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

Objective To explore the association of Toll-like receptor 4 TLR4 and lipopolysaccharide receptor CD14 gene polymorphisms with Kawasaki disease (KD) susceptibility.Methods Three-color fluorescent staining flow-cytometry was used to detect the expression of TLR4 in peripheral blood white blood cell of 76 KD children and 118 healthy control group.The gene of TLR4 (-896A/G), (-1196C/T) and CD14 (-260C/T) polymorphisms was identified by polymerase chain reaction-restriction fragment length polymorphisms; and the relationship between genotype and KD was analyzed.Results 1.The values of mean fluorescence intensity (MFI) of TLR4 in peripheral blood white blood cell of the KD groups and the healthy control groups were 2.87?0.96, 10.55?4.87, 23.36?8.28 and 3.26?0.65, 7.55?1.21, 25.41?6.97, respectively; There was a gradual increase of these values on lymphocyte, neutrophilic leukocyte and mononuclear cell in both groups.2.(-896A/G), (-1196C/T) polymorphisms of TLR4 gene were not found in both groups.3.The frequency of each genotype of CD14 gene (-260C/T) was 35.5%CC, 30.3%CT, 34.2%TT in KD group and 38.1%CC, 47.5%CT, 14.4%TT in healthy control group.The frequency of each genotype was significantly different in 2 groups(?2=11.62 P

Objective To compare and quantify the determinants in quantitative electroencephalogram(q-EEG) and heart rate variability power spectrum analysis(HRV-PSA) of ketamme(KTM) anesthesia for preschoolers. Methods Seventy four cases were selected and assigned into 3 groups named A(4-5 years), B(5-6 years), C(6-7 years), 22,28,24 cases in every group respectively. All cases were induced with KTM 5 mg /kg intramuscularly and changes of determinants were recorded continuously. If body movement happened, KTM would be injected with 1 mg/kg. Results On pre- anesthesia, BIS in group A was the least among 3 groups, while LF/HF and HRVI were the largest(P

According to Chinese medicine, the atlantoaxial joint is a composite joint composed of tendons and bones, and the stability of the joint depends on the 'tendon-bone balance' involving tendons, ligaments, atlas and axis. Multiple causes of 'tendon off-position, joint subluxation' will lead to joint 'tendon-bone imbalance', which will evolve into atlantoaxial subluxation (AAS), endangering human health. Chinese therapeutic massage (tuina) is a very effective treatment for AAS in adults, but conventional manipulations are prone to ineffectiveness or accidents due to neglect of the causal relationship of the 'tendon-bone imbalance' and inappropriate manipulations. Compared with conventional manipulations, the rational choice of modified manipulations under the guidance of 'tendon-bone balance' theory is more effective and less risky, and more worthy of clinical promotion. From the 'tendon-bone balance' theory, we considered the shortcomings of conventional manipulations, and introduced several modified manipulations that have their own strengths in 'tendon smoothing' and 'bone setting', in order to provide new ideas for treatment of AAS in adults.