Prevention and control of HIV/AIDS in China: lessons from the past three decades / 中华医学杂志(英文版)

In the past 37 years, human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) has undergone various major transmission routes in China, with the world most complex co-circulating HIV-1 subtypes, even the prevalence is still low. In response to the first epidemic outbreak of HIV in injecting drug users and the second one by illegal commercial blood collection, China issued the Anti-Drug Law and launched the Blood Donation Act and nationwide nucleic acid testing, which has avoided 98,232 to 211,200 estimated infections and almost ended the blood product-related infection. China has been providing free antiretroviral therapy (ART) since 2003, which covered >80% of the identified patients and achieved a viral suppression rate of 91%. To bend the curve of increasing the disease burden of HIV and finally end the epidemic, China should consider constraining HIV spread through sexual transmission, narrowing the gaps in identifying HIV cases, and the long-term effectiveness and safety of ART in the future.

The spectrum of chronic diseases and influential factors of immigrants moving water source area of South-to-North Water Diversion Project / 中华疾病控制杂志

Objective To understand the prevalence and disease distribution of migrants within the water source area of the Middle Route Project of South-to-North Water Diversion Project and analyze the influencing factors. Methods By multi-stage stratified cluster sampling method, 307 immigrants and 676 immigrants were selected from Danjiangkou reservoir area, Shiyan city, Hubei Province. Results The prevalence of chronic diseases among in-migration was 51.8%. The prevalence rates of the top five chronic diseases were waist and leg pain, hypertension, gastritis, heart disease and diabetes. The prevalence of chronic diseases among out-migration was 65.1%. The prevalence rates of the top five chronic diseases were waist and leg pain, hypertension, gastritis, heart disease and bronchitis. The rate of chronic disease, the rate of two weeks and the rate of two weeks' visit were higher than that of emigration(all P<0.05). The results of multivariate analysis showed that the factors influencing the chronic diseases of immigrants were 60 years old (OR=59.928，P<0.001), unsatisfied family income (OR=0.377, P=0.002) and poor economic status (OR=0.517, P=0.028). The factors influencing the chronic diseases of immigrants were 60 years old (OR=26.190, P<0.001), smoking (OR=1.856,P=0.004), unsatisfactory family income (OR=0.598,P=0.029) and poor economic status (OR=0.460,P<0.001). Conclusions The prevalence of migrants within a high level is at a high level. Actually raising the income of immigrants is conducive to improving the health condition of immigrants.

The stability of intraocular lenses in primary angle-closure glaucoma after phacoemulsification / 眼科新进展

Objective To observe the stability of intraocular lens (IOL) in primary angle-closure glaucoma by ultra-long scan depth spectral domain optical coherence tomography (UL-OCT) after the phacoemulsification.Methods Totally 42 patients (42 eyes) with primary closed-angle glaucoma (PACG) and age-,gender-matched 40 patients (40 eyes) with age-related cataract were included in the study.All of patients underwent phacoemulsification combined with softec HD IOL implantation.Images were obtained by UL-OCT in 1 week,1 month and 3 months after the surgery for the calculation and analysis of the IOL decentration,tilt and the space between IOL and posterior capsule (IOL-PC space).And finally the intergroup differences at the different time-points were compared with the independent sample t test.Results The IOL decentration after 1 week,1 month and 3 months was (0.182 ± 0.054) mm,(0.232 ±0.081)mm,(0.183 ±0.089) mm in the PACG group,and (0.342 ± 0.141)mm,(0.288 ±0.110)mm,(0.249 ± 0.132)mm in the ARC group.There was statistically significant difference in IOL decentration 1 week after surgery between the two groups (P =0.006),but the differences in this variable at the other two time-points between the two groups were not statistically significant (both P ＞ 0.05).The tilt on the vertical axis at 1 week,1 month and 3 months after surgery was (3.670 ± 6.610) °,(-0.940 ± 4.730) °,(0.540±9.510)° in the PACG group,and (-4.090±7.610)°,(-5.100±5.530)°,(-1.430 ± 8.800) ° in the ARC group.The tilt on the vertical axis of the PACG group was less than that of the ARC group at 1 week after surgery,with statistical difference (P =0.025),but there was no significant difference in this variable at the other two time-points (both P ＞ 0.05).Moreover,the tilt on the horizontal axis showed no statistically significant differences (all P ＞ 0.05).The IOL-PC space on horizontal axis at 1 week,1 month and 3 months after surgery was (0.111 ±0.091)mm2,(0.044 ±0.066)mm2,(0.055 ±0.055) mm2 in the PACG group,and (0 176 ±0.213) mm2,(0.255 ±0.303) mm2,(0.059 ± 0.066) mm2 in the ARC group.The IOL-PC space on horizontal axis of the PACG group was less than that of the ARC group at 1 month after surgery,with statistical difference (P =0.045),but there was no significant difference in this variable at the other two time-points (both P ＞ 0.05).Moreover,the IOL-PC space on vertical axis showed no statistically significantdifferences (all P ＞ 0.05).Conclusion The stability of Softec IOL in the PACG group is better than that in ARC group in 3 months after phacoemulsification.

Tilt of IOLs and change of axial length in patients of posterior capsular opacification after Nd:YAG laser capsulotomy / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To study the tilt of the intraocular lens (IOL) after Nd:YAG capsulotomy (YAG) and variation of the axial length (AL) in patients with posterior capsular opacification (PCO).METHODS: The study involved 18 eyes of 14 patients with PCO after uncomplicated phacoemulsification surgery and IOL implantation.All patients had taken examinations,including testing best corrected visual acuity (BCVA) by using standard logarithmic visual acuity chart,images of ocular anterior segment and AL by OCT.After the examinations,YAG was operated upon all patients.Each eye received one drop of Diclofenac Sodium Eye Drops immediately after YAG,and patients had taken examinations listed above again.One week later,BCVA and OCT were tested as well.Data (BCVA,tilt of IOLs,and AL) were recorded and analyzed statistically by SPSS.RESULTS: Mean patient age was 73.93±6.94y,including 5 males and 9 females,8 left eyes and 10 right eyes,altogether 14 patients with 18 eyes.In this study,tilt of IOLs was defined as the angle of anterior surface of IOL and pupil plane (briefly called Tilt,unit:°).Before YAG,mean Tilt was 2.896±2.286°,mean AL was 23.56±0.55mm.1h after YAG,mean Tilt was 4.702±2.991°,mean AL was 23.40±0.59mm,and BCVA enhanced 3.72±1.74 lines.1wk after YAG,9 patients with 12 eyes were involved in the study.The mean Tilt of these 12 eyes was 3.175±1.791° 1h after YAG and 3.434±1.835° 1wk after YAG.There were significant differences between Tilt before YAG and Tilt 1h after YAG.There were no significant differences between AL before YAG and AL 1h after YAG.There were no significant differences between Tilt 1h after YAG and Tilt 1wk after YAG.The lines of enhancement of BCVA 1h after YAG was correlated to differences between Tilt before YAG and Tilt 1h after YAG,of which the correlation coefficient was-0.523.CONCLUSION: IOLs of patients with PCO tilted after YAG,while AL rarely changed.After YAG,the less IOLs tilted,the more BCVA enhanced.

Association analysis of accommodative microfluctuations and wavefront aberration in emmetropia and myopia in teenagers / 中华实验眼科杂志

Background When focusing on a target,the accommodative system exhibits small variations in power within a range,termed microfluctuations.Exploring the correlation between the characters of microfluctuations and the aberrations of the eyes through a critical period-teenager can deepen the understanding of the onset and development of myopia.Objective This study was to investigate the correlation between accommodative microfluctuations and wavefront aberrations of human eyes,and to explore the role of accommodative microfiuctuations in the development of myopia.Methods A cross-sectional study was designed and performed.Fifty-four teenagers aged from 12 to 15 years were enrolled in this study in Eye Hospital,Wenzhou Medical University from 2010 to 2011,including 19 emmetropic subjects,18 incipient myopic subjects and 17 progressive myopic subjects,who were chosen based on the refractive changes for the last two years.The accommodative response and microfluctuations were measured by WAM-5500 infrared autorefractor with RSVP at 25,33 and 50 cm respectively,each RSVP distance was tested for 5 minutes.The accommodative values were divided into low frequency component (LFC) (0-0.6 Hz),middle frequency component(MFC) (0.6-0.9 Hz) and high frequency component (HFC) (1.0-1.4 Hz) after Fourier spectrum analysis.The wavefront aberrations of the whole eye and corneal were recorded by i-Trace aberrometer and Humphrey corneal topography.The differences of accommodative response,microfluctuations and aberrations were evaluated and compared among the emmetropic group,incipient myopic group and progressive myopic group.The correlations of accommodation and aberrations were analyzed.This study followed Declaration of Helsinki,and informed consent was obtained from each subject.Results Under the 25 cm and 33 cm reading distance,the accommodative response values were (2.78 ± 0.35) D and (2.19 ± 0.27) D in the emmetropic group,which were significantly higher than (2.44±0.33) D and (1.89±0.35)D in the progressive myopic group (P=0.002,0.003).LFC,MFC and HFC were remarkably increased as the reading distance decreased (Fdistance =8.480,14.270,21.400;all at P ＜0.01).A significant difference was seen in LFC among different reading distances (Fgroup =4.115,P＜0.05),and the LFCs in the progressive myopic group were considerably higher than those in the emmetropic group in the 25,33 and 50 cm reading distances (P=0.044,0.038,0.032).No significant differences were found in MFC and HFC among the three groups (Fgroup =0.859,0.682;both at P＞0.05).Under the 25 cm and 33 cm reading distances,significant positive correlations were found between LFC and corneal coma,intraocular coma,whole ocular aberrations or intraocular higher order aberrations (all at P＜0.05),however,no significant correlations were seen between MFC or HFC and wavefront aberrations (all at P＞0.05).Conclusions In teenagers,the accommodative response of emmetropia is much stronger than that of progressive myopia,and the accommodative microfluctuation in emmetropia and incipient myopia is much less than that in progressive myopia.These shifts are possibly associated with the variability,and microfluctuations of accommodation is greater in progressive myopes than emmetropes.There are certain correlations between wavefront aberrations and accommodative microfluctuations.The refractive group differences in the accommodative microfluctuations may be related to differences in the wavefront between myopes and emmetropes.Under near reading distance,LFC is correlated with higher order aberrations.

Relationship of visual function with the diagnosis and therapy of eye-related diseases——require for further research / 中华实验眼科杂志

Visual cognition is a comprehensive procedure of information processing from eyes,visual pathway through cerebral cortex.Visual function covers down multiple concepts of ocular structures,psycophysics,photochemistry and photoelectric information transformation,reflecting visual acuity,contrast visual acuity,visual field,color vision,binocular vision,visual perception and many other detailed parameters.Ocular abnormal status is reflected to certain visual function while visual function is various and anfractuous from kinds of ocular problems.These complex networks lead to some misunderstanding of research in the filed of visual function concept.An expatiation of the diversified visual function is helpful for us to integrate visual function and ocular ailment process.This paper tried to explicit some misconceptions,and accentuated the importance of clinical research around visual function for the diagnosis and treatment of eye diseases and nervous system diseases.

Laser-assisted outpatient septal spur surgery / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#The objective was to investigate the effectiveness of holmium-YAG laser-assisted septoplasty for septal deviations under local anesthesia.@*METHOD@#All holmium-YAG laser-assisted septoplasty procedures performed at Beijing hospital (Beijing, China) between August 2009 and May 2012. These patients were operated upon in an outpatient surgical suite.@*RESULT@#The success rate after surgery with regard to nasal obstruction (50 patients) is 92.0% (46 patients) of patients reporting remarkable improvement. Of the 32 patients with rhinologic headaches, A total of 28 subjects (87.5%) had their headache scores improved by 50% or more after surgery; nine (28.1%) were pain free at the last follow-up; four (12.5%) had a less than 25% reduction in their headache score. There were no patients with severe postoperative bleeding. There were no patients with septal perforation.@*CONCLUSION@#The holmium-YAG laser-assisted septoplasty is a useful approach to correct septal deviations. There is improved safety due to the enhanced viewing conditions and ample operating space during septal surgery, particularly in posterior septal spurs. The holmium-YAG laser-assisted septoplasty can limit the dissection to the area of deviation, thereby reducing postoperative swelling and the development of complications. It also has other advantages including lower medical costs, and faster return to full activity.

Main issues, causes and strategies for AIDS prevention and control in health care systems / 中国卫生政策研究

Objective:To summarize the main issues, analyze the causes and offer a strategy for AIDS preven-tion and control for all types of healthcare facilities in the health care system. Methods:184 leaders and experts of tertiary-level healthcare facilities ( provinces, cities and counties) from 30 provinces who had been engaged in AIDS prevention and control for more than five years were studied through a questionnaire including the issues and causes in AIDS prevention and control. Results: According to the results of the respondents and experts’ demonstration, the main issues were identified, including a lack of human resources in the system of disease control facilities, a lack of relevant agencies involved in AIDS response, the difficulty for AIDS patients to receive surgery and follow-up, poor detection of HIV, shortcomings in medical insurance, and so on. Conclusion: Based on the analysis of issues and causes, the paper offers strategic solutions: Clearly define the responsibilities of various health institutions in AIDS prevention and control;promote the participation of primary health institutions in AIDS prevention and control; im-prove the medical service system for AIDS patients;improve AIDS medical security policies;reform the management system of antiretroviral therapy drugs;and strengthen technical support from disease control facilities.

Weight analysis of influencing factors of human angle Kappa / 中华实验眼科杂志

Background Angle Kappa is the angle between the pupillary axis and visual axis,and it is a major consideration in corneal refractive surgery and strabismic surgery.Researches showed that age and refractive status affect angle Kappa value,and additionally,the measuring results of angle Kappa are associated with instruments.Objective This study was to investigate and weight the influences of axial length,anterior chamber depth and corneal curvature to angle Kappa.Methods A cross-sectional study was designed.Fifty health volunteers were included from Dec 2009 to Aug 2010,with the age of 18-38 years and average diopter of-1.0 D and best corrected visual acuity of 1.0.The horizontal and vertical angle Kappa was binocular measured with a testing machine designed by laboratory of School of Optometry & Ophthalmology Wenzhou Medical University.IOLMaster was employed to measure the ocular axial length,anterior chamber depth and corneal curvature radius.A multiple linear regression model was established to analyze the influences of axial length,anterior chamber depth and corneal curvature radius to angle Kappa.Results An efficacious regression equation was established as Y =15.554-0.587X1+0.724X2+ 0.232X3 with the independent variables as axial length(X1),anterior chamber depth (X2),corneal curvature (X3) and dependent variable as horizontal angle Kappa (Y) (R =0.788,R2 =0.621,P =0.000).Horizontal angle Kappa showed a negative correlation with axial length (b1 =-0.587,β1 =-1.002,P =0.000) and a positive correlation with anterior chamber depth (b2 =0.724,β32 =0.296,P =0.030).No significant correlation was found between corneal curvature radius and horizontal angle Kappa (b3 =-0.232,β3 =-0.068,P=0.338).A new regression equation was Y =14.235-0.622X1 + 0.824X2 after removed the corneal curvature variable (R =0.786,R2=0.618,P =0.000),with a negative correlation between horizontal angle Kappa and axial length (b1 =-0.622,β1 =-1.062,P＜0.05) or positive correlation between horizontal angle Kappa and the anterior chamber depth (b2 =0.824,β2 =0.337,P＜0.05).In addition,a multiple linear regression equation among 3 independent variables and dependent variable of vertical angle Kappa was Y =0.492-0.020X1 +0.038X2 +0.089X3 (R =0.436,R2 =0.191,P =0.000).However,no significant correlations were seen between vertical angle Kappa and axial length,anterior chamber depth or corneal curvature radius (all at P ＞ 0.05).Conclusions Ocular axial length and anterior chamber depth have an obvious influence to horizontal but not vertical angle Kappa.Axial length appears to have more influence to horizontal angle Kappa than anterior chamber depth.

Repeatability and reproducibility of macular thickness profiles of intra-retinal layers determined by an automated algorithm with RTVue100 OCT / 中华实验眼科杂志

Background Evaluation of intra-retinal layer thickness plays an important role in the diagnosis and monitor of various eye diseases,and spectral domain optical coherence tomography (OCT) is a frequently used tool.Software analysis method was used to measure the retinal thickness in previous study,but the study on the reliability of automatic layered software is lack.Objective This study was to evaluate the repeatability and reproducibility of thickness profile measurement of intra-retinal layers determined by an automated algorithm applied to OCT images from RTVue100 OCT instrument.Methods In this prospective cross-sectional study,retinal thickness images at 6 mm around fovea were obtained from 18 right eyes of 18 normal subjects with RTVue100 OCT instrument.The retinal images were segmented into retinal nerve fiber layer (RNFL),ganglion cell layer and inner plexiform layer(GCL+IPL),inner nuclear layer (INL),outer plexiform layer (OPL),outer nuclear layer (ONL),inner segment (IS),outer segment (OS) and retinal pigment epithelial (RPE) layer using automated algorithm method.Then Matlab software was used to analyze the measuring outcome.Interclass correlation coefficient (ICC) and coefficients of reproducibility (COR) were calculated from the results of two-time examination by the same examiner to evaluate the repeatability and from the results of two different examiners to assess the reproducibility.Written informed consent was obtained from each subject prior to any medical procedure.Results The entire retinal thickness measured by RTVue-OCT was (303.22± 14.10) μm in the horizontal meridian and (306.68 ± 13.32) μm in the vertical meridian,with the maximum values of retinal thickness in the GCL+ IPL and ONL.Whether in the horizontal meridian or in the vertical meridian,the ICC and COR were ＜0.60 in the OPL,IS and OS;while those in the RNFL,GCL+IPL,INL,ONL and RPE layer were ＞0.70.Conclusions RTVue OCT with automated algorithm is a useful and reliable approach to the measurement of intra-retinal layer thickness.Automated segmentation can offer accurate and repeatable thickness profile of OCT retinal image.This method may improve the diagnosis and monitoring of retinal diseases.

Clinical practice and training for students majoring in optometry and ophthalmology / 中华医学教育探索杂志

To improve the clinical skills of medical students and to train qualified and profes-sional ophthalmologist,the school of optometry and ophthalmology in Wenzhou Medical College car-ried out reforms and innovations in clinical practice and training. In order to strengthen and train clin-ical thinking and clinical skills,and to cultivate the humanistic qualities of medical students,the di-verse-training mode were applied in clinical practice and training. In this paper explored the design goal, objective and actual effect of diverse-training mode for clinical practice and training.

Exploring bilingual teaching effectiveness in clinical medicine / 中华医学教育探索杂志

Bilingual teaching has become an important teaching method in the Higher Medical Education.The major of Optometry and Ophthalmology in Wenzhou Medical College is an organic integration of the modem western optometry and traditional ophthalmology,and also have the advantage of international education background.In the past twenty years,we have made positive practices and explorations in bilingual teaching.In this paper,we will take The Contact Lens Course ( National recconmentation course and National bilingual demonstration course ) for example to share the useful experiences and results,and to set an important model in spreading bilingual teaching for other clinical medicine disciplines.

Acceptability and related factors on male circumcision among young men with Yi ethnicity in onecounty of Sichuan province / 中华流行病学杂志

Objective To explore the acceptability of male circumcision (MC) as an HIV prevention method and its related factors among young men of Yi ethnicity in Liangshan prefecture. Methods 446 young men were selected in Butuo county,under stratified sampling method. Using a self-designed questionnaire,face to face interviews were taken to collect HIV-related risk behaviors,knowledge and acceptability of MC. Results After an introduction on MC by interviewers,40.6% of the interviewees expressed their willingness in taking this surgery. The main reason for acceptance was that they felt this surgery might reduce the risk of HIV infection (90.1%). For those who refused to take this surgery,most of them thought it was too sensitive and embarrassing (52.5%) and were afraid that it might affect their procreation ability. Data from logistic regression analysis indicated that the acceptability of MC was associated with the following factors as: age,income,experience of commercial sexual behavior. They also felt that messages related to male MC surgery could reduce the risk of being infected with HIV/STDs or induce pain when having sexual intercourse,or it might cause partial infection after surgery,or they might be mocked at if taking the surgery. Conclusion It is the prerequisite in helping young people of Yi ethnicity to have a good understanding on MC as for Yi people,embarrassment attitudes towards sex appears to be one of the big obstacles against the popularization of this surgery. The operation should be provided by trained and professional doctors,with standardized procedure,in good sanitary conditions and free for service.

Study on filtering blebs imaging by anterior segment optical coherence tomography / 眼科研究

Objective To seak a available way of evaluating morphology of filtering blebs after trabeculectomy is very important for forecasting the successful rate of surgery.At the present time,filtering blebs were commonly evaluated by using the slim lamp microscope,but it did not to exactly reflect the filtering passage.This study aimed to evaluate the morphology of filtering blebs after trabeculectomy with anterior segment optical coherence tomography (AS-OCT).MethodsThis was a prospective study.Sixty-nine eyes of 53 patients who had previously undergone trabeculectomy were selected in this study,including 25 eyes with open-angle glaucoma,38 eyes with close-angle glaucoma and 6 eyes with secondary glaucoma.These filtering blebs were classified into functional type (typeⅠandⅡ) and nonfunction type (type Ⅲ and Ⅳ) under the slit lamp microscope based on the van Buskirk grading scales.Intra-bleb morphology and structure were characterized as diffuse-like,cystic-like,encapsulating-like and flatten-like by AS-OCT in reference to the Leung method.The consistency between the two methods was evaluated by the Chi-Square test.Written informed consent was obtained from all the patients before surgery.ResultsThe average follow-up time was 10.78±11.0 months.All the patients finished the examination during the follow-up duration.The average intraocular pressure was(14.9±4.5)mmHg during the observation period.There were 38/69 (55.1%) functioning blebs and 31/69 (44.9%) non-function blebs under the slim lamp microscope.AS-OCT imaging showed diffuse-like blebs in 26 eyes (15.9%),cystic-like blebs in 11 eyes (27.5%),encapsulating-like blebs in 19 eyes (18.8%) and flatten-like in 13 eyes with the intraocular pressure of(13.16±3.77)mmHg,(15.36±2.92)mmHg,(15.77±5.07)mmHg and (16.62±5.33)mmHg,respectively,showing a significant difference among them (F=3.32,P＜0.05).These patterns of different OCT presented a good consistency with the clinical outcome (χ~2=0.03,P=0.86).ConclusionAS-OCT allows the observation of filtering blebs after glaucoma surgery.It is probably to visualize the internal structure of filtering bleb and deep sclerectomy.Functional and dysfunctional filtering blebs delivery gives different OCT patterns.This could be a new way to assess the postoperative healing process.

Study on the effect of intervention about acquired immunodeficiency syndrom among men who have sex with men / 中华流行病学杂志

Objective To study the outcomes of AIDS intervention programs and to provide scientific evidence for developing pertinent strategy on intervention among men who have sex with men (MSM).Methods MSM were recruited through snowballing and investigated by face to face interview in 2006 and 2007 respectively.SPSS 12.0 was used to compare the change of cognition about AIDS,sexual behavior,prevalence rates of HIV and Syphilis before and after the intervention program among the population under study.Results The cognition about AIDS among MSM was obviously improved after the intervention with the rate increased from 74.3% to 82.4% (P=0.01).The rate of last time condom use among MSM increased from 56.4% to 65.5% (P=0.00).The rate of consistent condom use during six months among MSM increased from 31.8% to 41.9% (P=0.00).The rates of both condom use during commercial sex with men and with women did not change much among MSM.The prevalence rates of HIV in 2006 and 2007 were 10.4% and 10.8% and of syphilis in 2006 and 2007 were 9.3% and 7.3% respectively which were not significantly different between before and after the intervention.Conclusion The cognition about AIDS among MSM was improved obviously.However,the rate of consistent condom use was still low,reflecting the segregation phenomenon between their behavior and cognition.All our findings implied that it was crucial to carry out AIDS prevention and control programs.

Acceptability of vaginal microbicides among female sex workers in urban Beijing,China / 中华流行病学杂志

Objective To explore the aaitudes and willingness towards vaginal microbicides use among female sex workers(FSWs)for HIV/AIDS and sexually transmitted infection(STI)prevention jn an urban district of Beiiing,China,as well as its related factors.Methods A cross-sectional study using convenience sampling Was conducted.A total of 54 FSWs were recruited from Shijingshan District in urban Beijing.Main outcome vailables were measured by microbicide acceptability score with questionnaire,including high-risk sexual behaviors,self-reported condom use,self-reported HIV/STI history and perception on the risk of HIV/STI.Results Mean score of microbicide acceptability in FSWs was 2.73(ranging 1 to 4).Acceptability score varied by the type of their sex panner(P=0.049),experience of HIV testing(P=0.037)and concems about contracting STI(P=0.042).Willingness to use and covert use of microbicides in FSWS varied significantly with their sex partners(P=0.001).Conclusion FSWs in Shijingshan district might have a positive response to vaginal microbicides use across all hypothetical characteristics in general.Further study iS needed for comprehensive understanding of contextual factors related to it.

Application of negative pressure sucking technique in the elderly after nasal septal reconstruction / 中华老年医学杂志

ObjectiveTo investigate the application value of negative pressure sucking technique in the elderly after nasal septal reconstruction. MethodsForty elderly patients after nasal septal reconstruction were divided into two groups randomly, with twenty patients in each. The cases in observing group received negative pressure sucking technique while those in controlling group received nasal packing with vaseline gauze following the surgery. The amount of bleeding of the first 24 hours after operation, the comfort degrees evaluated by using visual analogue scale (VAS),hematoma of nasal septum, edema in nasal cavity and duration of hospitalization after operation were compared between the two groups. ResultsThe amount of bleeding of the first 24 hours afteroperation was more in observing group than in controlling group[(14.2±8.1)ml vs. (7.2±4.1)ml, P<0.05]. The VAS score and the number of cases who felt discomfortable moderately or severely were significantly less in observing group than in controlling group at 6 h, 12 h and 24 h after operation(all P<0.05). The nasal cavity gap were significantly wider in observing group at the 3rd day after operation(P=0.001), and the duration of hospitalization after operation was significantly shorter in observing group [(4.5±0.9) d] than in controlling group [(5.42±0.9) d](P=0.042)Conclusions Negative pressure sucking technique applied in the elderly after nasal septal reconstruction can significantly relieve the distress of patients, reduce the edema in nasal cavity and shorten the duration of hospitalization, but does not increase the risk of hemorrhage.

Study on using the multiplier method in estimating the size of men who have sex with men population in Shanghai / 中华流行病学杂志

<p><b>OBJECTIVE</b>To estimate the size of men who have sex with men (MSM) in Shanghai.</p><p><b>METHODS</b>Multiplier method was used in the study and two popular Shanghai-based MSM websites were selected as targeted institutions. The number of MSM (r) who visited website during a given period was investigated by a web-based questionnaire. Meanwhile, a survey was conducted among MSM living in Shanghai to obtain the proportion of MSM who had visited the websites during the given period, the reciprocal number of this proportion was the multiplier (m), therefore, population size can be estimated by r multiplied by m.</p><p><b>RESULTS</b>The MSM population was estimated as 398 433 when website A was selected as target institution and 370 755 was estimated when website B was selected. The estimated population of MSM accounted for 7.1% and 6.6% of male population aged 15 to 49 years old in Shanghai, respectively.</p><p><b>CONCLUSION</b>It was feasible to use multiplier method which selecting MSM website as target institution to estimate the size of MSM population, however, the representativeness of this study sample should be considered seriously.</p>

Study on the patterns of sexual contact and behavioral features of men who have sex with men / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the patterns of sexual contact and behavioral features of men who have sex with men (MSM) and to analyze the related potential risks:</p><p><b>METHODS</b>A face to face interview with a standardized questionnaire was conducted on 673 MSM from May to July, 2006 in Haerbin, Heilongjiang province. Mixing matrices were computed based on characteristics of MSM and their sexual partners and different models were used for goodness-of-fit.</p><p><b>RESULTS</b>648 questionnaires were completed. Age and marriage status of sexual contact patterns were assertive with values of Q which were found to be 0.03 and 0.41, respectively. Values of Q showed big difference according to age and marriage status of sexual mixing Patterns among different sites. A tendency for age and marriage pairing in clustering around main diagonal (table 5, table 6) suggested that MSM and their partners were similar in ages and marriages while young MSM tend to have older partners. Most of the MSM had large number of sexual partners and frequently changing their sexual partners. The proportions of consistent condom use changed greatly (chi2 = 76.22, P < 0.001) over time with the proportions of consistent condom use and commercial sex behaviors among 15-24 age groups of 50.9% and 22.5%, respectively.</p><p><b>CONCLUSION</b>Among MSM, sexual mixing patterns were weakly assertive,suggesting potential HIV transmission risk did exist since high risk behavior often occurred among MSM and their sexual partners.</p>

Application of Typical Case Image Analysis to the Evaluation of Ophthalmologic Clinical Skills / 中华医学教育探索杂志

3-year practice and questionnaire of the graduates majoring in ophthalmology indicate ophthalmologic typical case image implicates very much clinical information,can satisfy ophthalmologic clinical skills test,reflect examinee's clinical knowledge and technical skill level and guide intern to cultivate clinical thinking capability.