During the past few years, it was found that hemophiliacs suffered from AIDS increasingly from year to year. The first case of hemophilia with AIDS was found in the fourth quater of 1981. Eight cases of hemophilia occurred in 1982, and 12 cases of AIDS were found in the hemophiliacs in 1983. The goal of this paper was to test the titer of CMV, EBV, HTLV and EA in the blood stream of hemophiliacs. Hemophiliacs had much higher sensitivity to CMV and EBV than the healthy control. There was a significant difference between these hemophiliacs without any symptoms of AIDS and healthy man. The relationship between hemophilia and AIDS and the cause that the hemophiliac suffers from AIDS are discussed.

Objective To analyse the prevalence rate of the cardiovascular and cerebrovascular disease and their susceptible factors in employees of AISCO.Methods A total 95 912 persons,to analyse the history of cardiovascular and cerebrovascular disease,smoking,blood pressure,diabetes mellitus,TC,HDL-C,BMI,and the value of TC/HDL-C so as to find the risk stratification of cardiovascular and cerebrovascular disease.Results There were 1 910 persons with CAD(2.00%),607 with cerebrovascular(0.63%),19453 smoking(20.28%),788 with diabete(0.82%),31698 with hypertention(33.05%),8347 with hypercholesteremia(8.70%),55462 over weight(57.83%),and 10 487 with TC/HDL-C≥3.5.the probability suffer from cardiovascular were mostly in very-low-risk(68.14%)and low-risk(5.75%),and carotid atherosclerosis were mostly in high-risk(44.23%),intermediate-risd(23.21%)and very-high-risk(10.51%)without low-risk and very-low-risk.Conclusion The health condition of the investigation population was not optimism and we will make more efforts for health education.

Objective To find a procedure for facial rejuvenation w hi ch is simple, safe with lasting aesthetic results and to make it popularized eas ily. Method We performed complete face lifting first by extens ive subcutaneous detatchment. Secondly we plicated the superficial musclo-apon eurofic system (SMAS), including the superficial temporal fascia and the SMAS su perior to the parotid fascia, 1 cm anterior to the incision line by No.1 silk su tures. The distance of plication was about 1-2 cm. Interval of suture was 1 cm. After dissection under the platysma for 1-2 cm, we pulled the posterior edge of platysma postlaterally, and sutured it to the sternocleiodomasoid fascia. The n we suspended the obiculoris oculi and the SMAS lateral to the nasoalar and com issura oris by 4-0 absorbable surtures. If necessary, we plicated the platysma near the anterior border of the detachment. Results We performe d rhytidectomy on 48 patients by extesive subcutaneous detachment and multiple S MAS suspension in the past two years. The results were satisfactory after 3-16 months follow -up. There were no serious complications (including injury of fa cial nerve and skin necrosis and severe bleeding which needed another operation to clean up the hematoma). The aesthetic results were lasting. Complications in cluded temporal hair loss in 3 cases, in which one patient accepted hair transpl antation, and in another two patients alopecia zone were incised and sutured pri marily. Two cases had scar hyperplasia behind the ear, who required revision. Tw o cases had temporary asymmetry which were given no treatment and recovered 3 mo nths after operation. Conclusion This procedure overcomes the s hortcoming caused by simple subcutaneous rhytidectomy, in which improvement is t emporary. The SMAS is well perserved to avoid the facial nerve injury, the most severe complication of rhytidectomy. Therefore, rhytidectomy by extensive subcu taneous detachment and multiple SMAS suspension is a simple and safe procedure w ith lasting aesthetic results.

Objective To explore the clinical technique and curative effect of tissue expansion in repairing soft tissue defects of eyelid.Methods Repair of eyelid defects with tissue expansion was performed in 21 patients(21 eyes)from Apr.2004 to Apr.2009,in whom there were 9 males and 12 females,aged 6-48 years(mean 29),in a course of 6 months to 23 years.Twelve defects were in upper eyelid and 9 in lower eyelid.The areas of eyelid scars ranged from 5mm?20mm to 30mm?50mm,and 10 patients were with ectropion of eyelid due to cicatrical contraction.Tissue expanders sized 30-100ml were implanted beneath the normal skin adjacent to lesions of eyelids,and normal saline solution was periodically injected for 3 to 4 months to slowly expand the overlying skin.Then the expanders were removed,and different sizes of adjacent expanded skin flaps were used with rotation to repair the eyelid defects and restore normal position of palpebral margins.Results Satisfactory wound healing was obtained in all the 21 patients with no complication.Sixteen patients were followed-up for 1 to 16 months(mean 10 months),in them the expanded flap survived nicely with acceptable cosmetic result,and the postoperative scar was not conspicuous.No recurrence of ectropion occurred except one with mild ectropion due to termination of expanding treatment by the patient.Conclusion Tissue expansion technique is a reconstructive option for eyelid defects.

Objective To investigate the ultrasonic and pathological features of porcine striped muscle injury from thermal and chemical factors respectively, and to analyze the limitation of ultrasound diagnosis given by doctors with different skill levels. Methods An experimental study using fresh porcine striped muscle in vitro was designed, where the injury were caused by microwave ablation (2 450 MHz) and Anhydrous acetic acid (99.8%) injection separately. Blind to pathologic results, the two-dimensiona sonograms taken from each model were analyzed by sonographers with different skill levels independently. Finally, the diagnoses were evaluated and compared among them. Results Two-dimensional sonograms showed distinct changes of the textures in both injury models, which was characterized as the disappearance of regular tissue structure. However, the corresponding histopathology revealed obvious differences between the two interventions on ultrasonograms. There was no statistical difference between chief physician and attending doctor (both of them had over 5-year experiences on skeletal muscle ultrasound ) in identifying the ultrasonic features of boundary, shape and muscle texture (Kappa=0.933, 0.845, 0.789;Kappa=0.790, 0.935, 0.865, all P<0.05). Compared with residents′diagnosis, there were signiifcant differences in identifying the ultrasonic features of echo level and muscle texture in both injury models:Echo level in thermal injury group:chief physician vs residents, Kappa=0.323;attending doctor vs residents, Kappa=0.297. Texture feature in thermal injury group:chief physician vs residents, Kappa=0.259;attending doctor vs residents, Kappa=0.112. Texture feature in chemical injury group:chief physician vsresidents, Kappa=0.253;attending doctor vs residents, Kappa=0.070. Conclusions Microwave ablation and Anhydrous acetic acid can cause different histopathologic changes in correspondence with various features on two-dimensional sonograms. But ultrasonographers with different skill levels leads to signiifcant variations in identiifcation and qualitative diagnosis, which is impossible to be quantitatively analyzed. Chief physician and attending doctor can draw a consistent conclusion and demonstrate the ultrasounic characteristics in porcine striped muscle injury model from thermal or chemical factors.

Objective To investigate the technical feasibility and clinical significance of non-vascular contrast-enhanced ultrasound(NVCEUS) in screening pyelogenie cyst out of simple renal cysts so as to avoid damage to the urinary tract from absolute ethanol while undergoing percutaneous aspiration and ethanol sclerotherapy(PAEST). Methods Following an inclusion criteria 23 patients with renal cysts were selected to receive NVCEUS scanning by means of administrating SonoVue contrast agents through puncture needle into their renal cyst lumen prior to the injection of absolute ethanol for sclerosing treatment. By the demonstration of hyperechoic contrast agents leaving from intra cyst into renal collecting system,a pyelogenic cyst was defined. The patients with this kind of cyst was not allowed for further ethanol sclerotherapy. Results NVCEUS made 3 patients with pyelogenic cyst resembling simple ones free from ethanol selerotherapy,and 4 patients suspicious of pyelogenic cyst due to weird cyst configuration remain in the list of simple cyst for further selerotherapy. Conclusions NVCEUS of renal cyst is highly capable of differentiating pyelogenie cyst from simple cyst and highly valuable in increasing the safety for the procedure of PAEST.

Objective To detect fat emboli in cardiac chamber of the patients undergoing total knee arthroplasty(TKA) by transesophageal echocardiography(TEE), and to discuss the relevant clinical value.Methods Eleven female patients with 12 osteoarthritis(OA) knees were underwent TKA. According to whether using tourniquet or not,12 knees were divided into 2 groups at random:tourniquet-related group (6 knees) and control group(6 knees). Echo intensity and ultrasonic characteristics of fat emboli in cardiac chamber were studied dynamically by multiplane TEE in various periods of the whole operation. Results All of the patients were implanted knee prostheses successfully. In different periods of TKA, fat emboli appeared as isoechoic or hyperechoic particles, which were found in right atrium, but nothing could be found in left heart. The imaging of the particles was flowing with duration time of 10～600s, like dots, lines, "moving star" or "shower". While femur expanding(0～3mins),the particles in right atrium and ventricle became more and more, and the echo intensity became significantly higher than those in other periods. After releasing tourniquet(0～5mins),most particles with highest echo intensity were observed in right heart,showing like "snowstorm" in tourniquet-related group, and more emboli were still detected at the end of monitoring (10 min after releasing tourniquet) by TEE,compared to the control group. No patient suffered from fat embolism syndrome(FES) with clinical manifestation. Conclusions Fat emboli in cardiac chamber can be observed sensitively by real-time TEE dynamically during TKA. It should be encouraged and promoted to analyze ultrasonic characteristics to facilitate the early detection, early diagnosis and early clinical intervention for the subclinical type of FES.

CD4 +CD25 +Foxp3 +regulatory T cells(Tregs)are essential for tumor immunosuppressive mi-croenvironment and secrete some inhibitory cytokines IL -10,IL-35,TGF-β1 and FGL2 which are key media-tors of Treg immunosuppressive function .Tregs have been shown to be important contributors to the tumor escape immunosurveillance and play a critical role in the induction of suppression to CD 4 +T,CD8 +T and NK cell,and suppression of specific anti -tumor immunity .Further research of the role of Tregs in tumor immunosuppressive microenvironment is important to understand malignant tumor pathogenetic and immunological therapeutics .In ad-dition,Tregs and inhibitory cytokines become more critical for clinical applications ,prognosis evaluation and ther-apies.

Objective To summarize the experience in treating coronary artery fistula (CAF) by using Guglielmi detachable coils. Methods During the period from July 2009 to November 2014 at the Affiliated Changhai Hospital of Second Military Medical University, interventional treatment of CAF by using Guglielmi detachable coils was performed in 40 patients. The clinical data were retrospectively analyzed. The feasibility, safety and effectiveness of this technique were evaluated. Results Successful transcatheter closure of CAF with Guglielmi detachable coils was achieved in all 40 patients; the average Guglielmi detachable coils used in each patient was(2.33±1.38) coils. No procedure-related complications occurred. Intra-operative angiography showed that residual shunt completely disappeared in 12 patients (30%) and blood flow was significantly decreased in 28 patients (70%). All the patients were followed up for 1-65 months, neither complications such as recurrent bleeding and ischemia nor stenosis and occlusion of related arteries, or fistula cavity rupture occurred. Conclusion The use of Guglielmi detachable coil in interventional treatment of CAF is safe and effective, although its long-term effect needs to be further verified.

Objective To evaluate the application effect of teaching-picture archiving and communication system (T-PACS) in training image reading ability of eight-year-program students. Methods Sixty students were divided into two groups: control group (applying traditional teaching method) and experimental group (applying traditional teaching method and T-PACS) when doing clinical medical image reading ability training. Making multimedia teaching movie, clinical image reading teaching and establishing image database by T-PACS were used in experiment group. Mean-while, reading room was set up and classroom teaching and problem-oriented assignments were in-creased. Finally objective evaluation of image recognition ability and questionnaire were used to compare the teaching effect. Measurement data were expressed as x±s. Total scores of image reading were am-alyzed by t test. Full score rates were analyzed by X2 test. Results The results showed that the score of medical image reading ability was higher in experimental group (90.08±4.52) than in control group (86.92±4.68) (P=0.010). There were differences in respiratory and orthopedic full score rate (P=0.006;P=0.035). Most students thought that application of T-PACS could effectively improve the teaching and learning quality. Conclusions Application of T-PACS can improve the medical image reading ability of eight-year-program medical students and is worth further promoting.