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Objective To analyze the genetic subtypes of human immunodeficiency virus (HIV) and the prevalence of pretreatment drug resistance in the newly reported HIV-infected men in Guangxi. Methods The stratified random sampling method was employed to select the newly reported HIV-infected men aged≥50 years old in 14 cities of Guangxi from January to June in 2020.The pol gene of HIV-1 was amplified by nested reverse transcription polymerase chain reaction and then sequenced.The mutation sites associated with drug resistance and the degree of drug resistance were then analyzed. Results A total of 615 HIV-infected men were included in the study.The genetic subtypes of CRF01_AE,CRF07_BC,and CRF08_BC accounted for 57.4% (353/615),17.1% (105/615),and 22.4% (138/615),respectively.The mutations associated with the resistance to nucleoside reverse transcriptase inhibitors (NRTI),non-nucleoside reverse transcriptase inhibitors (NNRTI),and protease inhibitors occurred in 8 (1.3%),18 (2.9%),and 0 patients,respectively.M184V (0.7%) and K103N (1.8%) were the mutations with the highest occurrence rates for the resistance to NRTIs and NNRTIs,respectively.Twenty-two (3.6%) patients were resistant to at least one type of inhibitors.Specifically,4 (0.7%),14 (2.3%),4 (0.7%),and 0 patients were resistant to NRTIs,NNRTIs,both NRTIs and NNRTIs,and protease inhibitors,respectively.The pretreatment resistance to NNRTIs had much higher frequency than that to NRTIs (2.9% vs.1.3%;χ2=3.929,P=0.047).The prevalence of pretreatment resistance to lamivudine,zidovudine,tenofovir,abacavir,rilpivirine,efavirenz,nevirapine,and lopinavir/ritonavir was 0.8%, 0.3%, 0.7%, 1.0%, 1.3%, 2.8%, 2.9%, and 0, respectively. Conclusions CRF01_AE,CRF07_BC,and CRF08_BC are the three major strains of HIV-infected men≥50 years old newly reported in Guangxi,2020,and the pretreatment drug resistance demonstrates low prevalence.
Subject(s)
Male , Humans , Middle Aged , Reverse Transcriptase Inhibitors/therapeutic use , HIV Infections/drug therapy , Drug Resistance, Viral/genetics , China/epidemiology , Mutation , HIV-1/genetics , Protease Inhibitors/therapeutic use , GenotypeABSTRACT
PURPOSE@#The long-term situation of children with spinal cord injury (SCI) was investigated, and suggestions for helping them better return to the society were provided.@*METHODS@#SCI patients less than 18 years old hospitalized in Beijing Boai Hospital from January 2011 to December 2020 were retrospectively analyzed. Information including motor function, complications, characteristic changes, self-care abilities, school attendance and social participation were collected by telephone interview and electronic questionnaire. All the answers were statistically analyzed.@*RESULTS@#A total of 86 cases were enrolled, 77 girls and 9 boys, with a median injury age of 6 years and 2 months. The follow-up time was 3-130 months. The main cause of trauma in these children was sport injury (66.3%), the thoracic spinal cord was involved the most (91.9%), and complete SCIs accounted for the majority (76.7%). In terms of complications, children with complete SCIs were more likely to have urinary incontinence, constipation and characteristic changes (p < 0.05); whereas the incomplete SCIs often have spasticity (p < 0.05). As to the daily living abilities, children with incomplete lumbar SCIs were more capable to accomplish personal hygiene, transfer, and bathing independently than those with complete injuries, or cervical/thoracic SCIs, respectively (p < 0.05). Moreover, children older than 9 years care more able to dress and transfer independently than the youngers (p < 0.05). Wheelchair users accounted for 84.9% and more than half of them were able to propel wheelchair independently, and those who move passively in wheelchairs were mostly introverted kids (p < 0.05). Almost all (93.8%) children with incomplete injuries were able to walk independently. Most (79.1%) children continued to attending school, and 41.9% participated in interest classes. Unfortunately, 67.4% of the children spent less time playing with their peers than before the injury.@*CONCLUSION@#SCIs impair physical structures and function of children, affect their independence in daily living, and restrict school attendance and social interaction. Comprehensive rehabilitation after injury is a systematic work. Medical staff and caregivers should not only pay attention to neurological function, but also help them improve self-care abilities. It is also important to balance rehabilitation training and school work and social participation.
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Male , Female , Humans , Child , Adolescent , Follow-Up Studies , Retrospective Studies , Spinal Cord Injuries/complications , PrognosisABSTRACT
Objective:To study the changes of brain motor control function in patients with complete spinal cord injury within three to six months. Methods:From January, 2017 to January, 2019, eleven inpatients with complete spinal cord injury and twelve healthy controls were screened with functional magnetic resonance imaging during attempted/executive movement (MA/ME) and motor imagery (MI). The involved area and activation were compared between the groups under tasks. Results:More areas were activated in the patients than in the controls as MA/ME, such as bilateral primary sensorimotor cortex, supplementary motor area, lateral globus pallidus, cerebellum, contralateral thalamus and putamen. During MI, the activation was more in the patients in ipsilateral primary motor cortex, supplementary motor area, dorsal premotor area, contralateral supplementary motor area, insular and basal ganglia. The patients induced more activation as MA than as MI in ipsilateral primary motor cortex, bilateral supplementary motor area and cingulate motor area, and contralateral cerebellum. Conclusion:The activation remains normal in primary motor cortex and supplementary motor area for subacute complete spinal cord injury patients when undergoing motor tasks, but some reorganization may occur in parietal lobe and cerebellum that involve in sensorimotor integration.
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Objective To study whether and how rotenone reduces the activity of protein phophatase 2A (PP2A). Methods MN9D cells (mouse midbrain dopaminergic cell line) were divided into normal group (normal cultured), con-trol group (dimethyl sulfoxide of same volume with rotenone group was added in medium), rotenone group (50 nmol/L rotenone was added to the culture medium for 24 hours) and rotenone+C2 group (pretreatment of 5 mol/L C2-ceramide for eight hours, and then exposed to 50 nmol/L rotenone for 24 hours). MTT was used to detect cell viability. Total PP2A levels and tyrosine phosphorylation levels were measured with Western blotting. PP2A activity was detected with colorimetric assay.Results Compared with the control group, the cell viability reduced (P<0.01), phosphorylation of tyrosine 307 of PP2A inceased (P<0.01), and activity of PP2A decreased in the rotenone group (P<0.05). And compared with the rote-none group, the cell viability improved (P<0.01), phosphorylation of tyrosine 307 of PP2A deceased (P<0.01), and activity of PP2A increased (P<0.05) in the rotenone+C2 group. Conclusion Rotenone can inhibit activity of PP2A through increasing phosphorylation of tyrosine 307 at the catalytic subunit of PP2A, which might be involved in reducing cell viability, and implicate a new treatment strategy for Parkinson's disease.
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Objective To compare the clinical feasibility of excising epiglottis cyst by CO2 laser and high frequency under laryngomicroscope. Methods 44 cases with epiglottic cysts were divided into two groups, with 22 cases in observation group (OG) and also 22 cases in control group (CG). All patients were operated by a laryngomicroscopic surgery under a general anesthesia, while cases in OG under CO2 laser and patients in CG under high frequency electric knife to remove the cyst. Then, analyse and compare the clinical feasibility. Results The average operating time is significantly shorter , and the VAS of sore throat is obviously lower in OG than that in CG. Thanks to the accurate and precise operation by CO2 laser, the epiglottis cysts are able to be removed intact, the surrounding tissues and epiglottic cartilage are better protected. There is no recurrence in both groups. Conclusion The operation performed with CO2 laser under micro-laryngoscope holds such advantages as accurate and easy to operate, better protect cyst wall, and fewer side hurting.
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Objective To compare the clinical feasibility of excising epiglottis cyst by CO2 laser and high frequency under laryngomicroscope. Methods 44 cases with epiglottic cysts were divided into two groups, with 22 cases in observation group (OG) and also 22 cases in control group (CG). All patients were operated by a laryngomicroscopic surgery under a general anesthesia, while cases in OG under CO2 laser and patients in CG under high frequency electric knife to remove the cyst. Then, analyse and compare the clinical feasibility. Results The average operating time is significantly shorter , and the VAS of sore throat is obviously lower in OG than that in CG. Thanks to the accurate and precise operation by CO2 laser, the epiglottis cysts are able to be removed intact, the surrounding tissues and epiglottic cartilage are better protected. There is no recurrence in both groups. Conclusion The operation performed with CO2 laser under micro-laryngoscope holds such advantages as accurate and easy to operate, better protect cyst wall, and fewer side hurting.
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ObjectiveTo analyze and evaluate the responsiveness and feasibility of the quality of life instrument for patients with systemic lupus erythematos(SLE).Methods143 cases of SLE patients were measured by QLICD-SLE before and after treatment and the data were analyzed with the traditional hypothesis test and combining the effect size,standardized response mean,the relative efficiency,the standard effect size and the feasibility analysis methods.Results(1)Paired t test before and after treatment indicated that there were significant differences between after treatment and before treatment in physical(t=2.39,P<0.05) and specific module domain(t=2.22,P<0.05),while there were no significant promotion in the scores of psychological function,social function and total score after treatment.There were no significant changes of SES,SRM and CR after treatment.(2)Most patients could understand the meaning of the instrument well and spent 15-20 minutes to finish it.The rate of recovery and completed were 98.0% and 97.8% respectively.ConclusionsThe QLICD-SLE can detect clinical change of treatment with good responsiveness and feasibility.
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Increasingly accumulated results from randomized controlled trials and other clinical studies have demonstrated that male circumcision reduces the risks of acquisition and transmission of HIV, HPV, HSV-2, and other sexually transmitted infections, and thus has a potential role in preventing cervical cancer, penile cancer and prostate cancer. The prevalence of male circumcision in China is currently less than 5%. The clinical evaluation studies and randomized controlled trials of the Shang Ring device showed excellent safety profiles, extremely high acceptability, and satisfaction among the participants and service providers in Africa and China. Given the recent recommendations by the World Health Organization and the Joint United Nations Program on HIV/AIDS (UNAIDS), voluntary medical male circumcision should be promoted in China at the national level as an important alternative intervention to reduce reproductive tract infections and prevent both males and females from reproductive tract cancers. More emphasis is required on the studies of the long-term health benefits of male circumcision in uro-andrology.
Subject(s)
Female , Humans , Male , China , Circumcision, Male , HIV Infections , Penile Neoplasms , Prevalence , Randomized Controlled Trials as Topic , Sexually Transmitted Diseases , Urinary Tract Infections , Uterine Cervical Neoplasms , World Health OrganizationABSTRACT
<p><b>OBJECTIVE</b>To understand the distribution of HIV-1 subtypes in Guangxi Zhuang Autonomous Region.</p><p><b>METHODS</b>294 participants who were infected by HIV-1 in 2008 - 2009 and residing in 13 cities in Guangxi were enrolled into this study. Epidemiological information showed that heterosexual transmission was the main transmitting route. 1584 bp full length gag gene, 3147 bp full length pol gene and 558 bp env (C2V3) fragments were amplified by using RT-PCR and then directly sequenced. NCBI genotyping tool and Mega 5.03 software were used to determine the HIV subtypes. Simplot and Recombinant HIV-1 Drawing Tool were used for the analysis of recombination.</p><p><b>RESULTS</b>A total of 739 sequences, including 270 gag, 246 pol and 223 env (C2V3), were successfully obtained from 294 plasma specimens. Genotypes of HIV from 272 participants were determined. CRF01_AE was found the dominant (77.6%), followed by CRF08_BC (10.7%) and CRF07_BC (7.4%). 7 unique recombinant forms, 4 subtype B (B') and 1 subtype G were also identified. No significant difference on the distribution of subtypes among different regions and ethnics was found. Among the 7 unknown recombinant forms, 6 strains were mosaic B and/or C fragments with CRF01_AE genome as the backbone, while one strain originated from CRF07_BC and CRF08_BC.</p><p><b>CONCLUSION</b>Currently, CRF01_AE was found the major subtype of HIV epidemic in Guangxi. New recombinant forms with CRF01_AE as backbones had been emerging, which called for serious attention.</p>
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , China , Epidemiology , Genes, Viral , Genotype , HIV Infections , Epidemiology , HIV-1 , Genetics , Molecular EpidemiologyABSTRACT
OBJECTIVE@#To explore the main reasons of medical malpractice of fetal abnormalities and to analyze the key points and the ideas in judicial appraisal.@*METHODS@#According to the related laws, regulations and clinical practice guidelines, the medical faults and the contribution degree in 12 medical malpractice cases about fetal abnormalities were analyzed.@*RESULTS@#There were medical faults in five cases. Among them, the doctors did not fulfill the duty of inform in 2 cases, did not analyze the abnormal results comprehensively in 2 cases, did not have qualified medical conditions and normative reports in 1 case. The hospitals needed to take the minor responsibility in 2 cases and slight responsibility in 2 cases.@*CONCLUSION@#The key points in the judicial appraisal are whether the doctors abide by the related laws, regulations and clinical practice guidelines in prenatal examination, screen and diagnosis, and whether the doctors realize the limitations of ultrasonic testing and fulfill the obligation of inform.
Subject(s)
Female , Humans , Pregnancy , Expert Testimony , Fetus/abnormalities , Forensic Medicine , Informed Consent , Malpractice/statistics & numerical data , Medical Errors/statistics & numerical data , Prenatal Diagnosis , Retrospective Studies , Ultrasonography, PrenatalABSTRACT
<p><b>OBJECTIVE</b>To investigate the changes of the T lymphocytes and their subsets before and after receiving highly active anti-retroviral therapy (HAART) in children who were infected with HIV or AIDS patients.</p><p><b>METHODS</b>Ninety-nine children met the criteria were recruited. All of them had received HAART in Guangxi Center for Disease Control and Prevention from May 2006 to April 2009. Peripheral blood of 2 milliliter was collected before treatment (D0) and after 3, 6, 12, 18, 24, 30, and 36 months (M3, M6, M12, M18, M24, M30 and M36), respectively. Four-color fluorescence flow cytometry was used for the detection of the absolute numbers of CD3(+), CD4(+), CD8(+) T lymphocytes in peripheral blood. And then, the percentages of CD3(+), CD4(+), CD8(+) T lymphocytes in the CD45(+) cells and the ratio of CD4/CD8 were calculated.</p><p><b>RESULTS</b>Sixteen-five (65.66%) cases were treated with lamivudine (3TC)/zidovudine (AZT)/nevirapine (NVP), and 16 (16.16%), 8 (8.08%) and 10 (10.10%) cases were treated with 3TC/stavudine (D4T)/NVP, 3TC/AZT/efavirenz (EFV) and 3TC/AZT/lpv-rtv (LPV/r), respectively. The median of the ratio of CD4/CD8 were 0.39, 0.51, 0.61, 0.65, 0.70, 0.73 and 0.76 in M3, M6, M12, M18, M24, M30 and M36, respectively which were significantly higher than that in D0 (0.19) (Z values were -5.158, -7.375, -9.078, -8.853, -8.373, -5.845 and -5.844 respectively, P < 0.000). The median of CD4% were 16.92%, 22.70%, 25.54%, 26.66%, 27.99%, 30.36% and 29.30% respectively in M3, M6, M12, M18, M24, M30 and M36 respectively, which were also higher significantly than that in D0 (9.92%) (Z values were -5.268, -7.568, -9.496, -9.171, -8.760, -6.190 and -5.964 respectively, P < 0.000). In addition, the median of the absolute numbers of CD4(+)T lymphocytes in peripheral blood were 631, 813, 1050, 946, 1057, 1166 and 894 cells/mm(3) respectively in M3, M6, M12, M18, M24, M30 and M36, which were higher significantly than that of D0 (382 cells/mm(3)) (Z values were -3.318, -5.288, -6.661, -5.886, -5.801, -4.110 and -3.600 respectively, P < 0.000). However, the median of CD8% were 47.25%, 43.01%, 43.04%, 42.60%, 41.37%, 40.83% and 38.31% respectively in M3, M6, M12, M18, M24, M30 and M36, which were lower significantly than that of D0 (53.17%) (Z values were -3.082, -4.697, -5.282, -5.846, -5.757, -3.883 and -4.380 respectively, P < 0.001).</p><p><b>CONCLUSION</b>There is certain rules for the changes of T lymphocytes and their subsets, which may play important roles in the evaluation of the therapeutic effect and the clinical application guidance of HAART.</p>
Subject(s)
Child , Child, Preschool , Female , Humans , Infant , Male , Acquired Immunodeficiency Syndrome , Drug Therapy , Allergy and Immunology , Antiretroviral Therapy, Highly Active , CD4-Positive T-Lymphocytes , CD8-Positive T-Lymphocytes , HIV Infections , Drug Therapy , Allergy and Immunology , Lymphocyte Count , T-Lymphocyte SubsetsABSTRACT
OBJECTIVE@#The injury instruments were identified and studied according to the cleaver traces on bone.@*METHODS@#The bone and fresh shrub branches were cut with the same part of the same cleaver respectively. To visualize the traces on the bone by histological processing and to match the traces on bone and branch by the comparison microscope. Then to analyze the character of traces on the bone.@*RESULTS@#Cutting-line traces made by cleaver on the bone can be fully matched with those in the shrub branch sample.@*CONCLUSION@#Cleaver traces on the bone can be displayed clearly and shown at micro level. It will provide a new method for the identification of suspected weapon.
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Humans , Bone and Bones/pathology , Expert Testimony , Femur/pathology , Forensic Pathology/methods , Microscopy, Electron/methods , Violence , Wood , Wounds and InjuriesABSTRACT
Objective To analyze the genetic characteristics of HIV-1 CRF01_AE strains prevailing in. the four provinces of southern China. Methods Plasma samples were collected from the newly diagnosed HIV-1 individuals reported in 2006 in Guangdong, Guangxi, Jiangxi and Hunan province. The gag and env gene fragments were amplified from RNA template extracted from plasma using RT and nested PCR methods. CRF01_AE sequences were analyzed by phylogcnetie methods and characterized by calculating the genetic distance and Entropy analysis. Results Two main epidemic clusters were found to exist in the CRF01 AE strains from 210 HIV-1 CRF01 AE infected individuals collected in the 4 provinces, southern China. It was found that no international reference strain was closely correlated with cluster Ⅰ , which including 123 samples. The strains in cluster Ⅱ, consisting 57 cases of samples, were closely related with the strains identified in Vietnam. Genetic distance analysis of gag and env genes showed that the diversity of cluster Ⅰ was obviously less than that of cluster Ⅱ. Data on nucleotide polymorphism showed that nucleotides compositions of 42 sites in gag and 40 sites in env wer esignificantly different between the two clusters. When compared with cluster Ⅱ , the polymorphism decreased at 61 nucleotide sites but increased at 21 sites in cluster Ⅰ. Conclusion This was the first report describing that two main epidemic clusters were existed in CRF01_AE strains prevailing in the 4 provinces, Southern China. The vires in cluster Ⅰ was the dominant strain in this region, with shorter period of circulation and higher proportion seen in the HIV-infected population, which might belong to CRF01_AE strain with certain features facilitating the spread of the virus. The virus in cluster Ⅱ was highly homology with the CRF01_AE strains from Vietnam, and seemed to have had several events of epidemics in populations in border regions of China and Vietnam.
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Objective: This study intended to explore the relationships of the polymorphism of phase II drug-metabolizing enzyme, microsomal epoxide hydrolase 1 (EPHX 1) with the habits of smoking and alcohol drinking, and their interactions on risk of deve-loping primary hepatocellular carcinoma (HCC). Methods: The genotypes at codon 113 of exon 3 of gene EPHX 1 were analyzed in 105 patients with HCC and 151 healthy controls in Guangxi Province by using polymerase chain reaction followed by restriction fragment length polymorphism (PCR-RFLP). The habits of smoking and alcohol drinking of all the subjects were investigated. Results: The frequencies of Tyr/Tyr, Tyr/His and His/His genotypes at codon 113 of exon 3 of gene EPHX 1 were 27.62%, 21.90%, and 50.48% for HCC patients and 21.19%, 34.44%, and 44.37% for healthy controls, respectively. There was no significant difference (P > 0.05). Smoking increased the risk of developing HCC for patients with His/His genotype. The OR value was 2.99 (95% CI: 1. 29-6.91). For the HBV-positive patients, polymorphism of EPHX 1 and the habits of smoking and alcohol drinking had synergistic effects on the development of HCC. Conclusion: The interaction between the environmental factors such as smoking and alcohol drinking and polymorphism of EPHX 1 gene may increase the risk of developing HCC.
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<p><b>OBJECTIVE</b>To explore the reconstitution of immune function and viral suppression condition and to analyze the occurrence of drug resistance HIV-1 variants and its prevalence after using HAART in Guangxi Autonomy Region.</p><p><b>METHODS</b>From July 2004 to October 2005, 133 HIV infected individuals who had received HAART for more than three months were recruited, and 58 infected persons with no antiviral therapy were selected as controls. Questionnaire was used to collect information about the adherence of HAART therapy. Immune reconstruction and viral suppress conditions were obtained by CD4+ counts and viral load and RT-PCR were used to amplify the PR and RT regions of HIV-1 genome while HIV-1 drug resistance rates were analyzed to show the occurrence and prevalence in both treated and naive patients.</p><p><b>RESULTS</b>In terms of CD4+ T cell counts: 70.69% of the treated patients showed obvious increase and 23.28% had no apparent change but 6.03% of them went down. 70.48% of the patients who had received antiviral therapy more than 3 months had their viral load lower than the low detectable limitation. When comparing the log of viral load between treated and untreated cohort, the mean value of the treated was obviously less than the untreated (P < 0.05). However,the result of drug resistance showed no obvious difference between the treated and untreated groups.</p><p><b>CONCLUSION</b>The antiviral therapy being used in Guangxi region, had achieved obvious effect on the reconstruction of immune system and the suppression of viral replication in vivo under good adherence while the occurrence of drug-resistant HIV strain did not show obvious difference between treated and naive patient groups.</p>
Subject(s)
Humans , Antiretroviral Therapy, Highly Active , CD4 Lymphocyte Count , Case-Control Studies , China , HIV Infections , Drug Therapy , Epidemiology , Virology , HIV-1 , Patient Compliance , Prevalence , Reverse Transcriptase Polymerase Chain Reaction , Viral LoadABSTRACT
<p><b>OBJECTIVE</b>To study the compatibility of composite herbal medicines of the Ling Gui Zhu Gan Decoction.</p><p><b>METHOD</b>Ethanol extract test solutions of the different combinations were prepared according to the orthogonal layout L16(4(5)). Pharmacologic experiments, such as the time of surviving of mice in shortage of oxygen in regular air pressure, the antagonizing effect on arrhythmia induced by chloroform and diuresis were carried out with the solutions. Variance analysis, canonical correlation and stepwise regression analysis were applied to interrelate the amount of each drug and the pharmacologic data.</p><p><b>RESULT</b>The results confirmed that Fuling and Guizhi are the basis, while Baizhuand Gancao are the adjuvans, which is conformed to the theory of TCM.</p><p><b>CONCLUSION</b>This study provides a significant try for studying the compatibility of composite herbal medicines.</p>