Factors associated with syphilis/HIV infection among men who have sex with men in Shenzhen,2011-2016 / 中华预防医学杂志

Objective@#To investigate the factors associated with syphilis/HIV infection among men who have sex with men (MSM) maintaining a single sexual partner in Shenzhen.@*Methods@#Respondent driven sampling and snowball sampling method were used to recruit MSM receiving voluntary counseling and testing in Shenzhen Rainbow clinic from 2011 to 2016. Inclusion criteria: aged 18 years and above; reported having one or more anal sexual partners in the recent 6 months. A total of 3 109 men who have sex with men (MSM) were involved in the study. Questionnaire-based interviews were conducted on a one-on-one basis. Data were collected including socio-demographic information, human immunodeficiency virus (HIV) testing history, history of blood donation and drug abuse in the recent two years, self-identified sexual orientation, role in homosexual behavior, ever being money boys (MB) and clients of MB, female sexual partners in the recent 6 months. 5 ml blood samples were taken after questionnaires. Syphilis was screened using toluidine red unheated serum test for the antibody of treponema pallidum and then confirmed by treponema pallidum particle assay. The enzyme-linked immunosorbent assay (ELISA) was used for screening HIV and western blot was used to confirm the HIV screening results. The difference of condom use among MSM between female sexual partners and male sexual partners were compared. Multivariate unconditional stepwise logistic regression model was used to analyze factors associated with syphilis infection and HIV positive among MSM.@*Results@#A total of 3 109 eligible participants with mean (SD) age of 31.49 (8.64) years were enrolled in this study. Among them, 565 cases were infected with syphilis (18.17%), 330 cases were infected with HIV (10.61%), and 165 cases (5.31%) were syphilis co-infected with HIV. 791 (25.44%) reported maintaining a single sexual partners in the recent 6 months. Compared to MSM with multiple sexual partners, the prevalence of syphilis and HIV infection among MSM with a single sexual partner were lower, and the OR (95%CI) were 0.64 (0.51-0.81) and 0.66 (0.49-0.90), respectively.@*Conclusion@#The proportion of fixed single sexual partner was much lower among MSM in Shenzhen. Maintaining a single sexual partners can reduce the risk of syphilis/HIV infection among MSM.

Expression profiles of Th17 pathway-related genes in patients with syphilis serofast reaction analyzed by PCR-Array technique / 中华微生物学和免疫学杂志

Objective To detect the expression of Th17 pathway-related genes in patients with syphilis serofast reaction and to investigate the mechanism of Th17 cells in syphilis serofast reaction. Meth-ods Peripheral blood samples were collected from patients with syphilis serofast reaction ( n=8 ) , patients who were syphilis-seronegative after treatment (n=8) and healthy subjects (n=8). Total RNA was extrac-ted from each blood sample and then reversely transcribed into cDNA. PCR-Array analysis was performed to quantify the expression levels of Th17 pathway-related genes. Results The expression levels of genes with a fold change >2 (up or down regulated) were defined as differentially expressed. (1) Compared with the control group, the patients with syphilis serofast reaction showed increased expression of genes encoding fork-head box protein 3 (Foxp3) and IL-10, but decreased expression of genes encoding C-C motif chemokine 22 (CCL22), colony stimulating factor 2 (CSF2), CSF3, chemokine (C-X-C motif) ligand 6 (CXCL6), IL-17A, IL-17D, IL-21, IL-23R, IL-9, interferon regulatory factor 4 (IRF4), RAR-related orphan receptorα( RORα) , RAR-related orphan receptor γ ( RORγ) and signal transducer and activator of transcription 3 (STAT3). (2) Compared with the seronegative syphilis group, the expression levels of genes encoding Foxp3 and IL-10 in patients with syphilis serofast reaction were up-regulated, while the expression of genes encoding CCL22, CSF2, CSF3, IL-17A, IL-21, IL-23R, IRF4, RORγ and STAT3 were down-regulated. (3) The expression levels of genes encoding CXCL6 and IL-9 in seronegative syphilis group were lower than those in control group. Conclusion The abnormal expression of Th17 pathway-related genes might relate to the pathogenesis of serofast state of syphilis.

Study on the expression characteristics of caveolin-2 in the psoriasis vulgaris / 实用医学杂志

Objective To analyze the differential expression of caveolin-2 in the psoriasis vulgaris and normal skin tissues, and investigate the relationship between caveolin-2 and the development of psoriasis vulgaris. Methods The expression of caveolin-2 mRNA and protein in psoriasis vulgaris patients and normal skin tissues were detected by quantitative PCR, immunohistochemistry and Western blot respectively. Results The quantitative PCR showed that the expression of caveolin-2 mRNA significantly decreased in the psoriasis vulgaris skin tissues when compared with the normal skin tissues (P < 0.01). The immunohistochemistry demonstrated that the caveolin-2 protein was mainly expressed in the cytoplasm of the basal layer cells in the normal skin tissues, but the caveolin-2 protein was not expressed in the lesions of psoriasis vulgaris. And the results of Western blot showed that the expression of caveolin-2 protein was significantly reduced in the psoriasis vulgaris skin tissues compared with the normal skin tissues. Conclusion The expression of caveolin-2 was reduced or lost in lesional epidermis of psoriasis vulgaris patients, which may serve as an aetiological factor in the development and or progression of psoriasis.

Contact tracing of pregnant women infected with syphilis and the associated factors / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the current status of contact tracing among pregnant women infected with syphilis and to analyze the associated factors from patients' perspective.</p><p><b>METHODS</b>Pregnant women who aged 18 years old, receiving prenatal care services in Shenzhen, diagnosed with syphilis according to national diagnostic criteria (WS 273-2007) from 2008 to 2011 were recruited and the total number was 3 551. Information of both pregnant women (including demographic information, laboratory results, syphilis diagnosis, and personal life history) and their partners (including results of partner tracing and laboratory examination) were collected with structured questionnaire by face-to-face interview. Multivariate non-conditional logistic regression model was applied to analyze the factors associated with partners' contract tracing. Odds ratio (OR) and its 95% confidential interval (95%CI) were calculated.</p><p><b>RESULTS</b>The average age was 28.72 among recruited 3 551 syphilis-infected pregnant women, with standard deviation of 5.21 and range of 18 to 40. Totally 2 550 partners attended antenatal clinics and received syphilis examination, with a contact tracing rate of 71.81%. The OR(95%CI) was 1.70(1.26-2.30) for pregnant women with college or above education when comparing with those with senior high school or below education. The OR(95%CI) was 0.57(0.45-0.71) for those unmarried or divorce when comparing with those married. The OR (95% CI) was 0.73(0.56-0.94) and 0.65(0.53-0.81) for those screened in 28-36 gestational weeks and those screened in >36 gestational weeks or right before delivery separately, when comparing with those screened in ≤27 gestational weeks. The OR (95% CI) was 1.45(1.14-1.84) for those having received sufficient treatment before pregnancy when comparing with those diagnosed with latent syphilis. The OR(95%CI) was 0.31 (0.24-0.39) for those having no treatment or not standardized treatment when comparing with those having standardized penicillin treatment. The OR(95%CI) was 0.53 (0.43-0.65) for those terminating the pregnancy when comparing with those giving birth to a baby. The OR(95%CI) was 1.24 (1.05-1.46) for those having two or more love histories when comparing with those having only one love history. The OR(95%CI) was 4.74 (3.54-6.35) for those intending to disclose the serostatus to their partner when comparing with those showing unwillingness to disclose the serostatus.</p><p><b>CONCLUSION</b>The successful rate of contact tracing among pregnant women infected with syphilis was high. The implementation of contact tracing may be affected by many factors, including patients' education levels, marital status, gestational weeks of screening, stage of syphilis, treatment status, outcome of pregnancy, number of love histories, and willingness of serostatus disclosure.</p>

Factors associated with HIV and syphilis infection among men who have sex with men blood donors in Shenzhen / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the distribution and factors associated with HIV and syphilis infection among Men who have sex with men blood donors (MSMBD) in Shenzhen.</p><p><b>METHODS</b>A total of 813 MSMBD were recruited using snowball sampling and respondent driven sampling from 2009 to 2012 in Shenzhen. Questionnaire-based interviews were conducted on a one-on-one basis. Data were collected including socio-demographic information, HIV testing history, self-identified sexual orientation, role in homosexual behavior, information about having sex with male sexual partners in the past six months and information about having sex with female sexual partners in the past six months.5 ml blood samples were taken and tested for treponema pallidum and HIV antibodies. Comparisons of syphilis and HIV infection among different years were analyzed by the Cochran-Armitage trend test. Factors associated with syphilis and HIV infection were analyzed by the univariate logistic regression and multivariate unconditional logistic regression.</p><p><b>RESULTS</b>The prevalence of syphilis, HIV, and syphilis-HIV co-infection among 813 participants were 22.0% (179/813), 8.0% (65/813), and 4.2% (34/813), respectively. In the multivariate logistic regression analysis, ever tested for HIV (versus without HIV testing history, OR (95%CI) = 0.369(0.213-0.641)) will decrease the risk of HIV infection among MSMBD in comparison with never tested for HIV (OR (95%CI) = 0.37 (0.21-0.64) ); having five or more anal sexual partners in the past six months and co-infected with syphilis will increase the risk of HIV infection among MSMBD in comparison with having 0-1 sexual partners (OR (95%CI) = 2.04 (1.03-4.06) ) and negative syphilis (OR (95%CI) = 4.52(2.64-7.73)), respectively, bisexual orientation, having 2-4 anal sexual partners and having five or more anal sexual partners in the past six months, using condoms not for every act of anal sex, co-infected with HIV will increase the risk of syphilis infection among MSMBD in comparison with homosexual orientation (OR (95%CI) = 1.60(1.12-2.27)), having 0-1 sexual partner in the past six months (OR (95%CI) = 1.77 (1.09-2.87) and OR (95%CI) = 1.84(1.09-3.08) ) , using condoms for every act of anal sex (OR (95%CI) = 1.61 (1.10-2.36) ) and negative HIV (OR (95%CI) = 4.02 (2.33-6.96)), respectively.</p><p><b>CONCLUSION</b>The prevalence of HIV and syphilis among MSMBD in Shenzhen are much higher with complex influence factors. The relevant government should pay great attention to it and ensure the blood safety.</p>

Temporal and spatial distribution as well as prediction model of sexually transmitted diseases in elderly men in Shenzhen / 中华老年医学杂志

Objective To analyze the status quo of sexually transmitted diseases (STDs) of the elderly in recent years in Shenzhen, to explore the characteristics of temporal and spatial distribution,and to establish prediction model of STDs of the elderly in Shenzhen. MethodsUsing the surveillance system data of STDs from 2005 to 2009 in Shenzhen city, the incidence, temporal and spatial distribution of syphilis and gonorrhea were analyzed in the elderly aged 50 years and over by SaTScan. The incidence prediction model of STDs was established by Eviews 5.0.Results (1)The incidences of the two kinds of STDs from 2005 to 2009 in Shenzhen were on the rise and on more marked increase in male than in female. The rising velocity in over-60 year age group was similar with in 50-59 year age group. The rising velocity of syphilis was faster than gonorrhea. (2)The space-time distribution analysis showed there were clusters of the STDs in elderly men in 2005 in Lianhua and Meilin districts (P = 0. 026, RR= 2.13). (3) ARIMA (0, 1,1) (0,0, 1) 12 model was a suitable forecasting model for STDs in elderly men in Shenzhen. Conclusions

Sequence analysis and genotyping of genital Chlamydia trachomatis among patients with suspected-Neisseria gonorrhoeae / 中华微生物学和免疫学杂志

Objective To understand the prevalence rate of genital Chlamydia trachomatis among a population with suspected-Neisseria gonorrhoeae infection,the distribution of Chlamydia trachomatis genotypes,assess changes in omp1 sequences among patients with Neisseria gonorrhoeae and Chlamydia trachomatis coinfections.Methods Four hundred and one swabs were collected.Chlamydia trachomatis and Neisseria gonorrhoeae were detected by Roche Amplicor System.DNA were extracted from those samples and were amplified by nested PCR.PCR products were sequencing and analyzed by software Mega4.0.Results The prevalence of genital Chlamydia trachomatis infection,Neisseria gonorrhoeae infection and coinfection with genital gonorrhoea and genital chlamydia were 82.3%,24.2% and 21.7% each.Eight genotypes were identified in 73 sequences,including E(27.4%),G/Ga(23.3%),D/Da(16.4%),F(13.7%),J (11.0%),H(5.5%),B and K(each 1.4%).Sequencing analysis showed that 3 cases(4.1%) had missense mutation,including genotype D/Da,E,G/Ga.Genotypes F,H,J and K were more variable,however,most of them were silent mutation.Conclusion The prevalence rate of genital Chlamydia trachomatis among a population with Neisseria gonorrhoeae infection was high.The most common genotypes were genotype E,G/Ga,D/Da and F; Sequencing analysis has provided a tool for the molecular epidemiology of genital Chlamydia trachomatis infections.

Risk factors in association with congenital syphilis: a case control study / 中华皮肤科杂志

Objective To investigate the risk factors in association with congenital syphilis, in order to provide a basis for further improvement of the ongoing Prevention of Mother to Child Syphilis Transmis- sion Project in Shenzhen. Methods A nested case-control study was designed in neonates with risk of con- genital syphilis. The case group included 51 neonates with congenital syphilis, and the control group included 320 neonates without the disease. Results The risk factors in association with congenital syphilis were mother's age, residence, education level, weeks of gestation at time of starting standardized treatment,moth- er's TRUST titer at time of diagnosis; and also father's education level, occupation and history of multiple sex partners, as showed with univariate logistic regression analysis. After adjusted with multivariate uncondi- tional logistic regression analysis, 4 independent risk factors were found, namely, mother's age, father's edu- cation level, weeks of gestation at time of starting standardized treatment, and mother's TRUST titer at time of diagnosis. Conclusions Risk factors in association with congenital syphilis are identified, which provide important clues for effective prevention of congenital syphilis.

The genetic polymorphisms of DC-SIGN and DC-SIGNR among female sex workers / 中华皮肤科杂志

Objective To determine the genetic polymorphisms of DC-SIGN and DC-SIGNR among HIV negative Chinese female sex workers. Methods The 69 bp tandem repeat numbers in exon 4 of the DC-SIGN and DC-SIGNR were examined by PCR in 234 HIV-1-seronegative female commercial sex workers. Results It was found that 4 of 234 individuals were heterozygous in DC-SIGN. For DC-SIGNR, the allele frequencies were seven times repeated in 65.2%, 5 in 18.4%, and 9 in 11.9%. Those patterns of alleles frequencies were significantly different compared with those reported in the Caucasians residing in Europe. Conclusion Polymorphisms of DC-SIGN repeat region seem to be infrequent in Chinese female sex workers and those of DC-SIGNR are different from what reported in other races.

Diagnosis of Neonatal Congenital Syphilis with Treponema pallidum IgM Western Blot / 中华皮肤科杂志

Objective To evaluate the clinical usefulness of Treponema pallidum IgM Western blot (TP-IgM-WB) test in the diagnosis of neonatal congenital syphilis. Methods Eight cases of neonatal congenital syphilis, whose mothers were diagnosed as syphilis at different pregnant stages, were tested by TRUST, TPPA, FTA-ABS-19S-IgM and TP-IgM-WB. The results and clinical manifestations were analysed. Results Three of 8 cases presented clinical manifestations of congenital syphilis, including typical cutaneous lesions, syphilitic pneumonia, and multi-system failure. The others were asymptomatic. In all 8 cases TP-IgM-WB was positive. Of them 7 cases FTA-ABS-19S-IgM was positive. Six cases (including 3 symptomatic) were positive to all four tests. One case was positive to FTA-ABS-19S-IgM and TP-IgM-WB, but negative to TRUST and TPPA. One case was negative to FTA-ABS-19S-IgM, but positive to TPPA, TP-IgM-WB and TRUST, and TRUST titer was 4 times as high as her mother. Conclusions In view of its high specificity and sensitivity, TP-IgM-WB could be used as a confirmatory test for the diagnosis of both symptomatic and asymptomatic neonatal congenital syphilis.