Objective To understand the attitude of health workers towards people living with HIV and AIDS(PLWHA) and AIDS knowledge and desire for related training among them in selected hospitals in Beijing.Method Convenience sampling was used to select health workers from 32 hospitals of different levels in 4 districts within Beijing.Anonymous self-administrated questionnaires were used to collect the information regarding AIDS knowledge and desire for relevant training.Results A total of 1 292 health workers completed the questionnaire.They demonstrated a moderate level of general AIDS knowledge,but a low level of knowledge related to AIDS diagnosis and therapy.Of them 39.7% had received specialized AIDS training and 96% had strongly desire for such specialized training.Most health workers sympathized with PLWHA and understood their situation,while some of them were afraid of PLWHA and wanted to have minimal contact with PLWHA.91.3% of the health workers expressed that PLWHA should have the same rights to medical services.At the same time,49.2% of the health workers stated that they would not like to work in hospitals or departments which accepted PLWHA.80% of the health workers expressed concern over acquiring HIV infection in the workplace.52.7% of them thought that they had a risk of becoming infected in the workplace.Conclusion The level of AIDS knowledge among health workers in Beijing needs to be improved.Specialized training to enhance and develop health workers knowledge of prevention,diagnosis and treatment of AIDS is required.Most of the health workers do not discriminate against PLWHA,but they express concern over infection in the workplace.

Objective To investigate the morbidity,clinical feature,diagnosis and therapy of ovarian disease in children.Methods Eighty-two children with ovarian disease were admitted and treated in Nanjing children's hospital from Jan.1992 to Jan.2007,were analyzed retrospectively with age,emergency admissions or not,dwell,pathology and method of operation.Results The age of 82 patients ranged from 1 day to 14 years old and the mean age was 6.7 years old.Thirty-one cases(37.8%) were emergency admissions and 51 cases(62.2%) were routine admissions.Twenty-seven cases(32.9%) were rural patients and 55 cases(67.1%) were urban patients.Forty-five cases(54.8%) were nontumorous disorder,31 cases(37.8%) were benign tumor and only 6 cases(7.4%) were malignant tumor.About the morbidity,12 patients(14.6%)were admitted from 1992 to 1996,24 patients(29.5%) from 1997 to 2001 and 46 patients(55.9%) from 2002 to 2007.Chemotherapy were carried out in 6 cases with malignant tumor in internal medicine,2 cases with sexual precosity kept observation,the others were cured.Conclusions Ovarian disease can occur at any age in children.The clinical manifestation is characterized mainly by acute abdomen.The incidence of ovarian disease of children in urban areas is higher than that children in rural areas.The morbidity continues to show an upward tendency and the pathologic manifestations are mostly benign,laparoscopic operation has obviously superiority.

Objective To analyze the clinical features of pandrug-resistant Acinetobacter baumannii (PDR-Ab) in a hospital and compare the efficacy of different antibiotic treatments on patients with pneumonia caused by PDR-Ab.Methods Data were ret- rospectively collected from all isolated PDR-Ab strains in our hospital from February 2004 to March 2005.The clinical features and outcomes were reviewed.Results A total of 77 strains of PDR-Ab were collected, 45 of which were pathogens causing clini- cal infections (35 strains from lower respiratory tract, 6 from bloodstream, 3 from drainage fluid, and 1 from wounds).Lower respiratory tract was the most common source of PDR-Ab.More than 90% of the isolated PDR-Ab strains produced OXA-23 type?-lactamase.Cefoperazone-sulbactam plus minocyeline showed good efficacy for patients with PDR-Ab pneumonia.The total clinical cure rate was 68.4%.Bacterial eradication rate was 42.1%.The factors influencing bacterial clearance were pro- longed mechanical ventilation prior to positive culture (17.5 d vs 5.5 d).mixed infection (100% vs 12.5%) and lower GCS score (9.1?0.7 vs 13.2?2.1).Concomitant septic shock (OR=13.8) and APACHEⅡscore (OR=2.1) were independent factors of clinical outcome.Conclusions Nosocomial infections caused by PDR-Ab are not untreatable.Our analysis suggests that cefoperazone-sulbactam plus minocycline may be an effective treatment for lower respiratory tract infections caused by PDR-Ab in our hospital.

AlM:To investigate biological measurement parameters of anterior segment in acute angle- closure glaucoma ( AACG) .METHODS:Forty-six eyes of 46 patients with AACG and 52 eyes of 52 patients with shallow anterior chamber and 50 eyes of 50 normal individuals were examined. The parameters of anterior segment including chamber crowd rate (CCR), lens thickness (LT), lens position (LP) and anterior chamber depth ( ACD ) were measured by A-ultrasound according to different ages in each group. The data were performed statistical analysis in three groups.RESULTS: ln each age range group (≥50 ~ 59 years old, ≥60 ~ 69 years old, ≥70 years old ) , statistically significant differences in three groups ( AACG, shallow anterior chamber group and the controls ) were found in CCR, LT, LP, ACD (P<0. 01). There were statistically significant differences only in CCR (P<0. 01) but not in LT, LP and ACD ( P > 0. 05 ) between AACG and shallow anterior chamber group in each age range group.CONCLUSlON: CCR can be used as the index of evaluating crowding state of anterior segment in AACG patients and the sensitivity is better than LT and LP.

Objective To study the influence of sivelestat sodium on platelets activity,injury and count during cardiopulmonary bypass (CPB)in dogs.Methods Twelve adult health dogs were randomly divided into control group (group C,n=6)and sivelestat sodium group (group S,n=6). Sivelestat sodium at 15 mg/kg was administrated intravenously before the establishment of CPB and then was maintained intravenously at 10 mg·kg-1·h-1 to the end of CPB in the group S,and the same volume of saline was used in the group S.The levels of neutrophil elastase (NE),malondialdehyde (MDA),granular membrane protein-140 (GMP-140),thromboxaneB2 (TXB2 ),the count of plate-lets and the hematocrit (Hct)were measured before CPB,15 and 45 min after cross-clamping and 30, and 60 min after aortic unclamping in both groups.Results The levels of NE,GMP-140,TXB2 at T2-T5 and MDA at T3-T5 were significantly higher than those at T1 in both groups;moreover the lev-els were significantly lower in group S than group C (P<0.05).The levels of Plt at T2-T5 were sig-nificantly lower than those at T1 in both groups;moreover the levels were significantly higher in group S than group C (P <0.05).Conclusion Sivelestat sodium reduced the levels of plasma NE, MDA,GMP-140,TXB2 inhibited the activation of Plt,and decreased the injury and consumption of Plt,which presents the protective effects for Plt during CPB.

Aged ; Aged, 80 and over ; Humans ; Kidney Diseases ; diagnosis ; etiology ; Male ; Middle Aged ; Nephelometry and Turbidimetry ; Pneumoconiosis ; complications ; Pulmonary Disease, Chronic Obstructive ; complications ; Retinol-Binding Proteins ; urine

OBJECTIVETo study the necessity, feasibility, security of carotid angioplasty and stenting (CAS) for symptomatic carotid stenosis combined with kinking.

METHODSTwelve patients with symptomatic carotid stenosis and kinking demonstrated by digital subtraction angiography (DSA) received CAS from December 2003 to December 2009. There were 9 male and 3 female patients, age ranged from 59 to 77 years (mean 69.3 years). All the patients' clinical, imaging, intervention and follow up data were collected and analyzed.

RESULTSAll CAS procedures were successfully performed with 14 self-expandable stents placed. The mean degree of stenosis was reduced from 85.6% before stenting to 11.2% after stenting, the angle of kinking, according to Metz' category, were improved from less than 90° to more than 120° in each case. No perioperative procedure related stroke and transient ischemic attack (TIA) occurred. The clinical symptoms and signs of cerebral ischemia were improved or disappeared for all patients. During follow-up of these 12 patients for 6 to 72 months, one patient experienced ipsilateral carotid territory TIA and another patient experienced contralateral carotid territory TIA. DSA follow up of 5 patients demonstrated 1 case with in-stent restenosis and arterial kinking remote to the stent of internal carotid artery. CAS were performed again and CT angiography follow up demonstrated no kinking and restenosis 2 years after the intervention. Duplex scan of the other 7 patients demonstrated neither kinking nor restenosis.

CONCLUSIONSCAS seems to be feasible and safe for the patients with symptomatic kinking and stenosis, and maybe helpful to lower the risk of cerebral ischemia, but further study is needed.

Aged ; Angioplasty, Balloon ; methods ; Carotid Stenosis ; surgery ; Feasibility Studies ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Stents ; Treatment Outcome

BACKGROUND: Total knee arthroplasty is a procedure for treatment of knee osteoarthritisa with standardized, mature technology and affirmative efficacy. Total knee arthroplasty can result in overt excessive bleeding, decreased hemoglobin levels, patient mouth infection and other complications. As a new technology, autologous blood transfusion device can effectively reduce the rate of blood transfusion through reinfusing the unwashed and filterable drainage blood after operation. Up to now, no systematic reviews incorporating meta-analyses have found directly sufficient evidence to compare autologous blood transfusion drainage and no drainage after primary total knee arthroplasty. OBJECTIVE: To study the clinical efficacy, safety and potential advantages of the application of autologous blood transfusion device/no drainage based on the meta-analysis. METHODS:PubMed, Embase, the Cochrane Library, CBMdisc, China HowNet, VIP, Wanfang database were searched comprehensively by computer. The search strategies were developed by the way of MeSH terms combining with free words: “total knee replacement” OR “total knee arthroplasty” OR “total knee prosthesis” OR “unicompartmental” OR “unicondylar” OR “unicompartmenta” OR “arthroplasty, replacement, knee” [MeSH terms] AND “autologous blood transfusion” OR “Autotransfusion” OR “blood transfusion, autologous” [MeSH Terms] OR “Intraoperative Blood Salvage” OR “Intraoperative Blood” OR “Postoperative Blood Salvage” OR “Intraoperative Blood Cel Salvage” OR “Operative Blood Salvage” [MeSH Terms]. Data included in the final literature were analyzed using RevMan 5.3.5 software recommended by Cochrane. The main outcome measure was the rate of transfusion. The secondary outcome measures were the average change in hemoglobin, hemoglobin levels at the 3rd day, hospitalization time and intraoperative mouth infection rate. RESULTS AND CONCLUSION:Five randomized controlled trials, a total of 667 patients were enroled. Meta-analysis results showed that there were no significant differences in the transfusion rate (OR=0.73, 95%CI: 0.47-1.13;Z=1.41,P=0.16), average change in hemoglobin (WMD=0.20, 95%CI:-0.28-0.68;Z=0.82,P=0.41), the hemoglobin levels at the 3rdday (WMD=0.41, 95%CI:-0.26-1.09;Z=1.20,P=0.23), hospitalization time (OR=1.01, 95%CI: 0.06-16.27;Z= 0.01,P=1.00), intraoperative mouth infection rate (OR=1.01, 95%CI: 0.06-16.27;Z=0.01,P=1.00) between the postoperative use of autologous blood transfusion and no drainage. These results suggest that the meta-analysis of outcome measures has not provided the evidence-based medical support for the clinical efficacy of autologous blood transfusion device (including blood transfusion rate, the average change in hemoglobin, average hemoglobin change at the 3rd day, hospitalization time). Given the inherent limitations of the quality of the included studies and the publication bias, future high-quality, large-volume, multi-center randomized controled trials are awaited to confirm and update the findings of this analysis.

Objective To assess the clinical efficiency , safety and potential advantages of autologous blood transfusion (ABT) drains compared with the closed-suction/no drainage. Methods Pubmed, Embase, Cochrane Library, CBMdisc, CNKI, VIP and WANGFANG were searched comprehensively. The statistical anal-ysis was conducted by using the Cochrane Collaboration review Manager 5.3.5. Results The pooled data of seventeen RCTs including a total of 1 993 patients showed that the patients in the ABT drainage group might benefit from the low rate of blood transfusion [ 16 . 59% and 37 . 47%, OR: 0 . 28 ( 0 . 14 ~ 0 . 55 ); 13 . 05% and 16.91%, OR: 0.73 (0.47 ~ 1.13), respectively]. The ABT drainage and the closed-suction drainage/no drainage have the similar clinical efficiency and safety length of hospital stay and wound infection on days 3 post-operative haemoglobin. Conclusion This systematic review provides the evidence that the ABT drainage offers a safe and efficient alternative to CS/no drainage with the lowered blood transfusion rate.

ObjectiveTo study the situation of grasping knowledge on Cardiopulmonary Resuscitation ( CPR ) among the medical undergraduate interns before going to the clinic.MethodsEighty-five interns enrolled in 2011 were investigated by theory and skill exams to evaluate the cognition level on CPR and the survey results were analyzed by x2.ResultsThe average correct rate of the whole interns' theory and skill was only 44.8％.Theory exams of the clinical group performed better than non-clinical group (x2=8.57,P＜ 0.01 ).There was also no statistically significant difference between the clinical group and the non-clinical group about the average correct rate of the skill (x2=2.72,P＞0.05 )as well as between the female group and the male group (x2=0.03,P＞0.05 ).ConclusionThe medical undergraduate interns'theory and skill of CPR were generally poor,they should be trained before internship.