Objective To investigate and analyze structure of risk perceived by people using HIV voluntary counseling and testing services and related factors.Method Two hundred and sixty eight VCT users were selected from 2 CDCs and 2 hospitals in Beijing and their perceived risks in the process of VCT were assessed by using self-administered question- naires.Factor analysis was performed to understand the relationship between different perceived risks,and risks perceived by different users were evaluated.Results Six factors were obtained from the factor analysis which included:fear of priva- cy disclosure,embarrassment,concern over the reliability of HIV tests,cost & time consumption,the tragic outcomes of HIV positive tests,and potential medical expenditures in the future.And the risks perceived by low and high income users were much higher than those perceived by middle income users.Conclusion There are clear structure of risks perceived by people using HIV voluntary counseling and testing,and people with different incomes have different levels of perceived risks.

Animals ; Caspase 1 ; genetics ; metabolism ; Disease Models, Animal ; Female ; Flurothyl ; Gene Expression Regulation ; Hippocampus ; metabolism ; pathology ; Interleukin-18 ; genetics ; metabolism ; Interleukin-1beta ; genetics ; metabolism ; Male ; RNA, Messenger ; Rats ; Rats, Sprague-Dawley ; Reverse Transcriptase Polymerase Chain Reaction ; Seizures ; metabolism ; pathology ; Time Factors ; Up-Regulation

AIM: To explore the surgical methods and clinical effects on young patients with congenital lower eyelid entropion.
METHODS: There were 27 patients ( 45 cases ) who suffered congenital lower eyelid entropion accepted the modified blepharosphincterectomy. The clinical effects and complications were evaluated.
RESULTS: After followed up for 6mo, 42 eyes were fully recovered, 3 eyes were unsuccessful and the cure rate was 93%, 5 eyes suffered minor lower eyelid skin folds, none had lower eyelid retraction and ectropion.CONCLUSION: Modified blepharosphincterectomy is an ideal cosmetic surgical treatment for young patients with congenital lower eyelid entropion. It is an effective surgical treatment with fewer complications.

Objective To investigate clinical characteristics of the multi-center breast DCIS (ductal carcinoma in situ), in order to improve the rate of early diagnosis. Methods Clinical data of 23 multi-center breast DCIS patients admitted and operated on from September 2003 to February 2009 at our department were retrospectively reviewed. Results There were 4 cases associated with nipple discharge,and 18 cases with preoperative negative physical examination (78%). In the preoperative examination within 6 months, the positive rate of mammography was 90% mainly characterized by the existence of diffuse and multiple small calcifications. The positive rate of MRI was 25%, B ultrasound had no positive findings. The patients that were confirmed multi-center breast DCIS by intraoperative frozen section examination received mastectomy and ipsilateral axillary L1, L2 lymph node dissection. Conclusion The diffuse and multiple small calcification is one of early clinical characteristics of multi-center breast DCIS. Although the disease has a wide range of lesion, it still is an early tumor, and has a favourite prognosis after comprehensive treatment.

Objective This study describes the protective effect of myocardial isehemic post- conditioning on ischemic-reperfused myocardium (I/ R) of diabetic rat and its Signaling mechanism. Methods Healthy SD rats weighing 25O-30Og were divided into 6 groups; (1) Blank control; (2) Ischemia-reperfusion; (3) Post conditioning; (4) Diabetic postconditioning ; (5) Diabetic ischemia-reperfusion; ( 6) Diabetic blank control group. Ten rats in each group were randomly selected. Introduction of diabetic rat model: 65 mg/kg STZ was injected into the intraperitoneal cavity, until 2 consecutive blood glucose measurements≥ 16.65 mmol/L were reached after48h. The diabetic model was successful when rats had following symptoms, such as more drinking, more eating, polyuria, weight loss and epilation. Langendorff isolated rat heart perfusion was used for the experiment. Following parameters were measured and compared: Coronary perfusion flow, myocardial infarct size, western blot for measurement of P-Akt, changes in myocardium and mitochondrian observed by Electron microscopy. Results Blood glucose concentration in diabetic group was (23. 15±2. 16) mmol/L and (4. 16±0. 31) mmol/L in non-diabetic group. There was a significant difference (P <0. 01) between the two groups. There were more coronary flow in post-conditioning groups (Post group and Dpost group) than ischemia-reperfusion groups (IR group and DIR group) (6.5±1.2、5.6±1.0 vs. 3.4±1.0、2.0±1.3). The myocardial infarction size was smaller in post-conditioning groups than in ischemia-reperfusion groups (25.2±2.1、34.2±3.6 vs. 47.5±3.5 、65.2±4.5). There was more expression of P-Akt and the myocardial fibers and mitochondrian in post-conditioning groups were better preserved. Conclusion Postconditioning has protective effects in diabetic rat hearts. The mechanism may be associated with Akt activation.

The radiosensitivity of esophageal carcinoma is one of the bases for making dividualized treatment program.Predition of radiosensitivity before radiotherapy has become a hot spot of the current study.It has been demonstrated that radiosensitivity of esophageal carcinoma is correlated to p53 portein,bcl-2portein,human epidermal growth factor receptors (hEGFR),vascular endothelial growth factor (VEGF),hypoxia-inducible-factor-1 (HIF-1),cyclooxygenase-2(COX-2) and so on.Detection of these markers may be helpful for predicting the radiosensitivity of esophageal carcinonla and making optimal treatment program.In addition,radiosensitivity of tumor can be predicted according to radiation-induced esophagitis grade and endiscopic uhrasonography(EUS).

Objective To study cervical central group (VI region) lymph node metastasis with papillary thyroid microcarcinoma and correlative influencing factors.Methods Clinical data of 215 papillary thyroid microcarcinoma patients undergoing surgery between Jan 2007 and Jan 2011 were analyzed retrospectively.Results All patients accepted bilateral thyroidectomy and bilateral cervical central group lymph node dissection.The total incidence of cervical central group lymph node metastasis was 36.7％ (79/215).Factors relating to cervical central group lymph node metastasis rate were:age (with one year elder,the likelyhood of lymph node metastasis was 0.935 times lesser),gender (the ratio of female to male was 0.202),the number of foci and the sum of the diameters of all lesions.Conclusions Patients with papillary thyroid microcarcinoma may suffer from lymph node metastasis of the cervical central group,and lymph node metastasis rate increases significantly in young or male patients,and when the lesions were multifocal or the sum of the tumor diameter ＞ 0.5 cm.

Academic Inspection is not only an important part of clinical teaching,but also a vital tache of improvement for medical treatment quality.Unlike internal medicine and surgery,acdemic inspection of ICU has its own characteristics.PBL teaching method on acdemic inspection of attending doctor in ICU is explored in this article.

Objective To evaluate the effect of remifentanil pretreatment on myoclonus after etomidate injection.Methods Sixty patients undergoing scheduled for intestinal endoscopy under general anesthesia were divided into remifentanil group and control group by random digits table method with 30 cases each.Before 0.3 mg/kg etomidate was given,the patients in remifentanil group and control group were pretreated with remifentanil 0.5 μ g/kg or amount of 0.9％ sodium chloride.Myoclonus was observed and recorded.Nausea,pruritis and apnea were observed after procedures.Results The incidence of myoclonus was 73.3％(22/30) in control group,mild in 11 cases,moderate in 10 cases and severe in 1 case.The incidence of myoclonus was 6.7％(2/30) in remifentanil group and mild in 2 cases.There was significant difference in the incidence of myoclonus between two groups (P ＜ 0.01).In control group,the ratio of myoclonus was 14/16 in males and 8/14 in females.In remifentanil group,male and female each had 1 case of myoclonus.There was no nausea,pruritis and apnea in remifentanil group.Conclusion Pretreatment with 0.5 μ g/kg remifentanil reduces myoclonus after etomidate injection,male patients are more associated with the incidence of myoclonus than female patients.

Objective To investigate the role of early enteral nutrition on TLR 4 signaling pathway in rats with acute necrotizing pancreatitis (ANP).Methods Sixty SD rats were randomly divided into three groups:sham operation group ( SO group ) , total parenteral nutrition group ( TPN ) , early enteral nutrition group ( EEN ) .One day after ANP model induction , the serum level of amylase was measured .Nutrient solution was given for five days , then the rats were sacrificed , and the blood , pancreas and colon tissue were collected.The serum levels of IL-6, TNF-αwere detected by ELISA .Pathologic changes of pancreas were observed by HE staining.The intestinal TLR4, NF-κB expression was measured by Western blot .Results Mortality rates of SO group, TPN group, EEN group were 0, 50%, 25%, respectively; the serum levels of amylase were (744 ±41), (3 278 ±219), (2 227 ±169) U/L, respectively;the serum levels of TNF-αwere (81.57 ±18.25), (465.72 ±42.47), (223.21 ±29.94)ng/L, respectively; the serum levels of IL-6 were (362.83 ±41.32), (932.46 ±57.21), (628.62 ±142.24) ng/L, respectively; the pancreatic pathologic scores were (0.91 ±0.15), (11.1 ±0.61), (6.9 ±0.62);the intestinal TLR4 expressions were 0.7506 ± 0.003, 1.3404 ±0.004, 0.9544 ±0.004;the intestinal NF-κB expressions were 1.33 ±0.50, 6.92 ±1.06,2.93 ±0.89.The values of TPN and EEN group were significantly higher than those of SO group (P<0.05). The values of EEN group were significantly lower than those of TPN group (P<0.05).Conclusions EEN can inhibit TLR4 and NF-κB signal pathway in gut , then reduce IL-6 and TNF-αexpression and relieve inflammatory reaction of ANP , finally decrease the mortality of ANP .