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ObjectiveTo analyze the changes in HIV， syphilis and hepatitis C prevalence among men who have sex with men （MSM） in Taizhou City， Zhejiang Province from 2017 to 2022， and the utilization of HIV intervention services and its influencing factors. MethodsMSM participants were recruited from HIV sentinel surveillance in Taizhou through snowball sampling method. Participants’ socio-demographic characteristics， sexual behavior characteristics， knowledge of HIV and utilization of HIV intervention services were collected and statistically described by questionnaire survey. Blood samples from MSM sentinel population were also collected for HIV， syphilis， and HCV antibody testing. Multivariate logistic regression analysis was used to analyze the influencing factors for utilizing HIV intervention services among MSM. ResultsA total of 2 499 MSM were included in the analysis from 2017 to 2022， with HIV prevalence of 5.8%， syphilis prevalence of 4.0%， and HCV prevalence of 0.6%. The infection rate， proportion of homosexual anal sex and heterosexual sex showed a decreasing trend， while the proportion of condom use during homosexual anal sex， condom publicity and distribution， AIDS consultation and testing， acceptance of peer education， and online temporary homosexual sex showed an increasing trend. All these differences were statistically significant. Multivariate logistic regression analysis showed that COVID-19 epidemic （aOR=1.66， 95%CI：1.04‒2.64） and HIV knowledge awareness （aOR=2.57， 95%CI：1.22‒5.40） were positively correlated with increased acceptance of condom publicity and distribution， and utilization of AIDS counseling and testing. Those who sought male sexual partners through offline route （aOR=3.44， 95%CI： 1.16‒10.21）， and had a history of sexually transmitted diseases within one year （aOR=5.47， 95%CI： 1.04‒28.76） were positively correlated with community-based methadone maintenance therapy， clean needle provision and exchange services， while COVID-19 epidemic （aOR=0.35， 95%CI： 0.14‒0.88） was negatively correlated with the utilization of these services. COVID-19 epidemic （aOR=2.11， 95%CI： 1.54‒2.89）， HIV knowledge awareness （aOR=2.09， 95%CI： 1.08‒4.02）， offline search for male sexual partners （aOR=1.47， 95%CI： 1.03‒2.11）， and awareness of HIV infection of sexual partners （aOR=2.09， 95%CI： 1.62‒2.69） were positively correlated with the increased use of peer education service， while married or cohabited （aOR=0.73， 95%CI： 0.55‒0.98） and VCT （aOR=0.61， 95%CI： 0.46‒0.82） were negatively correlated with utilization of peer education service. ConclusionHIV infection rate of sentinel MSM population in Taizhou decreases， while the utilization of HIV intervention services increases in general. Targeted measures should be developed according to the changes in sexual behavior and HIV intervention services among MSM populations in Taizhou to improve the HIV intervention services for the MSM population.
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ObjectiveTo determine the prevalence of hepatitis C virus （HCV） infection and identify the underlying risk factors among drug users in Taizhou City of Zhejiang Province during 2009‒2020. MethodsA consecutive cross-sectional survey was conducted. A total of 400 drug users in correctional settings were randomly selected from April to August. The drug users were interviewed with a questionnaire to collect demographic characteristics， AIDS-related knowledge， detoxification service， drug use， and sexual behavior. Blood samples were then collected for anti-HCV antibody testing. Chi-square test and multivariate conditional logistic regression were used. ResultsA total of 5 042 drug users were included in this study. Seroprevalence of HCV was determined to be 22.7%. From 2009 to 2019， the seroprevalence showed a significant downward trend， from 34.9% to 8.8% （χ2=221.025， P<0.001）. However， in 2020， the seroprevalence was 12.7%. The multivariate logistic regression analysis showed that senior age （≥25 years old）， cohabitation， taking traditional or mixed drugs， injection drug use， and needle sharing were risk factors associated with HCV seroprevalence. ConclusionSince 2009， HCV seroprevalence among drug users in Taizhou City has shown a downward trend， however， it has increased slightly in 2020. It warrants strengthening prevention and treatment measures in response to risk factors related to HCV infection among drug users.
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Objective To investigate the clinical significance of neutrophil-to-lymphocyte ratio (NLR)in assessing response to cardiac resynchronization therapy(CRT)in elderly patients.Methods Clinical data of 105 elderly patients with chronic heart failure(CHF)who had received CRT at our hospital from January 2006 to January 2017 were retrospectively analyzed,and patients were divided into a no-response group(n=42)and a response group(n=63)according to CRT outcomes after 6 months.General clinical data were compared between the two groups.Factors influencing response to CRT were analyzed by logistic regression model analysis.The receiver-operating characteristic(ROC)curve was used to assess the predictive value of NLR in response to CRT.Results Compared with the response group,the no-response group had increased baseline levels of initial QRS width,serum creatinine(Scr) and uric acid(UA)(P ＜0.05).There was no significant difference in left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter (LVESD),the New York Heart Association (NYHA) functional classification,neutrophil count,lymphocyte count and NLR between the two groups before CRT(P＞0.05).After 6 months of CRT,the LVEDD,NYHA functional class,neutrophil count and NLR were higher,and LVEF and lymphocyte count were lower in the no-response group than in the response group(P ＜0.05).The difference in NLR between 6 months after CRT and before CRT(△NLR)was higher in the no-response group than in the response group(P ＜0.05).Multi-factor Cox regression analysis showed that NLR (OR =1.895,95％CI:1.538～5.284,P =0.031)and △NLR(OR =2.579,95％CI:2.110～8.329,P =0.005) were independent risk factors for CRT (HR =1.590,95 ％ CI:1.215 ～ 2.146,P =0.013).ROC curve analysis showed that ROCAUC of △NLR in the no-response group was 0.891,95％CI:0.832～0.937,which was higher than that at 6 months after CRT(0.813,95 ％ CI:0.765～0.864)(Z=2.712,P＜0.05).Conclusions The increase in NLR after CRT may be an early sign for noresponse to CRT,and dynamic monitoring of NLR should be promoted to assess the prognosis of patients undergoing CRT.
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Objective To assess the left ventricular synchronization and global systolic function in patients with implanted dual-chamber (DDD) mode cardiac pacemakers by real-time three-dimensional echocardiography(RT-3DE). Methods Left ventricular systolic synchronization and global function were evaluated in 20 patients with implanted DDD mode cardiac pacemakers and 20 normal people by RT-3DE. The left ventricular end-diastolic volume (LEDV), end-systolic volume ( LESV), stroke volume (SV), left ventricular ejection fraction (LVEF), the mean value of time from the start of electrocardiographic QRS wave to the point of minimal systolic volume (Tmean) of the 17 segments and those standard deviation(T-SD),the maximal difference of time among all 17 segments(Tmax) were obtained by RT-3DE. Results Compared with control group, LESV was significantly increased,SV, LVEF were significantly decreased and T-SD,Tmax were significantly prolonged (P <0.01 ). There were no differences in LEDV and Tmean between the two groups (P>0.05). In patients group,LVEF correlated closely with T-SD (r =-0.674, P<0.05) and Tmax (r = - 0. 634, P < 0. 05). Conclusions There were left ventrieular systolic asychronization and global systolic dysfunction in patients with implanted dual-chamber (DDD) mode cardiac pacemakers,which could be assessed by RT-3DE.
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AIM: To observe platelet activation and fibrinolytic activity and evalute the effects of valsartan and amlodipine in elderly patients with essential hypertension. METHODS: Double antibody sandwich ELISA and spectrophotometric assay were used to examine the levels of platelet alpha granule membrane protein (GMP 140), tissue type plasminogen activator (t PA) and its inhibitor (PAI 1) in 57 elderly patients with essential hypertension and 30 normotensives. Valsartan was given in 29 cases (groupⅠ) and amlodipine in 28 cases (group Ⅱ) for 12 weeks. RESULTS: Elevated GMP 140, decreased t PA activity, and elevated PAI 1 activity were detected in the patients, but not in normotensives (P