Condom stigma among men who have sex with men population: Concept synthesis / 中南大学学报(医学版)

OBJECTIVES@#The epidemic of acquired immune deficiency syndrome (AIDS) among men who have sex with men (MSM) is severe in China. And MSM has now become a key population for the infection and transmission of AIDS. At present, the bottleneck of AIDS prevention and control among MSM population is low rate of continuous condom use and high incidence of unsafe sexual behavior. Inductive summarization of the literature revealed that the most critical reason for low rate of continuous condom use among the MSM population was condom-related stigma. Although many studies mentioned condom-related stigma among MSM populations, there has been no any definition of MSM-related condom stigma and no measurement for it. Therefore, the paper aims to explore barriers to condom use among MSM, then construct the conceptual and operational definition of "MSM-related condom stigma" through Meta synthesis and concept synthesis, and provide a new perspective for AIDS prevention and control among MSM.@*METHODS@#Based on evidence-based method, "PICoS" framework and Meta-synthesis was used to include the literatures. Then, we used synthesized qualitative evidence from included studies to construct the concept and operational definition of MSM-related condom stigma by the means of thematic analysis and concept synthesis.@*RESULTS@#According to the results of the concept synthesis, MSM-related condom stigma refers to any taboos or misbeliefs about condom use or feeling ashamed or embarrassed to talk about using condoms which perceived by individuals at the individual, interpersonal, and social levels.It was demonstrated through 4 sub-themes at operational level: a symbol of distrust, a symbol of HIV/sexual transmitted infections (STIs) prevention, a symbol of an embarrassing topic, and a symbol of violating the traditional cognition of sexual intercourse. According to the Social-ecological Model (SEM), a symbol of distrust refers to that the MSM population believes that not using condoms represents mutual trust between sexual partners, while using condoms is difficult to express intimacy, trust and loyalty between sexual partners. A symbol of HIV/STIs prevention at the interpersonal level refers to that the MSM population believes that condom use is a "symbol" for the prevention or infection of AIDS; on the one hand, if someone proposes to use condoms, he may be considered infected with HIV or have unsafe sex experiences, thus, making it difficult to propose condom use; on the other hand, if they believe that sexual partners are "AIDS free" (often a wrong perception, such as sexual partners may have the risk of AIDS infection although they do not have AIDS), it is considered that condom use is completely unnecessary. The environmental level includes a symbol of an embarrassing topic and a symbol of violating the traditional cognition of sexual intercourse. A symbol of an embarrassing topic refers to the MSM population feels shame about topics related to sexual behavior and is embarrassed to carry/buy/propose condom use or be ashamed to engage in conversations about whether to use condoms during sexual behavior. And a symbol of violating the traditional cognition of sexual intercourse: The MSM population have limitations in their perception of "sex" or "sexual behavior" and believe that real sex (behavior) is unobstructed contact between the bodies and exchange between all body fluids.@*CONCLUSIONS@#The concept of MSM-related condom stigma is proposed for the first time, and its operational definition is given. The concept includes 3 levels and 4 dimensions. It is helpful to understand MSM people's attitude and cognition towards condoms, and adds indicators with cultural sensitivity and behavioral sensitivity to the behavioral intervention for AIDS in the future.

Clinical characteristics and genetic analysis of a neonate with Smith-Magenis syndrome / 中华医学遗传学杂志

OBJECTIVE@#To explore the clinical features and genetic etiology for a neonate with Smith-Magenis syndrome (SMS).@*METHODS@#Copy number variation sequencing (CNV-seq) was applied to the neonate and his parents, and the genotype-phenotype correlation was analyzed.@*RESULTS@#On the second day after birth, the neonate had presented with pathological jaundice and immunodeficiency. Cranial MRI revealed ventricular enlargement and enlargement of cisterna magna. At 3 months, the infant has presented with square face, prominent forehead, deep-set eyes, hypertelorism, palpebral fissure upward and button noses. Genetic testing showed that he had carried a 2.9 Mb deletion in 17p11.2 region, seq[GRCh37] del(17)(p11.2)(chr17:16 836 379-19 880 992). The same deletion was not found in either parent.@*CONCLUSION@#SMS is mostly diagnosed in child and adulthood, but rarely in neonates. For neonates with SMS, the neurological and behavioral abnormalities have not been shown, but pathological jaundice, CNS abnormalities and immune deficiency may be the characteristics, which require attention of neonatal physicians.

Progress in sleep disorders in multiple system atrophy / 中华神经科杂志

Multiple system atrophy can have various forms of sleep disorders, including insomnia, rapid eye movement sleep behavior disorder, sleep-disordered breathing, periodic leg movements during sleep and excessive daytime sleepiness. This article will focus on the concept, classification, pathogenesis, clinical features, diagnosis and treatment, aiming to deepen clinicians′ understanding of the disease, which will be helpful for early diagnosis and treatment.

Application of HIV prevention information transmission model in prevention of high-risk sexual behavior among men who have sex with men / 中南大学学报(医学版)

OBJECTIVES@#To explore the effect of HIV prevention information transmission model in the prevention of high-risk sexual behavior among men who have sex with men (MSM).@*METHODS@#To establish the HIV "expert-key informant-MSM" preventive information transmission model and to intervene the MSM high-risk sexual behavior. Before and 3 months after the intervention, MSM was measured by general information questionnaire, AIDS knowledge and sexual behavior questionnaire, MSM Health Belief Scale for HIV Prevention, and Safe Sexual Self-efficacy Scale.@*RESULTS@#AIDS knowledge and sexual behavior scores in MSM after the intervention were significantly higher than those before the intervention (=-13.047, <0.001); the scores of health belief before and after the intervention were significantly higher (=-3.272, =0.001); condom use in MSM after the intervention was more common than that before the intervention (<0.05), except for commercial sex.@*CONCLUSIONS@#The application of HIV prevention information transmission model can effectively improve AIDS-related knowledge, HIV prevention health beliefs, condom use rate of MSM population, and in turn promote the transformation of their high-risk sexual behavior.

Investigation on the patients′ utilization of Internet plus nursing service / 中华医院管理杂志

Objective:To investigate the utilization of Internet plus nursing service and its influencing factors.Methods:From October 2018 to January 2019, 247 patients registered on the Internet plus nursing service platform were randomly surveyed to understand the status quo of Internet plus nursing service. The influencing factors were analyzed based on the Anderson health service model.Results:Among the 247 patients who received Internet plus nursing, 74.5%(184 cases) were women. The average age was 37 years(20-81 years). The median number of times of nursing service received by the patients was 2 times. Infusion was the most accepted nursing service on the platform. Patients who are older, do not have basic medical insurance, the source of routine care is not a Class A tertiary hospital, and do not have chronic diseases used the Internet platform to receive nursing services more frequently.Conclusions:Internet plus nursing service has been initially recognized by patients. The predisposing factor affecting the tendency of individuals to continue using Internet plus nursing services is age, enabling factors are health insurance status and regular nursing sources, and the need factor is chronic disease.

Impact of community subculture on high-risk sexual behavior of men who have sex with men based on health belief model / 中南大学学报(医学版)

OBJECTIVES@#To explore the Impact of community subculture of men who have sex with men (MSM) on the occurrence of high-risk sexual behavior based on the health belief model.@*METHODS@#A qualitative research method was used to conduct in-depth interviews with 17 MSM by one-to-one and half-structured way, and thematic analysis was used to analyze the data.@*RESULTS@#There were several factors for high-risk sexual behavior in MSM subculture, such as trust, subjective assessment for partner or personal health status, the role in inserting, awareness of HIV infection among partners, perception of HIV and homosexual discrimination, difficulty in maintaining a fixed partner, family responsibility,and so on. Self-efficacy also affected MSM's high-risk sexual behavior.@*CONCLUSIONS@#High-risk sexual behavior in MSM population is influenced by individual, group, and intra-circle subculture. Cognitive bias for HIV infection in MSMs can be intervened by constructing a preventive intervention model for high-risk sexual behavior.

Status and influencing factors of rush poppers use and HIV infection among men who have sex with men in Changsha / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the relationship between use of rush poppers and HIV infection, and associated factors among men who have sex with men in Changsha.</p><p><b>METHODS</b>A cross-sectional study was conducted in Changsha from April to December, 2014. Men who have sex with men who came for HIV counseling and testing services were invited to fill out a survey. A total of 608 MSM were finally recruited. The survey included socio-demographic characteristics, sexual roles, sexual behaviors in last 6 months and rush poppers use, HIV infection among MSM. After finishing the questionnaire, 5 ml blood was also drawn for HIV testing. Chi-square test or Fisher probabilities was used to compare usage of rush poppers and HIV antibody positive rate among MSM who had different characteristics and sexual behaviors. Multi-factor unconditioned logistic regression model was used to explore related factors about rush poppers use and HIV infection of MSM.</p><p><b>RESULTS</b>Among 608 MSM, 29.8% (181) said they ever used rush poppers, and 13.3% (81 cases) were HIV positive. Among MSM who ever used rush poppers, 18.8% (34/181) were HIV positive; While among those who never used rush poppers, 10.5% (45/427) were HIV positive (χ(2)=7.65,P=0.006). Compared with MSM who had no For One Night sex in the last 6 months,OR (95% CI) value of MSM who had 6-10 times For One Night sexes in last 6 months to use rush poppers was 4.32 (1.77-10.57). Compared with MSM who self-identified as top,OR (95% CI) value of MSM who self-identified as bottom or versatile using rush poppers were 2.99 (1.53-5.86), or 3.60 (2.13-6.09). Compared with MSM who self-identified as top, OR (95% CI) value of MSM who self-identified as bottom or versatile to infect HIV were 3.19 (1.35-7.58), or 2.33 (1.12-4.85). Compared with MSM who used condoms at every anal sex,OR (95% CI) value of MSM who used condoms sometimes or never used to infect HIV were 1.93 (1.12-3.35) or 1.87 (0.64-5.50). Compared with MSM who never used rush poppers,OR (95% CI) value of MSM who ever used rush poppers to infect HIV was 1.88 (1.12-3.16).</p><p><b>CONCLUSION</b>A large percentage of MSM population in Changsha used rush poppers, and HIV antibody positive rate among MSM was high. MSM who had more frequencies of For One Night sexes, self-identified as bottom or versatile were more likely to use rush poppers and more susceptible to HIV infection. In addition, MSM who had low frequency of condom use in the last 6 months in anal intercourse were more likely to infect HIV.</p>

Effect of TanshinoneⅡA on Renal Tumor Growth Factor-beta 1 and Nuclear Factor-kappa B in Diabetic Nephropathy Rats / 广州中医药大学学报

Objective To observe the effect of tanshinone ⅡA on renal transforming growth factor beta 1 (TGF-β1) and nuclear factor-kappa B (NF-κB) p65 mRNA and protein expression in diabetic nephropathy (DN) rats, thus to evaluate the therapeutic effect and mechanism of tanshinone ⅡA. Methods SD rats were used as the experimental animal. DN rat model was induced with 40 mg/kg of streptozocin ( STZ) . The rats were randomized into normal group, model group, and tanshinone ⅡA ( 10 mg·kg -1·d -1, im) group. On the experimental day 30, we examined the body weight, water in-take volume, 24-hour urine protein, fasting glucose ( Glu) , serum creatinine ( Cr) , blood urea nitrogen ( BUN) , total protein ( TP) and albumin ( Alb). Renal slices after periodic acid Schiff staining ( PAS) were used for the observation of renal pathology. Semi-quantitative reverse transcription polymerase chain reaction ( RT-PCR) was used for the detection of renal TGF-β1 and NF-κB p65 mRNA expression, and Western blotting method was used for the measurement of TGF-β1 and NF-κB p65 protein expression in rats of different groups. Results Compared with the normal group, body weight was decreased, water in-take volume and 24-hour urine protein were increased, serum Glu, Cr, and BUN levels were elevated, TP and Alb levels were decreased, renal pathological damage occurred, and renal TGF-β1 and NF-κB p65 mRNA and protein expressin were promoted in the model group (P<0.05 or P<0.01). Tanshinone ⅡA group had an effect on decreasing water in-take volume, 24-hour urine protein, serum levels of Glu, Cr and Bun, increasing TP and Alb levels, relieving renal pathological damage, and reducing the protein and mRNA expression of renal TGF-β1 and NF-κB p65 ( P<0.05 or P<0.01 compared with the model group). Conclusion Tanshinone ⅡA has protective effect on kidney probably through inhibiting renal TGF-β1 and NF-κB p65 expression in DN rats.