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Human genetic resources include specimen samples and related information. The application and regulation of human genetic resources in China started at the end of the 20th century and have progressed rapidly. However， many challenges remain. In this paper， we reviewed the current status of sample conservation and management and provided recommendations for further development of human genetic resources in China. The aim is to effectively protect and rationally utilize China's human genetic resources， safeguard national security and people's health， and promote the building of a community of common health for mankind.
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Objective:To investigate the correlation between serum uric acid to albumin ratio (UAR) and large-artery atherosclerosis (LAA), its severity and short-term outcome.Methods:Patients with acute ischemic stroke admitted to the Department of Neurology, the Affiliated Hospital of Qingdao University from September 2017 to August 2022 were retrospectively enrolled. They were classified into LAA and non-LAA according to the TOAST etiological criteria. Patients with LAA were further divided into mild stroke group (≤8) and moderate to severe stroke group (>8) according to the National Institutes of Health Stroke Scale score at admission, and good outcome group (≤2) and poor outcome group (>2) according to the modified Rankin Scale score at discharge. Multivariate logistic regression analysis was used to determine the correlation between UAR and LAA, its severity and short-term outcome. The predictive value of UAR for poor outcomes in patients with LAA was evaluated by receiver operating characteristic (ROC) curve. Results:A total of 4 178 patients with acute ischemic stroke were enrolled, including 2 751 males (65.8%), aged 61.95±10.73 years. There were 2 000 (47.9%) patients with LAA, including 1 112 (55.6%) mild stroke and 888 (44.4%) moderate to severe stroke; 813 (40.65%) had good short-term outcomes and 1 187 (59.35%) had poor outcomes. UAR in the LAA group was significantly higher than that in the non-LAA group ( P<0.05). In patients with LAA, the UAR of the moderate to severe stroke group and the short-term poor outcome group were significantly higher than that of the mild stroke group and the short-term good outcome group, respectively (all P<0.05). Multivariate logistic regression analysis showed that the UAR was an independent risk factor for LAA (odds ratio [ OR] 1.043, 95% confidence interval [ CI] 1.016-1.071; P=0.002), its severity ( OR 2.000, 95% CI 1.860-2.151; P<0.001), and short-term poor outcomes ( OR 1.456, 95% CI 1.379-1.537; P<0.001). ROC curve analysis showed that the area under the curve of UAR for predicting short-term poor outcomes in patients with LAA was 0.727 (95% CI 0.704-0.750; P<0.001). The optimal cutoff value was 6.62, and the sensitivity and specificity were 86.6% and 56.7%, respectively. The area under the curve of UAR for predicting short-term poor outcomes in patients with LAA was greater than that predicted solely by uric acid and albumin. Conclusions:UAR is associated with LAA, its severity and poor prognosis, and has higher predictive value for poor outcomes in patients with LAA.
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Objective:Through retrospective analysis of perioperative management data of ambulatory thyroid surgery under the concept of enhanced recovery after surgery (ERAS), we provide foundation for the safe implementation of ambulatory thyroid surgery.Methods:From January 2019 to December 2019, patients undergoing thyroid surgery were enrolled in the study under the concept of ERAS at the ambulatory surgery center of Xiangya Hospital, Central South University. Data of patients during perioperative period were collected, including adverse events, anesthesia recovery, postoperative and post-discharge recovery were recorded.Results:This study was included 703 cases of patients, thyroid nodules in 374 cases, thyroid malignant tumor in 329 cases. There were no significance difference in the operation time, anesthesia time, wake up of time, and postanesthesia care unit (PACU) time between the two groups (all P>0.05). No hypertension, hypotension, tachycardia, bradycardia or other arrhythmias occurred during perioperative period. No adverse events such as intraoperative awareness and delay of wake up occurred. No severe pain, nausea, vomiting, dizziness and other discomfort occurred after surgery. All 703 patients were discharged from hospital within 24 hours. Conclusions:Anesthesiologists participate in patient management according to the perioperative medicine requirements, and ambulatory thyroid surgery may be performed safely under the concept of ERAS.
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Objective:To investigate the efficacy of intermittent pneumatic compression (IPC) combined with drugs in the prevention of lower extremity deep venous thrombosis (DVT) after joint replacement and its risk factors.Methods:A total of 80 patients receiving joint replacement surgery in Jinhua People's Hospital from January 2019 to December 2020 were included in this study. They were randomly divided into observation and control groups, with 40 patients in each group. To prevent lower extremity deep venous thrombosis, the control group was given low molecular weight heparin, and the observation group was given IPC in addition to DVT. The incidence of DVT post-surgery and coagulation function pre- and post-surgery were compared between the two groups. The incidence of adverse reactions was recorded in each group. In addition, 40 patients who developed DVT after joint replacement surgery from January 2019 to December 2020 (DVT group) and 40 patients who did not develop DVT (no DVT group) were included. The factors influencing the occurrence of DVT were analyzed by binary logistic regression.Results:The incidence of DVT in the observation group was significantly lower than that in the control group (5.00% vs. 20.00%, χ2 = 4.11, P < 0.05). At 7 days after surgery, prothrombin time, activated partial thromboplastin time, fibrinogen in the observation group were (11.73 ± 0.51) seconds, (27.05 ± 1.17) seconds, (3.89 ± 0.52) g/L, respectively, which were significantly lower than (12.03 ± 0.43) seconds, (27.65 ± 1.30) seconds, and (4.18 ± 0.59) g/L in the control group ( t = 2.84, 2.33, 2.17, all P < 0.05). There was no significant difference in the incidence of adverse reactions between observation and control groups (5.00% vs. 2.50%, χ2 = 0.00, P > 0.05). There were significant differences in age, body mass index, history of hypertension, and operative time between patients with DVT and those without DVT ( χ2 = 4.11, 5.16, 4.71, 8.65, all P < 0.05). Logistic regression analysis showed that age ( OR = 1.57, 95% CI = 1.239 - 2.014), body mass index ( OR = 6.71, 95% CI = 1.298 - 34.794), history of hypertension ( OR = 3.23, 95% CI = 1.980 - 5.296), operative time ( OR = 6.29, 95% CI = 2.058 - 19.225) were independent risk factors for DVT after joint replacement surgery (all P < 0.05). Conclusion:There are many factors that influence the occurrence of DVT after joint replacement surgery. Intermittent pneumatic compression combined with drugs for prevention of lower extremity DVT is safe and effective.
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Objective:To investigate the predictive value of the National Institutes of Health Stroke Scale (NIHSS) score at baseline and 24 h after the onset for the outcomes after endovascular mechanical thrombectomy (EMT) in patients with acute ischemic stroke.Methods:Patients with anterior circulation large vessel occlusive acute ischemic stroke received EMT in the Affiliated Hospital of Qingdao University from July 2018 to June 2020 were enrolled prospectively. According to the modified Rankin Scale scores at 3 months after the onset, they were divided into good outcome group (0-2) and poor outcome group (3-6). The demographic and clinical data between the groups were compared. Multivariate logistic regression analysis was used to determine the independent influencing factors of clinical outcomes. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of the independent influencing factors for outcomes. Results:A total of 124 patients were included. Their age was 65.23±12.40 years, 80 were males (64.5%). The baseline NIHSS score was 15 (interquartile range, 11-19). Seventy-two patients (58.1%) had a good outcome and 52 (41.9%) had a poor outcome. Univariate analysis showed that there were significant differences in age, degree of vascular recanalization, baseline and 24 h NIHSS score after onset, and whether having intracranial hemorrhage or not between the good outcome group and the poor outcome group ( P<0.05). Multivariate logistic regression analysis showed that there was a significant independent correlation between the NIHSS score at 24 h after onset and the poor outcome (odds ratio [ OR] 1.243, 95% confidence interval [ CI] 1.125-1.373; P<0.001). ROC curve analysis showed that the area under the curve of poor outcome predicted by baseline NIHSS score was 0.639 (95% CI 0.542-0.737), and the predictive sensitivity and specificity were 80.8% and 45.8% respectively. The area under the curve of poor outcome predicted by NIHSS score at 24 h after onset was 0.830 (95% CI 0.759-0.902), and the predictive sensitivity and specificity were 94.2% and 65.3% respectively. Conclusion:In patients with anterior circulation large vessel occlusive acute ischemic stroke receiving EMT, the NIHSS score at 24 h after onset has higher predictive value for poor outcomes at 3 months after onset, and is significantly better than the baseline NIHSS score.
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Objective:To investigate the expression of integrin ανβ3 in conjunctival scar after glaucoma filtration surgery and to explore its role in the formation of filtering scar in rats.Methods:Fifty-five SPF male SD rats aged 6-8 weeks were selected to establish the model of glaucoma filtration surgery, and 15 unsuccessful modeling rats were excluded.The remaining rats were divided into control group, transforming growth factor (TGF) group, integrin ανβ3 receptor antagonist LM609 group and TGF+ LM609 group, with 10 rats in each group.The conjunctival flap of different groups was treated with cotton piece containing 0.9% sodium chloride, TGF-β2 (2 mg/ml), LM609 (40 μg/ml), TGF-β2 (2 mg/ml)+ LM609 (40 μg/ml) solution for two minutes, respectively, according to grouping.The intraocular pressure (IOP) was monitored with an iCARE tonometer before operation and at 3 days, 1 week, 2 weeks after operation, and the average IOP ratio ([postoperative IOP/preoperative IOP]×100%) was calculated.At 3 days, 1 week and 2 weeks after operation, slit lamp microscopy was used to observe the morphological changes of filtering blebs and calculate the survival rate of filtering blebs.Two weeks after operation, the operative eyeball tissues were removed and made into paraffin section.The inflammatory changes, fibrosis and collagen deposition of bulbar conjunctiva in the operation area were observed by hematoxylin-eosin staining and picric acid-sirius red staining, respectively.Western blot was used to detect the expression of integrin αν and β3.Immunohistochemical staining was used to detect the expression of integrin ανβ3 in the conjunctival tissue of operation area.The use and care of the rats complied with the Instruction Notions with Respect to Care for Laboratory by State Ministry of Science and Technology.The study protocol was approved by an Ethics Committee of The Daping Hospital, Army Medical University (No.2017-06).Results:The IOP of rats in each group was significantly decreased on the third day after operation compared with before operation, and gradually recovered to the preoperative level in the first to second week after operation.The mean IOP ratios of the control group, TGF group, LM609 group and TGF+ LM609 group were (101.80±4.44)%, (103.90±5.65)%, (94.10±7.45)% and (100.60±4.61)%, respectively, showing a statistically significant difference among them ( F=4.571, P=0.010). The mean IOP ratio of LM609 group was lower than that of the control group, TGF group and TGF+ LM609 group (all at P<0.05). Two weeks after operation, the filter blebs became flat and the bulbar conjunctival tissue was slightly thickened in the control group and TGF+ LM609 group, and bulbar conjunctival tissue was significantly thickened with a large number of blood vessels growing in the TGF group, and localized small filter blebs as well as less vascularization were seen in the LM609 group.The survival rate of filtering bleb in the TGF group was significantly lower than that in the control group, LM609 group and TGF+ LM609 group, and the survival rate of filtering bleb in the LM609 group was significantly higher than that in the control group and TGF+ LM609 group (all at P<0.05). Two weeks after operation, there were fewer infiltrated inflammatory cells and looser collagen fiber deposition in the conjunctival tissue in the LM609 group and TGF+ LM609 group compared with the TGF group.The relative expression levels of integrin αν and β3 under conjunctival tissue in the TGF group were significantly higher than those in the control group, LM609 group and TGF+ LM609 group (all at P<0.05). Immunohistochemical staining showed that integrin ανβ3-positive cells were mainly in the conjunctival tissue around the operation area and microtubules.The number of integrin ανβ3-positive cells in the conjunctival tissue of the operation area in the TGF group were significantly greater than those of other groups. Conclusions:Integrin ανβ3 is highly expressed in the scar of conjunctival tissue after filtering surgery in rats.The inhibition of integrin ανβ3 can reduce the deposition of fibers and prolong the survival of filtering blebs, suggesting that integrin ανβ3 may be involved in the formation of conjunctival scar.
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Objective@#To investigate prevalence and influencing factors of overweight and obesity among children and adolescents in Jiangxi Province, and to provide the basis for strategies for prevention and treatment of overweight and obesity.@*Methods@#Using stratified random cluster sampling ,a total of 77 780 primary and middle school students in 11 districts of Jiangxi Province were investigated with physical examination and questionnaire during March to November in 2019.@*Results@#The detection rates of overweight and obesity of children and adolescents in Jiangxi province were 20.5% and 8.4%, respectively. Which decreased with the increase of the learning stage（ χ 2=178.65, 389.86）,with significantly higher in boys and urban areas （ χ 2=1 061.06, 504.21;56.17, 34.14）（ P ＜0.01）.In different economic areas, the detection rates of overweight and obesity in moderate economic area( 23.3 %, 9.7%) were the highest, followed by high economic area (21.1%, 8.7%) and low economic area(18.2%, 7.2%), and the differences were statistically significant（ χ 2=266.29, 143.90， P ＜0.01）.The results of multivariate Logistic regression analysis showed that in terms of social demography, overweight and obesity of children and adolescents in Jiangxi Province were associated with economic area, residence, learning stage and gender; in terms of dietary behavior, overweight of children and adolescents in Jiangxi Province was associated with consumption frequency of sugary drinks, sweets, fresh fruits and vegetables, and the influencing factors of obesity were consumption frequency of sweets and fresh fruits( P <0.05).@*Conclusion@#The situation of overweight and obesity of children and adolescents in Jiangxi Province is sorrisome, and comprehensive prevention and control should be carried out with the joint efforts of society, school and family.
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Objective:To analyze the work stress of medical staff at different medical institutions in Shanghai under the background of normalized prevention and control of 2019 novel coronavirus diseases(COVID-19), for evidence of relieving the work stress of medical staff.Methods:From September to November 2020, two community health service centers, one secondary hospital and one tertiary hospital were selected from each district of Jing′an District, Jiading District and Pudong New Area of Shanghai, totaling 12 medical institutions. The medical staff were selected by stratified random sampling. A self-designed questionnaire was used to conduct an online questionnaire survey on the work stress of medical staff. The survey data were analysied by descriptive analysis, and different groups were compared with chi square test.Results:1 422 valid questionnaires were obtained. There was a significant difference in self-rated routine work stress of medical staff between community health service centers and secondary/tertiary hospitals( P<0.001). The proportions of medical staff whose self-rated routine work stress was " quite stressed" or " very stressed" at community health service centers and secondary/tertiary hospitals were 39.77%(317)and 55.36%(346)respectively. There was a significant difference in self-rated COVID-19 prevention stress of medical staff between community health service centers and secondary/tertiary hospitals( P<0.001), the proportions of medical staff who considered the COVID-19 prevention was " quite stressed" or " very stressed" were 86.45%(689)and 76.48%(478)respectively. Conclusions:The overall work stress of medical staff at medical institutions in Shanghai was high.The prevention and control of COVID-19 increased the pressure of medical staff at all levels of medical institutions.
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Objective:To understand the current situation of appeals for rights and interests of medical staff in community health institutions and secondary/tertiary hospitals in Shanghai, for the suggestions on improving the job satisfaction and enthusiasm of medical staff.Methods:From September to November 2020, two community health service centers(stations), one secondary hospital and one tertiary hospital were selected from Jiading District, Pudong New Area and Jing′an District of Shanghai respectively. An online questionnaire survey was conducted among medical staff in medical institutions selected by stratified random sampling. The survey covered the main demographic information as well as 12 rights and interests demands, namely " salary promotion" among other. Descriptive analysis was performed on the data, and chi square test was used for comparison between groups.Results:1 759 valid questionnaires were recovered in this survey, and 1 654 medical employees(94.03%)reported a high degree of appeal for " salary promotion" . Compared with the medical staff in community health service centers(stations), the medical staff in secondary/tertiary hospitals reported higher demands for " training and study" " title appointment" and " academic promotion" , presenting a difference statistically significant( P<0.05). There were significant differences between doctors and nurses in " routine expense reimbursement" " staff recruitment" " professional title appointment" " children′s education" " cultural and recreational activities" and " opinion feedback channels" ( P<0.05). Conclusions:Salary promotion was the common demand of medical staff at all levels of medical institutions. Medical staff at secondary/tertiary hospitals had higher demands for career development. There were some differences in appeals for rights and interests between doctors and nurses. Medical institutions at all levels should continue to promote the reform of salary system, pay attention to the respective rights and interests of doctors and nurses, and improve their job satisfaction and enthusiasm.
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Objective:To explore the application and effect of the situational case teaching in online internship teaching of anesthesiology.Methods:Thirty-four anesthesiology undergraduates in batch 2015 were randomized into two groups, the experimental group and the control group, with 17 students in each group. The experimental group adopted situational case teaching method, and the control group were taught by the traditional case-based teaching method. The questionnaire survey was used to assess the evaluation of students' personal comprehensive ability and teaching effect on the two groups. The data were analyzed by SPSS 19.0, and the measurement data were expressed by (mean ± standard deviation). Independent sample t test was used for comparison between the two groups, with significant difference when P<0.05. Results:The experimental group is superior than the control group in improvement of learning interest, self-learning ability, comprehensive expression and, communication ability, problem analyzing and solving ability, ability of uniting theory with practice, adaptability, and teamwork ability ( P<0.05). The recognition degree of this teaching mod and teaching effects is also significantly higher than that of the control group ( P<0.05). Conclusion:The situational case teaching mode has achieved good results in the online internship teaching of anesthesiology. This method can stimulate students' learning interest, improve learning efficiency, enhance students' ability of clinical practice and comprehensive quality, and also be beneficial to the improvement of teaching quality.
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OBJECTIVE@#To elucidate the pathogenic role of leukotriene B4 (LTB4) in pulmonary hyper-permeability and inflammation induced by lung-protective mechanical ventilation (LPMV) in rabbits.@*METHODS@#Thirty-two healthy Japanese white rabbits were randomized into 4 groups for treatment with vehicle or bestatin (a leukotriene A4 hydrolase inhibitor that inhibits LTB4 production) administered intragastrically at the daily dose of 8 mg/kg for 5 days, followed by sham operation (group S and group BS, respectively, in which the rabbits were anesthetized only) or LPMV (group PM and group BPM, respectively, in which the rabbits received ventilation with 50% oxygen at a tidal volume of 8 mL/kg for 5 h). The concentrations of LTB4 and cyclic adenosine monophosphate (cAMP) in the lung tissues were analyzed by ELISA. cAMP content, protein kinase A (PKA) protein expression and the Rap1-GTP protein to total Rap1 protein ratio were determined to assess the activities of cAMP/PKA and Rap1 signaling pathways. The lung injury was evaluated by assessing lung permeability index, lung wet/dry weight ratio, polymorphonuclear leukocyte (PMN) count in bronchoalveolar lavage fluid (BALF), pulmonary myeloperoxidase (MPO) activity and lung histological scores.@*RESULTS@#None of the examined parameters differed significantly between group S and group BS. All the parameters with the exception of lung histological score increased significantly in group PM and group BPM as compared to those in group S (@*CONCLUSIONS@#LPMV can induce LTB4 overproduction to down-regulate cAMP/PKA and Rap1 signaling pathways in the lungs of rabbits, which results in lung hyper-permeability and inflammation. Bestatin can inhibit LTB4 production in the lungs to protect against LPMV-induced lung hyper-permeability and inflammation.
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Animals , Rabbits , Bronchoalveolar Lavage Fluid , Leukotriene B4 , Lung , Lung Injury/prevention & control , Neutrophils , Respiration, Artificial/adverse effectsABSTRACT
OBJECTIVES@#It is an important reform for medical education in China to combine professional postgraduate training with standardized resident training. This study aims to evaluate the depression and perceived stress in postgraduate students of clinical medicine and residents from society and to determine the relation between depression and perceived stress in medical residents.@*METHODS@#Chinese Perceived Stress Scale (CPSS) and Self-Rating Depression Scale (SDS) were applied to 330 residents (including 235 postgraduate students of clinical medicine and 95 residents from society) from a Class-A Grade-3 genernal hospital in Hunan Province to evaluate and compare the depression and perceived stress in postgraduate students of clinical medicine and residents from society. Pearson correlation analysis was performed to assess the association between depression and perceived stress. Stress resources between 2 groups of residents were observed and compared.@*RESULTS@#Of the 235 postgraduate students of clinical medicine, 148 (63.0%) showed depression and 162 (68.9%) showed elevated perceived stress. Main stress resources were academic pressure, scientific research pressure, and employment pressure. Of the 95 residents from society, 52 (54.7%) showed depression and 58 (61.1%) showed elevated perceived stress. Main stress resources were economic stress, employment pressure, and academic pressure. The scores of CPSS and SDS were significantly higher in postgraduate students of clinical medicine than those in residents from society (@*CONCLUSIONS@#Residents (including postgraduate students of clinical medicine and residents from society) possess depression and elevated perceived stress with positive correlation. The postgraduate students of clinical medicine show higher level of depression and perceived stress than the residents from society under the "unified double-track" training system.
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Humans , China/epidemiology , Depression/epidemiology , Internship and Residency , Students, MedicalABSTRACT
Objective To understand the survival status and influencing factors for HIV/AIDS patients on highly active anti-retroviral therapy (HAART) in Shandong province.Methods Both Kaplan-Meier (K-M) method and cumulative incidence function (CIF) were used to calculate the cumulative incidence of AIDS-related death respectively,and Fine-Gray model was used to identify the influencing factors related to survival time.Results Through K-M method,a higher AIDS-related cumulated death rate than the CIF,was estimated.Among all the HIV/AIDS patients who initiated HAART from 2003 to 2015 in Shandong,5 593 of them met the inclusion criteria.The cumulative incidence rate for AIDS-related death was 3.08％ in 1 year,4.21％ in 3 years,5.37％ in 5 years,and 7.59％ in 10 years respectively by CIF.Results from the F-G analysis showed that HIV/AIDS patients who were on HAART,the ones who had college degree or above (HR=0.40,95％CI:0.24-0.65) were less likely to die of AIDS-associated diseases.However,HIV/AIDS patients who were on HAART and living in the western areas of Shandong (HR=1.33,95％CI:1.01-1.89),diagnosed by medical institutions (HR=1.39,95％CI:1.06-1.80),started to receive care ≥1 year after diagnosis (HR=2.02,95％CI:1.30-3.15),their CD,cell count less than 200 cells/μl (HR=3.41,95％CI:2.59-4.59) at the time of diagnosis,with NVP in antiviral treatment (ART) regime (HR=1.36,95％CI:1.03-1.88),at Ⅲ/Ⅳ clinical stages (HR=2.61,95％CI:1.94-3.53) and CD4 cell count less than 350 cells/μl (HR=5.48,95％CI:2.32-12.72) at initiation of HAART ect.,were more likely to die of AIDS-associated diseases.Conclusions With the existence of competing risks,the cumulative incidence rate for AIDS-related death was overestimated by K-M,suggesting that competing risk models should be used in the survival analysis.Measures as early diagnoses followed by timely care and early HAART could end up with the reduction of AIDS-related death.
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To explore whether Wnt3a exerts a role in neuropathic pain through Jumonji C domain 6 (JMJD6)-associated epigenetic modification. Methods: SD rats were divided into 4 groups: A sham group, a chronic constriction injury (CCI) group, a CCI+negative lentiviral expression vector (LV-NC) group and a CCI+lentiviral overexpression vector (LV-JMJD6) group. The sciatic nerve CCI model of SD rat and JMJD6 lentiviral expression vector were constructed. On the third day after CCI, the intrathecal catheter was prepared, and 20 μL of normal saline and lentivirus-containing reagent (virus titer 1×108 TU/mL) were administered. The rats' paw withdrawal mechanical threshold (PWMT) and paw withdrawal thermal latency (PWTL) were monitored, and Western blotting was used to detect the expression of Wnt3a and NR2B protein in the spinal cord. Co-immunoprecipitation was applied to detect the interaction between JMJD6 and Wnt3a. Results: Compared with the sham group, the PWMT of the rats in each group after CCI was significantly decreased and the PWTL was significantly shortened (P<0.05). Compared with the CCI group and the CCI+LV-NC group, PWMT in the CCI+LV-JMJD6 group was increased significantly on the 10th day and the 14th day after CCI, and the PWTL was significantly prolonged on the 14th day after CCI (P<0.05). On the 14th day after CCI, the expression levels of Wnt3a and NR2B in the CCI group and the CCI+LV-NC group were significantly higher than those in the sham group. After intrathecal injection of lentiviral vector, Wnt3a and NR2B protein expression levels in the CCI+LV-JMJD6 group were lower compared with the CCI+LV-NC group (P<0.05). The results of co-immunoprecipitation showed no direct interaction between Wnt3a and JMJD6. Conclusion: Wnt3a is involved in mediating neuropathic pain, and its effect may be related to the epigenetic modification of JMJD6, which is likely regulated through indirect interaction.
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Animals , Rats , Injections, Spinal , Neuralgia , Rats, Sprague-Dawley , Signal Transduction , Spinal Cord , Wnt3A ProteinABSTRACT
Objective@#This study aimed to examine the demographic characteristics, HIV related knowledge and behavior, correlates of bisexual behavior and status of HIV infection among men who have sex with men only (MSMO) and men who have sex with both men and women (MSMW) in Shandong province.@*Methods@#According to the requirements from "National HIV/AIDS sentinel surveillance program" , a cross-sectional survey was conducted to collect information on demographics, sexual and drug use behaviors, and HIV-related services among MSM in nine sentinel surveillance sites from April to July in 2018. Blood samples were drawn for serological tests on both HIV and syphilis antibodies.@*Results@#A total of 3 474 participants were included in this study. Related information on these participants would include: average age as (31.66±9.01) years; 35.06% (1 218) married or cohabiting with a woman, 50.52% (1 755) had college or higher education, 80.11% (2 783) self-identified as gays and 14.22% (494) self-identified as bisexual men,16.87% (586) ever having sex with woman in the past 6 months, 10.51% (365) ever using drugs. HIV and syphilis prevalence rates were 2.99% (104/3 474) and 2.76%(96/3 474). Through multivariable logistic models, MSMW were more likely to be ≥35 years of age, local residents, self-identified as heterosexual/bisexual/uncertain, ever having commercial sex with man but less likely to consistently use condoms in the past 6 months, less using internet/dating software to find male sex partners and less using drugs. There was no significant differences noticed in the following areas: number of sexual partners in the last week, condom use in the last six months with commercial sex partners, with HIV or syphilis infection and self-reported history of STD in the past year between MSMO and MSMW (P>0.05). HIV-infected MSM were more likely to have the following features, ≥45 years of age, non-local residents, finding male sex partners from the bothhouses, park/toilets or from the internet/dating software, also less likely to consistently use condoms in the past 6 months, using drugs or with syphilis infection.@*Conclusions@#High prevalence of bisexual behavior as well as higher risk of HIV infection were noticed among MSM in Shandong province. It is important to strengthen related surveillance and effective intervention programs for MSM with different characteristics in Shandong province.
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Objective@#To understand the survival status of AIDS patients after initiation of antiretroviral treatment (ART) in Shandong province during 2003 to 2017, and to determine the factors associated with survival status.@*Methods@#A retrospective cohort study was conducted among AIDS patients initially received antiretroviral therapy from 2003 to 2017. The epidemiological characteristics of the subjects were described, and life tables were used to estimate the survival rates, the influencing factors were analyzed by Cox regression model.@*Results@#A total of 9 813 cases were enrolled in this study, of the subjects, the median age was 34.9±11.0 years. The median of baseline CD4+ T lymphocyte count was 300.0(P25-P75: 163.0, 428.0)cells/μl, and 83.2% of them were at clinical stage Ⅰ (World Health Organization, WHO). The cumulative survival rates were 97.7%, 96.7%, 95.8% and 93.7%, 1, 3, 5, and 10 years after the initiation of ART respectively. Multivariate Cox regression model analysis showed that the risk of the mortality among those infected through homosexual behavior was 38% lower than that of patients infected via blood or other routes, and HR was 0.62 (95%CI: 0.43-0.89). Higher education level had lower mortality risk(the mortality risk of those with university degree or above was lower, compared to those with primary and lower cultural level, HR=0.41, 95%CI: 0.26-0.65). At baseline, AIDS patients at clinical stage Ⅰ(WHO) had lower mortality risk than those who were at clinical stageⅡ, Ⅲ, and Ⅳ(WHO). Lower baseline CD4+ T lymphocyte count had higher mortality risk.@*Conclusions@#Survival rate was higher after initial antiretroviral therapy among AIDS patients in Shandong province. CD4+ T lymphocyte count level, WHO clinical stage, and presence or absence of clinical symptoms at baseline are the main factors influencing the survival time of AIDS patients after ART.
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Objective@#To understand the results of tuberculin skin test (PPD) in preschool children after the vaccination of BCG, and to analyze the effect of BCG vaccination on latent tuberculosis infection in children.@*Methods@#From January to November 2018, a total of 1 359 preschool children from 14 kindergartens in 8 districts and cities of Jiangsu Province were selected for tuberculin test(PPD), and chest X-ray examination was performed on children with strong PPD results.@*Results@#The positive rate of PPD in preschool children in Jiangsu Province was 23.33%, of which strong positive and moderate positive (PPD≥10 mm) were totaled 6.47%. There were 149 boys (21.29%) with PPD positive reactions and 168 girls(25.50%) with PPD positive reactions, and differences of PPD positive reactions with different genders were of no statistical significance (χ2=3.36, P>0.05) And there were 201 children (25.35%) with PPD positive reactions in northern Jiangsu, 116 children (20.50%) with PPD positive reactions in southern Jiangsu. There were significant differences in the results of PPD positive and negative reactions between different regions(χ2=4.35, P<0.05). There was 1 case of PPD positive reactions among 3-year-old children(0.71%), 19 cases among 4-year-old children(3.89%), 31 cases among 5-year-old children(8.96%), and 37 cases among 6-year-old children(9.63%), and the differences of PPD positive reactions of different age groups were of statistical significance(χ2=21.69, P<0.01).@*Conclusion@#The positive rate of PPD in preschool children in Jiangsu Province is very low, indicating that PPD can be used as a detection method for latent infection in children. The overall positive rate of PPD in preschool children in Jiangsu Province is also low, and appropriate measures should be taken to protect susceptible children and effectively prevent and control childhood tuberculosis.
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Objective To understand the survival status and influencing factors for HIV/AIDS patients on highly active anti-retroviral therapy (HAART) in Shandong province.Methods Both Kaplan-Meier (K-M) method and cumulative incidence function (CIF) were used to calculate the cumulative incidence of AIDS-related death respectively,and Fine-Gray model was used to identify the influencing factors related to survival time.Results Through K-M method,a higher AIDS-related cumulated death rate than the CIF,was estimated.Among all the HIV/AIDS patients who initiated HAART from 2003 to 2015 in Shandong,5 593 of them met the inclusion criteria.The cumulative incidence rate for AIDS-related death was 3.08％ in 1 year,4.21％ in 3 years,5.37％ in 5 years,and 7.59％ in 10 years respectively by CIF.Results from the F-G analysis showed that HIV/AIDS patients who were on HAART,the ones who had college degree or above (HR=0.40,95％CI:0.24-0.65) were less likely to die of AIDS-associated diseases.However,HIV/AIDS patients who were on HAART and living in the western areas of Shandong (HR=1.33,95％CI:1.01-1.89),diagnosed by medical institutions (HR=1.39,95％CI:1.06-1.80),started to receive care ≥1 year after diagnosis (HR=2.02,95％CI:1.30-3.15),their CD,cell count less than 200 cells/μl (HR=3.41,95％CI:2.59-4.59) at the time of diagnosis,with NVP in antiviral treatment (ART) regime (HR=1.36,95％CI:1.03-1.88),at Ⅲ/Ⅳ clinical stages (HR=2.61,95％CI:1.94-3.53) and CD4 cell count less than 350 cells/μl (HR=5.48,95％CI:2.32-12.72) at initiation of HAART ect.,were more likely to die of AIDS-associated diseases.Conclusions With the existence of competing risks,the cumulative incidence rate for AIDS-related death was overestimated by K-M,suggesting that competing risk models should be used in the survival analysis.Measures as early diagnoses followed by timely care and early HAART could end up with the reduction of AIDS-related death.
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Objective To analyze the expression and clinicopathological significance of seven in absentia homolog 2 (SIAH2) in epithelial ovarian carcinoma, and to discuss its role in the development of epithelial ovarian carcinoma. Methods The expression of SIAH2 was determined by immunohistochemical S-P method in 165 cases of ovarian samples and SIAH2 expression was examined by Western blot. In the combination with follow-up data, survival curves were calculated using the Kaplan-Meier method and relationship between SIAH2 expression and prognosis of ovarian carcinoma patients was analyzed by the log-rank test. Cox proportional hazards regression model was used to examine the independent predictive factors in the patients with epithelial ovarian carcinoma.Results SIAH2 expression in epithelial ovarian cancer (76.4％) was higher than that of borderline ovarian tumors (41.7％) , benign ovarian cysts (5.13％) and normal ovarian tissues (2.86％) , and there were significant differences (all P < 0.05). No statistical significance of SIAH2 expression was found between benign ovarian cysts and normal ovarian tissues (P> 0.05). The expression of the SIAH2 was significantly correlated to histological grade, FIGO stage and lymph node metastasis (P < 0.05).The relative expression of SIAH2 in normal ovarian tissue, benign ovarian cyst, borderline ovarian tumor and epithelial ovarian cancer was 0.12 ± 0.05, 0.11 ± 0.04, 0.57 ± 0.08 and 1.05 ± 0.10, respectively. No difference of SIAH2 expression was found between normal ovarian tissues and benign ovarian cysts (P> 0.05). The expression of SIAH2 increased from ovarian tissues/benign ovarian cysts to borderline ovarian tumor to epithelial ovarian cancer and the difference was statistically significant (all P < 0.05).The survival curves of patients with SIAH2 (+) differed from those of patients with SIAH2 (-) and the difference was statistically significant (P < 0.05). Multiple factor analysis revealed that the higher expression of SIAH2 was an independent prognostic factor for overall survival. Conclusions The over-expression of SIAH2 plays an important role in the tumorigenesis and progression of epithelial ovarian cancer. The over-expression of SIAH2 may serve as a biomarker for poor prognosis of epithelial ovarian cancer patients.
ABSTRACT
Objective To explore the causes of secondary drug resistance among HIV infected persons who were receiving antiretroviral therapy in Shandong province,and provide evidence for the improvement of antiretroviral therapy strategy.Methods A case-control study was designed with 1 ∶ 2 matching on case and control groups.Household and face-to-face interview were conducted in October,2015.All the study subjects were screened from both the drug resistant database of antiretroviral therapy of Shandong provincial laboratory and national comprehensive HIV/AIDS database in Shandong.The sample size was estimated as 330 cases including 110 drug resistant and 220 non-drug resistant cases.Subjects were people living with HIV/AIDS (PLWHA) aged 15 or older and received antiretroviral therapy for more than 6 months with records of virus load (VL).Subjects who presented VL above 1 000 copies/ml would receive drug resistance testing.Subjects who were confirmed resistant to with secondary drug,were selected as case group,the rest subjects with non-secondary drug resistance would form the control group.EpiData 3.1 software and SPSS 22.0 software were used to establish a database.Related influencing factors were analyzed with non-conditional stepwise logistic regression model.Results A total of 288 cases were enrolled,including 103 in the case and 185 cases in the control groups,with average age as (37.62 ± 1.06) years and (37.90 ± 0.74)years old,respectively.Most of them were male,married/cohabitant,with education level of junior/senior high school or below and under Han nationality.Results from the multivariate logistic regression model showed that ORs (95％CI) of receiving antiretroviral therapy for 1-3 years,or more than 3 years were equal to 8,80 (3.69-21.00),3.00 (1.20-7.53),compared with receiving antiretroviral therapy less than one year,respectively.OR (95％ CI) of Among the PLWHA that with missing rate above 25.0％ on medication,the OR appeared as 15.41(4.59-51.71),compared with not missing medication.OR (95％ CI) among those who took the medicine themselves was 0.22 (0.07-0.74).Conclusions Factors as duration of treatment,missing rate on medication and taking medicine by oneself were of influence on secondary drug resistance.Other factors as duration on antiretroviral therapy longer than 1 year,missing rate above 25.0％ on medication,were related to the risk on secondary drug resistance.However,if the medicine was taken by oneself,it served as a protective factor for secondary drug resistance.It is necessary to strengthen the intervention and health education programs related to antiretroviral therapy.