Objectives:To understand the use of pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) and related factors in men who have sex with men (MSM) in Shandong Province, and provide reference for the promotion of PrEP and PEP in MSM.Methods:From April to July in 2022, MSM were recruited from 7 sentinel surveillance sites in Shandong Province for a questionnaire survey, and the sample size of each city site was 400. The information about sociodemographic characteristics, sexual behaviors, the uses of PrEP and PEP and others were collected from the MSM, and blood samples were collected from them for HIV and syphilis testing.Results:A total of 2 815 MSM were investigated, the majority of them were aged less than 30 years (55.7%, 1 569/2 815), unmarried (68.6%, 1 931/2 815) and had education background of college and above (56.5%, 1 590/2 815). Only 9.2% (258/2 815) had used PrEP and 10.8% (305/2 815) had used PEP. Multivariate logistic regression showed that factors associated with high likelihood of PrEP use in MSM included age ≤30 years (a OR=4.04, 95% CI:1.25-13.01), self-perceived lower risk of HIV infection (a OR=1.76, 95% CI:1.16-2.68), group sex and commercial sex in the past six months (a OR=1.51, 95% CI: 1.10-2.09; a OR=1.69, 95% CI: 1.16-2.47), new-type drug use (a OR=1.53, 95% CI: 1.11-2.11), receiving peer education (a OR=1.56, 95% CI: 1.03-2.37), other people using PrEP (a OR=3.29, 95% CI: 2.48-4.36), and being HIV negative (a OR=8.40, 95% CI:1.12-63.12). Factor associated with low likelihood of PrEP use in MSM was anal sex with casual partner (a OR=0.67, 95% CI:0.49-0.90). Factors associated with high likelihood of PEP use in MSM included age under 50 years (≤30 years old: a OR=2.41, 95% CI:1.02-5.69; 31-49 years old: a OR=3.33, 95% CI:1.42-7.85), no self-perceived risk for HIV infection (a OR=1.87, 95% CI:1.12-3.11), group sex in the past six months (a OR=1.68, 95% CI:1.23-2.29), new-type drug use (a OR=3.86, 95% CI:2.94-5.07) and receiving no peer education (a OR=1.54, 95% CI:1.12-2.12). Conclusions:In Shandong, a higher proportion of MSM used PrEP and PEP. Peer education and self-perceived HIV infection risk education should be strengthened to increase the rates of PrEP and PEP use in MSM.

Humans ; COVID-19 ; Consensus ; SARS-CoV-2 ; China

Objective To compare the accuracy of double contrast-enhanced ultrasound (DCEUS) and multi-detector row CT (MDCT) in determining the gross classification in patients with gastric carcinoma (GC) preoperatively.Methods 239 patients with GC proved by endoscopic biopsy were included.DCEUS (intravenous microbubbles combined with oral contrast-enhanced ultrasound) and MDCT were performed preoperatively.The diagnostic accuracy of DCEUS and MDCT in determining gross classification was calculated and compared.Results The overall accuracy of DCEUS in determining the gross appearance of GC was higher than that of MDCT (85％ vs.80％,P ＜ 0.05);there was no significant difference in accuracy between DCEUS and MDCT for Borrmann Ⅰ and Ⅳ classification of AGC (x2 =1.175,P =0.323 for type Ⅰ;x2 =2.171,P =0.141 for type Ⅳ);the accuracy of DCEUS for EGC,Borrmann Ⅱ and Ⅲ classification of GC was higher than that of MDCT (x2 =16.307,P =0.000 for EGC;x2 =39.950,P =0.000 for type Ⅱ;x2 =35.770,P =0.000 for type Ⅲ).Conclusion DCEUS is valuable in determining gross typing of gastric adenocarcinoma preoperatively.

Objectives The aim of this study is to compare efficacy and safety of radiofrequency ablation versus operation for overmuch residual thyroid removal before 131I treatment in differentiated thyroid cancer.Methods Clinical data from 52 newly diagnosed differentiated thyroid cancer patients who treated with operation at Zhejiang Cancer Hospital from January 2014 to December 2016 were retrospectively reviewed.The serum TSH was less than 30 IU/ml,and 99mTc thyroid imaging and ultrasound examination showed obviously residual thyroid tissue after 3 weeks of low iodine diet and discontinuation of euthyrox.Of these patients,28 cases received radiofrequency,while 24 cases treated with operation.The operation time,the waiting time of 131I treatment and the efficacy of residual thyroid tissue clearance were compared between two groups.At the same time,the complications of the two groups were observed.Results The mean values of operation time between two groups were(22.14±7.12)min and(55.45±13.56)min,respectively,and there was a statistically significant difference(t=11.822,P＜0.05).The mean waiting time of 131I treatment in patients received radiofrequency was(9.40±4.14)days,while the mean waiting time in operation group was(13.53±4.55)days,and the differences were statistically significant(t=9.144,P＜0.05).In RFA group,hoarseness,temporary parathyroid injury and permanent parathyroid injury were observed in 2 cases,0 case and 1 case,respectively.While there were 2 cases,3 cases and 0 case in the operative group.There were no significant differences between the two groups(all P ＞ 0.05).85.7%(24/28)of patients in RFA group and 91.7%(22/24)in operation group showed favorable efficacy of residual thyroid removal,and there were no significant differences between the two groups(P＞0.05).Conclusion Compared with operation,postsurgical residual thyroid tissue removal in differentiated thyroid cancer by ultrasound guided radiofrequency ablation by ultrasound guided is safe and effective,and provides a new minimally invasive treatment for patients who are reluctant to undergo surgery.

OBJECTIVETo assess the value of ultrasonography in differential diagnosis of xanthogranulomatous cholecystitis (XGC) and wall-thickening type of gallbladder cancer (GBC).

METHODSThe clinical features and sonographic finding of 31 patients with XGC and 36 patients with wall-thickening type of GBC were retrospectively reviewed. The diagnosis of all cases was confirmed by pathological examination, and the ultrasonographic manifestations of the thickening of the gallbladder wall, intramural hypoechoic nodules, gallbladder mucosa line, gallbladder stones, biliary dilatation and gallbladder-liver boundary were compared between two groups.

RESULTSThere were significant differences in the intramural hypoechoic nodules, the continuous gallbladder wall mucosal line and dilatation of bile duct between XGC and GBC groups (all<0.05), while no statistically significant differences in the other sonographic features(all>0.05). In the six positive sonographic features of the XGC patients, the intramural hypoechoic nodules and the continuous mucosa line of the gallbladder wall had highest accuracy in the diagnosis of XGC(64.2% and 65.7%).

CONCLUSIONSIntramural hypoechoic nodule and the continuous mucosal line are characteristic sonographic features of XGC, which can be used for the diagnosis of XGC.

Objective: To compare aortic annular diameter measured by transthoracic echocardiography (TTE), transesophageal echocardiography (TEE), and multislice computed tomography (MSCT) in patients with severe aortic stenosis, and to evaluate the impact on selection of prosthetic valve type in transcatheter aortic valve implantation (TAVI). Methods: Clinical data of 138 patients with severe aortic stenosis referred for TAVI between January 2014 and June 2016 in our hospital were retrospectively analyzed.The difference of aortic annular diameter measured by TTE, TEE, and MSCT were compared.TTE was performed after TAVI to evaluate the accuracy of measurement before TAVI. Results: (1) Aortic annular diameter was (23.37±2.22) mm by TTE and (23.52±1.70) mm by TEE (P=0.12). Pearson correlation analysis showed that aortic annular diameter measured by TTE was correlated to that measured by TEE (r=0.87, P<0.05). (2)The long-axis diameter and the short-axis diameter measured by MSCT multiplanar reconstruction were significantly different ((27.86±2.87) mm vs. (21.91±2.53) mm, P<0.05). There was no significant difference between the mean of the long- and short-axis diameters and the diameter derived from cross-sectional area by MSCT ((24.92±2.38) mm vs. (24.84±2.25) mm, P=0.08). However, the diameter derived from the circumference ((25.35±2.34) mm) was significantly larger than the mean of the long- and short-axis diameters and the diameter derived from cross-sectional area by MSCT, and the difference were (0.43±0.62) mm and (0.51±0.62) mm respectively(both P<0.05). (3) Measurements of the aortic annulus diameter by MSCT including the mean of the long- and short-axis diameters, diameter derived from cross-sectional area, and diameter derived from the circumference were larger than the measurement by TTE and TTE (all P<0.05). (4) Implantation was successful in all patients.Moderate to severe paravalvular leakage was detected in 3 patients at 7 days post TAVI, and 1 patient developed severe prosthetic valve restenosis at 6 months post TAVI and received valve-in-valve implantation. Conclusions In severe aortic stenosis patients referred for TAVI, the aortic annular diameter derived from TTE and TEE measurements are smaller than that from MSCT.In the absence of a gold standard, selection of prosthetic valve type in TAVI procedure should rely on comprehensive considerations, which is of importance to get good clinical results for severe aortic stenosis patients underwent TAVI.

OBJECTIVETo analyze chromosome aberration in a child with mental retardation and abnormalities and its parents.

METHODSChromosome G banding, multiplex ligation-dependent probe amplification, fluorescence in situ hybridization and single nucleotide polymorphisms array were employed for analysis.

RESULTSKaryotype analysis revealed that the child was 46,XX and the father was 46,XY, while the mother was 46,XX, add (12)(p13). Subtelomeric region analysis with MLPA displayed that the child has reduced ACP1 gene copy number in 2p25 region and increased SLC6A12,KDM5A gene copy numbers in 12p11 region. SNP-array has fine mapped the duplication to 12p13.33-p12.3, a 15.142 Mb region, and a deletion to 2p25.3 for 3.194 Mb, which resulted in duplication of 9 genes including SLC6A12 as well as deletion of 11 genes including SNTG2, respectively. FISH analysis revealed that the child was 46,XX,ish,der(2),t(2;12)(p25;p13)mat, or partial monosomy 2p25 and partial trisomy 12p13. In addition,the mother was a carrier with cryptic balanced translocation chromosome, 46,XX,isht(2;12) (p25;p13). Mental abnormalities and retardation of the child may be attributed to heterozygous deletion of SNTG2, MYT1L genes and duplication of SLC6A12 gene.

CONCLUSIONCombined use of MLPA, FISH and SNP-array can facilitate accurate diagnosis of cryptic rearrangement at genomic level.

Adolescent ; Adult ; Carrier Proteins ; genetics ; Child ; Child, Preschool ; Chromosome Banding ; Chromosome Deletion ; Chromosomes, Human, Pair 12 ; genetics ; Chromosomes, Human, Pair 2 ; genetics ; Female ; Gene Rearrangement ; Humans ; Intellectual Disability ; diagnosis ; genetics ; Male ; Pedigree ; Protein Tyrosine Phosphatases ; genetics ; Proto-Oncogene Proteins ; genetics ; Translocation, Genetic ; Trisomy ; Young Adult

Objective To evaluate the association of the size of thyroid nodules and accuracy of fineneedle aspiration cytology in diagnose of thyroid nodules.Methods 691 thyroid nodules in 630 patients pathologically confirmed were retrospectively analyzed in our hospital.All imaging data of preoperative ultrasound-guided FNAC were collected in our review.Yields of FNAC were divided into six levels according to the classification criteria of the Bethesda system(level Ⅰ,insufficient material or nondiagnosed;level Ⅱ,benign ; level Ⅲ,atypical hyperplasia; level Ⅳ,follicular neoplasm ; level Ⅴ,suspicious for malignancy; level Ⅵ,malignant),＞level Ⅳ was the malignant cytologic criteria for diagnosis of thyroid nodules.According to the maximal diameter of thyroid nodules,the nodules were divided into group A(L≤0.5 cm),group B(0.5 cm＜L＜1.0 cm) and group C(L≥1.0 cm).Postoperative pathologic results were taken as the gold standard.Results Of 691 nodules,there were 176(25.47％),298(43.13％) and 217(31.40％) in group A,group B and group C respectively.Among the three groups,accuracy of ultrasound-guided FNAC in group B (90.94 ％) was higher than in group A(80.11％) and group C(83.41 ％),with statistically significant(P ＜0.05).There was not statistically different between group A and group C(P ＞0.05).The specificity,positive predictive value and negative predictive value were not statistically different among three groups(P ＞0.05).Conclusions The size of thyroid nodules was partly associated with accuracy of ultrasound-guided FNAC.

Objective To explore the preliminary evaluation of transesophageal echocardiography in percutaneous edge-to-edge repair of mitral regurgitation.Methods Ten consecutive patients were treated with percutaneous edge-to-edge repair of mitral regurgitation using the MitraClip system.All of them had moderate-severe (n =1) or severe (n =9) central MR and high operative risk.MitraClip implantation performed under echocardiographic and fluoroscopic guidance in general anaesthesia.Preoperative and postoperative immediate echocardiographic data were prospectively collected.Results All operations succeed with one MitraClip implanted to 5 patients and two MitraClips implanted to 5 patients.Postoperative immediate echocardiography observed MR reduction,6 cases to mild,2 cases to mild-to-moderate and 2 cases to moderate.No complications occurred in all patients,such as Clip off,pericardial effusion/tamponade,or mitral valve damage.Conclusions Echocardiography guarentees the success of MitraClip based transcatheter mitral valve repair operations with safety and effectiveness.

Objective To apply the binary Logistic regression model and evaluate the value of grey scale ultrasonography(US),ultrasond elastography(UE) and contrast-enhanced ultrasound(CEUS).Methods US,UE and CEUS were performed in 130 patients with 142 solid thyroid micronodules (the largest diameter less than 10 mm).Pathology was followed up as golden diagnosis criteria.A Logistic model on the basis of ultrasonographic features was obtained.A receiver operating characteristic(ROC) curve was used to assess the performance of Logistic model.Results Four ultrasonic indexes were finally entered into the Logistic regression model including microcalcification,acpect ratio,advanced CEUS mode and elasticity score.The percentage correction of prediction was 92.1％ (129/142),the area under the ROC curve was 0.944.Conclusions The multivariate analysis model of binary Logistic regression can describe and analyze the process of differential diagnosis of malignant and benign solid thyroid micronodules by ultrasonography,and select out the valuable indexes for differential diagnosis.