Sexual behavior of HIV-positive men who have sex with men (MSM) are different from the general MSM. HIV-positive men who know their HIV status are more likely to have sex with positive partner and to engage in receptive anal intercourse as a self harm reduction approach than the general MSM. It is important to strengthen behavioral interventions so as to practice safe sexual behavior to prevent HIV transmission and maintain high life quality among HIV-positive MSM.

Objective To explore the surgical management and its results of intercondylar fracture of humerus through approach of extra-articular oblique osteotomy of olecranon. Methods From March 1995 to October 2003, 26 patients of intercondylar fracture of humerus were treated surgically through approach of extra-articular oblique osteotomy of olecranon, and the fracture was reduced and fixed with "8" steel wire. The patients were 15 men and 11 women with a mean age of 43.2 years (range 19-68 years). 14 fractures occurred on the left extremity and 12 on the right. The fractures resulted from traffic accident or fall in 23 and other trauma in 3. According to AO/ASIF classifation, type C1 fracture was found in 3, C2 in 5 and C3 in 18. 5 patients suffered open fracture(Custilo scaleⅠin 3, and Ⅱ in 2). Contusion of skin occurred in 3 and multiple injuries in 5, while primary injury of ulnar nerve occurred in 4. The rehabilitation exercises began at 2-7 d post-operatively. The healing of the osteotomy was evaluated with physical examination and plain X-ray film, and the function of elbow was assessed according to Cassebaum scale. Results 21 patients were followed from 9 months to 8 years(average, 18 months). Of these 21 cases, all the osteotomies healed in 6.2 weeks averagely, no nonunion, delayed union, separation or malunion was found. Heterotopic ossification occurred in 4 cases, and obviously limited locomotion of elbow in 2. Of the 4 patients with primary injury of ulnar nerve, no breaking was found during exploration, and the nerve was displaced anteriorly. 3 of these 4 patients recovered completely, and mild sensory disturbance and dyskinesis remained in 1. The function of the elbow showed excellent in 12, good in 6, fair in 1 and poor in 2. The locomotion of the elbow averaged 110?. Conclusion The use of the approach of extra-articular oblique osteotomy of olecranon for surgical management of intercondylar fracture of humerus has many advantages, it provides satisfactory stability with simple technical procedure avoiding intra-articular invasion, it facilitates rehabilitation exercises and provides good results with low complication rate.

OBJECTIVE To culture dendritic cells from the peripheral blood ofpatients with laryngeal squamous cell carcinoma. METHODS Peripheral blood was collected from patients under sterile conditions. The mononuclear cells were separated by centrifugation through a density gradient (Ficoll-Hypaque). The adhesion cells, collected from the mononuclear cells, were cultured with interleukin-4 (IL-4, 100ng),granulocyte/macrophage colony stimulating factor (GM-CSF, 100ng) and tumor necrosis factor ? (TNF-?, 100ng) in RPMI 1640 medium for 7 days. The cell morphology was observed under electronic microscope, and the characteristic surface marker CD80 of the cells was analyzed by flow cytometry. MTT colorimetry was employed to assess the proliferation of the mixed lymphocytes. The mixed lymphocytes were stimulated by DC loaded with laryngeal carcinoma antigen. RESULTS A large quantity of cells characteristic of dendritic cell was obtained. Cytometry analysis showed that 33.76 % of mononuclear cells expressed the characteristic marker CD80. After being cultured for 7 days, the expression level of CD80 was significantly increased (69.15 %). Few DC with laryngeal carcinoma antigen could play a role in stimulating lymphocyte proliferation, and the proliferation effect was optimized when the ratio between DC and T cells was 1:5. CONCLUSION A large number of DCs with high purityand sufficient treatment dose can be cultured in vitro from the peripheral blood of patients with laryngeal carcinoma. This technique may play an important role in experimental studies for clinical applications.

Objective To investigate the efficiency and safety of the automated external defibrillator (AED); and to compare the defibrillating efficacy between the domestic AED and the imported AED. Method Fourteen Peking white swine weighed (30 ± 1 ) kg, were anaesthetized and arterial cannula was inserted into the left femoral artery for collecting blood samples and measuring artery blood pressure, cardiac output (CO) and external vascular lung water index (EVWI) by using PiCCO monitor, and another cannula was inserted into the left femoral vein to place an electrode as a temporary pace maker, and then ventricular fibrillation (VF) was induced by using a programmed electrical stimulation instrument. The swine were divided into two groups randomly ( random number) after VF was confirmed by electrocardio-monitor,and the domestic made AED (M group, n = 7) or imported AED (Z group, n = 7) were used respectively in 7 swine of each group. The electrodes of defibrillator were stuck to the precordium and sternum separately, and defibrillation was delivered by the AED signal. The entire procedure of defibrillation was repeated four times. The number of defibrillation delivery required to get normal cardiac rhythm was recorded. Twenty minutes after restoration of spontaneous circulation (ROSC), blood sample was taken to measure myocardial enzyme. The CO and EVWI were measured too. Measurement data was analyzed by repeated ANOVA and enumeration data was analyzed by Chi-square test. A value of P ＜0.05 was regarded as being significant statistical difference. Results There were 54 episodes of VF induced in 14 swine and only one swine in Z group was dead after 2nd episode of VF, resulting in 98.1% success rate of resuscitation. There were 37 defibrillation deliveries given to swine of M group, and 75.0% produced normal cardiac rhythm after the first delivery of defibrillation,whereas 80.0% in Z group after 32 defibrillation deliveries. The length of time from AED turned on to the recognition of ECG signal of VF was (29 ± 1 ) s. There were 2 occasions in both groups that the AEDs failed to recognize the VF signal emerged on ECG after the first induction of VF by electrical shock. Similarly, there were 2 occasions in Z group that the AED incorrectly recognized the signal of ventricular tachycardia as that of VF, but no harm was done after defibrillation delivery given following the signal of AED. During the entire course of experiment, heart rate,blood pressure and CO of all survived swine were stable,but the EVWI and myoglobin (MYO) gradually increased as time elapsed until the 3rd or 4th episode of VF leading to significant differences from the original ones. There were no significant differences in all biomarkers between two groups. Conclusions The VF can be ceased by AED safely and efficiently. There are no significant differences in signal recognition, efficacy of defibrillation and myocardial injury found between the domestic made AED and imported AED; but AED may not be good to be recommended to the professional staff of resuscitation because of its incorrect reorganization of ECG owing to over-automation.

Objective To investigate the clinical outcome of post-traumatic tibial osteomyelitis treated by induced membrane technique combined with the antibiotic cement-coated locking plate.Methods A restrospective case series analysis was made on 71 cases of post-traumatic tibial osteomyelitis treated by induced membrane technique from September 2014 to September 2014.There were 55 males and 16 females, aged 18-60 years(mean, 37.4 years).Mean length of bone defect following debridement was 4.5 cm(range, 4-11 cm).Antibiotic cement-coated locking plates were used to provide the stability of the bone defects after one-stage debridement.Bone grafting and exchanging the plates with ntramedullary nails were done during the second-stage surgery.Parameters were monitored dynamically after operation to evaluate infection recurrence and bone healing, including C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), clinical features(sinus formation, redness and swelling, warmth and pain) and X-ray films of the involved limbs.Results All patients were followed up for 13-25 months (mean, 19.5 months).There was no sign of recurring infection and CRP and ESR were normal in all cases after the first stage surgery.However, four cases (6%) had recurrent infection with sinus exudates and their CRP and ESR were abnormal after the second stage surgery, and further treatments were carried out on these patients.Follow-up showed bony union in all patients within mean 5.5 months (range, 4-6 months).Conclusion Induced membrane technique with antibiotic cement-coated locking plates for treatment of post-traumatic tibial osteomyelitis can shorten bone healing time and decrease infection recurrent rate without obvious impact on osteogenic activity.

Objective To study the clinical significance of a novel marker of platelet clumps count provided by hematology analyzer in differentiating true thrombocytopenia from EDTA-dependent pseudothrombocytopenia (EDTA-PTCP). Methods Samples from 65 cases of thrombocytopenia (including 15 EDTA-PCTP samples and 50 random samples of true thrombocytopenia) and 50 healthy controls were analyzed using hematology analyzers, and samples with low platelet counts were checked by replacing citric acid and using manual microscope observation to identify true thrombocytopenia from EDTA-PTCP. A novel marker of platelet clumps count was used to differentiate the two diseases for samples anficoagulated with EDTA or citric acid. Results In 65 patients with thrombocytopenia, platelet counts were (48±11)×109/L detected by automatic hematology analyzers. Fifty of 65 cases were true thrombocytopenia which showed low platelet counts [(48±10)×109/L by automated analyzer and (46±11)×109/L by manual assay]. No significance was observed between them (t=-1.26, P0.05). Platelet clumps counts were 86±15. No platelet clamps were detected under microscope. The other 15 cases were EDTA-PTCP [platelet counts were (48±12)×109/L and platelet clumps counts (840±184) were increased significantly by automated analyzer and using EDTA anticoagulant] which showed obviously platelet clumps and no less platelet counts under microscope. After replacing citric acid, platelet counts [(141±13)×109/L by automated analyzer and (134±17)×109/L by manual microscope assay] were increased significantly. No significance was observed between them (t=-1.29, P0.05). Platelet clumps counts (75±12) were decreased obviously compared with EDTA anticoagulant method (t=-6.82, P<0.001). No platelet clumps were detected under microscope. Conclusion Platelet clumps counts may be a useful clinical indicator for monitoring of platelet aggregates, especially for EDTA-PTCP caused by platelet clumping.

Pass an overview about medical social work ethics and analyzed the reasons.Based on China′s na-tional conditions and the basis of the particularity of medical social work in China, puts forward the paths of the lo-calization of medical social work ethics, namely, improve the adaptability of western medical ethics of social work, realizes the Chinese traditional culture and western medical social work ethics, mutual accommodation, with the so-cialist core values at the head of the medical social work ethic construction in our country.

Objective To develop ELISA kit stabilizer for each component ,with which the shelf life of kit could meet the com-mercial need .Methods A series of stabilizers for microplate ,enzyme-labeled antibody and standards were prepared by the means of experience and orthogonal approach ,through controlled trials ,screening out the best stabilizer formulations .Results A kind of coa-ted stabilizer (mass fraction :bovine serum albumin 0 .5% ,gelatin 0 .25% ,trehalose 5% ,PEG4000 0 .1% ) and a kind of enzyme la-beled antibody stabilizer (mass fraction :Bovine serum albumin 1% ,peptone 1% ,sucrose 10% ,trehalose 5% ,PEG4000 0 .25% ) were screened out .Conclusion The ELISA kits can be stable at 4 ℃ for 1 year after treated with the obtained stabilizers .

Objective:To compare the titanium-porcelain bonding strength between CAD/CAM and cast pure titanium.Methods:Pure titanium samples were prepaired by CAD/CAMand casting respectively and fused with porcelain.The bond strength between tita-nium and porcelain of the samples was measured with three-point test.The titanium-porcelain interface was investigated under scanning electronic microscope(SEM).Results:The bond strength of CAD/CAMpure titanium to porcelain was (35.95 ±3.74)MPa and cast pure titanium to porcelain was (28.37 ±1 .98)MPa(P <0.05).SEMobservation showed that there was thin transition layer between titanium substrate and ceramic in CAD/CAM bond interface,titanium and porcelain combined closely,no obvious pores.However, there was thicker transition layer and small pore in cast pure titanium to porcelain bonding interface.Conclusion:The bonding strength of porcelain to CAD/CAMpure titanium is greater than that of porcelain to casting pure titanium.

Objective To establish an appropriate cut-off value of high sensitivity cardiac troponin T (hs-cTnT) and optimal combination measurement in the early diagnosis of acute myocardial infarction (AMI).Methods This research is a prospective study.342 patients admitted to emergency department with chest pain,43 patients with renal failure,40 patients with pneumonia and 18 premature with patent ductus arteriosus were involved from June 2012 to June 2013 in Peking University Third Hospital.The plasma hs-TnT,NT-proBNP,cardiac troponin Ⅰ (cTnI),CK-MB and copeptin were measured.The distribution of hs-cTnT among associated diseases was analyzed,the diagnostic performance of hs-cTnT and the role of combination hs-cTnT with NT-proBNP,CK-MB and copeptin were evaluated by receiver operating characteristic (ROC) curve.The statistical method was used to calculate the Sensitivity,specificity,negative predictive value and positive predictive value of hs-cTnT in the diagnosis of AMI.Results As compared to patients with STEMI(median 0.52 μg/L,range 0.037-7.610 μg/L),hs-cTnT was lower in the patients with Non-STEMI(median 0.127 5 μg/L,range 0.021-4.260 μg/L).However,the levels of hs-TnT in other diseases were also increased increased in varyng degrees (Chi-square =76.432,P ＜ 0.05)The areas under the curve (AUC) for hs-cTnT and cTnI in the diagnosis of AMI were 0.862 (95％ CI:0.729-0.928) and 0.748 (95％ CI0.666-0.818) respectively (Z =2.713,P ＜ 0.05).Taking 0.014μg/L and 0.035 μg/L as cut-off value of hs-TNT,the sensitivities were 100％ vs 95.1％,the specificities were 44.4％ vs 65.7％.The combination of hs-cTnT,NT-proBNP,CK-MB resulted in a increase in AUC (0.915,95％ CI:0.838-0.964) (Z =2.147,P ＜ 0.05) and the combination of hs-cTnT and copeptin resulted in a increase in AUC 0.921 (95％ CI:0.820-0.975) (Z =2.589,P ＜ 0.05).Conclusion With the cut-off value of 0.035 μg/L for diagnosis of AMI was appropriate,and the combination measurement can improve the accuracy of early diagnosis of AMI.