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Objective@#To investigate the migration characteristics and follow-up treatment among HIV/AIDS patients after HIV confirmation in Yiwu City, Zhejiang Province from 2016 to 2020, so as to provide insights into the optimization of the HIV/AIDS control strategy among floating populations.@*Methods@#The reported HIV/AIDS patients' demographics, follow-up and treatment data in Yiwu City from 2016 to 2020 were captured from the HIV/AIDS Prevention and Control Information System of Chinese Disease Control and Prevention Information System. The migration characteristics, antiretroviral therapy and outcomes of HIV/AIDS patients were analyzed after HIV confirmation, and the factors affecting the migration of HIV/AIDS patients after HIV confirmation were identified using a Cox proportional hazard regression model.@*Results@#A total of 1 189 HIV/AIDS patients were enrolled, including 988 men (83.10%) and 806 cases without Zhejiang provincial household registration (67.79%). There were 441 patients (37.09%) migrating out of Yiwu City after HIV confirmation, with a migration rate of 17.73/100 person-years, and there were 366 patients migrating out of Zhejiang Province, with a cross-province migration rate of 30.78%. Among participants without Zhejiang provincial household registration, 395 patients (49.01%) migrated out of Yiwu City, including 337 patients (85.32%) returning to their household registration provinces, which mainly included Yunnan, Sichuan, Guizhou and Hunan. Cox proportional hazard regression analysis showed a high risk of migration among minority ethnic populations (HR=1.375, 95%CI: 1.044-1.811), retires (HR=3.605, 95%CI: 1.771-7.335), students (HR=8.969, 95%CI: 4.095-19.645), patients without Zhejiang provincial household registration (HR=4.545, 95%CI: 3.164-6.529) and patients identified through physical examination of floating populations or employees (HR=1.318, 95%CI: 1.006-1.727), and a low risk among married patients with spouses (HR=0.721, 95%CI: 0.569-0.913) and with an educational level of junior high school and above (HR: 0.428~0.753, 95%CI: 0.280-0.952). Among all floating HIV/AIDS patients, there were 26 cases lost to follow-up (5.90%) and 49 deaths (11.11%). In addition, the proportion of absence of antiretroviral therapy, HIV infection progressing into AIDS patients and failure in HIV inhibition were all greater among floating HIV/AIDS patients than among non-floating patients (P<0.05).@*Conclusions@#A high risk of migration was found among HIV/AIDS patients without Zhejiang provincial household registration, unmarried patients, patients with a low education level, retirees, students, and patients identified through physical examination of floating populations or employees in Yiwu City from 2016 to 2020, and migration does not facilitate the sustainability of antiretroviral therapy and follow-up, which may affect the prognosis of HIV/AIDS.
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BACKGROUND: Previous studies have shown that stress response can cause immune dysfunction in the body. T cell immunoglobulin and ITIM domain (TIGIT) is an immunoregulatory receptor that can inhibit T cell activity, promote T cell apoptosis and promote T cell subgroup distribution imbalance. Whether the immune response mechanism of stress response is related to the expression and function of TIGIT is still unclear. OJECTIVE: To investigate the expression of immunomodulatory receptor TIGIT in thymus cells and peripheral blood mononuclear cells in an anger rat model and its significance to immune function. METHODS: Forty-eight Wistar male rats were randomly divided into normal group, 7-, 14-and 21-day model groups, with 12 rats in each group. In addition to the blank group, social isolation method with plantar electric shock method was used to establish rat anger models in the other groups. The behavioral changes of rats were observed by open-field test and aggressive behavior test, and the changes in body mass and thymus index before and after the test were recorded. The positive expression of TIGIT in thymus and peripheral blood mononuclear cells of rats in each group was observed by immunohistochemistry, and the expression levels of CD4+ and CD8+ T cells in the peripheral blood were measured by flow cytometry. The correlation between TIGIT expression in thymus and peripheral blood mononuclear cells and the CD4+/CD8+ ratio of T cell subsets in the peripheral blood was analyzed. An ethical approval for the study was obtained from the Animal Ethics Committee of Jiangxi University of Traditional Chinese Medicine. RESULTS AND CONCLUSION: In the 14-and 21-day model groups, the scores of horizontal and vertical activities in the open-field test of rats were higher than the control group (P < 0.05 or P < 0.01). In the 7-, 14-and 21-day model groups, the attack hiding time of the attack behavior test was significantly shortened (P < 0.01), the number of attacks and the cumulative attack time were significantly increased (P < 0.01), and the body mass and thymus index were significantly decreased compared with the control group (P < 0.05 or P < 0.01). In the 7-and 14-day model groups, the expression level of TIGIT in thymus and peripheral blood mononuclear cells was significantly higher than the control group (P < 0.01), while the CD4+/CD8+ ratio level of the peripheral blood T cell subsets was significantly lower than the control group (P < 0.05 or P < 0.01). The CD4+/CD8+ ratio of T cell subsets in the peripheral blood of random samples of rats was negatively correlated with the expression level of TIGIT in T cells of thymus (r2=0.627 0, P < 0.000 1) and in mononuclear cells (r2=0.624 4, P < 0.000 1). These results indicate that the model rats in the stress-induced anger state have obvious changes in animal behavior, present with thymus atrophy and abnormalities in peripheral blood T lymphocyte subsets CD4+/CD8+ ratio and immune function. This phenomenon may be related to the thymus and peripheral blood mononuclear cells TIGIT expression level, but the specific mechanism needs to be elucidated further.
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Objective@#To understand the awareness of HIV testing results before having sex among men who have sex with men （MSM） .@*Methods@#The MSM from a gay bar in Zhejiang Province were recruited through convenience sampling method. A questionnaire survey was conducted to collect the information about demographic characteristics,sexual behaviors,awareness of HIV status between sexual partners and HIV testing results during August of the year 2016. The awareness of HIV testing results before having sex among MSM and the influencing factors were analyzed .@*Results@#A total of 124 MSM were recruited in this study,56.56% of whom aged from 25 to 39 years,and 61.29% were single,divorced or widowed. The number of sexual partners they had in the last year ranged from 1 to 40,with median of 8. The MSM who had casual sexual partners accounted for 70.97%. The MSM who had regular HIV testing accounted for 90.32%,yet who would like to share the HIV testing reports with partners only accounted for 18.55%. Whether asking about the HIV status before having sex or not was associated with age,marriage status,the number and characters of sexual partners（P<0.05）. The MSM who were informed of the HIV status of commercial partners,casual partners and regular partners accounted for 0,5.10% and 19.77%,respectively. The main reasons for MSM not knowing about the HIV status of their sexual partners were“condom use would prevent HIV infection”（78.38%）,“never thought about HIV infection”（53.15%）,and “there was no need to ask as the partner looked healthy”（36.94%） .@*Conclusion@#The proportion of MSM who were aware of HIV testing results before having sex was not high and was associated with age,marriage status,the number and characters of sexual partners. Lack of knowledge about HIV infection might contributed to this low proportion.
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Objective To analyze the curative effect of traditional Chinese medicine(TCM)combined with early enteral nutrition(EN)for treatment of patients with severe acute pancreatitis(SAP). Methods 70 SAP patients were randomly divided into TCM plus EN group(36 cases)and conventional therapy group(34 cases). Both groups received routine treatment. Additionally,TCM+EN group received early EN and TCM decoction treatment〔the ingredients of decoction including radix bupleuri,radix paeoniae alba,radix scutellariae,fructus aurantii immaturus, magnolia bark,raw rhubarb(rhubarb was added at last during cooking the decoction)and natrii sulfas exsiccatus (dissolved in water to be administered)each 10 g,the decoction was concentrated to 150 mL and then administered via a stomach tube to the patient,afterwards the tube was clipped for 2.5-3 hours,twice a day,4-7 days constituting a therapeutic course〕. After treatment,the time for patients' symptoms improvement,the situation of intestinal recovery, the length of stay in hospital,the total medical cost,serum C-reactive protein(CRP),aspartate aminotransferase (AST), lactate dehydrogenase (LDH), amylase (AMY), acute physiology and chronic health evaluationⅡ(APACHEⅡ)score and complications,intensive care unit(ICU)transfer rate and case fatality rate in two groups were observed. Results The time for symptoms improvement of abdominal tenderness(day:1.68±1.01 vs. 3.89±1.07), abdominal distension(day:2.17±1.48 vs. 4.24±3.23),abdominal pain(day:3.12±1.14 vs. 4.94±3.21)and the intestinal recovery of exhaust defecation time(day:3.48±0.92 vs. 5.32±3.30)of SAP patients after treatment in the TCM+EN group were faster significantly than those in the conventional therapy group(all P0.05). Among the 70 patients with SAP,the cause of the disease due to gallstone accounted for 55.72%,hyperlipidemia for 37.14%,alcoholic for 4.28%and other 2.86%. Conclusion The use of TCM combined with early EN for treatment of patients with SAP can enhance the curative effect of SAP,reduce the hospitalization time and the total cost of patients,and decrease complications and mortality,that is conducive to the faster recovery of patients.