Objective To discuss the security of negative HBsAg blood by correlation analysis between 5 markers of hepatitis B and HBV-DNA among blood donors with HBsAg negative.Methods 5 markers of hepatitis B were detected by ELISA and HBV-DNA by real-time PCR.Results In 3 398 samples of negative HBsAg blood donors,the total positive rate of HBV-DNA was 2.73%.Among them,the type series of HBsAb(+),HBcAb(+)account 6.59%,the positive rate of HBV-DNA was 5.80%;the type series of HBsAb(+),HBeAb(+),HBcAb(+)account 4.74%,the positive rate of HBV-DNA was 6.83%;the type series of HBcAb(+)alone account 6.24%,the positive rate of HBV-DNA was 5.19%;the type series of HBeAb(+),HBcAb(+)account 5.86%,the positive rate of HBV-DNA was 4.52%;the type series of HBsAb(+)alone account 31.99%,the positive rate of HBV-DNA was 1.56%;the type series of entire negative results account 44.59%,the positive rate of HBV-DNA was 2.11%.Conclusions Blood donors with negative HBsAg still have the risk of infecting HBV,especially when HBcAb is positive alone,or combining with other positive markers such as HBsAb,HBeAb,latent transfusion'infection,the risk was remarkably increased.As a result,we should detect the other markers of hepatitis B simultaneously and carry out real-time PCR technique to screen blood in order to reduce infection rate arising from transfusion.

Objective To explore the causing factors of radiocontrast-induced nephropathy (RCIN) after coronary angiography and the rule of hydratation.Methods 279 cases of coronary angiography were retrospectively analyzed,and the clinical features,basic renal function and volume of intra-venous fluid received on operation day between the patients with and without RCIN were compared.Results The total mortality rates of radiocontrast-induced nephropathy were 6.81%(19/279);in patients with hypertension,the RCIN rates were 8.65%(16/185);in patients with diabetic,the RCIN rates were 12.1%(12/99);in patients with preexisting renal dysfunction,the RCIN rate was 0%(0/16);the multifactor Logistic analysis showed that the factors causing RCIN were age,diabetic,the volume of intra-venous fluid,however,the factors such as gender,smoking,hypertension,coronary heart disease,chronic renal failure were irrelative with RCIN.Conclusion The incidence of RCIN in people over 60 years old is much higher.Such condition may be partly cansed by the decreasing renal reserve capacity.Sufficient hydration is an effective way to decrease RCIN.

Objective To investigate the value of ultrasound-guided core needle biopsy in diagnosing precancerous lesions of breast cancer.Methods Totally 605 cases were enrolled.Ultrasound characteristics were recorded.The pathological diagnosis on ultrasound-guided core needle biopsy was compared with the findings of the excisional biopsy and follow-up results.Results In all of the 605 cases,3 cases were failed on ultrasound-guided core needle biopsy because of less biopsied tissue.The accuracy of ultrasound-guided core needle biopsy was 97.84％ (589/602),the Kappa value was 0.96 (P=0.01).In biopsy,42 cases were precancerous lesions of breast cancer,and divided into according group (n=32) and upgrading group (n=10) according to surgical pathology or follow-up results.The rate of underestimation was 23.81 ％ (10/ 42).Compared to according group,microcalcification,acoustic attenuation,rich vascular and suspicious axillary lymph nodes had statistical difference in upgrading group (all P＜0.05).Conclusion Ultrasound-guided core needle biopsy is ac curate in the diagnosis of breast neoplasm,however,ultrasound-guided core needle biopsy diagnosis of precancerous lesions are partly underestimated.To some degree,ultrasound characteristics of precancerous lesions of breast cancer could predict the underestimation.

Objective To study the advantages and summerize the practice of laparoscopic appendectomy (LA) for elderly patients. Methods Forty one elderly patients with appendicitis aged from 60 to 76 were treated with LA. The operative procedure, surgical indications, recovery, postoperative pain, and complications, as well as the period and the cost for hospitalizing were studied. Results All 41 patients were comfirmed appendicitis through LA. Thirty nine patients undergone LA were operated smoothly. Only two patients were cured with exploratory laparotomy. The preoperative diagnosis was confirmed in 6 patients and the complication of other diseases were found in 5 cases by LA. Two cases were operated by abdominal incision during LA. Postoperative complications, such as infection of the incision and pain were less occurred. The concurred diseases with appendicitis need simple treating. The hospitalizing period was 4 days on the average and the cost was 20%～30% higher than other procedures. Conclusions Most of elderly patients can be early diagnosed and timely treated by LA. LA could be a more popular choice for the elderly patients with appendicitis since its advantages of safe and minimal invasion. It has been an outstandihg method in treating appendicitis compared to other traditional methods.

Objective To study the results of an improved method of laparoscopic treatment of inguinal hernia in children. Methods Between January 1999and October 2003,94 inguinal hernias in 86 children between 2～14 years of age were treated by laparoscopic surgery using a single trocar hole. 54 children showed a right inguinal hernia, 32 a left hernia,and 8 cases presented bilateral hernias. Of the unitaleral hernias, 10 were occult hernias. All the patients were treated by purse-string suture around the internal ring under direct vision with laparoscopy. Results Operative time was from 10-30(average 16) minutes. There were no intra-or post-operative complications. All were followed up for 4-60 months, with no recurrences . Conclusions This method of laparoscopic hernia repair is less traumatic, postoperative recovery is fast and stitch removal is not necessary. It can also be used for the treatment of occult and bilateral inguinal hernias.

Objective To explore effects of Naikan cognitive therapy on improving clinical symptoms in patients with convalescent schizophrenia. Methods The 69 convalescent schizophrenic patients with convalescent clinical state were consecutively recruited. All the patients were divided into Naikan cognitive therapy ( NCT) group an control group at random and were pretreated with antipsychotic agent therapy. In NCT group,the patients received NCT for successive 7 days. In control group,the patients only received antipsychotic agent therapy. Pre-and post-treatment positive and negative syndrome scale( PANSS) , Nurses'observation scale for inpatient evaluation (NOSIE) were administered to all subjects. Results ① A significant decrease occurred in PANSS total score, negative symptom score, positive symptom score, compound scale score, general psychopathology score, reaction retardation score and paranoid score in NCT group ( t = 2. 672～7. 370, P < 0. 05). In the post-treatment, PANSS total score, negative symptom score, positive symptom score, compound scale score, reaction retardation score and thought disorder score were significantly lower in NCT group than those in control group ( t ' = 2. 696, P = 0. 009; t = 5. 186, P=0.000; t = 3.757, P = 0.001; t = 2.634,P = 0.011; t ' =2.376, P = 0.021). ②A significant decrease occurred in NOSIE total negative score( 10.43 ± 9. 24 vs 13. 87 ± 8. 03, t = 3. 463 , P = 0. 002) , irritation score(3. 13 ±0.43 vs8.53 ±4.98, t = 6. 139, P=0.000) and retardation score(1.07 ± 1.64 vs 2. 20 ±2.85, t = 2.067, P = 0.048) in NCT group. Conclusion NCT can possibly improve part clinical symptoms of patients with convalescent schizophrenia to a certain extent,especially negative symptom,but need to further prove the effect of NaiKan cognitive therapy.

Objective To explore the value of high frequency echocardiography to evaluate cardiac structure and function of rat with acute myocardial infarction (AMI).Methods The rat AMI model was established by ligating the proximal left anterior descending coronary artery. The cardiac structure and function of model rats were examined with high frequency echocardiography in the 2nd and 8th week after ligation successfully. Another 20 healthy rat were selected as the sham operative group.Results The survival rat is 82.0% beyond 24 hours. At 2nd week, the model animals had an increased end-diastolic diameter (EDD), end-systolic diameter (ESD), end-diastolic volume (EDV), and further end-systolic volume (ESD), compared with the sham operative group. Ejection fraction (EF) and fraction shortening (FS) of model rats decreased. The ratio of E/A was higher. At 8th week, these parameters deteriorated left atrial diameter (LA) increased ( P<0.05). EF and FS were relevant to dp/dtmax.Conclusion High frequency echocardiography can evaluate left ventricle remodeling of rat dynamically.

Objective To explore the method and therapeutic effect of high-frequency ultrasound guided paracentesis for the treatment of perirectal abscess.Methods Thirty-three patients with perirectal abscess were treated under the guidance of high-frequency ultrasound.Results All 33 patients were treated successfully,the curative rate was 100%.Six patients were treated 3 times,6 patients were treated twice and 21 patients were treated once.Conclusion High-frequency ultrasound guided paracentesis for the treatment of perirectal abscess has the superiorities of little distress,rapid therapeutic effect without complications,worthy Of further clinical application.