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Objective To investigate the clinicopathological features of early gastric cancer ( EGC) with micropapillary pattern. Methods In 447 consecutive EGC patients at Changzhou No. 2 People′s Hospital admitted from January 2006 to December 2016, 8 ( 1. 8％) with micropapillary adenocarcinoma (≥5％) were enrolled in the observation group and the remaining 439 were included in the control group. Clinicopathologic features including age, gender, gross pattern, tumor location, size, invasion depth, lymphovascular invasion, lymphatic metastasis and pathological stage were analyzed and compared between the two groups. Results There were no significant differences between the two groups in age, gender, gross pattern, tumor location or size (all P>0. 05). The observation group showed significantly more frequent submucosal invasion ( 100. 0％, 8/8 ) , lymphovascular invasion ( 62. 5％, 5/8 ) , lymphatic metastasis (62. 5％, 5/8), and higher pathological stage (Ⅱ+Ⅲ 25. 0％, 2/8) compared with those in the control group, which were 52. 4％ ( 230/439 ) , 9. 1％ ( 40/439 ) , 13. 9％ ( 61/439 ) , and 5. 9％ ( 26/439 ) , respectively ( all P<0. 05 ) . Conclusion EGC with micropapillary pattern is rare with a high liability to lymphovascular invasion, lymphatic metastasis, and higher pathological stage, compared to EGC without micropapillary pattern.
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Objective@#To explore the psychological distress status of HIV-infected pregnant women and analyze the possible influencing factors.@*Methods@#A total of 483 HIV-infected pregnant women were enrolled for this study by a cluster random sampling method from Sept. 2014 to Apr. 2017. Participants completed questionnaires including Distress Thermometer (DT), Berger HIV Stigma Scale (BHSS), HIV/AIDS Stress Scale (SS-HIV), Social Support Rating Scale (SSRS) and general questionnaire.@*Results@#The detection rate of psychological distress was 68.1%, the detection rates of moderate, severe and extreme psychological pain were 49.7%, 17.6% and 0.8% respectively. The detection rate of continuing pregnancy (75.2%) was higher than the termination pregnancy (56.4%), the difference was statistically significant (χ2=18.44, P<0.01). There were significant differences in the detection rates between continuing pregnancies at different gestational ages (χ2=15.41, P<0.01), and the termination pregnancy varies little with pregnancy (χ2=0.03, P>0.05). The mean DT score was 4.85 ± 1.82. The score of continuing pregnancy (5.94 ± 1.73) was higher than the termination pregnancy (4.20 ±1.96), the difference was statistically significant (t=4.57, P<0.01). Logistic regression analysis showed that CD4+ T lymphocyte count, infection route, perceived discrimination, related stress and social support were the common influencing factors of all pregnant women, factors affecting continuing pregnancy also include high risk pregnancy and gestational age.@*Conclusions@#HIV-infected pregnant women have higher incidence of psychological distress. The influencing factors are mainly related to the infection characteristics, pregnancy characteristics, BHSS, SS-HIV and SSRS, and has nothing to do with the general social demographic characteristics. The DT can be used as a screening tool to quickly identify psychological distress of the group.
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Objective To study the acceptability and associated factors of pre-exposure prophylaxis (PrEP) based on different sexual purpose among human immunodeficiency virus (HIV) male serodiscordant couples.Methods HIV-negative female spouses of HIV-positive male in Guigang,Guiping and Pingnan county in Guangxi Zhuang Autonomous Region were recruited by the existing epidemic database and the method of cluster random sampling.A face-to-face questionnaire survey was conducted during June 2013 to November 2016.Information including the general condition and acceptability of PrEP was surveyed.x2 test and Logistic regression were used to analyze the data.Results A total of 526 qualified questionnaires were collected.The intention rate of PrEP based on physiological sexual purpose was 66.9％ (352/526),the intention rate of PrEP based on fertility purpose was 93.3％ (491/526).The difference was statistically significant (x =139.48,P＜0.01).The reasons of refusal included worrying about its safety,effectiveness poor confidentiality and low self-assessment risk of infection.Logistic analysis showed that the associated factors of the intention rate of PrEP based on physiological sexual purpose included cognition of PrEP (OR=0.70,P=0.014),the number of lifetime partners (OR=0.55,P＜0.01),frequency of sexual behavior (OR=1.33,P=0.016),willingness of condom use (OR=0.16,P＜0.01),infection risk self-assessment (OR =0.22,P＜0.01),male viral load (OR=1.25,P=0.035),male CD4+ T lymphocyte count (OR=0.37,P＜0.01) and male usefulness of medication or not (OR=1.59,P＜0.01).The influencing factors of the intention rate of PrEP based on physiological sexual purpose included with or without children (OR =1.70,P＜0.01),cognition of PrEP (OR=0.72,P=0.026),willingness of using condom (OR=0.18,P＜0.01),infection risk self-assessment (OR=0.14,P＜0.01) and male CD4+ T lymphocyte count (OR=0.45,P＜0.01).Conclusions The acceptability of PrEP based on fertility purpose is significantly higher than that on the physiological purpose.It is more feasible to conducting clinical trials of PrEP in peri-conceptional period HIV serodiscordant couples.The main influencing factors include the uninfected individual behavior characteristics and infection features of HIV infected men,and have nothing to do with the general social demographic characteristics.
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Objective To analyse the multi-slice spiral CT(MSCT) findings of small cholangiocarcinoma of common bile duct.Methods 15 cases with pathologically verified small cholangiocarcinoma of common bile duct were undergone unenhanced and three-phase contrast-enhanced MSCT scan.The entire morphologic changes of common bile duct were analysed with curved planar reformation(CPR).Results The attenuation of tumor relative to pancreas was iso-density in all cases at plain CT scan,hypo-density in 10 cases,iso-density in 3 cases and hyper-density in 2 cases at arterial phase,hypo-density in 1 case,iso-density in 3 cases and hyper-density in 11 cases at portal phase,iso-density in 5 caaes and hyper-density in 10 cases at delayed phase.The focal wall thickening of common bile duct appeared as circular or eccentric in 13 cases,intraluminal nodule in 2 cases,common bile duct was narrowing sharply in 11 cases and ending abruptly in 4 cases at obstructive level.Conclusion The small cholangiocarcinoma of common bile duct is of certain characteristics at unenhanced and three-phase contrast-enhanced CT scan.