Background:When colonic adenoma involves diverticulum,inflammation in the diverticulum will increase the risk of adenomatous dysplasia.Therefore,patients with colonic diverticulum adenoma are at a higher risk of colon cancer,and the adenoma needs to be resected to avoid poor outcome and improve prognosis.Aims:To explore the efficacy and safety of endoscopic mucosal resection(EMR)in treatment of colonic diverticulum adenoma.Methods:Fourteen consecutive cases of colonic adenoma near or involving a diverticulum treated by EMR from Jun.2018 to Jan.2022 at the First People's Hospital of Hangzhou Lin'an District were collected,and their clinical characteristics and outcomes were analyzed.The primary outcome was complications,including bleeding,perforation,and electrocoagulation syndrome,while the secondary outcomes were the en bloc resection rate,complete resection rate and local recurrence rate.Results:Among the 14 patients with colonic diverticulum adenoma,13 were type A(near a diverticulum)while 1 was type B(involving a diverticulum).The diameter of the lesion was(0.76±0.25)cm,and the operation time was(19.67±5.33)minutes.The main histological type was tubular adenoma,and the pathological results was intraepithelial neoplasia in most of the cases.Delayed hemorrhage was observed in 1 patient(7.1%),and electrocoagulation syndrome in 1 patient(7.1%).No perforation event occurred.The en bloc resection rate and complete resection rate were 100%.Ten patients accepted reexamination of colonoscopy within 1 year after surgery,and no local recurrence was found.Conclusions:EMR is safe and effective for treatment of colonic diverticulum adenoma.However,patients using antiplatelet drugs and adenoma involving both appendiceal orifice and diverticulum should be alert to postoperative complications.

Objective To investigate the prevalence of Helicobacter pylori(H.pylori)positivity in the urban areas of Chongqing and its relationship with age,season,and gender.Methods A total of 4,836 patients who underwent 14C-UBT testing at our hospital from April 2023 to March 2024 were selected.The detection rate of H.pylori and the infection status of H.pylori in different age groups,genders,and seasons were analyzed.Logistic regression analysis was performed on factors related to H.pylori infection identified in the univariate analysis.Results The positive detection rate of H.pylori in the 4,836 subjects was 29.3％,with a higher rate in males than in females,showing a statistically significant difference(P＜0.05).The highest positive detection rate of H.pylori was in the summer season,and the peak positivity rate for H.pylori was observed in the 30-39 age group.There was a statistically significant difference in the positive detection rate of H.pylori across seasons and among different age groups(P＜0.05).Multivariate logistic regression analysis indicated that gender,age,and season were all influential factors in the outcome of H.pylori infection(P＜0.05).Conclusion The prevalence of H.pylori infection in the urban areas of Chongqing is relatively low,and gender,age,and season are all influential factors for H.pylori infection.

Objective:To study the multi-locus sequence typing (MLST) gene characteristics of Brucella isolates in Guizhou Province. Methods:Brucella strains, which were isolated from 2017 to 2021 in Guizhou Province (preserved in the Bacterial and Viral Seed Bank of Guizhou Center for Disease Control and Prevention) were identified Brucella and species/types by BCSP31-PCR and AMOS-PCR methods, respectively. MLST method was used for genotyping, and Biometrics 8.0 software was used for cluster analysis of the typing results. Results:A total of 32 strains of Brucella were isolated in Guizhou Province and identified as Brucella melitensis ( B.melitensis) by BCSP31-PCR and AMOS-PCR methods. These strains were classified into 2 ST types (ST8 and ST39) by MLST method, with 28 strains of ST8 type(87.5%) and 4 strains of ST39 type (12.5%). The 28 strains of ST8 type were distributed in 7 cities (prefectures) of Guizhou Province, while the 4 strains of ST39 type were only found in Qianxinan Buyi and Miao Autonomous Prefecture. The cluster analysis results showed that ST8 and ST39 types strains were clustered in a group with the reference strain of B.melitensis, and there was only one nucleotide site difference between ST39 and ST8 types in the glk gene, indicating a close genetic relationship. Conclusions:B.melitensis is the main pathogen of the brucellosis epidemic in Guizhou Province in recent years. ST8 is the dominant MLST genotype in Guizhou Province.

Background:Studies have confirmed that colorectal tumors may be caused by normal mucosa near or inside the diverticulum,and patients with colon diverticulum are more likely to develop colon cancer than those without diverticulum.When colorectal adenoma involves diverticulum,the inflammatory state in the diverticulum will increase the risk of adenomatous dysplasia.Therefore,adenomas involving colon diverticulum are more likely to develop malignant changes,and adenomas involving colon diverticulum need to be resected to avoid colon cancer outcomes.Improved prognosis.Aims:To explore the efficacy and safety of endoscopic mucosal resection(EMR)treatment of colorectal tumors near or involving a diverticulum.Methods:Fourteen consecutive cases of adenoma(near or involving a diverticulum)during EMR treatment from Jun.2018 to Jan.2022 were collected,and analyze their clinical characteristics and outcomes.The main outcomes were adverse events,including bleeding,perforation,and electrocoagulation syndrome,while the secondary outcome was the total resection rate,block resection rate and local recurrence rate.Results:Among the 14 patients with colon adenoma,1 case was inside the diverticulum,13 cases were near the diverticulum,the diameter of the lesion was(0.76±0.25)cm,the operation time was(19.6±5.33)min.The main tissue types were tubular adenomas,and the pathologic characteristics were low grade intraepithelial neoplasia.Among the complications,delayed hemorrhage was found in 1 case(7.1%),the patient had a history of taking antiplatelet drugs(clopidogrel),electrocoagulation syndrome was found in 1 case(7.1%),and appendiceal orifice and diverticulum were involved in this patient,with no perforation event.The whole resection rate and the complete resection rate were 100%(14/14).Within 1 year after surgery,10 patients came to the hospital for re-examination of colonoscopy,and no local recurrence was found.Conclusions:EMR treatment involving colonic diverticulum adenoma is safe and effective.However,patients with adenoma involving antiplatelet drugs and appendiceal orifice and diverticulum should be alert to postoperative complications.

Environmental endocrine disrupting chemicals are a kind of exogenous chemicals that generally exist in the environment, and can disturb the endocrine homeostasis and adversely affect reproductive, immune, neurological, and other functions after entering the body, among which the damage to the reproductive system is the most significant one. Studies have confirmed that the long-term exposure to environmental endocrine disrupting chemicals have irreversible and harmful effects on primordial germ cell growth, reproductive organ development, and reproductive endocrine regulation, and also have obvious correlations with the occurrence and development of various reproductive system tumors. This paper reviewed various reproductive toxicities induced by common environmental endocrine disrupting chemicals in the developmental and reproductive stages, and associated mechanisms involved in the occurrence and development of reproductive system tumors.

A survey on professional knowledge levels was conducted from April to October 2019 among 388 general practitioners (GPs) from 46 community health service centers and 30 township health centers of 6 provinces selected by stratified random sampling method. The overall knowledge test score was 31.82—84.09(56.94±9.19) points, and the pass rate was 36.3% (141/388). There were significant differences in test scores among participants with different types of work units, regions, provinces, marital status, educational background, professional titles, types of employment, length of service, and training status (all P<0.05). Multivariate regression analysis showed that educational background ( B=-2.835), professional title ( B=-8.867), and participation in professional course training ( B=2.214) were the influencing factors of knowledge level (all P<0.05). The pass rates in knowledge of prevention/health management (13.7%, 53/388) and policies and regulations (12.1%, 47/388) were low. The results show that the levels of professional knowledge among GPs working in grassroots health institutions are relatively low, and suggest that continuing education should be strengthened to improve the professional knowledge level of GPs in primary care institutions, particularly, knowledge of health policies and regulations, disease prevention and health management.

Objective:To determine the effect of pelvic floor electrical stimulation combined with conventional treatment on neurogenic bladder dysfunction after spinal cord injury.Methods:The Pubmed/Medline, Embase, Cochrane, CINAHL, China National Knowledge Infrastructure, CQVIP and Wanfang databases were electronically searched for reports published before April 2019 of randomized and controlled trials testing the effect of electrical stimulation of the pelvic floor on neurogenic bladder after spinal cord injury. Meta-analysis of all the reports collected was performed.Results:Seven randomized and controlled trials with 319 patients were identified. Together they showed that compared with conventional treatment, pelvic floor muscle stimulation better increased bladder capacity and reduced the volume of residual urine. Average single urination output was increased, while the frequency of urination decreased along with episodes of urinary incontinence. Average lower urinary tract symptoms scores were also significantly better.Conclusions:Electrical stimulation of the pelvic floor combined with conventional therapy may be more effective than conventional therapy alone in alleviating the symptoms of neurogenic bladder.

Objective To evaluate 3.0T high resolution magnetic resonance (HRMRI) scanner for determining the carotid plaque vulnerability.Method Fifteen inpatients with carotid plaque stenosis were enrolled.The stenosis rate confirmed by Doppler ultrasound was 50％-99％ (excluding those with 100％ occlusion of the carotid artery).Head and neck coil 24 (HNC 24) was used for extracranial carotid artery plaque scan.Results There was no statistically significant difference between pathology and 3.0T HRMRI in the detemination of carotid plaque composition (P =0.546)and carotid artery stenosis rate (P =0.289).HRMRI showed good consistency with pathology in detecting intraplaque hemorrhage (Kappa =0.816) and lipid necrosis core (Kappa =0.771),and normal consistency with pathology in detecting calcification (Kappa =0.674).The highest sensitivity (87.23％) and the highest specificity (97.77％) of intraplaque hemorrhage were detected for the core of lipid necrosis.Conclusion The 3.0T high resolution magnetic resonance detailed analysis of extracranial carotid plaque composition,morphology,luminal stenosis,plaque lumen and wall area data for assessment.

Objective: To explore the effects of Yueju pill on Nitricoxide-cyclic guanosine monophosphate (NO-cGMP) signaling in mouse hippocampus. Methods: Single dose of Yueju pill was administered, and mouse hippocampi were got out after administration for 12 min, 24 min, 30 min, 3 h and 24 h. The concentrations of NO and cGMP were detected by ELISA. Other mice were randomly divided into the following groups: control group (con), L-arg group (L-arg), Yueju pill group (YJ) and L-arg+ Yueju pill group (L-arg+YJ) . Control group was treated with saline, YJ group was treated with Yueju pill (13.5 g·kg-1), and L-arg group was treated with L-arg (750 mg·kg-1) . Tail suspension test (TST) was measured30 min after administration.Results:12 min after YJ administration, the concentration of NO was significantly lower than that in control group (P ＜ 0.05) and the concentration of c GMP was also significantly lower than that in control group (P ＜ 0.05) . In the TST test, the immobility time in YJ group was significantly shorter than that in control group (P ＜ 0.01), and the immobility time in L-arg+YJ group was significantly longer than that in YJ group (P ＜ 0.01) . In open field test (OFT), the spontaneous activity of mice were not affected by administering L-arg or YJ. Conclusion: Yueju pill may rapidly alleviate depression-like behaviors of mice through regulating NO concentration, then influencing downstream cGMP and activating the NO-cGMP signaling in cells.

Objective To explore the efficacy of laparoscopic liver resection (LLR) in the treatment of patients with hepatocellular carcinoma (HCC) at complicated region. Methods Clinical data of 89 patients with HCC at complicated region treated in West China Hospital of Sichuan University between February 2015 and February 2017 were analyzed retrospectively. These patients were divided into LLR group and open liver resection group (OLR group) according to different operative procedures. There were 36 patients in LLR group, including 27 males and 9 females, with an average age of (54±13) years old. There were 53 patients in OLR group, including 44 males and 9 females, with an average age of (52±11) years old. The informed consents of all patients were obtained and the local ethical committee approval was received. Perioperative conditions and postoperative quality of life score in both groups were compared using t test or Kruskal-Wallis rank sum test, and survival analysis was conducted using Kaplan-Meier test and Log-rank test. Results The length of operation was (268±89) min in LLR group, significantly longer than (210±74) min in OLR group (t=3.365, P<0.05). The postoperative length of hospital stay was (6.2±1.2) d in LLR group, significantly shorter than (7.2±2.3) d in OLR group (t=-2.347, P<0.05). The operation expenses was (19.1±9.3) thousand RMB in LLR group, which was significantly higher than (6.1±1.7) thousand RMB in OLR group (t=10.425, P<0.05). The score of daily activity, accessory symptoms of HCC and score of quality of life were (25±4), (64±7) and (151±20) points in LLR group, significantly higher than (23±3), (60±7) and (144±9) points in OLR group, respectively (t=2.278, 2.375, 2.720; P<0.05). The overall survival, disease-free survival were respectively 93.0%, 78.0% in OLR group, and respectively 97.0%, 79.0% in LLR group, where no significant difference was observed (χ2=0.276, 0.029; P>0.05). Conclusions Compared with OLR, LLR can obviously shorten the length of hospital stay and improve the postoperative quality of life for patients with hepatocellular carcinoma (HCC) at complicated region. It is safe and feasible.