Objective: To investigate the awareness rate of non-occupational post-exposure prophylaxis (nPEP) for AIDS and its influencing factors among men who have sex with men (MSM) in Yangzhou City, Jiangsu Province. Methods: From January to June 2024, MSM aged ≥16 years in Yangzhou City were recruited using the snowball sampling method. Basic information, sexual behavior characteristics, awareness and usage of nPEP, and awareness of pre-exposure prophylaxis (PrEP) for AIDS were collected through questionnaire surveys. Factors affecting awareness of nPEP among MSM were analyzed using multivariable logistic regression model. Results: A total of 740 participants were enrolled, with a median age of 29 (interquartile range, 14) years. There were 497 participants with a college degree and above educational level, accounting for 67.16%. A total of 541 participants resided in urban areas, accounting for 73.11%. The awareness rate of nPEP was 57.30%. The primary channels for awareness were the internet and healthcare institution promotions, with 159 and 119 participants, accounting for 37.50% and 28.07%, respectively. A total of 57 participants had utilized nPEP, with a usage rate of 7.70%. The main reason for using nPEP was having unprotected sex, with 21 participants, accounting for 36.84%. Multivariable logistic regression analysis revealed that unmarried MSM (OR=2.369, 95%CI: 1.236-4.540) and those who were aware of PrEP (OR=28.067, 95%CI: 17.664-44.597) had a significantly higher likelihood of being aware of nPEP. Conclusions The awareness rate and usage rate of nPEP among MSM in Yangzhou City are both relatively low. Awareness of nPEP is mainly influenced by marital status and whether participants are aware of PrEP.

Objective:To investigate the effects of the expanded lateral thoracic artery perforator flap in the reconstruction of breast scar contracture deformity after burns in minor females.Methods:The study was a retrospective observational study. From July 2018 to October 2023, 8 female children aged 4 to 12 years and with breast scar contracture deformity after burns, who met the inclusion criteria, were admitted to the Department of Burns and Plastic Surgery of Guangzhou Red Cross Hospital of Jinan University. The skin and soft tissue expander (hereinafter referred to as expander) was placed in the first stage. The contracture scar was removed and released in the second stage, and the wound formed after the scar was removed measured between 9 cm×8 cm and 15 cm×10 cm. The expanded lateral thoracic artery perforator flap was designed and transferred to repair the wound with resected flap area of 10 cm×9 cm to 16 cm×11 cm, and the wound at the flap donor area was directly sutured. The complications such as incision infection, hematoma, and expander exposure were observed after stage Ⅰ surgery. After stage Ⅱ surgery, the survival of the flap and the wound healing at the flap donor area were observed. During the 1-year follow-up after the stage Ⅱ surgery, the breast development was evaluated according to tanner staging performance of female pubertal breast development, the aesthetic effect of the affected breast was evaluated by using the aesthetic effect evaluation standard after breast surgery, the Vancouver scar scale (VSS) was used to score the scar condition at the flap donor and recipient areas, and the satisfaction of the children's families with the surgical outcomes was investigated by using a self-made scale.Results:After stage Ⅰ surgery, no incision infection, hematoma, expander exposure, or other complications occurred in 8 children. After stage Ⅱ surgery, only one child had tissue necrosis at the distal end of the flap with a size of about 2 cm×1 cm, which healed after dressing change, and the flap in other children had good blood supply, soft texture, moderate thickness, and similar color to the skin at the recipient area. The wounds at all flap donor areas healed well. During the 1-year follow-up after stage Ⅱ surgery, 7 children had normal breast development, with their breast volume, height, and shape being almost the same as or similar to the healthy side, with the aesthetic effect of all being grade Ⅰ; the breast in one child had not yet developed, and these indicators were not evaluated. The locations of nipple areola complex in 8 children were almost the same as or similar to those in the healthy side, and their skin color, integrity, texture, and elasticity of the partial breast repaired by the transferred flap were similar to those in the healthy side, with the aesthetic effect of all being grade Ⅰ. The shapes of nipple and areola in 5 children were inconsistent with those in the healthy side because of the original scar, with the aesthetic effect of all being grade Ⅱ, and the shapes of nipple and areola in the other 3 children were consistent with those in the healthy side, with the aesthetic effect of all being grade Ⅰ. The VSS score of the scar at the flap recipient area was 2-5, and the VSS score of the scar at the flap donor area was 1-3. Seven children's families were satisfied with the surgical effect, and one child's family was basically satisfied with the surgical effect.Conclusions:For the breast scar contracture deformity of minor females after burns, the expanded lateral thoracic artery perforator flap is used for reconstruction before puberty, which results in fewer postoperative complications, good breast shape, and hidden scar at the flap donor area. It is beneficial for the normal development of adolescent breasts, and is one of the safe and effective methods for the treatment of breast scar contracture deformity in minor females after burns.

Objective:To investigate the effects of the expanded lateral thoracic artery perforator flap in the reconstruction of breast scar contracture deformity after burns in minor females.Methods:The study was a retrospective observational study. From July 2018 to October 2023, 8 female children aged 4 to 12 years and with breast scar contracture deformity after burns, who met the inclusion criteria, were admitted to the Department of Burns and Plastic Surgery of Guangzhou Red Cross Hospital of Jinan University. The skin and soft tissue expander (hereinafter referred to as expander) was placed in the first stage. The contracture scar was removed and released in the second stage, and the wound formed after the scar was removed measured between 9 cm×8 cm and 15 cm×10 cm. The expanded lateral thoracic artery perforator flap was designed and transferred to repair the wound with resected flap area of 10 cm×9 cm to 16 cm×11 cm, and the wound at the flap donor area was directly sutured. The complications such as incision infection, hematoma, and expander exposure were observed after stage Ⅰ surgery. After stage Ⅱ surgery, the survival of the flap and the wound healing at the flap donor area were observed. During the 1-year follow-up after the stage Ⅱ surgery, the breast development was evaluated according to tanner staging performance of female pubertal breast development, the aesthetic effect of the affected breast was evaluated by using the aesthetic effect evaluation standard after breast surgery, the Vancouver scar scale (VSS) was used to score the scar condition at the flap donor and recipient areas, and the satisfaction of the children's families with the surgical outcomes was investigated by using a self-made scale.Results:After stage Ⅰ surgery, no incision infection, hematoma, expander exposure, or other complications occurred in 8 children. After stage Ⅱ surgery, only one child had tissue necrosis at the distal end of the flap with a size of about 2 cm×1 cm, which healed after dressing change, and the flap in other children had good blood supply, soft texture, moderate thickness, and similar color to the skin at the recipient area. The wounds at all flap donor areas healed well. During the 1-year follow-up after stage Ⅱ surgery, 7 children had normal breast development, with their breast volume, height, and shape being almost the same as or similar to the healthy side, with the aesthetic effect of all being grade Ⅰ; the breast in one child had not yet developed, and these indicators were not evaluated. The locations of nipple areola complex in 8 children were almost the same as or similar to those in the healthy side, and their skin color, integrity, texture, and elasticity of the partial breast repaired by the transferred flap were similar to those in the healthy side, with the aesthetic effect of all being grade Ⅰ. The shapes of nipple and areola in 5 children were inconsistent with those in the healthy side because of the original scar, with the aesthetic effect of all being grade Ⅱ, and the shapes of nipple and areola in the other 3 children were consistent with those in the healthy side, with the aesthetic effect of all being grade Ⅰ. The VSS score of the scar at the flap recipient area was 2-5, and the VSS score of the scar at the flap donor area was 1-3. Seven children's families were satisfied with the surgical effect, and one child's family was basically satisfied with the surgical effect.Conclusions:For the breast scar contracture deformity of minor females after burns, the expanded lateral thoracic artery perforator flap is used for reconstruction before puberty, which results in fewer postoperative complications, good breast shape, and hidden scar at the flap donor area. It is beneficial for the normal development of adolescent breasts, and is one of the safe and effective methods for the treatment of breast scar contracture deformity in minor females after burns.

Background There are few studies on the diet quality of patients with thyroid cancer, and the relationship between diet quality and thyroid cancer remains uncertain. Objective This study aims to assess the diet quality with the Chinese Health Diet Index (CHDI) and to explore the relationship between diet quality and papillary thyroid carcinoma (PTC). Methods A 1∶1 gender- and age-matched hospital-based case-control study included newly diagnosed PTC patients and matched controls from Shanghai Cancer Hospital and Renji Hospital (East) in Shanghai, China. A structured questionnaire was applied to collect data on general characteristics, history of diseases, dietary intakes, and lifestyles. Food intakes in the past one year were assessed using a validated food frequency questionnaire, from which the CHDI score was calculated. The CHDI, according to the Dietary Guidelines for Chinese Residents, was employed to evaluate the diet quality of the two groups. A multiple conditional logistic regression model was conducted to explore the relationship between diet quality and PTC. Results A total of 350 pairs of cases and controls were recruited. The overall median CHDI score of the cases was lower than that of the controls (67.8 vs. 73.4, P<0.001). The cases had lower median scores of fruits (6.8 vs. 9.5), dairy products (3.6 vs. 5.6), and soybeans (4.6 vs. 5.5) than the controls (P<0.05); the cases had a higher median score of refined grains than the controls (5.0 vs. 4.9), and the percentage of the cases that met diet recommendations for refined grains was higher than the percentage of the controls (65.4% vs. 48.6%) (P<0.05); the cases showed lower median scores of whole grains/beans/tubers, total vegetables, dark vegetables, and fish/shrimps (0.9 vs. 1.4, 3.1 vs. 4.4, 3.6 vs. 5.0, and 3.3 vs. 4.0, respectively), and the percentages of the cases meeting their diet recommendations were lower than the percentages of the controls (6.3% vs. 8.6%, 32.6% vs. 42.0%, 38.6% vs. 50.6%, and 34.0% vs. 40.3%, respectively, P<0.05). The results of multiple conditional logistic regression analysis suggested that qualified and good diet quality were associated with a reduced the risk of PTC (qualified diet quality, OR=0.37, 95%CI: 0.23−0.62; good diet quality, OR=0.19, 95%CI: 0.10−0.36); the statistical significance remained after excluding patients who had a history of benign thyroid conditions (qualified diet quality, OR=0.28, 95%CI: 0.15−0.52; good diet quality, OR=0.20, 95%CI: 0.09−0.43). Conclusion Those with qualified or good diet quality have a lower risk of PTC. PTC patients have insufficient intakes of fruits, dairy, soybeans, whole grains/beans/tubers, vegetables, and fish/shrimps.

Background Thyroid carcinoma is a serious threat to human health in Shanghai and a focus of cancer prevention and treatment. Objective This study aims to assess the relationship between foods rich in iodine and papillary thyroid carcinoma (PTC)．Methods In a hospital-based case-control study matched by gender and age (±3 years old), 402 pairs of cases (new incidences) and controls were included and studied. A validated questionnaire and food frequency questionnaire survey was conducted face to face to obtain demographic characteristics and dietary intake. A multiple conditional logistic regression model was applied to explore the relationship between foods rich in iodine (including seaweeds, kelp, and dried shrimps) and PTC. Results The mean age of the participants was (41.17±11.51) years in this study. Compared with the controls, more cases had a lower education and a manual occupation (P<0.05); more cases were overweight or obese, had a history of benign thyroid conditions, and had a family history of thyroid diseases (P<0.05); the two groups were different in the frequency of CT examination in the past ten years (P<0.05). The results of multiple conditional logistic regression analysis showed that consumption of iodine-rich foods was associated with a lower risk of PTC (for <1 time per week, OR=0.20, 95%CI: 0.12−0.35; for 1−2 times per week, OR=0.18, 95%CI: 0.10−0.33; for ≥3 times per week, OR=0.13, 95%CI: 0.04−0.44) (P<0.05). Specifically, those who consumed seaweeds (for <1 time per week, OR=0.18, 95%CI: 0.11−0.30; for 1−2 times per week, OR=0.11, 95%CI: 0.05−0.23; for ≥3 times per week, OR=0.15, 95%CI: 0.03−0.75), kelp (for <1 time per week, OR=0.28, 95%CI: 0.18−0.43; for ≤2 times per week, OR=0.24, 95%CI: 0.11−0.50), and dried shrimps (for <1 time per week, OR=0.44, 95%CI: 0.29−0.69; for ≤2 times per week: OR=0.34, 95%CI: 0.18−0.65) had a lower risk of PTC (P<0.05). After excluding patients who had a history of benign thyroid conditions, the favorable association remained significant among patients who had consumption of iodine-rich foods, seaweeds, shrimps, and kelp (P<0.05). Conclusion Less PTC patients consume iodine-rich foods than the controls.

Objective To investigate the protective effects of Platycodon grandiflorum total saponins (PGTS) on acute lung injury (ALI) in rats and the related mechanisms.Methods Total of 60 SD rats were randomly (random number) divided into control group,model group,low-,middle-and high-dose PGTS group,and dexamethasone group,10 rats in each group.The latter 4 groups and dexamethasone group were injected with 50,100,200 mg/kg PGTS and 5 mg/kg dexamethasone,respectively.After 1 h,the latter 5 groups were intraperitoneally injected with mg/kg LPS to establish the ALI model.The clinical symptoms of the rats were observed.After 12 h,the arterial PaO2 and PaCO2,serum TNF-α and IL-10 level,lung wet/dry weight ratio (W/D),lung tissue SOD,GSH-Px and MDA level and NF-κB protein expression were determined.Results Rats in model group manifested noticeable symptoms of acute lung injury (ALI) and lung tissue lesions.In treatment group with appropriate PGTS dose,ALI symptoms and lung lesions were significantly alleviated,arterial PaO2 was markedly increased (P ＜ 0.05),PaCO2 was decreased obviously (P ＜ 0.05),serum TNF-α level was prominently decreased (P ＜ 0.05),IL-10 level was strikingly decreased (P ＜ 0.05),lung W/D ratio was significantly decreased (P ＜0.05),lung tissue SOD and GSH-Px level were distincdy increased (P ＜0.05),MDA was clearly decreased (P ＜ 0.05),and NF-κB protein expression was plainly decreased (P ＜ 0.05),compared with model group.Conclusions PGTS has undoubted protective effects on acute lung injury induced by LPS in rats.The mechanism may be associated with its role of anti-inflammation,anti-lipid peroxidation and down regulation of NF-κB protein level in lung tissue.

OBJECTIVETo evaluate the effect of techniques of precise liver surgery for donor hepatectomy in living donor liver transplantation.

METHODSEighty-nine donors aged from 19 to 57 years were performed by the same surgical team from June 2006 to December 2013 in Chinese People's Liberation Army General Hospital.Individualized surgical program were developed according to preoperative imaging examination and hepatic functional reserve examination. The evaluation included liver function, liver volume, vascular anatomy and bile duct anatomy. According to the results after the operation, preoperative evaluation accuracy, postoperative donor liver function and postoperative complications were analyzed. ANOVA analysis was used to compare the difference of graft volume by two-dimensional, three-dimensional calculation method and actual postoperative graft weight. Pearson correlation test and linear regression analysis were used to verify the correlation between the estimated graft volume each method and actual graft postoperative weight.

RESULTSAll the 89 cases operation protocol as following, there were 5 cases with left lateral lobe graft, 10 cases with left lobe liver graft, 74 cases with right lobe graft. There were 59 cases with middle hepatic vein (MHV) harvested, and 30 cases without MHV. The mean graft volume by two-dimensional, three-dimensional calculation method and actual postoperative graft weight were (656.2±134.1) ml, (631.7±143.2) ml and (614.5±137.7) ml respectively. ANOVA analysis results showed that there were no statistically significant difference in the three methods (P>0.05). Compared to the actual postoperative graft weight, the average error rate of the two methods were 7.9% and 5.3% respectively. Pearson correlation test showed the graft volume calculated by two-dimensional and three-dimensional methods had a significantly positive correlation with actual graft weight (r=0.821, 0.890, P<0.01) and linear regression analyze showed the R2 were 0.674 and 0.792, respectively. The accuracy rate of preoperative evaluation about portal vein, hepatic vein, hepatic artery and bile duct were 100%, 100%, 97.8% and 95.5%, respectively. The preoperative plan and postoperative practical scheme coincidence rate was 95.5%. Overall donor complication rate was 7.4%. All donors were alive. Sixteen donors received right lobe hepatectomy with gallbladder preserved had a good liver function and gallbladder function.

CONCLUSIONThrough the precise preoperative evaluation, surgical planning, fine operation and excellent postoperative management, precise liver surgery technique can ensure the safety of donor in living donor liver transplantation.

Adult ; Bile Ducts ; Body Weight ; Hepatectomy ; methods ; Hepatic Artery ; Hepatic Veins ; Humans ; Linear Models ; Liver Transplantation ; methods ; Living Donors ; Middle Aged ; Portal Vein ; Postoperative Complications ; Postoperative Period ; Young Adult

Objective To provide Meta-analysis evidence of laparoscopic partial nephrectomy (LPN) vs open partial nephrectomy (OPN) in assisting clinical decision making.Methods By searching CHKD,PUBMED,Wanfang and VIP database self-built library up to June 30,2012,both Chinese and English literatures of LPN and OPN efficacy in controlled study were included with strict exclusion criteria by two independent screenings of the literature.Data extraction and quality assessment were done by using the RevMan 5.1 META analysis software.Results A total of four English and six Chinese literature were included in this Meta-analysis.There were 1636 cases of partial nephrectomies.Of these patients,794 cases were treated with LPN,842 cases were treated with OPN.Meta analysis results showed that:in terms of operative time (SMD =0.10,95％ CI-O.40-0.59,P =0.70),surgical complication (OR =1.03,95％ CI0.73-1.44,P =0.88),positive surgical margin (OR =1.64,95 ％ CI0.83-3.23,P =0.16),warm ischemia time (SMD =1.07,95％ CI-0.02-2.16,P =0.05),postoperative tumor recurrence (OR =0.58,95％ CI 0.26-1.30,P =0.18),there was no significant difference.But in terms of intraoperative blood loss (SMD=-1.08,95％CI-1.57--0.59,P＜0.01),postoperative hospital stay (SMD=-0.81,95％CI-0.97--0.65,P ＜0.01),the differences were significant in favor of LPN.Conclusion Comparing with OPN,LPN has advantages in intraoperative blood loss and post-operative hospital stay,no obvious advantages in operative time,surgical complications,positive surgical margin,warm ischemia time and tumor recurrence.

Objective To optimize plan for right lobe living donor hepatectomy based on the territorial volume drained by the middle hepatic vein (MHV) as shown by preoperative MR image in donors.Methods Utilizing preoperative MR dynamic enhancement scanning image,virtually plot three types of hepatic parenchyma transsection plane based on the variation of including MHV for right lobe graft procurement. Results From June 2006 to May 2010,65 adult-to-adult right lobe living donor liver transplantations was performed at General Hospital of Chinese PLA,in which there were 43 grafts including MHV (66.2％,43/65 ), eight grafts including partial MHV which was dissected before the V4b abouchement ( 12.3％,8/65) and 14 grafts not including MHV (21.5％,14/65). There was no postoperative death in donors and the postoperative complications developed in 10.76％ (7/65). The recipients' perioperative mortality was 7.69％ (5/65). Ttwenty-one complications developed in 18 recipients,and the morbidity was 32.31％. The cumulative survival rates were 86％,77％ and 68％respectively for 1,2 and 3 years. Conclusions The optimizing liver resection plane could be practically designed preoperatively for right lobe graft procurement based on the territorial volume drained by MHV.

Objective To evaluate the feasibility and safety of hand-assisted laparoscopic one-stage operation for colorectal cancer with single hepatic metastasis.Methods The clinical data of 6 patients of colorectal cancer with single hepatic metastasis treated with hand-assisted laparoscopic one-stage operation between Aug 2009 and Mar 2010 were analyzed retrospectively.Result Procedures were completed successfully in all cases and there was no conversion to open surgery.The mean operation time was (183 ±45) min,the mean blood loss in operation was (165 ±70) ml,the mean time to intestinal function recovery was (69.4 ± 10.5) h,and the average length of stay was (9.5 ±3.2) d.There was no major intraoperative or postoperative complications.All the patients received chemotherapy and up to 30 months follow-up found good condition in all but one dying of widespread intraabdominal tumor metastasis.Conclusions Handassisted laparoscopic one-stage operation for colorectal cancer with hepatic metastasis is feasible and safe.