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Objective:To compare the performance of rapid tests for HIV-1 antibody detection in serum and urine specimens of men who have sex with men (MSM) for investigating suitable technology in the prevention and control of AIDS in Beijing.Methods:A total of 874 cases of MSM were recruited in the AIDS clinic of Beijing Center for Disease Prevention and Control. HIV-1/2 antibody rapid test kit (Kit A, Alere Determine), urine HIV-1 antibody rapid test kit (Kit B, Wantai Biological Pharmacy) and HIV-1/2 antibody Western blot kit (Kit C, IMT) were used for antibody detection. The sensitivity, specificity and consistency of the three rapid test kits for HIV-1 antibody detection in serum and urine specimens were analyzed.Results:Among the 874 cases of MSM, 447 were positive for HIV-1 antibody (51.14%) and 427 were negative. One false negative result occurred by using Kit A and 23 by using Kit B. Taking Kit C as reference, the sensitivity of Kit A and Kit B was 99.78% and 94.85%, respectively; the specificity of both was 100%; the overall consistency was 99.89% ( Kappa=0.998) and 97.37% ( Kappa=0.947), respectively. Conclusions:Although the sensitivity of urine rapid test kit was not as sensitive as serum rapid test kit, it was more suitable for self-test due to its convenience in sampling, high safety and high accessibility. It was suggested that urine rapid test kit should be popularized in MSM population for HIV-1 antibody screening.
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Objective To evaluate the randomness and representativeness of respondent-driven sampling (RDS) tool in conducting the investigation in MSM population,in Beijing,2017.Methods RDS tool was used to recruit MSM population for a face-to-face interview with structured questionnaire and serological tests.Results A total of 600 MSM people were sampled and interviewed.The median number of personal network of seeds was 10,which was higher than other MSM people recruited.The numbers of recruitments by wave presented a skewed positive distribution and the highest number was in the fourth wave.It was also dramatically varied from different seeds.Three seeds had the longest chains and had recruited 184,113 and 92 MSM people,respectively.In contrast,five seeds recruited less than 10 MSM people.Two college students were the most non-generative seeds and each recruited only 1 MSM person.After five to nine waves of sampling,the major demographic characteristics reached equilibrium.Both convergence and bottleneck plots of major demographic characteristics reached convergence,although the plots on marriage and education did not.The homophiles of characteristics were all closed to 1,except for education.The HIV positive rate appeared as 7.9％ (95％CI:4.4％-11.4％). Conclusions Results from this study showed that RDS could be used as a feasible sampling method for the study on MSM population with major demographic characteristics reached equilibrium.The process of recruitment appeared controllable and reasonable,showing that this could represent the MSM population in Beijing,in some degree.
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Objective To evaluate the randomness and representativeness of respondent-driven sampling (RDS) tool in conducting the investigation in MSM population,in Beijing,2017.Methods RDS tool was used to recruit MSM population for a face-to-face interview with structured questionnaire and serological tests.Results A total of 600 MSM people were sampled and interviewed.The median number of personal network of seeds was 10,which was higher than other MSM people recruited.The numbers of recruitments by wave presented a skewed positive distribution and the highest number was in the fourth wave.It was also dramatically varied from different seeds.Three seeds had the longest chains and had recruited 184,113 and 92 MSM people,respectively.In contrast,five seeds recruited less than 10 MSM people.Two college students were the most non-generative seeds and each recruited only 1 MSM person.After five to nine waves of sampling,the major demographic characteristics reached equilibrium.Both convergence and bottleneck plots of major demographic characteristics reached convergence,although the plots on marriage and education did not.The homophiles of characteristics were all closed to 1,except for education.The HIV positive rate appeared as 7.9％ (95％CI:4.4％-11.4％). Conclusions Results from this study showed that RDS could be used as a feasible sampling method for the study on MSM population with major demographic characteristics reached equilibrium.The process of recruitment appeared controllable and reasonable,showing that this could represent the MSM population in Beijing,in some degree.
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Objective To study the expression of interleukin-6 (IL-6) and hepcidin in patients with diffuse large B-cell lymphoma (DLBCL) and their significance in anemia. Methods 45 DLBCL patients with or without anemia were analyzed. Peripheral blood samples were collected during diagnosis, and the concentrations of IL-6, hepcidin, serum ferritin and hemoglobin (Hb) were measured. 24 healthy volunteers were collected as controls. Results The levels of plasma hepcidin and IL-6 in patients with DLBCL were (347±171)μg/L and 0.27 ng/L (0-9.61 ng/L), respectively, and compared with those [(175 ± 92)μg/L] and 0 ng/L in healthy controls, the differences were statistically significant (both P1 (P=0.010) were increased. The levels of IL-6 in patients of male (P=0.003), stage Ⅲ-Ⅳ (P=0.008) or IPI>1 (P=0.004) were significantly higher. The level of hepcidin was highly correlated with serum ferritin (r=0.77, P<0.001), weakly correlated with IL-6 (r=0.31, P=0.030), and not correlated with Hb (r=-0.12, P=0.3). There was a negative correlation between IL-6 expression and Hb (r=-0.35, P=0.009). Multivariate analysis showed that IL-6 could predict anemia (P=0.03), whereas hepcidin could not (P=0.89). Conclusion The elevated hepcidin level is frequent in DLBCL, and the elevated IL-6 plays the major role in the development of anemia.
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Objective To study the reasons for conversion to laparotomy in laparoscopic pancreaticoduodenectomy (LPD).Methods Of the 74 patients who underwent LPD in Yi Jishan Hospital,Wan Nan Medical College from May 2012 to Dec 2016,7 patients were converted to laparotomy.The clinical and operative data of the 7 patients were reviewed.Results There were 6 males and 1 female.The age ranged was 51 to 66 years.The pathologies included tumor of pancreatic head in 5 patients,chronic inflammation of pancreas in 1 patient and duodenum papilla cancer in 1 patient.The reasons for conversion were:uncontrollable bleeding in 4 patients with superior mesenteric vein injury in 1 patient,portal vein injury in 1 patient and first jejunal vein injury in 2 patients,respectively.The bleeding was controlled successfully after laparotomy in all the 4 patients.The conversion in the remaining 3 patients were due to difficulty in the operative procedures which resulted from severe adhesions between the tumor and the major vessels.There were 2 patients who had invasion of the SMV by tumor.They underwent vascular resection after laparotomy.The remaining patient had chronic inflammation and the lesion was resected successfully after careful dissection.Of the 7 patients,1 patient developed pancreatic fistula,1 patient developed delayed gastric emptying and 1 patient developed both bile leakage and delayed gastric emptying.They were all treated conservatively.There was no peri-operative death in the study.Conclusion Uncontrollable bleeding and severe adhesions between the lesion and major vessels were the major reasons in LPD for conversion to laparotomy.
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Objective: To investigate the effects and safety of recombinant human brain natriuretic peptide [rhBNP] in the treatment of elderly acute myocardial infarction induced cardiac failure
Methods: One hundred and forty-six patients who were diagnosed as elderly acute myocardial infarction induced cardiac failure in the hospital from July 2014 to July 2015 were selected. They were divided into a test group and a control group, 73 each. Patients in both groups were given conventional treatment such as stabilization of atherosclerotic plaques, anti-platelet and remodeling and reversion of myocardium. The curative effects and the incidence of adverse reactions of the two groups were observed
Results: The overall efficacy of the test group and the control group was 87.7% and 65.8% respectively, and the difference had statistical significance [P<0.05]. The heart rate, urine volume, n-terminal probrain natriuretic peptide level and left ventricular ejection fraction [LVEF] of both groups significantly improved after treatment, and the improvement of the test group was superior to that of the control group [P<0.05]. The serum creatinine of the test group remarkably reduced after treatment [P<0.05]. The incidence of hypotension and arrhythmia of the test group was lower than that of the control group during hospitalization period [P<0.05]
Conclusion: rhBNP can effectively relieve the clinical symptoms, cardiac function indexes and hemodynamic indexes of patients with elderly acute myocardial infarction induced cardiac failure, with a high safety. It can be extensively applied in the treatment of acute myocardial infarction in combination with cardiac failure
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<p><b>OBJECTIVE</b>To analyze the proportion and associated factors of taking subsequent confirmation test among men who have sex with men (MSM) after being tested positive in oral fluid HIV antibody test.</p><p><b>METHODS</b>By using successive sampling, 1 003 MSM, who were tested positive in oral fluid HIV antibody test in China-Bill & Melinda Gates Foundation AIDS prevention Program (Extension program) in Beijing during May 1 to December 31, 2013, were recruited. The inclusion criteria included: the objects were men who reported having sex with men; the objects aged more than 18 years old; the objects were tested positive in oral fluid HIV antibody test; the objects had not been reported as HIV positives in China Information System for Disease Control and Prevention previously. According to the program strategy, MSM grassroots organizations transferred the respondents to seek subsequent confirmation tests in specific Center for Disease Control and Prevention (CDCs) or hospitals. The subsequent confirmation tests included: fingertip blood HIV antibody rapid test, venous blood Enzyme Linked Immunosorbent Assay (ELISA) HIV antibody test and venous blood Western Blot (WB) HIV antibody test. Chi-square test was adopted to compare the proportion of taking subsequent confirmation tests in different groups. Nonconditional multivaritae binarylogistic regression analysis was taken to identify the associated factors with whether taking subsequent confirmation tests and to calculate the OR (95% CI) values.</p><p><b>RESULTS</b>The 1 003 respondents were (30.9 ± 9.1) years old. Among all objects, 87.8% (881/1 003) of them took fingertip blood HIV antibody rapid tests and the positive rate was 85.4% (752/881). 98.0% (737/752) of those who were identified as positive in fingertip blood HIV rapid tests took ELISA and WB tests, and the positive rate was 94.4% (696/737). Comparing with those who were expected to seek subsequent confirmation tests in CDCs, the OR (95% CI) value of those who were expected to seek tests in hospitals was 5.10 (1.69-15.36). The OR (95% CI) values of those who used condom sometimes and those who never used condom in anal sex were 5.81 (2.14-15.77) and 3.45 (2.00-5.97) respectively, in comparison with those who reported not having anal sex or using condom consistently in anal sex during the past 6 months. Comparing with the respondents recruited from the internet, the OR (95% CI) values of those recruited in bathrooms, parks/toilets and bars were 0.17 (0.05-0.53), 0.10 (0.04-0.29) and 0.22 (0.06-0.79) respectively. The likelihood of taking subsequent confirmation test decreased with the increase of number of male sexual partners in the past 3 months, and the OR (95% CI) value was 0.92 (0.86-0.99).</p><p><b>CONCLUSION</b>The potential HIV positive MSM in the bathroom, park/toilet and bars are less likely to take subsequent confirmation test. Those who do not use condom consistently during anal sex are more likely to seek subsequent confirmation test. Medical organization conducting subsequent confirmation tests is more likely to increase the confirmation test rate of potential HIV positive MSM. The number of male sexual partners has negative correlation with whether to accept the subsequent confirmation test.</p>
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Humans , Male , Beijing , Condoms , HIV Antibodies , HIV Seropositivity , Diagnosis , Homosexuality, Male , Mass Screening , Patient Acceptance of Health Care , Risk-Taking , Sexual Behavior , Sexual Partners , Surveys and QuestionnairesABSTRACT
<p><b>OBJECTIVE</b>To discuss the application of right-inferior-posterior "artery first" approach in laparoscopic pancreaticoduodenectomy.</p><p><b>METHODS</b>Clinical data of 17 patients who underwent laparoscopic pancreaticoduodenectomy through right-inferior-posterior "artery first" approach in our department from February 2014 to April 2015 were retrospectively analyzed. The operation began at the inferior flexure of duodenum. After entering the Toldt's space, the left renal vein (LRV) was revealed and the root of superior mesenteric artery (SMA) was exposed just above the LRV. SMA was dissected along its trunk till the horizontal part of duodenum.</p><p><b>RESULTS</b>Of these 17 cases, adenocarcinoma of pancreatic head was observed in 5 cases, adenosquamous carcinoma in 2 cases, mucinous cycstic neoplasm in 1 case, adenocarcinoma of lower common bile duct in 4 cases, and duodenal papilla cancer in 5 cases. Fifteen cases were accomplished successfully with laparoscopy and 2 cases were converted to open approach. The average operating time was (320 ± 85) min and mean intraoperative blood loss was (305 ± 175) ml. The cutting margins were tumor negative in all the patients. The average number of harvested lymph node was 15.4 ± 6.5. Postoperative complication occurred in 5 cases. Two cases of bile leakage and 2 cases of pancreatic fistula were cured with conservative treatment. One case of delayed abdominal hemorrhage was resolved with reoperation.</p><p><b>CONCLUSION</b>Right-inferior-posterior "artery first" approach is safe and feasible in laparoscopic pancreaticoduodenectomy.</p>
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Humans , Adenocarcinoma , Duodenal Neoplasms , Duodenum , Laparoscopy , Mesenteric Artery, Superior , Operative Time , Pancreas , Pancreaticoduodenectomy , Postoperative Complications , Retrospective StudiesABSTRACT
BACKGROUND:Integrated Traditional Chinese and Western Medicine minimaly invasive treatment for halux valgus based on wrapped curtain method with “8”-shaped bandage and sub toe pad external fixation has been used for a long time in the clinic. This method abandons the internal implant fixationandexternal plaster fixation. After surgery, patients could take care of themselves. However, theactivity of the broken end may cause fracture nonunion, which once aroused scholars’ question. Recently, with the continuous improvement of foot biomechanics research, foot finite element model and applications become a reality. OBJECTIVE:To evaluate thestability of osteotomy after the operation of wrapped curtain method with“8”-shaped bandage and sub toe pad external fixation on the basis of static finite element method. METHODS:A young female volunteer with halux valgus was selected, whose body weight was 58 kg, and right foot halux abductor valgus angle was 24°; intermetatarsal angle was 13°; proximal articulator set angle was 7°; distal articulator set angle was 7°. CT was used to scan the right foot. ABAQUS software was applied to establish a finite element model of right foot halux valgus bone, and model of the first metatarsal neck minimaly invasive osteotomy was simulated based on wrapped curtain method with external fixation. Von Mises stress and displacement at the osteotomy endwere calculated. RESULTS AND CONCLUSION:(1) The maximum stress was 0.067 MPa without external fixation, and the maximum stress was 1.258 MPa with the external fixation. Stress was mainly distributed in the outer edge of the osteotomy. (2) The maximum absolute displacement was 0.363 mm without external fixation, and the maximum absolute displacement was 0.716 mm with external fixation. The two largest displacements were both in the Z-axis direction. Statistical analysis confirmed that the four nodes absolute displacement and stress were significantly different (P 0.05). The four nodes relative displacements were statisticaly significant in Z-axis (P< 0.05). (5) These findings suggest that the external fixation based on wrapped curtain method after halux valgus surgery could effectively reduce osteotomy displacement. The moderate stress and elastic fixation are conducive to fracture healing.
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al from abroad, which have no reports in China. METHODS: The dissection of flexor policis longus tendon and flexor policis brevis muscle and the medial and extensor halucis longus, flexor policis longus, adductor muscle and abductor halucis muscle cross head and oblique head, medial and lateral head of flexor policis brevis muscle and flexor halucis longus tendon and the extensor halucis longus tendon. These parameters included length, width, thickness, cross-sectional area, lateral heads, extensor halucis longus muscle and tendon and the transverse head of adductor policis muscle and the oblique head, abductor policis brevis from the left leg and foot of fresh female specimens was performed. The cross-sectional area and length located in a fixture were measured and calculated for each sample. Sample loading was done, and one sample was measured four times to gather strength limit, maximum load data, and the load displacement curve. According to Hooke’s law, the elastic modulus of each specimen was calculated. al from abroad, which have no reports in China. METHODS: The dissection of flexor policis longus tendon and flexor policis brevis muscle and the medial and extensor halucis longus, flexor policis longus, adductor muscle and abductor halucis muscle cross head and oblique head, medial and lateral head of flexor policis brevis muscle and flexor halucis longus tendon and the extensor halucis longus tendon. These parameters included length, width, thickness, cross-sectional area, lateral heads, extensor halucis longus muscle and tendon and the transverse head of adductor policis muscle and the oblique head, abductor policis brevis from the left leg and foot of fresh female specimens was performed. The cross-sectional area and length located in a fixture were measured and calculated for each sample. Sample loading was done, and one sample was measured four times to gather strength limit, maximum load data, and the load displacement curve. According to Hooke’s law, the elastic modulus of each specimen was calculated. Abstract BACKGROUND:Currently, the material parameters of foot three-dimensional finite element models are almost OBJECTIVE:To preliminarily measure the parameters of foot muscle and tendon materials in Chinese people. RESULTS AND CONCLUSION: Relevant measurement data were harvested from nine samples, including the maximum loading, ultimate strength and elastic modulus test.
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ObjectiveTo study the role of laparoscopic splenectomy (LS) using the anterior approach with sequential layered dissection. MethodsFrom December 2007 to July 2009, we performed 27 LS using the anterior approach with sequential layered dissection. The clinical data were retrospectively analyzed. ResultsThe range of splenic length was 8-20 cm. Accessory spleen was found in 6 patients (22.2%). The mean operative time was 125 mins. The mean intraoperative blood loss was 90 ml, and the mean postoperative stay was 5.5 days. ConclusionsLaparoscopic splenectomy using the anterior approach with sequential layered dissection could be carried out smoothly and rapidly. It reduced accidental injuries and shortened the operative time.
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Objective To evaluate the long-term results of minimal incision osteotomy for hallux valgus.Methods From February 1996 to May 1999,372 cases(705 feet)with hallux valgus were treated with minimal incision osteotomy.Seventy-nine cases after surgery were followed up for more than 5 years,including 6 males(10 feet)and 73 females(140 feet)with an average age of 47 years(range,13-75 years).The average follow-up time was 7.5 years(range,5.3-13.2 years).The preoperative and postoperative hallux valgus angles(HVA),intermetatarsal angles(IMA),the tibial sesamoid position(TSP),American orthopedic foot and ankle society(AOFAS)score,range of movement of the first metatarsophalangeal joint,and lateral metatarsalgia etc.were observed and measured.And the clinic outcome were studied and evaluated.Results Based on Wen Jian-min's clinic curative effect evaluation criterion(2001),56 feet(37.3%)were excellent,88 feet(58.7%)good ,6 feet(4.0%)fair.The rate of excellent or good was 96.0%(144/150).The postoperative mean AOFAS score was 84.20±4.32 points(range,60-100 points).The mean HVA decreased from 33.28 to 12.31 degrees,the mean IMA from 11.75 to 6.80 degrees.The TSP was corrected from an average preoperative grade of 4.29 to a grade of 3.07 at final follow-up.There are no nonunion or delayed union of osteotomy,avascular necrosis of the 1st metatarsal head,infection,hallux varus.Four feet(2.7%)had numbness in the medial of the big toe.The 1st metatarsophalangeal joint range of motion decreased from 70.20 to 69.53 degrees.There were 97 feet(64.7%)with the 2-5 metatarsalgia before operation,and 35 feet(23.3%)disappeared,54 feet(36.0%)improved,8 feet(5.3%)aggravated after operation.Conclusion Minimal incision osteotomy technique is sound and reliable method to treat hallux valgus.The osteotomy technique is simple,and could provide satisfactory long-term results with lower complication rate.
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Objective To review the experience in the management of gastric cancer with liver cirrhosis and portal hypertension.Method A retrospective analysis was made in 35 gastric cancer cases with liver cirrhosis and portal hypertension admitted into our hospital from January 2000 through June 2009.Result There were no intraoperative death in this group.Postoperative ascites occurred in 19 patients,anastomotic leakage in one case,anastomotic bleeding in 2 cases,wound bleeding in 2 cases,intraabdominal infection in 17 cases (of which combined fungal infection in 4 patients),incision infection in one patient and chylous leakage in one case.The morbidity rate was 71%.Four patients died during hospitalization including multiple organ dysfunction syndrome in 2 cases,with mortality rate of 11%. Conclusion In order to reduce the incidence of mortality and complications,we should complete preoperative evaluation,correct perioperative management,guide surgery with damage control concept,follow individualized principles and emphasize on preventive devascularization.
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Objective To discuss the clinical effects of knee osteoarthritis treated with arthroscope and electro-acupuncture. Methods 57 patients (57 knee joints involved) , who were diagnosed by physical examinations and MRI as knee osteoarthritis, were treated by arthroscopy preoperatively and electro-acupuncture and rehabilitation training postoperatively. Results Among the total of 57 cases, 39 cases were recovery (68%), 17 cases were improved (30%), l case was ineffective (2%). The score of preoperative and postoperative HSS assessment was ( 50.3 ± 5.42 )and ( 59.2± 5.28 )respectively (P < 0.05 ). Conclusion The treatment of knee osteoarthritis with arthroscope and electro-acupuncture is effective.
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<p><b>OBJECTIVE</b>To evaluate the efficacy and feasibility of the Chinese drugs for supplementing Qi and activating blood circulation in preventing DVT after big operations in orthopaedics and traumatology and observe the change of D-dimer before and after treatment.</p><p><b>METHOD</b>Seventy patients ranging in age from 39 to 94 years who were treated by big operations in orthopaedics and traumatology were divided into two groups randomly. Traditional Chinese medinine (TCM) group (group A) and western medicine group (group B). On the 2rd day after operation d-dimer was tested from both groups and the patients in group A were given one dose of TCM every day and the patients in group B were subcutaneously injected low-molecular-weight heparins calcium (LMWH). On the 8th after operation d-dimer was tested again from both groups. The parameters, such as the incidence of DVT and pulmonary thromboembolism, bleeding condition, were evaluated respectively.</p><p><b>RESULT</b>The D-dimer decreased in group A and had significant difference (P < 0.05), group B had no significant difference, there was also no significant difference between two groups. DVT was found in 1 patient in group B (1/35). Petechiae were found in 10 patients in group A (10/35) and in 26 patients in group A (26/35), which had significant difference (P < 0.05).</p><p><b>CONCLUSION</b>Both the Chinese drugs and anti-coagulation drug can prevent the incidence of DVT effectively, and Chinese herbs are feasible in the prevention of DVT.</p>
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Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Anticoagulants , Blood Circulation , Drugs, Chinese Herbal , Heparin, Low-Molecular-Weight , Orthopedic Procedures , Orthopedics , Postoperative Complications , Drug Therapy , Qi , Traumatology , Venous Thrombosis , Drug TherapyABSTRACT
Objective To study the application of viral load for differentiating diagnosis of early HIV infection. Methods Thirteen indeterminate specimens, which showed early HIV infection of antibody detection, were selected. Viral load of the specimens were detected. People with suspicious infection were followed up and certified infection status through EIA and Western blot. Results Twelve of 13 indeterminate specimens which indicated early HIV infection, had positive viral loads. One antibody-positive infant was confirmed to have been infected by HIV and 11 recent infected (window period) persons were certified during the follow-up. One antibody-positive infant had negative viral load and was certified noninfected per-son during the follow-up. Viral load testing results accorded with HIV infection status. Conclusion Viral load testing can be used to diagnose HIV early infection, including antibody-positive infants (within 18 months) and recent infected persons. Viral load testing could be diagnostic in determinate specimens during early HIV infection.
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[Objective] To retrospectively analyze the treatment of tailor's bunion with minimal incision osteotomy,and to investigate the indications and effects of this procedure.[Method]Thirty-seven patients(69 feet)underwent the procedure from July 2002 to August 2007.The axial and lateral films of all feet with loading were taken before and after operation.AOFAS were recorded and analyzed preoperatively and postoperatively.[Result]The forth intermetatarsal angle was 14.36??7.32? before operation and 9.36??2.92?after operation.The unguis aduncus angle of digitus quintus pedis was 20.44??7.36? before operation and 4.36??1.35?after operation.The forth reforming intermetatarsal angle was 10.36??.2.81? before operation and 7.83??2.37?after operation.The exstrophy angle of the fifth metatarsal was 5.46??1.70? before operation and 2.13??0.38?after operation.The score of AOFAS was 45.7?5.6 before operation and 85.3?5.1 after operation.[Conclusion]The treatment of tailor's bunion with minimal incision osteotomy is easy to operate and its therapeutic effect is convincing.
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With the combined interruption of the superior mesenteric vein, the splenic artery and vein and the portal vein, we successfully separated the adhesion between the collum pancreatis and the portal vein which is difficult to separate in 8 cases During the separation, the portal vein was damaged in 2～5 parts, and the size of wounds of vein were of 2～6mm in length, but the amount of bleeding was small and the bleeding speed was slow All the wounds were easily repaired under direct vision We consider that the mothod of the combined interruption is safe and effective for the separation of the adhesion between the collum pancreatis and the portal vein, and is helpful to increasing the success rate of removing carcinoma of the head of pancreases The interruption is safe for 20～25 minutes under normothermia