Research progress of autologous peritioneal patch for repairing defective blood vessels / 中华肝胆外科杂志

In the process of radical resection of abdominal malignant tumors, large blood vessels are often invaded, which not only increases the difficulty of operation, but also directly affects the curative effect and prognosis. As the concept of expanded radical surgery combined with vascular resection and reconstruction and related techniques have been gradually recognized, surgeons have begun to use autologous, allogeneic or artificial vessels to repair the defective blood vessels during surgery, so as to achieve the effect of radical surgery. However, due to the short comings of these materials, scholars have been looking for better alternatives. In view of the fact that the mesothelial cells of the peritoneum and the endothelial cells of the blood vessels have many similarities in embryology, histology and physiology, and peritoneum is also easier to obtain than autologous, allogeneic or artificial vessels. To make the autologous peritoneum into a patch for repairing the defective blood vessels is feasible in theoretical and technical. In this paper, we review the current research progress of autologous peritoneal patch to repair blood vessels of defect.

Status of sleep insufficiency and related factors in children and adolescents with mental disorders / 四川精神卫生

ObjectiveTo investigate the status of sleep insufficiency in children and adolescents with mental disorders and related influencing factors. MethodsA total of 131 children and adolescents who were admitted to the Third People's Hospital of Fuyang from February to June 2021 and met the diagnostic criteria of International Classification of Diseases， tenth edition （ICD-10） for schizophrenia， depression or childhood-onset mood disorders were selected as the research subjects. A self-compiled questionnaire was used to collect the general demographic information， sleep status， lifestyle habits， family and school status of the selected individuals. The demographic information was compared between sleep sufficiency group and sleep insufficiency group. Spearman rank correlation was used to screen the influencing factors. Results① Among 131 children and adolescents with mental disorders， 93 cases （71.0%） had sleep insufficiency. There were significant differences between sleep insufficiency group and sleep sufficiency group in terms of disease types （χ2=8.798， P=0.012）， experience of being beaten in recent 6 months （χ2=3.427， P=0.035）， being scolded in recent 6 months （χ2=4.145， P=0.031）， and cyberbullying over the past year （χ2=4.187， P=0.041）. ② Among patients with sleep insufficiency， 77 cases （82.8%） reported difficulty in falling asleep and 69 cases （74.2%） reported nocturnal awakenings. ③ Sleep insufficiency in children and adolescents with mental disorders was positively correlated with the experience of being scolded （r=0.210， P=0.037） or beaten （r=0.145， P=0.023） over the past 6 months and cyberbullying over the past year （r=0.179， P=0.041）. ConclusionChildren and adolescents with mental disorders suffer a high risk of sleep insufficiency， and is closely associated with depressive disorder， experience of being scolded or beaten over the past 6 months， and cyberbullying over the past year.

Separation and Purification of Alhagi sparsifolia n -butanol Extract Monomeric Compounds and Study on Their Effects on Human Cervical Cancer HeLa Cells / 中国药房

OBJECTIVE： To separate and purify Alhagi sparsifolia n-butanol extract monomeric compounds， and to investigate its effects on the proliferation and metastasis of human cervical cancer HeLa cells. METHODS： The n-butanol extract was separated and purified by silica gel column， Sephadex LH-20 gel column and prep-HPLC. The structures of compounds were analyzed and identified according to physicochemical properties and spectrum （mass spectrum， hydrogen spectrum， carbon spectrum） data. Using human cervical cancer HeLa cells as objects， 5-FU as positive control， MTT assay was used to detect the inhibitory rate of HeLa cells pretreated with different doses of compounds （6.25， 12.5， 25， 50， 100， 200 μg/mL）； IC50 was calculated to screen active monomers. Scratch test was used to investigate the effects of above active monomers （all 50 μg/mL） on the migration ability of HeLa cells. Kim’s formula was used to evaluate the effects of 5-FU separately combined with above active monomers [（3.125+6.25），（6.25+12.5），（12.5+25），（25+50）μg/mL]. RESULTS： Six compounds were isolated from the n-butanol extract part of A. sparsifolia and identified as butin （Ⅰ）， 3′，4′，7-trihydroxyisoflavone （Ⅱ）， p-methoxyphenylacetic acid （Ⅲ）， 4-hydroxyacetophenone （Ⅳ）， aurantiamide acetate （Ⅴ）， protocatechualdehydea （Ⅵ）. Compared with blank control group， 5-FU and each compound （5-FU：6.25-200 μg/mL， compound Ⅰ： 12.5-200 μg/mL； compound Ⅱ： 25， 50， 200  μg/mL； compound Ⅲ： 6.25， 100， 200 μg/mL； compound Ⅳ： 50， 100， 200 μg/mL； compound Ⅴ： 12.5， 25， 200 μg/mL； compound Ⅵ： 6.25-200 μg/mL） could significantly increase the cell inhibition rate. IC50 of compound Ⅰ， Ⅴ， Ⅵ were decreased significantly （P＜0.05 or P＜0.01）， and those of compound Ⅰ and Ⅵ were lower relatively. The migration distance of cells in 5-FU and compound Ⅰ and Ⅵgroups were decreased significantly， compared with blank control group （P＜0.05 or P＜0.01）. 5-FU separately combined with compound Ⅰ and Ⅵ showed additive and enhanced inhibitory effects on the proliferation of HeLa cells （synergistic index＞0.9）. CONCLUSIONS： Compounds Ⅰ-Ⅵ are isolated from Alhagi for the first time. Butin and protocatechualdehydea are active monomers of its n-butanol extract part. Above two monomers can inhibit the proliferation and migration of human cervical cancer Hela cells， with strong inhibitory effect in vitro， and stronger inhibitory effect combined with 5-FU than any compound alone.

Clinical study and clinical significance of cement distribution after vertebral augmentation / 中华创伤杂志

Objective To analyse the cement distribution after vertebroplasty and investigate the feasibility and clinical significance of its typing.Methods A retrospective case-series study examining the bone cement distribution on anteroposterior radiograph after vertebral augmentation was conducted on 1 324 patients (2 119 vertebrae) with osteoporotic vertebral compression fractures (OVCF) from May 2009 to May 2016.Among the patients,due to refracture,147 patients suffered two or more surgeries with a vertebral refracture rate of 11.1％.One or more adjacent vertebrae refracture occurred in 105 patients with the adjacent vertebrae refracture rate of 7.9％.The vertebral body was split into four regions on the basis of the central vertical and bilateral pedicle of vertical line.According to the bone cement distribution in the four regions,there were five distribution types:type Ⅰ:1-4 regions;type Ⅱ:2-3 regions;type Ⅲ:1 and 4 regions;type Ⅳ:3 and 4 or 1 and 2 regions;type Ⅴ:1 or 4 regions.The X-ray of 40 patients was randomly typed by three orthopedics physicians,and the complication rate and refracture rate of adjacent vertebrae in each type were calculated.Credibility and repeatability analysis were performed.Results The average credibility of the typing was 92.5％.The Kappa coefficient was 0.850 on average.The repeatability of two times of typing was on average 95％,and the Kappa coefficient was 0.900 on average.From type Ⅰ to Ⅴ,there were 26 cases (3.5％),16 cases (4.5％),29 cases (7.3％),40 cases (9.9％),and 41 cases (18.1％) of adjacent vertebral refracture.There were 10 cases of the same vertebral refracture and 5 cases of scoliosis deformity in the type Ⅴ,with incidence rates of 4.4％ and 2.2％,respectively.Conclusions Being reliable and repeatable,the typing for cement distribution after vertebral augmentation is simple and practicable.The type Ⅳ and Ⅴ cement distribution carries higher risk of refracture in adjacent or the same vertebral body and long-term scoliosis than others types.

Effect of dexmedetomidine on blood coagulation function following radical gastrectomy / 临床麻醉学杂志

Objective To explore the effect of dexmedetomidine on blood coagulation following radical gastrectomy.Methods ASA Ⅰ or Ⅱ patients aged 51-70 years weighing 53-75 kg scheduled for radical gastrectomy were randomly allocated to two groups:dexmedetomidine group (group D)and control group (group C).Dexmedetomidine 0.5 μg/kg was intravenously infused over 10 minutes before anesthesia induction,followed by a rate of 0.5 μg·kg-1 ·h-1 until peritoneal closure in group D and volume-matched normal saline was administrated in group C.Radical gastrectomy was performed under total intravenous anesthesia with propofol and remffentanil.A series of warming measures were implemented and artificial colloid and heparin flushing fluid were not used.Postoperative patient-controlled intravenous analgesia was performed to maintain visual analogue scale≤3.The blood samples were collected for TEG and standard coagulation monitoring before dexmedetomidine and saline administration and 3 h after surgery.Results The temperature and hematocrit in the postoperative period were significantly less than the preoperative period in two groups (P＜0.01).In both groups,the activity of plasma antithrombin Ⅲ was significantly decreased and the concentration of plasma FDP was significantly increased in the postoperative period when compared with the preoperative period (P ＜0.01).In group D,the R time was significantly shortened and MA value was significantly increased in the postoperative period when compared with the preoperative period (P＜0.05) and there were no significant differences in the K time and α angle between the preoperative and postoperative period.In group C,the R and K time were significantly shortened and the value for MA and α angle were significantly increased in the postoperative period compared with the preoperative period (P＜0.01).The platelet counts,PT,APTT,and plasma fibrinogen concentration were comparable between the preoperative and postoperative period in both groups.The requirements of propofol and remifentanil in group D were significantly less than group C (P＜0.05).In the preoperative period,the plasma antithrombin Ⅲ activity,FDP concentration,and the values for all TEG variables were similar in both groups.In the postoperative period,the value for MA and the concentration of plasma FDP in group D were less than that in group C and the value for R and the activity of plasma AT Ⅲ in group D were more than group C (P＜0.05 or P＜0.01) and there were no significant differences in the K time and α angle in both groups.There were no significant differences in the temperature,hematocrit,platelet counts,PT,APTT,and plasma fibrinogen concentration in the preoperative and postoperative periods between the two study groups.Conclusion Adjunctive dexmedetomidine in general anesthesia could inhibit the decrease of R time and raise of the value for MA,inhibit the decrease of plasma an tithrombin Ⅲ activity and raise of FDP concentration,which indicated that dexmedetomidine can improve blood coagulation state after radical gastrectomy.

Curved injection needle for unilateral percutaneous vertebroplasty in osteoporotic vertebral compression fractures / 中国脊柱脊髓杂志

Objectives:To investigate the clinical outcomes of unilateral percutaneous vertebroplasty(PVP) by using curved injection needle in osteoporotic vertebral compression fractures(OVCFs).Methods:From January 2015 to January 2016,47 patients(14 males and 33 females) with OVCFs were enrolled in this study.The patients were 53-89 years old (66.4±6.5 years),36 cases were single segmental vertebral fracture,11 cases were double segment vertebral fracture.T9 fracture occured in 7 cases,T10 fracture in 7 cases,T11 fracture in 9 cases,T12 fracture in 13 cases,L1 fracture in 12 cases,L2 fracture in 9 cases,and L3 fracture in 1 case.The fluoroscopy time and bone cenent dosage were recorded.The VAS score,ODI,relative height restoration of vertebra and Cobb angle were compared between preoperation and postoperation.The bone cement leakage(venous leakage and perivertebral leakage) and other complications were observed.Results:The average fluoroscopy time was 1.6±0.3nin,the average bone cement dosage was 6.7±1.2ml.Bone cement leakage occured in 11 cases with the rate of 23.4％.The patients were followed up for 3-12 months (6.5±1.3 months).The VAS,ODI,the relative height of injured vertebra and the local Cobb angle before operation,at 2 days after operation and final follow-up were:7.6±1.3,(71.4±3.2)％,0.48±0.21,15.5°±4.2°;2.2±1.0,(27.2± 2.6)％,0.82±0.17,7.2°±2.8°;1.7±0.7,(26.5±2.7)％,0.80±0.15,7.5°±3.7°.At 2 days after operation and final follow-up,the VAS score,ODI score,the relative height and Cobb angle of injured vertebra were significantly improved when compared to those before operation (P＜0.05);There was no significant difference between 2 days after operation and final follow-up(P＞0.05).Conclusions:The advantages of unilateral PVP by using curved injection needleless in OVCFs are less fluoroscopy time,even distribution of bone cement,and less leakage.

A survey on high-risk behaviors and HIV infection among men having sex with men who use drugs in Tianjin in 2016 / 中华预防医学杂志

Objective@#To analyze the characteristics of high risk sexual behaviors and HIV infectious status among men who have sex with men (MSM) who use drugs in Tianjin in 2016.@*Methods@#From April to December in 2016, MSM who use drugs in Tianjin were targetedly and extensively mobilized to receive testing by snowball sampling method. The inclusion criteria were as follows: men aged 18 years old and above; have had oral or anal sex with men in the last 6 months; have had drug abuse history in the last 6 months, including the use of rush poppers, 5-Methoxy-diisopropyltryptamine (5-MeO-DiPT), and Methamphetamine Synthesis substances; and with no mental disorder or mental deficiency. In this study, 302 MSMs were recruited to collect information of social demographic characteristics, drug abuse situation, sexual behavior after drug use, HIV test and the infectious status was collected through the online questionnaire, and the descriptive analysis was conducted.@*Results@#From January to December 2016, a total of 302 subjects were recruited, among whom 194 (64.2%) aged 21-30 years old, 223 (73.8%) were unmarried and 28 (9.3%) were students. In the past 6 months, 297 (98.3%) used rush poppers, 31 (10.3%) used 5-MeO-DiPT, and 14(4.6%) used Methamphetamine Synthesis substances. The proportion of having sex after using the three types of drugs were 87.9% (n=261), 83.9% (n=26) and 92.9% (n=13), 85.5% (n=254), 87.1% (n=27) and 92.9% (n=13) of the subjects reported the sexual pleasure and sexual desire increased after using drugs, respectively. After using the three types of the drugs,58.6% (n=174), 83.9% (n=26) and 92.9% (n=13) of the subjects reported the duration of each sexual activity prolonged. In the past 3 months,48.3% (n=146) had stable sexual partners, 72.5% (n=219) had temporary sexual partners and 12.3% (n=37) had group sexual behaviors. 41 out of 302 subjects were HIV positive with the HIV positive rate at 13.6%.@*Conclusion@#Most of the MSM who use drugs were young, and always had sex when they use drugs. There is a relatively high HIV prevalence in this population.

The situation and associated factors of facility-based HIV testing among men who sex with men in Beijing / 中华预防医学杂志

Objective@#To understand the prevalence of facility-based HIV testing and its associated factors among men who have sex with men (MSM) in Beijing city.@*Methods@#An application-based cross-sectional survey was employed to understand HIV site test situation and associated factors. The survey was carried out from May 14th to 21st, 2016. Users of a smart phone application for gay dating were recruited and those eligible for this survey were investigated with an online self-administered questionnaire. Information of demographics, sexual behaviors, facility-based HIV testing history and recreational drug abuses were collected. The multivariate logistic regression was used to make comparison among different groups and assess associated factors.@*Results@#A total of 7 494 participants were enrolled in the survey with mean age of (28.81 ± 7.38) years, 87.14% (6 530/7 494) sought sexual partners through internet. The proportion of facility-based HIV testing in 1 year was 42.55% (3 189/7 494), MSM who were 25-29 years had higher proportion of facility-based HIV testing in 1 year, the proportion was 45.56%(1 104/2 423). Among MSM who could insist in using condom during anal sex (50.46% (1 539/3 050)), the proportion of HIV site testing in 1 year was higher. The MSM who reported seeking healthcare for symptoms of a sexually transmitted infections (STIs) in the past year or ever using recreational drug had higher proportion of facility-based HIV testing, the proportions were 56.81% (409/720) and 52.00% (1 340/4 917), respectively. Compared with alone cohabitation, cohabitating was associated with decreased odds of HIV facility-based testing in past 1 year(odds ratio (OR)= 0.79, P<0.001). Compared with homosexual sexual orientation, bisexual sexual orientation was associated with decreased odds of facility-based HIV testing (OR=0.83, P=0.004). With the increasing of number of male anal sex partners, the odds of HIV facility-based testing was increasing (OR=1.31, P<0.001) But with the decreasing of the frequency of condom using with male anal sex partners, the odds of facility-based HIV testing was decreasing (OR=0.85, P=0.014). Using recreational drugs (OR=1.36, P<0.001) and seeking healthcare for symptoms of a STI in the past 1 year (OR=1.73, P<0.001) were associated with decreased odds of HIV site testing.@*Conclusion@#MSM in Beijing had lower proportion of facility-based HIV testing in past 1 year. Multiple anal sex partners, using recreational drugs, seeking healthcare for symptoms of a STI in the past year, cohabitating, bisexual sexual orientation, and lower frequency of condom using with male anal sex partners were associated with the odds of HIV facility-based testing in past 1 year.

Risk factor and prognosis of concurrent depression in elderly patients with acute myocardial infarction treated with percutaneous coronary intervention / 中国医师进修杂志

Objective To study the risk factor and prognosis of concurrent depression in elderly patients with acute myocardial infarction (AMI) treated with percutaneous coronary intervention (PCI). Methods Two hundred and ninety-five AMI patients who received PCI and whose clinical data were complete were selected. Depression was determined by a self-rating scale (SDS), and was confirmed when SDS standard score≥53 scores. The patients were divided into 2 groups according to the ages:senium (age ≥ 60 years, 144 cases) group and younger group (age<60 years, 151 cases). Multiple Logistic regression analysis was used to analyze the related factors of depression. The patients were followed up for 1 year, and the rehospitalization rate, incidence of major adverse cardiovascular events (MACE) and left ventricular ejection fraction (LVEF) at 12 months were compared. Results The incidence of depression in senium group was significantly higher than that in younger group: 41.7%(60/144) vs. 21.2%(32/151), and there was statistical difference (P<0.05). Female gender, hypertension and type 2 diabetes mellitus were the independent risk factor for depression in patients with AMI after PCI (P<0.05). In senium group, the rehospitalization rate and incidence of MACE in patients with depression were significantly higher than those in patients without depression: 18.3% (11/60) vs. 6.0% (5/84) and 15.0% (9/60) vs. 4.8%(4/84), the LVEF was significantly lower than that in patients without depression:(41.50 ± 2.25)%vs. (49.76 ± 2.93)%, and there were statistical differences (P<0.05). The LVEF in patients with depression of senium group was significantly lower than that in patients with depression of younger group:(41.50 ± 2.25)%vs. (51.50 ± 2.32)%, and there was statistical difference (P<0.05). Conclusions The elderly AMI patients treated with PCI have higher rates of depression. Female gender, hypertension and type 2 diabetes mellitus are the important risk factor for depression after PCI. Depression has a significant effect on the prognosis of AMI patients, especially on LVEF in elderly patients.

Clinical Outcomes for Stent-thrombosis at Different Times in Patients After Drug-eluting Stent Implantation / 中国循环杂志

Objective: To study the clinical outcomes of stent-thrombosis (ST) at different times in patients after drug-eluting stent (DES) implantation. Methods: A total of 131 coronary angiography conifrmed ST patients in our hospital from 2005-01 to 2015-04 were studied. According to the time of ST occurrence, the patients were divided into 2 groups: Early ST group, ST occurred ≤30 days,n=42 and Late ST group, ST occurred >30 days,n=89. The in-hospital and follow-up information was collected; clinical outcomes were compared between 2 groups. Results: The in-hospital MACE occurrence rate in Early ST group was higher than that in Late ST group (16.7% vs 4.5%),P=0.04. There were 123 patients survived to discharge and they were followed-up for the median of 38.00 (15.00, 62.00) months. Kaplan-Meier analysis estimated that the MACE-free survival was similar between 2 groups (41.9% vs 36.3%), P=0.43. Conclusion: In-hospital MACE occurrence was higher in early ST patients, while the long term prognosis was similar between the early and late ST patients for whom with DES implantation.

Feasibility study of guiding catheter passing through spasmodic vess els during percutaneous coronary intervention via radial artery access by the aid of PCI guiding wire and balloon / 中国介入心脏病学杂志

Objective To explore the safety and feasibility of guiding catheter passing through spasmodic vessels in patients undergoing percutaneous coronary intervention (PCI) via radial artery access by the aid of PCI guiding wire and balloon .Methods The clinical data of 33 coronary artery disease (CAD) patients undergoing PCI via radial artery access with radial artery or (and) brachial artery spasm ( group A ) were retrospectively analyzed .Among all these patients , guiding catheters were delivered through the spasmodic vessels successfully by the aid of PCI guiding wires and balloons .The clinical data of other 38 CAD patients having PCI during the same period performed by other operators via radial artery or ( and ) brachial artery approach and experienced vessel spasm were anlysed as the control ( group B ) .All patients in group B received conventional anti-spasm management during PCI .All vessel spasm was identified by angiography.For patients in group A , a diameter of 0.014 inch guiding wire was chosen to pass through the spasmodic vessel segment carefully and gently .The diameter of balloon should be chosen according to the diameter of guiding catheter .A balloon diameter of 2.0 mm and 2.5 mm was corresponded to 6F and 7F guiding catheter respectively .The balloon was advanced to the tip of guiding catheter , keeping a half in catheter and a half in vessel followed by inflating the balloon with a pressure of 8 atm.The balloon was kept inflated the guiding catheter was pushed in vitro carefully and slowly until the catheter passed through the spasmodic vessel segment .Then the balloon was deflated and pulled out together with PCI guiding wire . Exchanged a diameter of 0.035 inch wire and completed the positioning of guiding catheter .After finishing the PCI, radial or ( and) brachial angiography was performed again to observe if spasm disappeared and to determine if there any contrast medium exudation .For patients in group B , routine approach was applied including administration of nitroglycerine , diltiazem or nitroprusside etc . to relieve vessel spasm. Results The location of vessel spasm was similar in group A and group B ( P=0.150 ) , and the incidence rate of spasm in brachial artery was higher than that in radial artery in both groups .The chance of guiding catheter crossing the spasmodic vessel segment was significantly higher in group A than in group B ( 100%vs.39.5%, P=0.00).In patients whose guiding catheter could pass through the spasmodic vessel segment successfully , time spent in group A was shorter than in group B ( P=0.000 ) .The patient number which time spent was less than five minutes , five to 15 minutes and more than 15 minutes was 30 and 2 ( 90.1%vs.13.3%) , 3 and 7 ( 9.9% vs.46.7%) and 0 and 6 ( 0% vs.40.0%) in group A and in group B respectively.The incidence of forearm hematoma was lower in group A than in group B without statistical difference [6.1%(2/33) vs.18.4%(7/38), P =0.113].Conclusions It is safe and feasible for passing guiding catheter through spasmodic vessels during PCI via radial artery access by the aid of PCI guiding wire and balloon .

Structural characterization and analysis of Omalizumab and its biosimilar CMAB007 by LC-MS / 生物工程学报

We compared the similarity of Omalizumab (Xolair; a humanized anti-immunoglobulin E monoclonal antibody) and it's biosimilar CMAB007. An in depth characterization of a candidate biosimilar was carried out using a systematic approach, the approach provides a set of routine tools that combine accurate intact mass measurement, peptide mapping, and released glycan profiling. CMAB007 and Omalizumab had the same primary structure and exhibited almost the same content of C-terminal lysine variants. The types of detected free oligosaccharides were very similar, such as sialylation, fucosylation and high mannose types. CMAB007 could be considered as a highly similar molecular to Omalizumab and expected to be the first humanized anti-immunoglobulin E monoclonal antibody drug in China.

A preliminary study on the relevance of facial morphologic angles of Xi'an youths / 实用口腔医学杂志

Objective:To explore the correlativity between facial morphologic angles of Xi'an youths.Methods:60 Xi'an residents aged 18 -40 years(30 males and 30 females)with normal facial profile,without operation and trauma experience,received 3dMD scaning.12 morphologic angles were measured.Data were statistically analysed by SPSS 19.0 software.The correlative relationship and formulas of facial angles were studied.Results:Nasofrontal angle of the males was larger than that of the females(P 0.05).Correlativity between each pair of 5 angles was concluded by a logic diagram(R≥0.7),the correlativity of 4 pairs was positive and 3 negative.Conclusion:The facial morphologic angles of Xi'an youths are correlated and coordinated.

Yang Lishan’s Understanding of Latent Evils / 浙江中医药大学学报

[Objectives]To extract Yang Lishan’s description of latent evils ,summarize his arguments, and provide reference for exploring his academic ideology further. [Methods] Use the literature methodology, take“latent evils”and“pestilential pathogen”as keywords, retrieve the related description in Yang Lishan’s book, summarize his main opinions on latent evils. [Results] Yang Lishan wholly refused the theory of latent cold evil turning into pathogenic warm, and he believed that the cause of latent evils is pestilential pathogen, thereby distinguishes warm disease from exogenous febrile disease on etiology level. He described the disease’s quality, afferent pathway, hiding spot, the way out, therapeutic method, prescription and recuperation in details, which are mature enough to form a complete theoretical system. The prescription Sheng Jiang Powder represents experiment with the thought of treating pestilential pathogen with drugs and special medicine for special disease, which makes the etiology of pestilential pathogen to have real directive value. [Conclusion] Yang Lishan’s theory of latent evils has implications in treatment and prevention of epidemic diseases.

Syphilis infection and its high risk factors among men who have sex with men by different recruitment channels / 中华预防医学杂志

<p><b>OBJECTIVE</b>To understand the syphilis infection and its high risk factors among men who have sex with men (MSM) recruited from different channels.</p><p><b>METHODS</b>Supported by the China-Gates Foundation HIV program from July to December 2011, we cooperated with community based organizations to conduct syphilis testing intervention among MSM from 14 cities (Beijing, Shanghai, Tianjin, Chongqing, Harbin, Shenyang, Qingdao, Xi'an, Nanjing, Wuhan, Hangzhou, Changsha, Kunming, and Guangzhou) and one province (Hainan province). Participants were recruited from different channels by the staff of local CBOs, Demographic (e.g. age, marital status, and education) and behavioral (e.g. condom use and sexual partners) data were collected using anonymous questionnaires. Blood samples were also collected to test for syphilis. A total of 34 100 MSM participated in the survey. Participants were excluded from data analysis (1 399, 4.1%) if they did not receive syphilis tests or they completed less than 80.00% of the key questions in the survey. Chi-square tests were used to understand the socio-demographic and behavioral differences between each group. Results of syphilis tests were also compared. Logistic regression models were used to test the statistical significance of these differences.</p><p><b>RESULTS</b>A total of 32 701 MSM were enrolled and received syphilis testing. The average age of participates was 30.96 ± 9.57. And among them, 2 284 cases (7.0%) were recruited from gay bathhouses, 4 774 (14.6%) from gay bars, 6 266 (19.2%) from the internet, 1 997 (6.1%) from the parks/toilets and 17 380 (53.1%) from other channels. MSM recruited from the bathhouses had the highest syphilis infection rate than other 4 groups: gaybars (4.5%, 216/4 774), internet (6.7%, 422/6 266), parks/toilets (8.3%, 166/1 997), other channels (6.4%, 1 103/17 380) (χ² = 164.58, P < 0.001). The multivariate logistic regression analysis showed that being > 20 years of age (P < 0.001), having more than 2 homosexual partners in recent 3 months (8.0% (1 408/17 714), OR (95% CI) = 1.44 (1.04-1.98)), having no sex with females in past 3 months (6.8% (1 446/21 276), OR (95% CI) = 1.25 (1.07-1.46)), and not using condom at last anal sex (8.0% (769/9 668), OR (95% CI) = 1.13 (1.03-1.25)) were associated with a higher probability of being infected with syphilis. Whereas MSM married (7.2% (456/6 305), OR (95% CI) = 0.84 (0.73-0.98)), having a college or a higher education (5.3% (829/15 684), OR (95% CI) = 0.60 (0.53-0.67)), being local residents (6.5% (1 843/28 185), OR (95% CI) = 0.73 (0.61-0.87)) and living in the local province of project cities (6.6% (170/2 593), OR (95% CI) = 0.67 (0.53-0.85)) were protective factors.</p><p><b>CONCLUSION</b>MSM who were recruited from gay bathhouses have a higher rate of syphilis infection than those in channels relatively. They are older, with low education levels and high-risk sexual behaviors. Tailored interventions are required in the future, especially for MSM from gay bathhouses.</p>

Allocation analysis of central government AIDS special funding in priority sites of HIV/AIDS prevention and control / 中华预防医学杂志

<p><b>OBJECTIVE</b>To analyze the allocation and trend of central government AIDS special funding in 4 priority sites of HIV/AIDS prevention and control across calendar years.</p><p><b>METHODS</b>Information about the allocation of central government special AIDS funding and cumulative HIV/AIDS survivor numbers of Z city, D prefecture, L prefecture and D prefecture were collected until 2013. Data were collected from 2004-2013 for Z city and D prefecture, and data from 2009-2013 were collected for L and Y prefecture. Funding allocation among all working areas and their trend over time were analyzed.</p><p><b>RESULTS</b>From 2004-2013, the total amount of special funding in Z prefecture was 110.15 million RMB. The largest three areas of allocation were key population response (29%, 3 190/11 015), surveillance and testing (23%, 2 535/11 015) and human resource (13%, 1 498/11 015). The least area of allocation was follow-up and prevention of discordant couple transmission (2%, 251/11 015). The total amount of special funding in D prefecture from 2004-2013 was 109.77 million RMB. The largest three areas of allocation were treatment and care (25%, 2 691/10 977), follow-up and prevention of discordant couple transmission (17%, 1 843/10 977) and surveillance and testing (15%, 1 656/10 977). The least area was blood safety (1%, 135/10 977). From 2009 to 2013, the total amount of special funding in L prefecture was 55 million RMB. The largest three areas of allocation were surveillance and testing (60%, 3 298/5 500), high risk population intervention (14%, 768/5 500) and follow up and prevention of discordant couple transmission (12%, 675/5 500). The least area was blood safety (0.1%, 8/5 500). From 2009-2013, the total amount of special funding in Y prefecture was 55 million RMB and the largest three areas of allocation were project management and others (28%, 1 527/5 500), key population response (19%, 1 046/5 500) and high risk population intervention (17%, 922/5 500). The least area of special funding was blood safety (2%, 106/5 500). Among three HIV/AIDS epidemic related key areas (surveillance and testing, follow-up and prevention of discordant couple transmission, treatment and care), 2004-2013, allocated funds were between 2.96-3.36, 0-0.37, 0.37-1.97 million RMB in Z city; 0.64-2.35, 0.00-3.00, 2.00-4.70 million RMB in D prefecture; 2009-2013, allocated funds were between 2.67-8.85, 0.41-2.39, 0.35-1.84 million RMB in L prefecture, 1.18-2.84, 0.70-1.05, 0.46-0.89 million RMB in Y prefecture.</p><p><b>CONCLUSION</b>The allocation patterns of central government AIDS special funding among key working areas were different across 4 different sites; in each individual site, the trend of special funding allocation was stable among HIV epidemic related key areas over calendar years.</p>

Dynamic lumbar pedicle fixation in repair of lumbar degenerative disease:K-Rod elastic rod, universal elastic rod and Dynesys system / 中国组织工程研究

BACKGROUND:Discectomy and pedicle fixation fusion are golden standard to repair lumbar degenerative disease, but the treatment would induce other complications such as degeneration of adjacent segments or severer pre-existing spinal degeneration. For the problem of lumbar fusion and fixation, lumbar elastic fixation has recently been a hot focus. ＜br> OBJECTIVE:To evaluate the short-term effectiveness of dynamic lumbar pedicle fixation in repair of lumbar spinal stenosis and lumbar disc herniation. ＜br> METHODS:From December 2010 to December 2012, 62 cases of lumbar spinal stenosis and lumbar disc herniation treated with lumbar dynamic system were included. The involved segments included:5 cases at L 3/4 , 20 cases at L 4/5 , 20 cases at L 5 S 1 , 6 cases at double segment L 3/4 and L 4/5, 8 cases at double segment L 4/5 , L 5 S 1 , 3 cases at L 3/4 and L 5 S 1 . There were 34 males and 28 females with an average age of 50.8 years (range 32 to 72 years). According to different fixation systems, they were assigned to three groups:general dynamic lumbar fixation system in 17 cases, K-Rod posterior dynamic stabilization system in 28 cases, and Dynesys system in 17 cases. The fol ow-up time was from 24 to 48 months. Evaluation indexes included visual analogue scale, Oswestry disability index, imaging analysis and excellent and good rate of curative effects. ＜br> RESULTS AND CONCLUSION:Compared with before treatment, visual analogue scale score and Oswestry disability index were significantly improved at 6 months after treatment and final fol ow-up (P＜0.01). No apparent changes were detected in the length of inserted segments and adjacent segments before treatment and during final fol ow-up. There were no significant differences in the excellent and good rate in each group after treatment (P>0.05). These data indicated that the lumbar dynamic system was an effective option for lumbar disc herniation and spinal stenosis. Although there are some differences in the structure of three kinds of flexible fixation, no obvious difference in early therapeutic effects was detected. Long-term effects deserve further investigations.

Main issues, causes and strategies for AIDS prevention and control in health care systems / 中国卫生政策研究

Objective:To summarize the main issues, analyze the causes and offer a strategy for AIDS preven-tion and control for all types of healthcare facilities in the health care system. Methods:184 leaders and experts of tertiary-level healthcare facilities ( provinces, cities and counties) from 30 provinces who had been engaged in AIDS prevention and control for more than five years were studied through a questionnaire including the issues and causes in AIDS prevention and control. Results: According to the results of the respondents and experts’ demonstration, the main issues were identified, including a lack of human resources in the system of disease control facilities, a lack of relevant agencies involved in AIDS response, the difficulty for AIDS patients to receive surgery and follow-up, poor detection of HIV, shortcomings in medical insurance, and so on. Conclusion: Based on the analysis of issues and causes, the paper offers strategic solutions: Clearly define the responsibilities of various health institutions in AIDS prevention and control;promote the participation of primary health institutions in AIDS prevention and control; im-prove the medical service system for AIDS patients;improve AIDS medical security policies;reform the management system of antiretroviral therapy drugs;and strengthen technical support from disease control facilities.

Analysis of CT radiation dose based on radiation-dose-structured reports / 中华放射医学与防护杂志

Objective To analyse the CT radiation dose statistically using the standardized radiation-dose-structured report (RDSR) of digital imaging and communications in medicine (DICOM). Methods Using the self-designed software, 1230 RDSR files about CT examination were obtained searching on the picture archiving and communication system ( PACS ) . The patient dose database was established by combination of the extracted relevant information with the scanned sites. The patients were divided into adult group (over 10 years) and child groups (0-1 year, 1-5 years, 5-10 years) according to the age. The average volume CT dose index ( CTDIvol ) and dose length product ( DLP) of all scans were recorded respectively, and then the effective dose ( E) was estimated. The DLP value at 75% quantile was calculated and compared with the diagnostic reference level ( DRL) . Results In adult group, CTDIvol and DLP values were moderately and positively correlated ( r=0?41 ) , the highest E was observed in upper abdominal enhanced scan, and the DLP value at 75% quantile was 60% higher than DRL. In child group, their CTDIvol in group of 5-10 years was greater than that in groups of 0-1 and 1-5 years ( t=2?42, 2?04, P<0?05);the DLP value was slightly and positively correlated with the age (r=0?16), while E was moderately and negatively correlated with the age ( r = -0?48 ) . Conclusions It is a simple and efficient method to use RDSR to obtain the radiation doses of patients. With the popularization of the new equipment and the application of regionalized medical platform, RDSR would become the main tool for the dosimetric level surveying and individual dose recording.