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Objective:To determine the prevalence of facility-based HIV testing and its associated factors among men who have sex with men （MSM） in Shanghai. Methods:From June 2018 to December 2020， MSM were recruited by a community organization “Shanghai CSW&MSM Center （SCMC）”. A total of 3 251 MSM were included as follows： being 18 years old and above， being HIV-negative or with unknown HIV status， living in Shanghai， had homosexual behavior in the past year， and completed informed consent. Using a self-designed questionnaire， we performed an online survey powered by www.wjx.cn to collect information on demographics， sexual behavior， and facility-based HIV testing. A total of 3 240 valid questionnaires were collected. Univariate and multivariate logistic regression were used to determine the factors associated with facility-based HIV testing. Results:A total of 3 240 MSM participated in the study with mean age of （29.7±6.2） years .The prevalence of facility-based HIV testing was 63.2% （2 049/3 240）， Multivariate logistic regression showed that the participants with a college degree or above were less likely to have facility-based HIV testing（OR=0.73，P=0.008）， compared to those with lower educational background. The proportion of the MSM who sought sexual partners through the internet received facility-based testing was 68.7%. Compared to the participants with the sexual role being 0 （only be penetrated）， those being 0.5 （both penetrated and be penetrated） and 1 （only penetrated） were both more likely to have the HIV testing （both P<0.05）. Those who used condoms during the last homosexual behavior were more likely to be tested than those who did not （OR=1.39， P=0.001）. Those who had been diagnosed with sexually transmitted diseases were more likely to be tested than those who did not （OR=2.05， P<0.001）. The participants who had used HIV self-testing kits in the past were more likely to be tested than those who did not （OR=2.31， P<0.001）. Conclusion:MSM in Shanghai have lower utilization of facility-based HIV testing， which may be improved by strengthening the advocacy of facility-based HIV testing services through the internet and peer education， and innovating service models.
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Objective To introduce and conduct effectiveness evaluation of peer-group level care and management mode in people living with HIV and AIDS(PLHAs)in Jing'an District, Shanghai. Methods We recruited PLHAs who were managed by Jing'an District and participated in the peer-group care activities from 2015 to 2016, and collected their data of general conditions, behavior, antiretroviral therapy, life quality, social support, mental status and medical modes, and then conducted effectiveness evaluation of the mode by multivariate logistic regression model and linear regression model. Results A total of 300 PLHAs were included with 150 cases in each group. PLHAs in target group had higher proportion of antiretroviral therapy[82.7%(124/150)and 64.7%(97/150)]. In addition, they got higher scores in mental health(48.5±9.2 and 43.9±10.6)and social support(28.7±8.2 and 24.8±6.6), and lower scores in depressive severity index(0.5±0.1)and avoidance of medical modes(16.1±3.0 and 17.0±2.5). Multivariate analysis showed that PLHAs in target group had less sex partners(zero partner, OR = 2.1, 95%CI:1.1-3.9;one partner, OR = 3.6, 95%CI:1.9-6.8)and increased condom use(no sex, OR = 5.3, 95%CI:2.4-11.7;complete use, OR = 10.6, 95%CI:4.7-24.1;random miss, OR = 5.1, 95%CI:1.8-14.8)in the last 12 months. Conclusion The effect of peer-group level care and management mode is significantly good in promoting behavior change, enhancing health concern and increasing antiretroviral therapy.
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OBJECTIVE@#To observe the effect of acupuncture-moxibustion on negative emotions and plasma tryptophan (Trip)-kynurenine (Kyn) metabolism in the patients with Crohn's disease (CD) at the mild and moderate active stage.@*METHODS@#A total of 66 CD patients were randomized into an observation group (33 cases, 1 case dropped off) and a control group (33 cases, 2 cases dropped off). In the observation group, acupuncture was applied in combination with moxibustion. In the control group, the sham-acupuncture was used in combination with sham-moxibustion. In both of the observation group and the control group, acupuncture was applied to Zhongwan (CV 12), Shangjuxu (ST 37), Sanyinjiao (SP 6), Gongsun (SP 4), Hegu (LI 4), Quchi (LI 11), Taixi (KI 3) and Taichong (LR 3), and moxibustion was applied to Tianshu (ST 25) and Zusanli (ST 36). The treatment was given once every two days, 3 times a week, totally for 12 weeks. Separately, before and after treatment, the score of the hospital anxiety-depression scale (HADS) and the score of intestinal core symptoms (degree of abdominal pain and frequency of diarrhea) were observed in the patients of the two groups. The concentration of plasma indoleamine 2,3-dioxygenase 1 (IDO1) and the ratios of Kyn/Trp, QuinA/Kyn, KynA/Kyn and KynA/QuinA were compared between the two groups.@*RESULTS@#Compared with before treatment, the scores of HADS-A and HADS-D in the observation group and the score of HADS-A in the control group were all reduced after treatment (@*CONCLUSION@#Acupuncture and moxibustion relieve the negative emotions of anxiety and depression in CD patients at mild and moderate active stage, which is probably related to the regulation of plasma Trp-Kyn metabolic pathway.
Subject(s)
Humans , Acupuncture Points , Acupuncture Therapy , Crohn Disease/therapy , Emotions , Moxibustion , Plasma , Treatment Outcome , TryptophanABSTRACT
Needle retention is an important step in the acupuncture procedure. How to optimize scientifically the duration of needle retention according to individual case has been considered in the medical circle. In this paper, by collecting the literatures on needle retention from the early dynasty to the contemporary time, the evolution of the needle retention from a short duration to a long one with the productivity improvement was elaborated. On the base of the views of the medical scholars of all dynasties, it was concluded that the ultimate purpose of needle retention is to improve the effects of acupuncture on the premise of ensuring the safety of acupuncture. Hence, the clinical physician should optimize the duration of needle retention cautiously in compliance with the tolerance of patient so as to save the time cost of both physician and patient, avoid the occurrence of tolerable effect of acupuncture and reduce the potential safety hazard of acupuncture induced by the long duration of needle retention.
Subject(s)
Humans , Acupuncture Therapy , Moxibustion , Needles , Physicians , Time FactorsABSTRACT
[Objective]To ascertain the status and related factors of antiretroviral therapy adherence and analyze the influence of management mode on adherence in HIV infected patients in Jing' an District, Shanghai. [Methods]We recruited 150 HIV infected patients who participated in the "peer group care"activities (target group) and those from another 150 patients who did not (control group) but received antiviral treatment during the period from 2015 to 2016 (221 cases in total) into the study. We collected data on general conditions, behavioral way, antiretroviral therapy adherence, life quality, social support, mental status and medical coping modes, and analyzed the related factors of antiretroviral therapy adherence by linear regression model. [Results]The 221 HIV infected patients were included, with 124 in target group and 97 in control group. The proportion of good antiretroviral therapy adherence was 86.0％, with 91.9％ in target group and 78.4％ in control group. Multiple analysis showed that the related factors of antiretroviral therapy adherence were management mode (β = 1.871, P < 0.001) , disposable income per month (β = 0.600, P = 0.001) , social support utilization (β = 0.174, P = 0.044) and yield attitude of medical coping modes (β =-0.153, P = 0.003). [Conclusion]Antiretroviral therapy adherence of HIV infected patients in Jing'an District should be further improved. "Peer group level care and management mode"could effectively promote the increase of antiretroviral therapy adherence; however, it should be improved and perfected in the aspects of its coverage and content.
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Objective To observe the clinical efficacy of ordinary acupuncture plus Zhigou (TE6) and Zhaohai (KI6) in treating constipation due to yin deficiency in Parkinson's disease. Method Sixty eligible patients were randomized into a control group and a treatment group, 30 cases each. The control group was intervened by ordinary acupuncture by selecting the Dance-tremor Control Zone, Baihui (GV20), Fengchi (GB20), Fengfu (GV16), Quchi (LI11), Yanglingquan (GB34), Taixi (KI3) and Taichong (LR3). Based on the ordinary acupuncture, Zhigou (TE6) and Zhaohai (KI6) were added in the treatment group. The treatment was given three times a week, 12 sessions as a course, and the therapeutic efficacy was evaluated after 2 successive treatment courses by using Patient Assessment of Constipation Quality of Life Scale (PAC-QOL), Bristol Stool Scale (BSS), Cleveland Clinic Score (CCS) and Unified Parkinson's Disease Rating Scale (UPDRS) as the observation indexes. Result Before the intervention, there were no significant differences in comparing the PAC-QOL, Bristol, CCS and UPDRS scores between the two groups (P>0.05);after the treatment, the scores of PAC-QOL, Bristol, CCS, and motor function and activities of daily living in UPDRS dropped significantly in the two groups (P<0.05); the PAC-QOL, Bristol and CCS scores in the treatment group were significantly lower than those in the control group after the treatment (P<0.05); the treatment group had a significantly higher effective rate in improving constipation symptoms than the control group (P<0.05); there was no significant difference in comparing the UPDRS score between the two groups after the intervention (P>0.05). Conclusion Ordinary acupuncture plus Zhigou and Zhaohai can significantly improve the quality of life, stool form and difficulty in defecation in constipation of yin-deficiency type in Parkinson's disease, and the therapeutic efficacy is superior to that of ordinary acupuncture.
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Acupuncture anesthesia is a technique by partially or completely replacing anesthetics with acupuncture in surgery based on the traditional acupuncture analgesia mechanism.It emerged in the 1950s,went viral in the 1970s and then gradually fell into decline.In the recent years,this technique has regained attention and further research.Acupuncture anesthesia can be classified as either pure acupuncture anesthesia or acupuncture-medication combined anesthesia.To expand the application of this technique,a patient with non-ST elevation acute coronary syndrome in urgent need of percutaneous coronary intervention (PCI) received pure acupuncture anesthesia because of an allergy to lidocaine,and the operation went successfully.This is the first time that pure acupuncture anesthesia and coronary arteriography were combined,which is of great significance in further study and development of acupuncture anesthesia.
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Objective To investigate the clinical efficacy of acupuncture at Hegu plus Fuliu in treating hyperhidrosis in Parkinson’s disease. Methods Fifty-seven Parkinson’s disease patients with hyperhidrosis were randomly allocated to a treatment group of 28 cases and a control group of 29 cases. The control group received conventional acupuncture and the treatment group, acupuncture at Hegu plus Fuliu in addition. The VAS score and the HDSS score were recorded in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups.Results There were statistically significant pre-/post-treatment differences in the VAS score and the HDSS score in the two groups (P<0.01). There were statistically significant post-treatment differences in the VAS score and the HDSS score between the treatment and control groups (P<0.01). The total efficacy rate was 96.4% in the treatment group and 72.4% in the control group; there was a statistically significant difference between the two groups (P<0.05).Conclusion Acupuncture at Hegu plus Fuliu can effectively reduce hyperhidrosis in Parkinson's disease patients.