Objective To explore the clinical value of laparoscopy combined with radionuclide imaging in the diagnosis and treatment of pediatric gastrointestinal hemorrhage, especially for Meckel’s diverticulum and double intestine. Methods ~ 99m Tc~-pertechnetate abdominal scintigraphy was performed in 22 children with a history of recurrent hemafecia or melena in this hospital from December 1998 to December 2005. All the children were given a laparoscopic exploration. Results Among the 22 patients, scintigraphy showed positive findings in 18 patients and negative, 4 patients. The positive patients were all confirmatively diagnosed by laparoscopic surgery and pathological examinations, including Meckel’s diverticulum in 14 patients and duplications of alimentary tract in 4 patients. In the other 4 patients with negative results, no organic pathologic changes was identified by laparoscopy in 3 patients and Meckel’s diverticulum was found after laparoscopic exploration in 1 patient. Conclusions Radionuclide imaging is an important method in the diagnosis of gastrointestinal tract hemorrhage in children and provides scientific basis for surgical intervention. The combination of laparoscopy and radionuclide imaging not only has values in the diagnosis and treatment of pediatric gastrointestinal hemorrhage, but also minimizes the blindness and trauma of exploratory laparotomy.

Objective To analyze the causes and preventions of the perioperative complications of micro-laparoscopic hernioplasty in infants and children with indirect inguinal hernia.Methods From January 1997 to January 2007,4500 infants or children with indirect inguinal hernia,including 702 cases who were complicated with hydrocele testis,were treated by micro-laparoscopic hernioplasty in our hospital.By laparoscopy,the endocycle was sutured circularly under the peritoneum using a self-designed needle.Then,only the peritoneum was ligated.Results No organ injury or complication occurred during the operation.The mean operation time was 9 min(5-13 min).Among the patients,4250 received a follow-up of 7-36 months(mean,25 months).Postoperative complications were found in 132 patients(3.1%),included scrotal gas in 10(0.24%),scrotal hydrocele in 16(0.38%),umbilical hernia in 27(0.64%),extraperitoneal emphysema in 20(0.47%),abdominal wall hematoma at the burr hole in 15(0.35%),foreign body sensation at the suture sites in 30(0.71%),scrotal hematoma in 8(0.19%),and iatrogenic cryptorchism in 6(0.14%).Thirty-five patients had recurrence(0.82%).Conclusions Micro-laparoscopic hernioplasty is a safe and reliable method for indirect inguinal hernia in infants and children.It is important to be familiar with the anatomy of the hernia under a laparoscope and to perform the operation carefully so that to avoid or decrease the perioperative complications.

Objective To evaluate the efficacy of mini-laparoscopic hernioplasty with Mesh strengthening in the treatment of hernia in adults. Methods We used mini-laparoscopic and self-decided needle-like instruments to perform 106 cases of Mesh replacement in addition to hernioplasty in treatment ot hernia in adults from January,1999 to Junuary,2001. Results Operation time ranged from 20min to 25min.Food-intake began in the operative day.No Complications occurred.The patient discharged 3d～4d after the operation.Following-up period lasting 5months to 2.5years showed no relapse occurred. Conclusions Mini-laparoscopic hernioplasty combined with Mesh strengthening is feasible in the treatment of hernia in adults.The method have the advantages ot mini-invasion,simple proccedures,shorter operation time and quicker recovery.

Objective To study a new operative procedure for hydrocele in children under mini-lapascope.Methods 103 children with hydrocele aged from 1 to 9 years old were performed by suture around internal rings under mini-laparoscope from November 2000 to March 2002. Results The operative time was (5～8) minutes and hospital stay (4～5) days. The incision didn't need suture and there was no obvious scar after operation. All cases were followed up at 1st month, 6th month and 1st year postoperatively. All cases recovered except for 2 cases recurred at 1st month postoperatively. Conclusions Suture around internal rings under mini-laparoscope is a minimally invasive and simple method for the treatment of hydrocele in children. It can find and deal with hidden patent internal rings.

Objective To investigate the expression of HOXB7 in colorectal cancer and its relationship with clinicopathological factors and prognosis.Methods Eighty-seven patients with colorectal cancer were retrospectively analyzed.The expression of HOXB7 mRNA and protein in colorectal cancer tissues was detected by RT-PCR and immunohistochemical methods.Their correlation with clinicopathological parameters and prognosis was analyzed.Results The relative expression level of HOXB7 mRNA in colorectal cancer tissue was(42.4 ± 16.3),which was significantly higher than(19.4 ± 7.6) in the paracancerous normal tissue(P＜0.05).The positive expression rate of HOXB7 protein in colorectal cancer tissues was 73.9％,which was obviously higher than 10.3 ％ in the paracancerous normal tissue (P＜ 0.05);expression of HOXB7 protein was significantly correlated with the TNM stage,lymph node metastasis and distant metastasis(P＜0.05),moreover the patients with HOXB7 positive expression had poorer prognosis.Conclusion HOXB7 protein expression is up-regulated in colorectal cancer tissue,and its high expression is correlated with the clinicopathological factors and prognosis in the patients with colorectal cancer.

Objective:To develop a Risk Assessment Index System (RAIS) on HIV infection among young students based on Delphi method and to provide individual HIV infection risk assessment, targeted prevention and control measures.Methods:Delphi method was applied to determine the index system and weight of the assessment tool through three rounds of expert consultation and overall consideration of opinions and suggestions from 19 experts.Results:The positivity coefficients of three rounds of expert consultation were 100%. The authority coefficient of experts was between 0.887 and 0.945. The Kendall's W coefficients through first, second and third round specialist consultation was 0.379, 0.329 and 0.248, respectively (all P<0.001). The coefficients of variation in the third round were all less than 0.25, indicating that experts' opinion tend to be consistent and the results are highly reliable. The HIV infection risk assessment index system among young students consisted of 7 first grade indices and 54 second grade indices, of which weight was calculated. Conclusions:The RAIS on HIV infection for young students was initially established based on Delphi method, and could be used in the development of HIV infection risk assessment tools for personalized prevention and intervention among young students. However, the reliability, validity and effect of this assessment index system need to be further evaluated.

Objective:To explore the difference of sexual health characteristics and demands in students in different groups, and provide the basis for targeted sexual health eduction for AIDS prevention in young students.Methods:A survey was conducted based on the requirement of health education about sexual health and AIDS prevention in young students by the education department of Guangdong province. A two-step cluster analysis was performed on the survey data obtained by convenient sampling, the variables and number of clusters included were determined by combination of analysis results and professional knowledge. The demographic characteristics, the content and form of sexual health education needed were compared among different groups.Results:Survey data of 3 884 students were collected, and six variables were used for classification: cognition or occurrence masturbation, sexual behavior, frequency of sexual information acquisition, number of acceptable sex partners and AIDS knowledge awareness rate. By these variables, the students were classified into three levels of risk groups: high risk group (46.6%), medium risk group (39.9%) and low risk group (13.5%). As for demographic characteristics, high risk group, with a median age of 19 years, had the highest proportions of boys (65.9%), students with non-heterosexuality orientation (15.2%), urban residents (58.2%), only children (30.8%) and undergraduates (54.7%). Medium risk group, with a median age of 19 years, had the highest proportions of girls (82.7%) and vocational college students (34.0%). Low risk group, with a median age of 18 years, had the highest proportions of rural residents (52.4%), non-only child (80.6%), senior high school students (41.3%), non-boarding students (17.5%) and students without internship and part-time job experience (43.2%). In terms of health education demands, high risk group had a higher demand of information about self-identity, sexual safety, sexual decision making, contraception, abortion, and sexually transmitted disease or AIDS prevention. Medium risk group paid more attention to value on love and marriage, sexual assault. Low risk group showed a higher demand of adolescent physiology knowledge. Compared with low risk group, high risk group had a higher demand of peer education, Internet/multimedia, anonymous counseling and other forms of sexual health education. The differences were significant.Conclusion:The characteristics, sexual knowledge awareness, attitude and behavior, and health education demands of young students in different groups are different, so health education materials and methods should be developed according to the characteristics of different groups to enhance the acceptance and enthusiasm of students and improve the quality of sexual health education.

Objective:To analyze the influencing factors for HIV testing services utilization in students with self-assessed high risk of HIV infection.Methods:The research framework of the influencing factors for HIV testing services utilization in students was developed based on Andersen's health services utilization behavioral model and related literature. A cross-sectional survey was performed in students with self-assessed high risk of HIV infection by an online HIV infection risk assessment tool from March to April 2019. Multiple logistic regressions were applied with hierarchical model.Results:A total of 526 students were included in the study (age: 19.30±1.19 years old), in whom 96.2% agreed that HIV testing should be received after high-risk behavior. 56.7% (298/526) had sexual behavior and the HIV testing rate was 11.0% (58/526). The HIV testing rates in students who had and had no sex behavior were 13.42%(40/298) and 7.89% (18/228), respectively. According to the results from multivariate logistic regression analysis, non-heterosexual (compared with heterosexual, OR=7.88, 95% CI: 3.98-15.61) and higher score of AIDS knowledge awareness (compared with lower score, OR=2.05, 95% CI: 1.07-3.93) in propensity factor module, and having risk sexual behavior (compared with having no risk sexual behavior, OR=2.66, 95% CI: 1.41-5.03) and having diagnosis of STD infection in hospital (compared with having no such diagnosis, OR=6.35, 95% CI: 2.21-18.27) in demand factor module, and receiving health education about AIDS prevention in the past year (compared with receiving no such health education, OR=0.29, 95% CI: 0.11-0.76) and receiving health education about AIDS testing service in the past year (compared with receiving no such health education, OR=3.67, 95% CI: 1.71-7.90) in ability factor module were the influencing factors for utilization of HIV testing services. Conclusions:The acceptance of HIV testing in students needs to be improved urgently. Propensity factors, such as their AIDS knowledge awareness and sexual orientation, and demand factors, such as having risk sexual behavior and STD infection, have obvious impacts on the utilization of HIV testing services. However, health education about AIDS prevention and HIV testing service can play a more important role in facilitating the utilization of HIV testing in students. In the future, we should further strengthen the publicity of voluntary HIV counseling and testing service in students with particular attention to girls and those with risk sexual behaviors.

Objective:To evaluate the effect of "self-categorization" on decision of health preference and the influence of self-categorized deviation in knowledge, attitude and practice (KAP) on the willingness of seeking help for sexual health among young students.Methods:From March to April 2019, young students who used a WeChat applet for sexual health and HIV infection risk assessment, which is called "Detective Bear" were recruited and investigated. According to the consistency between the self-categorization of KAP for sexual health and the systematic categorization from their honest answers, the participants were allocated into three groups: consistent, low or high status, according to their judgment on sexual information acquisition, sexual attitude, and the actual number of sexual experiences. Logistic regression was used to analyze the differences in the willingness to seek help for sexual health problems between the three groups.Results:2 009 students with an average age of (19.2±1.1) were included. 54.7% (1 099/2 009) were female, and 98.4% (1 976/2 009) were college, undergraduate or postgraduate students. 49.0% (984/2 009) were in the consistent group, 10.9% (219/2 009) had a lower self-categorization, 40.1% (806/2 009) had a higher self-categorization. Compared with the consistent group, students with lower self-categorization of KAP for sexual health were less likely to assess HIV voluntary counseling and testing (a OR=0.65, 95% CI: 0.43-0.99). However, students with higher self-categorization seemed to dislike seeking help for sexually transmitted diseases (a OR=0.76, 95% CI: 0.59-0.98). Conclusions:Deviation in self-categorization of KAP for sexual health will reduce the young students' willingness to seek help for related problems. Especially those with lower self-categorization, lack of risk consciousness, and refuse to assess counseling and testing may increase the HIV/AIDS epidemic among this population. It is necessary to strengthen the capacity of self-assessment for young students while promoting sex education.

Objective:To summarize the design and analysis of testing results of a WeChat applet, which is called "Detective Bear", for sexual health and HIV infection risk assessment in young students, and evaluate its feasibility and effectiveness.Methods:Based on self-categorization theory, by using cluster analysis and Delphi expert consulting method, the framework of WeChat applet, risk assessment index system and preventive intervention content were determined. Young students were recruited by student associations for the application test, the results of the repeated tests and the satisfaction survey were collected and analyzed.Results:The study included 393 participants who repeated the test twice and 750 participants who volunteered to participate in the satisfaction questionnaire survey. The applet contains five modules: self-role judgment, self-test, risk assessment, assessment report generation and background management. The risk assessment module contains 6 first-level indicators and 55 second-level indicators. Assessment report generation module includes role diagnosis type, radar chart of HIV sexual health KAP and intervention prescription. In 393 students who repeated the test, the awareness of AIDS to be a serious sexually transmitted disease, the epidemic trend in young students in China, with active seeking HIV testing services and caring the infected improved. The satisfaction survey showed that 75.7% of students (568/750) accepted the applet, 86.5% (649/750) agreed the evaluation report, 83.1%(623/750) thought that there were some problems, but it was easy to use, 93.3% (700/750) said they can learn something from the applet and 84.1% (631/750) satisfied with the page design. Some students thought the questionnaire was too long and somewhat difficult to complete ( P<0.05), and some reported that more can be learned ( P<0.05). Conclusions:The applet integrates AIDS prevention related knowledge and practice into a challenging, interesting, interactive game and provide individualized, concrete risk assessment and self-intervention for young students, which can effectively help students to improve the awareness of AIDS related knowledge and get links for access to condoms, testing and other intervention services. However, its large-scale application and long-term effect need to be further tested.