Interpretation of the diagnostic part of Clinical Practice Guideline:Diagnosis and Treatment in Children with Allergic Rhinitis / 中国实用儿科杂志

Allergic rhinitis is a common and difficult chronic nasal disease in children,which may affect the quality of life of children,and even cause complications such as sinusitis,secretory otitis media,sleep apnean syndrome and so on.This article explains the diagnostic part in the Clinical Practice Guideline:Diagnosis and Treatment in Children with Allergic Rhinitis developed by Otolaryngology Professional Committee,Pediatrician Branch,Chinese Medical Doctor Association. Child allergic rhinitis should be diagnosed according to family history,allergic disease history,clinical manifestation and the consistent allergen detection.Infants can be diagnosed only according to family history,allergic disease history and clinical manifestations.

Relationship between children's obstructive sleep apnea hypopnea syndrome and nasal diseases / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the relationship between children obstructive sleep apnea hypopnea syndrome (OSAHS) and nasal diseases.</p><p><b>METHODS</b>Three hundred and thirty-eight cases of pediatric OSAHS confirmed by polysomnography (PSG) had been enrolled as the treatment group, and divided into mild subgroup, moderate subgroup and severe subgroup according to the obstructive apnea index (OAI) and apnea hypoventilation index (AHI). The other two hundred and seven pediatric vocal cord nodule cases without OSAHS had been randomly selected as the control group. The retrospective analysis of upper respiratory tract infection frequency per year, expression levels of total IgE (tIgE) and allergen-specific IgE (sIgE), results of electronic nasopharyngoscope test and nasal sinus CT scans had been performed in all the pediatric cases. The data were analyzed by SPSS 17.0.</p><p><b>RESULTS</b>The upper respiratory tract infection frequency per year, ratio of cases with positive results of tIgE, ratio of cases with nasosinusitis, ratio of cases with narrow nasal cavity in the experiment group were respectively 8.7 ± 5.7, 60.9%, 79.9% and 50.0%, while those in the control group were respectively 4.4 ± 2.6, 32.8%, 12.1% and 6.3%, with significant difference between groups (t = 7.578,χ(2) value was 41.943, 237.704, 110.322, all P < 0.01). The multiple regression analysis indicated that, nasosinusitis and narrow nasal cavity were the two major risk factors of pediatric OSAHS (OR1 = 16.008, OR2 = 4.671, all P < 0.01), with combined effects (OR = 113.430, P < 0.01) . The rank test analysis in term of risk factors of severity of OSAHS had indicated that, prevalence of nasosinusitis and narrow nasal cavity were increased as rising severity of OSAHS (χ1(2) = 21.571, χ2(2) = 17.304, all P < 0.01).</p><p><b>CONCLUSIONS</b>Infection and allergy are risk factors of pediatric OSAHS. Nasosinusitis and narrow nasal cavity are two major risk factors of pediatric OSAHS, which have positive relationship with the severity of OSAHS.</p>

Studies on the determinants and changes related to the natural CD4 + T cell counts among antiretroviral treatment-naive HIV/AIDS patients in Dehong prefecture, Yunnan province / 中华流行病学杂志

Objective To explore the determinants and changes ofCD4+ T cell counts among antiretroviral treatnent-naive HIV/AIDS patients in Dchong prefecture, Yunnan province. Methods A retrospective cohort analysis was conducted on HIV-infected local residents, being reported during 1989 through May 2010, in Dehong prefecture. The patients had received at least two CD4 + T cell counting tests before receiving the antiretroviral treatment (ART). Difference between the first and the last CD4 + T cell counts was calculated and described. Logistic regression analysis was conducted to examine the determinants of significant depletion of CD4 + T cell counts among them. Results A total of 4487 HIV/AIDS patients were included in the study. The change of CD4 +T cell counts between the first and the last CD4 + T cell count tests had a median of-2.0 cells/μ l in month (IQR: -8.2-3.6) and was significantly associated with socio-demographic characteristics, HIV transmission mode,the first or baseline CD4+ T cell counts and the time interval between the first and the last CD4 + T cell counting tests etc. About 60.0％ (2693/4487) of the HIV/AIDS patients had deletions of CD4 + T cell counts, and 31.2％ (1400/4487) had significant ( ≥ 30％ ) deletions of CD4 + T cell counts. Results from the multiple logistic regression analysis indicated that age, ethnicity,marital status, HIV transmission mode, the first CD4+ T cell counts and the interval between the first and the last CD4+ T cell counting tests were significantly associated with the significant depletion of CD4 + T cell counts. Conclusion The changing rate of CD4 + T cell count among ART-naive local HIV-infected patients in Dehong prefecture, Yunnan province was relatively slow. However,substantial proportion of them showed significant decreases of CD4 + T cell counts, which was determined by many factors. More efforts were needed to systematically and consistently follow-up those HIV-infected patients and measure their CD4+ T cell counts in China, in order to instantaneously monitor the disease progression,and the initiation of ART, if necessary.

Tracing the sources of newly reported HIV infections in Dehong prefecture of Yunnan province / 中华流行病学杂志

Objective To trace and provide HIV-testing among those having contacts with HIV-infected individuals at various levels in Dehong prefecture, Yunnan province and to evaluate the effectiveness and feasibility of such investigation as a supplemental strategy for HIV testing and control. Methods Newly reported HIV infections from August throughout October in Dehong prefecture, in 2008 were asked to provide contact information of persons whom they had high risk contacts with. Persons having had risk contacts with HIV-infected cases were hereof interviewed and their blood tested on the sero-status of HIV. Results A total of 335 HIV cases were newly reported during this three-month period. A total of 309 cases of them and 148 HIV infections identified thereafter from their risk contacts were under informed consent, to participate in this study. A total number of 3395 risk contacts were reported, of whom only 20.7% (704/3395) had 'contact information' and 51.3% (361/704) were successfully located and interviewed, including 117 previously confirmed HIV infections and 244 people with unknown HIV status. The majority of them (203 or 83.2% of 244) were then tested for HIV and 56(27.6% of 203) were tested positive for HIV. The proportion of having detailed contact information and the proportion of being traced or followed among reported risk contacts of HIV infections were 68.8% and 68.2% for spouses of HIV patients, respectively, which were much higher than those among commercial sex partners (1.2% and 16.7%), casual sex partners (37.3% and 22.3% ) and peers who sharing needles (34.1% and 56.4% ). Conclusion Newly reported HIV infections reported a large number of risk contacts and new HIV infections were identified among them. It was extremely difficult to trace commercial sex partners or casual sex partners on their HIV infection status. Nevertheless, tracing the risk contacts of newly reported HIV infections seemed to be helpful in identifying new HIV infections and in understanding the nature of transmission towards controlling the HIV epidemics.

Incidence and risk factors on HIV infection among injection drug users in Dehong prefecture area of Yunnan province / 中华流行病学杂志

<p><b>OBJECTIVE</b>To determine the incidence and risk factors on HIV infection among injection drug users (IDU) in Dehong prefecture area of Yunnan province.</p><p><b>METHODS</b>An epidemiological cohort of HIV-negative IDU had been developed and followed since October, 2004. HIV new infections and related behaviors had been investigated every six months.</p><p><b>RESULTS</b>By the end of 2008, 760 HIV-negative IDU had been recruited and followed for a total of 1153.6 person-years. 47 new HIV infections were identified, with an overall incidence of 4.07/100 person-years during the follow-up period. The HIV incidence was 4.45/100 person-years during 2004 - 2006, 4.50/100 person-years in 2007 and 2.54/100 person-years in 2008. Both the behavior of drug injection and the HIV incidence among the cohort had substantially decreased during the follow-up period. Multiple regression analysis using Cox proportional hazard model indicated that people with Jing-po ethnicity (Hazard ratio, HR = 2.56, 95%CI: 1.06 - 6.19) and other minorities except for Dai (HR = 3.26, 95%CI: 0.89 - 11.96) were at higher risk for HIV infection than the people with Han ethnicity. People injecting drugs with (HR = 2.27, 95%CI: 0.98 - 5.25) or without (HR = 5.27, 95%CI: 2.25 - 12.34) needle sharing were at higher risk for HIV infection than those reporting having no drug injection behavior during the follow-up period.</p><p><b>CONCLUSION</b>Both the behavior of drug injection and the HIV incidence among former IDU in Dehong prefecture area of Yunnan province had been decreasing during the four years. However, needle sharing remained the most important risk factor for HIV new infection among IDUs. IDUs with different ethnicities seemed to have different risks towards HIV infection.</p>