The outlook of people living with HIV (PLHIV) has changed for the better. With the discovery of effective drugs HIV is more like a chronic disease. The family doctor has several roles in HIV medicine: find, test, treat, and retain. Find - at risk individuals, and reduce their HIV risks. Test – to diagnosis those with acute HIV infection, to identify the asymptomatic patients, and to identify those with AIDS defining illnesses. Treat - participate in shared care management with HIV specialists. Retain – retain wellbeing of PLHIV - monitor for complications, provide patient education to help them minimise complications. Routine testing for HIV infection is now the practice. For treatment, A combination ART regimen consisting of two NRTIs + one active drug from one of the classes: NNRT, PI, INSTI, or a CCRS antagonist. Retaining the wellbeing of PLHIV requires monitoring for complications, and providing patient education to help them minimise complications.

Changhai hospital begins to practice resident standardization training.This article introduced the basic instance of it, analyzed and summarized the experiences and problems in the process.At last we give some advices to improve the job of resident standardization training.

BACKGROUND:Induced pluripotent stem cels and mesenchymal stem cels-derived microvesicles have been confirmed in various tissue repairs, which are expected to become more effective and safe therapy for articular cartilage repair. OBJECTIVE:To overal understand the research progress in the use of induced pluripotent stem cels and mesenchymal stem cels-derived microvesicles in articular cartilage repair. METHODS: A computer-based search of PubMed and CNKI was performed by the first author for articles related to stem cel treatment of osteoarthritis published from 2003 to 2015. The keywords were “articular cartilage injury, bone marrow mesenchymal stem cels” in English and Chinese, respectively. In the same field, articles published recently or in authorized journals were preferred. RESULTS AND CONCLUSION:Articular cartilage injury is stil a difficulty in the orthopedics. Many repair methods have been reported, but they al have limitations. Induced pluripotent stem cels and mesenchymal stem cels-derived microvesicles bring a new hope for patients with articular cartilage injury. However, there are stil many problems to be solved, such as extracting and purifying a large amount of cels, proliferation and differentiation potentials, and mechanism underlying cartilage repair.

Objective To investigate the protective effect of Gingko Biloba extract (GBE) on acute lung hemorrhage induced by Lipopolysaccharide(LPS) in newborn rats. Methods 1. Acute lung hemorrhage models were reproduced by intraperitoneal injection with LPS (5 mg/kg). 2. Thirty two rats were randomly divided into 4 groups,GBE groups (4 mg/kg,8 mg/kg, 16 mg/kg) and LPS group 5 mg/kg. Results In group LPS, extensive lung hemorrhage was observed after 4 hours of injection . TNF - ? iung content was obvious in LPS group. The expression of lung nuclear factor(NF-kB )immunohistochemistry wasobvious. While the parameters were obviously attenuated by GBE before LPS. Conclusion GBE may be useful in the treatment of acute pulmonary inflammatory disease.

A turbid solution was formed through the reaction between ?-PGA and cetylpyridinium chloride(CPC) and the turibidity was measured by using ultraviolet-visible spectroscopy at 680nm.The linearity between the concentration of ?-PGA and its absorbance,the stability,repeatability and recovery of the method were studied.Through the reaction of ?-PGA with CPC,a homogeneous turbid solution was formed.The turbid solution was stable in 3h under proper pH value and ion strength,the absorbance of the solution at 680nm had a good linear relationshi Pwith the concentration of ?-PGA in the range 12.5~50?g/ml(R2=0.9939).The recovery was within the range of 86%~99.75%(n=5).The relative standard division of the method for determining ?-PGA at the concentrations of 5,10 and 40?g/ml were 0.14%,0.23%和0.025% repeatability.The turbidmetric method has advantages of convenience,simplicity and good repeatability and can be used to control the quality of ?-PGA and its products.

Objective To investigate whether or not extracorporeal shock wave (ESW) treatment is safe for treating low back pain caused by lumbar facet joint degeneration by observing its effects on the lumbar segment of the spinal cord.Methods Five adult dogs were used for this study.ESWs were focused on their right L_(4～5) facet joints. The energy output was set at 40% of the maximum output,and a total of 1000 shocks were delivered at a frequency of 120/min.Before and 3 days after the treatment,the somatosensory evoked potentials (SEPs) induced by stimulating the tibial nerve were recorded from the animals' scalps,and the motor function of their hind limbs was evaluated with Tarlov's scale.The animals were then sacrificed and the L_(4～5) segments of their spinal cords were taken for histopatho- logical observation,with the T_(12) segments taken as controls.Results Three days after ESW treatment,the left and the right hind limbs scored 5 and 4 on the Tarlov scale.The amplitude of SEPs decreased and their latency increased. Histopathological observation showed mild swelling of the L_(4～5) segment of the spinal cord with congested veins on the surface.Erythrocyte and leukocyte exudation as well as myelin sheath swelling in the spinal cord were also observed un- der the microscope,but with no demyelination.Conclusion ESW had some adverse effects on the spinal cord when focused on the facet joint.Further studies of the safety range of ESW energy and distance are needed.

OBJECTIVETo observe the therapeutic effects of steel plate fixation after the failure of arthrodesis of ankle by screw fixation.

METHODSFrom August 2001 to October 2011, 15 patients were with steel plate fixation after failure of arthrodesis of ankle by screw fixation. Among patients, 9 cases were males and 6 cases were females,ranging age from 40 to 65 years old with the average of 56 years old. Ten cases were in left and 5 cases were in right. Screws were removed and steel plate was fixed intraoperatively, and plaster external fixation for postoperation. Clincal effect were evaluated according to AOFAS scoring system from pain, waliking ability and aligment before and after operation, and X-ray was used to evaluate joint fusion after operation.

RESULTSAll patients were followed up, and the duration ranged from 4 months to 4 years with an average of 2 years. The incison were healed in stage I. No ankle pain,injury of blood vessel and nerve,infection and farilure of internal fixation occuerred. The AOFAS score increased from 36.86 +/- 8.32 preoperatively to 85.09 +/- 4.65 (t = -26.366, P = 0.000).

CONCLUSIONSteel plate fixation after the failure of ankle arthrodesis of screw fixation has the advantages of rigid stability, simple manipulation and high success rate, less pain, perfect recovery.

Adult ; Aged ; Ankle Joint ; diagnostic imaging ; surgery ; Arthrodesis ; Bone Plates ; Bone Screws ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; instrumentation ; Humans ; Male ; Middle Aged ; Steel ; Tomography, X-Ray Computed ; Treatment Failure

Objective To study the influence of progesterone on the cell proliferation of hormone?dependent breast cancer and observe the co?effect of vitamin D and progesterone of different levels on the proliferation of the cell line T?47D in hormone?dependent breast cancer and the interaction be?tween vitamin D and progesterone. Methods The cultured T?47D cells were divided into the high and the low progesterone mono?treated groups to observe the effects of different levels of progesterone on the cell proliferation of hormone?dependent breast cancer cell line(T?47D). The high and the low vitamin D mono?treated groups were set to observe the effects of different levels of vitamin D on the cell proliferation. Groups treated by differ?ent levels of progesterone combined with vitamin D were set to observe the interaction between them. Normal breast cancer cells were set as the con?trol group. The two?factor two?level parallel factorial experiment was conducted to observe the co?effect of different levels of progesterone and vitamin D on the proliferation of T?47D. The growth and apoptosis of cells was observed through detection of absorbance in each group by MTT. Results The cell concentration in high and low progesterone treated groups was increased than that in the control group,and was increased in the low proges?terone treated group compared with the high progesterone treated group(P<0.05). The cell concentration in dual?low level treated group was de?creased than that in the other three groups which were two?factor treated and the control group(P<0.05). Conclusion Progesterone stimulates the cell proliferation of hormone?dependent breast cancer. The concentration?based interaction between vitamin D and progesterone indicates that the bi?directional effect of progesterone on breast cancer cells may be related to the concentration of progesterone and other factors,but the specific interac?tion and the mechanism is unclear.

Nerve root compression due to ligamentum flavum hematoma is extremely rare, with less than 70 cases reported in the literature. The clinical presentation and images were similar to those of spinal epidural tumors. Herein, we reported a previously healthy 64-year-old female who presented with right radicular leg pain. Neurological examination was consistent with right L5 root compression. The magnetic resonance imaging revealed a mass posterior to the L5 thecal sac, appearing as high intensity on T1-weighted and T2-weighted images. During operation, the dark hematoma within the ligamentum flavum was found. The pathological examination confirmed the diagnosis of hemorrhage. Her prognosis following surgery was excellent.
Sciatica

OBJECTIVETo investigate the clinical efficacy of Panlongqi tablet (Chinese characters) combined with lumbar facet joint release for lumbar spinal stenosis of type Fengshi Bizu (Chinese characters).

METHODSSince February 2012 to February 2013, 120 patients with lumbar spinal stenosis of Fengshi Bizu (Chinese characters) syndrome were retrospectively studied. According to different treatment methods, 120 patients with lumbar spinal stenosis were divided into Panlongqi tablet (Chinese characters)group and control groups, respectively. In Panlongqi tablet (Chinese characters)group, 60 patients were treated by Panlongqi tablet (Chinese characters) combined with lumbar facet joints release solution including 26 males and 34 females with an average age of (60.40±3.36) years old ranging from 46 to 65 ; the course of the disease was 2 to 15 years (averaged 7.6 years). In control group the other 60 patients were treated with lumbar facet joint release including 24 males and 36 females with an average age of (61.20±2.47) years old ranging from 48 to 63; the course was 3 to 14 years (averaged 6.9 years). The clinical effect of patients were evaluated by JOA and ODI score before treatment, at 4 weeks and 3 months after treatment.

RESULTSAll patients were followed up for 4 to 7 months (means 5.6 months). After 3 months,7 cases in control group recurrenced symptoms,only 1 case in Panlongqi tablet (Chinese characters) group recurrenced. At 4 weeks and 3 months of follow-up, ODI score and JOA score of Panlongqi tablet group were much better than those of the control group.

CONCLUSIONFor lumbar spinal stenosis of type Fengshi Bizu (Chinese characters),which were treated with lumbar facet joint release with Panlongqi tablet(Chinese characters), supplemented by back muscle exercise, in relieving waist and low back pain symptoms and improving functional status of lower lumbar spine, can obtain satisfactory clinical outcome, is a good method of conservative treatment for such diseases.

Aged ; Combined Modality Therapy ; Drugs, Chinese Herbal ; administration & dosage ; Exercise Therapy ; Female ; Humans ; Lumbosacral Region ; physiopathology ; Male ; Middle Aged ; Punctures ; Retrospective Studies ; Spinal Stenosis ; drug therapy ; physiopathology ; therapy