Cervical anastomosis by the thoracic approach for the treatment of upper esophageal cancer can simplify surgical steps and reduce incidence of anastomotic leak. This approach has been used for 26 patients with upper esophageal cancer who were admitted to the Jiangsu Cancer Hospital from July 2006 to August 2009. The mean length between lesion and incisor was 23.3 cm. General anesthesia and double-lumen intubation through left posterolateral incision in the fifth intercostal space was adopted. The stomach was dissociated with the technique of "in situ dissociation", and esophagus was dissociated conventionally. Double purse-string suture was adopted to fix the esophageal mucosa onto the supportive base of the stapler, and make purse-string suture to fix stomach on the center pole of the stapler. There was one failure case which has been converted to the manual cervical anastomosis, and the operations for the rest 25 cases were completed successfully, without anastomotic leakage and positive margin. The average blood loss was (352 ±211 )ml, and the average operation time was (3.7 ±0.6 )hours.

OBJECTIVE: To investigate the efficacy and related factors of Z-palatoplasty for treating severe obstructive sleep apnea hypopnea syndrome (OSAHS). METHOD: Thirty-two severe OSAHS patients with Friedman II and III oropharyngeal airway had Z-palatoplasty. Twenty-three patients with modified Mallampti Index (MMI) III-IV had coblation tongue channeling (CTC) simultaneously. The patients were followed up for one year post operatively. RESULT: After operation, the apnea and hypopnea index (AHI) decreased from (54.74 +/- 20.38)/h to (22.72 +/- 18.36)/h; the lowest artery oxygen saturation (LSaO2 ) increased from (0.74 +/- 0.08) to (0.85 +/- 0.14); the Epworth sleep scale (ESS) decreased from (12.24 +/- 5.78) to (5.35 +/- 3.62); the percentage of time with oxyhemoglobin saturation below 0.90 (CT90) decreased from (31.48 +/- 20.15) to (15.73 +/- 12.29). All of the differences were statistically significant (P < 0.01). According to related criterion of chinese journal of otorhinolaryngology head and neck surgery in 2009, accumulative excellence rate was 71.9% and accumulative valid rate 84.4%. Six patients had temporary velopharyngeal insufficiency and returned to normal after 3 months. CONCLUSION Z-palatoplasty is an effective and safe surgical approach for OSAHS patients with Friedman II/III.
Adult ; Female ; Humans ; Male ; Middle Aged ; Otorhinolaryngologic Surgical Procedures ; methods ; Palate ; surgery ; Pharynx ; surgery ; Sleep Apnea, Obstructive ; surgery ; Treatment Outcome ; Uvula ; surgery

Objective: To understand the HIV and syphilis infection and related treatment status of low-fee female sex workers (FSWs) in 3 provinces of China. Methods: Four cross-sectional survey data of low-fee FSWs from six cities (counties) in Guangxi, Yunnan and Hunan Province between October 2012 and July 2015 were obtained from the national science and technology major special project intervention study for reducing sexually transmitted diseases (STDs) and acquired immunodeficiency syndrome (AIDS) in low-fee FSWs' database, which included social demographic characteristics, sexual service characteristics and related medical care seeking behaviors, etc. A total of 2 050 subjects were included in the database. Results: The age of the subjects was (35.16±9.76) years old, with a minimum age of 15 and a maximum age of 67. Those who use condoms every time in commercial sex accounted for 58.9% (n=1 206). Among the reasons of not using condom, the proportion of client reluctant to use was the highest (81.0% (n=682)). Only 38.1% (n=782) was tested for HIV in the last six months. HIV confirmed positive rate was 6.8% (n=139), previous positive accounts for 76.3% (n=106). Rate of antiviral therapy was 55.4% (n=77). By the end of 2015, the loss rate of antivirus treatment was 18.2% (n=14). Those who self-reported symptoms of sexually transmitted diseases in the last 6 months accounted for 9.4% (n=191). 50.3% (n=96) of reporters chose to go to formal hospitals, 23.0% (n=44) chose to go to private clinics and 20.4% (n=39) chose their own medication. The syphilis infection rate was 13.5% (n=277), among them, 91.3% (n=253) were asymptomatic. Conclusion Among low-fee FSWs, the rates of HIV and syphilis infection are higher, the condom consistent use rate, HIV antibodies and syphilis test rate are lower. In this group, active seeking medical idea is poor, the rate of anti-virus treatment and the rate of seeking medical treatment in formal medical institutions is low.

OBJECTIVETo understand the current situation and characteristics of commercial sexual behavior among old male clients in Guangxi, and to explore the associated risk factors of HIV infection.

METHODSThe areas in Guangxi where more old male HIV cases were reported followed by survey on those male clients who were over 60 years of age, were selected. A total of 5 ml blood sample was collected to test antibodies of HIV and syphilis. Risk factors were calculated by the multivariate logistic analysis method.

RESULTSA total of 1 236 questionnaires were completed in the survey. 65.61% of the old male clients were from low-grade venues with 53.64% of them never using a condom when engaging in commercial sex behavior. 47.33% of them patronized sex workers for around 10 years. 53.32% of them patronized prostitutes not less than 2 times in the last 30 days. Thirty subjects were HIV positive (2.43%) and 40 were syphilis positive (3.24%). Factor as 'having fixed partners' (OR = 0.302, 95% CI:0.140-0.650) appeared protective for the old male clients of HIV infection, with a history of patronizing sex workers from 1 to 5 years (OR = 2.552, 95% CI: 1.086-5.998). Frequency of patronizing sex workers not less than 4 times in the last 30 days (OR = 3.002, 95%CI:1.047-8.607) seemed the high risk factor of HIV infection.

CONCLUSIONOlder-aged male clients showed high HIV and syphilis infection rates in Guangxi, and most of them were using the low-grade venues. Commercial sexual behaviors in the areas would include early and, frequent exposure, but with poor protections. High risk factors of HIV infection might relate to "no fixed sexual partners" and "frequently commercial sexual behavior".

Aged ; Antibodies ; China ; epidemiology ; Condoms ; HIV Infections ; epidemiology ; Humans ; Male ; Middle Aged ; Risk Factors ; Sex Work ; statistics & numerical data ; Sex Workers ; Sexual Behavior ; Sexual Partners ; Surveys and Questionnaires ; Syphilis ; epidemiology