Regional analysis of high risk factors of hypertensive disorders in pregnancy with organ or system impairment / 中华妇产科杂志

Objective: To explore the influencing factors of pregnancy-induced hypertensive disorders in pregnancy (HDP) with organ or system impairment in pregnant women, and to analyze and compare the differences of HDP subtypes in different regions of China. Methods: A total of 27 680 pregnant women with HDP with complete data from 161 hospitals in 24 provinces, autonomous regions and municipalities were retrospectively collected from January 1, 2018 to December 31, 2018. According to their clinical manifestations, they were divided into hypertension group [a total of 10 308 cases, including 8 250 cases of gestational hypertension (GH), 2 058 cases of chronic hypertension during pregnancy] and hypertension with organ or system impairment group [17 372 cases, including 14 590 cases of pre-eclampsia (PE), 137 cases of eclampsia, 2 645 cases of chronic hypertension with PE]. The subtype distribution of HDP in East China (6 136 cases), North China (4 821 cases), Central China (3 502 cases), South China (8 371 cases), Northeast China (1 456 cases), Southwest China (2 158 cases) and Northwest China (1 236 cases) were analyzed. By comparing the differences of HDP subtypes and related risk factors in different regions, regional analysis of the risk factors of HDP pregnant women with organ or system impairment was conducted. Results: (1) The proportions of HDP pregnant women with organ or system impairment in Northeast China (79.05%, 1 151/1 456), Central China (68.42%, 2 396/3 502) and Northwest China (69.34%, 857/1 236) were higher than the national average (62.76%, 17 372/27 680); the proportions in North China (59.18%, 2 853/4 821), East China (60.85%, 3 734/6 136) and South China (59.56%, 4 986/8 371) were lower than the national average, and the differences were statistically significant (all P<0.05). (2) Univariate analysis showed that the proportions of primiparas, non-Han, non-urban household registration, irregular prenatal examination and PE history in the hypertension with organ or system impairment group were higher than those in the hypertension group, and the differences were statistically significant (all P<0.05). Multivariate logistic regression analysis showed that primiparas, non-Han, non-urban household registration, irregular prenatal examination and PE history were independent risk factors for HDP pregnant women with organ or system impairment (all P<0.05). (3) Primipara: the rates of primipara in Northeast China, North China and Southwest China were higher than the national average level, while those in South China, Central China and Northwest China were lower than the national average level. Non-Han nationality: the rates of non-Han nationality in Northeast China, North China and Northwest China were higher than the national average, while those in East China, South China and Central China were lower than the national average. Non-urban household registration: the rates of non-urban household registration in Northeast China, North China, and Southwest China were lower than the national average, while those in East China, Central China were higher than the national average. Irregular prenatal examination: the rates of irregular prenatal examination in North China, South China and Southwest regions were lower than the national average level, while those in Northeast China, Central China and Northwest China were higher than the national average level. History of PE: the incidence rates of PE in Northeast China, North China, South China and Southwest China were lower than the national average level, while those in Central China and Northwest China were higher than the national average level. Conclusions: Primiparas, non-Han, non-urban household registration, irregular prenatal examination, and PE history are risk factors for HDP pregnant women with organ or system impairment. Patients in Northeast, Central and Northwest China have more risk factors, and are more likely to be accompanied by organ or system function damage. It is important to strengthen the management of pregnant women and reduce the occurrence of HDP.

HIV infection status and related factors in men who have sex with men in sentinel surveillance in Shanxi province, 2010, 2015 and 2020 / 中华流行病学杂志

Objective: To understand the infection status of HIV and related factors in men who have sex with men (MSM) in Shanxi province in 2010, 2015 and 2020. Methods: According to the sentinel surveillance protocol, continuous cross-sectional survey were conducted to collect the information about basic characteristics, general demographic characteristics, AIDS knowledge awareness, high-risk sexual behavior, sexually transmitted diseases, intervention services and HIV infection rate of the MSM in Shanxi in 2010, 2015 and 2020. Results: In 2010, 2015 and 2020, a total of 2 708 MSM were included in this study. There were significant differences in HIV infection rate among three years (χ2=23.76, P<0.001) with an increasing trend with year (trend χ2 =17.34, P<0.001). The rates of anal sex, commercial sex and heterosexual behavior in the past 6 months were 77.62% (2 102/2 708), 5.91% (160/2 708) and 28.14% (762/2 708) respectively, and the rates of consistent use of condom were 52.52% (1 104/2 102), 63.13% (101/160) and 23.49%(179/762) respectively, and the rate of consistent condom use was low. Results from multivariate logistic regression analysis showed that different cities, having educational level of junior high school or below, being recruited through internet, voluntary counseling and testing, suffering from sexually transmitted diseases, occasional condom use in anal sex in the past 6 months were the correlative factors of HIV infection of MSM. Conclusions: The HIV infection rate of MSM in Shanxi increased year by year from 2010, 2015 to 2020. The HIV/AIDS-related risk behavior persisted, and the proportion of condomuse adherence was low, and the HIV detection rate was low in the MSM, so targeted and effective measures should be taken to promote the condom use adherence and regular HIV testing in MSM.

Forensic Individual Identification Based on the New Coding Method of Oral Pano-ramic Tomography / 法医学杂志

Objective To discuss a new coding method for individual identification based on oral panoramic tomography, analyze the diversity of different coding modules in nonhomologous images and the consistency and the matching rate of the coding indexes of different coding modules in homologous images, and evaluate the application value of the different modules and the new coding method in individual identification. Methods The oral panoramic tomography images of 1 000 patients with permanent teeth were collected retrospectively. Each patient had two images taken at different times （called the Early database and the Late database according to the chronological order）. Each image was coded according to the designed coding method. A computer program was designed to compare the diversity of different modules, and calculate the diversity and consistency of different coding modules as well as the matching rate of the coding indexes. Results The diversity of the 4 modules that reflected teeth characteristics was much higher than that of other modules in the same database. The highest diversity was noticed in the module of right mandibular teeth in samples of both databases. The coding consistencies of the 4 modules were all above 50%. Besides, 90.2% of the matching rates of indexes of homologous images were over 80%. Conclusion The 4 modules have higher application value in individual identification, especially the right mandibular teeth. The coding method has a certain value in forensic individual identification.

Acupuncture and drug for subcortical ischemic vascular disease complicated with depression: a randomized controlled trial / 中国针灸

<p><b>OBJECTIVE</b>To explore the difference in the efficacy and effect mechanism of subcortical ischemic vascular disease (SIVD) complicated with depression between acupuncture and medication.</p><p><b>METHODS</b>Sixty patients were randomized-into an acupuncture group and a medication group, 30 cases in each one. In the acupuncture group, acupuncture was applied to Baihui (GV 20), Shuigou (GV 26), Fengfu (GV 16), Fengchi (GB 20) and the others, once a day, 6 times a week. The treatment of 4 weeks made one session and totally 2 sessions were required. In the medication group, nimodipine 30 mg, three times a day and fluoxetine 20 mg, once a day were prescribed for oral administration, for 8 weeks totally. Before treatment, at the end of the 4th week and at the end of the 8th week of treatment, cerebral blood flow velocity (CBFV) and solubility CD40 ligand (sCD40L) were determined respectively. The scores in Montreal cognitive assessment (MoCA) and Hamilton' s depression scale (HAMD) were evaluated in the two groups. The efficacies on cognitive function and depression symptoms were compared in the patients between the two groups. Results Compared with the outcome before treatment, mean blood flow velocity (Vm) of middle cerebral artery (MCA), anterior cerebral artery (ACA) and posterior cerebral artery (PCA) was increased significantly at the end of the 4th week of treatment in the two groups (all P<0.05). At the end of the 8th week, Vm was increased much significantly (all P<0.01). The differences were not significant in comparison between the two groups (all P>0.05). Compared with the expression before treatment, sCD40L was reduced significantly after treatment in the patients of the two groups (all P<0.01), but the differ- ence was not significant between the two groups (all P>0.05). Compared with that before treatment, MoCA score was increased significantly after treatment in the two groups (all P<0.01), HAMD score was reduced sig- nificantly (all P<0.01), the differences were not significant in comparison between the two groups (all P>0.05). The total effective rate of cognitive improvement was 86.7% (26/30) in the acupuncture group and was 80.0% (24/30) in the medication group, the differences were not significant in comparison of the two groups (P>0.05). The total effective rate of the improvement in depression was 93.3% (21/30) in the acupuncture group and was 86.7% (26/30) in the medication group, the differences were not significant in comparison of the two groups (P>0.05).</p><p><b>CONCLUSION</b>Acupuncture could significantly increases CBFV and reduces serum sCD40L expressions in the patients of SIVD complicated with depression, and significantly improves cognitive function and relieves depression symptoms. The efficacy of it is similar to that of western medication. The increase of serum sCD40L expression is possibly involved in the occurrence and development of SIVD. Reducing sCD40L expression contributes to the alleviation of damage induced by cerebral ischemia and reperfusion.</p>

Evaluation of BED-CEIA assay with dried blood spot specimens in China / 中华流行病学杂志

Objective To study the feasibility of using dried blood spot (DBS) specimens in BED-CEIA assay and to estimate the HIV-1 incidence with DBS in China. Methods 10 313 participants from 27 voluntary counseling and testing(VCT) sites were enrolled in this study. Both plasma and DBS specimens were collected. 349 eligible pairs of HIV-1 positive specimens confirmed by Western Blot were available for BED-CEIA and the results compared. Negative control, low positive control, high positive control and calibrator in DBS were used to evaluate the stability and repeatability of the detection results of DBS specimens. Results Of the total HIV positives, 294 and 53 participants were tested as long-term or recent HIV infections by both DBS and plasma specimens. Two participants showed different results from DBS and plasma specimens, but their final An values were close to the cutoff value of BED-CEIA assay. The concordance rate between the two types of specimens was 99.43% and the R2 linear of the stability and repeatability results of DBS specimens reached 0.9551 and 0.95, respectively. Conclusion Although some individual specimens showed different results, the incidence rates calculated from both types of specimen were equivalent. DBS specimens were suitable for estimating the HIV incidence and could be popularized in China. However, further studies regarding window period and adjustment coefficients of BED-CEIA assay are needed.

Survival and immune response of rural HIV/AIDS patients after free antiretroviral therapy / 中华流行病学杂志

Objective To assess the adherence,immunologic and survival responses in HIV-infected patients receiving free antiretroviral therapy (ART). Methods All adult HIV-infected patients in Wenxi county who started antiretroviral treatment (ART) between 01 July 2001 and 31 December 2006 and aged above 18 years were included in this study. Epidemiological survey and laboratory tests were performed before,0.5 months after, 1 months after, 2 months after and every 3 months after initiation of ART to recognize the adherence, efficacy (CD4+ T cell counts) and survival to the regimens. Results The median follow-up time period was 16.5 months (Interquartile: 15.5-20.8 months). At baseline, the median of CD4+ T cell counts were 154 cells/μl (Interquartile: 81-212 cells/μl). Treatment was effective in most of the patients, the CD4+ T cell count of patients increased after the initiation of ART. The maximum increase was recorded at month 3, from the median of 154 cells/μl to 220 cells/μl (P<0.001) ,and thereafter the count remained stable. When comparing with patients with baseline CD4+ T cell count≥100 cells/μl, those with baseline CD4+ T cell count < 100 cells/μl showed a higher mean increase in the first three months of treatment. The cumulative probability rates of remaining alive were 0.94,0.88 and 0.87 at 3,12,24 months, respectively. In multivariate Cox's proportional hazard models, after adjustment for the type ofinitial regimens (NVP vs. EFV/IDV), CD4+T cell count of less than 50 cells/μl (vs. 50 cells/μl or more) was strongly associated with death hazard ratio 0.21 (95% CI:0.06-0.68). Conclusion Our data showed that ART was effective for improving immunologic response of adult patients with HIV/AIDS. CD4+ T cell count at initiation was associated with survival time in patients starting ART,suggesting that monitoring of CD4+ T count should be strengthened to early initiate antiretroviral therapy for HIV-infected patients.

Expression of N-methyl-D-aspartate receptor 1 in acute intoxicated encephalopathy induced by 1,2-dichloroethane / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To study the role of N-methyl-D-aspartate receptor 1 in acute intoxicated encephalopathy induced by 1,2- dichloroethane(1,2-DCE).</p><p><b>METHODS</b>Forty-two Sprague-Dawley rats, which had been randomly divided into 1 control, 3 exposure and 3 after-exposure observation groups were exposed to 1,2-DCE for 12 hr by continual static inhalation except control group. Dosage of exposure groups was 5.0, 10.0, 20.0 g/m(3) on sequence. That of after-exposure observation groups was 10.0 g/m(3). Rats of after-exposure observation groups were observed continually for 2,4,6 hr after exposure. The expression of N-methyl-D-aspartate receptor-1 (NMDAR1) was detected by immunohistochemical method.</p><p><b>RESULTS</b>NMDAR1 stained neurons were mainly distributed at cerebral cortex and hippocampus. Compared with that of control group, the percentages of positive cells of NMDAR1 increased evidently at 10.0, 20.0 g/m(3) groups (P < 0.05). They were (18.33 +/- 1.86)%, (64.17 +/- 2.86)% at cerebral cortex, (15.5 +/- 1.87)%, (47.83 +/- 2.16)% at hippocampus. The percentages were also elevated obviously in 2, 4, 6 h after-exposure observation groups. They were (39.07 +/- 3.01)% (70.17 +/- 2.93)% (39.83 +/- 2.32)% at cerebral cortex, (16.30 +/- 1.03)% (19.80 +/- 1.17)% (16.50 +/- 1.05)% at hippocampus; Compared with that of 10.0 g/m(3) group, the percentages increased significantly only in 4 hr group at hippocampus.</p><p><b>CONCLUSION</b>The overactivation of NMDAR1 is the main route by which excitatory amino acids chose to join the development of acute intoxicated encephalopathy induced by 1,2-DCE.</p>

Effect of 1, 2-dichloroethane on blood brain barrier / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the effect of 1, 2-dichloroethane (1, 2-DCE) on blood brain barrier.</p><p><b>METHODS</b>Acute toxic encephalopathy model was copied with the consecutive static inhalation of 1, 2-DCE. The water content of brain tissue was measured, and the blood brain barrier permeability was detected with lanthanum nitrate. The brain microvascular endothelial cells and neuroglial cells were cultured in vitro, which were administrated with 1, 2-DCE. The cell morphologic structures were observed under light microscope and electron microscope.</p><p><b>RESULTS</b>(1) The extracellular edema was most found in the cerebral tissue and the leakage of lanthanum particles through the barrier were found with the lanthanum tracking method. (2) The water content in cerebral cortex in the moderate and high dose groups was significantly higher than that in the control group and became severer with the increases of the intoxicated time. The water content in cerebral medulla was significantly increased only at 6 hours after the intoxication. (3) The normal morphological structure of brain microvascular endothelial cells and neuroglial cells could be injured by 1, 2-DCE, and the injury to neuroglial cells caused by 1, 2-DCE occurred earlier and severer than that to brain microvascular endothelial cells.</p><p><b>CONCLUSION</b>1, 2-DCE can damage blood brain barrier and induce cerebral edema.</p>

A retrospective cohort study on the survival of blood-borne human immunodeficiency virus cases in a county, China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To understand the survival rate of adult blood-borne human immunodeficiency virus (HIV) cases in a county.</p><p><b>METHODS</b>A retrospective cohort study was carried out to determine the survival from HIV infection and related factors among 78 adult HIV cases infected by blood and confirmed by the end of 2002. Kaplan-meier method was used to describe the survival distribution and Cox proportional hazard model was used to determine the factors associated with the survival time.</p><p><b>RESULTS</b>The total mortality after infection was 78.57/1000 p-y and AIDS related mortality was 72.95/1000 p-y. The median survival time was 7.40 years (95% Confidence Interval: 6.79 - 8.02). After adjustment for the clinical stage at presentation (HIV or AIDS), people who got infected at the age of 30 - 40 years or infected by the end of 1995 would proceed to death slower than the other groups.</p><p><b>CONCLUSION</b>The survival of HIV cases infected by blood at the county level might have been underestimated and should be adjusted when HIV/AIDS was estimated and projected. Survival was associated with age when infection started so different survival functions should be used on different age groups that infection started.</p>

The relationship between excitatory amino acids and acute intoxicated encephalopathy induced by 1,2-dichloroethane / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To explore the relationship between excitatory amino acids (EAAs) and acute in toxicated encephalopathy induced by 1,2-dichloroethane (1,2-DCE).</p><p><b>METHODS</b>SD rats were randomly divided into 7 groups: 1 control group, 3 exposure (5.0, 10.0, 20.0 g/m(3)) groups and 3 duration (2, 4, 6 h after 10.0 g/m(3) exposure) groups. Rats were exposed to 1,2-DCE for 12 h by continual static inhalation. Water content of cerebral cortex and medulla was measured by wet-dry method; The contents of glutamate (Glu), aspartate (Asp), glycine (Gly) and gamma-aminobutyric acid (GABA) in brain tissues were determined by high performance liquid chromatography (HPLC).</p><p><b>RESULTS</b>Water content of cerebral cortex in 3 exposure groups (76.10% +/- 1.41%, 76.45% +/- 0.75%, 79.95% +/- 1.45% respectively) were higher than that of control group (74.22% +/- 1.77%, P < 0.05, P < 0.01). That of medulla was increased significantly merely at 20.0 g/m(3) (71.77% +/- 3.07%, P < 0.05). Water content of cortex in 3 duration groups (79.36% +/- 2.10%, 79.48% +/- 1.21%, 80.64% +/- 1.93% respectively) were higher than that of 10.0 g/m(3) instant exposure group (P < 0.05). The content of Asp [(4.83 +/- 0.35) micro mol/g, (7.17 +/- 0.40) micro mol/g, (10.52 +/- 0.39) micro mol/g], Glu [(23.86 +/- 0.62) micro mol/g, (31.21 +/- 2.50) micro mol/g, (28.23 +/- 1.58) micro mol/g] and Gly [(5.59 +/- 1.01) micro mol/g, (6.06 +/- 0.83) micro mol/g, (7.26 +/- 1.34) micro mol/g] in exposure groups were higher than those of corresponding control groups [(3.72 +/- 0.48) micro mol/g, (21.09 +/- 1.20) micro mol/g, (3.83 +/- 0.44) micro mol/g, P < 0.05, P < 0.01]. Compared to 10.0 g/m(3) instant group, Asp content was increased at 2, 4, 6 h (P < 0.01), Glu content at 2, 4 h (P < 0.05), and peak value of Glu appeared at 4 h [(35.40 +/- 2.40) micro mol/g] while Gly content was significantly decreased (P < 0.01). GABA did not show evident changes in both exposure or duration groups (P > 0.05).</p><p><b>CONCLUSION</b>EAAs appears to be related with the development of acute intoxicated encephalopathy induced by 1,2-DCE, and its damage to neuron might be one of the mechanisms of brain edema.</p>