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1.
Article in Chinese | WPRIM | ID: wpr-880109

ABSTRACT

OBJECTIVE@#To assess the impact of early relapse (ER) after autologous hematopoietic stem cell transplan-tation (AHSCT) on overall survival (OS) for multiple myeloma (MM) patients.@*METHODS@#Clinical data of 37 patients with MM undergoing AHSCT in department of hematology of Shanxi Bethune Hospital from January 2012 to December 2017 were retrospectively analyzed. The effect of ER on OS of patients was analyzed. The effects of international staging system (ISS) staging, cytogenetics, pre-transplant efficacy, minimal residual disease, and age on OS of the patients were also analyzed respectively.@*RESULTS@#Among the 37 patients, 13 cases (35.1%) had ER, and 24 cases (64.9%) had non-ER. 3 patients with ER had extramedullary disease, but none with non-ER showed extramedullary disease. More than or equal to very good partial rate (VGPR) in patients with ER and without ER were 3 cases (23.1%) and 15 cases (62.5%), respectively, and the curative effect of the former was significantly lower than that of the latter (P<0.05). The median follow-up time was 31 (12-96) months, and median OS time was 93 months in all the patients. The median survival time of patients with ER was 17 months, and the median progression free survival was 7 months, both were significantly shorter than 93 months and 38 months of patients with non-ER (P<0.05). Univariate analysis showed that the OS was affected by ER, cytogenetic abnormalities (FISH), and ≥VGPR before transplantation. Multivariate analysis showed that ER was an independent prognostic factor.@*CONCLUSION@#The prognosis of patients with ER after AHSCT in newly diagnosed MM is poor. ER is an independent prognostic factor of survival.


Subject(s)
Hematopoietic Stem Cell Transplantation , Humans , Multiple Myeloma , Prognosis , Recurrence , Retrospective Studies , Transplantation, Autologous , Treatment Outcome
2.
Article in Chinese | WPRIM | ID: wpr-777929

ABSTRACT

Objective To understand the prevalence of HIV infection and its influencing factors in the premarital physical examination population in Dehong Prefecture, Yunnan Province, 2017. Methods The data of people receiving premarital medical examination was collected, the demographic characteristics was described and the related factors was analyzed by Logistic regression. Results There were 21 875 participants receiving premarital medical examination in Dehong. 98(0.45%) participants were confirmed positive for HIV and male infection rate was 0.47% (52/10 955) and female was 0.42% (46/10 920). Among the 98 patients, 20 patients were infected in the first time, and main route was sexual transmission accounting for 81.63% (80/98). Logistic multivariate regression analysis showed that age, ethnicity and drug use were the influencing factors for premarital couples infecting HIV. The risk of HIV infection in 31-40 and 41-50 years old group was higher than the people under 25 years old group(OR=3.78, 95% CI:1.81-7.89, P<0.001;OR=3.95, 95% CI:1.72-9.08, P=0.001). The infection risk of Dai and Jingpo ethnic group was higher than that of the Han ethnic(OR=1.86, 95% CI:1.06-3.29, P=0.031;OR=3.25, 95% CI:1.81-5.84, P<0.001). The risk of infection among drug users was much higher than non-drug users (OR=926.76, 95% CI:271.65-3 161.71, P<0.001). Conclusion Age, ethnicity, and drug use are influencing factors of HIV infection among premarital couples. Targeted measures need to be taken against risk factors. HIV infection is mainly transmitted by sexual transmission. It can be effectively detected and controlled through premarital medical examination.

3.
Article in Chinese | WPRIM | ID: wpr-775957

ABSTRACT

OBJECTIVES@#To investigate the effect of Procyanidins (OPCs) on the autophagy of laryngeal cancer cell line TU686 and to explore the effect of OPCs on the chemosensitivity of laryngeal cancer cells to DDP in terms of autophagy and apoptosis.@*METHODS@#CCK-8 was used to detected the effect of different concentrations of OPC and DDP on TU686 cell viability. Experimental grouping: Both kinds of cells were divided into CON group, DDP group, OPC group and MIX group. Annexin-V-FITC/PI double staining of flow cytometry was used to detect the effect of each experimental group on the apoptosis. Cell immunofluorescence staining was used to detect the formation of autophagy. Western blot was used to detect the expression of autophagy-related and apoptosis-related proteins. Autophagy inhibitors (3-MA) were used to study the effect of autophagy on apoptosis.@*RESULTS@#The results of CCK-8 showed that TU686 cells were inhibited by OPC and DDP in a concentration-dependent manner for 24 hours. LC3-Ⅱ protein staining showed that compared with CON group, DDP group and OPC group, MIX group significantly induced autophagy formation in TU686 cells (<0.05). Flow cytometry showed that compared with CON group, apoptosis of TU686 cells was induced in DDP group, OPC group and MIX group. And the effect of MIX on apoptosis was significantly higher than that of OPC and DDP groups (<0.05). After pretreatment with 3-MA, the apoptotic effect of OPC group and MIX group on TU686 cells was significantly decreased (<0.05). Western blot results showed that the expression of LC3-Ⅱ and Caspase-3 in DDP, OPC and MIX groups was significantly higher than that in CON group (<0.05). In MIX group, the expression of LC3-Ⅱ and Caspase-3 also had significant difference (<0.05) compared with single drug group. After using 3-MA to inhibit autophagy, the expression of LC3-Ⅱ was significantly decreased (<0.05), and the expression of Caspase-3 was decreased along with LC3-Ⅱ, but the decrease of Caspase-3 expression was only significant in OPC and MIX group (<0.05).@*CONCLUSIONS@#OPC can induce autophagy in laryngeal carcinoma TU686 cells and promote its apoptosis, which in turn enhances sensitivity of laryngeal cancer cells to cisplatin chemotherapy.


Subject(s)
Antineoplastic Agents , Apoptosis , Apoptosis Regulatory Proteins , Autophagy , Cell Line, Tumor , Cisplatin , Pharmacology , Drug Resistance, Neoplasm , Humans , Laryngeal Neoplasms , Drug Therapy , Proanthocyanidins , Pharmacology
4.
Journal of Leukemia & Lymphoma ; (12): 453-458, 2018.
Article in Chinese | WPRIM | ID: wpr-807297

ABSTRACT

Objective@#To compare the clinical efficacy and safety of bortezomib, cyclophosphamide, dexamethasone (VCD) regimen and bortezomib dexamethasone (VD) regimen in the treatment of the patients with newly diagnosed multiple myeloma (NDMM).@*Methods@#The clinical data of 73 patients with NDMM in Shanxi Dayi Hospital from January 2013 to January 2016 were retrospectively analyzed. According to the chemotherapy regimen, the patients were divided into VCD group (41 cases) and VD group (32 cases). The efficacy and adverse reactions of the two groups were evaluated.@*Results@#The overall response rate of VCD group and VD group was 80.5% (33/41) and 78.1% (25/32) respectively, and the difference was not statistically significant (χ 2= 0.061, P= 0.804); and complete remission (CR) rate was 36.6% (15/41) and 15.6% (5/32) respectively, and the difference was statistically significant (χ 2= 3.970, P= 0.046); the median progression-free survival (PFS) was 27 months and 24 months respectively, and the median overall survival (OS) was 35 months and 33 months respectively, and the differences were not statistically significant (all P > 0.05). Most adverse reactions occurred in grade 1-2, in which peripheral polyneuropathy and thrombocytopenia were the most common. Peripheral neuritis was the most common finding among the adverse reactions of grade 3. The incidence of adverse reactions in both groups was not statistically significant (P > 0.05).@*Conclusions@#VCD and VD regimen could be recommended as a better induction therapy for NDMM patients. Compared with VD scheme, VCD scheme has a higher CR rate.

5.
Journal of Leukemia & Lymphoma ; (12): 743-747, 2017.
Article in Chinese | WPRIM | ID: wpr-663940

ABSTRACT

Objective To observe the clinical effects and safety of sodium valproate combined with decitabine for treatment of myelodysplastic syndrome (MDS). Methods Forty-two patients with MDS were enrolled in department of hematology in Shanxi Dayi Hospital from February 2012 to February 2017. According to random number table, the patients were divided into the control group (21 cases) and the experimental group (21 cases). The patients in the control group received decitabine at the dose of 20 mg·m-2·d-1, and intravenous infusion was completed in 2 hours, continuous therapy up to 5 days, 4 weeks as a course; the patients in the experimental group received combined medication, orally given sodium valproate 0.2 g once, 3 times per day. One week later, the dosage was added to 0.4 g once, 3 times per day. Both groups received at least 4 courses of treatment. The treatment was stopped when serious adverse reactions or obvious disease progression occurred. The bone marrow smear was rechecked every 4 weeks after treatment to evaluate the efficacy. The expressions of ASXL1, DNMT3A and TET2 in bone marrow cells were detected by fluorescence quantitative PCR before and after treatment. Results The total treatment response rate of the experimental group and the control group were 76.2 % (16/21) and 57.1 % (12/21) respectively, and there was statistically significant difference (P< 0.05); the total remission rate of the two groups was 47.6 % (10/21) and 38.1 %(8/21) respectively, and there was no significant difference (P> 0.05). All patients had slight adverse reactions, and the adverse reaction rate was 42.9 % (9/21) and 38.1 % (8/21), and there was no significant difference (P>0.05). The content of TET2 mRNA and DNMT3A mRNA after treatment in both groups were decreased compared with the expressions before treatment, and there were significant differences (P<0.05). However, there was no significant difference between the two groups after treatment (P> 0.05); the content of ASXL1 mRNA had no obvious change in the control group and a dramatic decrease in the experimental group compared with that before treatment (P<0.05). Conclusion Sodium valproate combined with decitabine has favorable effects and mild adverse reactions for treatment of MDS, besides, it can influence the expressions of TET2, DNMT3A and ASXL1.

6.
Article in Chinese | WPRIM | ID: wpr-256542

ABSTRACT

<p><b>OBJECTIVE</b>To explore the risk factors for acute respiratory distress syndrome (ARDS) in children receiving surgeries for critical and complex congenital heart disease (CCHD).</p><p><b>METHODS</b>According to the 2011's Berlin definition of ARDS, the clinical data were collected from 75 children without ARDS (group I) and 80 children with ARDS (group II) following surgeries for CCHD performed in the Department of Cardiac Surgery of our hospital from January, 2009 to May, 2014. Univariate analyses and logistic regression were used to analyze the risk factors contributing to the occurrence of ARDS following the surgeries.</p><p><b>RESULTS</b>In the 80 patients who developed ARDS postoperatively in group II, 27 had mild ARDS, 25 had moderate ARDS, and 28 had severe ARDS; death occurred in 17 (21%) cases. Univariate analyses showed that 23 parameters were significantly different between groups I and II (P<0.05), including weight; preoperative PCO2, left ventricular ejection fraction, pulmonary artery pressure, pulmonary infection, and coagulation abnormalities; early postoperative serum globulin; intraoperative aortic cross clamp (ACC) time; cardiopulmonary bypass (CPB) time; operation time; blood loss and blood transfusion amount intraoperatively and during the first 8 h after operation; lactic acid level immediately after the operation and its maximum increasing rate within 24 h postoperatively; postoperative serum levels of albumin and creatinine; serum levels of B-type natriuretic peptide, procalcitonin, C-reactive protein, and prealbumin 24 h after operation; and age. Logistic regression analyses showed that intraoperative ACC time, CPB time, the maximum increasing rate of lactic acid within 24 h after operation, serum procalcitonin 24 h after operation and intraoperative blood loss were independent risk factors for postoperative ARDS.</p><p><b>CONCLUSION</b>The risk factors of ARDS identified in these children can predict the occurrence of ARDS following the surgeries and timely interventions can improve the success rate in treatment of postoperative ARDS in children with CCHD.</p>

7.
Article in Chinese | WPRIM | ID: wpr-477896

ABSTRACT

Detection of lipids ,lipoprotein and lipid metabolism related indicators is important in the risk assessment and prevention of atherosclerotic cardiovascular disease ( ASCVD ) .Along with the research progress,there are still defects within the established lipid biomarkers and methods ,which need continuous optimization.The ASCVD risk assessment is expected to be further improved as the new biomarkers are coming up.

8.
Article in Chinese | WPRIM | ID: wpr-329818

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the possible effects of apolipoprotein A1 gene (APOA1) rs670 and rs5069 polymorphisms on plasma lipid profiles in healthy adolescents with different body mass index (BMI).</p><p><b>METHODS</b>Totally 723 adolescents were divided into four groups according to their BMI: group 1[BMI =(17.80 ± 0.75)kg/m2], group 2[BMI = (19.39 ± 0.32) kg/m²], group 3[BMI = (20.68 ± 0.43) kg/m²], and group 4[BMI=(23.40 ± 2.05) kg/m²]. Height, weight, waist circumference, hip circumference, blood pressure, heart rate, plasma lipids, and blood glucose were determined, BMI and waist to hip ratio (W/H ratio) were calculated,and genome DNA was extracted for analyzing the genotypes of the APOA1 rs670 and rs5069 polymorphisms by polymerase chain reaction-restriction fragment length polymorphism.</p><p><b>RESULTS</b>No significant differences in height, weight, BMI, waist circumference, hip circumference, W/H ratio, blood pressure, heart rate, plasma lipids, and blood glucose between APOA1 rs670 or rs5069 genotypes were observed among group 1, group 2, and group 3. In group 4, A carriers of the rs670 polymorphism had significantly higher systolic blood pressure (P=0.017) and blood glucose levels (P=0.009) than the adolescents with the GG genotype. T carriers of the rs5069 polymorphism had significantly higher height (P=0.013), weight (P=0.011), and hip circumference (P=0.026) than the adolescents with the CC genotype.</p><p><b>CONCLUSIONS</b>In healthy adolescents with higher BMI, APOA1 rs670 polymorphism is associated with systolic blood pressure and blood glucose levels. The elevation of systolic blood pressure and blood glucose levels in A carriers of APOA1 rs670 polymorphism may be favorably modulated by weight loss.</p>


Subject(s)
Adolescent , Apolipoprotein A-I , Genetics , Body Mass Index , Female , Humans , Lipids , Blood , Male , Polymorphism, Genetic
9.
Medical Principles and Practice. 2014; 23 (3): 282-285
in English | IMEMR | ID: emr-152787

ABSTRACT

This study was designed to evaluate the effects of cord blood mononuclear cell transplantation in multiple system atrophy [MSA]. Cord blood mononuclear cells [1-2 × 10 8 cells/6 ml] were injected into the subarachnoid space using lumbar puncture in patients 1 and 2 and cisterna magna puncture in patient 3 in the 3 patients with MSA. The cord blood mononuclear cell transplantation was repeated 30 days after the first treatment in patients 1 and 2; it was repeated twice in patient 3. The clinical outcomes of treatment were used to assess the Unified Multiple System Atrophy Rating Scale [UMSARS] before, 90 and 180 days after the cell transplantation. There were no clinically noticeable side effects from the cord blood mononuclear cells. The UMSARS scores improved after 90 days of the cord blood mononuclear cell therapy in all 3 patients, the most significant improvement being that in urinary incontinence and ability to walk. Cord blood mononuclear cell transplantation was safe and potentially effective in the treatment of MSA in the 3 patients

10.
Chinese Journal of Hematology ; (12): 966-969, 2014.
Article in Chinese | WPRIM | ID: wpr-278968

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the efficacy and toxicity of modified FLAG and CAG on relapsed or refractory acute myeloid leukemia (AML).</p><p><b>METHODS</b>Sixty-one patients with relapsed or refractory AML were divided into modified FLAG or CAG group. In modified FLAG group: G-CSF 200 μg·m⁻²·d⁻¹ on days 0-5; fludarabine 30 mg·m⁻²·d⁻¹ on days 1-5; Ara-C 1.0 g·m⁻²·d⁻¹ on days 1-5. In CAG group: Ara-C 10 mg·m⁻²·12 h⁻¹ on days 1-14, aclarubicin 20 mg/d on days 1-4, G-CSF 200 μg·m⁻²·d⁻¹ on days 0 1-14.</p><p><b>RESULTS</b>The complete response (CR) rate was 43% (12/28) and the partial response (PR) rate 18% (5/28) with the overall response (OR) rate of 61% in modified FLAG group. CR rate was 21% (7/33) and PR rate 15% (5/33) with OR rate of 36% in CAG group. There was significant statistical difference between two groups (P<0.05). The main toxicities of these groups were myelosupression and infection. The infection rate was 68% (19/28) in modified FLAG group (twenty-two patients were treated in the sterile laminar flow ward duing neutropenic period), treatment related mortality (TRM) in modified FLAG group was 7%; The infection rate was 55% (18/33) in CAG group (no patient was treated in the sterile laminar flow ward), TRM in CAG group was 3%. There was no significant statistical difference in two groups (P>0.05).</p><p><b>CONCLUSION</b>Modified FLAG was effective for relapsed or refractory AML. The supportive cares to strengthen infection-controlled measures and shorten the period of bone marrow suppression produced the additional effect. CAG regimen has low adverse reactions and could be individualized to elder or weak patients.</p>


Subject(s)
Aclarubicin , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Cytarabine , Granulocyte Colony-Stimulating Factor , Humans , Leukemia, Myeloid, Acute , Drug Therapy , Recurrence
11.
Chinese Journal of Cardiology ; (12): 1006-1009, 2013.
Article in Chinese | WPRIM | ID: wpr-356468

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the lipid-regulating effect and safety of combined statin and bezafibrate therapy in acute coronary syndrome(ACS) patients complicating with dyslipedemia.</p><p><b>METHODS</b>One hundred and four hospitalized patients with established ACS and increased serum triglycerides (TG) levels and/or low serum levels of high density lipoprotein cholesterol (HDL-C) were selected. Except for conventional therapy, the patients were randomly divided into 2 groups: control group (n = 52), treated with atorvastatin 20 mg qn or other statin equivalent to 20 mg atorvastatin; treatment group (n = 52), treated with the same dose statin plus bezafibrate 200 mg bid. The serum levels of total cholesterol (TC), TG, low-density lipoprotein cholesterol (LDL-C) and HDL-C were assessed before and after 6 and 12 weeks treatment, side effects and adverse events were recorded.</p><p><b>RESULTS</b>After 6 weeks treatment, the serum levels of TC, TG and LDL-C in two groups were significantly reduced compared to baseline (all P < 0.05), which were further declined after 12 weeks treatment, and the reduction was more significant in treatment group(29.8%, 38.0% and 36.1%, respectively) than in control group(14.7%, 9.8% and 26.7%, respectively) (all P < 0.05). After treatment, the serum levels of HDL-C in the two groups were significantly higher than the baseline levels, especially after 12 weeks treatment (all P < 0.05), and the elevations of HDL-C levels in control group and in treatment group were 19.3% and 24.2%, respectively, but there were no significant difference between the two groups (P > 0.05). After 12 weeks, the rates reaching to target goals of LDL-C, TG, HDL-C, and non-HDL-C levels in the treatment group (69.2%, 88.5%, 92.3%, 46.2% and 65.4%, respectively) were significantly higher than those in the control group (34.6%, 65.4%, 46.2%, 7.7% and 42.3%, respectively, all P < 0.05). No serious side effects were observed in the two groups during the treatment period.</p><p><b>CONCLUSION</b>The combined statin and bezafibrate treatment is safe and could increase the ratios of reaching target lipid levels in ACS patients complicating with increased TG and (or) decreased HDL-C.</p>


Subject(s)
Acute Coronary Syndrome , Drug Therapy , Aged , Anticholesteremic Agents , Therapeutic Uses , Atorvastatin , Bezafibrate , Therapeutic Uses , Dyslipidemias , Female , Heptanoic Acids , Therapeutic Uses , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors , Therapeutic Uses , Lipids , Blood , Lipoproteins , Blood , Male , Middle Aged , Pyrroles , Therapeutic Uses , Treatment Outcome
12.
Article in English | WPRIM | ID: wpr-46115

ABSTRACT

Chronic constipation (CC) may impact on quality of life. There is substantial patient dissatisfaction; possible reasons are failure to recognize underlying constipation, inappropriate dietary advice and inadequate treatment. The aim of these practical guidelines intended for primary care physicians, and which are based on Asian perspectives, is to provide an approach to CC that is relevant to the existing health-care infrastructure. Physicians should not rely on infrequent bowel movements to diagnose CC as many patients have one or more bowel movement a day. More commonly, patients present with hard stool, straining, incomplete feeling, bloating and other dyspeptic symptoms. Physicians should consider CC in these situations and when patients are found to use laxative containing supplements. In the absence of alarm features physicians may start with a 2-4 week therapeutic trial of available pharmacological agents including osmotic, stimulant and enterokinetic agents. Where safe to do so, physicians should consider regular (as opposed to on demand dosing), combination treatment and continuous treatment for at least 4 weeks. If patients do not achieve satisfactory response, they should be referred to tertiary centers for physiological evaluation of colonic transit and pelvic floor function. Surgical referral is a last resort, which should be considered only after a thorough physiological and psychological evaluation.


Subject(s)
Asia , Asian Continental Ancestry Group , Colon , Constipation , Health Resorts , Humans , Pelvic Floor , Physicians, Primary Care , Primary Health Care , Quality of Life , Referral and Consultation , Sprains and Strains
13.
Article in Chinese | WPRIM | ID: wpr-352959

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the effects of a high-carbohydrate diet on the lipid and apolipoprotein ratios in healthy young adults with different genotypes of the polymorphism at -75 site in the promoter region of the gene of apolipoprotein AI (APOA1).</p><p><b>METHODS</b>Fifty-six subjects aged (22.89 +/- 1.80) years were given a wash-out diet for 7 days, followed by a high-carbohydrate diet for 6 days. The wash-out diet contained 15% protein, 31% fat, and 54% carbohydrate. The high-carbohydrate diet contained 15% protein, 15% fat, and 70% carbohydrate. Twelve-hour fasting serum lipids and apolipoproteins B100 and AI were measured on the mornings of the 1st, the 8th, and the 14th days from the beginning of the wash-out diet. The ratios of triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC)/HDL-C, low-density lipoprotein cholesterol (LDL-C)/HDL-C, and apolipoprotein B100 (APOB100)/apolipoprotein AI (APOAI) were calculated. The genome DNA was extracted and the polymorphism of APOA1 -75 G/A was determined by polymerase chain reaction followed by restriction fragment length polymorphism assay.</p><p><b>RESULTS</b>At baseline, the lipid and apolipoprotein ratios showed no significant differences between the GG genotype and the A carriers in males (P > 0.05), whereas the female A carriers had a significantly higher ratio of LDL-C/ HDL-C compared with the female subjects with the GG genotype (P < 0.05). Following the high-carbohydrate diet, significant decreases of TC/HDL-C were found in all the groups, regardless of sex and genotype (P < 0.01). LDL-C/HDL-C experienced significant decreases in both the genotypes in males (P < 0.05), while in females, significant decrease of LDL-C/HDL-C was only observed in A carriers (P < 0.01).</p><p><b>CONCLUSION</b>The A allele of the -75 G/A polymorphism in APOA1 may have specific effects on the LDL-C/HDL-C ratio in females.</p>


Subject(s)
Adult , Apolipoprotein A-I , Genetics , Apolipoproteins , Blood , Dietary Carbohydrates , Metabolism , Female , Genotype , Humans , Lipids , Blood , Male , Polymorphism, Genetic , Young Adult
14.
Chinese Journal of Epidemiology ; (12): 1026-1030, 2012.
Article in Chinese | WPRIM | ID: wpr-289591

ABSTRACT

Objective To examine the mortality and risk factors among HIV-infected patients during 1989-2011 in Dehong prefecture,Yunnan province.Methods All HIV-infected patients reported during 1989-2011 in Dehong prefecture who held local residency were included in the study.Mortality rates and cumulative survival rates were calculated.Multiple regression analysis under Cox proportional hazard model was conducted to examine the risk factors for deaths.Results A total of 13 006 HIV-infected patients were included in this study including 73.2% males,79.1% peasants and 48.7% married at the time of reporting.64.5% of the patients were ethnic minorities,and 68.7% were illiterate or having received only primary school education.All the patients were followed-up for a total of 55 962.30 person-years with 4648 patients died,with overall mortality rate as 8.31/100person-years.The mortality rate had been increasing from 1990 to 2004 but decreasing since 2005.The average survival time since the identification of HIV infection was 9.48 years overall,and was 16.65 years for those having received antiretroviral treatment (ART) and 7.67 years for those without ART.Data from multiple regression analysis indicated that ART and socio-demographic characteristics such as age,gender,ethnicity,occupation,marital status,education background etc.were significantly associated with death among HIV-infected patients.Conclusion The comprehensive AIDS campaigns including ART had significantly reduced the deaths among HIV-infected patients in Dehong prefecture.More efforts on the scaling up program of ART as well as the enhanced management and follow-up program tailored for HIV-infected patients with different sociodemographic characteristics were needed to further reduce the deaths in the area.

15.
Saudi Medical Journal. 2011; 32 (10): 1009-1016
in English | IMEMR | ID: emr-144009

ABSTRACT

To determine the effect of sevoflurane combination with epidural anesthesia on myocardial injury in patients with coronary artery disease [CAD] undergoing non-cardiac surgery. The investigation was performed in TianJin NanKai Hospital, TianJin, China from November 2009 to March 2010. Eighty patients with CAD undergoing elective abdominal surgery were randomized into 4 groups: group S1- combined sevoflurane general and epidural anesthesia; group S2 - standard sevoflurane general anesthesia; group P1 - combined propofol general and epidural anesthesia; and group P2 - standard propofol general anesthesia. Mean arterial pressure, central venous pressure, electrocardiogram, and bispectral index was monitored throughout the surgery. The serum levels of interleukin-6 [IL-6], interleukin-8 [IL-8], tumor necrosis factor-alpha TNF-alpha, cardiac troponin I [cTnI], and glycogen phosphorylase BB [GP-BB] was measured at different time points during surgery. The ST depression in group P1 and S2 was significantly higher than that in group S1 [p=0.000] and lower than that in group P2 [p=0.00]. The serum levels of IL-6, IL-8, TNF-alpha, cTnI, and GP-BB in group P1 and S2 were dramatically greater than that in group S1 [p=0.00], and lower than that in group P2 [p=0.00]. Sevoflurane in combination with continuous epidural anesthesia could protect against myocardial damage in patients with CAD, downregulation of IL-6, IL-8, and TNF-alpha might contribute to this protection


Subject(s)
Humans , Male , Female , Anesthesia, Epidural , Coronary Artery Disease , Myocardial Reperfusion Injury , General Surgery
16.
Chinese Journal of Epidemiology ; (12): 125-129, 2011.
Article in Chinese | WPRIM | ID: wpr-295910

ABSTRACT

Objective To determine the adherence to and its determinants of methadone maintenance treatment (MMT) among heroin addicts in Dehong prefecture in Yunnan province from 2005 to 2009. Methods A dynamic cohort analysis was conducted with the time of treatment initiation as the time of cohort entry, to calculate the proportion of adhering to the treatment at different time points after initiation of the treatment, and to study the determinants of adherence.Results A total of 3758 had been treated. Among them, 95.8% were males, 75.8% aged between 20-39 years, 90.4% were peasants or unemployed, 57.0% were ethnic minorities, 35.0% were single and 55.5% were married with spouses, 43.9% were illiterate or educated at most primary school. The age of first using drugs averaged at 23.93 years. About 96.3% of the study subjects had used heroin and 21.7% were HIV-infected. The minimum time under MMT was less than 1 month and the maximum 61 months. The median methadone dose at first delivery was 25 ml, with the minimum 1 ml and the maximum 330 ml. By the end of the study or observation period, a total of 1798 patients had withdrawn from treatment and 1960 were still under treatment. The proportions of adherence to or still being under the treatment after 1,3,6,9, 12,24, 36,48 and 60 months treatment were 0.919,0.847,0.756, 0.690, 0.637, 0.519, 0.417, 0.360 and 0.321, respectively. Multiple regression analysis using Cox proportional hazard model indicated that withdraw from the methadone maintenance treatment was significantly associated with location of the treatment clinics, year of treatment initiation, marital status, HIV infection status, methadone dose of first delivery and the result of last urine test for heroin use. Conclusion MMT attendants in Dehong prefecture had a relatively high withdraw rate and low adherence rate. More efforts are needed to provide tailored counseling and education to MMT attendants, to provide family and community support, appropriate methadone dose at first delivery, and to better coordinate with local police department.

17.
Chinese Journal of Epidemiology ; (12): 882-887, 2011.
Article in Chinese | WPRIM | ID: wpr-241124

ABSTRACT

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.

18.
Chinese Journal of Epidemiology ; (12): 896-901, 2011.
Article in Chinese | WPRIM | ID: wpr-241121

ABSTRACT

Objectives To analyze the fatality and causes of death related to comprehensive prevention and care programs among HIV-infected patients in Dehong prefecture of Yunnan province,from 1989 to 2010. Methods Data on HIV/AIDS death cases in Dehong prefecture were extracted from the "Chinese National Comprehensive HIV/AIDS Prevention and Care Information System" and were analyzed. Results From 1989 to the end of 2010,a total of 13 493 HIV/AIDS cases registered as local residents or currently living m Dehong, had been reported. Among them, 8569 were reported as HIV cases with 2036 deaths and the other 4924 were reported as AIDS cases with 2251 deaths. A few of the cases had survived for 15-20 years. By the end of 2010, the number of deaths was higher than the number of survivors among HIV/AIDS cases reported before 2004, whereas the number of survivors was higher than the number of deaths among HIV/AIDS cases reported in 2004 and there after. During the twenty years' period,the proportion of reported HIV/AIDS cases died in the same year showed a secular trend of being low-highest-low, rising up to > 10.0% in 200 1, peaking at 18.9%in 2003 and then continuously going down to 5.8% in 2010. The proportion of HIV/AIDS cases who survived at the beginning but died later in the year was going down since 2007. The proportion of HIV/ AIDS deaths died directly from AIDS was increasing whereas the proportion of HIV/AIDS deaths dying directly from overuse of drugs was decreasing in the recent years. Among HIV/AIDS deaths, the proportion of ever received CD4 + T-cell testing and the proportion of ever having received antiretroviral treatment were also increasing in the past years, reaching to 89.9% and 25.5% in 2010,respectively. Conclusion The case fatality of HIV/AIDS was decreasing in the past years in Dehong prefecture. More efforts were needed to scale up the CD4 + T-cell count testing and antiretroviral treatment in order to further reduce both morbidity and mortality among HIV/AIDS patients in Dehong prefecture. It is critical to improve surveillance program on HIV/AIDS deaths in the rural

19.
Chinese Journal of Epidemiology ; (12): 763-766, 2010.
Article in Chinese | WPRIM | ID: wpr-341040

ABSTRACT

Objective To study the natural history of HIV-1 infection among intravenous drug users (IDUs) detected in late 1989 in the study area and the factors related to survival of these IDUs infected with HIV. Methods 196 injecting drug users first detected during August and December, 1989 were observed in Ruili county, Yunnan province. Data gathered from the 20-year follow-up program was collected and analyzed retrospectively. Results After 20 years' follow-up period, 90.3% of the 196 IDUs with HIV infection died, 5.1% of them were still alive, and 4.6% were lost. The crude pre-AIDS mortality rate was 98.1/1000 person-years, and the AIDS mortality rate was 54.9/1000 person-years. Malaria, septicemia were the main causes of death among the natural diseases whereas overdose and accidental causes were the principal causes related to those non-disease deaths.The median survival time from sero-conversion to death was 8.6 years (95%CI: 7.6-9.7). The median survival time from sero-conversion to death due to AIDS was 11.3 years (95%CI: 10.3-12.8) with the incubation time as around 10.3 years. People older than 30 years at seroconversion and length of drug usage were associated with shorter survival time, with hazards ratios as 1.9 and 0.7, respectively.Conclusion A high pre-AIDS mortality was observed among IDUs. Both the median survival time from sero-conversion to death and the HIV incubation period were shorter than that observed in the developed countries. Age of HIV infection seemed to have a strong effect on survival.

20.
Journal of Leukemia & Lymphoma ; (12): 169-171, 2010.
Article in Chinese | WPRIM | ID: wpr-471606

ABSTRACT

Objective To provide data for reference on the impact of cyclosporin A (CsA) on the proliferation of the bone marrow mesenchymal stem cells in MDS patients through the investigation of the impact of cyclosporin A on human bone marrow mesenchymal stem cell proliferation. Methods The absorption rates of the bone marrow mesenchymal stem cells in the control group and the MDS patient group were determined by using the tetrazolinm salt (MTT) micro-colorimetric enzyme reaction. The concentrations of cyclosporine A are 2.5×10~4 ng/μl, 2.5×10~3 ng/μl, 2.5×10~2 ng/μl and 2.5×10ng/μl respectively. Results There is no significant difference between the each result by using different concentrations of CsA., which indicates the impact of CsA on the growth of mesenchymal stem cells is not significant(P >0.05). In the serial of concentrations mentioned, no cytotoxicity of CsA is observed. However, there is difference between the selected indicators of the control group and the patient group (P 0.05). There is no significant difference between the absorption rates of the group treated by CsA of every concentration and the corresponding control group. Conclusion The impact of CsA on the bone marrow mesenchymal stem cell proliferation is significant in neither healthy people nor MDS patients.

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