Cost-Effectiveness Analysis of Combined Chemotherapy Regimen Containing Bedaquiline in the Treatment of Multidrug-Resistant Tuberculosis in China / 生物医学与环境科学（英文）

OBJECTIVE@#This study aims to estimate the cost-effectiveness of the combined chemotherapy regimen containing Bedaquiline (BR) and the conventional treatment regimen (CR, not containing Bedaquiline) for the treatment of adults with multidrug-resistant tuberculosis (MDR-TB) in China.@*METHODS@#A combination of a decision tree and a Markov model was developed to estimate the cost and effects of MDR patients in BR and CR within ten years. The model parameter data were synthesized from the literature, the national TB surveillance information system, and consultation with experts. The incremental cost-effectiveness ratio (ICER) of BR vs. CR was determined.@*RESULTS@#BR ( vs. CR) had a higher sputum culture conversion rate and cure rate and prevented many premature deaths (decreased by 12.8%), thereby obtaining more quality-adjusted life years (QALYs) (increased by 2.31 years). The per capita cost in BR was as high as 138,000 yuan, roughly double that of CR. The ICER for BR was 33,700 yuan/QALY, which was lower than China's 1× per capita Gross Domestic Product (GDP) in 2020 (72,400 yuan).@*CONCLUSION@#BR is shown to be cost effective. When the unit price of Bedaquiline reaches or falls below 57.21 yuan per unit, BR is expected to be the dominant strategy in China over CR.

Study on Thalassemia in Han Population in Sanya of Hainan Province / 中国实验血液学杂志

OBJECTIVE@#To study the distribution characteristics of thalassemia genotype in Han Population in Sanya of Hainan Province.@*METHODS@#Gap PCR and reverse dot hybridization were used to detect and analyze the thalassemia gene in 572 suspected thalassemia carriers of Han Population in Sanya.@*RESULTS@#Among the 572 Han Population in Sanya, 271 cases of thalassemia gene abnormality were detected, among which 161 cases were founded to be carriers of α-thalassemia gene. A total of 9 genotypes were detected, in the following order of the detection rate was －－SEA/αα，－α3.7/αα，－α4.2/αα，－－SEA/－α3.7，－－SEA/－α4.2，－α4.2/－α4.2，－α3.7/－α4.2，－α3.7/－α3.7，－－SEA/－－SEA. Among them, the deletion type (－－SEA/αα) in southeast Asia was the most common, accounting for 66 cases. 99 cases of β-thalassemia were detected, there were 7 genotypes, all of which were heterozygous. The order of the detection rate was CD41-42/βN, IVS-II-654/βN, CD17/βN, CD71-72/βN, -28/βN, －29/βN, CD27-28/βN. Among them, CD41-42/βN was the most common, accounting for 51 cases. In addition, 11 cases of combined α and β thalassemia were detected. Five kinds of genotypes were checked out, the order of detection rate was －α3.7/αα composite CD41-42/βN, －－SEA/αα composite IVS-II-654/βN, －α4.2/－α4.2 composite CD41-42/βN, －α4.2/αα composite －29/βN , －－SEA/ －α4.2 composite CD41-42/βN.@*CONCLUSION@#Han Population in Sanya of Hainan Province is a high-risk population of thalassemia, the genotype characteristics are different from other areas with high incidence of thalassemia in China. The main type of α-thalassemia is the deficiency mutation of southeast Asia, while CD41-42 heterozygous mutation is the main type of β-thalassemia.

Overview of quality standards of Eucommiae Cortex in China and overseas / 中国中药杂志

Eucommiae Cortex is an authentic medicinal material with broad growing areas( such as Hunan and Sichuan provinces in China. It is well-known for its efficacy in tonifying liver and kidney,strengthening muscles and bones,and stabilizing fetus. It has also been proven in pharmacology to possess the functions such as lowering blood pressure and lipids. Hence,Eucommiae Cortex has attracted increasing attention. The current quality standards of Eucommiae Cortex vary in different countries or regions. The quality of Eucommiae Cortex products on the market is affected by mix-ups of non-medicinal parts and insufficient growth years. In view of these problems,this paper summarizes the current quality standards and research progress of Eucommiae Cortex in China and overseas,aiming to provide a reference for the establishment of the quality standards of Eucommiae Cortex.

Survival analysis of HIV-infected patients on antiretroviral therapy during 2006-2019 in Taizhou City / 上海预防医学

Objective:To examine the survival status and explore factors related to death among human immunodeficiency virus （HIV） infected patients receiving antiretroviral therapy （ART） in Taizhou City during 2006‒2019. Methods:A retrospective cohort study was conducted to analyze the data on HIV-infected patients receiving ART in Taizhou during 2006‒2019. Kaplan-Meier （K-M） method was used to calculate the cumulative survival rate and cumulative treatment success rate. Cox regression model was used to determine survival status and factors associated with ART. Results:A total of 2 904 HIV-infected patients was included. The cumulative survival rate after 1， 3， 5， and 8 years of ART were 96.9%， 94.9%， 93.1% and 92.1%， respectively， and the cumulative treatment response rate were 91.3%， 85.3%， 81.8% and 73.8%， respectively. Compared with aged 18-30 years old， baseline CD4+T cell >350 count/μL， normal hemoglobin level， effective ART， no clinical symptom at baseline， and homosexual transmission， we found that aged 51-60 years old（HR=4.94，95%CI：1.66-14.69）， aged over 60 years old（HR=9.14，95%CI：3.14-26.63）， anemia at baseline（HR=2.24，95%CI：1.55-3.23）， baseline CD4+T cell <200 count/μL（HR=4.35，95%CI：2.14-8.86）， ART failure （HR=3.90，95%CI：2.73-5.58）， heterosexual transmission（HR=1.92，95%CI：1.15-3.20）， and signs of symptom at baseline（HR=1.68，95%CI：1.16-2.41） were risk factors of HIV-related death. Conclusion:The effect of ART in Taizhou City is confirmed with a high cumulative survival rate and treatment success. We should pay additional attention to senior HIV-infected patients with anemia at baseline and intensively monitor the effect of ART. Interventions such as “treat after discover” are supposed to be implemented more widely to further reduce HIV-related mortality.

Analysis of AIDS sentinel surveillance among college students in Taizhou of Zhejiang Province in 2016‒2018 / 上海预防医学

Objective:To determine the prevalence of AIDS/HIV， sexual behavior， knowledge， and access to HIV-related services among college students in Taizhou from 2016 through 2018， and provide scientific evidence for developing targeted strategies and measures. Methods:Based on the National HIV/AIDS Sentinel Surveillance， a cross-sectional survey was conducted annually among college students in three sentinels by a multi-stage cluster sampling across Taizhou， using questionnaire and laboratory examination. Results:A total of 4 185 college students were surveyed during 2016–2018， in which the proportion of reporting sexual behavior was 7.7%， with 58.4% using condom at. Sexual behavior， with fixed sexual partners， casual partners， commercial partners， and homosexual partners accounted for 68.7%， 23%， 4.0%， and 4.0%， respectively. Sexual experience and sexual behavior with fixed partners were statistically different among colleges and gender， which was much higher in male and vocational schools. The awareness rate of HIV/AIDS knowledge was 65.8%； 3.6% was found to have HIV voluntary counseling and testing， in which 7.8% had sexual behavior， indicating an upward trend over years. No college student tested positive for HIV from 2016 to 2018， and only one tested positive for anti-syphilis antibody and one positive for anti-hepatitis C antibody. Conclusions:Young male and vocational students in Taizhou are likely to have more sexual behavior and lower awareness on HIV/AIDS. College students have at-risk sexual behavior， insufficient awareness of HIV/AIDS， which may facilitate high risk of infection. It warrants further strengthening HIV/AIDS health education.

Single Center Analysis of Bloodstream Infection Clinical Characteristics and Prognosis in Patients with Hematological Malignancies in the Tropics / 中国实验血液学杂志

OBJECTIVE@#To analyze the characteristics, prognosis and risk factors of bloodstream infection in patients with hematological malignancies in the tropics, so as to provide evidence for the prevention and treatment of bloodstream infection.@*METHODS@#The clinical features, blood culture results and prognosis of patients with bloodstream infection in patients with hematological malignancies admitted to Hainan Hospital of PLA General Hospital were retrospectively studied.@*RESULTS@#The most common primary infection site of the 81 patients with hematological malignancies was lung (46.91%), followed by PICC (11.11%). The detection rate of Gram-positive bacteria and Gram-negative bacteria in the blood culture was 60.98% and 30.02%, respectively. Coagulase-negative staphylococci was the most common Gram-positive bacteria resulting in bloodstream infection in our study. Of the Gram-negatives, Klebsiella pneumoniae (34.38%) was predominant, followed by Escherichia coli (18.75%) and Pseudomonas aeruginosa (18.75%). Gram-positive bacteria was highly sensitive (100%) to vancomycin, linezolid and tigecycline. Study showed that Gram-negative bacteria had low sensitive to quinolones, in particular, the resistance rate of Escherichia coli to quinolones was as high as 83.33%. In terms of overall survival (OS), the 30-days OS of patients with Gram-negative and Gram-positive septicemia was 77.42% and 92.00%, respectively. There was no statistically significant difference between the two groups. Multivariate analysis revealed that septic shock (P=0.001, RR=269.27) was an independent risk factor for 30-day mortality, and remission status (P=0.027, RR=0.114) was an independent predictor of a favourable outcome of bloodstream infection in patients with hematological malignancies.@*CONCLUSION@#Gram-positive bacteria are the main pathogens causing bloodstream infections in patients with hematological malignancies in the tropics. Improving the care of PICC is an important measure to reduce the incidence of bloodstream infection in patients with hematological malignancies in the tropics. A correct treatment relieving disease and effective prevention and treatment of septic shock can reduce mortality of patients with bloodstream infection in patients with hematological malignancies in the tropics.

Clinical Analysis of Allogeneic Hematopoietic Stem Cell Transplantation for Treatment of 12 Patients with Acute Leukemia in Tropical Area / 中国实验血液学杂志

OBJECTIVE@#To analyze the efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for treatment of acute leukemia in the tropical area.@*METHODS@#Twelve acute leukemia patients who were underwent allo-HSCT from April 2013 to November 2018 in Hainan Hospital of Chinese PLA General Hospital were selected, including 5 cases of acute lymphoblastic leukemia (ALL) and 7 case of acute myeloid leukemia (AML). Three cases received HLA matched sibling hematopoietic stem cell transplantation, 8 cases received haploidentical hematopoietic stem cell transplantation, 1 cases received partially mismatched unrelated hematopoietic stem cell transplantation. Pretreatment regimen: 9 cases received modified BU/CY+ATG pretreatment regimen, 3 cases received BU/CY pretreatment regimen. Graft-versus-host disease (GVHD) prevention regimen: all patients received cyclosporine A, mycophenolate mofetil combined with short-term methotrexate regimen. The clinical efficacy of allo-HSCT in treatment of acute leukemia in the tropical area was analyzed by detecting hematopoietic reconstitution, GVHD, infection, relapse and survival after transplantation.@*RESULTS@#All the 12 patients achieved granulocyte reconstruction and megakaryocyte reconstruction. The median time of granulocyte reconstruction was 11.5 (6-14) days, and the median time of megakaryocytic reconstruction was 12.5 (10-22) days. Within 100 days after transplantation, the acute GVHD occurved in 8 cases, including 6 cases of Ⅱ-Ⅳ degree acute GVHD and 2 cases of Ⅲ-Ⅳ degree acute GVHD, 11 cases survived more than 100 days after transplantation, and the chronic GVHD occurred in 1 case, which was mildly limited. Pulmonary infection occurred in 7 cases, cytomegaloviremia occurred in 6 cases, EB viremia occurred in 6 cases, and hemorrhagic cystitis occurred in 5 cases. 2 cases relapsed and eventually died, and the remaining 10 patients survived without disease until the date of follow-up. The median follow-up time was 4 (1-68) months, 83.3% (10/12) survived without disease, and 16.7% (2/12) relapsed.@*CONCLUSION@#Allo-HSCT is an effective method for the treatment of acute leukemia in adults. Leukemia patients should be transplanted as soon as possible after remission. The incidence of pulmonary fungal infection in transplanted patients in tropics is high, therefore the prevention and treatment of fungal infection should be strengthened.

Regularity of body surface resistance at the acupoints of three yin meridians of the foot in reflecting physiological changes of the uterus / 针刺研究

OBJECTIVE: To investigate the specific regularity of body surface resistance at different acupoints of the meridians associated with the uterus in reflecting menstrual cycle by observing the change in body surface resistance at source points, cleft points, confluent points, and non-specific points of three yin meridians of the foot in different menstrual cycles in normal female college students, to lay a foundation for the in-depth research on the mechanism of acupoints reflecting the function of zang-fu, and to provide a reference for the clinical and scientific research on the biophysical characteristics of menstrual cycle-related acupoints in normal female. METHODS: A total of 90 normal female college students were recruited. The source points, cleftpoints, confluent points, and non-specific points of three yin meridians of the foot which were located in the adjacent spinal segments of the uterus were selected, and body surface resistance was monitored for 30 consecutive minutes at the same time-points of menstrual phase, follicular phase, ovulation phase, and luteal phase to observe the change in the resistance of each acupoint during the menstrual cycle. RESULTS: There was no significant change in the resistance value of unilateral acupoints during the menstrual cycle (P>0.05). In the same period, there was no significant difference in resistance value between unilateral three source points, three cleftpoints, different acupoints of the spleen meridian, and different acupoints of lumbar 4 dermatomere (P>0.05). As for the comparison of resistance of the same acupoint at the left and right sides, Taichong (LR3) at the left side had a higher resistance value than that at the right side in the menstrual phase (P<0.05); Taibai (SP3) at the left side had a higher resistance value than that at the right side in the ovulation phase (P<0.05); Zhongdu (LR6) at the left side had a higher resistance value than that at the right side in the follicular phase, the ovulation phase, and the luteal phase (P<0.05); Taixi (KI3), Diji (SP8), and Sanyinjiao (SP6) at the left side had a higher resistance value than those at the right side in the menstrual phase, the follicular phase, the ovulation phase, and the luteal phase (P<0.05); Shuiquan (KI5) at the left side had a lower resistance value than that at the right side in these four phases (P<0.05). CONCLUSION: The change trend of the resistance of the acupoints at the left and right sides associated with the three yin meridians of the foot can specifically reflect the change in qi and blood in the uterus during the menstrual cycle. The change trend of the source and cleft points of the liver meridian in the menstrual phase is different from that in the other phases, and the change trend of SP3, a source point of the spleen meridian, in the ovulation phase is different from that in the other phases, which suggests the specificity of meridian points in reflecting function. The mechanism by which meridian points reflect the function of zang-fu is associated with the meridian points and the spinal cord segments of zang-fu, and meanwhile, it has a specific relationship with the meridians to which meridian points belong and the attributes of acupoints.

Clinical Characteristics and Prognosis of U2AF1 Mutation in Patients with Acute Myeloid Leukemia / 中国实验血液学杂志

OBJECTIVE@#To investigate the incidence, clinical features of U2AF1 gene mutation in patients with acute myeloid leukemia(AML) and its effect of prognosis.@*METHODS@#A total of 161 patients with AML were enrolled. The second-generation sequencing method was used to detect U2AF1 gene mutation, and the relationship between U2AF1 mutation and clinical features, prognosis was analyzed.@*RESULTS@#The mutation rate of U2AF1 gene in 161 AML patients was 3.73%. The counts of peripheral blood leukocytes and platelets in the U2AF1 gene mutation group were lower than those in the wild type group. The complete response rate of U2AF1 gene mutation group was 66.67%, while that in wild type group was 55.48%, which shows no significant difference between the two groups (P=0.70). The median EFS of wild type group and the mutant group was not reached and reached to 133 days, respectively (P=0.03), while the medium OS in two groups was not reached and reached to 210 days (P=0.01).@*CONCLUSION@#The AML patients with U2AF1 mutation positive have a poor prognosis as compared with the wild type group, which may be a poor prognostic factor for acute myeloid leukemia.

Comparison of risk for HIV, syphilis and HCV infection between club drug users and traditional drug users in TaizhouCity / 上海预防医学

Objective To compare the risk for HIV, syphilis and HCV infection between club drug users and traditional drug users in Taizhou City of Zhejiang Province, in order to provide evidence for further behavioral intervention. Methods Drug users in Taizhou were surveyed with the questionnaires for national HIV sentinel surveillance during 2016-2019.Blood samples were collected for detection of HIV, syphilis and HCV antibodies. Results A total of 1 612 drug users were surveyed, in which club drug users accounted for 78.7% and traditional drug users 21.3%.Significant differences were observed in gender, age, educational level, ethnic background, and household registration between these two groups (P < 0.05).Among club drug users, injecting drug users accounted for 7.1%, lower than traditional drug users (P < 0.001).Among the injecting drug users, those who shared needles with others accounted for 8.9%, similar to the traditional drug users (P>0.05).In the past year, the proportion of having sex after drug abuse among club drug users was 77.9%, higher than traditional drug users (P=0.002).The proportion of condom use during sex were nearly 30.0% for both club drug users and traditional drug users.Of the club drug users, 0.2% were infected with HIV, which was not significantly different from that in traditional drug users (P>0.05).The prevalence of syphilis among club drug users was 12.6%, higher than traditional drug users (P < 0.05);whereas the HCV prevalence (10.4%) was lower among club drug users (P < 0.001). Conclusion The threats of blood-borne transmission and sexual transmission of diseases are common among club drug users, suggesting the need of targeted intervention measures.

Study on the body surface temperature variation patterns of the meridian acupoints related to the physiological status of the uterus / 针灸推拿医学（英文版）

Objective: By observing the body surface temperature changes of different meridian acupoints located at the same or adjacent spinal segments of the uterus during the whole storing and releasing process of the uterus under normal physiological condition by the infrared thermal imaging technology, to explore the specific patterns that the functions of Zang-fu organs are reflected on the biophysical characteristics of acupoints, and to enrich the functional specificity theory of the meridian acupoints, thus to provide a reference for discussing the biophysical characteristics of meridian acupoints associated with the menstrual cycle in healthy female college students. Methods: Ninety healthy subjects were included. Infrared thermal imaging device was used to detect the body surface temperature of the Yuan-Primary points, the Xi-Cleft points, the crossing points, the non-specific points, the unrelated meridian acupoints and the non-meridian non-acupoint points of the three yin meridians of foot located at the same or adjacent spinal cord segment with uterus, during the menstrual phase, the follicular phase, the ovulation phase and the luteal phase. The absolute skin temperature difference between the left and right acupoints with the same name was used as the main outcome indicator. Results: The temperature difference between left and right Diji (SP 8, the Xi-Cleft point of the Spleen Meridian) during the ovulation phase was significantly higher than that during the other 3 phases (all P<0.05). There was no statistically significant difference in the temperature difference between the other meridian acupoints and non-meridian non-acupoint points during the 4 phases (all P>0.05); the absolute temperature difference value of each meridian acupoint was not statistically different from each other in the same phase (all P>0.05). Conclusion: The temperature of Diji (SP 8) specifically reflected the onset of ovulation, and the thermal characteristics of Diji (SP 8) specifically reflected the physiological changes of uterus. The meridian acupoints reflecting the performance of Zang-fu function is not only associated with the spinal cord segment innervating the acupoints, but also associated with the characteristics of the acupoints and the meridians to which the acupoints belong.

Status and associated factors of recreational drug use among man who have sex with man in Nanjing / 中华疾病控制杂志

Objective To understand the prevalence of synthetic drug use among man who have sex with man (MSM) in Nanjing and the associated factors. Methods MSM were recruited by snow-ball sampling, peer recommendation and network recruitment. Multivariate logistic regression analysis was performed to evaluate the correlated factors of recreational drug use. Results 29.6% of the 876 MSM ever used recreational drugs. The prevalence of HIV and syphilis infections were 9.5% and 9.0% respectively. After controlling the influence of correlated factors, recreational drug use was correlated with unprotected anal intercourse in the past 6 months(OR=1.83, 95% CI: 1.35-2.47, P<0.001), multiple male sex partnership in the past 6 months(OR=2.25, 95% CI: 1.65-3.05, P<0.001), higher HIV prevalence (OR=1.95, 95% CI: 1.21-3.17, P=0.007) and higher syphilis prevalence(OR=1.71, 95% CI: 1.02-2.84, P=0.040). Multivariate Logistic analysis showed that demographic and behavioral factors associated with recreational drug use including: less than 30 years old (OR=1.50, 95% CI: 1.07-2.11, P=0.020), self-identified as homosexual orientation (OR=1.65, 95% CI: 1.16-2.34, P=0.005), seeking male partners mainly via the internet(OR=1.58, 95% CI: 1.07-2.35, P=0.022), higher monthly income(OR=1.57, 95% CI: 1.13-2.17, P=0.007), receptive sexual role(OR=1.55, 95% CI: 1.04-2.32, P=0.033). Conclusions MSM has a high prevalence of recreational drug use in Nanjing, which was positively correlated with HIV/syphilis infection and high risk behaviors. Intervention efforts should be devoted to reduce and combat drug use among MSM.

Characteristics and influencing factors of heterosexual behavior among young men who have sex with men in Taizhou City from 2015 to 2018 / 中华疾病控制杂志

Objective To investigate characteristics and influencing factors of heterosexual behavior among young men who have sex with men (YMSM) in Taizhou, and to provide evidence for conducting intervention on acquired immune deficiency syndrome (AIDS). Methods The demographic characteristics, behavioral characteristics and AIDS related knowledge of YMSM in Taizhou were investigated by the method of questionnaire survey from January to July in 2015, February to September in 2016, January to August in 2017, and January to August in 2018. Human immunodeficiency virus (HIV), syphilis and hepatitis C virus (HCV) were tested in everyone. Results A total of 432 YMSM were recruited, including 56 YMSM who had heterosexual behavior. 14.3% of YMSM who had heterosexual behavior never used condoms when having heterosexual behavior. 26.8% did not use condoms when having the last heterosexual behavior. The detection rates of HIV and syphilis were both 5.4%. No HCV positive person was found. The awareness rate of AIDS related knowledge was 91.1%. In multivariate logistic regression, marital status and local residence time were influencing factors of heterosexual behavior among YMSM. Conclusions YMSM in Taizhou are at risk of spreading HIV and syphilis. Although the awareness rate of AIDS related knowledge is better, there are still high-risk behavior such as commercial sex behavior and knowledge-practice separation such as not using condoms. It is necessary to promote intervention activities for safe sexual behavior, especially among YMSM who are married and live in the local areas for less than 2 years.

Salvianolic acid B exerts anti-hepatic fibrosis-carcinoma effect via mediation of pSmad3C/pSmad3L / 中国药理学通报

Aim To observe the effect of Salvianolic-aid B ( Sal B ) on the progression of hepatic fibrosis-carcinoma in mice induced by diethylnitrosamine ( DEN ) and investigate the mechanism of Sal B in-volved in the shift between pSmad 3 C/p21-mediated tumor suppressive signaling and pSmad 3L/PAI-1/c-Myc-mediated pro-fibrogenic/oncogenic signaling . Methods A total of 100 male Kunming mice were randomly grouped , DEN-induced hepatic fibrosis-car-cinoma model of mice was established , which was in-tragastrically treated by Sal B with two dosages ( 15 , 30 mg · kg -1 ) and colchicine with one dosage ( 0.2 mg· kg -1 ) , respectively.The mice were sacrificed at 12th week or 16th week after the start of DEN adminis-tration.Pathological changes of livers in each group were assessed by liver biopsy , hematoxylin-eosin ( HE ) staining and Van Gieson ( VG ) staining .The protein expressions of pSmad3C, pSmad3L, p21, plas-minogen activator inhibitor-1 ( PAI-1 ) and c-Myc in liver tissues were assayed by Western blot .Results In the normal control group , the surface of mouse liver was smooth and soft , and the structure of the hepatic lobule was intact.In the DEN alone group, at 12th week, the surface of mouse liver was rough and hard , the hepatic lobule was encysted or separated by colla-gen bundles, and pseudolobules emerged.At 16th week, the surface of mouse liver in the DEN alone group was rough with some nodules. HE and VG staining showed that the hepatocytes of nodules with obvious atypia and hyperchromatic nuclei were veri-fied.However, these pathological changes were evi-dently improved in Sal B treatment groups compared with the DEN group , which was proved by reductive cirrhotic nodules and alleviative fibrosis at 12th week, and decreasing cancerous nodes and ameliorative dif-ferentiation via Sal B treatment at 16th week.Western blot results showed that the protein expression of pS-mad3C, pSmad3L, PAI-1 were less, and c-Myc ex-pression was scarcely found in normal group; in DEN alone group, at 12th week, the protein expression of pSmad3C had no significant change , while the protein levels of pSmad3L, PAI-1, p21 were up-regulated, and at 16th week, the protein expressions of pS-mad3C, pSmad3L, p21, PAI-1 and c-Myc increased. In Sal B treatment group, the expressions of p21 and pSmad3C increased significantly , pSmad3L and PAI-1 protein levels markedly decreased at 12th week, the expression of pSmad3C increased obviously , p21 was almost unchanged , and the expression of pSmad 3L, PAI-1 and c-Myc were significantly reduced at 16th week .Conclusions Sal B could delay the progression of hepatic fibrosis-carcinoma in mice induced by DEN , and the mechanism may involve mediating the shift of pSmad3C/p21 and pSmad3L/PAI-1/c-Myc signaling.

Characteristics of patients on methadone maintenance treatment in Taizhou City / 预防医学

Objective To investigate the characteristics of methadone maintenance treatment(MMT)clients, and to explore their retention rate and associated factors in Taizhou, Zhejiang Province. Methods Heroin or opiate addicts who started MMT between 2006 and 2014 in study area were included. Data including demographics, history of drug use and treatment information was extracted from the National MMT Data Management System and descriptive analysis were conducted. Multiple logistic regression models were used to explore factors associated with retention rate. Results In total, 2 262 MMT clients were included for analysis. Most of them were male(87.53%), single, divorced or widowed(55.75%), and had an education of junior middle school or below(88.68%). Almost all of them (98.32%)were heroin addicts, and the age at first drug use ranged from 9 years to 54 years, with average age of(25.06±6.34)years. A total of 1 123(49.65%)clients had a history of inject drug use and 81(3.58%)clients had ever shared needles with others. The average duration on MMT was 5.02±2.01 years, and the average methadone dosage during treatment was (34.49 ±22.69)mL. The MMT retention rate was 29.2% (661/2 262). In multivariable analysis, districts such as Huangyan District, Yuhuan County and Linhai City, aged≥40 years and average methadone dosage>20 mL during treatment were independently and positively associated with retention rate. Conclusion Most of MMT clients in Taizhou are male, unmarried, and had low education level. The retention rate is low in Taizhou but older patents and those receive high methadone dosage have a relatively higher retention rate.

Drug resistance analysis on smear-positive pulmonary tuberculosis in Taizhou City from 2015 to 2017 / 上海预防医学

[Objective]To ascertain the drug resistance for pulmonary tuberculosis in Taizhou City, and to provide basis for tuberculosis prevention and control strategy. [Methods] The sputum samples were collected form 267 smear positive pulmonary tuberculosis patients who registered in a drug susceptibility testing (DST) monitoring site in Taizhou City form 2015 to 2017. Then with culture, identification of Mycobacterium and DST for 9 anti-tuberculosis drugs [isoniazid (INH) , rifampicin (RFP) , ethambutanol (EMB) , streptomycin (SM) , kanamycin (KAM) , ofloxacin (OFX) , crinkledmycin (CPM) , promethylamine (PTO) and para amino salicylate (PAS) ] by using proportion method performed on all sputum specimens. [Results]Of the 267 smear positive cases, 220 were cultured with 190 culture positive (17 were identified as nontuberculous mycobacterial infections) , 28 culture negative, and 2contaminated. Among 160 cases with the result of DST to 9 drugs, the overall drug resistance rate was22.5％. The overall drug resistance rates were 21.4％ and 33.3％ in the newly diagnosed patients and retreated patients respectively. There was no significant difference between the two groups (P>0.05). The multidrug resistance rate was 3.1％, and had a significant difference between the new and retreated patients (0.7％ vs. 26.7％, P<0.01). Drug resistances rates of the 9 drugs ranged from high to low as:INH (8.1％) , PTO (8.1％) , SM (6.9％) , RFP (6.3％) , OFX (2.5％) , PAS (2.5％) , EMB (2.5％) , CPM (2.5％) and KAM (2.5％). There was no gender difference found in drug resistance rates (P> 0.05). Neither was there age difference (P> 0.05). [Conclusion] The epidemic of drugresistant of tuberculosis in Taizhou City are still high, especially that of acquired multi-drug resistance of tuberculosis. We must continue to improve the "three-in-one"management model, improve the quality of clinical diagnosis and treatment, and strengthen community medication management.

Sentinel surveillance on HIV status and related factors among men who have sex with men above 50 years in Taizhou Prefecture from 2010 to 2017 / 上海预防医学

[Objective] To investigate the HIV infection status and behavioral characteristics of men who have sex with men (MSM) over the age of 50 in Taizhou during 2010-2017 HIV sentinel surveillance, analyze the related factors of HIV infection, and provide basis for developing targeted intervention strategies. [Methods] HIV sentinel surveillance data from 2010 to 2017 in Taizhou was used to analyze the demographic characteristics, HIV awareness, and sexual behaviors of MSM over the age of 50. Also, HIV infection status and related factors were analyzed by multivariate regression analysis. [Results]A total of 334 MSM aged over 50 were surveyed by HIV sentinel surveillance in 2010-2017, and the HIV positive rate was 14.1％. The average age of the 334 MSM was (59.6 ± 7.2) years, and those with junior high school education and below accounted for 76.0％, with awareness of AIDS knowledge being 85.6％. And78.7％ of them had anal sex with men in the past 6 months. Among them, 30.4％ used condoms each time. And 4.8％ of them had commercial sex with men and 37.1％ had sex with women in the past 6months. Multivariate analysis showed that syphilis-positiveness was a risk factor for HIV infection and awareness of HIV-related knowledge proved to be a protective factor for HIV infection. [Conclusion] The MSM over 50 years old in Taizhou has a high rate of HIV-positiveness and high-risk behaviors exist. It is imperative to strengthen dynamic HIV surveillance for this population and behavioral intervention to reduce HIV related risky behavior.

Genotype Analysis of Patients with Thalassemia in Sanya Area of Hainan Province in China / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To explore the frequency and spectrum of thalassemia gene mutations of the population in Sanya area of Hainan province in China.</p><p><b>METHODS</b>The type and frequency of gene mutation in 1060 patients with suspected thalassemia were analyzed by Gap-PCR and reverse dot blot (RDB).</p><p><b>RESULTS</b>The detection on mutation of thalassemia gene were found in 539 suspected thalassemia patients, the total detected rate was 50.85% (539/1060), out of them 330 (31.13%) were diagnosed with α-thalassemia, 162 (15.28%) with β-thalassemia, and 47 (4.43%) as carriers of both α and β-thalassemia. In α-thalassemia patients, genotype were as follows in proper order--SEA/αα (9.25%)、-α /αα (5.94%)，HbH (5.56%)，-α /αα (5.00%)，-α /-α (2.36%)，-α /-α (1.70%), and -α/-α(1.32%). In β-thalassemia patients, there were 9 gene mutations: CD41-42 (9.8%), CD17 (1.32%), 654 (1.23%), CD71-72 (1.23%), IVS-II-654 (1.04%), -28 (0.37%), CD43 (0.19%), -29 (0.18%) and βE (0.09%). In the α and β composite thalassemia there were 12 genotypes. The -α/αα was the most common genotype co-existed with β-thalassemia (1.70%), followed by the -α /αα genotype (0.94%).</p><p><b>CONCLUSION</b>The data of this study provide the frequency and the spectrum of thalassemia gene mutations in the sanya area of Hainan province, which can contribute to set up the strategies for the prevention and control of thalassemia in this area.</p>

Detection of drug resistance genes and homology of carbapenem-resistant Klebsiella pneumoniae / 中国感染控制杂志

Objective To explore the drug-resistant genotypes and homology of carbapenem-resistant Klebsiella pneumoniae (CRKP).Methods 38 strains of clinically isolated CRKB in a hospital between September 2015 and February 2016 were collected,drug resistance genes were detected with polymerase chain reaction (PCR),homology of strains was analyzed with pulsed-field gel electrophoresis (PFGE).Results All 38 strains were from intensive care unit(ICU) and surgical intensive care unit(SICU),accounting for 39.48％ and 34.21 ％ respectively.38 strains all harboured drug resistance genes blaKPC and blaSHV,6 strains harboured blaCTT.PFGE revealed that strains were divided into types A,B,C,and D,type C was predominant(65.78％,25/38).Of type A strains,strains 14,15,and 16 carried drug resistance genes blaKPC 2,blaSHV,and blaCTT-M-15 respectively,these strains were all isolated from SICU patients,strains 14 and 15 were isolated on the same day,strain 16 was isolated on the following week;of type C strains,homology of strain 10,18,25,and 28 was 100％.strian 10 and 18 were isolated from ICU patients,strains 25 and 28 were isolated from patients in division I of neurology ICU(both were transferred from ICU),and both were isolated during patient hospitalization in ICU,the isolation time only differed for one day.Conclusion The main drugresistant genotypes of CRKB in this hospital are mainly blaKPC and blaSHV,there is epidemic of clone strains in this hospital.

Nursing intervention of small dose paclitaxel synchronous chemotherapy and radiotherapy in non-small cell lung cancer (middle and advanced stage) / 中国生化药物杂志

Objective To observe the effect of low-dose paclitaxel concurrent chemotherapy of advanced non-small cell lung cancer in the application in the treatment, analysis of the nursing intervention. Methods From February 2014 to March 2017 in our hospital 31 cases of advanced non-small cell lung cancer patients as the research object, the patients were given low-dose paclitaxel concurrent radiotherapy chemotherapy in the treatment of patients with adverse reactions, according to the selection of targeted nursing intervention, observation of this group of patients. Results The degree of toxicity is the after treatment of the patients with psychological, clinical, prevention of infection, diet and other aspects of nursing intervention, all patients with adverse reactions were mitigated, and completed the treatment program. Conclusion Low dose paclitaxel concurrent radiotherapy and chemotherapy and the application of nursing intervention in advanced non-small cell lung cancer with precise, can effectively alleviate the adverse reaction in the treatment of patients, as a disease. It provides the guarantee for the prognosis of the disease and has practical value.