ABSTRACT
Objective:To compare the clinical efficacy of anatomical reconstruction of coracoclavicular ligament at the original insertion point and clavicular hook plate fixation in the treatment of acromioclavicular joint dislocation.Methods:Retrospective analysis was made on the data of 67 patients with acromioclavicular joint dislocation who received surgical treatment in the Department of Orthopaedics of the First Affiliated Hospital of Nanjing Medical University from June 2015 to January 2021. According to the surgical method, they were divided into reconstruction group (using the technique of anatomical reconstruction of coracoclavicular ligament at the original insertion point) and hook plate group (using the clavicular hook plate). There were 37 cases in the reconstruction group, including 26 males and 11 females, aged 47.2±9.6 years (range, 18-65 years), 13 cases on the left and 24 cases on the right. Among the 37 patients, 8 were sports injuries, 14 were falls, 11 were traffic accidents, and 4 were external force injuries. The average time from injury to surgery was 8.3±2.3 days. There were 30 cases in the hook plate group, including 24 males and 6 females, aged 47.4±9.7 years (range, 18-67 years), 12 cases on the left and 18 cases on the right. Among the 30 patients, 7 were sports injuries, 11 were falls, 9 were traffic accidents, and 3 were external force injuries. The average time from injury to surgery was 7.9±2.6 days. The surgical time, incision length, intraoperative bleeding, hospital stay, postoperative coracoclavicular separation ratio, and postoperative complications were compared between the two groups. Constant-Murley score and visual analog scale (VAS) were used to assess the shoulder joint function and pain degree of patients.Results:Both groups of patients were followed up, with a follow-up time of 12.3±0.4 months for the reconstruction group and 12.2±0.5 months for the hook plate group. The operation time (105.8±10.0 min), incision length [12.0 (11.0, 13.0) cm] and hospitalization time (6.8±2.1 d) in the reconstruction group were longer than those in the hook plate group [48.3±4.9 min, 10.0 (10.0, 11.0) cm, and 5.5±2.7 d], while the intraoperative blood loss (75.1±3.9 ml) was less than that in the hook plate group (90.3±6.3 ml), the differences were statistically significant ( P<0.05). The VAS [4.0 (3.0, 5.0), 3.0 (3.0, 3.0), 2.0 (1.0, 2.0) points] and Constant-Murley score (65.4±4.5, 84.9±2.5, 90.1±2.5 points) of the reconstruction group at 3 days, 3 months, and 12 months after surgery were better than those of the hook plate group [5.0 (4.0, 5.0), 4.0 (4.0, 4.0), 3.0 (3.0, 4.0) and 56.9±3.5, 79.6±4.0, 86.8±2.4 points], the difference was statistically significant ( P<0.05). At the last follow-up, there was a statistically significant difference in the separation ratio of coracoclavicular distance between the reconstruction group (0.12±0.08) and the hook plate group 0.22±0.15 ( t=3.25, P=0.002). There was no significant difference ( Z=-0.52, P=0.605) in the separation ratio of acromioclavicular distance [0.16 (0.05, 0.25) and 0.16 (0.04, 0.40)]. In the hook plate group, 6 cases had shoulder joint foreign body sensation and 2 cases had acromioclavicular joint redislocation (both Rockwood type III). Because the shoulder joint function did not affect their daily life, neither patient underwent secondary surgery. And no case of acromioclavicular joint redislocation occurred in the reconstruction group. Conclusion:Compared with the clavicular hook plate fixation, anatomic reconstruction of coracoclavicular ligament at the original insertion point in the treatment of acromioclavicular joint dislocation can reduce the pain of the shoulder joint earlier, which has the characteristics of small trauma, good effect, and reduces the steps of internal fixation removal, and has good clinical curative effect.
ABSTRACT
Objective:To compare the clinical efficacy between coracoclavicular ligament anatomical reconstruction and clavicular hook plate in the treatment of Neer Ⅱb distal clavicular fractures.Methods:A total of 64 patients with Neer Ⅱb clavicular fracture were treated at Department of Orthopaedics, The First Affiliated Hospital to Nanjing Medical University from September 2016 to June 2019. They were 35 males and 29 females, aged from 19 to 68 years (average, 50.7 years). They were assigned into 2 groups according to their operative methods: a reconstruction group of 30 cases undergoing coracoclavicular ligament anatomical reconstruction and a hook plate group of 34 cases undergoing fixation with a clavicular hook plate. The 2 groups were compared in terms of hospital stay, operation time, intraoperative blood loss, surgical incision length, postoperative coracoclavicular separation ratio, visual analogue scale (VAS) and Constant-Murley shoulder scores at 3, 6 and 12 months after operation, and postoperative complications.Results:There was no significant difference in general data between the 2 groups, showing comparability between groups ( P>0.05). Operations were completed uneventfully and surgical incisions healed by primary intention in both groups after operation. All the patients were followed up for 12 to 24 months (average, 14.6 months). The operation time [(74.6±22.0) min] and incision length [(10.4±0.4) cm] were significantly shorter but the intraoperative blood loss [(90.2±5.3) mL] was significantly less in the hook plate group than those in the reconstruction group [(95.6±20.8) min, (12.4±0.9) cm and (74.2±3.5) mL] ( P<0.05). There was no significant difference in hospital stay between the 2 groups ( P>0.05). At 3, 6 and 12 months after operation, the VAS scores (1.8±0.5, 1.2±0.3 and 1.1±0.2) and Constant-Murley scores (85.2±4.6, 91.1±2.6 and 92.1±2.2) in the reconstruction group were significantly better than those in the hook plate group (3.2±1.0, 1.6±0.3 and 1.5±0.3; 73.6±2.9, 85.9±4.6 and 87.0±3.1) ( P<0.05). At the last follow-up, the postoperative coracoclavicular separation ratio (elevation) in the hook plate group (0.20±0.16) was significantly greater than that in the reconstruction group (0.10±0.05) ( P<0.05). Conclusion:In the treatment of Neer ⅡB distal clavicular fractures, coracoclavicular ligament anatomical reconstruction may lead to better fixation and fewer postoperative complications than a clavicular hook plate, demonstrating fine clinical efficacy.
ABSTRACT
Objective:To conduct an MRI observation on the incidences of ligamentous injuries and fracture morphology in Schatzker type Ⅳ tibial plateau fracture (TPF) and investigate their influence on knee stability.Methods:A retrospective analysis was conducted of the 30 patients with Schatzker type Ⅳ TPF who had undergone surgery at Department of Orthopaedic Trauma, Jiangsu Provincial People's Hospital from January 2010 to December 2019 and whose preoperative X-ray, CT and MRI were available. They were 18 males and 12 females, aged from 22 to 75 years (mean, 45.4 years). They were divided into a dislocation-free group and a dislocation group according to the absence or presence of knee dislocation on their anteroposterior X-ray films. The fracture morphology was assessed on CT according to the modified three-column classification. The incidences of ligamentous injuries [involving anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), posterolateral complex (PLC) and anterolateral ligament (ALL)] were investigated on MRI. The 2 groups were compared in fracture morphology and incidences of ligamentous injuries. Multiple linear regression (MLR) analysis was used to identify the main factor contributing to preoperative knee dislocation.Results:The dislocation group had 12 patients and the dislocation-free group 18. The fracture involving medial+posteromedial+posterolateral columns was found in 66.7% of the patients (20 cases), and accounted for 83.3% (10 cases) in the dislocation group. The incidence was 96.7% (29 cases) for ACL injury, 43.3% (13 cases) for PCL injury, 70.0% (21 cases) for MCL injury, 90% (27 cases) for PLC injury, 73.3% (22 cases) for ALL injury and 90% (27 cases) for the multiple-ligament disruption. There was a significant difference in the posterolateral column injury between the dislocation-free group [55.6% (10/18)] and the dislocation group [91.7% (11/12)] ( P < 0.05), but there were no significant differences between the 2 group in the injury to any other single ligament or multiple ligaments ( P>0.05). The MLR analysis confirmed that the posterolateral column injury was a risk factor for coronary plane dislocation in Schatzker type Ⅳ TPF( P<0.05). Conclusions:In Schatzker type Ⅳ TPF, the incidences of ligamentous injuries are very high but the fracture of posterolateral column may be the main cause for preoperative knee dislocation in some patients.
ABSTRACT
Objective:To evaluate the outcomes of complex hyperextension tibial plateau fractures treated via combined anteromedial and anterolateral approaches.Methods:From January 2013 through July 2018, 11 complex hyperextension tibial plateau fractures were surgically treated at Department of Orthopaedics, The First Affiliated Hospital to Nanjing Medical University. The patients were 7 males and 4 females, aged from 23 to 62 years (average, 41.5 years). All the fractures affected both tibial condyles. Of them, 6 had hyperextension varus injury, 3 simple hyperextension injury without varus or valgus at the coronal view, and 2 hyperextension valgus injury. All their fractures were exposed and reset via combined anteromedial and anterolateral approaches. After surgery, orthosis of the knee joint was used to protect the affected limbs and the patients were followed up regularly at the outpatients department. At the final follow-up, the knee function was evaluated using The Hospital for Special Surgery (HSS) scoring system while the posterior slope angle and the tibial plateau angle were assessed on their X-ray films.Results:No neurological symptoms were observed in the 11 patients whose wounds healed by the first intention. They were followed up from 6 to 28 months (average, 18.5 months). All the fractures obtained anatomical reduction by the X-ray after operation. Regular follow-ups showed no reduction loss, implants loosening or breakage. The fractures united after 10 to 16 weeks (average, 12.5 weeks). At immediate postoperation, the posterior slope angle was 12.8°±1.6° and the tibial plateau angle 3.8°±1.1°; at 6 months postoperation, the posterior slope angle was 11.9°±1.7° and the tibial plateau angle 3.6°±1.8°. There were no significant differences between immediate postoperation and 6 months postoperation in the above indexes ( P>0.05). At the final follow-up, the HSS scores ranged from 85 to 96 (mean, 90.4), the knee flexion from 120° to 140° (mean, 127.2°), and the knee extension from -5° to 5° (mean, 0°). Conclusions:Surgery via combined anteromedial and anterolateral approaches can lead to fine short-term outcomes for the complex hyperextension tibial plateau fracture which affects both tibial condyles. As long-term outcomes have not been available, further observations should be made. In addition, since this type of fractures is likely complicated with neurovascular or ligament lesions, attention should be paid to the injury to such soft tissues.
ABSTRACT
Objective To investigate the therapeutic efficacy of truly anatomic reconstruction of the coracoclavicular ligament with two Endobutton devices for acute acromioclavicular joint dislocation of Rock-wood type Ⅴ.Methods From May 2013 to October 2015,25 patients with acromioclavicular joint dislocation of Rockwood type Ⅴ underwent truly anatomic reconstruction of the coracoclavicular ligament using two Endobutton devices.They were 15 men and 10 women,from 18 to 67 years of age (mean,43.0 years).All the dislocations were unilateral,involving 14 left and 11 right sides.The visual analog scale (VAS) and the Constant scoring were used at 3,6,12,18 and 24 months postoperatively for assessments of pain and shoulder function.The coracoclavicular distances on the healthy and affected sides were measured on their anteroposterior X-ray films of bilateral shoulders.Results The 25 patients were followed up for 24 to 48 months (mean,34.0 months).Their VAS score were decreased significantly from preoperative 5.0 ± 0.9 points to 0 ±0.5 points at 24 months after surgery,their Constant score increased significantly from preoperative 45.0 ± 5.6 points to 95.0 ± 2.9 points at 24 months after surgery,and their coracoclavicular distances at the affected side restored significantly from preoperative 23.0± 5.4 mm to 8.0 ± 0.9 mm at 24 months after surgery (all P ＜ 0.05).There was no significant difference in the coracoclavicular distance between the affected and the healthy sides at 24 months after surgery (P ＞ 0.05).No serious complications like acromioclavicular joint re-dislocation or clavicular condylar fracture occurred in any patient.Conclusions Truly anatomic double Endobutton reconstruction of the coracoclavicular ligament is a safe,reliable and creative surgical technique that may yield good to excellent clinical and radiological outcomes in the treatment of acute acromioclavicular joint dislocation of Rockwood type Ⅴ.
ABSTRACT
Objective To investigate the early predictors of Mycoplasma pneumoniae pneumonia (MPP) in children with blockage of airway mucous plug.Methods Retrospective analysis was executed on the clinical data of 130 children,who were diagnosed as MPP and treated with fiberoptic bronchoscopy at the Department of Pediatrics,the First Hospital of Jilin University,from September 2016 to January 2017.The patients were divided into the mucus plug group (60 cases)and the control group(70 cases) according to the performance of flexible bronchoscopy.The general information,clinical manifestations,laboratory examination,radiological features,bronchofibroscopic findings and treatment were compared between 2 groups.The multiple Logistic regression analysis and receiver operating characteristic (ROC) curve were used for the single factor with clinical and statistical significance to identify the early predictors of the MPP with blockage of airway mucus plug.Results Compared with the control group,the fever peak [39.8 ℃ (39.5 ℃,40.0 ℃) vs.39.5 ℃ (39.0 ℃,39.8 ℃)],the fever duration [(11.3 ± 3.1) d vs.(7.8 ± 2.4) d],hospitalization time [(13.5 ± 3.8) d vs.(8.5 ± 3.2) d],white blood cells (WBC) [(9.4 ± 3.7) × 109/L vs.(8.2 ± 2.9) × 109/L],the percentage of neutrophils (NE) (0.698 ± 0.112 vs.0.623 ± 0.119),C-reactive protein (CRP) [48.2 (19.8,91.0) mg/L vs.12.4 (7.1,25.4) mg/L],lactic dehydrogenase(LDH) [466.5(371.5,639.0) U/L vs.323.0 (273.2,376.8) U/L],the proportion of combined with pleural effusion (56.7％ vs.17.1％),atelectasis(23.3％ vs.7.1％),necrosis (16.7％ vs.0) and involved lobes more than 2 (40.0％ vs.21.4％) were higher in the mucus plug group,and these indicators had significantly statistical differences (Z =-3.394,t =-6.957,-8.021,-2.046,-3.672,Z =-6.402,-6.433,x2 =22.074,6.786,12.639,5.306,all P ＜ 0.05).The multiple Logistic regression analysis showed that the febrile time,CRP and LDH were independent predictors for the MPP with blockage of airway mucus plug.The ROC curve analysis showed that the cut-off values of the 3 predictors were febrile time ≥ 9.5 d [area under curve (AUC) =0.810,95 ％ confidence interval (CI):0.738-0.883],CRP ≥ 30.4 mg/L (AUC =0.826,95％ CI:0.757-0.895),and LDH ≥ 343.5 U/L (AUC =0.828,95％ CI:0.756-0.900).Conclusion The fever duration ≥9.5 d,increased CRP (≥30.4 mg/L),and increased serum LDH (≥343.5 U/L)can be applied as one of the early predictors for MPP in children with mucus plug.
ABSTRACT
Objective To explore the clinical characteristics,diagnosis and treatment of polycythemia vera(PV) transforming to acute myeloid leukemia(AML).Methods The clinical features and process of diagnosis and treatment in 4 cases of PV transforming to AML were analyzed.Results The case 1 had 10 years history of PV,after experiencing PV,had myelofibrosis and transformed to AML at the end stage of natural disease course;the case 2 had 7 years history of PV,orally took hydroxyurea(HU) treatment in recent 2 years and transformed to AML at present,his chromosome karyotype analysis showed 46,XY,del(7)(q31q36),del (18) (q22)[10],which was considered as treatment-related AML;the case 3 and 4 orally took H U for a long time after diagnosing HU,and respectively turned into AML during the pathologic polyemia stage after 6 and 7 years.Conclusion PV can be transformed to AML,the safety of HU in treatment should by paid attention to.
ABSTRACT
Objective To understand the related risk behaviors,knowledge and status of HIV/ AIDS infection among rural adults of Derung minority,to provide relevant messages for the development of HIV/AIDS intervention strategy in this minority group.Methods We used system sampling method to conduct a cross-sectional survey in 6 administration villages of Derung Township,Gongshan Derung and Nu Autonomous County in Nujiang Lisu Autonomous Prefecture of Yunnan Province,with a sample size estimated as 383.Adult residents with Derung minority in six villages of Gongshan County were involved,with relevant information collected through door-to-door visit.HIV antibody was tested and SPSS 17.0 was used for statistical analysis.Results Information on 394 valid respondents was collected,with age as between 18 and 65 (34.39 ± 9.74),80.7％ (318/394) as married,54.0％ (213/394) having had primary school education,13.2％ (52/394) as migrant workers.In this population,the overall HIV infection rote appeared as 0.5％ (2/400),mainly through sexually transmission.The rate of awareness on HIV/AIDS was 69.8％ (275/394),mainly through free publicized materials 50.0％ (197/394).Rates on premarital sexual behavior on multiple sexual partners in the past year,on temporary sexual partners in the past year,having commercial sexual experiences in the past year and ever used condoms when engaging in casual sex,were 6.4％ (60/366),18.0％(66/366),5.7％(21/366),1.9％(7/366) and 8.0％(25/311),respectively.Conclusions Few numbers of HIV infections were identified among the migrating workers with Derung minority,with sexual transmission as the major route,along with the increased number of rural migrant workers and the low rates both on AIDS knowledge and condom use,accompanied by the high risk sexual behavior appeared in this rural adult residents of Derung minority.Relative strategies on HIV/AIDS intervention and control should be developed.
ABSTRACT
Objective To understand the related risk behaviors,knowledge and status of HIV/ AIDS infection among rural adults of Derung minority,to provide relevant messages for the development of HIV/AIDS intervention strategy in this minority group.Methods We used system sampling method to conduct a cross-sectional survey in 6 administration villages of Derung Township,Gongshan Derung and Nu Autonomous County in Nujiang Lisu Autonomous Prefecture of Yunnan Province,with a sample size estimated as 383.Adult residents with Derung minority in six villages of Gongshan County were involved,with relevant information collected through door-to-door visit.HIV antibody was tested and SPSS 17.0 was used for statistical analysis.Results Information on 394 valid respondents was collected,with age as between 18 and 65 (34.39 ± 9.74),80.7％ (318/394) as married,54.0％ (213/394) having had primary school education,13.2％ (52/394) as migrant workers.In this population,the overall HIV infection rote appeared as 0.5％ (2/400),mainly through sexually transmission.The rate of awareness on HIV/AIDS was 69.8％ (275/394),mainly through free publicized materials 50.0％ (197/394).Rates on premarital sexual behavior on multiple sexual partners in the past year,on temporary sexual partners in the past year,having commercial sexual experiences in the past year and ever used condoms when engaging in casual sex,were 6.4％ (60/366),18.0％(66/366),5.7％(21/366),1.9％(7/366) and 8.0％(25/311),respectively.Conclusions Few numbers of HIV infections were identified among the migrating workers with Derung minority,with sexual transmission as the major route,along with the increased number of rural migrant workers and the low rates both on AIDS knowledge and condom use,accompanied by the high risk sexual behavior appeared in this rural adult residents of Derung minority.Relative strategies on HIV/AIDS intervention and control should be developed.
ABSTRACT
Objective To understand the characteristics of newly detected HIV infection cases and related high risk behaviors in the areas with high HIIV infection prevalence in Yunnan province.Methods A questionnaire survey was conducted with census method during January to March 2016 among newly detected HIV infected persons in Dehong,Honghe,Lincang and Dali prefectures in Yunnan during 2012-2015.Results Among 451 HIV seropositive cases,the major transmission route of HIV was heterosexual contact,accounting for 92.5％ (417/451).The total awareness rate of AIDS related knowledge was 73.0％ (329/451).The rates of condom use at sex with regular sexual partners,occasional sexual partners,commercial sexual partners and men who have sex with men within 1 year before knowing their infection status were 48.7％ (167/343),4.2％ (7/165),9.9％ (15/151) and 0.0％ (0/3),respectively.The risk factors for using no condom at sex with regular sexual parmers included living at Dali,being farmer,unmarried,cohabitation,divorced and widowed,monthly income under 1 000 yuan (RMB),living in urban area before infection,knowing no AIDS related knowledge etc.The risk factors for using no condom at sex with occasional sexual partners included living in Dehong,Honghe and Lincang,aged ≤30 years and being farmer.The injecting drug users accounted for 8.2％ (37/450) and 75.5％ of these cases had received AIDS related intervention (340/450).Conclusion High prevalence of heterosexual transmission of HIV,poor AIDS related knowledge on awareness,high risk behavior and poor condom use and poor intervention service utilization were found among newly detected HIV infected persons in areas with high HIV infection prevalence in Yunnan.
ABSTRACT
Objective To understand HIV incidence in community residents and epidemiological characteristics of newly detected HIV infection cases in Dali,Yunnan province.Methods A cohort study was conducted among 146720 community residents who were tested to be HIV negative during 2010-2011,they were followed-up from June 1,2014 to May 31,2015.Results A total of 136356 community residents received follow up (92.9％).The follow-up time was 0.23-5.40 years (medium:3.43 years),cumulatively 459675 person years,and 78 people were found to be HIV positive.The incidence rate of HIV infection was 0.170/1000 person years.The incidence rate was 0.037/1000 person years in age group 15-29 years,0.288/1000 person years in age group 30-44 years,0.210/1000 person years in age group 45-59 years,0.204/1000 person years in age ≥60 years;0.213/1 000 person years in males,0.130/1000 person years in females;0.248/1000 person years inHan ethnic group,0.149/1000 person years in Minorities;0.194/1000 in people with education level ≤junior middle school,0.046/1000 person years in people with education level ＞ junior middle school;0.070/1000 person years in the unmarried,0.194/1000 person years in the married and 0.425/1000person years in the divorced/widowed.Cox proportional hazards regression analysis showed that being male (HR=l.731),aged 30-44 years (HR=13.158),aged 45-59 years (HR=10.329),aged ≥60years (HR=8.291),unmarried (HR=3.162) and divorced/widowed (HR=2.689) were the risk factors for HIV infection,while the education level ＞ junior middle school (HR=0.132) was the protective factor for HIV infection.Conclusions By medium 3.43 years follow up,the cohort study showed that incidence rate HIV infection was 0.170/1000 person years in the community residents in Dali.Male,middle aged and old people,people with low education level,the unmarried and the divorced/widowed had relatively higher risk to be infected with HIV,Close attention should be paid to the prevention and control of AIDS in these populations.
ABSTRACT
Objective To understand the characteristics of newly detected HIV infection cases and related high risk behaviors in the areas with high HIIV infection prevalence in Yunnan province.Methods A questionnaire survey was conducted with census method during January to March 2016 among newly detected HIV infected persons in Dehong,Honghe,Lincang and Dali prefectures in Yunnan during 2012-2015.Results Among 451 HIV seropositive cases,the major transmission route of HIV was heterosexual contact,accounting for 92.5％ (417/451).The total awareness rate of AIDS related knowledge was 73.0％ (329/451).The rates of condom use at sex with regular sexual partners,occasional sexual partners,commercial sexual partners and men who have sex with men within 1 year before knowing their infection status were 48.7％ (167/343),4.2％ (7/165),9.9％ (15/151) and 0.0％ (0/3),respectively.The risk factors for using no condom at sex with regular sexual parmers included living at Dali,being farmer,unmarried,cohabitation,divorced and widowed,monthly income under 1 000 yuan (RMB),living in urban area before infection,knowing no AIDS related knowledge etc.The risk factors for using no condom at sex with occasional sexual partners included living in Dehong,Honghe and Lincang,aged ≤30 years and being farmer.The injecting drug users accounted for 8.2％ (37/450) and 75.5％ of these cases had received AIDS related intervention (340/450).Conclusion High prevalence of heterosexual transmission of HIV,poor AIDS related knowledge on awareness,high risk behavior and poor condom use and poor intervention service utilization were found among newly detected HIV infected persons in areas with high HIV infection prevalence in Yunnan.
ABSTRACT
Objective To understand HIV incidence in community residents and epidemiological characteristics of newly detected HIV infection cases in Dali,Yunnan province.Methods A cohort study was conducted among 146720 community residents who were tested to be HIV negative during 2010-2011,they were followed-up from June 1,2014 to May 31,2015.Results A total of 136356 community residents received follow up (92.9％).The follow-up time was 0.23-5.40 years (medium:3.43 years),cumulatively 459675 person years,and 78 people were found to be HIV positive.The incidence rate of HIV infection was 0.170/1000 person years.The incidence rate was 0.037/1000 person years in age group 15-29 years,0.288/1000 person years in age group 30-44 years,0.210/1000 person years in age group 45-59 years,0.204/1000 person years in age ≥60 years;0.213/1 000 person years in males,0.130/1000 person years in females;0.248/1000 person years inHan ethnic group,0.149/1000 person years in Minorities;0.194/1000 in people with education level ≤junior middle school,0.046/1000 person years in people with education level ＞ junior middle school;0.070/1000 person years in the unmarried,0.194/1000 person years in the married and 0.425/1000person years in the divorced/widowed.Cox proportional hazards regression analysis showed that being male (HR=l.731),aged 30-44 years (HR=13.158),aged 45-59 years (HR=10.329),aged ≥60years (HR=8.291),unmarried (HR=3.162) and divorced/widowed (HR=2.689) were the risk factors for HIV infection,while the education level ＞ junior middle school (HR=0.132) was the protective factor for HIV infection.Conclusions By medium 3.43 years follow up,the cohort study showed that incidence rate HIV infection was 0.170/1000 person years in the community residents in Dali.Male,middle aged and old people,people with low education level,the unmarried and the divorced/widowed had relatively higher risk to be infected with HIV,Close attention should be paid to the prevention and control of AIDS in these populations.
ABSTRACT
Breast imaging reporting and data system (BI-RADS) is a standardized system for reporting breast pathology covered mammography,ultrasound and MRI.BI-RADS improves the standardization in interpretation of medical imaging and reduces the confusion of breast imaging interpretation.It is a widely accepted risk assessment and quality assurance tool in mammography,ultrasound and MRI.The development history,clinical applications,limitations of BI-RADS,as well as the clinical applications combined with other imaging techniques were reviewed in this article.
ABSTRACT
Objective To establish a novel convenient loop?mediated isothermal amplification(LAMP)method with the unique genes coding Plasmodium helical interspersed sub?telomeric superfamily(PHIST)for the rapid molecular diagnosis of P. falciparum. Methods The unique genes coding PHIST with high expression mRNA profile during the ring form or schizont period of P. falciparum were screened and selected from the PlasmoDB database. The LAMP primers of targeted genes were de?signed by the online software(PrimerExplorer V4). The LAMP assay was executed by the color?displaying method with SYBR Green. The dried blood spots of P. falciparum from clinical isolates were collected and the genomic DNA(gDNA)was extracted. For evaluation of sensitivity,the gDNA was diluted to four gradients(10?1,10?2,10?3,and 10?4). For assessment of specificity, the gDNA(s)of P. vivax,P. yoelii,Taenia saginata,and Schistosoma japonicum were also extracted. Results Totally,61 P. falciparum unique genes coding PHIST were found. The PF3D7_1372300 with high expression value during the ring form and PF3D7_1401600 with high expression value during the schizont period were selected for LAMP assay. The lowest detectable lim?its of PF3D7_1372300 and PF3D7_1401600 were 130.5 parasite/μl and 1 305.3 parasite/μl,respectively. Specific tests showed the amplified products of P. falciparum was positive and all the others including P. vivax,P. yoelii,T. saginata,and S. japoni?cum were negative. Conclusions The established LAMP method with PF3D7_1372300 gene is sensitive,specific,simple and useful. It can be applied to the field investigation and clinical diagnosis for falciparum malaria.
ABSTRACT
Objective To explore the effects of renal denervation (RDN) on hypothalamus angiotensinⅡ(AngⅡ) and oxidative stress in myocardial infarction (MI) dogs. Methods Eighteen mongrel dogs were randomly divided into MI group (n=6), RDN group (n=6) and sham operation group (n=6). Myocardial infarction model was made in the former two groups by gelatin sponge embolization of the left anterior descending artery. One week after MI, RDN was given to dogs in RDN group. Levels of AngⅡ, malondialdehyde (MDA), superoxide dismutase (SOD) and expression of gp91phox protein were detected four weeks after MI. Results Compared with control group, hypothalamus AngⅡ, MDA and expression of gp91phox protein were increased in MI group (P<0.01), but SOD was decreased (P<0.01). There was a negative correlation between AngⅡand SOD activity in MI group (r=-0.849, P < 0.01). There was a positive correlation between AngⅡ and expression of gp91phox protein in MI group (r=0.950, P<0.01). Compared with MI group, hypothalamus AngⅡ, MDA and expression of gp91phox protein were decreased in RDN group (P<0.01), but SOD was increased (P<0.01). Conclusion RDN can de?crease the level of hypothalamus AngⅡand the level of hypothalamus oxidative stress, and improve heart function of MI dogs.
ABSTRACT
<p><b>OBJECTIVE</b>To understand the prevalence of high risk behaviors and influencing factors among HIV infected persons aged ≥50 years.</p><p><b>METHODS</b>Face to face questionnaire interview was conducted among the HIV infected persons selected in Jianshui, Gejiu and Mengzi counties in Yunnan province through random sampling in June 2015. The sample size was 450.</p><p><b>RESULTS</b>Among the HIV infected persons surveyed, 41.2% (122/296) had sexual behaviors with their spouses during past year, and the consistent condom use rate was 66.4% (81/122). Among the HIV infected males, 8.9% (28/313) had commercial sexual behaviors during past year, and the consistent condom use rate was 17.9% (5/28). Among the HIV infected females, 0.7% were still engaged in commercial sex service during past year. Among the 450 HIV infected persons, 32 (7.1%) reported having casual sex behaviors during past years, and the consistent condom use rate was 18.7% (6/32). The rate of commercial sexual behavior in urban residents (13.4%, 19/115) was higher than that in rural residents (4.5%, 9/198), the difference was statistically significant (χ(2)=11.715, P=0.001). The risk factors for commercial sex behaviors included lack of family and social support, aged 50-59 years, living in urban area, higher income and being male. The risk factors for using no condom included living in rural area, lower education level, lack of family and social support and higher income.</p><p><b>CONCLUSIONS</b>Risk sex behaviors are still prevalent in HIV infected people aged >50 years, which exacerbated HIV transmission. Further efforts should be focused on the education about AIDS prevention and control and promoting protected sexual behaviors. Additional effort should be done to improve the family and social support for HIV infected people aged >50 years. Moreover, comprehensive intervention for low-paid female sex workers also needs to be strengthened.</p>