Objective To investigate the prevalence of colorectal cancer in community people in Shanghai,and clarify the necessity of colorectal cancer screening in community residents.Methods From April 2013 to September 2014,colonoscopy examination was carried out in people who participated in colorectal cancer screening in Shanghai with positive result of fecal occult blood test or with high-risk in colorectal cancer evaluated with the risk factors questionnaire.A total of 1 990 individuals were recruited.The colonoscopic results of them were retrospectively analyzed.Chi-square test was performed for statistical analysis.Results The 1 990 individuals received colonoscopy examination aged from 50 to 92.Among the 1 990 individuals with colonoscopy examination,colorectal polyps,colorectal cancer and carcinoid were found in 1 027 cases,and the total detection rate was 51.6％.The detection rate of colorectal polyps was 48.7％ (969/1 990),and the maximum diameter of polyps was 3.5 cm.The detection rate of colorectal polyps of the male was 59.3％ (532/897),which was higher than that of the female (40.0％,437/1 093),and the difference was statistically significant (x2 =73.7,P＜0.01).The detection rate of colorectal polyps in group 50 to 60 (not include 60) years old,60 to 70 (not include 70) years old,70 to 80 (not include 80) years old and ≥80 years old was 37.5％ (139/371),48.7％ (524/1 075),55.9％ (248/444) and 58.0％ (58/100),respectively.The difference was statistically significant (x2 =31.3,P＜0.01).The detection rate of colorectal cancer was 2.7 ％ (54/1 990).The detection rate of male rectal cancer was 3.8％ (34/897),which was significantly higher than that of female (1.8％,20/1 093),and the difference was statistically significant (x2 =7.2,P＜0.05).The detection rate of colorectal cancer in group 50 to 60 (not include 60) years old,60 to 70 (not include 70) years old,70 to 80 (not include 80) years old and ≥80 years old was 1.6％ (6/371),1.9％ (20/1 075),4.3％ (19/444) and 9.0％ (9/100),respectively.The difference was statistically significant (x2 =23.7,P＜0.01).The detection rate of rectal carcinoid was 0.2 ％ (4/1 990).Conclusions The prevalence of colorectal polyps and cancer is high in screening community people with high-risk of colorectal cancer.Colorectal cancer screening in community people ≥ 50 years old with sequential screening method is important.

Background:Colorectal polyps are common gastrointestinal diseases,which are closely related to the development of colorectal cancer. Aims:To investigate the clinical features of high-risk people with intestinal polyps in colorectal cancer screening. Methods:People in Hongkou District,Shanghai,who were positive in fecal occult blood test or of the high risk category in colorectal cancer questionnaire from April 2013 to December 2014 were enrolled,and colonoscopy was performed at Branch of Shanghai First People’s Hospital. The overall detection rate,gender,age,location of lesion, morphology,and pathology were analyzed. Results:A total of 985 patients with colorectal polyps were recruited in this study. The overall detection rate of polyps was 48. 7% . The prevalence of colorectal polyps was significantly higher in males than in females(58. 7% vs. 38. 9% ;χ2 = 79. 788,P < 0. 01). The detection rates of colorectal polyps in different age groups were statistically significant(χ2 = 23. 820,P < 0. 01). Detection rate of polyps was significantly higher in left colon than in right colon(62. 4% vs. 37. 6% ;χ2 =190. 643,P <0. 01). The overall detection rate of protruding lesion 0-Ⅰwas 94. 5% ,and slightly elevated lesion 0-Ⅱa was 48. 3% . Detection rate of adenomatous pylops was significantly higher than non-adenomatous pylops(59. 3% vs. 47. 1% ;χ2 = 27. 326,P < 0. 01). The histological results were differed between two examination in 119 patients. Only 17. 8% of the patients operated were followed up by colonoscopy,and polyps recurred in 62. 3% of them. Conclusions:A higher incidence of colorectal polyps is found in people with high risk of colorectal cancer screening. High quality colonoscopy examination and effective operation in time can reduce the incidence of colorectal cancer.

The identification and diagnosis of coronavirus disease 2019 (COVID-19) is of great significance in the treatment of COVID-19. Based on Diagnosis and Treatment Protocol for COVID-19 (Trial Version 5) issued on February 8, 2020 by the National Health Commission, there is no fungal pneumonia among the disease listed in the identification and diagnosis item. Thus, we reported a case of patient with AIDS associated with pneumocystis carinii severe pneumonia admitted to Shanghai Fourth People′s Hospital affiliated to Tongji University School of Medicine in January, 2020, which was helpful in improving the identification and diagnosis of COVID-19.

OBJECTIVE: To explore the genetic basis for a child with metachromatic leukodystrophy (MLD). METHODS: Clinical data of the patient was collected. Genomic DNA was extracted from peripheral blood samples of the child and his family members. Potential variant was screened by whole exome sequencing (WES), and candidate variant was verified by Sanger sequencing. The pathogenicity the variant was analyzed by multiple sequence alignment of the amino acid sequence and three-dimensional model prediction of its protein product. RESULTS: The child was found to harbor compound heterozygous variants c.257G>A (p.R86Q) and c.467del (p.G156Afs*6) of the ARSA gene, among which the c.467del (p.G156Afs*6) frameshift variation was unreported previously. Multiple sequence alignment showed that the site of the c.257G>A (p.R86Q) missense variant is highly conserved. Three-dimensional structure modeling analysis showed that the partial deletion due to the p.G156Afs*6 variant may cause significant alteration of the structure of ARSA protein. CONCLUSION The discovery of novel variant in ARSA has enriched the mutational spectrum of MLD and may facilitate the understanding of the genotype-phenotype correlation of MLD.
Cerebroside-Sulfatase/genetics* ; DNA ; Genetic Association Studies ; Humans ; Leukodystrophy, Metachromatic/genetics* ; Mutation

Objective:To estimate the safety of myomectomy in twin pregnant women with intramural myomas during cesarean section.Methods:The clinical data of 145 cases of twin pregnancies with intramural myomas who were delivered by cesarean section in Beijing Obstetrics and Gynecology Hospital, Capital Medical University from June 2013 to December 2021 were collected. Maternal demographics, fibroids′ characteristics, maternal and fetal outcomes were compared between groups of cesarean section with myomectomy (myomectomy group, 49 cases) and cesarean section only (non-myomectomy group, 96 cases).Results:Compared with non-myomectomy group, myomectomy group had significantly prolonged operative time [50.0 minutes (37.5-57.5 minutes) vs 40.0 minutes (35.0-50.0 minutes), respectively; P=0.007] and significantly longer postoperative hospital stay [4.0 days (3.0-4.0 days) vs 3.0 days (3.0-4.0 days), respectively; P=0.047). Other maternal and fetal outcomes such as estimated blood loss, hemoglobin difference, postpartum hemorrhage, blood transfusion, B-Lynch structure, uterine artery ligation, postoperative fever and neonatal Apgar score showed no significant differences (all P>0.05). For intramural myomas <5 cm, there were no significant differences in maternal and fetal outcomes between myomectomy group and non-myomectomy group (all P>0.05). For intramural myomas ≥5 cm, operative time [55.0 minutes (40.0-60.0 minutes) vs 42.5 minutes (40.0-50.0 minutes), respectively; P=0.019] was significantly prolonged, postoperative hospital stay [4.0 days (4.0-5.0 days) vs 4.0 days (3.0-4.0 days), respectively; P=0.048] was significantly longer in myomectomy group than non-myomectomy group, but there were no significant differences in other maternal and fetal outcomes (all P>0.05). Conclusion:For twin pregnancies with intramural myomas, it is safe and feasible to remove intramural myomas during cesarean section by experienced obstetricians.