Analysis of late diagnosis and its influencing factors of newly reported HIV/AIDS in Guizhou Province from 2014 to 2018 / 中华疾病控制杂志

Objective To find late diagnosis and its influencing factors of newly reported HIV/AIDS in Guizhou Province from 2014 to 2018. Methods Through the Chinese National Comprehensive HIV/AIDS Prevention and Care Information System,all newly reported HIV/AIDS cases from 2014 to 2018 in Guizhou Province were analyzed and related factors of late diagnosis were analyzed using binary Logistic regression model. Results From 2014 to 2018, there were 33 611 newly reported HIV/AIDS cases in Guizhou Province, and the late diagnosis rates of newly reported cases were 35.46%, 34.49%, 38.35%, 39.74% and 38.80% respectively. The analysis showed that the proportion of late diagnosis cases from medical institutions increased year by year ( 2=64.603,P<0.001). By analyzing the late diagnosis rate of cases from different sample sources, medical institutions was significantly higher than that reported by voluntary counseling and testing, positive spouses or sexual partners( 2=276.033,P<0.001). Multivariate analysis showed that gender, marital status, route of transmission, occupation, ethnicity and source of samples were associated with the late diagnosis of newly reported cases (all P<0.05). Conclusions It shows a slow upward trend of late diagnosis rate among HIV/AIDS reported in Guizhou Province from 2014 to 2018.On the one hand, it is of great significance to continue to strengthen the publicity and education of the whole population in Guizhou , in order to improve the awareness of HIV active detection. On the other hand, we should continue to expand HIV testing in Guizhou Province to improve the early detection level of HIV/AIDS.

Mortality analysis among HIV/AIDS cases in Guizhou Province from 1995 to 2017 / 中华疾病控制杂志

Objective To investigate the distribution of death among human immunodeficiency virus/acquired immuno deficiency syndrome(HIV/AIDS) cases in Guizhou Province from 1995 to 2017. Methods The HIV/AIDS death cases from 1995 to 2017 were downloaded from “Chinese National Comprehensive HIV/AIDS Prevention and care Information system” in Guizhou Province and were analyzed. Results From 1995 to 2017, Guizhou Province reported a total of 43 794 HIV/AIDS cases and 11 527 deaths according to current address. After excluding missing persons, the HIV/AIDS mortality rate of the province was 29.8%. The proportion of reported HIV/AIDS cases died in the same year ( 21995-2012=139.5, P<0.001; 22012-2015=28.2, P<0.001) and the proportion of HIV/AIDS cases ( 21995-2012=109.1, P<0.001; 22012-2014=57.2, P<0.001) who survived at the beginning but died later in the year all showed a trend being low-high-low. In the analysis of the detection history of death cases, the detection proportion of cluster of differentiation 4(CD4) T-cell and the proportion of antiviral treatment had been increasing year by year. The analysis of the cause of death found that the proportion of death caused by AIDS increased firstly and then declined, and the proportion of death due to excessive drug abuse showed a trend of declining year by year. Conclusions The mortality rate of HIV/AIDS in Guizhou Province was still high, and decreased rather slow. Expanding the coverage of HIV monitoring and screening is one of the key tasks of AIDS prevention and control. CD4+T-cell testing and free antiviral treatment should be strengthened to reduce the mortality rate of HIV/AIDS in Guizhou Province in the future.

Preparation and quality control of Bushen Yinao Dispersible Tablets / 中草药

Objective: To optimize the preparation technology of Bushen Yinao Dispersible Tablets (BYDT) and establish a method for the quality control of BYDT. Methods: The prescription of BYDT was optimized by single factor test with the disintegrating time as index. The contents of psoralen and isopsoralen were determined by HPLC. The dissolution of BYDT was determined and compared with other two preparations. Results: PVPP was optimized as the disintegrants, MCC was optimized as the stuffing bulking agents, the proportion of PVPP and MCC was 1:2.7, and 80% ethanol was optimized as adhesives. The concentration of psoralen and isopsoralen showed a good linear relationship at the range of 4.2-52.5 and 4.6-57.5 μg/mL (r=0.9998), respectively. The average recoveries of psoralen and isopsoralen were 98.89% with RSD of 0.53%; and 100.65% with RSD of 0.93%, respectively. The total content and dissolution of psoralen and isopsoralen had no significant differences among different batches. BYDT had the higher dissolution speed and could reach the highest dissolution rate in vitro compared with the other preparations. Conclusion: This prescription of BYDT is reasonable and effective. The method is simple and accurate and could be used for the quality control of BYDT.

Effects of continuous blood purification on hemodynamics and oxygenation in patients with acute respiratory distress syndrome / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the effects of continuous blood purification on the hemodynamics and oxygenation in patients with acute respiratory distress syndrome (ARDS).</p><p><b>METHODS</b>Twenty-one patients with ARDS were treated with continuous veno-venous hemofiltration (CVVH) combined with plasma exchange. Hemodynamics and oxygenation were measured or calculated at scheduled intervals using Swan-Ganz catheters.</p><p><b>RESULTS</b>The mean arterial pressure, partial pressure of arterial oxygen, oxygen delivery, oxygen consumption increased, heart rate, mean pulmonary arterial pressure, pulmonary capillary wedge pressure, blood lactate concentration all decreased significantly after the treatment, and the oxygen extraction ratio underwent no obvious changes.</p><p><b>CONCLUSIONS</b>Continuous blood purification can increase blood and oxygen supply but has no significant effects on oxygen extraction ratio in ARDS patients.</p>

Mechanism and re-ablation strategy for postablation atrial tachyarrhythmia in atrial fibrillation patients / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the mechanism and re-ablation strategy of recurrent atrial tachyarrhythmia (ATA) following circumferential ablation of pulmonary veins (PV) in patients with atrial fibrillation (AF).</p><p><b>METHODS</b>Fifteen patients with recurrent ATA following first AF ablation procedure were included in this study. Under CARTO guidance, PVs were remapped and ablated subsequently for relapse of left atrium to PV conduction. The whole atrium was then remapped and individualized ablation was made to eliminate inducible ATA.</p><p><b>RESULTS</b>Left atrium to PV conduction relapses were evidenced in 14 patients. After re-ablation, there were no inducible ATA in 9 patients, inducible left atrial macro-reentry tachycardia in 3 patients and all were terminated by further linear ablation on the roof and left atrial isthmus, inducible atrial focal tachycardia from left atrial isthmus in 1 patient and was eliminated after additional focal ablation, inducible right atrial macro-reentry tachycardia in 2 patients and were eliminated by right isthmus linear ablation. During 1 - 16 (5.5 +/- 4.4) months follow-up, ATA was disappeared in 13 patients and reduced in another 2 patients.</p><p><b>CONCLUSIONS</b>Relapse of left atrium to PV conduction is one of the main mechanisms for postablation ATA in patients with AF. Atrial macro-reentry tachycardia and focal atrial tachycardia were less common mechanisms for postablation ATA. Re-ablation focused on closing the PV gaps and additional individualized focal and lineal ablation strategies were helpful for treating postablation ATA in AF patients.</p>

Study on the correlation of between infection, inflammation and coronary artery disease / 中华流行病学杂志

<p><b>OBJECTIVE</b>Recently studies showed infections of Chlamydia pneumoniae (Cp), Helicobacter pylori (Hp) and cytomegalovirus (CMV) played roles in the development of atherosclerosis. The aim of this study was to study relationship between infection of Cp, Hp and CMV, systemic inflammation and coronary artery disease (CAD).</p><p><b>METHODS</b>Fourty-five patients with at least one coronary artery stenosis > 50% and 33 control subjects with negative coronary angiography were recruited for this case-control study from May 2000 to October 2001. Antibodies against Cp, Hp and CMV were measured and serum C-reactive protein (CRP) levels determined for each case. CRP level > 0.8 mg/dl was defined at elevated CRP level.</p><p><b>RESULTS</b>The prevalence of Cp IgG, Hp IgG or Hp IgA antibody was associated with CAD (P = 0.017, P < 0.001, P = 0.009). After adjustment for age, gender, smoking, hypertension, hyperlipidemia and diabetes, the association was still seen. Mean CRP value was significantly higher in patients with CAD, compared to those without CAD (P < 0.001). Multivariate analysis showed statistical significance (P = 0.03). Elevated levels of CRP were found to be an important parameter for CAD (P = 0.032). The prevalence of Cp IgG antibody, Hp IgG and CMV IgG antibody all showed no association with elevated levels of CRP (P = 0.391, P = 0.253, P = 0.724). The ratio of elevated levels of serum basic CRP in the group with IgG antibodies to 3 pathogens was 32.1% while in the group with IgG antibodies to <or= 2 pathogens it was 14.9%. But with no significance difference between the two (P = 0.078).</p><p><b>CONCLUSIONS</b>Two chronic infections, Cp and Hp, might increase the risk of CAD. There was no association of CMV infection with CAD. C-reactive protein was an independent parameter of CAD, but the increased systemic inflammation in CAD did not seem to be related to aforesaid infection.</p>

Hypercoagulability existing in the local left atrium of patient with mitral stenosis / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the pathogenesis of thromboembolism in patients with mitral stenosis in a pre-thrombotic state.</p><p><b>METHODS</b>The biochemical markers' levels in plasma for platelet activity [soluble P-selectin (GMP-140)], states of thrombin generation [antithrombin III (AT III) and protein C (PC)], fibrinolysis [D-dimer (DD), plasminogen activator inhibitor 1 (PAI-1), tissue plasminogen activator (t-PA) and FDP] and von Willebrand factor (vWF) were determined from blood specimens obtained from the femoral veins and arteries and the right and left atria of 43 consecutive patients (20 with atrial fibrillation and 23 with sinus rhythm) with mitral stenosis (MS), undergoing percutaneous mitral valvuloplasty. The same parameters were compared with those of 15 control subjects, who had no detectable heart disease, but with paroxysmal supraventricular tachycardia undergoing radiofrequency catheter ablation of the left accessory pathway through a transseptal passage.</p><p><b>RESULTS</b>Blood from the left atrium contained an excessive amount of platelet activity, thrombin generation and fibrinolysis compared with the blood from the right atrium, and the femoral veins and arteries. However blood from the right atrium was much lower in these activities when compared with those from the left atrium, and the femoral veins and arteries in both groups. Compared with those in the control subjects, GMP-140 in the left atrium was significantly higher (P < 0.05) and AT III was significantly lower (P < 0.05) in patients with MS. Compared with the patients with MS and spontaneous left atrial echocontrast (LASEC) </= 1, the patients with MS and LASEC >/= 2 had significantly higher levels of GMP-140 in plasma (P < 0.05), and significantly lower levels of AT III (P < 0.05) and PC (P < 0.01) levels in the left atrium. However, there were no significant differences between patients with atrial fibrillation and those with sinus rhythm regarding amounts of plasma coagulation markers in the left atrium. Univariate regression analysis revealed that LASEC was negatively correlated with plasma levels of blood from the left atria in the patients with MS.</p><p><b>CONCLUSION</b>Coagulability is increased in the left atria of patients with MS and is positively correlated with LASEC.</p>

Radiofrequency catheter ablation autonomic nerve injury / 浙江大学学报·医学版

OBJECTIVE: To investigate the correlation between RFCA catheter cumulative energy and autonomic nerve injury. METHODS: Forty-one patients with paroxysmal supraventricular tachycardia were enrolled, Patients were excluded if they had Diabetes, Hypertension, Congestive Heart Failure or other organic heart disease. HRV and biochemical markers were measured before and after the RFCA. RESULTS: Compared with pre-ablation values,there was significantly decrease in post-ablation low frequency (LF) and high frequency (HF). This was noted in both the septal group (AVNRT and septal pathway) and free wall group (free wall accessory pathway).Post-procedure,the sensitivity of cardiac troponin I(cTnI) for myocardial injury detection was 58.3%, AST was 41.7%. This was significantly higher than other markers(CK:4.2%, CK-MB:10.4%, LDH:20.8%). The post-ablation sensitivity of cTnI was 54.2%, 6.3% and 52.1%at 1 hour, 12 hours, and 24 hours respectively. A significant correlation between cumulative energy and delta HF(r=0.688,P=0.01) or delta LF (r=0.462, P<0.05).was noted in free wall group.(delta HF=pre-ablation HF-post-ablation HF/pre-ablation HF x 100%). There was no significant correlation between biochemical markers and either delta HF or delta LF. CONCLUSION: RFCA induced injury on cardiac autonomic nerves related to both cumulative energy and ablation site,but not size of myocardial injury as determined by cTnI measurement. cTnI is an excellent biochemical marker of myocardial injury.