Objective To evaluate the usefulness of real-time three-dimensional transesophageal echocardiography (RT-3D TEE) in the perventricular device occlusion of the ventricular septal defect (VSD).Methods Sixty patients underwent perventricular device occlusion of VSD were divided into two groups.Group A:30 patients,3D images of VSD were obtained intraoperatively by RT-3D TEE.3D images were analyzed and the maximal and minimum area and maximal diameter of VSD were measured in the cardiac cycle.The size of selected VSD occluder was the diameter calculated from the maximal area based on the formula πD2/4 and plus 1～2 mm.Simultaneously,two dimensional transesophageal echocardiography (2D TEE) images of VSD were obtained and measured on standard views.Group B:other 30 patients,intraoperative 2D TEE was performed to measure the diameter of VSD on standard views.The selection VSD occluder was based on the maximal diameter plus 1～2 mm.Results The VSDs shape showed oval,class round and irregular by RT-3D TEE imaging.There was a significant difference between the maximal area and smallest area of VSD appeared in the cardiac cycle obtained by RT-3D TEE (P<0.01).There was a significant difference between the maximal diameter by measurement of RT-3D TEE and 2D TEE (P<0.01).Of all 30 patients with evaluation of VSD size based on the RT-3D TEE,1.1 times attempts of device occlusion were performed on one patient (33/30).Of the other 30 cases with evaluation of VSD size by 2D TEE,2 cases were failed with device occlusion because of instant residual shunt.Of the remaining 28 cases,1.43 attempts of device occlusion were performed on one patient (40/28).Conclusions RT-3D TEE can accurately reveal the size of VSD,and aid in the selection of VSD occluder in the device occluding procedure of VSD.

OBJECTIVETo introduce a new procedure of laparoscopic adrenal surgery.

METHODSThirty patients with adrenal disease underwent surgery by a 70 degrees lateral decubital trans-abdominal laparoscopic approach, which wa compared with 30 degrees decubital laparoscopic operation in 26 patients.

RESULTSThe procedure is superior to open laparotomy. There was significant difference in average operative time (77.2 min vs. 215.7 min), blood lost volume (27.0 ml vs. 94.5 ml), and postoperative complications (13.3% vs. 46.0%). Postoperative feeding time and hospitalization time were shortened markedly.

CONCLUSIONSThis modified technique is safe, straightforward, with a good anatomic view during operation. It could be widely adopted for the treatment of benign adrenal disease, especially pheochromocytoma.

Adrenal Gland Diseases ; surgery ; Adrenalectomy ; methods ; Female ; Humans ; Intraoperative Complications ; prevention & control ; Laparoscopy ; methods ; Male ; Postoperative Complications ; prevention & control ; Posture ; Treatment Outcome

We compared the RT-LAMP,LAMP and L-J for detecting MTB to provide the rapid diagnosis method for tu-berculosis.In this assay,NTM and other common respiratory bacteria were used to detect specificity,Mycobacterium tubercu-losis specific products were identified by restriction enzyme digestion.To detect sensitivity,we used RT-LAMP,LAMP and L-J to detect 100 cases sputum specimens from patients with tuberculosis and 22 cases control sputum specimens,the 10 times dilution of 1 ng/μL H37Rv standard strains was used to detect RT-LAMP limit.The results showed that the positive rate of RT-LAMP,LAMP and L-J were 100%,92%,88%.RT-LAMP and L-J,RT-LAMP and LAMP were statistically signifi-cant,RT-LAMP had 10 times higher sensitivity than LAMP,RT-LAMP not only to identify viable but also capable of detec-ting a single copy of MTB.So RT-LAMP is superior to LAMP and L-J and is practical for use in primary medical care institu-tion or peripheral laboratory.

OBJECTIVETo investigate drug resistance status in patients with highly active antiretroviral therapy (HAART) in Shandong province.

METHODSA total of 758 patients were separated from the anticoagulatory whole blood during May and October in 2011. The entire protease gene and part of the reverse transcriptase gene were amplified by RT-PCR and nest-PCR in the samples with viral load larger than 1000 copies/ml, then sequenced the gene fragments. Mutation of drug resistant gene and drug susceptibility was analyzed by the online tool HIV db program developed by Stanford University.

RESULTSThe rate of virologic failure in patients was 9.1% (69/758). A total of 53 gene sequences that acquired were used for genotypic resistance analysis. A total of 23 patients were indicated drug resistance with the total of 3.1% (23/742). Drug resistance rates of nucleotide reverse transcriptase inhibitor (NRTI) and non-NRTI(NNRTI) were 2.4% (18/742) and 3.0% (22/742), respectively, and the primary mutation types of drug resistance were M184V and Y181C for NRTI and NNRTI, with no resistance to protease inhibitor (PI). In the 23 patients indicated drug resistance, 78.3% (18/23) were NRTI resistance, 95.7% (22/23) were NNRTI resistance and 73.9% (17/23) dual NRTI and NNRTI resistance.

CONCLUSIONThe presence of drug resistant gene in HIV strains among AIDS patients with HAART in Shandong province was at low level, but mutation diversity was found in drug resistant gene.

Acquired Immunodeficiency Syndrome ; drug therapy ; virology ; Adolescent ; Adult ; Aged ; Antiretroviral Therapy, Highly Active ; Drug Resistance, Viral ; genetics ; Female ; Genes, Viral ; Genotype ; HIV-1 ; drug effects ; genetics ; Humans ; Male ; Middle Aged ; Mutation ; Sequence Analysis ; Viral Load ; Young Adult

AIMTo explore the changes of epidermal growth factor (EGF) and epidermal growth factor receptor (EGFR) expressions in cryptorchid children and their clinical significance.

METHODSThe level of serum EGF was measured by radioimmunoassay (RIA) and the expression of EGFR by immunohistochemistry.

RESULTS(1) The level of serum EGF was significantly lower in cryptorchid children than in normal subjects at age group of 5-9 years (P<0.01) and 10-14 years (P<0.01), (2) The level of EGF was significantly lower in boys with impalpable testis than in those with extracanalicular and intracanalicular testes (P<0.01), (3) The serum EGF level increased significantly 6 months after orchiopexy (P<0.05), (4) The EGFR expression in testicular Leydig's cells was lower in 2 approximately 4 year-old boys than in those over 5 years (P<0.05) and (5) the EGFR expression was less positive in the impalpable group and the intracanalicular group than that of the extracanalicular group (P<0.01).

CONCLUSIONThe EGF and EGFR expressions may correlate with the age and the position of testes; orchiopexy improves the EGF and EGFR expressions in cryptorchid boys.

Adolescent ; Aging ; Biomarkers ; analysis ; Child ; Child, Preschool ; Cryptorchidism ; blood ; metabolism ; pathology ; Epidermal Growth Factor ; blood ; metabolism ; Humans ; Immunohistochemistry ; Leydig Cells ; metabolism ; pathology ; Male ; Receptor, Epidermal Growth Factor ; blood ; metabolism

Objective To assess the laparoscopic technique combined with open surgical technique in pyeloplasty.Methods Overall,45 patients with ureteropelvic junction obstruction underwent laparo- scopic dissection of the renal pelvis and upper ureter transperitoneally,and pyeloplasty was performed through a expanded trocar-incision(extension of 1-2 cm)as open surgery was performed.Results The opera- tion was successful in all 45 patients.The mean operative time was 58 min(range,40-85 min),and the mean blood loss was 22 ml(range,15-30 ml).No complication was observed during and after operation. Follow-up for 3-36 months was available in 34 patients.Intravenous urography(IVU)showed no obstruc- tion of the anastomotic stoma,and B-ultrasound indicated relief of hydronephrosis.Conclusions Laparo- scopic approach combined with open surgery in pyeloplasty is an effective way to treat ureteropelvic junction obstruction.This technique can simplify the operative manipulation and shorten the operative time without more trauma to the patients.It is worth general application in clinical practice.

Objective To study the prevalence of smoking and its influential factors among pupils in Shandong.Methods A multi-stage stratified-cluster random sampling method was used in the survey.6050 students from 3 different cities of Shandong province were selected as the study population.A self-administered anonymous questionnaire was designed and the survey was conducted by trained investigators.Results The rate of attempting smoking among pupils under study in Shandong province was 6.0％ while the current smoking rate was 1.2％.The average age of children who initiated smoking cigarette was 7.8 ± 2.1 with 80.5％ of them due to curiosity.34.7％ of them got the cigarettes from their families.In terms of the motivation of buying cigarettes,74.3％ of them claimed that the access to purchase was easy.Data from multivariate unconditional logistic regression analysis showed that the smoking behavior of pupils was influenced by their familial or surrounding environments.Conclusion Tobacco control programs on pupils should be strengthened with more powerful control measures including health education.

Animals ; Carbon Tetrachloride ; adverse effects ; Chemical and Drug Induced Liver Injury, Chronic ; prevention & control ; Chronic Disease ; Granulocyte Colony-Stimulating Factor ; therapeutic use ; Mice ; Mice, Inbred BALB C

Aged ; Humans ; Laparoscopy ; methods ; Male ; Middle Aged ; Prostatectomy ; methods ; Prostatic Neoplasms ; surgery

OBJECTIVEThis study was to investigate the condom use and its factors on sex workers in Shandong province, and to provide effective suggestions for AIDS prevention strategies and interventions.

METHODSFrom April to July in 2009, 4732 female sex workers were investigated through anonymous questionnaires from 11 cities which were selected based on the AIDS epidemic, geographic location, economic conditions in Shandong province. Serum samples were collected and antibodies were tested by ELISA and TPPA from 4641 people.

RESULTS4732 female sex workers who were 15 - 58 years old were investigated and the majority belonged to the low age group (≤ 24 years old) which accounted for 61.5% (2912/4732). Among the 4732 female sex workers, the unmarried, the divorced, or the widowed females accounted for 72.8% (3441/4725) and 72.0% (3403/4726) of them were poorly educated.42.3% (1994/4719) of them were found from other provinces. The right answers for knowledge of AIDS accounted for 45.7% (2164/4732). 80.6% (3416/4236) of these females were found to used condoms in the most recent commercial sex activity. The rate of consistently using condoms in sex activity during the last month was 58.4% (2467/4221). In this survey, 7.3% (337/4637) of investigated females had been diagnosed with sexually transmitted diseases, 30.7% (1449/4726) of them had received HIV antibody test, 70.4% (3323/4732) of these people had received the AIDS intervention services, and 3.6% (167/4668) of them had ever used drug. Multivariate logistic regression analysis showed that high education level (junior high school or lower vs senior high school or higher, adjusted OR = 0.77, 95%CI: 0.67 - 0.90), having received the HIV intervention (received vs unreceived, adjusted OR = 1.36, 95%CI: 1.17 - 1.58), antibody detection (done vs not done, adjusted OR = 1.33, 95%CI: 1.15 - 1.55), and good knowledge about AIDS (low score group vs high score group, adjusted OR = 0.37, 95%CI: 0.32 - 0.44) were independent factors that increased safe sex behavior; while using drug (drug vs not drug, adjusted OR = 0.22, 95%CI: 0.15 - 0.31) was a negative factor.

CONCLUSIONThe prevalence rate of HIV infection among female sex workers was low in Shandong province. However, the low rate of condom use and the high prevalence of self-reported STD-related symptoms suggested that more attentions should be paid to the factors of risk behaviors, and more targeted interventions are critically needed.

Acquired Immunodeficiency Syndrome ; prevention & control ; Adolescent ; Adult ; China ; Condoms ; utilization ; Female ; Humans ; Middle Aged ; Population Surveillance ; Prevalence ; Safe Sex ; statistics & numerical data ; Sex Workers ; statistics & numerical data ; Sexually Transmitted Diseases ; prevention & control ; Surveys and Questionnaires ; Young Adult