Incidence and related factors of antiviral drug resistance in HIV-infected pregnant and postpartum women in some areas of three western provinces of China from 2017 to 2019 / 中华预防医学杂志

Objective: To analyze the incidence and related factors of drug resistance in HIV-infected pregnant and postpartum women in some areas of three western provinces of China from 2017 to 2019. Methods: From April 2017 to April 2019, face-to-face questionnaires and blood sample testing were conducted in all health care institutions providing maternal and perinatal care and midwifery-assisted services in 7 prevention of mother-to-child transmissi project areas in Xinjiang, Yunnan and Guangxi provinces/autonomous regions. Information was collected during the perinatal period and viral load, CD4+T lymphocytes and drug resistance genes were detected at the same time. The multivariate logistic regression model was used to analyze the relationship between different factors and drug resistance in HIV-infected pregnant and postpartum women. Results: A total of 655 HIV-infected pregnant and postpartum women were included in this study. The incidence of drug resistance was 3.4% (22/655), all of whom were cross-drug resistant. The rate of low, moderate and high drug resistance was 2.1% (14/655), 1.2% (8/655) and 0.8% (5/655), respectively. The drug resistance rate in the people who had previously used antiviral drugs was 1.9% (8/418), and the drug resistance rate in the people who had not used drugs was 5.9% (14/237). The NNRTI drug resistance accounted for 2.8% (18/655) and the NRTI drug resistance rate was 2.5% (16/655). The multivariate logistic regression model showed that the risk of HIV resistance was lower in pregnant women who had previously used antiviral drugs (OR=0.32, 95%CI: 0.11-0.76). Conclusion: Strengthening the management of antiviral drug use and focusing on pregnant and postpartum women who have not previously used antiviral drugs can help reduce the occurrence of drug-resistant mutations. Personalized antiviral therapy should be considered to achieve viral inhibition effects in clinical practice.

Incidence and related factors of antiviral drug resistance in HIV-infected pregnant and postpartum women in some areas of three western provinces of China from 2017 to 2019 / 中华预防医学杂志

Objective: To analyze the incidence and related factors of drug resistance in HIV-infected pregnant and postpartum women in some areas of three western provinces of China from 2017 to 2019. Methods: From April 2017 to April 2019, face-to-face questionnaires and blood sample testing were conducted in all health care institutions providing maternal and perinatal care and midwifery-assisted services in 7 prevention of mother-to-child transmissi project areas in Xinjiang, Yunnan and Guangxi provinces/autonomous regions. Information was collected during the perinatal period and viral load, CD4+T lymphocytes and drug resistance genes were detected at the same time. The multivariate logistic regression model was used to analyze the relationship between different factors and drug resistance in HIV-infected pregnant and postpartum women. Results: A total of 655 HIV-infected pregnant and postpartum women were included in this study. The incidence of drug resistance was 3.4% (22/655), all of whom were cross-drug resistant. The rate of low, moderate and high drug resistance was 2.1% (14/655), 1.2% (8/655) and 0.8% (5/655), respectively. The drug resistance rate in the people who had previously used antiviral drugs was 1.9% (8/418), and the drug resistance rate in the people who had not used drugs was 5.9% (14/237). The NNRTI drug resistance accounted for 2.8% (18/655) and the NRTI drug resistance rate was 2.5% (16/655). The multivariate logistic regression model showed that the risk of HIV resistance was lower in pregnant women who had previously used antiviral drugs (OR=0.32, 95%CI: 0.11-0.76). Conclusion: Strengthening the management of antiviral drug use and focusing on pregnant and postpartum women who have not previously used antiviral drugs can help reduce the occurrence of drug-resistant mutations. Personalized antiviral therapy should be considered to achieve viral inhibition effects in clinical practice.

Calculating the Number of Pregnant Women Receiving Standardized Services for PMTCT of HIV in Liangshan Prefecture, Based on the Equivalent Method / 生物医学与环境科学（英文）

Objective@#To calculate the number of pregnant women who receive standardized prevention of mother-to-child transmission (PMTCT) services for HIV annually.@*Methods@#HIV-positive pregnant women in six counties of Liangshan Prefecture in 2017 were selected as study subjects. The entire process, from when the subjects first received the PMTCT of HIV services to the end, was divided into four stages, which were further divided into 25 phases. The equivalent coefficient was used to indicate the weight of workload in each phase. Seven experts were invited to score the equivalent coefficient; the number of pregnant women who received standardized services to prevent the transmission of HIV was calculated.@*Results@#A total of 663 HIV-positive pregnant women were registered in six Liangshan Prefecture counties in 2017. This figure was converted into 7,780 person-months devoted to HIV-positive pregnant women, with 260 person-months (3.34%) spent on the first antenatal care, 1,510 person-months (19.41%) during pregnancy, 378 person-months (4.86%) on delivery, and 5,632 person-months (72.39%) on post-partum period. The equivalent coefficient calculation showed that 314 HIV-positive pregnant women received standardized PMTCT services.@*Conclusion@#The number of pregnant women receiving standardized services for the PMTCT of HIV can be calculated accurately using the equivalent method to identify the gap between the level of PMTCT of HIV intervention services needed and the actual workload.

Analysis of partner attitude toward HIV infected pregnant women and its influencing factors in western China during 2005-2011 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To analyze partner attitude change and influencing factors on HIV infected pregnant women HIV disclosure.</p><p><b>METHOD</b>A multi-stage cross sectional method was used to collect information by questionnaires on 1164 HIV infected pregnant women in 6 counties including Ruili and Longchuan in Yunnan, Hezhou, Lingshan and Pingxiang in Guangxi and Yining in Xinjiang. Information on demographic characteristics and sexual behavior of the subjects and partner attitude toward HIV infected pregnant women were obtained. The influencing factors of partner's discrimination against HIV infected pregnant women were analyzed.</p><p><b>RESULT</b>A total of 991(85.1%) HIV infected pregnant women have disclosed HIV status to partners among 1164 respondents and 39 (3.9%) reported they were discriminated against partners. Multivariate analysis showed that the 6.5% (15/231) of HIV infected pregnant women in urban had discrimination from their husbands while the ratio among rural pregnant women was lower(3.2% (24/760), OR = 0.40, 95%CI:0.12-0.77) . Compared with the ratio of discrimination among the women of first marriage(2.9%, 21/731), the discrimination ratio among women with remarriage and other status was higher (6.5% (15/232),OR = 2.45, 95%CI:1.61-5.25 and 10.7% (3/28),OR = 3.77, 95%CI:1.46-9.88) respectively. The discrimination ratio among pregnant women with multiple sexual partners was 5.9% (23/389), higher than women with single partner (2.6%, 15/580) (OR = 2.21, 95%CI:1.80-6.23).</p><p><b>CONCLUSION</b>The discrimination toward HIV infected pregnant women from husbands was related to demographic characteristics and sexual behaviors.</p>

Association between C-reactive protein gene +1059 G/C polymorphism and the risk of coronary heart disease: a meta-analysis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>C-reactive protein (CRP) gene +1059 G/C polymorphism has been reported to be associated with coronary heart disease (CHD) risk, but the results remain inconclusive. This meta-analysis was therefore conducted to clarify these controversies.</p><p><b>METHODS</b>A comprehensive search was conducted to identify all case control studies on the association between CRP gene +1059 G/C polymorphism and CHD risk. All the related studies were further strictly selected according to the inclusion criteria. Meta-analysis was performed with STATA 10.1 (StataCorp, USA). The association was assessed by odds ratio (OR) and 95% confidence interval (CI); both Begg's funnel plot and Egger's regression test were used to assess the publication bias.</p><p><b>RESULTS</b>This meta-analysis on a total of 13 studies comprising 6316 CHD cases and 4467 controls showed no significant association between CRP gene +1059 G/C polymorphism and CHD risk in the overall study (for C/C+C/G vs. G/G: OR = 1.01, 95% CI = 0.81-1.25, P = 0.96; for C/C vs. C/G+G/G: OR = 1.17, 95% CI = 0.77-1.77, P = 0.47; for C/C vs. G/G: OR = 1.17, 95% CI = 0.77-1.77, P = 0.47; for C allele vs. G allele: OR = 1.01, 95% CI = 0.81-1.24, P = 0.96). However, in the subgroup analysis by ethnicity, the results showed significant association between CRP gene +1059 G/C polymorphism and CHD risk among Caucasians (for C/C vs. G/G: OR = 2.54, 95% CI = 1.13-5.72, P = 0.02; C/C vs. C/G+G/G: OR = 2.45, 95% CI = 1.09-5.51, P = 0.03), but not among Asians and Africans (P > 0.05).</p><p><b>CONCLUSION</b>CRP gene +1059 G/C polymorphism may be associated with increased CHD risk among Caucasians and more evidences need to validate the conclusion.</p>

Efficacy analysis of different antiretroviral drug regimens in mother to child HIV transmission prevention in some regions of China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To determine the efficacy of different antiretroviral drug regimens in mother to child HIV transmission prevention (PMTCT) in China.</p><p><b>METHODS</b>From January 1st 2006 to Dec 30th 2008, a total of 1072 pairs of HIV positive pregnant women and their babies who were HIV antibody positive and older than 18 months were recruited in this study. These women who had received maternal health care in health care institutions were from 23 provinces. Subjects were investigated by questionnaire, including social demographic data, usage of ARVs, safe delivery and artificial feeding, and other PMTCT related informations. The trend of different antiretroviral drug regiments in different period were analyzed by Cochran-Mantel-Haenszel (CMH) χ(2) test. By stratified analysis and Fisher exact χ(2) test, the efficacy of different antiretroviral drug regimens in mother to child HIV transmission prevention were studied. Antiretroviral drug regimens applications mainly included sd-NVP drug regimen, prophylaxis regimen and highly active anti-retroviral therapy (HAART).</p><p><b>RESULTS</b>Among 1072 pairs of HIV positive maternities and babies, 31 babies older than 18 months were HIV infected, MTCT rate was 2.9% (31/1072). (1) The proportion of using ARVs was increasing from 76.4% (306/395) in 2006 to 83.8% (372/444) in 2008, the difference was significant (CMH χ(2) = 6.4, P < 0.05). (2) The ratio that HIV infected maternities adopted ARVs rose from 3.4% (6/178) in 2006 to 26.3% (104/395) in 2008, the ratio increased year by year (CMH χ(2) = 53.1, P < 0.01). On the contrary, usage of sd-NVP declined from 88.8% (158/178) in 2006 to 70.9% (264/372) in 2008 (CMH χ(2) = 48.5, P < 0.01). (3) Among maternities adopted vaginal delivery and artificial feeding, the MTCT rate of ARVs combination group was 1.0% (1/104), while the MTCT rate of sd-NVP group was 5.9% (16/272) (Fisher χ(2) = 5.5, P < 0.05). (4) In the case of artificial feeding, the MTCT rate of prophylaxis regimens and HAART among maternities adopted vaginal delivery was 3.1% (1/32) and 0 respectively. Among maternities adopted cesarean delivery, MTCT rate of prophylaxis regimens and HAART was 3.2% (2/63) and 3.1%(1/32) respectively, both showed no significant difference (Fisher χ(2) = 1.4, P > 0.05; Fisher χ(2) = 0.0001, P > 0.05).</p><p><b>CONCLUSION</b>Effect of combination of antiretroviral drugs to PMTCT is obvious, the rate of mother to child HIV transmission of prophylaxis regimens and HAART has not shown significant difference.</p>

Analysis on the intervention services status of prevention of mother to child transmission of HIV/AIDS in China / 中华预防医学杂志

<p><b>OBJECTIVE</b>The purpose of this study is to get to know the intervention services implementation status of prevention of mother to child transmission (PMTCT) of HIV/AIDS in China, and the trend of recent five years.</p><p><b>METHODS</b>We carried out relevant surveys and investigations among the areas where PMTCT work had been implemented during January 2005 to December 2009. Health providers in these fields provided routine maternal health care, HIV counseling and test for 10 360 655 pregnant women and comprehensive intervention measures to 10 123 HIV infected pregnant women which included antiretroviral (ARV) drugs usage, safety delivery, and exclusive breastfeeding, and collected relevant data and materials to analysis the ratio of main interventions and its change trend.</p><p><b>RESULTS</b>The HIV/AIDS counseling rate was increasing year by year (χ(2)(trend) = 3184.5, P < 0.001), during 2005 to 2009 the rate was 69.8% (406 151/581 975), 84.5% (1 346 745/1 594 579), 90.3% (1 582 757/1 753 191), 93.7% (1 926 224/2 055 232), 82.3% (3 599 228/4 375 678) respectively. HIV/AIDS test rate was increasing (χ(2)(trend) = 146 194.7, P < 0.001), the rate from 2005 to 2009 was 57.8% (336 459/581 975), 80.8% (1 287 812/1 594 579), 87.0% (1 524 595/1 753 191), 89.2% (1 833 246/2 055 232), 85.5% (3 741 337/4 375 678)respectively. The total number of HIV/AIDS infected maternities was 10 123 during 2005-2009, 6156 of them delivered, the general usage rate of ARVs was 71.0% (4373/6156), and increasing to 75.3% (1554/2065) by the end of 2009, the rates of 2005 to 2008 were 64.6% (362/560), 66.9% (623/931), 66.7% (857/1284), 74.2% (977/1316) respectively. The difference was significant (χ(2)(trend) = 47.6, P < 0.001). The proportion of using ARVs during pregnant period was 58.5% (2557/4373). The proportion of using ARVs among born infants of HIV infected maternities was 83.4% (4999/5994), and increasing yearly, 77.2% (409/530) of 2005, 80.1% (720/899) of 2006, 83.8% (1053/1257) of 2007, 89.4% (1116/1249) of 2008, 82.6% (1701/2059) of 2009, the difference was significant (χ(2)(trend) = 13.0, P < 0.001). The general rate of exclusive breastfeeding was 92.9% (5276/5681) and the rate of HIV test in 18 months was 74.6% (2482/3324).</p><p><b>CONCLUSION</b>The rate of HIV/AIDS counseling and test of general maternities is increasing and the proportion of mainly intervention measures have been increased year by year.</p>

Therapeutic effect of dense-packing autologous hair grafting technique for restoration of seborrheic alopecia / 中华医学美学美容杂志

Objective To investigate the therapeutic effect of dense-packing auto hair grafting technique on the restoration of seborrheic alopecia. Methods With local anesthesia, a scalp strip was harvested from the back of the head. Under operating microscope (Various graft was created from the scalp strip, including micro-grafts with 1-2 hairs, mini-grafts with 3-4 hairs and sliver graft with 5-6 hairs. In the alopecia recipient area, micro slots were made with a small triangle-edged needle for the micro-grafts,mini slits were made with mini blade for the mini-grafts and foramen ovale were made with a slot punch. The grafts were then implanted into these holes. Results 32 cases of seborrheice alopecia were treated with the above mentioned technique from March 2007 to July 2009. Postoperative following up for 12-24 month showed that the grafted hairs were growing well with average 90 % survival of the hair. 81 % of the patients obtained satisfactory results with only one stage operation. Six patients needed the second operation to improve the appearance. All of the patients were satisfied with the appearance. Conclusions The dense-packing hair grafting technique with various grafts not only saves time of operation, but also obtains dense grafted hair and well appearance. The results are satisfactory to most patients with only one stage operation.

Relationship of Etiopathogenesis,Therapy and Prognosis in Children with Chronic Arrhythmia / 实用儿科临床杂志

Objective To explore the relationship of etiopathogenesis,therapy and prognosis in children with chronic arrhythmia.Met-hods Forty cases aged 48 h to 12 years old between Sep.2003 to Oct.2006 were selected.All children had vertigo,syncope,Adam-Stoke syndrome,cardiac shock.Some cases were detected with complete atrioventricular block(CAVB)(33 cases),sinus bradycardia(5 cases) or sick sinus syndrome(2 cases) by electrocardiogram(ECG) at least 2 times,and these symptoms lasted 3 days at least.Congenital CAVB children having no clinical symptom were given no treatment.Cases having sinus bradycardia,sick sinus syndrome resulted from viral myocarditis,the earlier were given antiviral medicine,energy composition,intravenous megavitamin C,isoprenaline,and large dose of adrenocortcal hormone simultaneously.Some were given human ?-globulin.Eight of them were set temporary pacemaker because of unsatisfactory treatment,and 2 of them were set permanent pacemaker.Results Twenty-eight cases were cured,9 cases were improved and 3 cases died.Six out of the cured cases and improved cased were set permanent or temporary pacemaker.Conclusions Early discovery,early diagnosis,and early temporary pacemaker use will lead a better prognosis in regular treatment.On the contrary,the delayed treatment on children with viral myocarditis and CAVB caused by dilated cardiomyopathy will lead a negative prognosis.

Prognosis and Etiological Treatment of Cardiogenic Syncope in Children / 实用儿科临床杂志

Objective To explore the prognosis and etiological treatment of cardiogenic syncope in children.Methods The cause,clinical manifestation,treatment and prognosis of 45 children with syncope were made in affiliated hospital of Qingdao medical university were su mmarized and analyzed.They were divided into arhythmia group and other groups,the former included myocarditis,dilated cardiomyopathy,and post-operation of congenital heart disease and the latter included tetralogy of fallot,pulmonary stenosis,hypertrophic cardiomyopathy,pericarclial effusion,and right atrial myxoma.Results There were 29 cases(64.44%) with arrhythmia in this group,of which there were 18 cases with complete atrioventricular block(CAVB),2 cases with second degree type Ⅱ atrioventricular block,3 cases with ventricular tachycardia,2 cases with bradycardia,2 cases with atrial flutter,1 case with supraventricular tachycardia,and 1 case with nonconducting atrial premature.There were 16 cases(35.56%) with other etiologies,of which there 8 cases with tetralogy of Fallot,2 cases with pulmonary stenosis,hypertrop-hic cardiomyopathy,pericardial effusion,and right atrial myxoma,respectively.Children with CAVB,bradycardia,or ventricular tachycardia resulted from viral myocarditis were given anti-virus medicine,protecting myocardium,neoepinephrine,and intravenous vitamin C 100-200 mg/(kg?d).Dexamethasone 1-2 mg/(kg?d) was given in earlier period for short course,and some children were given human ?-globulin.Eight cases were placed temporary pacemaker because of unsatisfactory therapeutic efficacy,and 1 case was placed permanent pacemaker.In all,38 cases(84.44%)were cured,1 case(2.22%)was improved,and 4 cases(8.88%) died.Conclusions Cardiogenic syncope is pediatric emergency and shall be treated immediately.Temporary pacemaker shall be placed at the right moment.