Objective To understand HIV/AIDS related knowledge and attitude among different population groups in Rizhao.Method Self-designed questionnaires were used to investigate HIV/AIDS related knowledge and attitude among rural and urban residents,hotel attendants and government officers.Results The rates of right answers on HIV/AIDS related questions among the government officers,the urban residents,the hotel attendants and the rural residents were 83.38%,72.45%,72.33% and 66.36%,respectively.Conclusion Although different population groups in Rizhao city have relatively high awareness of HIV/AIDS,there still exist some deficiencies,and consequently education and publicity in this respect should be further strengthened.

Objective To observe the therapeutic effects of arsenic trioxide combined with transcatheter arterial chemoembolization on treatment of primary liver cancer with pulmonary metastases.Methods Sixty patients were randomly divided into two groups:group A (treatment group,n =30) and group B (control group,n =30).Group A was received periodic transcatheter arterial chemoembolization (TACE) and 10 mg arsenic trioxide by intravenous infusion for 5 hours per day,3 days after TACE.Each cycle consisted of 14 days' administration,and repeated after 2 weeks.Each patient was received 3-4 successive cycles.Group B was received periodic TACE alone.Objective efficiency,benefit rate,quality of life and the correlates with metastatic tumor size and number in the both groups were recorded.Results The objective efficiency was 26.7％ (8/30),and the benefit rate was 60.0％ (18/30) in group A,while they were 0 and 16.7％ (5/30) in group B with significant statistics differences (x2 =7.067,P =0.008;x2 =11.915,P =0.001).The quality of life was improved in 4 patients and stable in 18 of group A,while no patient was improved and 13 were stable in group B (x2 =9.669,P =0.008).There was a significantly positive correlation between the tumor burden and therapeutic effect (Kendall r =-0.765,P ＜ 0.001 ;Spearman r =-0.821,P ＜ 0.001).Conclusion Arsenic trioxide combined TACE is an effective treatment method in treating primary liver cancer with pulmonary metastases.

[ ABSTRACT] AIM:To investigate the damage in human umbilical vein endothelial cells ( HUVECs) induced by recombinant soluble human CD40 ligand (rshCD40L).METHODS:The cultured HUVECs were treated with rshCD40L for 12 h.The survival activity of the HUVECs was observed by MTS assay.The expression of E-selectin, intercellular ad-hesion molecule (ICAM)-1, tissue factor (TF) and tissue factor pathway inhibitor (TFPI) was measured by ELISA.The activity of superoxide dismutase ( SOD) and the level of malondialdehyde ( MDA) were detected by the methods of thibabi-turic acid (TBA) .RESULTS:Compared with normal group, different concentrations of rshCD40L (0.5, 1, 2, 3 mg/L) had no obvious effect on the survival activity of the HUVECs (P>0.05).rshCD40L at concentration of 0.5 mg/L promo-ted the secretion of E-selectin, sICAM-1, TF and TFPI in the HUVECs (P<0.01).rshCD40L at concentration of 0.5 mg/L also increased MDA content and reduced the activity of SOD in the HUVECs (P<0.05).CONCLUSION:0.5~3mg/L rshCD40L has no obvious effect on endothelial cell survival, but already causes endothelial dysfunction by increas-ing endothelial inflammation and exogenous coagulation reaction, inducing lipid peroxides injury and reducing antioxidant capacity.

Objective To review the experiences of 31 cases of totally thoracoscopic cardiac surgery of cardiopulmonary bypass in children with congenital heart disease.Methods Thirty one children with congenital heart disease received totally thoracoscopic cardiac surgery procedures during the period from October 2012 to May 2016.The ages of these children were ranged from 2 years and 7 months old to 6 years old with average value (4.6 ± 1.4)years old.The body weights were ranged from 12 ～ 24 kg with average value (17 ± 3.5) kg.Among 31 children,there were 12 cases of atrial septal defect,and 19 cases of ventricular septal defect.Through three-hole shape incision at the right chest wall,each hole was 1.5 to 2.0 cm long,and operation field were revealed totally by thoracoscope.Cardiopulmonary bypass was built through femoral arteriovenous intubation.Results Thirty one children were all cured.None of them suffered severe complications such as renal failure,respiratory failure,low cardiac output syndrome,atrioventricular block,and residual shunt.Duration of cardiopulmonary bypass was 62 ～ 185 (126.4 ± 45.2) min,and duration of myocardial ischemia was 18 ～ 118 (53.4 ± 31.2)min.Duration of Postoperative mechanical ventilation was 2 ～ 7 (5.3 ±-1.5) h.Duration of intensive care unit (ICU) stay was 15 ～ 21 (19 ± 1.3) h.Drainage volume of 24 hours after operation was 0～ 130(57 ± 36.2)ml.Volume of red blood cell transfusion was 0 ～ 2 (1.2 ± 0.8) U.Postoperative hospital stay was 4 ～ 7 (6.2 ± 1.2) d.Conclusions For children with congenital heart disease as simple atrial septal defect or ventricular septal defect,thoracoscopic surgical repair can be achieved the same therapeutic results as traditional median sternotomy surgery while having advantages such as smaller incision,less bleeding and none sternal maluniorts.

Objective To investigate the clinical application of pancreatic head resection with the second portion duodenectomy (PHRSPD). MethodsThe clinical data of 4 PHRSPD cases were analyzed retrospectively. ResultsThere were 3 benign and 1 low-grade malignant periampullary tumors. The mean surgical time was 417 min, mean blood transfusion was 533 ml, mean hospital stay was 28.6 days. Delayed gastric emptying was encounted in one case. There was no hospital morality or major surgical complications. All cases were alive in the follow-up ranging from 6 to 36 months. There was no newly developed diabetes mellitus or severe gastroenteral symptoms. No reccurrence was found in the case with low-grade malignant duodenal tumor after 26 months. ConclusionsPHRSPD is an efficient way to treat benign and low-grade periampullary neoplasm and accompanying massive bleeding episodes.

Objective:To determine whether CD46, CD55, and CD59 are differentially expressed in neoplastic and adjacent nor-mal colon tissues and to investigate their influence on clinicopathologic variables. Methods:Immunohistochemistry (a modified two-step method) was used to detect the expression of CD46, CD55, and CD59 in a tissue microarray of 121 cases of colon cancer and corre-sponding adjacent non-tumor tissues with detailed clinical information, including gender, age, differentiation, TNM classification, tu-mor location, and tumor histotype. The colon carcinoma microarray was constructed from patients' samples obtained from the Depart-ment of Gastrointestinal Surgery of Xijing Hospital of the Fourth Military Medical University between October 2004 and June 2006. The correlation between expression and clinicopathologic features was analyzed. Results:The expression levels of CD46, CD55, and CD59 were significantly higher in colon cancer tissues compared with those in normal adjacent colon tissues (P<0.001). CD46 expres-sion was not related to any specific patient characteristics, such as age, gender, grade of tumor differentiation, or TNM classification (P>0.05). The expression levels of CD55 and CD59 were correlated with the grade of colon cancer differentiation. Low levels of CD55 and CD59 were detected in cancer cells of highly differentiated cancer, whereas stronger staining for CD55 and CD59 was mainly observed in cancer cells of moderately and poorly differentiated colon cancer (P<0.05). In addition, the expression levels of CD55 and CD59 were higher in stages III and IV colon cancer than those in stages I and II according to TNM classification (P<0.05). Conclusion:CD46, CD55, and CD59 are up-regulated in colon cancer. Specifically, CD55 and CD59 are of clinical relevance to differentiation and TNM staging of colon cancer, and their expression might be closely related to clinical biological behaviors.

Objective To evaluate the safety and feasibility of totally laparoscopic radical distal gastrectomy (TLDG)and intracorporeal gastroduodenostomy using laparoscopic linear staplers in gastric cancer patients.Methods Clinical data were reviewed on the perioperative outcomes of 17 gastric cancer patients who received totally laparoscopic distal gastrectomy and intracorporeal gastroduodenostomy using endoscopic linear staplers from June 2012 to June 2013 at Department of General Surgery,Lishui Central Hospital.Results The mean operation time were (2.6 ± 0.4) h,TLDG with deltashaped anastomosis was successfully carried out in all the patients except for 1 case who was converted to open surgery.There was no serious complication and no death in this series.The postoperative pain in TLDG was less than laparoscopy assisted distal gastrectomy.Conclusions Totally laparoscopic distal gastrectomy and intracorporeal gastroduodenostomy using endoscopic linear staplers is a new method with high safety and feasibility.

Objective To assess the therapeutic value of transcatheter arterial chemoembolization combined 125iodine seed implantation for primary hepatic carcinoma with portal vein tumor thrombus.Methods The data of 23 patients ranging from 34 to 70 years old [ average age ( 56 ± 8) years ] with primary hepatic carcinoma with portal vein tumor thromhosis of type Ⅱ and type Ⅲ were retrospectively collected.The tumor number of liver parenchyma ranged from 1to 15 ( median number 4).The average diameter of tumor thrombus was (20.5 ± 1.5 ) mm and average length was ( 37.4 ± 2.6 ) mm.All of the tumors of liver parenchyma in 23 patients were treated by transcatheter arterial chemoembolization (TACE) and tumor thrombus were treated with 125iodine seed implantation.Before the 125iodine seed implantation,the formula dosage,the number,the spatial distribution,the intensity of radioactivity and the matched peripheral dosage of seed were calculated by treatment planning system (TPS).Then the 125iodine seeds were implanted in different levels and locations of port vein thrombosis under CT guided.Results The follow-up period ranged from 1to 26 months.The times of transcatheter arterial chemoembolization were 1to six times (median time 3.1±0.4) and the 125iodine seed implantation in the port vein thrombosis were 1to 2 times ( median time 1.4 ± 0.5 ).The numbers of implanted 125iodine seeds were 4 to 17 ( median number 7.0 ± 1.0).The median survival time was 18.0 months (3-24 months).The 3,6 and 12 months survival rates were 91.3％ ( 21/23 ),69.6％ ( 16/23 ),and 60.9％ ( 14/23 ).There was no severe side-effect related to therapy.Conclusions Transcatheter arterial chemoembolization combined 125iodine seed implantation for portal vein tumor thrombosis could significantly prolong the median survival time of patient with primary hepatic carcinoma with portal vein tumor thrombosis.

Objective To analyze the clinical factors predicting long-term survival after curative resection of pancreatic head carcinoma. Methods The clinical data of 58 patients with ductal adenocarcinoma of pancreatic head who underwent curative resection of carcinoma of pancreatic head from 1996 to 2004 were collected and were analyzed by SPSS 10.0 with Cox Proportional Hazards Model. Results 58 patients, including 30 male and 28 female patients, were involved in this study. Pancreaticoduodenectomy were performed in 14 cases and extended resections were performed in 44 cases. The overall 1, 3, 5 year survival rates was 46.6%, 29.3% and 8.6%, respeclively. The 1,3, 5 year survival rates of pancreatoduodenectomy with extended regional lymphadenectomy was 43.1%, 22.7% and 6.8%, respectively. UICC staging, peri-pancreatic nerve invasion and blood infusion had significant effects on the prognosis after curative resection. Conclusions The long-term prognosis after curative resection of pancreatoduodenectomy was still dismal. Much importance should be paid to early diagnosis and comprehensive management for pancreatic head cancer.

Objective:To investigate whether thymic stromal lymphopoietin ( TSLP) participate in asthmatic airway remodeling partially by promoting myofibroblast accumulating in the lung. Methods:Twelve mice evenly were randomly divided into four groups:a saline group;an HDM-exposed group;an IgG isotype-treated group and an anti-TSLP-treated group. The supernatant of bronchoalveolar lavage fluid ( BALF) was used to analyze the levels of TSLP,IL-25 and IL-33 by ELISA. Fluorescence-labeled collagenⅠ( ColⅠ)/α-smooth muscle actin (α-SMA) -dual-positive myofibroblasts were examined by confocal microscopy. Results:Chronic allergen exposure induced obviously abnormal airway structural changes,which were inhibited by blocking TSLP. We detected a highly increased number of myofibroblasts in the sub-epithelial zone in mice from HDM-challenged group. However, TSLP neutralization significantly reduced myofibroblasts recruitment. Moreover,blocking TSLP not only decreased the level of TSLP,but also inhibited the expression levels of TGF-β1 and IL-33 in BAL fluid. Conclusion:The results suggest that orchestrating myofibroblasts recruiting into the lungs is one of the main pathogenesis that TSLP involves in airway remodeling in asthmatic mice.