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@#Objective By analyzing the means of donor maintenance from the perspective of intensive care medicine,the difference of clinical indicators before and after donor treatment is obtained,summarizing the treatment experience and effect of clinical maintenance of donor donors,and providing more clinical evidence for the maintenance and treatment of organ donation donors.Methods A retrospective analysis was performed on 76 organ donors collected from the Department of Intensive Care Medicine,Army Medical Center,Chinese People's Liberation Army from January 2014 to December 2021,collected donor maintenance treatment,including mechanical ventilation,continuous renal replacement therapy(CRRT)treatment,enteral nutrition and parenteral nutrition,enteral and parenteral nutrition,plasma exchange,at the same time,the paired t test was used to compare the organ function before and after treatment.Results The lung,liver and kidney of 76 donors were evaluated before and after treatment to determine the number of eligible donors.The difference between the number of eligible donors of kidney and liver before and after treatment was statistically significant(P<0.05).There was no significant difference in lung evaluation(P>0.05).Conclusion Timely and effective organ support therapy for organ transplantation donors is beneficial to the recovery of organ function and improve the utilization rate of organ.
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Objective@#To analyze the factors affecting the dropping-out from methadone maintenance treatment (MMT) in Hangzhou City, so as to provide the evidence for improving the compliance to MMT.@*Methods@#One MMT clinic was sampled from each of the eight districts in Hangzhou City using a cluster random sampling method, and patients that received MMT and were at ages of 18 years and older and registered during the period from December 2020 through June 2021 were recruited. Participants' basic characteristics, illegality and crime within 6 months prior to MMT and family and social relationships were collected through questionnaire surveys, and factors affecting the dropping-out from MMT were identified using a multivariable logistic regression model. @*Results@#A total of 315 outpatients were included from MMT clinics. The participants had a mean age of (45.33±7.63) years, and included 245 men (77.78%) and 70 women (22.22%), with a dropping-out rate of 65.71%. Multivariable logistic regression analysis showed a low likelihood of dropping-out from MMT among patients at ages of 60 years and older (OR=0.080, 95%CI: 0.018-0.350), employees (OR=0.415, 95%CI: 0.236-0.727), patients without drug-related infectious diseases (OR=0.411, 95%CI: 0.231-0.731), patients with per dossing of 60 mL and higher (OR=0.431, 95%CI: 0.236-0.787) and patients without contact with drug-using friends (OR=0.328, 95%CI: 0.185-0.582), and a high possibility of dropping-out from MMT among patients with poor relationship with family members (OR=2.905, 95%CI: 1.127-7.488). @*Conclusion@#Age, working status, drug-related infectious diseases, dosing, relationship with family members and contact with drug-using friends affected the dropping-out from MTT in Hangzhou City.
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Benign ureteral strictures refers to obstructive lesions caused by the narrowing of ureteral lumen,which may lead to severe renal function damage and even failure.It is related to the incarcerated stones,the ureteral lithotripsy,and the pelvic and abdominal surgery.The primary treatment of benign ureteral strictures is surgery,but the cure rate is closely related to the characteristics of the stricture.In the past,repair and reconstruction surgery has been used for treatment,although the cure rate is high,it is traumatic,risky and slow in postoperative recovery.At present,endovascular surgery treatment is widely used in the treatment of benign ureteral strictures with short stricture length,short disease course,good renal function,and non-ischemic stricture due to the characteristics of small trauma,low risk,and fast recovery.Meanwhile,long-term maintenance treatment of indwelling ureteral stents can also effectively protect renal function.Therefore,in the treatment of benign ureteral strictures,the most appropriate individualized treatment plan should be provided for the patients based on the patient's physical conditions and stricture characteristics.
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Cervical cancer is a common malignant tumor that threatens women's life and health. Among them, the prognosis of recurrent or advanced cervical cancer is poor, and such patients often receive surgical treatment, radiotherapy, chemotherapy, etc., which makes it more difficult to choose a treatment plan. Even after the most effective treatment methods, the treatment failure rate of advanced cervical cancer is still high. Thanks to the research progress of tumor cell signaling pathway-related targets and immunotherapy, especially immune checkpoint inhibitors, new breakthroughs have been made in cervical cancer maintenance therapy. Targeted maintenance therapy, immune maintenance therapy, and multi-drug combination maintenance therapy are currently popular areas of cervical cancer maintenance therapy.
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Objective:This study aims to evaluate the clinical effect of Changyanqing mixture combined with mesalazine enteric-coated tablets in the maintenance treatment of ulcerative colitis(UC) in remission period. Method:The 140 patients with UC in remission period were randomly divided into control group (70 cases) and observation group (70 cases). The 61 patients in control group completed the therapy (6 cases lost or lost to follow-up and 3 were eliminated), 63 patients in observation group completed the therapy (5 cases lost or lost to follow-up and 2 were eliminated). Both groups′ patients got treatment of lifestyle adjustment, and they also took mesalazine enteric-coated tablets orally, 0.5 g/time, 3 times/day. Patients in observation group took Changyanqing mixture orally for a month in the morning and evening every day, 150 mL/time, and then changed to 150 mL/time, 1 time/day, for 3 consecutive months, finally changed to once every other day for 8 months. Patients in control group took simulated medicine of Changyanqing mixture orally in the same way as observation group. The treatment was continued for 12 months. When UC recurred during the treatment, patients took mesalazine enteric-coated tablets orally at 1 g/time, 3 times/day until remission, when the above intervention plan was continued to be adopted. The recurrence rate, first recurrence time within 12 months (duration from remission to Mayo≥3) and the degree of disease activity at recurrence were recorded. Scores of traditional Chinese medicine(TCM)syndrome and inflammatory bowel disease questionnaire (IBDQ) were evaluated once every 2 months. Before treatment, and at the 6<sup>th</sup> and 12<sup>th</sup> month after treatment, colonoscopy and mucosal histology were performed once, enteroscopic mucosal scores, Geboes index of mucosal histology were evaluated, and fecal calprotectin(FC) levels were detected. Also, safety evaluation was conducted. Result:During 12 months, the recurrence rate in observation group was 20.63% (13/63), lower than 39.34% (24/61) in control group(<italic>P</italic><0.05), the frequency of recurrence and the first recurrence duration in observation group were all less than those in control group(<italic>P</italic><0.01). All these meant the disease activity of patients in observation group was lighter than that in control group (<inline-formula><alternatives><mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M3"><mml:msup><mml:mrow><mml:mi>χ</mml:mi></mml:mrow><mml:mrow><mml:mn mathvariant="normal">2</mml:mn></mml:mrow></mml:msup></mml:math><graphic specific-use="big" xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="alternativeImage/444CE72A-DE9D-4013-BB0B-F487F60C8DC8-M003.jpg"><?fx-imagestate width="3.30200005" height="3.64066648"?></graphic><graphic specific-use="small" xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="alternativeImage/444CE72A-DE9D-4013-BB0B-F487F60C8DC8-M003c.jpg"><?fx-imagestate width="3.30200005" height="3.64066648"?></graphic></alternatives></inline-formula>=5.947, <italic>P</italic><0.05). After repeated measurements of variance analysis, scores of TCM syndrome, enteroscopic mucosal scores, Geboes index and FC levels in two groups gradually increased(<italic>P</italic><0.05), and scores of IBDQ gradually decreased (<italic>P</italic><0.05) during the 12-month period. At the second, fourth, sixth, eighth, tenth and twelfth month, scores of TCM syndromes in observation group were lower than those in control group (<italic>P</italic><0.01), and scores of IBDQ were higher than those in control group (<italic>P</italic><0.01). At the sixth and twelfth month after treatment, intestinal endoscopic mucosal scores, Geboes index and FC levels in observation group were all lower than those in control group (<italic>P</italic><0.01). And there were no adverse reactions related to Changyanqing mixture. Conclusion:Changyanqing mixture combined with mesalazine enteric-coated tablets in the maintenance treatment of patients with UC in remission can control the FC level, further reduce the recurrence rate, delay the recrudescence-time, reduce the frequency of UC and the disease activity, maintain the good remission state of UC, stabilize the quality of life of patients, and ensure the safety of clinical use.
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Ovarian cancer is a common gynecological malignancy and the most common cause of cancer death. Ovarian cancer is usually treated with surgery combined with chemotherapy as the preferred treatment. In recent years, with the continuous development of medical technology and the in-depth research on ovarian cancer at home and abroad, the molecular targeted therapy of ovarian cancer has received extensive attention. Among them, the poly ADP-ribose polymerase (PARP) inhibitors have made great breakthroughs and advances in the precise and standardized treatment of ovarian cancer. This paper discusses the study of PARP inhibitors in sensitivity biomarkers of ovarian cancer, and reviews the standardized treatment of PARP inhibitors in maintenance therapy of ovarian cancer.
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Objective: To investigate the efficacy of Xiaoyan Decoction in the treatment of non-small cell lung cancer (NSCLC) by retrospective study. Methods: Patients with NSCLC treated in the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from January 1, 2013 to December 30, 2017 were collected. The patients were divided into two groups: Xiaoyan Decoction plus subtractive prescription combined with symptomatic treatment group (46) and symptomatic treatment group (50). Analyze the survival of the two groups of patients, compare the Karnofsky scores of the two groups, and analyze the sex, age, smoking history, drinking history, histological grade, chemotherapy regimen, pathological type, TCM syndrome type, vascular invasion, and soft tissue invasion Correlation with patient prognosis. Results: There was a significant difference in median progression-free survival (mPFS) between the two groups (P 0.05).The quality of life of patients in Xiaoyan Decoction plus subtractive prescription combined with symptomatic treatment group was significantly improved (P < 0.05), among which, lung squamous cell carcinoma, no vascular, no soft tissue invasion, and patients with phlegm heat obstruction of lung syndrome had the best efficacy (P < 0.05). Conclusion: Xiaoyan Decoction combined with symptomatic maintenance therapy can prolong median progression-free survival (mPFS) and improve the quality of life of patients with advanced NSCLC. The best beneficiaries are patients with lung squamous cell carcinoma, phlegm-heat obstructive pulmonary syndrome without vascular or soft tissue invasion.
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Objective: To investigate the effects of protracted abstinence (PA) and methadone maintenance treatment (MMT) on the brain function of heroin addicts for 6 months. Methods: Twenty-two heroin addicts with PA for 6 months intervention (PA group), 25 heroin addicts with MMT for 6 months intervention (MMT group), and 35 normal controls (control group) were recruited. The resting data were collected by fMRI. The low-frequency amplitude (ALFF) method was used to calculate the intensity of local brain spontaneous activity in the 3 groups. The differences in ALFF of the 3 groups were analyzed and compared. Results: There were significant differences in ALFF between the 3 groups in the right frontal medial, left medial frontal gyrus, left island leaf, left tongue lingual, right lingual gyrus and right auxiliary motion zone (all P0.05). Conclusion: After 6 months of intervention, there are still abnormalities in some brain regions between PA and MMT, but PA may be more conducive to brain function recovery in heroin addicts.
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Objective: To investigate the prevalence of alcohol use and related influencing factors among the patients with methadone maintenance treatment (MMT) in Shanghai, and to provide information for the alcohol intervention in the future. Methods: A total of 837 MMT patients were investigated and evaluated by General Situation Questionnaire, Alcohol Use Disorders Identification Test, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, General Well-being Schedule. According to whether drinking or not in the past year, the two groups were divided into the non-drinking group and the drinking group. T-test, Chi-square test and multivariate Logistic regression analysis were used to detected between two groups. Results: 30.9% of the patients had drinking behavior in the past year, 13.8% of them had problem drinking behavior. The main factors affecting patients' drinking behavior were sex (P=0.029), age of first drug use (P=0.005), drinking before taking heroin (P=0.000) and drinking when taking heroin (P=0.000). Conclusion: In Shanghai, alcohol consumption is generally prevalent among MMT patients who lack awareness of the dangerous of drinking. In the future, targeted intervention measures should be taken to reduce the harm of drinking among MMT patients.
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S-1 and capecitabine are relatively ideal agents for maintenance treatment of advanced gas-tric cancer. In clinical trials of using immune and targeted drugs for maintenance treatment of advanced gastric cancer,ipilimumab fails to obtain positive results,ramucirumab has not obtained research data,and trial regimens of maintenance treatment with trastuzumab,bevacizumab and avelumab have all shown initial efficacy. Traditional Chinese medicine therapy has shown some effectiveness in maintenance treatment,which still needs further researches.
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Colorectal cancer is one of the common malignant tumors,and its morbidity and mortality are in the third and fourth places,respectively. About 60% of patients are in an advanced stage at the diagnosis,and their 5-year survival rate is around 13% . In the past 20 years,since the standardized application of advanced first-line chemotherapy and targeted drugs for metastatic colorectal cancer(mCRC),mCRC treatment has made a major breakthrough. The use of oxaliplatin,capecitabine,bevacizumab,cetux-imab and other drugs have doubled the median survival and increased the 5-year survival rate by 20% . The usual mode of first-line treatment of mCRC in the late stage is continuous medication until the disease progress or the intolerable toxicity occurs. However,be-cause of the accumulation of toxicity of chemotherapy drugs,only one-third of patients can continue to receive treatment until the dis-ease progresses. After completing established initial treatment cycle and achieving CR/PR/SD,the patients continue to use low -dose,low-toxic drugs for maintenance treatment,which can delay the progression and metastasis of the tumor,and reduce the side effects of drug. At present,maintenance therapy has become the main treatment mode after advanced first -line chemotherapy for mCRC. However,the optimal maintenance regimen for mCRC remains inconclusive,and existing maintenance regimens still do not find a balance between optimal outcome and maximum quality of life. This article will review the clinical studies of mCRC′s existing main-tenance treatment regimens,summarize the current status of mCRC maintenance therapy,and discuss individualized treatment strate-gies.
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Objective To investigate the effect of transfer service utilization in increased methadone dosage after missed dose of participants in methadone maintenance treatment (MMT).Methods We selected 9 MMT clinics in Guangdong Province and collected the data from the web-based system of MMT management. All the participants who had utilized the transfer service from January 2008 to December 2016 were included in our study. We explored multilevel Logistic regression analysis to explore the associated factors of changing methadone dosage after missed dosage of transfer participants.Results A total of 197 patients were included in the study for a total of 840 person-time transfer services. Of these, 119 (14.26%) had increased-dose after transfer. The patients whose (1) dose of methadone was less than 60 ml/d during the transfer period (OR=2.88, 95%CI:1.85-4.50, P<0.001), (2)had longer transfer period (OR=1.02, 95%CI: 1.01-1.03, P<0.001), and (3) fewer cumulative transfertimes (OR=0.97, 95%CI:0.95-0.99, P=0.004) were more likely to increase the methadone dosage after the missed.Conclusions The characteristic of transfer service utilization could result in the increasing methadone dosage after missed doses in transfer participants. This finding suggest MMT clinic should strengthen the supervision of transfer patients, especially those who failed to return on time after transfer. The doctors in MMT should carefully consider the dose adjustment requirements from patients and improve the efficacy of methadone maintenance treatment.
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Objective To evaluate the effect of an emollient containing Prinsepia utilis Royle oil extracts and other extracts on clinical symptoms and disease recurrence in children aged 2-12 years with atopic dermatitis (AD) in the remission period.Methods A multicenter,randomized,parallel-group,controlled clinical trial was conducted from December 2017 to September 2018.A total of 297 children aged 2-12 years with moderate AD were enrolled from 5 hospitals in China,and randomly divided into the test group (148 cases) and control group (149 cases).In the acute stage,the two groups were both topically treated with mometasone furoate cream once a day on the skin lesions,and with an emollient containing Prinsepia utilis Royle oil extracts and other extracts twice a day throughout the whole body for 2-4 weeks.The children would be enrolled into the remission stage if their Investigator's Global Assessment (IGA) score was ≤ 1 at following visits.In the remission stage,the test group was only topically treated with the emollient twice a day throughout the whole body,while mometasone furoate cream and the emollient were both withdrawn in the control group.At weeks 4,8 and 12 in the remission stage,the recurrence of AD,eczema area and severity index (EASI),children's dermatology life quality index (CDQOL) and adverse events were evaluated.Statistical analysis was carried out with SAS 9.4 software by using t test for comparison of normally distributed continuous data between two groups,chi-square test for comparison of unordered categorical data,Kaplan-Meier method for analysis of survival rates,Cox regression analysis for evaluating the effect of different therapies on AD recurrence in children in the remission stage,and Logistic regression analysis for analysis of odds ratio (OR) of EASI or CDQOL at week 4 in the remission stage between the test group and control group.Results Of the 297 children with AD,31 breached the clinical trial protocol,and 266 were included in the per protocol set (PPS),including 132 in the test group and 134 in the control group.In the PPS,114 and 106 patients completed the follow-up in the test group and control group respectively,and the recurrence rate was significantly lower in the test group (47,41.23%) than in the control group (84,79.25%;x2 =32.96,P < 0.001).The time to recurrence was significantly longer in the test group(61.99 d ± 2.80 d)than in the control group(39.17 d ± 2.54 d,t =6.03,P < 0.001),and the recurrence risk was significantly lower in the test group than in the control group (Log rank test,x2 =32.02,P < 0.001).After adjustment for age and gender,Cox regression analysis showed that the recurrence risk in the test group was 0.35 times that in the control group (HR =0.35,95% CI:0.24-0.51,P < 0.01).At week 4 in the remission stage,the EASI score at P50-P75 and P75-P100 in the test group were 0.42,0.25 times that in the control group respectively (95% CI:0.20-0.86,0.12-0.54 respectively;P =0.02,< 0.01respectively).Moreover,the CDQOL score at P75-P100 in the test group was 0.33 times that in the control group (95% CI:0.17-0.65,P < 0.01).No significant difference in the incidence of adverse events was observed between the two groups (P > 0.05).Conclusion Maintenance treatment with the emollient containing Prinsepia utilis Royle oil extracts and other extracts can markedly reduce the recurrence risk in AD children,improve clinical symptoms,and enhance the quality of life.
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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.
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Objective: To investigate the association between three single nucleotide polymorphism (SNP) genes DRD2 (rs1800497, rs6275, and rs1799978) and the dosage used on methadone maintenance treatment (MMT). Methods: From the methadone maintenance treatment centers, 257 MMT patients were recruited to participate in a case-control study and divided into two groups-control groups under low dosage (n=89) and case (n=168) group with high dosage. Quanto software was used to estimate the sample size as 180. Information related to social-demographic status, history on drug use and medication were collected. And DRD2 SNPs were genotyped to explore the relationship between polymorphism of DRD2 gene and the dosage of methadone maintenance treatment. Results: Distributions of DRD2 rs6275 between different groups were significantly different. Patients carrying TC genotype needed lower dose of methadone when compared to the patients that carrying CC genotype counterparts (OR=0.338, 95% CI: 0.115-0.986). Patients that carrying C allele at rs6275 needed lower methadone dose than those that carrying genotype TT (OR=0.352, 95% CI: 0.127-0.975). Distributions of genotypes, alles in the other two SNPs (rs1800497, rs1799978) were not significantly different between groups under different dosages. Conclusion: DRD2 rs6275 was associated with dosage of methadone used for the MMT patients. However, no significant associations were found between rs1800497, rs1799978 and the dosage of methadone.
Subject(s)
Humans , Alleles , Case-Control Studies , Drug Dosage Calculations , Genotype , Methadone/therapeutic use , Opiate Substitution Treatment , Opioid-Related Disorders/rehabilitation , Polymorphism, Single Nucleotide/genetics , Receptors, Dopamine D2/geneticsABSTRACT
Methadone maintenance treatment (MMT) greatly contributed to the successful outcomes of prevention and control on both AIDS and drug abuse in China. However, the features on drug abuse changed in the past decades, and the prevalence of new psychoactive substances abuse potentially somehow offset the achievement of MMT. This paper concised the information on research and surveys of this issue that targeting on the current situation, characteristics, related factors and relevant public health problem on new psychoactive substances abuse, among patients who have been on MMT, in China.
Subject(s)
Adult , Female , Humans , Male , China/epidemiology , Methadone/therapeutic use , Opiate Substitution Treatment , Prevalence , Psychotropic Drugs/adverse effects , Substance Abuse Treatment Centers , Substance-Related Disorders/epidemiology , Surveys and QuestionnairesABSTRACT
Objective: To explore the reasons and factors associated with new psychoactive substances abuse among patients with access to methadone maintenance treatment (MMT). Methods: A well-developed questionnaire and urine tests were used to collect information about demographic characteristics, condition of MMT and drug abuse, family and social support of MMT clients. A 1∶1 matched case-control study was conducted, and conditional logistic regression model was used to identify factors associated with new psychoactive substances abuse. Results: A total of 212 (106 pairs) clients receiving MMT were recruited, and most of them were males (78.3%, 166/212), married or cohabitant (48.6%, 103/212) and unemployed (63.2%, 134/212). The average age of the clients was (45.1±7.2) years. The main types of abused new psychoactive substances were benzodiazepine (62.3%, 66/106) and methamphetamine (39.6%, 42/106). The proportion of abusing multi new psychoactive substances was 8.5% (9/106). Results from multivariate conditional logistic regression analysis indicated that using opioid drug during the past 6 months of MMT treatment might increase the risk of abusing new psychoactive substances (OR=3.25, 95%CI: 1.35-7.79), benzodiazepine (OR=3.25, 95%CI: 1.11- 9.47) and methamphetamine (OR=13.31, 95%CI: 1.12-158.01). Moreover, MMT for more than9 years reduced the risk of abuse of new psychoactive substances (OR=0.03, 95%CI: 0.01-0.21), benzodiazepine (OR=0.02, 95%CI: 0.00-0.36) and methamphetamine (OR=0.02, 95%CI: 0.00-0.69). Conclusion: Less new psychoactive substances abuse might be associated with longer duration of MMT treatment. And inappropriate support from family and friends might increase the risk of abusing new psychoactive substances in MMT clients, especially in clients who used opioid.
Subject(s)
Adult , Humans , Male , Middle Aged , Case-Control Studies , China/epidemiology , Drug Users/statistics & numerical data , Logistic Models , Methadone/therapeutic use , Methamphetamine , Opiate Substitution Treatment , Prevalence , Psychotropic Drugs/adverse effects , Substance Abuse Detection/statistics & numerical data , Substance Abuse Treatment Centers , Substance-Related Disorders/epidemiology , Surveys and QuestionnairesABSTRACT
Objective: To estimate the prevalence of HIV/HCV co-infection and explore the influence factors and their interaction on HIV/HCV co-infection of patient's access to methadone maintenance treatment (MMT). Methods: A face to face interviews were conducted among 750 patients at two MMT clinics in Guangxi Zhuang Autonomous Region. The questionnaires information included demographic characteristics, HIV and HCV infection status, history of drug abuse, urine test for morphine, high risk sex behaviors, needle sharing, dropped out etc. Methods of χ(2) test one-way, multivariate logistic regression and interactions were used to analyze the related factors of HIV/HCV co-infection. Results: The study subjects included 750 participants, 18.31% (127/691) of patients were co-infected with HIV and HCV. The HIV/HCV co-infection rate in patients who shared needles with others or dropped out of treatment was 35.84% (81/226) and 19.88% (64/322) respectively, which were higher than those who have never shared needles or dropped out (9.89%, 46/465 and 17.07%, 63/369). Logistic regression analysis results showed that after adjusted for confounding factors, patients who shared needles (OR=4.50, 95%CI: 2.72-7.43) and dropped out of treatment (OR=1.71, 95%CI: 1.04-2.80) were more likely to be infected with HIV/HCV. Interaction analysis showed that sharing needles and dropping out of treatment exist additive effect on co-infection of HIV and HCV (RERI=4.21, AP=0.44, SI=1.95). Conclusions: Needle sharing and dropping out of treatment are associated with HIV/HCV co-infection. Health education, psychological counseling and other measures should be taken to reduce needle sharing and dropping out of MMT.
Subject(s)
Female , Humans , Male , China/epidemiology , Coinfection/epidemiology , HIV Infections/epidemiology , Hepatitis C/diagnosis , Logistic Models , Methadone/therapeutic use , Morphine , Needle Sharing , Opiate Substitution Treatment , Prevalence , Risk Factors , Sexual Behavior , Substance Abuse, Intravenous/drug therapy , Substance-Related DisordersABSTRACT
When facing the worldwide abuse of opioid substance, one of the effective responses is opioid substitution therapy (OST). However, different OST service patterns may affect the therapeutic outcome. Using the System Engineering Initiative for Patient Safety (SEIPS) model, we can analyze the factors that affecting the outcomes of patients from the perspective work system. In this paper, SEIPS model is used to describe the existing OST service model. According to the operation mechanism of the methadone maintenance treatment in China and the existing OST service model, some suggestions are put forward to carry out effective OST service in the country.
Subject(s)
Humans , Analgesics, Opioid/adverse effects , China , Delivery of Health Care , Methadone/therapeutic use , Opiate Substitution Treatment , Opioid-Related Disorders/therapy , Treatment OutcomeABSTRACT
Objective To investigate the association between three single nucleotide polymorphism (SNP) genes DRD2 (rs1800497,rs6275,and rs1799978) and the dosage used on methadone maintenance treatment (MMT).Methods From the methadone maintenance treatment centers,257 MMT patients were recruited to participate in a case-control study and divided into two groups—control groups under low dosage (n=89) and case (n=168) group with high dosage.Quanto software was used to estimate the sample size as 180.Information related to social-demographic status,history on drug use and medication were collected.And DRD2 SNPs were genotyped to explore the relationship between polymorphism of DRD2 gene and the dosage of methadone maintenance treatment.Results Distributions of DRD2 rs6275 between different groups were significantly different.Patients carrying TC genotype needed lower dose of methadone when compared to the patients that carrying CC genotype counterparts (OR=0.338,95% CI:0.115-0.986).Patients that carrying C allele at rs6275 needed lower methadone dose than those that carrying genotype TT (OR=0.352,95%CI:0.127-0.975).Distributions of genotypes,alles in the other two SNPs (rs1800497,rs1799978) were not significantly different between groups under different dosages.Conclusion DRD2 rs6275 was associated with dosage of methadone used for the MMT patients.However,no significant associations were found between rs 1800497,rs 1799978 and the dosage of methadone.