Objective To observe the therapeutic effect of minimally invasive evacuation of intracerebral hematoma in dog model of cerebral hemorrhage by using Purdy score, serum levels of neuron-specific-enolase (NSE) and numbers of perihematomal apoptotic cells. Method Twenty dogs were selected to prepoxe the model of cerebral hemorrhage, and they were randomly divided( random number) into minimally invasive treatment group and control group. Minimally invasive procedures were performed to evacuate the hematoma in minimally invasive treatment group in 6 hours after the models were established. The dogs of control group only received medical treatment. Purdy score and serum levels of neuron-specific-enolase were determined on 1,3,5,7 days after the evacuation of the hemotoma and apoptotic cells were counted after the dogs were sacrificed at 7 days after operation. All the results were compared with control group. Purdy score and serum levels of neuron-specific-enolase were compaired with variance analysis of repeated measurement design and apoptotic cells was compared with variance analysis of factorial design,the difference of the two groups showed with q test. P <0.01 showed the difference was significant. Results The Purdy scores in minimally invasive treatment group were 6.3 ± 1.702, 5.8 ± 1. 685,4.2 ± 1.762 and 4.1 ± 1.875 on 1,3,5 and 7 day after evacuation of the hematoma, significant difference was observed as compared with the control group(8.9 ± 1.632, 8.6± 1.342, 7.8±1.335, 7.9±1.468, P <0.01).The serum levels of neuron-specific-enolase were 0.632 ± 0.077, 0.721±0.771, 0.549±0.124 and 0.430 ±0.136 respectively in minimally invasive treatment group, while in the control group were 0.934 ± 0. 064, 0. 997 ±0.075, 0.986 ± 0.042, 0.874 ± 0.165, significant differences in serum levels of neuron-specific-enolase were found between the two groups(P < 0.01). The perihematomal apoptotic cells in minimally invasive treatment group(37.4 cells) was decreased significantly as compared with the control group(88.6 cells), with P < 0.01.Conclusions Minimally invasive procedures for evacuation of intracerbral hematoma might significantly reduce the neurological deficit score and decrease the serum neuron-specific enolase levels and numbers of apeptotic neurons.

Objective To evaluate left atrial function dynamic changes before and after radiofrequency catheter ablation (CA)with persistent atrial fibrillation (AF)and predict the maintain sinus rhythm of postoperative atrial fibrillation by speckle tracking imaging.Methods The study was including 45 cases underwent CA with persistent AF(preoperative 1 week,postoperative 24 hours,3 months,6 months)and 25 normal cases.Left atrial function and strain rate were analysed.These index were measured and calculated:the left atrial diameter index (LADI),left atrial area index (LAAI),left atrial maximum volume index (LAVImax)and left atrial ejection fraction(LAEF),left atrial wall strain rate of left ventricular systolie (SRs),left atrial wall strain rate of left ventricular early diastolie (SRe),left atrial systolic strain rate(SRa) and the average of left atrial wall each phase strain rate.Results ① LADI,LAAI,LAVImax were significantly increased;LAEF,SRs,SRe were decreased significantly;SRa were disappeared with AF compared with the control group.②LADI,LAAI,LAVImax decreased gradually,LAEF,SRs,SRe,SRa were gradually increased with the extension of the follow-up time.③Left atrial average SRs predicted maintenance of sinus rhythm with atrial fibrillation after operation of CA(odds ratio=0.607,95% CI=0.417-0.819,correction of P =0.017)was an independent predictor.Conclusions Speckle tracking imaging can quantitative evaluate left atrial function with persistent AF after CA.Left atrial global reservoir function predicts the efficacy of CA.

Secondary immune response is an important endogenous mechanism of neurological injury after ischemic stroke.Spleen and interferon-γγplay an important role in it.Monitoring the spleen size and the level of interferon-γγhave an important reference significance for the severity of stroke and outcome assessment.

Objective To analyze the influencing factors on AIDS-related deaths among HIV/AIDS patients in Guangzhou,Guangdong province.Methods A retrospective cohort was formed,based on available data of HIV/AIDS patients between 1991 and 2013 in Guangzhou,that were gathered from the Chinese AIDS Prevention and Control Information System.Cox proportional hazard model was used to identify the influencing factors for AIDS-related deaths.Results Data showed that factors as:existence of full-bloom AIDS when HIV infection was diagnosed (HR =2.717,95％ CI:2.039-3.621),diagnose of AIDS was made in the hospitals (HR=1.516,95％ CI:1.159-1.981),never received no CD4 count testing (HR=4.866,95％CI:3.674-6.444),no drugs were provided to those who met the criteria for treatment (HR=12.213,95％CI:8.467-17.616),and patients at aged ≥40 years when HIV infection was diagnosed etc.,were related to the risk for AIDS deaths.The risk of AIDS-related death was also high in those who did not meet the treatment criteria or receiving no treatment,when compared to those who had received the antiviral treatment (HR=1.936,95％ CI:1.145-3.272).Conclusion Factors as:earlier diagnosis of HIV/AIDS cases,provision of CD4 count testing and antiviral treatment to more cases etc,could decrease the risk for AIDS-related deaths and improve the survival rate on HIV/AIDS cases.

Objective To understand the human immunodeficiency virus (HIV) infection status and syphilis prevalence among men who have sex with men (MSM) receiving voluntary counseling and testing appointed through a web-based registering system and related factors.Methods The MSM receiving web appointed HIV counseling and testing from 2011 to 2012 in Guangzhou were recruited and a questionnaire survey was conduct among them to obtain the information about their demographic characteristics and sexual behavior.Binary and multivariate logistic regression model were used to identify the factors associated with HIV infection or syphilis prevalence.Results A total of 4 904 MSM were enrolled in the study,the average age of the MSM was (28.77 ± 7.24) years,and 70.3％ of them had high education level;the unmarried MSM accounted for 72.7％.The HIV infection rate and syphilis prevalence were 8.7％ and 4.4％ respectively.The co-infection rate of HIV and Treponema pallidum was 1.2％ (59/4 904).About one in three MSM did not use condom at latest homosexual behavior,43.5％ did not use condoms at each homosexual behavior in the past three months.Lower education level,occupation (worker or farmer),non-consistent condom use at each sex with men in the past three months,receiving HIV test or not and Treponema pallidum infection were associated with HIV infection.Age ≥40 years,lower education level,multi male sex partners in the past three months and HIV infection were associated with Treponema pallidum infection.Conclusion MSM receiving web appointed HIV counseling and testing had high prevalence of risk behaviors and high HIV infection rate,but had low previous HIV testing rate.It is necessary to strengthen the promotion of HIV test through web based appointment and conduct target behavior intervention in older MSM with lower education level.

Objective:To compare the efficacy of standardized incision and conventional incision for reduction and internal fixation of multiple rib fracture.Methods:A retrospective cohort study was conducted to analyze the clinical data of 192 patients with multiple rib fracture treated in 909th Hospital of Joint Logistics Support Force (Affiliated Dongnan Hospital of Xianmen University Medical College) from January 2020 to January 2022. There were 101 males and 91 females; aged 32-94 years [(51.5±16.6)years]. The patients underwent open reduction and internal fixation with nickel-titanium shape memory alloy embracer via standard incision such as anterior axillary longitudinal incision (standard incision group, n=96) or conventional incision such as posterolateral incision (conventional incision group, n=96). The incision length, operation time, intraoperative blood loss, number of fixed fractures, indwelling time of closed thoracic drainage tube, postoperative thoracic drainage volume, postoperative spontaneous ambulation time and length of hospital stay were compared in the two groups. The visual analogue scale (VAS) was used to evaluate pain at 1 month after operation. Postoperative complications were recorded. Results:All patients were followed up for 1-16 months [4.0(3.0, 10.5)months]. The operation time, intraoperative blood loss, indwelling time of closed thoracic drainage tube, postoperative thoracic drainage volume, postoperative spontaneous ambulation time, length of hospital stay and VAS at postoperative 1 month in standard incision group [(12.1±1.6)cm, (51.4±13.0)minutes, (191.5±16.8)ml, (2.8±0.6)days, (568.9±109.0)ml, (4.1±0.7)days, (11.4±1.7)days, (2.5±0.7)points] were better than those in conventional incision group [(13.7±1.9)cm, (62.0±8.8)minutes, (248.9±65.4)ml, (4.8±1.1)days, (655.9±121.9)ml, (5.2±0.9)days, (15.3± 1.7)days, (3.5±0.7)points] ( P<0.05 or 0.01). There was no statistical difference in the number of fixed fractures between standard incision group and conventional incision group (5.1±0.8 vs. 5.4±0.9) ( P>0.05). In standard incision group, there were 3 patients with poor wound healing, 5 with pulmonary infection, 3 with atelectasis and 3 with small pleural effusion. In conventional incision group, there were 11 patients with poor wound healing, 9 with pulmonary infection, 7 with atelectasis and 7 with small pleural effusion. The incidence of postoperative complications was 14.6% (14/96) in standard incision group and 35.4% (34/96) in conventional incision group ( P<0.01). Conclusion:For multiple rib fracture, standard incision is superior to conventional incision reduction in shortening the incision length, operation time, indwelling time of drainage tube, postoperative spontaneous ambulation time and length of hospital stay, reducing the intraoperative blood loss and postoperative thoracic drainage volume, alleviating the pain and reducing the postoperative complications.

Objective:To compare the clinical efficacy of extracorporeal membrane oxygenation (ECMO) and ventilation therapy in the treatment of severe blast lung injury.Methods:A retrospective cohort study was conducted to analyze the clinical data of 37 patients with severe blast lung injury admitted to 909th Hospital of Joint Logistics Support Force (Affiliated Dongnan Hospital of Xianmen University Medical College) from January 2000 to December 2021, including 23 males and 14 females; aged 26-50 years [(36.3±11.1)years]. The chest abbreviated injury score (AIS) was 3-5 points. In all, 16 patients were treated with ECMO from January 2017 to December 2021 (ECMO group) and 21 with ventilator from January 2000 to December 2016 (ventilator group). Blood gas analysis indexes [arterial pH, partial pressure of carbon dioxide (PaCO 2), partial pressure of oxygen (PaO 2), blood lactate (Lac)] and hemodynamics indexes [central venous pressure (CVP), cardiac output index (CI), pulmonary arterial systolic pressure (PASP), pulmonary capillary wedge pressure (PAWP)] were compared in the two groups at 30 minutes before treatment and at 2, 4, 6 hours after treatment. The mechanical ventilation time, ICU length of stay, acute physiology and chronic health evaluation II (APACHE II) score and mortality were measured at 7 days after treatment. Results:All patients were followed up for 24-48 months [(33.6±8.2)months]. The blood gas analysis and hemodynamic indexes were significantly improved in the two groups at 2, 4, 6 hours after treatment when compared with those at 30 minutes before treatment (all P<0.05), and the improvements were still statistically significant in ECMO group at 4, 6 hours after treatment when compared with those at 2 hours after treatment (all P<0.05), while not in ventilator group (all P>0.05). There was no significant difference in blood gas analysis indexes or hemodynamic indexes between the two groups at 30 minutes before treatment (all P>0.05). After treatment for 2, 4, 6 hours, blood gas analysis indexes and hemodynamic indexes in ECMO group were statistically different from those in ventilator group (all P<0.05). After treatment for 7 days, the mechanical ventilation time, ICU length of stay, APACHE II score and mortality were (3.2±1.2)days, (5.4±1.3)days, (14.1±3.3)points and 12.5% (2/16) in ECMO group, significantly different from (5.1±1.6)days, (7.6±1.6)days, (10.2±2.6)days and 28.6% (6/21) in ventilator group (all P<0.05). Conclusion:For severe blast lung injury, ECMO can attain rapid and continuous improvement of refractory hypoxemia and dyspnea, shorten the duration of mechanical ventilation and ICU length of stay and reduce the mortality rate when compared with ventilator therapy.

Objective: This article was to evaluate the applicability and feasibility of "Lingnanzhun" -an "Internet Plus-based HIV Self-testing Tool" targeting MSM in Guangzhou. Hopefully, the results could be used to improve the existing HIV testing services and to support the implementation and scale-up of HIV self-testing programs. Methods: Data were collected from a survey on HIV testing preferences among the Internet-using MSM in April to June, 2015. Univariate and multivariate logistic regression analysis were applied to identify factors associated with the use of HIV self-testing service provided by Lingnanzhun. Information related to the users of Lingnanzhun during September 2014 and December 2018 was also collected. Results: 769 MSM were recruited as participants. Of them, age distribution was 16-77(28.6±6.8) years old, 88.3%(679/769) were unmarried, 42.2%(325/769) were registered residents of Guangzhou, 82.1%(631/769) had university or college education. Among them, 195 (25.4%) used the HIV self- testing program of Lingnanzhun while 574 (74.6%) using the clinic service. Compared with the clinic service users, the Lingnanzhun users showed the following characteristics: longer experience in the MSM community ≥10 years (32.8% vs. 20.9%, 64/195 vs. 120/574); having male casual sexual partners ≥2 (42.1% vs. 29.6%, 82/195 vs. 170/574); having group sex (6.2% vs. 2.6%, 12/195 vs. 15/574) and having commercial sex with men (13.8% vs. 3.0%, 27/195 vs. 17/574). Data from the Lingnanzhun users showed that a total of 3 000 users had practised 5 038 times of self HIV-testings. 11.4% (343/3 000) of the Lingnanzhun users had never been tested. Conclusions It was applicable and feasible to provide Internet-based HIV self-testing service to MSM as a significant complement to the traditional facility-based HIV testing services. It was also useful in accessing those who were having higher risk or had never received HIV testing so as to increase the testing uptake and the frequency.

Objective: To analyze the characteristics of levels related to the risk through self-evaluation system, among MSM users in Guangzhou, between 2015 and 2017. Methods: Between 2015 and 2017, data was collected from the users of a self-evaluation system network related to HIV infection, based on the previous 'HIV health risk appraisal model’. Information on risk factors was collected to calculate the scores and levels of risks and to estimate the incidence of HIV. Taking the reference of R value on risks as (R=0.9-1.1) in general population. The ones with very low risk, with low risk, moderate risk, high risk and very high risk were set as R≤0.5, 0.5<R≤0.9, 0.9<R≤1.1, 1.1< R≤2.0 and R>2.0, respectively. The scores of modifiable risk factors were compared with different subgroups of MSM. Results: A total of 4 601 MSM were involved in this study, with the following features presented as: aged 16-64 (28.38±7.11) years, proportions of residence from Guangzhou, Guangdong province or other provinces as 38.6%(1 776/4 601)、35.4%(1 629/4 601) and 26.0%(1 197/4 601), 59.6%(2 742/4 601) received bachelor or above degrees. 81.3%(3 741/4 601) of them claimed as having homosexual orientation. R values of risk level on very low risk, low risk level, moderate risk, high risk and very high risk appeared as 12.9%(594/4 601), 50.9%(2 342/4 601), 17.0%(783/4 601), 14.8%(682/4 601) and 4.3%(200/4 601), respectively. Scores of modifiable risk factors decreased year by year (P<0.05), among MSM in this study. In either of the groups that experiencing insertive or receptive sex, the ones with heterosexual orientation presented the highest scores of modifiable risk factors (P<0.05). Conclusions The risk levels on HIV infections called for special attention among the users of the self-evaluation network system. Among the MSM that carrying either insertive or receptive sex role, the ones with heterosexual orientation had the highest risk levels and scores of modifiable risk factors in Guangzhou. Further study should be explored to better understand the causes of related risks.

Objective: To evaluate the effectiveness of the "Internet Plus-based AIDS Comprehensive Prevention Service System" among men who have sex with men in Guangzhou. Methods: Data through case-reporting and follow-up programs on MSM HIV/AIDS in Guangzhou was collected from the China Information System for Disease Control and Prevention, which including those from the referral and follow-up treatment compliance programs in 2008-2014 (pre-treatment) and 2017-2018 (post-treatment). According to the types of care services, three groups were set as: with "Internet Plus" service, with 'HIV counseling/testing service’ or with 'routine medical service’. General Estimating Equation (GEE) was used to analyze the follow up situation of HIV/AIDS cases, annually. Cox proportional hazard regression model was used to analyze the proportions of treatment referral, within the 30 days of diagnosis. Results: Before the implementation of immediate treatment after HIV diagnosis, 90.6% (707/780) of the HIV/AIDS cases received the first follow up program including the CD₄⁺ T cells counts (CD₄) test service within 90 days of diagnosis, in the "Internet Plus-based HIV/AIDS care service" group presented 1.19 times (95%CI: 1.14-1.25) of the routine medical service group. The implementation of immediate treatment after HIV diagnosis, compared with the routine medical service group, the "Internet Plus" service group presented 1.71 times (95%CI: 1.03- 2.83) more treatment referrals within the 30 days of diagnosis, when the first testing CD₄ was ≤200 cells/μl. Compared with the routine medical service group, the HIV counseling and testing service group showed 1.37 times (95%CI: 1.20-1.56) more of the treatment referrals within the 30 days of HIV diagnosis, after the first testing CD₄ counts as >200 cells/μl. Conclusion Standardized care and follow-up service should be promoted as soon as the referral and treatment programs were set after the diagnosis was made, under the "Internet Plus-based AIDS Comprehensive Prevention Service System" for the MSM population, in Guangzhou.