OBJECTIVETo investigate the clinical value of transanal endoscopic microsurgery (TEM) for rectal intraepithelial neoplasia (IN) and early rectal carcinoma.

METHODSFifteen patients with rectal tumor were selected to undergo local excision by TEM. The pre-operative diagnosis by biopsy and endoanal ultrasonography (EUS): rectal low-grade IN in 8 cases, high-grade IN in 4 and early rectal carcinoma in 3. The average distance of tumors from the anal verge was 7.2(4-15) cm. The average tumor size was 1.8(1-4) cm. The average proportion of the circumference of bowel lumen involved was 20%(10%-40%).

RESULTSAll the 15 rectal tumors were achieved complete excision (submucosal excision in 5, full-thickness excision in 10), and all the resection margins were clear. The average operating time was 57 (40-90) min. The average blood loss was 35 (10-60) ml. The average post-operative stay was 4.5 (2-9) d. The post-operative pathological diagnosis: rectal low-grade IN in 5 cases, high-grade IN in 6, early submucous invasive carcinoma (pT(1)) in 2, advanced carcinoma (pT(2)) in 2. The diagnostic accuracy of EUS in assessing invasive depth of rectal tumor was 86.7% (13/15). The average follow-up period of 15 patients was 6 (2-10) months. There was no local recurrence occurred.

CONCLUSIONTEM is an ideal minimally invasive procedure for the treatment of rectal IN and early rectal carcinoma, with excellent exposure and accurate excision, providing a high-quality tumor specimen for pathological staging. Pre-operative EUS is very important in selecting patients suitable for resection by TEM.

Adult ; Aged ; Anal Canal ; surgery ; Endoscopy ; Female ; Humans ; Male ; Microsurgery ; Middle Aged ; Rectal Neoplasms ; surgery ; Rectum ; pathology ; surgery

COVID-19 ; Heart Diseases ; Humans ; Incidence ; SARS-CoV-2 ; Singapore/epidemiology*

Objective: To assess the prevalence of blood donation and associated factors in men who have sex with men (MSM) in China. Methods: Our observational study was conducted between January and August, 2017 in 3 cities: Guangzhou, Shenzhen and Wuxi. Eligible participants were MSM (≥18 years old) who had either ≥2 male sex partners or unprotected anal sex with casual partners, or had been diagnosed with STI in the past 6 months. A self-completed tablet-based questionnaire was used to collect the information about MSM's socio-demographic characteristics, sexual behaviors and blood donation history. Results: A total of 603 MSM were enrolled in our study, including 302 in Guangzhou, 152 in Shenzhen and 149 in Wuxi, with a mean age of 27.9 years (SD=7.8). Overall, 29.2% (176/603) of the MSM reported a history of blood donation, and 33.1% (100/302)in Guangzhou, 27.6% (42/152) in Shenzhen and 22.8% (34/149) in Wuxi, the differences were not significant (χ(2)=6.421, P=0.093). Multivariate logistic regression analysis indicated that MSM had ever tested for HIV for ≥2 times in the past 12 months (vs. MSM tested for HIV one time, aOR=1.49, 95%CI: 1.08-2.19) or who had ever used gay dating app (vs. MSM who not used gay dating app, aOR=2.13, 95%CI: 1.12-4.44) were more likely to donate blood. Conclusions: Blood donation was common in MSM in China. Health education about blood donation in MSM should be strengthened to ensure the blood safety.
Adolescent ; Adult ; Blood Donors ; China ; Cities ; Cross-Sectional Studies ; Homosexuality, Male/statistics & numerical data* ; Humans ; Male ; Sexual Behavior ; Sexual Partners ; Surveys and Questionnaires