Multi-partners,unprotected sex,and alcohol and drug use are the main causes of HIV/STD transmission among MSM,and related interventions should be taken promptly.MSM are good candidates for studies and interventions as the retention rate is relatively high among this population group.

Drug resistance is the most important obstacle in the treatment of cancer.People can know more about the mechanisms of drug resistance by study of cancer stem cells,and then identify new therapeutic targets and to develope better anticancer strategies.If we regard cancer stem cells as the therapeutic targets we can selectively kill cancer stem cells without harming normal ones,so overcome the drug resistance and avoid cancer relapse or metastasis.

Objective To assess whether a follow-up endoscopy after endoscopic submucosal dissec-tion(ESD)for gastric lesions is effective for prevention of delayed bleeding. Methods Papers published in Medline,Embase,Cochrane library,Elsevier,Wanfang,VIP and CNKI were searched for the studies eval-uating the efficacy of follow-up endoscopy for reducing delayed postoperative bleeding after ESD for gastric le-sions. Statistic analyses were performed using RevMan 5. 1 software. Results A total of 10 studies including 4 randomized control trials and 6 cohort studies were enrolled. Analysis of these studies showed that the inci-dence of delayed bleeding was not significantly different between the patients receiving a follow-up endoscopy and those not(OR= 1. 38,95% CI:0. 89-2. 13,P= 0. 15). Also,there was no difference in the incidence of delayed bleeding between the prophylactic hemostasis and nonprophylactic hemostasis groups( OR = 1. 45, 95% CI:0. 65-3. 22,P= 0. 36). Conclusion A follow-up endoscopy after gastric ESD may contribute little to the prevention of delayed bleeding,but may be useful for the high-risk patients,which can control the bleeding rate at a low level.

Objective To investigate the influential factors for the colonoscopic polyp detection rate (PDR) and adenomade detection rate(ADR) in high-risk population in community colorectal cancer screening.Methods Data of patients who were determined as high-risk population in community colorectal cancer screening tests and received colonoscopy in the Digestive Endoscopic Center of Tongji Hospital from May 2014 to November 2014 were collected.PDR and ADR were calculated by different genders, ages, history of abdominal operation, anesthesia assistance, quality of bowel preparation and experience of operators.Thex2 test and logistic regression analysis were used to compare the PDR and ADR between different groups.Results A total of 417 patients received complete colonoscopies.The total PDR was 35.25％.Univariate analysis revealed that gender (OR =2.298,95％ CI: 1.525-3.463), history of abdominal operation (OR =0.596,95％CI:0.390-0.910), anesthesia assistance (OR =1.864,95％ CI: 1.086-3.200) and quality of bowel preparation were significantly associated with PDR while multivariate analysis revealed that only gender, history of abdominal operation and quality of bowel preparation were independent influential factors for PDR.The total ADR was 30.22％.Like PDR, univariate analysis revealed that gender(OR =2.113,95％CI: 1.382-3.229), history of abdominal operation(OR =0.604,95％ CI:0.387-0.941), anesthesia assistance(OR =2.344,95％ CI: 1.283-4.281) and quality of bowel preparation were significantly associated with ADR.However, multivariate analysis revealed that only gender, history of abdominal operation and quality of bowel preparation were independent influential factors for ADR.Conclusion For patients who were highrisk in community colorectal cancer screening, men have greater risk to develop polyps and adenomas than women.Colonoscopy should be more careful in patients with history of abdominal operation, for quality of bowel preparation is directly related to PDR and ADR.

Clinic probation teaching is an important part of medical education practice, whose teaching effect andquality have impact on the quality of cultivation for medical students. To solve the existing problems, Gannan MedicalCollege has combined the single clinic probation with social practice activities, expanded the probation teaching area,made the full use of students' capability, reformed the traditional probation teaching pattern, defined teaching objectivereasonably, which gives rise to the improvement in clinic teaching quality.

Objective To elucidate cerebral cortical response to esophageal acid exposure in normal individuals by functional magnetic resonance imaging (fMRI) and the characteristics of activity. Methods Fifteen volunteers were received intraesophageal perfusion with either 0.9% of sodium chloride or acid (0.1 mmol/L HC1) solutions. The modified block-design model of fMRI scanning was performed simultaneously. All of 32 minutes were needed for resting (A, 8 minutes), 0.9% of sodium chloride perfusion (B,8 minutes), acid perfusion (C,8 minutes) and 0.9% of sodium chloride perfusion again (D,8 minutes). Each chunk was consisted of 160 scans and every scan contained 3 seconds. Six hundred and forty scans were collected in all. The clinical response to esophageal acid exposure was observed and the changes in the cerebral regions was statistically analyzed. Results After perfusion of 0.9% of sodium chloride or acid, 10 out of 15 volunteers had chemosensitive complaints, such as pain in pars laryngen pharyngis, heartburn and chest complaint. The initial active domains involved deutocerebrum, anterior part of callosal gyrus, left side of insula, two sides of amygdale and subiculum hippocampi, two outers of forehead cortex. The provoked regions of acid perfusion (C-A) and 0.9% of sodium chloride perfusion again (D-A) were as same as that of the activated domains by initial perfusion of 0.9% sodium chloride (B-A). The intensity and amplitude of most provoked regions increased gradually(D-A> B-A, P< 0.01). Conclusions The two different stimulations of saline and acid provoke similar cerebral regions that may act in the regulation of esophageal sensitivity. There are the evidences of the central mechanism of esophageal visceral hypersensitivity by acid perfusion.

Objective To investigate the changes of esophageal visceral sence stimulated by esophageal distention in rabbits and the protein expressions of calcitonin gene related peptide(CGRP),P substance(SP),5-hydroxytryptamine(5-HT),Fos protein in central nervous system(CNS).Methods Twenty New Zealand rabbits were randomly divided into experimental group(n=8,received esophageal distention with 0.9 cm balloon for 30 s twice a day for 14 days),control group(n=6,received esophageal stimulation without balloon for 30 s twice a day for 14 days)and blank control grouop(n=6).The esophageal visceral sense was evaluated by animal behavior scores.The expressions of SP,CGRP,5-HT and Fos protein esophagus mucosa,spine,nucleus tractus solitari (NTS),periaqueductal gray(PAG)and thalamus were measured by immunochistochemistry.Results At the same behavior scores,the tube diameter of experimental group was significant lower than those of control group(P＜0.05).The expression of SP in esophagus mucosa,spine and NTS was significant increased in experimental group compared to two control groups(P＜0.05).The expression of CGRP and Fos in esophagus mucosa.spine,NTS,PAG and thalamus was increased in experimental group compared to two control groups(P＜0.05).The expression of 5-HT in esophagus mucosa and spine was higher in experimental group than that in control and blank control groups (esophagus: 27.67±3.27 vs 11.00±1.79 or 11. 17±1.33;spine:24.00±5.22 vs 11.33±2.94 or 11. 83±2. 48, P＜0. 01). But the expression of 5-HT in PAG was lower in experimental group( 13. 17±2.04) than that in control 17.67±2.07)and blank control (16.83±2.32) groups (P＜0. 05). There was significant correlation between CGRP and Fos, SP and Fos, CGRP and SP in spine (r=0. 813,0. 779,0. 772,P=0. 025,0.034, 0. 036, respectively). Conclusions Esophageal hypersensitivity may be induced by esophageal distention. The expresstion of SP, CGRP, 5-HT was increased in the esophageal mueosa and CNS, which indicate that these neurotransmitters and CNS may play an important role in the increase of esophageal visceral sense.

Objective To establish a method for determination of polysaccharides in Weixuening Granule, which can be used for quality control of the preparation. Methods Polysaccharides was determined by improved differential phenol-sulfuric method with glucose as reference, and the color conditions were optimized at the wavelength of 487 nm, with the concentration of phenol and sulfuric acid, and reaction time as investigated factors. Results The best color conditions of polysaccharides were 0.04 g/mL phenol 1 mL, 87.5% sulfuric acid 5 mL, and reaction time of 15 min. Glucose had a good linear relationship with absorbanceΔA at the range of 15.3-306.0μg, r=0.999 7. The average recovery was 103.5%, and RSD was 2.9%. The average content of polysaccharides in Weixuening Granule was 27.04%and RSD was 1.1%. Conclusion The method is simple, accurate, stable and reliable, and can be used to determine the content of polysaccharides in Weixuening Granule.

Objective To analyze the clinical effect of percutaneous sacroiliac screw internal fixation in treatment of sacroiliac joint dislocation. Methods From June 2002 to August 2006,16 patients with sacroiliac joint dislocation were treated with percutaneous sacroiliac screw internal fixation under C-arm X-ray tomography.There were 10 males and 6 females at age range of 10-58 years(mean 34.3 years).Results The operation lasted for 30-90 minutes(average 50.5 minutes).All patients were followed up for 12-36 months(average 18.3 months).The results of postoperative normotopia,lateral,ingate and egress Xray and CT scanning showed that all the screws were located within S1 and S2 of all,14 patients obtained satisfactory result of reduction,with no infection,nerve injuries,loosening or breakage of the screw fixation.The function and the sensation of the sacroiliac ioint and low extremities recovered to normal. Conclusions Percutaneous sacroiliac screw intemal fixation is an ideally safe and effective way to treat sacroiliac joint dislocation,for it has many advantages such as minimal invasion,reliable fixation,less complication and quick recovery.It is also very necessary to take caudad and cephalad view under an image intensifier during the operation to assure the accuracy of implantation.

Objective To evaluate the expression of substance P (SP) and caltenin gene related peptide (CGRP) in esophagueal mucosa from patients with non-erosive gnstroesophageal reflux disease (NERD) and reflux esophagitis (RE) and to explore their role in the development of NERD. Methods Fif-ty-one patients with typical symptoms of gnstroesophageal reflux disease (GERD) were evaluated with reflux disease questionnaire (RDQ), PPI test, endoscopy and 24hr esophageal pH monitoring. The patients were then divided into RE group (n = 21), NERD group with acid refluux (NERD+, n = 12) and NERD group without acid reflux (NERD-, n = 18) according to the evaluation results. The expression of SP and CGRP in esophagus mucosa from these patients and 10 healthy control subjects were assayed by immunohistochemis-try, and the stain positive index (PI) was calculated by Color patho-image analysis software and compared. Results The PIs of SP and CGRP in NERD- group were 96.77±31.74 and 24.76±29.15, respectively, which were significantly higher than those of NERD+ group (73.64±31.38, 9.78±10.30, respectively, P < 0.05), RE group (67.56±34.62, 9.61±6.20, respectively, P < 0.05) and control group (59.82± 46.15, 8.64±12.12, respectively, P < 0.05). Conclusion Expressions of SP and CGRP in esophagus mucosa from NERD patients without detectable acid reflux are significantly increased, they may play an im-portant role in esophageal visceral sensitivity.