Objective To describe the surgical technique and outcomes of arthroscopic reconstruction anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) and repair of the injured posteromedial complex (PMC) or posterolateral complex (PLC) structures of the knee joint in treatment of multiple ligaments injuries of knee. Methods From March 2005 to May 2007, 43 patients with multiple ligaments injuries of knee underwent arthroscopic reconstruction. Twenty-four patients were treated with arthroscopic reconstruction of combined ACL and PCL with allograft tendons and augmentation of PMC. The other 19 patients were treated with repair the PLC in addition to reconstruction of ACL and PCL. The International Knee Documentation Committee (IKDC) and Lysholm knee score were used for function evaluation. Results All patients were followed up for 24 to 48 months with an average of 33.10±9.65 months. The stability recovered when stress was applied to the knee at 0° and 20° of flexion. According to IKDC there was a significant improvement from severely abnormal (graded D) in 43 cases before surgery to normal (graded A) in 29 cases (67%), nearly normal (graded B) 11 cases (26%) and abnormal (graded C) 3 cases (7%) at follow-up. The average Lysholm score of the all cases were 46.7±4.2 and 89.6±2.8 before operation and at final follow-up, respectively (t=8.563, P＜0.01). Conclusion Excellence clinical results and good stability were achieved with arthrescopic reconstruction of ACL and PCL combined with repair or augmentation of the PMC and PLC simultaneously.

OBJECTIVETo explore the influencing factors of AIDS pathogenesis using the Bayesian network.

METHODSBased on follow-up data of 2 431 cases of HIV/AIDS from 1992-2011 in Shandong province, this study constructed the network structure by NPC algorithm, and used the EM algorithm for parameter learning to construct the Bayesian network of influencing factors and AIDS pathogenesis, then did inference by the Bayesian network.

RESULTSA total of 49.77% (1 210/2 431) were AIDS. Get a Bayesian network with 7 nodes and 11 directed arcs and the related parameters by studying the follow-up data of 2 431 cases. The area under receiver operating curve(ROC) was 0.75. There was a direct causal association among sample resource, transmission route, CD4(+)T lymphocyte count of HIV-antibody confirmed positive, antiviral therapy, opportunistic infection therapy, follow-up intervention and AIDS pathogenesis. The incidence probability was 42.83% for those who received antiviral therapy and follow-up intervention, and it was 68.96% for those who received antiviral therapy without follow-up intervention. The probability to receive follow-up intervention was 68.96% for cases transmitted by homosexual behaviors, and it was 34.00%, 42.24%, 1.06% and 22.70% respectively to be reported by medical institutions, testing and counselling, supervision institutions and special surveys.

CONCLUSIONThe Bayesian network revealed the mutual relation and effect intension among multi-factors and multi-stages by network inference. It showed that the rate of AIDS pathogenesis was lower for those who received antiviral therapy and follow-up intervention.

Acquired Immunodeficiency Syndrome ; drug therapy ; epidemiology ; pathology ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bayes Theorem ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Incidence ; Lymphocyte Count ; Male ; Middle Aged ; Young Adult

Objective: To analyze the epidemiological characteristics of HIV/AIDS infected students in Shandong Province, to provide a basis for the prevention and control of AIDS transmission in the student population. Methods: All 863 HIV/AIDS students cases during 2010-2019 were collected in Shandong Province. Epidemiological characteristics was described and the trends in the 10 years since 2010 was analyzed. Results: These 863 HIV/AIDS students were mainly transmitted through homosexual sex (763 cases, 88.41%), and the samples were mainly from voluntary consultation testing (433 cases, 50.17%). From 2010 to 2019, the proportion of student cases in the total number of cases showed an increasing trend ( χ 2 trend =30.21, P <0.01). Among them, the proportion of homosexual transmission cases increased year by year ( χ 2 trend =6.35, P =0.01), the proportion of cases aged 18-22 years increased year by year ( χ 2 trend =6.10, P =0.01), the proportion of cases with college degree or above increased year by year ( χ 2 trend =4.26, P =0.04). At present, voluntary consultation testing were the main source.There was no significant difference between the years of sample sources ( χ 2 trend =2.97, P =0.09). Conclusion The report number of students in Shandong Province are on the rise in recent years, especially those infected by same sex transmission, mainly with high education background, which calls for targeted strategies and intervention measures.

Based on the analysis of the network layout and functional structure of the central monitoring system,the daily maintenance strategy and common fault maintenance methods were discussed.In terms of function structure,the central monitoring system of inpatient ward was divided into four modules:network architecture,monitoring terminal,central monitoring and data management,which realized the functions of monitoring patients'vital signs,data transmission display,analysis and alarm.In the event of failure of equipment,the source of structural components was analyzed based on the fault phenomenon,and the failure handling was carried out by one by one.In the process of dealing with network faults,the signals before and after the switch were detected and analyzed according to the fault scope.When abnormal results of physiological parameters were found,the factors such as human operation,patient cooperation,and equipment hardware and software failures were considered at the same time.The cause of the failure was eliminated according to the results of the observation and test;the equipment returned to normal service after the failure.Medical personnel and equipment engineers should be familiar with the network layout of the central monitoring system,carry out routine maintenance,carefully make troubleshoot faults in maintenance and standardize operation and constantly improve the operation quality of the central monitoring system.

Based on synergetics, system theory and dissipative structure theory, the connotation and composition of the compound system of rural public health service in country area are described in the paper. The authors proposed that the synergy degree model of the compound system for rural public health service in county areas comprises the order degree model and the synergy degree model of the compound system, which are composed of such subsystems as functionality, service network, demand, and economy. They also probed into the evaluation method for synergy degree and built the measuring index system of synergy degree comprising 59 level-2 evaluation indicators.

Objective: To understand the survival status of AIDS patients after initiation of antiretroviral treatment (ART) in Shandong province during 2003 to 2017, and to determine the factors associated with survival status. Methods: A retrospective cohort study was conducted among AIDS patients initially received antiretroviral therapy from 2003 to 2017. The epidemiological characteristics of the subjects were described, and life tables were used to estimate the survival rates, the influencing factors were analyzed by Cox regression model. Results: A total of 9 813 cases were enrolled in this study, of the subjects, the median age was 34.9±11.0 years. The median of baseline CD4+ T lymphocyte count was 300.0(P₂₅-P₇₅: 163.0, 428.0)cells/μl, and 83.2% of them were at clinical stage Ⅰ (World Health Organization, WHO). The cumulative survival rates were 97.7%, 96.7%, 95.8% and 93.7%, 1, 3, 5, and 10 years after the initiation of ART respectively. Multivariate Cox regression model analysis showed that the risk of the mortality among those infected through homosexual behavior was 38% lower than that of patients infected via blood or other routes, and HR was 0.62 (95%CI: 0.43-0.89). Higher education level had lower mortality risk(the mortality risk of those with university degree or above was lower, compared to those with primary and lower cultural level, HR=0.41, 95%CI: 0.26-0.65). At baseline, AIDS patients at clinical stage Ⅰ(WHO) had lower mortality risk than those who were at clinical stageⅡ, Ⅲ, and Ⅳ(WHO). Lower baseline CD4+ T lymphocyte count had higher mortality risk. Conclusions Survival rate was higher after initial antiretroviral therapy among AIDS patients in Shandong province. CD4+ T lymphocyte count level, WHO clinical stage, and presence or absence of clinical symptoms at baseline are the main factors influencing the survival time of AIDS patients after ART.

Objective: To identify high risk behaviors and infection related factors among young adult males diagnosed with HIV/AIDS in Shandong Province, to provide evidence for targeted AIDS prevention and control strategies. Methods: By using convient sampling method, an face to face in depth interview on HIV related behaviors was conducted among young adult males newly diagnosed with HIV/AIDS in Shandong Province in July 2021. Results: A total of 31 young adult males diagnosed with HIV/AIDS were interviewed. All were male and infected through homosexuality behavior. Average age was (20.6±1.8) years. Totally 90.3% (28/31) were enrolled in tertiary education at the time of diagnosis. The findings revealed that 93.5% (29/31) of participants got infection due to unprotected homosexual behavior with the temporary partner whose HIV infection status was unknown, and 86.2% (25/29) got in touch with these temporary partner by social software. The awareness rate of knowledge about AIDS among all the participants was 100%, however, 83.9% (26/31) reported occasion condom usage while having homosexual behavior, and 16.1% (5/31) never did. Totally 74.2% (23/31) of the young adult males diagnosed with HIV/AIDS had a history of HIV testing before diagnosis. Conclusion The primary high risk behavior of HIV infection in young adult students are unawareness of HIV infection status for temporary sexual partner and the separation of knowing and doing. A targeted strategy should be developed to control the spread of HIV in young adult students.

OBJECTIVETo analyze survival time of AIDS death cases receiving Antiretroviral Therapy and related factors.

METHODSA retrospective cohort study was carried out to collect the data on death cases receiving Antiretroviral Therapy by the National HIV/AIDS Comprehensive Response Information Management System. Kaplan-Meier was used to calculate the median survival time, and compare survival time among different groups of age, sex, marriage status, infectious routes, WHO clinical stage, baseline CD4(+)T cell counts, and interval time from the start of ART to HIV confirmation. Life table and survival curve were applied to describe survival distribution. Cox proportional hazard model was used to determine the factors associated with the survival time.

RESULTSAmong 142 AIDS death cases, 125 (88.03%) were related with AIDS and 17(11.97%) were not. The total median survival time was 3.100 months (95%CI: 2.279-3.921). The cumulative survival rate was (52 ± 4)%, (33 ± 4)%, (26 ± 4)% in the first 3 months, 3-6 months, and 6-12 months. The median survival time of married or cohabitation group was 2.670 months (95%CI:1.470-3.870), and single (unmarried, divorced, separation, widowed) group was 5.870 months (95%CI: 2.617-9.123). The median survival time of WHO clinical stage I or II group was 5.870 months (95%CI: 3.989-7.751), and WHO clinical stage III or IV group was 1.700 months (95%CI: 0.885-2.515). The median survival time of baseline CD4(+)T cell counts ≤ 50 /µl group was 1.670 months (95%CI: 0.759-2.581), and 51-199 /µl group was 4.400 months (95%CI: 2.735-6.065), and ≥ 200/µl group was 7.100 months (95%CI: 0.000-14.542). The survival time was significantly different among different baseline marital status groups, different WHO clinical stage groups, and different CD4(+)T cell counts groups. The mortality risk of Single (unmarried, divorced, separation, widowed) group was 0.641 times of the risk in married or cohabitation group. The mortality risk of WHO clinical stage III or IV was 1.856 times of the risk in stage I or II. The mortality risk of baseline CD4(+)T cell counts 51-199 /µl group was 0.582 times of the risk in ≤ 50 /µl group, and ≥ 200 /µl group was 0.551 times of the risk in ≤ 50 /µl group.

CONCLUSIONThe total median survival time was relatively short. Most AIDS deaths happened in the first 3 months or 3-6 months after they received Antiretroviral Therapy, and the mortality trend slowed down in the following months. Married or cohabitation, low-baseline CD4(+)T cell counts, or WHO clinical stage III or IV were found to be the risk factors associated with AIDS death cases receiving Antiretroviral Therapy.

Acquired Immunodeficiency Syndrome ; Antiretroviral Therapy, Highly Active ; CD4 Lymphocyte Count ; Cohort Studies ; Disease Progression ; HIV Infections ; Humans ; Marital Status ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; Survival Rate