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Background@#Long coronavirus disease 2019 (COVID-19) in recovered patients (RPs) is gradually recognized by more people. However, how long it will last and the underlining mechanism remains unclear. @*Methods@#We conducted a prospective follow-up study to evaluate the long-term symptoms and clinical indices of RPs at one-year after discharge from Union Hospital, Wuhan, China between December 2020 to May 2021. We also performed the 16S rRNA sequencing of stool samples from RPs and healthy controls (HCs) and analyzed the correlation between the gut microbiota and long COVID-19. @*Results@#In total, 187 RPs were enrolled, among them, 84 (44.9%) RPs reported long COVID-19 symptoms at one-year after discharge. The most common long-term symptoms were cardiopulmonary symptoms, including chest tightness after activity (39/187, 20.9%), palpitations on exercise (27/187, 14.4%), sputum (21/187, 11.2%), cough (15/187, 8.0%) and chest pain (13/187, 7.0%), followed by systemic symptoms including fatigue (34/187, 18.2%) and myalgia (20/187, 10.7%), and digestive symptoms including constipation (14/187, 7.5%), anorexia (13/187, 7.0%), and diarrhea (8/187, 4.3%). Sixty-six (35.9%) RPs presented either anxiety or depression (42/187 [22.8%] and 53/187 [28.8%] respectively), and the proportion of anxiety or depression in the long symptomatic group was significantly higher than that in the asymptomatic group (41/187 [50.6%] vs. 25/187 [24.3%]). Compared with the asymptomatic group, scores of all nine 36-Item Short Form General Health Survey domains were lower in the symptomatic group (all P < 0.05). One hundred thirty RPs and 32 HCs (non-severe acute respiratory syndrome coronavirus 2 infected subjects) performed fecal sample sequencing.Compared with HCs, symptomatic RPs had obvious gut microbiota dysbiosis including significantly reduced bacterial diversities and lower relative abundance of short-chain fatty acids (SCFAs)-producing salutary symbionts such as Eubacterium_hallii_group, Subdoligranulum, Ruminococcus, Dorea, Coprococcus, and Eubacterium_ventriosum_group. Meanwhile, the relative abundance of Eubacterium_hallii_group, Subdoligranulum, and Ruminococcus showed decreasing tendencies between HCs, the asymptomatic group, and the symptomatic group. @*Conclusion@#This study demonstrated the presence of long COVID-19 which correlates with gut microbiota dysbiosis in RPs at one-year after discharge, indicating gut microbiota may play an important role in long COVID-19.
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Objective:To evaluate the effects of sugammadex on the quality of recovery after laparoscopic bariatric surgery in severely obese patients.Methods:One hundred and eighty patients, aged 18-65 yr, with body mass index ≥ 40 kg/m 2, undergoing elective laparoscopic bariatric surgery, of American Society of Anesthesiologists physical status Ⅲ, were enrolled and divided into 2 groups ( n=90 each) by the random number table method: sugammadex group (S group) and neostigmine group (N group). Before anesthesia, bilateral T 6 and T 9 paravertebral nerve blocks were performed, and 0.33% ropivacaine 15 ml was injected on each side.When the reappearance of T 2 was monitored under train-of-four (TOF) stimulation after the end of surgery, and sugammadex 2 mg/kg was intravenously injected in S group, and neostigmine 0.04 mg/kg and atropine 0.02 mg/kg were intravenously injected in N group.After the patient was transferred to the general ward, flurbiprofen axetil 50 mg was injected intravenously every 12 h, and oxycodone and flurbiprofen axetil were used for patient-controlled intravenous analgesia at the same time.When the numerical rating scale (NRS) score ≥4 and the analgesic pump was ineffective, bilateral T 7 paravertebral nerve block was performed for rescue analgesia, and 0.33% ropivacaine 15 ml was injected on each side.The postoperative quality of recovery was assessed by the 15-item Quality-of-Recovery scale before operation and at 24 h after operation.The TOF ratio ≥ 0.9 and extubation time were recorded.The SpO 2 at the time of transfer to post-anesthesia care unit (PACU), the lowest SpO 2 and occurrence of SpO 2 < 92% during PACU were recorded.The occurrence of residual muscle relaxation and Ramsay sedation score were recorded at 30 min after entering PACU.The time of PACU stay, time to the first off-bed activity and length of hospital stay were recorded.The cumulative consumption of oxycodone, requirement for rescue analgesia, dizziness, nausea and vomiting, hypoxemia, and pulmonary complications were recorded within 48 h after operation. Results:There were no significant differences in the total score of 15-item Quality-of-Recovery scale before surgery and at 24 h after surgery, cumulative consumption of oxycodone within 48 h after surgery, rate of rescue analgesia, and incidence of dizziness, nausea and vomiting, hypoxemia and pulmonary complications between the two groups ( P>0.05). Compared with N group, the scores of the three recovery indicators (feel energized with enough rest, engagement in work or family activities, and tension and anxiety) were significanatly increased, time to TOF ratio ≥ 0.9, extubation time, time of PACU stay, time to the first off-bed activity and length of hospital stay were shortened, and the incidence of residual muscle relaxation was decreased in S group ( P<0.05). Conclusions:Antagonizing residual muscle relaxation with sugammadex is helpful for the recovery of severely obese patients after laparoscopic bariatric surgery.
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Objective:To develop a questionnaire for compliance with the management standard of nosocomial infection control in hemodialysis rooms (centers), and to evaluate the reliability and validity.Methods:Based on the Knowledge, Attitude/Belief, Practice (KAP) survey model, the initial questionnaire was formed by using literature review, the brainstorming and expert consultation. And the final questionnaire was developed by preliminary investigation and the formal investigation, and the reliability and validity test was carried out.Results:The questionnaire consisted of 3 subscales of knowledge, attitude and practice, totaling 40 items. The S-CVI was 0.953, 0.979, 0.943 respectively and that of each item was above 0.867. In the exploratory factor analysis, 3, 1 and 3 common factors were extracted and the cumulative contribution rate was 47.178%, 68.313% and 62.271% respectively. The Cronbach α coefficient was 0.906 for the total questionnaire and 0.641, 0.958 and 0.864 for 3 subscales. The retest reliability was 0.954 for the total questionnaire and 0.694, 0.893 and 0.708 for 3 subscales.Conclusions:The questionnaire had high reliability and validity, which can be used as an effective evaluation tool for the standard to investigate the compliance of medical staffs in hemodialysis rooms.
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Objective:To identify the risk factors of catheter-related bloodstream infection in hemodialysis patients using Meta-analysis.Methods:We searched PubMed, Web of Science, Cochrane Library, Embase, CBM, CNKI and Wangfang Data to collect literature about risk factors of catheter-related bloodstream infection in hemodialysis patients. Data were analyzed by RevMan 5.3 after literature screening, data extraction, and quality appraisal according to criteria by two researchers independently.Results:Ten literatures were recruited,including 3 143 cases and 7 risk factors.According to Meta analysis, catheter indwelling time ( OR value was 2.59, 95% CI 1.18-5.68), times of intubation ( OR value was 10.02, 95% CI 5.93-16.92), femoral vein catheterization ( OR value was 1.73, 95% CI 1.32-2.25), age ( OR value was 1.94, 95% CI 1.50-2.51), diabetes mellitus ( OR value was 2.58, 95% CI 2.03-3.29) and hemoglobin level ( OR value was 1.61, 95% CI 1.18-2.18), were significantly different in each group (all P<0.05). Conclusions:The main of risk factors for catheter-related bloodstream infection in hemodialysis patients are catheter indwelling time, times of intubation, femoral vein catheterization, age, diabetes mellitus and hemoglobin level. However, the relationship between catheter-related bloodstream infection and albumin level needs to be confirmed by more studies.
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Objective:To explore abnormal microstructural changes of white matter in patients with white matter lesions(WML) using diffusion tensor imaging(DTI), and to determine the association of such abnormalities of DTI parameters with executive function.Methods:Totally 34 patients with WML were recruited from the department of Neurology, Beijing Tiantan Hospital, Capital Medical University from March 2012 to May 2019.All patients with WML were scored with Hamilton depression scale (HAMD) and Hamilton anxiety scale (HAMA), and assessed with Montreal cognitive assessment (MoCA) and clinical dementia rating(CDR). They were divided into WML-cognitive normal group, WML-vascular cognitive impairment-non dementia group and WML-Dementia group.The Stroop color and word test (SCWT), trail making test-A (TMTA), digit symbol test and verbal fluency test were carried out to evaluate executive function.In addition, the healthy elderly without WML lesions were selected as the control group after they were examined by MRI, and all brains of the subjects went through DTI with Siemens 3.0 T MR.The data were collected and analyzed by voxel based analysis (VBA). The anisotropy and mean diffusion coefficient of DTI in the region of interest (ROI) and other regions in the brain were studied in the four groups, and their correlation with scores of executive function in WML patients was analyzed.Results:(1)In these executive function test, there were significant differences between the patients with cognitive impairment (WML-VAD group, WML-VCIND group) and normal cognition group(WML-CN group, NC group), such as SCWT(B)(65.54±6.24 vs 43.67±0.95, 76.75±2.13 vs 43.67±0. 95, 65.54±6.24 vs 43.66±1.81, 76.75±2.13 vs 43.66±1.81), SCWT(C)(88.58±6.76 vs 61.63±1.31, 96.37±1.47 vs 61 63±1.31, 88.58±6.76 vs 66.31±8.19, 96.37±1.47 vs 66.31±8.19), TMTA(40.47±2.76 vs 30.92±0.47, 44.24±1.43 vs 30.92±0.47, 44.24±1.43 vs 31.99±2.07, 40.47±2.76 vs 31.99±2.07), TMTB(88.66±6.55 vs 80.34±0.61, 96.70±1.72 vs 80.34±0.61, 88.66±6.55 vs 83.10±5.91, 96.70±1.72 vs 83. 10±5.91), Digit Symbol Test(39.25±5.63 vs 47.00±2.55, 31.27±3.93 vs 47.00±2.5, 39.25±5.63 vs 48.86±4.34, 31.27±3.93 vs 48.86±4.34) and Verbal Fluency Test(8.94±1.00 vs 11.71±0.47, 6.64±0.81 vs 11.71±0.47, 8.94±1.00 vs 10.86±0.69, 6.64±0.81 vs 10.86±0.69) scores ( P<0.05); In the patients with cognitive impairment, there were significant differences between WML-VAD group and WML-VCIND group, such as SCWT(B), SCWT(C), TMTA, TMTB, digit symbol test and verbal fluency test scores ( P<0.05); There were significant differences between WML-CN patients and NC group in the scores of SCWT (C), verbal fluency test( P<0.05). (2)FA values in the genu of corpus callosum and the inferior longitudinal fasciculus were negatively correlated with the time of SCWT (B), SCWT (C) and the TMTA( r=-0.436--0.471), but positively correlated with the scores of digit symbol test and verbal fluency test( r=0.428-0.573). MD values in the genu of corpus callosum, the superior/inferior longitudinal fasciculus and the inferior fronto-occipital fasciculus were positively correlated with the time of SCWT (B), SCWT (C) and TMTA( r=0.432~0.609), but negatively correlated with the scores of digit symbol test and verbal fluency test( r=-0.424--0.630, all P<0.003125 after emendation). Conclusion:The executive function of patients with WML-Dementia decreases significantly.The more serious the damage of white matter microstructure, the more serious the damage of executive of function.
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Objective To establish a modified dual liver transplantation rat model. Methods Based on the classic donor Y-shaped double iliac vein recanalization of bilateral liver grafts and portal vein and bile duct of the recipients, the dual liver transplantation rat model was modified by increasing the rat body mass, increasing the right lower lobe of the right graft, appropriate bile duct length, trimming Y-shaped blood vessels, and "triangular" anastomosis. The operation time, cold ischemia time, warm ischemia time and anhepatic phase of dual liver transplantation were recorded. The incidence of postoperative complications of the recipients was observed. The survival rates of the recipients at postoperative 7 and 30 d were calculated. Results The operation time of dual liver transplantation in rat was (114±7) min, the cold ischemia time was (36±3) min, the warm ischemia time was (9.7±1.6) min, and the anhepatic phase was (19.9±2.2) min, respectively. The incidence of postoperative complications in the recipient rats was 31% (5/16) including 2 cases of peritoneal effusion, 1 case of hemorrhage, 1 case of bile leakage and 1 case of respiratory obstruction. The postoperative 7- and 30-d survival rates of the recipient rats were 81%(13/16)、56%(9/16), respectively. Conclusions The modified technique can establish a stable dual liver transplantation rat model, which deserves widespread application.
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Shortage of donors is a major obstacle for liver transplantation.Lee innovated dual graft living donor liver transplantation in 2001,obtained graft from two donors,and it was conducted in various parts of the world.At present,South Korea has the biggest numbers in operation,China,Japan,and Germany.Turkey,Romania,and other countries are relatively less;current clinical liver donor liver transplantation is mainly based on single graft living donor liver transplantation,and in some complicated cases,single graft liver transplantation cannot be completed due to various factors,at this situation dual grafts living donor liver transplantation can complete the treatment.Although dual donor liver transplantation can only be carried out in a few areas due to complex surgical procedures,it can enrich the treatment of liver transplantation and promotes the development of liver transplantation.
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Objective@#To understand the distribution of HIV-1 genotypes and the status of drug resistance among people living with HIV who had prepared to initiate antiretroviral therapy (ART) in Dehong Dai and Jingpo autonomous prefecture (Dehong).@*Methods@#A total of 170 adults with HIV were recruited in Dehong from January to June 2017, before initiating ART. HIV-1 pol genes were amplified and used to analyze the HIV-1 genotypes and drug resistance.@*Results@#A total of 147 samples were successfully sequenced. Based on the phylogenetic analysis, 12 HIV-1 genotypes were found among the subjects, including three predominant genotypes such as subtype C (29.9%, 44/147), unique recombinant forms (URFs) (27.2%, 40/147) and CRF01_AE (19.7%, 29/147). Circulating recombinant forms (CRFs) which were newly identified in this area in recent years were also found among these subjects, including CRF62_BC, CRF64_BC, CRF86_BC and CRF96_cpx. The distribution of HIV-1 genotypes between heterosexual transmission or intravenous drug use, showed statistical difference. Surveillance drug resistance mutations (SDRMs) were found among 8.8% (13/147) of the subjects. Proportion of drug resistant strains among injecting drug users (25.0%, 8/32) was higher than that among those heterosexual transmitted individuals (4.6%, 5/109, χ2=10.166, P=0.002).@*Conclusions@#Among people living with HIV-1 who had prepared to initiate ART, their HIV-1 genetics were highly complicated, with moderate prevalence rate of HIV-1 drug-resistant strains.
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Objective To explore the features of distribution on HIV-1 gene subtypes among newly reported HIV/AIDS cases in the border areas of Yunnan province.Methods A total of 233 newly reported HIV/AIDS cases aged 18 or more were consecutively included in the border counties of Dehong Dai and Jingpo autonomous prefecture (Dehong prefecture),Honghe Hani and Yi autonomous prefecture (Honghe prefecture) of Yunnan province from November 2015 to October 2016.HIV-1 RNA was extracted with pol and env genes amplified.HIV-1 gene subtypes were determined through phylogenetic analysis.Results A total of 146 out of 233 specimens were genotyped successfully.HIV-1 was found to have had 8 gene subtypes in Dehong prefecture,with the unique recombinant forms (URFs) as the predominant (52.8％,57/108) type,including 56.8％ (21/37) of the cases with Chinese ethnicity and another 50.7％ (36/71) were Myanmar citizens.Four HIV-1 gene subtypes were detected in Honghe prefecture,with CRF01_AE as predominant (71.1％,27/38),including 81.0％ (17/21) Vietnamese and 58.8％ (10/17) Chinese.Differences on the distribution of HIV-1 gene subtypes were seen statistically significant between Dehong prefecture and Honghe prefecture (x2=61.072,P＜0.001).Conclusions The distribution of HIV-1 gene subtypes showed big difference in the two border areas of Yunnan province,suggesting that both Chinese or non-Chinese citizens living in the area should be taken good care of,in terms of HIV/AIDS prevention and control.
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Objective To understand the related risk behaviors,knowledge and status of HIV/ AIDS infection among rural adults of Derung minority,to provide relevant messages for the development of HIV/AIDS intervention strategy in this minority group.Methods We used system sampling method to conduct a cross-sectional survey in 6 administration villages of Derung Township,Gongshan Derung and Nu Autonomous County in Nujiang Lisu Autonomous Prefecture of Yunnan Province,with a sample size estimated as 383.Adult residents with Derung minority in six villages of Gongshan County were involved,with relevant information collected through door-to-door visit.HIV antibody was tested and SPSS 17.0 was used for statistical analysis.Results Information on 394 valid respondents was collected,with age as between 18 and 65 (34.39 ± 9.74),80.7％ (318/394) as married,54.0％ (213/394) having had primary school education,13.2％ (52/394) as migrant workers.In this population,the overall HIV infection rote appeared as 0.5％ (2/400),mainly through sexually transmission.The rate of awareness on HIV/AIDS was 69.8％ (275/394),mainly through free publicized materials 50.0％ (197/394).Rates on premarital sexual behavior on multiple sexual partners in the past year,on temporary sexual partners in the past year,having commercial sexual experiences in the past year and ever used condoms when engaging in casual sex,were 6.4％ (60/366),18.0％(66/366),5.7％(21/366),1.9％(7/366) and 8.0％(25/311),respectively.Conclusions Few numbers of HIV infections were identified among the migrating workers with Derung minority,with sexual transmission as the major route,along with the increased number of rural migrant workers and the low rates both on AIDS knowledge and condom use,accompanied by the high risk sexual behavior appeared in this rural adult residents of Derung minority.Relative strategies on HIV/AIDS intervention and control should be developed.
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Cholangiocarcinoma is a malignant tumor originating from bile duct epithelial cells, among which hilar cholangiocarcinoma is the most common, accounting for about 58％-70％ of cholangiocarcinoma. Due to its atypical clinical features, special anatomical site, low radical resection rate, high recurrence rate and poor prognosis, the 5-year survival rate of hilar cholangiocarcinoma was only 14.7％-33.8％. Hence, the most effective method of hilar cholangiocarcinoma lies in early diagnosis and radical resection. Good perioperative management can improve the rate of radical resection of hilar cholangiocarcinoma and contribute a lot to prognosis of the patients. The perioperative management of hilar cholangiocarcinoma is described as follows.
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Objective To explore abnormal microstmctural changes of white matter in patients with white matter lesions using diffusion tensor imaging(DTI),and to determine the association of such abnormalities of DTI parameters with cognitive function.Methods The objects who have already confirmed with WML were collected from March 2012 to February 2018 through magnetic resonance imaging (MRI) scan from the neurology department of Beijing Tiantan Hospital.Use The hamilton depression scale(HAMD) and the hamilton anxiety scale (HAMA) to eliminate anxiety and depression,and divided into WML-CN group,WML-VCIND group and WML-VAD group with Mini-mental state examination (MMSE),Montreal Cognitive Assessment (MOCA)and clinical dementia rating(CDR).In addition,select the healthy elderly people without WML by MRI scan as the normal control group.All of the subjects were detected with the superconduct magnetic resonance imaging system (German SIEMENS 3.0T) for the DTI scanning.Original images were processed with VBA.Then explore the changes of FA and MD of DTI in whole brain and regions of interest in NC group,WML-CN group,WML-VCIND group and WWML-VAD group,and its correlation with the severity of cognitive impairment in patients with WML.Results The damage degree of the fiber microstructure of brain white matter was significantly correlated with the total grade point of MoCA (P＜0.01).In figure FA,the variance analysis of F test results showed that the significant brain areas were the splenium of the corpus callosum,the genu of corpus callosum,bilateral posterior internal capsule,retrolenticular part of internal capsule,anterior thalamic radiation,partial inferior longitudinal fasciculus and inferior fronto-occipital fasciculus,cingulate,external capsule,upper and posterior part of the radiation crowns,partial superior longitudinal fasciculus,etc.(P＜0.05 after FWE correction based on TFCE method).In Figure MD,the variance analysis of F test results showed that the statistically significant brain areas mainly included the left external capsule and hook,partial genu and splenium of corpus callosum,Bilateral,bilateral inferior fronto-occipital fasciculus,inferior longitudinal fasciculus,anterior thalamic radiation,retrolenticular part of internal capsule,cingulate,etc (P＜ 0.05 after FWE conection based on TFCE).Conclusion No matter whether cognitive impairment exists in patient with WML or not,all DTI parameters are different from those of normal people.The integrity of white matter fiber has been damaged with different degrees.The more severe the cognitive impairment in the external manifestations of patients with WML,the greater the damage to the intrinsic white matter microstructure.
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Objective To evaluate intraoperative placement of bile duct decompression drainage tube in CBD primary suture after laparoscopic choledocholithotomy.Methods 152 patients undergoing laparoscopic choledocholithotomy were divided into group A (placement of bile duct decompression drainage tube during operation,82 cases) and group B (no decompression drainage tube placement,70 casas).Results There was no significant difference in operative time and intraoperative bleeding between the two groups (P ＞ 0.05).In group B patients the abdominal drainage tube indwelling time,abdominal drainage volume,peritoneal drainage fluid bilirubin value,postoperative hospitalization time were significantly longer than group A,the difference was statistically significant (P ＜ 0.05).No recurrence of choledocholithiasis and biliary stricture were found in either groups.Conclusions Placement of bile duct decompression drainage tube in laparoscopic choledocholithotomy and CBD primary suture after laparoscopic choledochotomy can significantly reduce the incidence of biliary leakage and shorten the postoperative hospital stay.
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Objective To detect the plasma concentration of tacrolimus and the survival time of rats after small-volume liver transplantation,and to investigate the criteria for immunological rejection after small-volume liver transplantation.Methods Lewis rats and Brown Norway rats were used to establish a small volume and normal liver volume transplantation model,which were divided into 7 groups:whole liver transplantation group (WI),small volume allogeneic liver transplantation group (SI),and whole liver allograft group (WA),small volume allogeneic liver transplantation group (SA),whole liver allograft immunotherapy group (WAT),small volume allogeneic liver transplantation immunotherapy group (SAT),small volume allogeneic liver transplantation immunotherapy modulation group (SATa).Morphological and functional changes of liver tissue were studied postoperatively,AST and tacrolimus plasma concentrations were detected,and survival was recorded.Results Compared with the WA group,the inflammatory cells infiltrated in the portal area of the SA group,the inflammatory changes of the sinusoidal endothelial cells,and the proportion of TCRpositive lymphocytes increased.Four days after transplantation,peripheral blood tests showed that CD4+CD25+ double positive lymphocytes were significantly lower in the allograft group than in the allograft group,and the positive expression rate in the SA group (0.6％) was significantly lower than that in the WA group (1.8％).The differences were statistically significant (P＜0.05).In the SAT group,the blood concentration of tacrolimus was significantly higher than that in the WAT group at each time point (P＜0.05).The blood concentration of tacrolimus in the SATa group was relatively stable,and the plasma concentration of the SATa group was stable.And AST was significantly lower than the SAT group,the differences were statistically significant (P＜0.05).Compared with WAT group,the proliferation and apoptosis rate of hepatocytes in SAT group and SATa group were significantly increased.The proliferation of hepatocytes in SATa group was significantly higher than that in SAT group (P＜0.05).Survival analysis showed that the cumulative survival rate of the WA group was 85.7％,which was significantly higher than that of the SAT group (28.6％).The difference was statistically significant (P＜0.05).The cumulative survival rate of the SATa group was 51.7％.The survival time of WAt group was (57.4±25.0) days,SAT group was (28.0±29.10) days,SATa group was (39.7± 29.0) days,which were longer than untreated groups.The ratio of proliferation to apoptosis (PRA) increased with increasing time of tacrolimus.Regardless of blood concentration,tacrolimus plasma concentration was positively correlated with AST (R =0.758,P＜0.05),indicating RPA was inversely correlated with AST (R=-0.962,P＜0.05).Conclusion The use of tacrolimus significantly prolonged the survival time of small-volume allogeneic liver transplantation rats.Adjusting the amount of tacrolimus under the guidance of tacrolimus plasma concentration and AST serum value equation TD =-0.494TC-0.0035AST+ 260.487 to make the blood concentration relatively stable,it can further extend the allogeneic liver transplantation rat time to live.
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@#Objective To study the relationship between executive function and activities of daily living for patients with periventricular white matter lesions (PWMLs). Methods From January, 2016 to January, 2017, 35 PWMLs patients and 35 normal controls were collected. Their executive function and activities of daily living were assessed with neuropsychological tests and Activities of Daily Living Scale (ADL).Results Compared with the normal control group, the scores of Mini-Mental State Exam (MMSE) and Montreal Cognitive Assessment (MoCA) significantly decreased (t>13.726, P<0.001), the times of Trail-Making Test and Stroop Colour Word Test significantly lengthened, the Verbal Fluency Test score decreased (t=6.891, P=0.013) and the Digit-Symbol Substitution Test score did not improve (t=3.372, P=0.072) in PWMLs group. The Z score of executive function was positively correlated with ADL score (r=0.438, P=0.008).Conclusion The executive function and activities of daily living are impaired in PWMLs patients, and their activities of daily living is related to the severity of the executive function impairment.
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Objective To explore the features of distribution on HIV-1 gene subtypes among newly reported HIV/AIDS cases in the border areas of Yunnan province.Methods A total of 233 newly reported HIV/AIDS cases aged 18 or more were consecutively included in the border counties of Dehong Dai and Jingpo autonomous prefecture (Dehong prefecture),Honghe Hani and Yi autonomous prefecture (Honghe prefecture) of Yunnan province from November 2015 to October 2016.HIV-1 RNA was extracted with pol and env genes amplified.HIV-1 gene subtypes were determined through phylogenetic analysis.Results A total of 146 out of 233 specimens were genotyped successfully.HIV-1 was found to have had 8 gene subtypes in Dehong prefecture,with the unique recombinant forms (URFs) as the predominant (52.8％,57/108) type,including 56.8％ (21/37) of the cases with Chinese ethnicity and another 50.7％ (36/71) were Myanmar citizens.Four HIV-1 gene subtypes were detected in Honghe prefecture,with CRF01_AE as predominant (71.1％,27/38),including 81.0％ (17/21) Vietnamese and 58.8％ (10/17) Chinese.Differences on the distribution of HIV-1 gene subtypes were seen statistically significant between Dehong prefecture and Honghe prefecture (x2=61.072,P＜0.001).Conclusions The distribution of HIV-1 gene subtypes showed big difference in the two border areas of Yunnan province,suggesting that both Chinese or non-Chinese citizens living in the area should be taken good care of,in terms of HIV/AIDS prevention and control.
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Objective To understand the related risk behaviors,knowledge and status of HIV/ AIDS infection among rural adults of Derung minority,to provide relevant messages for the development of HIV/AIDS intervention strategy in this minority group.Methods We used system sampling method to conduct a cross-sectional survey in 6 administration villages of Derung Township,Gongshan Derung and Nu Autonomous County in Nujiang Lisu Autonomous Prefecture of Yunnan Province,with a sample size estimated as 383.Adult residents with Derung minority in six villages of Gongshan County were involved,with relevant information collected through door-to-door visit.HIV antibody was tested and SPSS 17.0 was used for statistical analysis.Results Information on 394 valid respondents was collected,with age as between 18 and 65 (34.39 ± 9.74),80.7％ (318/394) as married,54.0％ (213/394) having had primary school education,13.2％ (52/394) as migrant workers.In this population,the overall HIV infection rote appeared as 0.5％ (2/400),mainly through sexually transmission.The rate of awareness on HIV/AIDS was 69.8％ (275/394),mainly through free publicized materials 50.0％ (197/394).Rates on premarital sexual behavior on multiple sexual partners in the past year,on temporary sexual partners in the past year,having commercial sexual experiences in the past year and ever used condoms when engaging in casual sex,were 6.4％ (60/366),18.0％(66/366),5.7％(21/366),1.9％(7/366) and 8.0％(25/311),respectively.Conclusions Few numbers of HIV infections were identified among the migrating workers with Derung minority,with sexual transmission as the major route,along with the increased number of rural migrant workers and the low rates both on AIDS knowledge and condom use,accompanied by the high risk sexual behavior appeared in this rural adult residents of Derung minority.Relative strategies on HIV/AIDS intervention and control should be developed.
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Objective To study the HIV-1 drug resistance transmission level in HIV infected persons receiving no antiviral therapy in Dehong prefecture of Yunnan province in 2015.Methods A total of 72 plasma samples were collected from recently reported HIV-infected persons aged 16-25 years in Dehong from January to July 2015 for drug resistance gene detection.Results Forty eight samples were successfully sequenced and analyzed.Among them,31.2％ (15/48) were from Chinese,and 68.8％ (33/48) were from Burmese.Based on pol sequences,HIV genotypes included URF (52.08％,25/48),CRF01_AE (16.67％,8/48),RF07_BC (10.42％,5/48),subtype B (6.25％,3/48),subtype C (6.25％,3/48),CRF57_BC (6.25％,3/48) and CRF08_BC (2.08％,1/48).One drug resistant mutation site to non-nucleoside analog reverse transcriptase inhibitor (NNRTI) and two drug resistant mutation site to nucleoside analog reverse transcriptase inhibitor (NRTI) were detected in four sequences.Based on the statistical method of HIV drug resistance threshold survey,the prevalence of HIV-1 drug resistant strain was 5％-15％.Conclusions The proportion of Burmese among newly reported HIV-infected individuals aged 16-25 years in Dehong in 2015 was higher.HIV-1 genetic diversity was found in Dehong.The prevalence of HIV-1 drug resistant strain had reached a moderate level in Dehong.
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Objective To understand HIV incidence in community residents and epidemiological characteristics of newly detected HIV infection cases in Dali,Yunnan province.Methods A cohort study was conducted among 146720 community residents who were tested to be HIV negative during 2010-2011,they were followed-up from June 1,2014 to May 31,2015.Results A total of 136356 community residents received follow up (92.9％).The follow-up time was 0.23-5.40 years (medium:3.43 years),cumulatively 459675 person years,and 78 people were found to be HIV positive.The incidence rate of HIV infection was 0.170/1000 person years.The incidence rate was 0.037/1000 person years in age group 15-29 years,0.288/1000 person years in age group 30-44 years,0.210/1000 person years in age group 45-59 years,0.204/1000 person years in age ≥60 years;0.213/1 000 person years in males,0.130/1000 person years in females;0.248/1000 person years inHan ethnic group,0.149/1000 person years in Minorities;0.194/1000 in people with education level ≤junior middle school,0.046/1000 person years in people with education level ＞ junior middle school;0.070/1000 person years in the unmarried,0.194/1000 person years in the married and 0.425/1000person years in the divorced/widowed.Cox proportional hazards regression analysis showed that being male (HR=l.731),aged 30-44 years (HR=13.158),aged 45-59 years (HR=10.329),aged ≥60years (HR=8.291),unmarried (HR=3.162) and divorced/widowed (HR=2.689) were the risk factors for HIV infection,while the education level ＞ junior middle school (HR=0.132) was the protective factor for HIV infection.Conclusions By medium 3.43 years follow up,the cohort study showed that incidence rate HIV infection was 0.170/1000 person years in the community residents in Dali.Male,middle aged and old people,people with low education level,the unmarried and the divorced/widowed had relatively higher risk to be infected with HIV,Close attention should be paid to the prevention and control of AIDS in these populations.
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Objective:To discuss the performance management method for large medical equipments in hospitals.Methods:13 large medical equipments in a large hospital were selected as samples and the economic efficiency analysis method and comprehensive evaluation method were aaplied to carry out performance management of medical equipment.Results:11 sets of medical equipment had good economic returns,the remaining 2 sets of equipments had a greater degree of loss due to lack of business and lack of qualification.Conclusion:Performance management of large medical equipments would help change the efficiency management of equipment from extensive to elaborate management.