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Objective:To construct a comprehensive, systematic and quantifiable quality evaluation index system for blood purification care in ICU.Methods:The contents of the evaluation index system for blood purification care in ICU were determined by reviewing the literature, discussion of the research group and two rounds of Delphi expert consultation.Results:The response rate of the two rounds of experts was 100%. The authoritative coefficients of the two rounds of experts were 0.908 and 0.965 respectively. The coordination coefficient of the indicators of the second round of consultation results was 0.210-0.292, P<0.05 or 0.01. The quality evaluation index system for blood purification care included 3 first-class indicators, 16 second-class indicators, and 56 third-class indicators. Conclusions:The enthusiasm, authority, concentration of opinions and degree of coordination of the consulting experts are relatively high. The constructed evaluation system for the quality of blood purification care indicators can be used for reference in the implementation, training and quality control.
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Objective To understand the disease progression and human leukocyte antigen (HLA) gene polymorphism of HIV-infected persons without disease progress for long term,also known as long-term non-progressors (LTNPs),in Henan province.Methods A retrospective study was conducted in 48 LTNPs with complete detection and follow-up information during 2011-2016 in Henan.Changes of CD4 +T cells counts (CD4) and viral load (VL) during follow-up period were discussed.Polymerase chain reaction-sequence-specific oligonucleotide probe (PCR-SSOP) was used for the analyses of HLA-A,HLA-B and HLA-DRB1 alleles between LTNPs and healthy controls.Results From 2011 to 2016,forty-eight LTNPs showed a decrease of the quartile (P25-P75) of CD4 from 601.00 (488.50-708.72)/μl to 494.00 (367.00-672.00)/μl,and the difference was significant (P＜0.05).The increase of the quartile (P25-P75) of log10VL from 3.40 (2.87-3.97) to 3.48 (2.60-4.37),but the difference was not significant (P＞0.05).HLA polymorphism analysis revealed that HLA-B*13:02 and HLA-B*40:06 were more common in LTNPs (P＜0.05),while HLA-B*46:01 and HLA-DRB1*09:01 were more common in healthy controls (P＜0.05).Conclusions The CD4 of LTNPs in Henan showed a downward trend year by year.HLA-B*13:02 and B*40:06 might be associated with delayed disease progression for HIV infected persons in Henan.
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Objective To understand the disease progression and human leukocyte antigen (HLA) gene polymorphism of HIV-infected persons without disease progress for long term,also known as long-term non-progressors (LTNPs),in Henan province.Methods A retrospective study was conducted in 48 LTNPs with complete detection and follow-up information during 2011-2016 in Henan.Changes of CD4 +T cells counts (CD4) and viral load (VL) during follow-up period were discussed.Polymerase chain reaction-sequence-specific oligonucleotide probe (PCR-SSOP) was used for the analyses of HLA-A,HLA-B and HLA-DRB1 alleles between LTNPs and healthy controls.Results From 2011 to 2016,forty-eight LTNPs showed a decrease of the quartile (P25-P75) of CD4 from 601.00 (488.50-708.72)/μl to 494.00 (367.00-672.00)/μl,and the difference was significant (P＜0.05).The increase of the quartile (P25-P75) of log10VL from 3.40 (2.87-3.97) to 3.48 (2.60-4.37),but the difference was not significant (P＞0.05).HLA polymorphism analysis revealed that HLA-B*13:02 and HLA-B*40:06 were more common in LTNPs (P＜0.05),while HLA-B*46:01 and HLA-DRB1*09:01 were more common in healthy controls (P＜0.05).Conclusions The CD4 of LTNPs in Henan showed a downward trend year by year.HLA-B*13:02 and B*40:06 might be associated with delayed disease progression for HIV infected persons in Henan.
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Objective The study was aimed to explore the effect of care bundles on the management of nasal intestine for the cerebral apoplexy patients with dyspinic dysfunction. Methods A total of 102 cerebral apoplexy patients with dyspinic dysfunction, who were administrated with nasal intestine, were recruited in Qianfoshan Hospital of Shandong Province from August, 2016 to June, 2017. Random number table was applied to analyze the separate two groups, experimental group and control group, in which, the patients were administrated with care bundles and usual care. Various parameters, like one-time catheterization, complications of nasal intestine administration, hospital stay, cost and the patients' satisfaction degree, were compared between two groups. Results The success rate of once placed tube in the test group was 78.4％ (40/51), which was significantly higher than that in the control group [54.9％(28/51)], and the difference was statistically significant (χ2=6.353, P<0.05). The incidence of complications of indwelling nasoenteric tube, including unplanned extubation, reflux aspiration, tube-feeding associated diarrhea, were 9.8％(5/51), 17.6％(9/51), 11.8％(6/51), respectively. All of them were significantly lower than those of the control group, which were 37.3％(19/51), 41.2％(21/51), 31.4％(16/51), respectively, indicating that there was a statistical difference (χ2= 10.679, 6.800, 5.795). The days and costs of hospitalization were (11.0 ± 2.5) d, (9645.35 ± 193.30) yuan, respectively, which were significantly lower than those of the control group [(17.0 ± 4.2) d, (12523.79 ± 190.28) yuan], indicating that there was a statistical difference (t=8.767, 10.612, P<0.01). Patients' satisfaction was 90.2％(46/51), which was significantly higher than that of the control group [68.6％ (35/51)]. The difference was statistically significant (χ2=7.256, P<0.01). Conclusions The administration of care bundles for the cerebral apoplexy patients with dyspinic dysfunction can effectively increase the success rate of one-time catheterization, alleviate the complications, and therefore reduce the risk of aspiration pneumonia development. In addition, care bundles can remarkably alleviate the medical burden on the patients, shorten the hospital stays and improve the survival quality of the patients.
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<p><b>OBJECTIVE</b>To investigate the progression and drug resistance of long-term non-progressors during three follow-up in Henan province.</p><p><b>METHODS</b>In May 2009, 26 cases of long-term non-progressors were recruited who infected HIV more than 10 years with blood collection and supply routes, did not receive anti-retroviral therapy, CD4(+)T lymphocyte count ≥350/μl and did not show typical symptoms of AIDS from Weishi, Shangcai, and Linying of Henan Province. Continuous follow-up were conducted three times since 2009 every two years with cohort analysis, the epidemiological information of infection routes, infection time and blood were collected, and 78 parts of 10 ml EDTA anticoagulated whole blood were collected. The changes of CD4 (+) T lymphocytes, viral load, and virus gene variety were characterized from 2009 to 2014. In-house methods were used to explore primary drug resistance of long-term non-progressors. Nonparametric Kruskal-Wallis test were used to compare CD4(+) T lymphocyte count and viral load changes during different follow-up times.</p><p><b>RESULTS</b>The average age and infection time of 26 cases were (48.51 ± 6.75) years, (13.42 ± 4.26) years, respectively. Three follow-up times, CD4(+) T lymphocyte count P50 (P25-P75) was 573.5 (487.4-789.8), 499.8 (403.5-635.7), and 418.8 (297.6-537.8)/μl (H=63.99,P<0.001), respectively. And natural logarithm of viral load P50 (P25-P75) were 3.93 (3.43-4.55), 4.29 (3.78-4.75), 4.50 (4.01-4.81) (H=3.19,P=0.355), respectively. Subtype and phylogenetic analysis of HIV showed that prevalent cases were B subtype, accounting for 88.5% (23/26), and three cases showed restructuring changes. Two cases appeared highly resistant of 18 infected patients whose viral load >1 000 copies/ml.</p><p><b>CONCLUSION</b>The CD4(+)T lymphocyte had a declining trend, virus subtype recombinant changes in a few cases, and primary drug resistance was found of long-term non-progressors in Henan province.</p>
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Adult , Humans , Middle Aged , CD4 Lymphocyte Count , China , Cohort Studies , Disease Progression , HIV , Classification , HIV Infections , Epidemiology , HIV Long-Term Survivors , Phylogeny , Viral LoadABSTRACT
Objective To find out the exposure level and distributional characteristics of risk factors for stroke in health checkup population. Methods Target population was selected from two health management centers including Qianfoshan Hospital Affiliated to Shandong University and Shandong Provincial Hospital Affiliated to Shandong University in Shandong province. Data were investigated with a questionnaire which included general information, physical examination, laboratory examination and electrocardiography. Exposure rate of risk factors and its distributional characteristics were described. Results A total of 95 909 individuals were enrolled into data analysis, including 59 686 males (age:44.48± 14.43), 36 223 females (age: 44.80 ± 13.90). The major risk factors were lack of exercises (68.02%), overweight (60.54%)and dyslipidemia (58.27%). There were significant differences in age groups and sex. Conclusion Exposure rate of risk factor for stroke was high and there were substantial differences between sex and age in health checkup population. Screening and health management for stroke risks might be a necessary strategy for the preventive intervention.
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<p><b>OBJECTIVE</b>To study the condition of HIV-1 drug resistance mutation among failures of first-line antiretroviral therapy in Henan province.</p><p><b>METHOD</b>The sub platform of China's legal infectious disease monitoring information reporting system-HIV/AIDS integrated prevention and control data information management system was used to collect the information of patients experiencing first-line antiretroviral treatment failure (virus load ≥ 1 000 copies/ml) more than one year among nine cities of Henan in 2011. A total of 40 cases with no information and 212 cases with incomplete drug resistance results were deleted, and 1 922 cases were included in this study and genotype resistance testing was carried out. Non-conditional logistic regression analysis was used to analyse the influencing factors of drug resistance mutation.</p><p><b>RESULTS</b>A total of 1 922 cases were included in the analysis. 1 039 cases were males, 833 cases were females, the age was (45.7 ± 12.1) years, 82.73% (1 590) were married, and 87.93% (1 690) were transmitted by blood. 64.20% (1 234) patients acquired drug resistance. Nucleoside reverse transcriptase inhibitor (NRTI), non-nucleoside reverse transcriptase inhibitor (NNRTI) and protease inhibitor (PI) resistance mutations were found in 62.59% (1 203), 49.74% (956) and 0.94% (18) of subjects, respectively. 42.09% (809) of patients harbored NRTI and NNRTI resistance mutations synchronously. ≥ 1TAM was the most commonly emerged NRTI resistance mutation (41.94% (806)), the prevalences of TAM-1 and TAM-2 were 8.48% (163) and 4.24% (81), respectively. K65R/N and Q151M complex existed in 23 and 4 patients, respectively. K103N/S was the most commonly emerged NNRTI resistance mutation (34.32% (659)). Non-conditional logistic regression analysis showed that, factors associated with high drug resistance were the following: transmitted by mother to child (OR = 9.05, 95% CI: 1.14-72.12), clinical stage was IV (OR = 1.70, 95% CI: 1.09-2.66) and 5-year-treated (OR = 1.59, 95% CI: 1.03-2.47). Factors associated with low drug resistance were the following: 1-year-treated (OR = 0.19, 95% CI: 0.13-0.27).</p><p><b>CONCLUSION</b>Complex patterns of HIV-1 drug resistance mutations were identified among individuals experiencing failure of first-line antiretroviral therapy in Henan province. Factors associated with high drug resistance were lived in Luohe, Shangqiu, Nanyang, Xinyang, transmitted by mother to child, clinical stage was IV, and 5-year-treated.</p>
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Adult , Female , Humans , Male , Middle Aged , China , Drug Resistance, Viral , Genetics , Genotype , HIV Infections , Drug Therapy , HIV-1 , Genetics , Infectious Disease Transmission, Vertical , Prevalence , Protease Inhibitors , Therapeutic Uses , Reverse Transcriptase Inhibitors , Therapeutic UsesABSTRACT
<p><b>OBJECTIVE</b>To study the prevalence of antibody to hepatitis C virus (anti-HCV) among newly reported HIV infection cases in Henan province, 2012-2014.</p><p><b>METHODS</b>HIV-1 BED incidence test and anti-HCV test were conducted in newly diagnosed HIV infection cases in Henan, which were reported through national AIDS information system between 1 July 2012 and 30 June 2014.</p><p><b>RESULTS</b>The data of 4 267 newly reported HIV-1 infection cases were analyzed, the positive rate of anti-HCV was 13.19% (563/4 267). The anti HCV was highest in those infected with HIV through injection drug use (77.27%), the anti-HCV positive rates in those infected with HIV through blood donation/transfusion, heterosexual contact, homosexual contact and mother-to-child transmission were 15.06%, 15.81%, 3.74% and 8.96%, respectively. Kaifeng (32.04%), Nanyang (14.67%), Shangqiu (25.00%), Zhumadian (25.00%) and Zhoukou (18.86%) were the first five prefectures with the high anti-HCV positive rates. The anti-HCV positive rate in BED positive patients (recent HIV-1 infections) was 7.50% (86/1 146). The multivariate logistic regressions analysis revealed that BED negative, aged >40 years, being farmer, HIV infection though injection drug use and living in in Kaifeng, Nanyang, Shangqiu, Zhumadian and Zhoukou were the risk factors for HCV infection.</p><p><b>CONCLUSION</b>The positive rate of anti-HCV declined between 2012-2014 in newly reported HIV infection cases in Henan, but the positive rate of anti-HCV was high in risk population and in some areas.</p>
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Humans , Blood Donors , Blood Transfusion , China , Epidemiology , Coinfection , Epidemiology , HIV Infections , Epidemiology , Virology , HIV-1 , Hepacivirus , Hepatitis C , Epidemiology , Hepatitis C Antibodies , Blood , Heterosexuality , Homosexuality , Incidence , Prevalence , Risk Factors , Serologic Tests , Substance Abuse, IntravenousABSTRACT
<p><b>OBJECTIVE</b>To explore the related testing indicators variation of HIV long-term non-progress populations.</p><p><b>METHODS</b>The long-term non-progress populations in some areas of Henan were recruited, and the study was carried out according to different CD4(+)T lymphocytes counts for two groups. The dynamic characteristics of immune status and viral load between LTNP-1group (CD4(+)T lymphocytes ≥ 500/µl, 42 cases) and LTNP-2 group(350/µl ≤ CD4(+)T lymphocytes < 500/µl, 49 cases) from July 2010 to August 2013 were observed. The characteristics of HIV elite controllers during the follow-up were also described.</p><p><b>RESULTS</b>LTNP were recruited, 56% (51 cases) were men, and 44% (40 cases) were women. The study population were aged from 38 to 65 years old. A total of 320 individuals were followed-up, 14 cases were lost, 2 deaths, and 16 cases had received antiretroviral therapy during four years. To analyze the annual changes of CD4(+)T lymphocytes and VL of the group from 2010 to 2013, LTNP-1 group CD4(+)T lymphocytes from 654.0(545.2-809.5) decreased to 494.0(341.0-574.7), and LTNP-2 group decreased from 493.0 (429.5-770.0) to 343.5(253.0-500.8), CD4(+)T lymphocytes decline of over times of two groups in longitudinal analysis (χ(2) = 50.32, P < 0.01; χ(2) = 31.03, P < 0.01). lg (VL) of LTNP-1 group were 3.52 (3.15-4.27), 3.71 (2.70-4.55), 3.86 (3.59-4.55), 3.96 (3.25-4.36), and lg (VL) of TNP-2 group were 4.35 (3.72-4.83), 4.35 (3.97-4.94), 4.71 (3.96-4.95), 5.04(4.78-5.26), respectively (P > 0.05). The same year inter-group comparison found CD4(+)T lymphocytes of LTNP-1 group were higher than LTNP-2 group (Z = 5.23, P < 0.01; Z = 3.06, P < 0.01; Z = 2.51, P < 0.05; Z = 2.47, P < 0.05). VL of LTNP-2 group increased from 4.35(3.97-4.94) to 5.04 (4.78-5.26) during 2011 to 2013, were higher than LTNP-1 group in the same year (Z = 2.28, P < 0.05; Z = 2.58, P < 0.05; Z = 2.76, P < 0.05). 65 cases HCV antibody were positive in 91 individuals, and the HCV antibody positive rate was 76% (32/42), 67% (33/49) between LTNP-1 group and LTNP-2 group. Six elite controllers maintained CD4(+)T lymphocytes ≥ 500/µl, VL<1 000 copies/ml during four years follow-up.</p><p><b>CONCLUSION</b>The long-term non-progress populations in Henan were overall healthy, and VL were relatively stable, there was a decreased trend of CD4 year by year, and HCV co-infection rate was high.</p>
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Adult , Female , Humans , Male , Middle Aged , China , Epidemiology , Follow-Up Studies , HIV Infections , HIV Long-Term Survivors , HIV Seropositivity , T-Lymphocytes , Viral LoadABSTRACT
<p><b>OBJECTIVE</b>To study hepatitis C virus infection and related factors among newly reported HIV infections in Henan province.</p><p><b>METHODS</b>Both HIV-1 BED incidence and anti-HCV tests were applied on newly reported HIV-1 infections between 1 Jul. 2012 to 30 Jun. 2013 in Henan province.</p><p><b>RESULTS</b>2049 HIV-1 infections were newly reported between 1 July 2012 to 30 June 2013 in Henan province, with the positive rate of anti-HCV as 14.87% (271/1 887) and the proportion of BED positives was 26.34% (497/1 887). The recent HIV-1 infections appeared lower HCV prevalence than non-recent HIV-1 infection. Among 20-39 age group, HIV-1 infections had a lower HCV prevalence than among the other age groups. Patients carrying HIV-1 through injecting drug use showed higher HCV prevalence.</p><p><b>CONCLUSION</b>Under results on BED; age, infection route and area were influencing factors of HCV prevalence in newly reported HIV-1 infections in Henan province, suggesting that corresponding prevention programs should be targeted.</p>
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Adult , Female , Humans , Male , Young Adult , China , Epidemiology , Coinfection , Epidemiology , HIV Infections , HIV-1 , Hepatitis C , Epidemiology , PrevalenceABSTRACT
Objective To assess the reliability and validity of the Chinese version of Multidimensional fatigue symptom inventory-short form(MFSI-SF).Methods The reliability and validity of the Chinese version MFSI-SF were assessed in a sample of 203 cancer patients.Statistical software was used to perform the analysis.Results The results showed moderate correlation between items and the total scale,the content validity index was 0.82,and exploratory factor analysis indicated five dimensions of the scale,the cumulative variance contribution was 56.65％.Confirmatory factor analysis showed moderate model fitting:x2/df=l.73,GFI=0.83,AGFI=0.79,NNFI=0.94,RMSEA=0.06,criterion validity was 0.585,and the Cronbach α of the total scale was 0.896.Conclusions The results demonstrated good convergent validity,it is suitable to evaluate fatigue status in Chinese cancer patients.
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Objective To develop a PCR-mverse dot blot hybridization(RDB)assay to rapidly detect pathogenic mycoplasmas in genitourinary tract.Methods Universal primers were designed and applied to amplify the 16S rRNA gone of ureaplasma parvum(Up),ureaplasma urealyticum(Uu),Mycoplasma genitalium(Mg),Mycoplasma hominis(Mh)by using nestcd PCR.Specific nucleotide probes of Up,Uu,Mg and Mh Were constructed and immobilized onto nylon membranes.PCR products were denatured and hybridized、with specific oligonucleofide probes on nylon membrane.The sensitivity and specificity of the PCR-RDB assay were evaluated based.on the hybddizafion results.Also,PCR-RDB Was utilized to detect pathogenic mycoplasmas from 60 clinical samples.Results The four probes selectively hybridized with the PCR product of corresponding mycoplasmas,and no cross hybridization was observed.The detection limit of PCR-RDB Was one colony forming unit(CFU)of mycoplasma.Out of the 60 clinical samples、19were positive for mycoplasm,Mixed infections were found in three samples,including two coinfected with Up and Uu and one with Uu and Mg.Conclusion PCR-RDB is a rapid,specific and sensitive approach to the identification of pathogenic mycoplasmas in urogenital tract.