Objective To understand the common complications of PICC in olinical use. Methods Retrospectively summarize the data of PICC used in patients of SICU in 1999. Results In 1999, there were 14 pateints using PICC, among them 12 patients were male and the others were female. The average age was 71 years old. Embolus 4 cases' PICC were pulled out. Phlebitis occured in only one case. There are 2 patients presenting hyperpyrexia pulled the PICC out. But the cultures of PICC were negative. Conclusions The common complications of PICC are embolism,phlebitis and infection.

Objective To clone the human gene of Hepatitis B virus e antigen binding protein 1 (HBEBP1), which was screened with yeast two-hybrid system and bioinformatics techniques, to construct prokaryotic expression vector of pET-32a(+)-HBEBP1, and to induce the expression of recombinant protein in E. coli BL21. Methods The DNA fragment of HBEBP1 of about 372bp was amplified by reverse transcription PCR (RT-PCR), in which the mRNA was taken from HepG2 cells as the template, and cloned into pGEM-T vector. After restriction enzyme digestion identification and sequencing, the correct target DNA fragment was inserted into inducible prokaryotic expression vector pET-32a(+) and then transformed into competent E. coli BL21. By restriction enzyme digestion and PCR, the positive transformed clones were identified and induced with IPTG to obtain fusion protein. The HBEBP1 fusion protein was analyzed by Western blotting hybridization. Results The 372bp DNA fragment of HBEBP1 was amplified by RT-PCR. The recombinant expression vector pET-32a(+)-HBEBP1 was constructed successfully. After transformation with pET-32a(+)-HBEBP1 and induction with IPTG, the recombinant target protein of about 33kD was obtained, which was consistent with our anticipation. Western blotting assay showed that the protein had good specificity. Conclusions The recombinant prokaryotic expression vector pET-32a(+)-HBEBP1 is constructed, and the HBEBP1 gene is cloned successfully. The HBEBP1 fusion protein could be expressed in prokaryotic expression system of E. coli. These results lays a foundative for studying the immunogenicity and the biological characteristics of the HBEBP1 protein.

Objective To investigate the effects of tirofiban combined with nitroprusside injection through the rapid exchange balloon catheter with self-made side holes on no-reflow (NR)phenomenon during elective percutaneous coronary intervention (PCI).Methods A total of 49 patients with NR phenomenon were randomly divided into the balloon catheter group (n=25)and the guiding catheter group (n=24).Tirofiban combined with nitroprusside were used in both groups.Thrombolysis in myocardial infarction (TIMI)grade and corrected TIMI frame count (CTFC)of target coronary artery at 10 minutes after administration were assessed.Results At 10 minutes after drugs injection,there were 21 (84.0%)patients with target of coronary TIMI 3 grade in the balloon catheter group,and 13 (54.2%)patients in the guiding catheter group.The CTFC was (33.5±12.5)frame in the balloon catheter group,and (41.9±1 5.3)frame in the guiding catheter group.The difference in TIMI and CTFC between the two groups was significantly (P <0.05).Conclusion Injection tirofiban combined with nitroprusside through the rapid exchange balloon cathe-ter with self-made side holes in NR patients during elective PCI might be feasible and effective.

Objective To evaluate the clinical application of enzyme-linked immunospot(ELISPOT) assay for detection of M.tuberculosis antigen specific T cells in the rapid diagnosis of active tuberculosis.Methods Using the rapid enzyme-linked immunospot assay for detection of T cells with secretion of IFN-? specific for M.tuberculosis antigens in blood samples from 112 patients with tuberculosis, 24 patients with hepatitis C, 30 healthy persons, and 65 with other respiratory diseases.Results 107 of 112 tuberculosis patients had detectable M. tuberculosis antigen-specific T cells, whereas 2 of 30 healthy subjects and 65 patients with non-tuberculosis illnesses responded. This assay has a sensitivity of 95.5%, specificity of 93.3%.Conclusions M.tuberculosis specific T cells could serve as accurate markers of M.tuberculosis infection in an area of high tuberculosis prevalence.ELISPOT is a rapid, sensitive and specific method for detecting M.tuberculosis specific T cells.It also gives objective evidence to the diagnosis of active tuberculosis.

This study was aimed to compare clinical effect and safety of ring mixed hemorrhoids treatment with pro-cedure for prolapsed and hemorrhoids (PPH) and Milligan-Morgan (M-M) in order to evaluate their effects of health economics. Retrospective analysis was given on clinical data of 100 cases (including 48 cases in P group, 52 cases in M group) which met the inclusion criteria from June 2008 to June 2010 in the Affiliated Hospital of Luzhou Med-ical College. Statistical analysis was made on short- and long-term effect, patient satisfaction, perioperative and postoperative complications of two groups. The cost-effectiveness was analyzed with the effect of health economics methods. The results showed that there was no obvious difference on short-term effect between two groups. However, aspects such as surgery time, hospitalization time, back to work time, duration of pain, bleeding condition, postopera-tive pain and anal swelling in P group were significantly better than M group (P< 0.05); long-term effect and cost-effectiveness in M group were obviously better than P group (P < 0.05). There was no obvious difference on inci-dence rate of adverse reaction between two groups. It was concluded that the traditional external dissection and inter-nal ligation for circumferential mixed hemorrhoids had better clinical effect of both short- and long-term with better cost-effectiveness. It is still a better surgical treatment for circular mixed hemorrhoids.

OBJECTIVETo explore the clinical application value of Provider-Initiated HIV Testing and Counseling (PITC) by analyzing the positive rate of HIV tests for people in need of PITC and that of routine HIV tests.

METHODSWe retrospectively analyzed the demographic and epidemiologic data about the patients seeking PITC services or undergoing routine HIV tests in Nanjing Drum Tower Hospital between January and December 2013.

RESULTSThe positive rate of initial HIV screening was 1.98% in the PITC group and 0.24% in the routine test group, while that of confirmed HIV was 0. 40% in the former and 0.07% in the latter, both with statistically significant differences between the two groups (P < 0.01). The positive rate of HIV was markedly higher in males than in females, particularly in the PITC group.

CONCLUSIONPITC has a high clinical value in HIV detection for targeted subjects and therefore deserves general application in dermatology.

Counseling ; Dermatology ; Female ; HIV Seropositivity ; diagnosis ; epidemiology ; Humans ; Male ; Mass Screening ; methods ; Retrospective Studies ; Sex Factors

Objective To investigate effect of serum apoptosis factor and long-term effect on medical abortion patients by sequential misoprostol. Methods 80 cases of early pregnancy patients who required termination pregnancy, were selected and randomly divided into 2 groups.40 cases in control group were treated with mifepristone 25mg oral, misoprostol 600μg, 4 times a day.40 cases in experiment group were treated with sequential use of misoprostol.Effect of medical abortion, survivin and caspase-3 were compared after 7d treatment.Gynecological inflammation, dysmenorrhea and infertility were compared for 2 years.Results Compared with control group, complete abortion rate of the experiment group was higher (P<0.05).The incidence of adverse drug reactions of the experiment group was lower than control group (P<0.05) after 2 years follow.up.Compared with the control group, HCG,E3 and P of experimental group were lower (P<0.05).After 7 days of medication,survivin decreased,caspase-3 increased,compared with control group, survivin of the experiment group was lower, caspase-3 was higher ( P<0.05 ) .Conclusion Misoprostol sequential can improve the success rate of medical abortion abortion, reduce the complications of abortion, presumably with the inhibition of survivin expression, is associated up regulation of caspase-3 levels.

Objective To analyze the imaging features of mycobacterium in AIDSpatients.Methods Twenty-three cases of mycobacterium tuberculosis and 13 patients of non-tuberculous mycobacteria were proved etiologically and included in this study.All patients underwent X-ray and CT examinations,imaging data were analyzed and compared.Results The imaging findings of mycobacterium tuberculosis in AIDS patients included consolidation (n =11),pleural effusion (n =11),mediastinal lymphadenopathy (n =11).Pulmonary lesions were always diffuse distribution,and 14 patients of extrapulmonary tuberculosis were found.Pulmonary lesions in non-tuberculous mycobacteria tend to be circumscribed.Conclusions Non-tuberculous mycobacterial infection in AIDS patients is more common and usually combined with other infections.Imaging features are atypical.

Objective: To study the feasibility of closed and three-dimensional reconstruction of maxillary defects with titanium mesh and free forearm flap. Methods: Maxillary defects, 3 of type Ⅱ and 7 of type Ⅲ, due to tumor or trauma were closely reconstructed with titanium mesh to restore the profile of maxilla and with radial flap to close the oral and the nasal wound surfaces following total maxillectomy (in 3 cases) and subtotal maxillectomy(in 7 cases). Results: 10 cases were followed up for 3～18 months. All the flaps were alive. The maxilla nasal and oral cavity were restored in all the cases and denture was applied in 3 cases. No neoplasm were fond by CT. Mouth opening was 2.5～4.0cm. Epithelium on the surface of the titanium mesh was found by nasopharyngoscope in 2 cases. Conclusion: The closed and three-dimensional reconstruction of maxillary defect with titanium mesh and free forearm flap can restore the shape and the function of maxilla.

Objective To study the clinical effect of microsurgical treatment via lateral fissure approach on hypertensive basal ganglia hemorrhage.Methods Small bone flap via lateral fissure approach were applied to remove basal ganglia hematoma.Thirty two cases were recruited in the retrospective analysis.Results By head CT scan follow-up 24 h post operation,over 80％ percent of hematoma was successfully removed in 28 cases and over 40％ of hematoma was resided in 4 case.Patients were followed up for 3 - 6 months,according to the ADL (ADL)classification,the outcomes were:Grade Ⅰ in 4 cases( 12.5％ ),grade Ⅱ in 13 cases(40.6％ ),grade Ⅲ in 12 cases (37.5％)and grade Ⅳ in 3 cases (9.4％).No death occurred.Conclusion Small window approach on lateral fissure for microsurgical operation of hypertensive basal ganglia hemorrhage is a less invasive procedure with good surgical exposure and homeostasis.Neurological function was well recovered after surgery.