breast ultrasound examination every year for 3 rounds by year. The participants′ characteristics and screening results of the two groups were compared by χ 2 test, Fisher exact test or Wilcoxon rank-sum test. Results:A total of 20 080 subjects were enrolled. In the mass screening group, 9 434 (100%), 8 111 (85.98%) and 3 940 (41.76%) cases completed the 3 rounds of screening, and 10 646 (100%), 6 209 (58.32%) and 2 988 (28.07%) cases in the opportunistic screening group, respectively. In the opportunistic screening group, the proportions of less than 3 months lactation (1 275/9 796 vs. 1 061/8 860, χ2=4.597, P=0.032), non-fertility (850/10 646 vs. 574/9 434, χ2=27.400, P<0.01), abortion history (6 384/10 646 vs. 5 062/9 434, χ2=81.232, P<0.01), postmenopausal (2 776/10 646 vs. 2 217/9 434, χ2=17.757, P<0.01), long-term oral contraceptives(>6 months) (171/10 646 vs. 77/9 434, χ2=25.593, P<0.01) and family history of breast cancer in first-degree relatives (464/10 646 vs. 236/9 434, χ2=51.257, P<0.01) were significantly higher than those in mass screening group. The positive rate of screening (514/10 646 vs. 128/9 434, χ2=194.736, P<0.01), the detection rate of breast cancer (158/10 646 vs. 13/9 434, χ2=107.374, P<0.01), and positive rate of biopsy (158/452 vs. 13/87, χ2=13.491, P<0.01) in the opportunistic screening group were significantly higher than those of the mass screening group. The early diagnosis rate of the mass screening group was significantly higher than the opportunistic screening group (10/12 vs. 66/141, χ2=5.902, P=0.015). The average cost for detecting each breast cancer case of the mass screening group was 215 038 CNY, which was 13.6 times of the opportunistic screening group (15 799 CNY/case). In the opportunistic screening group, the positive rate of biopsy in primary hospitals was significantly lower than that in large-volume hospitals (79/267 vs. 79/185, χ2=8.267, P=0.004), but there was no significant difference in the mass screening group (6/37 vs. 7/50, χ2=0.082, P=0.774). Conclusions:Breast cancer screening can improve early detection rate. Compared with the mass screening mode, the opportunistic screening mode has the advantages of higher proportion of high-risk factors, higher positive rate of screening, higher detection rate of breast cancer, higher positive rate of biopsy, and lower cost of screening. However, the early diagnosis rate of breast cancer of opportunistic screening is lower than that of mass screening. The positive rate of opportunistic screening in primary hospitals is lower than that of large-volume hospitals. The two screening modes have their own advantages and should be chosen according to local conditions of different regions in China.