With the widespread adoption of low-dose CT screening and the extensive application of high-resolution CT, the detection rate of sub-centimeter lung nodules has significantly increased. How to scientifically manage these nodules while avoiding overtreatment and diagnostic delays has become an important clinical issue. Among them, lung nodules with a consolidation tumor ratio less than 0.25, dominated by ground-glass shadows, are particularly worthy of attention. The therapeutic challenge for this group is how to achieve precise and complete resection of nodules during surgery while maximizing the preservation of the patient's lung function. The "watershed topography map" is a new technology based on big data and artificial intelligence algorithms. This method uses Dicom data from conventional dose CT scans, combined with microscopic (22-24 levels) capillary network anatomical watershed features, to generate high-precision simulated natural segmentation planes of lung sub-segments through specific textures and forms. This technology forms fluorescent watershed boundaries on the lung surface, which highly fit the actual lung anatomical structure. By analyzing the adjacent relationship between the nodule and the watershed boundary, real-time, visually accurate positioning of the nodule can be achieved. This innovative technology provides a new solution for the intraoperative positioning and resection of lung nodules. This consensus was led by four major domestic societies, jointly with expert teams in related fields, oriented to clinical practical needs, referring to domestic and foreign guidelines and consensus, and finally formed after multiple rounds of consultation, discussion, and voting. The main content covers the theoretical basis of the "watershed topography map" technology, indications, operation procedures, surgical planning details, and postoperative evaluation standards, aiming to provide scientific guidance and exploration directions for clinical peers who are currently or plan to carry out lung nodule resection using the fluorescent microscope watershed analysis method.

OBJECTIVETo analyze the proportion and associated factors of taking subsequent confirmation test among men who have sex with men (MSM) after being tested positive in oral fluid HIV antibody test.

METHODSBy using successive sampling, 1 003 MSM, who were tested positive in oral fluid HIV antibody test in China-Bill & Melinda Gates Foundation AIDS prevention Program (Extension program) in Beijing during May 1 to December 31, 2013, were recruited. The inclusion criteria included: the objects were men who reported having sex with men; the objects aged more than 18 years old; the objects were tested positive in oral fluid HIV antibody test; the objects had not been reported as HIV positives in China Information System for Disease Control and Prevention previously. According to the program strategy, MSM grassroots organizations transferred the respondents to seek subsequent confirmation tests in specific Center for Disease Control and Prevention (CDCs) or hospitals. The subsequent confirmation tests included: fingertip blood HIV antibody rapid test, venous blood Enzyme Linked Immunosorbent Assay (ELISA) HIV antibody test and venous blood Western Blot (WB) HIV antibody test. Chi-square test was adopted to compare the proportion of taking subsequent confirmation tests in different groups. Nonconditional multivaritae binarylogistic regression analysis was taken to identify the associated factors with whether taking subsequent confirmation tests and to calculate the OR (95% CI) values.

RESULTSThe 1 003 respondents were (30.9 ± 9.1) years old. Among all objects, 87.8% (881/1 003) of them took fingertip blood HIV antibody rapid tests and the positive rate was 85.4% (752/881). 98.0% (737/752) of those who were identified as positive in fingertip blood HIV rapid tests took ELISA and WB tests, and the positive rate was 94.4% (696/737). Comparing with those who were expected to seek subsequent confirmation tests in CDCs, the OR (95% CI) value of those who were expected to seek tests in hospitals was 5.10 (1.69-15.36). The OR (95% CI) values of those who used condom sometimes and those who never used condom in anal sex were 5.81 (2.14-15.77) and 3.45 (2.00-5.97) respectively, in comparison with those who reported not having anal sex or using condom consistently in anal sex during the past 6 months. Comparing with the respondents recruited from the internet, the OR (95% CI) values of those recruited in bathrooms, parks/toilets and bars were 0.17 (0.05-0.53), 0.10 (0.04-0.29) and 0.22 (0.06-0.79) respectively. The likelihood of taking subsequent confirmation test decreased with the increase of number of male sexual partners in the past 3 months, and the OR (95% CI) value was 0.92 (0.86-0.99).

CONCLUSIONThe potential HIV positive MSM in the bathroom, park/toilet and bars are less likely to take subsequent confirmation test. Those who do not use condom consistently during anal sex are more likely to seek subsequent confirmation test. Medical organization conducting subsequent confirmation tests is more likely to increase the confirmation test rate of potential HIV positive MSM. The number of male sexual partners has negative correlation with whether to accept the subsequent confirmation test.

Beijing ; Condoms ; HIV Antibodies ; analysis ; HIV Seropositivity ; diagnosis ; Homosexuality, Male ; Humans ; Male ; Mass Screening ; Patient Acceptance of Health Care ; Risk-Taking ; Sexual Behavior ; Sexual Partners ; Surveys and Questionnaires

Objective To inject PPTA into the cochlea of guinea pigs through scala tympani fenestration ,to study the protective effect of PPTA injection on the cochlear damage induced by gentamicin and mechanism of oxy-gen free radical .Methods Randomly divided were the guinea pigs with normal hearing into three groups :the con-trol group ,GM group and PPTA group .We injected the artificial perilymph 10μl /d into cochlea through scala tym-pani fenestration on control group for 3 days ,injected GM 160 mg · kg -1 · d-1 on GM group for 3 days ,injected the PPTA 10 μl /d into the cochlea through scala tympani fenestration and injected GM 160 mg · kg -1 · d-1 at the same time on PPTA group for 3 days .We tested ABR and analyzed the hearing changes .We tested the OFR level reacted by SOD and GSH of the cochlea tissue .SEM and TEM were performed to observe the change of cell mor-phology .Results For ABR ,the control group was 12 .75 ± 3 .796 ,GM group 28 .230 ± 4 .953 ,PPTA group23 .47 ±9 .211 dB SPL(P<0 .05) .For SOD ,the normal group was 50 .241 ± 9 .080 ,GM group 28 .230 ± 4 .953 ,PPTA group 43 .089 ± 4 .587 U/mgprot(P<0 .05) .For GSH ,the normal group was 3 .03 ± 0 .33 ,GM group 1 .51 ± 0 .13 ,PP-TA group 2 .50 ± 0 .16 Ggsh/L(P<0 .05) .The changes of hair cells of PPTA group were obviously less severe than that of GM group .For TEM ,the changes of spiral ganglion and stria vascularis of PPTA group were obviously less severe than that of GM group .Conclusion Injecting PPTA through scala tympani fenestration can protect cochlea by generating the excess of OFR when confronting against GM .

Objective To understand the epidemiologic characteristics on newly reported HIV cases and those recently infected HIV-1 cases in the past few years in Beijing so as to find out their correlates.Methods All the qualified newly reported HIV serum samples from both the first quarters of 2009,2010 and the second quarter of 2011 in Beijing,were tested using the BED HIV-1 incidence capture enzyme immunoassay (BED-CEIA) to identify those recent HIV-1 infection (BED positive) samples and related socio-demographic characteristics.The proportions of BED positives were determined and the correlates analyzed by SPSS software.Results The Annual qualified newly reported HIV serum samples of each year from Beijing were 274,236 and 356,with BED positive rate among them as 35.0％,31.8％ and 33.7％,respectively.The majority of newly reported HIV cases of each year were males (89.1％,88.6％,91.9％),range of age as 20-39 years (77.4％,75.8％,82.0％),Han nationality (77.7％,88.6％,85.7％),and most of them were not permanent residents of Beijing (74.1％,80.5％,2011 data missed).The proportions of patients through sexual transmission showed upward trend(67.5％,76.2％,86.8％).Especially in the ‘man having sex with man’ (MSM) group,it showed a significantly increase (44.9％,45.3％,62.6％).The proportions of injection drug users (15.3％,8.1％,9.0％) declined to some extent during this period.Data from statistics indicated that the proportions of BED positives among newly reported HIV cases of each year were significantly correlated to factors as patients' sex,transmission route and source of samples,but not significantly correlated to patents' age or marital status.Male cases accounted for 96.9％ and MSM accounted for 73.5％ of all the BED-positives during 2009-2011.Conclusion MSM accounted for both large portion of newly reported HIV cases and recent HIV-1 infections which suggested an increasing trend in 2009-2011.It seemed that the characteristic and changing trends of HIV epidemic in Beijing was oriented by MSM population in the last years.