ObjectiveTo investigate the distribution of human immunodeficiency virus-1 (HIV-1)subtypes and the relationship with transmission routes in Shenzhen city. MethodsThe epidemiological survey was conducted in 429 subjects with HIV-1 infection.Vein blood was collected and prepared with anticoagulation.Thereafter,the viral nucleic acid was extracted and subsequently amplified for HIV-1 env,gag genes by reverse transcription nested polymerase chain reaction. The viral sequences were analyzed using Mega software and compared with those in HIV database. The HIV-1 subtypes were confirmed and evolutionary tree was established. The gene discrete rate of different subtypes was calculated.ResultsFour hundred qualified samples were identified as CRF01_AE (n=207),CRF07_BC (n=115),CRF08 _BC (n=14),CRF02_AG (n=1),B (n=49) and C(n=14),respectively.CRF01_AE was the predominant subtype that was detected in the subjects with different transmission routes,such as homosexual contact,heterosexual contact,intravenous drug use and hospital-acquired infection. Among these,sexual contact was the most common route.There were nine cases infected with subtype B HIV-1 in 10 case who were blood borne. The gene discrete rate was more significant in subtype B HIV-1 compared to the other subtypes.According to the evolutionary tree analysis,the viruses under the same subtype formed the relatively independent clusters by different transmission routes. But some overlaps were observed as well. Conclusions Tbere are many HIV-1subtypes in HIV-1 infected subjects in Shenzhen, while the recombinant viruses present as the predominant form.Transmission routes are various with sexual contact as the most common route.Every subset distributes unevenly and forms its own characteristic.Overlap can be observed among the gene distribution of different HIV-1 subtypes.

Objective To evaluate the damage to the brochial plexus produced by pulsed radiofrequency (PRF)and radiofrequency thermocoagulation(RFTC).Methods Fifty-five male Wistar rats weighing 250-300 g were randomly divided into 3 groups:groupⅠPRF(n=25):groupⅡRFTC(n=25)and groupⅢnormal control(n=5).The animals were anesthetized with intraperitoneal chloral hydrate.The left brochial plexus was exposed and PRF or RFTC was applied to the left brochial plexus.The voltage and current of the minimal stimulation which elecited muscle twitching and the impedance before and after operation were recorded in group PRF and RFTC.The nerve function was scored according to Tarloo(0=flaccid paresis,5=normal gait)before and at 3d after operation.The animals were killed and the left brachial plexus was removed immediately and at 1, 7,14,30 d after operation(n=5 at each time point)for determination of histopathological changes using microscope.Results The impedance and Tarlov score were significantly decreased after operation as compared to the baseline values before operation in group RFTC and were also significantly lower than in group PRF. Microscopic examination showed that the myelinated nerve fibers exhibited Wallerian degeneration and axon regeneration and the cytochondria in cylindraxile were severely injured or disappeared in group RFTC.The myelinated nerve fibers and the cytochondria in cylindraxile were significantly less injured after operation in group PRF than in group RFTC and returned to normal at 7 d and 30 d respectively.Conclusion The injury to brachial plexus produced by PRF is slighter than that produced by RFTC.

The scrota and testes of the rabbits were exposed to 2450 mHz microwave field and the temperature of scrotal skin was raised to 41-42℃ for 20 minutes. Ultrastructural observations on the peritubular tissue of ductus epididymides were studied at different intervals from 30 minutes to 4 months after the treatment, and alkaline phosphatase cytochemical changes were observed at intervals from 12 hours to 30 days. Pronounced morphological alterations of the smooth muscle cells and endothelial cells of capillaries were detected within 30 minutes to I hour following exposure. After 24 hours to 3 days, the thickening of the peritubular tissue were noted. The thickening and infolding of the proper lamina were also prominent. The degenerative smooth muscle cells generally returned to normal appearance after 3-4 months, but the thickening of the peritubular tissue and infolding of the proper lamina still appeared. Alkaline phosphatase was localized in the basal lamina, proper lamina, the innermost smooth muscle cells cytoplasm and surface vesicles. There were no obvious alterations of alkaline phosphatase activity after 12 hours. After 15 days, the alkaline phosphatase prominently decreased, while after 30 days the alkaline phosphatase increased nearly to normal.

Objective To observe the effect of power-assisted functional electrical stimulation (PAFES)therapy on ankle joint function recovery in stroke patients.Methods Ninety hemiplegic stroke patients were randomly and evenly divided into a control group,a PAFES group,and a neuromuscular electrical stimulation (NMES)group.All groups received conventional rehabilitation training.PAFES group adopted PAFES treatment on affected lower extremities and NMES group was given the NMES therapy on the tibialis anterior of the affected lower limbs,in addition to conventional rehabilitation training.The active range of motion (AROM) of ankle dorsiflexion,FuglMeyer motor assessment (FMA),Barthel index (BI) and Ankle flexion and extension movement (AFEM) in 10 seconds were evaluated before the trial and after 4 weeks treatment.Results After treatment,there were significant differences in the AROM of ankle dorsiflexion,FMA,BI and AFEM (P ＜ 0.05) compared with before treatment within each group.The improvement of AROM of ankle dorsiflexion in PAFES group (8.19 ± 3.39) ° and the values in NMES group (8.96 ± 3.68) ° were to a significantly greater extend than control group (3.88 ± 4.10) ° (P ＜0.05) ; the improvement of FMA and BI in PAFES group was also superior to those in NMES group and control group (P ＜ 0.05).Conclusion The intelligent PAFES therapy could help improve AROM of ankle dorsiflexion,the motor function of the affected lower extremity and the ability of the activities of daily living in stroke patients.

Objective To investigate the effect of indomethacin on prevention of heterotopic ossification (HO)after operative treatment of acetabular fractures.Methods Fifty patients with acetabular fractures received in our department operative treatment through Kocher-langenbeck(K-L)approach and oral administration of in- domethacin afer operation from February 2001 to August 2003.Forty-eight of them were successfully followed up for incidence of HO and their clinical functions were assessed.The results were compared with those of 40 patients who had been treated with the same operative procedures but without oral administration of indomethacin in our depart- ment from March 1993 to May 1998.The patients who could not tolerate the drug were not included.Results The follow-ups averaged 22.8 months(range,6 to 39 months).HO occurred in eight cases.The incidence of HO was 16.7%(8/48).According to Brooker evaluation of HO,five cases were rated as degreeⅠ,three as degreeⅡ, and none as degreeⅢorⅣ.The incidence of severe HO was 0.In the control group,the incidence of HO was 35.0%(14/40)and the incidence of severe HO was 10.0%(4/40).The differences were statistically significant (P＜0.05).Conclusion Oral administration of indomethacin after operative treatment of acetabular fractures can inhibit HO.

ObjectiveTo explore the relationships among atrial natriuretic peptide (ANP) and cerebral vasospasm (CVS) following subarachnoid hemorrhage (SAH) and hyponatremia.MethodsPlasma ANP levels and serum natrium and blood flow rate of intracal major arterial were assessed at different times (1 to 3 days, 7 days and 14 days after SAH) in 42 patients with SAH. Correlation analysis was carried out among plasma ANP, blood sodium level and blood flow rate of intracal major arterial.Results28 patients had CVS. Plasma ANP levels in CVS patients significantly elevated compared with non-CVS and control subjects (P<0.05). Hyponatremia in CVS patients also significantly elevated compared with non-CVS subjects (P<0.05). Plasma ANP level had significant negative relationship with serum natrium level at the 7th day and 14th day (r2=-0.778,r3=-0.653;P<0.01,P<0.05) in SAH patients. Plasma ANP level had significant positive correlation with middle cerebral artery mean flow velocity on the 7th day (r3=0.702,P<0.05) in SAH patients. Middle cerebral artery mean flow velocity had significant negative relationship with serum natrium level on the 7th day and 14th day (r2=-0.693,r3=-0.653 , both P<0.05) in SAH patients.ConclusionANP might cause hyponatremia following SAH and play an important role in pathogenesis of earlier period CVS.

Objective:To investigate the expression of wild type estrogen receptor(wER)and the ex-on-5 deleted ER(variant ER,vER)in human hepatocellular carcinoma(HCC)samples,and thereafteranalyze the possibility of HCC treatment by endocrine therapy.Methods:The mRNA expressions of wERand vER were analysed from 28 cases of HCC by RT-PCR.The expression of ER at the protein level wasdetected by immunohistochemistry(IHC).Results:IHC results showed that 39.3% of the HCC speci-mens expressed ER.The mRNA of wER was detected in 89.3%(25/28)of the HCC specimens whilethat of vER was detected in 96.4%(27/28).Twenty four out of 28 HCC cases(85.7%)expressedboth wER and vER.One out of 28 patients(3.5%)expressed only wER whereas 3 patients out of 28(10.7%)expressed vER only.Conclusion:Ninety six percent(27/28)of the HCC patients expressedvER,which suggests that the expression of vER is an important event in the development of HCC.

Objective To investigate survival for primary duodenal carcinoma patients after radical resection and identify risk factors associated with overall survival.Methods Data of 51 patients with primary duodenal carcinomas who underwent radical resection between December 2003 and December 2012 at Beijing Cancer Hospital were included.Survival analysis was drawn by Kaplan-Meier method,univariate and multivariate analyses were performed to identify variables associated with survival after resection by COX regression model.Results The median overall survival time was 67 months,and the median disease-free time was 40 months,1-,2-and 3-year overall survival rates were 88％,84％ and 67％,respectively.Multivariate analysis revealed that regional lymph-node positive (P =0.032) and CA199 ＞ 37 U/ml (P =0.037) were independent risk factors of patients' overall survival.Conclusions Radical resection improves survival for primary duodenal carcinoma patients.Regional lymph-node positive and CA199 ＞37 U/ml were the most important risk factors of patients'overall survival.

Objective This study is to explore the safety,feasibility and efficacy of robotic laparoendoscopic single-site(LESS) zero-ischemia partial nephrectomy.Methods Two patients underwent robotic laparoendoscopic single-site zero-ischemia partial nephrectomy by our urologic surgical team at 22-May-2017 and 31-May-2017 in our institution.The salient patient demographics and tumor characteristics,including age,gender,body mass index (kg/m2),Charlson Co-morbidity Index (Age-weighted),tumor laterality,diameter (cm),R.E.N.A.L.nephrometry score and preoperative split renal function GFR [ml/(min · 1.73 m2)] were:73/56,female/male,25.2/19.8,2/0,lcft/right,1.8/1.4,5a/4a,left 43.8、right 49.2/left 38.8 、right 48.7 respectively.A 2-3 cm longitudinal skin incision was made at 4 cm below the inferior margin of rib arch at the level of midaxillary line (case NO.1) or peri-umbilicus (case NO.2).The da Vinci Si robotic Single-siteTM Port was inserted.The line of Toldt was incised with the colon medially mobilized.Gerota's fascia was opened,the main renal artery or its branches were dissected,then the renal mass fully dissected and exposed.The renal mass was entirely removed with approximately 0.5-1.0 cm surrounding normal renal parenchyma (unclamping in case NO.1,and selective branch clamping in case NO.2) and kidney reconstruction was conducted with 1-0 Quill Suture via hem-o-lock sliding technique.Results The two procedures were smoothly completed without any extra skin incision.Operative duration,estimated blood loss and skin incision length was respectively 230/190 min,100/60 ml,3.6/2.5 cm.Duration of two selective renal artery branches clamping in case NO.2 was 39 and 24 min.Postoperative pain measured by the visual analog pain scale (VASP) at day 1,day 2,day 3 was 5/4,3/3,2/1,Time off oral intake,duration of drainage and length of stay after surgery was 2/4 d、2/4 d、6/7d,respectively.The recovery of both patients were uncomplicated and discharged smoothly.Pathological examination revealed oncocytoma in case NO.1 and papillary renal cell carcinoma in case NO.2.Conclusions The initial experience shows the robotic laparoendoscopic single-site zero-ischemia partial nephrectomy is a safe,feasible and efficacious procedure.It may exhibit clinical benefits for patients in terms of pain control,convalescence and cosmesis,but in this early stage the clinical indications should be strictly controlled.

Objective To evaluate the correlation between postoperative complications and prognosis after radical hepatic resection for colorectal liver metastasis (CRLM).Methods We retrospectively summarized patients' clinicopathological data and postoperative complications.Postoperative complications were graded using Dindo-Clavien system of classification.Then we investigate the relation between these data and prognosis.Results One hundred and seventy-three patients were recruited.Postoperative complications developed in 59 (34.1％) cases.37 patients had minor complications and 22 patients had major complications.On univariate (x2 =8.106,P =0.004) and multivariate analysis (x2 =8.006,P =0.005),complication was an independent predictor of overall survival (OS).However,in a subgroup of patients with minor compications,morbidity was not associated with a significant reduction in both OS (x2 =3.199,P =0.074) and disease-free survival (x2 =1.313,P =0.252).Conclusions Postoperative complications are an independent factor for long-term outcomes after hepatic resection for CRLM.