A multicenter study assessing the efficacy of various preoperative/pre-transfusion screening methods for blood transmitted disease / 中华检验医学杂志

Objective:This multi-centre study was conducted to assess the efficacy of various preoperative/pre-transfusion screening methods for blood transmitted disease.Methods:From July 2021 to December 2021, plasma samples of patients admitted to 10 hospitals were collected for screening preoperative/pre-transfusion blood transmitted disease. Nucleic acid detection technology was used to detect hepatitis B virus (HBV) DNA, hepatitis C virus (HCV) RNA and human immunodeficiency virus (HIV)(1+2) RNA, and the results were compared with the immuno-serological methods. χ 2 test and Kappa test were used to analyze the efficacy of these two methods. Results:A total of 8 655 valid specimens were collected from 10 hospitals. There was a statistically significant difference in the positive detection rate of HCV between the two methods ( P<0.001). There was no significant difference in the positive detection rate of HBV and HIV assessed by the two methods ( P>0.05), but the number of positive cases detected by HBV DNA and HIV RNA (218 and 4 cases) was significantly higher than the corresponding serological results (216 and 2 cases). At the same time, there were HBV, HCV and HIV immuno-serological omissions by the immuno-serological methods, among which 28 cases were HBsAg negative and HBV DNA positive, 2 cases were HCV antibody negative and HCV RNA positive, and 2 cases were HIV antigen/antibody negative and HIV RNA positive. In addition, in the 66 samples with inconsistent results from the two detection methods, 83.3% (55/66), 68.2% (45/66), 63.6% (42/66) and 62.1% (41/66) of patients aged was>45 years, tumor, surgery and male, respectively. Conclusions:Compared with immuno-serological tests, nucleic acid tests have the advantage in terms of sensitivity on detecting HBV, HCV and HIV infection and could reduce missed detection. The risk of transmission can be reduced by adding HBV, HCV, and HIV nucleic acid tests to preoperative/pre-transfusion immuno-serological tests screening for patients over 45 years of age and tumor patients.

Clinical value of nucleic acid detection for hepatitis B virus screening in hospitalized patients / 中华检验医学杂志

Objective:To explore clinical value of nucleic acid detection for hepatitis B virus (HBV) screening in hospitalized patients.Methods:This cross-sectional study collected and analyzed plasma samples from patients admitted to 10 domestic medical institutions from July 2021 to December 2021. Serological immunoassay and nucleic acid screening were used to simultaneously detect hepatitis B markers such as hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (HBsAb), hepatitis B e Antigen (HBeAg), hepatitis B e antibody (HBeAb), hepatitis B core antibody (HBcAb),and HBV DNA. Statistical analysis was performed on the serology, nucleic acid test results and clinical information of the patients.Results:Of the 8 655 collected samples, HBsAg was positive in 216 (2.50%) samples,HBV DNA was positive in 238 (2.75%) samples ( P>0.05); 210 (2.43%) samples were positive for both HBsAg and HBV DNA, 28 (0.32%) were HBsAg negative and HBV DNA positive, 6 cases (0.07%) were HBsAg positive and HBV DNA negative. Conclusion:These results indicate that the HBV DNA testing is equally effective as hepatitis B virus serological detection for hepatitis B virus screening in hospitalized patients.

Soft skills of nursing teachers in the department of gastroenterology and their impact on teaching behaviors / 中华医学教育探索杂志

Objective:To investigate the soft skills of nursing teachers in the department of gastroenterology and their impact on teaching behaviors.Methods:A total of 438 nursing teachers from the Department of Gastroenterology of 12 grade A tertiary hospitals in our province were selected as the subjects by cluster sampling. The general information questionnaire, nursing soft skill assessment scale, and clinical nursing mentors' behavior scale were used for a questionnaire survey. The scores for soft skills and teaching behaviors of nursing teachers were evaluated. A Pearson correlation analysis was conducted to discuss the correlation between soft skills and teaching behaviors. The independent sample t test and variance analysis were performed for univariate analysis of teaching behaviors. A multivariate analysis of teaching behaviors was performed by multiple linear regression analysis. Results:The total score of the nursing soft skill assessment scale was (164.75±18.49), and the average score of items was (3.43±0.49). The total score of the clinical nursing mentors' behavior scale was (94.26±8.48), and the average score of items was (4.10±0.46). The total score of nursing soft skills was positively correlated with the total score of teaching behaviors ( r=0.31, P<0.05). The total score of the behavior scale of nursing teachers varied significantly across different education backgrounds, professional titles, nursing ages, and teaching years ( P<0.05). The multiple linear regression analysis found that professional title, teaching years, and nursing soft skills were important factors affecting the teaching behavior level of nursing teachers, which could explain 39.50% of the teaching behavior level. Conclusion:Soft skills of nursing teachers in the Department of Gastroenterology are at a middle level. Professional title, teaching years, and soft skills are important factors affecting teaching behaviors. Improving soft skills of nursing teachers may help improve teaching behaviors.

Genetic Subtypes and Pretreatment Drug Resistance in the Newly Reported Human Immunodeficiency Virus-Infected Men Aged≥50 Years Old in Guangxi / 中国医学科学院学报

Objective To analyze the genetic subtypes of human immunodeficiency virus (HIV) and the prevalence of pretreatment drug resistance in the newly reported HIV-infected men in Guangxi. Methods The stratified random sampling method was employed to select the newly reported HIV-infected men aged≥50 years old in 14 cities of Guangxi from January to June in 2020.The pol gene of HIV-1 was amplified by nested reverse transcription polymerase chain reaction and then sequenced.The mutation sites associated with drug resistance and the degree of drug resistance were then analyzed. Results A total of 615 HIV-infected men were included in the study.The genetic subtypes of CRF01_AE,CRF07_BC,and CRF08_BC accounted for 57.4% (353/615),17.1% (105/615),and 22.4% (138/615),respectively.The mutations associated with the resistance to nucleoside reverse transcriptase inhibitors (NRTI),non-nucleoside reverse transcriptase inhibitors (NNRTI),and protease inhibitors occurred in 8 (1.3%),18 (2.9%),and 0 patients,respectively.M184V (0.7%) and K103N (1.8%) were the mutations with the highest occurrence rates for the resistance to NRTIs and NNRTIs,respectively.Twenty-two (3.6%) patients were resistant to at least one type of inhibitors.Specifically,4 (0.7%),14 (2.3%),4 (0.7%),and 0 patients were resistant to NRTIs,NNRTIs,both NRTIs and NNRTIs,and protease inhibitors,respectively.The pretreatment resistance to NNRTIs had much higher frequency than that to NRTIs (2.9% vs.1.3%;χ2=3.929,P=0.047).The prevalence of pretreatment resistance to lamivudine,zidovudine,tenofovir,abacavir,rilpivirine,efavirenz,nevirapine,and lopinavir/ritonavir was 0.8%, 0.3%, 0.7%, 1.0%, 1.3%, 2.8%, 2.9%, and 0, respectively. Conclusions CRF01_AE,CRF07_BC,and CRF08_BC are the three major strains of HIV-infected men≥50 years old newly reported in Guangxi,2020,and the pretreatment drug resistance demonstrates low prevalence.

Analysis of the difference in metabolites and gene expressions between pre-receptive and receptive endometria / 中华医学遗传学杂志

OBJECTIVE@#To analyze the difference in the gene expression, amino acid and carnitine levels in the cervical secretions between the endometria of pre-receptive and receptive stages, with an aim to provide clues for identifying new molecular markers for endometrial receptivity.@*METHODS@#Fifty nine infertile women treated at the Department of Reproductive Medicine of Linyi People's Hospital from January 6, 2020 to January 31, 2022 were selected as as the study subjects, which were matched with 3 pairs (6 cases) of infertile women preparing for embryo transfer based on factors such as age, body mass index, and length of infertility. Endometrial tissue samples were collected for gene transcription and expression analysis. Twenty five women who had become pregnant through assisted reproductive technology were selected as the control group, and 28 non-pregnant women receiving ovulation monitoring at the Outpatient Department were enrolled as the case group. Status of endometrial receptivity was determined by ultrasonography. In the former group, endometrial tissues were sampled for sequencing, and GO and KEGG database enrichment analysis of differentially expressed genes was carried out. In the latter group, cervical secretions were collected, and amino acid and carnitine levels were measured by mass spectrometry. Statistical analysis was carried out using rank sum test, t test and chi-square test with SPSS v25.0 software.@*RESULTS@#No difference was found in the clinical data of the patients with regard to age, body mass index, infertility years, AMH, FSH, LH, E2, and type of infertility. Compared with the receptive endometrial tissues, there were 100 significantly up-regulated genes and 191 significantly down-regulated genes in the pre-receptive endometrial tissue, with the most significantly altered ones being HLA-DRB5 and MMP10. The biological processes, molecular functions and pathways enriched by more differentially expressed genes in GO and KEGG were mainly immune regulation, cell adhesion and tryptophan metabolism. Analysis of secretion metabolism also revealed a significant difference in the levels of amino acids and carnitine metabolites between the two groups (P < 0.05), in particular those of Alanine, Valine, 3-hydroxybutyrylcarnitine (C4OH) + malonylcarnitine (C3DC)/captoylcarnitine (C10).@*CONCLUSION@#A significant difference has been discovered in the levels of gene transcription and protein expression in the endometrial tissues from the pre-receptive and receptive stages. The levels of amino acids and carnitine, such as Alanine, Valine, 3-hydroxybutyryl carnitine (C4OH)+malonyl carnitine (C3DC)/caproyl carnitine (C10), may be associated with the receptive status of the endometrium, though this need to be verified with larger samples.

Effect of heavy metal lead on anticoagulant activity of leech based on label-free quantitative proteomics / 中国中药杂志

Whitmania pigra is the most widely distributed species of leeches in the market. In this study, the effect of heavy metal lead pollution on the anticoagulant activity of Wh. pigra was studied and the potential mechanism was explored. Pb(NO_3)_2 was used to contaminate the breeding soil which was then used to rear Wh. pigra for 50 days(lead-contaminated group, LC group), and meanwhile the blank control group(CG group) was set. Proteins were extracted from the obtained leech samples, and the differentially expressed proteins between LC and CG groups were analyzed by label-free proteomics technology. In this study, a total of 152 differentially expressed proteins were screened out, of which 93 proteins were up-regulated and 59 proteins were down-regulated in LC group. Bioinformatics analysis showed that the biological processes enriched with the differentially expressed proteins were mainly vesicle-mediated transport and transport positive regulation; the enriched cell components were mainly endocytosis vesicles and apical plasma membrane; the enriched molecular functions mainly included carbohydrate binding. The differentially expressed proteins were enriched in 76 KEGG pathways, which mainly involved metabolic pathways, biosynthesis of secondary metabolites, and bacterial invasion of epithelial cells. In this study, two differentially expressed proteins with Antistasin domain were presumed, which provides reference for further exploring the regulatory mechanism and signal transduction underlying the effect of lead pollution on the anticoagulant activity of leech.

Effects of Human Immunodeficiency Virus-positive Mothers Receiving Antiretroviral Therapy to Prevent Mother-to-child Transmission on the Growth and Development of 18-month-old Children in Lingshan County of Guangxi / 中国医学科学院学报

Objective To evaluate the effects of antiretroviral therapy(ART)for the prevention of mother-to-child transmission(PMTCT)of acquired immune deficiency syndrome(AIDS)on the growth and development of 18-month-old children born by human immunodeficiency virus(HIV)-positive pregnant women in Lingshan County,Guangxi Zhuang Autonomous Region,and provide scientific evidence for improving the ART medication plan for PMTCT.Methods Lingshan County,ranking the first in the HIV-epidemic counties of Guangxi,was selected as the research site.According to the design of retrospective case-control study,we assigned all the subjects into the case group and the control group:(1)The case group included the HIV-positive pregnant women who had received ART for PMTCT and their HIV-negative infants in Lingshan County from 2010 to 2017.The historical cards and PMTCT data of them were collected from the national PMTCT database.(2)The control group included the healthy pregnant women and their healthy babies born in the Lingshan Maternity and Infant Hospital in 2017,and the children's growth and development data were collected.The stunted growth in children was defined as at least one of the three main indicators of body height,body weight,and head circumference below the normal range.Results The number of HIV-positive mothers and their infants in the case group was 391 and 368,respectively,and 87.21%(341/391)and 95.38%(351/368)of mothers and infants respectively received ART medication.The HIV positive rate,mortality rate,and mother-to-child transmission rate of 18-month-old children were 1.36%(5/368),4.35%(16/368),and 2.01%(5/249),respectively.The incidence of stunted growth of 18-month-old children in the case group and the control group was 42.12%(155/368)and 23.06%(101/438),respectively,with significant difference(

Effect of lead pollution on anticoagulant effect of Whitmania pigra based on in vitro anticoagulation experiment / 中国中药杂志

Leech has a good anticoagulant activity and is one of the raw materials for treatment of many cardiovascular and cerebrovascular diseases. This study was based on in vitro anticoagulant experiments( APTT and PT) to investigate the effects of lead contamination on the anticoagulant effect of leech. At present,the Hirudo circulating in the market are dominated by Whitmania pigra,therefore Wh. pigra were cultivated under a different lead pollution for 50 days. Then,the effects of Wh. pigra extract,extracting from different cultivating environment,on activated partial thrombin time( APTT) and prothrombin time( PT) were determined by automatic coagulation instrument. The results showed that the Wh. pigra extract significantly prolonged the APTT compared with the saline group.The APTT of the lead-high residual Wh. pigra was shorter than that of the blank Wh. pigra. The Wh. pigra extracts from different treatment groups had little effect on PT. The results showed that the lead residue in the Wh. pigra increased with the increase of lead in the cultured soil,the lead residual of the Pb-H group was( 10. 66±2. 79) mg·kg~(-1),which exceeded the lead limit specified in the 2015 edition of the Chinese Pharmacopoeia. The results indicated that growth environment pollution is one of the important factors causing excessive lead in Wh. pigra. Lead pollution will reduce the anticoagulant effect of Wh. pigra and affect its clinical efficacy.

Diversity of fungi on surface of Pheretima / 中国中药杂志

Traditional Chinese medicines( TCMs) are easily contaminated by fungi during planting,harvesting,processing,transportation and storage. The 2015 version of Chinese Pharmacopoeia stipulates the detection of aflatoxin in Dilong. After reviewing the literature,it has been found that there are no domestic and foreign scholars who have studied the surface fungi of Dilong. Pheretima,known as Dilong in China,is a commonly used TCMs in animal. In this experiment,8 batches of Dilong were collected from retail pharmacies in Beijing. The fungi on the surface of Dilong were cultured by traditional plate method and the single strain was obtained by the top purification method. The fungal colony morphology,microstructure characteristics and DNA barcode were used to isolate and identify the fungi. At the same time,based on Illumina Hi Seq 2500 high-throughput sequencing platform,the diversity of fungi on the surface of Dilong was analyzed. The results showed that 287 strains of 9 species of fungi were isolated and identified by plate method. Combined with 3 kinds of identification method,eight of nine fungi could be identified,respectively,Aspergillus niger,Penicillium,Alternaria nees,A. flavus,and Penicillium oxalicum,Humicola sp.,Talaromyces purpurogenus and A. insuetus,1 kind of fungi was not identified yet. Among them,Penicillium and Aspergillus were the dominant genus. The results of high-throughput sequencing belonged to 2 boundaries,6 gates,19 classes,44 orders,98 families,127 genus and 121 species in different classification levels. Wallemia,Aspergillus and Cordyceps were the dominant genus,and the relative abundances are 63. 33%,15. 28%,and 10. 28%,respectively. Through the diversity study on the surface fungi of Dilong in Beijing retail pharmacies,it can provide a reference for its safe storage and clinical use.

Potential value of autoantibodies as biomarkers of chronic graft-versus-host disease after allogeneic stem cell transplantation / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

We investigated the value of autoantibodies as biomarkers of chronic graft-versus-host disease (cGVHD) by analyzing the autoantibody profiles of 65 patients (34 cGVHD and 31 non-cGVHD) surviving longer than three months after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Autoantibodies to at least one antigen were detected in 45 patients (70.8%), with multiple autoantibodies detected in 30 patients (46.2%). Antinuclear antibodies (ANAs) were the most frequently detected autoantibodies, with a significantly higher prevalence in non-cGVHD patients and cGVHD patients than that in healthy controls (HCs). ANA-nucleolar (ANA-N) was the main immunofluorescence pattern of ANA-positivity in both the non-cGVHD and cGVHD groups. There was a higher prevalence of anti-Ro52-positivity in non-cGVHD and cGVHD patients than in HC. Liver cGVHD was significantly associated with anti-Ro52-positivity. However, cGVHD activity and severity were not associated with the presence of autoantibodies. Similarly, there were no significant differences in overall survival or relapse among the four groups of patients expressing autoantibodies. Our results suggest that autoantibodies have limited value in predicting cGVHD.

Characteristics of HIV-infected persons without long term disease progress and related factors in Guangxi Zhuang Autonomous Region / 中华流行病学杂志

Objective To understand the characteristics of HIV infected persons without long term disease progress [also known as long term non-progressors (LTNPs)],and related factors in Guangxi Zhuang Autonomous Region (Guangxi).Methods Data of persons living with HIV and receiving no antiretroviral therapy in Guangxi by the end of 2016 were collected from the national HIV/AIDS comprehensive control and prevention information system of China.Results By the end of 2016,there were 313 LTNPs in Guangxi,accounting for 2.3 ％ of those being reported for more than 10 years,5.4％ of those being reported for more than 10 years and surviving,and 26.6％ of those being reported for more than 10 years,surviving and receiving no antiretroviral therapy.Among the LTNPs,87.2％(273) were men,94.9％ (297) were aged ≤ 40 years,32.3％ (101) were farmers,55.6％ (174) were single,divorced or widowed,69.3％ (217) were of Han ethnic group,68.1％ (213) were injecting drug users,and 52.1％ (163) were from custody facilities.Multiple logistic regression analysis indicated that factors associated with delayed disease progression included age ≤40 years (compared with age ＞40 years,aOR=1.55,95％ CI:1.31-3.12) and injection drug use (compared with sexual transmission,aOR=1.23,95％ CI:1.10-1.74).Conclusions A number of LTNPs existed in HIV-infected individuals in Guangxi.Further research are needed to identify the related factors,and it is necessary to conduct large sample size studies on host immunology,genetics and the virology of HIV to explore the related mechanism.

Characteristics of HIV-infected persons without long term disease progress and related factors in Guangxi Zhuang Autonomous Region / 中华流行病学杂志

Objective To understand the characteristics of HIV infected persons without long term disease progress [also known as long term non-progressors (LTNPs)],and related factors in Guangxi Zhuang Autonomous Region (Guangxi).Methods Data of persons living with HIV and receiving no antiretroviral therapy in Guangxi by the end of 2016 were collected from the national HIV/AIDS comprehensive control and prevention information system of China.Results By the end of 2016,there were 313 LTNPs in Guangxi,accounting for 2.3 ％ of those being reported for more than 10 years,5.4％ of those being reported for more than 10 years and surviving,and 26.6％ of those being reported for more than 10 years,surviving and receiving no antiretroviral therapy.Among the LTNPs,87.2％(273) were men,94.9％ (297) were aged ≤ 40 years,32.3％ (101) were farmers,55.6％ (174) were single,divorced or widowed,69.3％ (217) were of Han ethnic group,68.1％ (213) were injecting drug users,and 52.1％ (163) were from custody facilities.Multiple logistic regression analysis indicated that factors associated with delayed disease progression included age ≤40 years (compared with age ＞40 years,aOR=1.55,95％ CI:1.31-3.12) and injection drug use (compared with sexual transmission,aOR=1.23,95％ CI:1.10-1.74).Conclusions A number of LTNPs existed in HIV-infected individuals in Guangxi.Further research are needed to identify the related factors,and it is necessary to conduct large sample size studies on host immunology,genetics and the virology of HIV to explore the related mechanism.

Epidemiological characteristics of HIV/AIDS in Guangxi Zhuang Autonomous Region, 2010-2017 / 中华流行病学杂志

Objective@#To understand the characteristics of HIV/AIDS epidemic in Guangxi Zhuang Autonomous Region (Guangxi) with a purpose to accurately provide scientific basis for prevention and control measures, 2010-2017.@*Methods@#Data were retrieved from case reporting cards of Guangxi during 2010 to 2017 through National HIV/AIDS Comprehensive Response Information Management System. Data was analyzed using epidemiological methods such number of cases, proportion and rate. χ2 test was used for statistical analysis.@*Results@#The HIV positive rate was 12.53 per ten thousand (85 182/67 959 000) in Guangxi during 2010 to 2017. The number of newly diagnosed HIV/AIDS cases and the number of death yearly respectively increased by 22.34%(2 602/11 648) and 32.83% (952/2 900) in 2011 compared with 2010, and both showed a six-year continuous downward trend (the number of newly diagnosed cases respectively 12 229 cases, 10 877 cases, 9 460 cases, 9 190 cases, 8 848 cases, 8 680 cases, and the number of death respectively 3 888 cases, 3 316 cases, 2 914 cases, 2 717 cases, 2 595 cases, 2 600 cases) from 2012 to 2017. But proportion of late discovery remained above 50.00% (50.53%-57.06%) for eight-years continuously. The ratio of male and female was 2.47 ∶ 1 (60 639/24 543). The ratio of males and females aged 50 and over was 2.71∶1 (28 654/10 557). Proportion of the cases in 25-49 years old group and 50 years old group accounting for 47.40%(40 377/85 182) and 46.03% (39 211/85 182) respectively. The occupation was farmers accounting for 68.40% (58 262/85 182), housekeeping, housework and unemployment accounting for 11.21% (9 546/85 182), student accounting for 0.86% (729/85 182). Heterosexual transmission accounted for 90.60% (77 171/85 182, homosexual transmission accounted for 3.13% (2 669/85 182), injection drug use transmission accounted for 4.60%(3 924/85 182) and mother-to-child transmission accounted for 0.73% (619/85 182).@*Conclusions@#The number of newly diagnosed cases and the number of death yearly showed a continuous downtrend for six-years from 2012 to 2017. However, proportion of late discovery remained above 50.00% for eight-years. The major route of infection was heterosexual transmission. With the change of HIV/AIDS newly epidemic mode in Guangxi, there are many new challenges for HIV/AIDS prevention and control work. Strategy of targeted intervention modes should be innovated for a new breakthrough.

Effect of baseline CD4+ T cell count on drop-out of antiretroviral therapy in HIV infected persons in Guangxi Zhuang Autonomous Region, 2008-2015 / 中华流行病学杂志

Objective To investigate the effect of baseline CD4+T cell count (CD4) on drop-out of antiretroviral therapy (ART) in HIV infected persons.Methods Retrospective cohort was conducted in this study.HIV infected persons aged≥ 18 years and receiving free ART for the first time in Guangxi Zhuang Autonomous Region (Guangxi) from 2008 to 2015 were selected from the antiretroviral treatment database of National Comprehensive HIV/AIDS Information System,with follow-up conducted till May 30,2016.Cause-specific Cox proportional hazard models were used to evaluate effect of different CD4 on the drop-out of ART in the HIV infected persons.Results A total of 58 502 eligible study participants were included in this retrospective cohort study.The average drop-out ratio was 4.8/100 person-years.After controlling the following baseline covariates:age,sex,marital status,route of HIV infection,WHO clinical stage before ART,initial/current ART regiment,ART regiment adjustment,and year of initiating ART for potential confounding,the adjusted HR of drop-out for HIV infected persons with 200-cells/μl,351-cells/μl and ≥500 cells/μl were 1.110 (95％CI:1.053-1.171,P＜0.001),1.391 (95％CI:1.278-1.514,P＜0.001) and 1.695 (95％CI:1.497-1.918,P＜ 0.001),respectively,in risk for drop-out compared with those with baseline CD4 ＜200 cells/μ 1.Among the HIV infected persons,56.0％ (1 601/2 861) of drug withdrawal was due to poor compliance with medication.Conclusions With the increase of baseline CD4 when initiating ART,the risk for the drop-out in HIV infected persons increased significantly.To further reduce the drop-out of ART,it is important to take CD4 into account in initiating ART and to strengthen the health education on treatment compliancy and training for healthcare providers.

Effect of baseline CD4+ T cell count on drop-out of antiretroviral therapy in HIV infected persons in Guangxi Zhuang Autonomous Region, 2008-2015 / 中华流行病学杂志

Objective To investigate the effect of baseline CD4+T cell count (CD4) on drop-out of antiretroviral therapy (ART) in HIV infected persons.Methods Retrospective cohort was conducted in this study.HIV infected persons aged≥ 18 years and receiving free ART for the first time in Guangxi Zhuang Autonomous Region (Guangxi) from 2008 to 2015 were selected from the antiretroviral treatment database of National Comprehensive HIV/AIDS Information System,with follow-up conducted till May 30,2016.Cause-specific Cox proportional hazard models were used to evaluate effect of different CD4 on the drop-out of ART in the HIV infected persons.Results A total of 58 502 eligible study participants were included in this retrospective cohort study.The average drop-out ratio was 4.8/100 person-years.After controlling the following baseline covariates:age,sex,marital status,route of HIV infection,WHO clinical stage before ART,initial/current ART regiment,ART regiment adjustment,and year of initiating ART for potential confounding,the adjusted HR of drop-out for HIV infected persons with 200-cells/μl,351-cells/μl and ≥500 cells/μl were 1.110 (95％CI:1.053-1.171,P＜0.001),1.391 (95％CI:1.278-1.514,P＜0.001) and 1.695 (95％CI:1.497-1.918,P＜ 0.001),respectively,in risk for drop-out compared with those with baseline CD4 ＜200 cells/μ 1.Among the HIV infected persons,56.0％ (1 601/2 861) of drug withdrawal was due to poor compliance with medication.Conclusions With the increase of baseline CD4 when initiating ART,the risk for the drop-out in HIV infected persons increased significantly.To further reduce the drop-out of ART,it is important to take CD4 into account in initiating ART and to strengthen the health education on treatment compliancy and training for healthcare providers.

Comparison of sinus tarsi and lateral L-shaped approaches in medial wall reduction and calcaneal alignment in treatment of calcaneal fractures / 中华创伤骨科杂志

Objective To compare the minimally invasive sinus tarsi approach and lateral intensive L-shaped approach in the therapeutic effects concerning medial wall reduction and calcaneal alignment for cal-caneal fractures. Methods A retrospective analysis was conducted of the 52 patients with calcaneal fracture who had been treated at Department of Foot & Ankle Surgery, Guangzhou Orthopaedic Hospital from January 2010 to December 2014. They were 39 men and 13 women, 28 to 46 years of age ( average, 40.4 years ). Of them, 26 were treated via the sinus tarsi approach ( minimally invasive group ) and the other 26 via the con-ventional lateral extensile L-shaped approach ( conventional group ) . X-ray axial films of the calcaneus were taken pre-operatively and post-operatively to evaluate the medial wall reduction and calcaneal alignment. The American Orthopedic Foot Ankle Society ( AOFAS ) ankle-hindfoot scale was adopted to assess the therapeutic effects. Results The average follow-up period for this cohort was 18 months ( from 12 to 24 months). The post-operative varus angle was 7.41°± 5.17°for the minimally invasive group and 8.01°± 5.33°for the con-ventional group; the correction of varus angle was 6.60°± 6.23°for the minimally invasive group and 8.57°± 6.64°for the conventional group; the good to excellent rate of medial wall reduction was 42.3% ( 11/26 ) for the minimally invasive group and 53.8% ( 14/26 ) for the conventional group; the AOFAS score was 89.5 ± 7.0 for the minimally invasive group and 86.2 ± 8.2 for the conventional group. There were no statistically signifi-cant differences between the 2 groups in all the above comparisons ( P ＞ 0.05 ). Conclusion The mini-mally invasive sinus tarsi approach can be a fine choice for treatment of calcaneal fractures, because it leads to no differences in medial wall reduction, postoperative varus angle and postoperative correction of varus angle, compared with the conventional lateral extensile L-shaped approach.

Effect of Phosphorylated-Extracellular Regulated Kinase 1/2 Inhibitor on Retina from Light-induced Photoreceptor Degeneration / 中华医学杂志(英文版)

Background@#The demonstrated role of mitogen-activated protein kinase (MAPK) in both cell apoptosis and the inflammation pathway makes it an attractive target for photoreceptor protection. The aim of this study was to investigate the protective effects of MAPK antagonists against photoreceptor degeneration and retinal inflammation in a rat model of light-induced retinal degeneration.@*Methods@#Sprague Dawley rats were treated with intravitreal injections of MAPK antagonists, inhibitors of p-P38, phosphorylated-extracellular regulated kinase (p-ERK) 1/2, and p-c-Jun N-terminal kinase (JNK) just before they were assigned to dark adaptation. After dark adaptation for 24 h, rats were exposed to blue light (2500 lux) in a light box for 24 h, and then returned to the normal 12-h light/12-h dark cycle. Samples were collected at different time points. MAPK expression during light exposure was examined with immunofluorescence. Photoreceptor death was detected with histopathology and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining. The expression of retinal p-ERK1/2, caspase 3, activated caspase 3, tumor necrosis factor (TNF)-α, and interleukin (IL)-1β was examined by Western blotting. Differences between groups were evaluated using unpaired one-way analysis of variance and least significant difference post hoc tests.@*Results@#MAPKs (P38, ERK1/2, and p-JNK) were phosphorylated and activated in the light injury groups, compared with normal group, and their expressions were mainly elevated in the outer nuclear layer (ONL). Among the selected MAPK antagonists, only the p-ERK1/2 inhibitor attenuated the loss of photoreceptors and the thinning of ONL in light injury groups. Besides, p-ERK1/2 inhibitor refrained light-induced photoreceptor apoptosis, which was presented by TUNEL positive cells. Light injury significantly increased the expression of p-ERK1/2 (1.12 ± 0.06 vs. 0.57 ± 0.08, t = 9.99, P < 0.05; 1.23 ± 0.03 vs. 0.57 ± 0.08, t = 11.90, P < 0.05; and 1.12 ± 0.12 vs. 0.57 ± 0.08, t = 9.86, P < 0.05; F = 49.55, P < 0.001), and induced caspase 3 activating (0.63 ± 0.06 vs. 0.14 ± 0.05, t = 13.67, P < 0.05; 0.74 ± 0.05 vs. 0.14 ± 0.05, t = 16.87, P < 0.05; and 0.80 ± 0.05 vs. 0.14 ± 0.05, t = 18.57, P < 0.05; F = 100.15, P < 0.001), compared with normal group. The p-ERK1/2 inhibitor significantly reduced p-ERK1/2 overexpression (0.61 ± 0.06 vs. 1.12 ± 0.06, t = -9.26, P < 0.05; 0.77 ± 0.06 vs. 1.23 ± 0.03, t = -8.29, P < 0.05; and 0.68 ± 0.03 vs. 1.12 ± 0.12, t = -7.83, P < 0.05; F = 49.55, P < 0.001) and downregulated caspase 3 activating (0.23 ± 0.04 vs. 0.63 ± 0.06, t = -11.24, P < 0.05; 0.43 ± 0.03 vs. 0.74 ± 0.05, t = -8.86, P < 0.05; and 0.58 ± 0.03 vs. 0.80 ± 0.05, t = -6.17, P < 0.05; F = 100.15, P < 0.001), compared with light injury group. No significant change in the total level of caspase 3 was seen in different groups (F = 0.56, P = 0.75). As for inflammation, light injury significantly increased the expression of TNF-α (0.42 ± 0.04 vs. 0.25 ± 0.05, t = 5.99, P < 0.05; 0.65 ± 0.03 vs. 0.25 ± 0.05, t = 14.87, P < 0.05; and 0.86 ± 0.04 vs. 0.25 ± 0.05, t = 22.58, P < 0.05; F = 160.27, P < 0.001) and IL-1β (0.24 ± 0.01 vs. 0.19 ± 0.02, t = 2.33, P < 0.05; 0.35 ± 0.02 vs. 0.19 ± 0.02, t = 7.97, P < 0.05; and 0.48 ± 0.04 vs. 0.19 ± 0.02, t = 14.69, P < 0.05; F = 77.29, P < 0.001), compared with normal group. P-ERK1/2 inhibitor significantly decreased the overexpression of TNF-α (0.22 ± 0.02 vs. 0.42 ± 0.04, t = -7.40, P < 0.05; 0.27 ± 0.02 vs. 0.65 ± 0.03, t = -14.27, P < 0.05; and 0.33 ± 0.03 vs. 0.86 ± 0.04, t = -19.58, P < 0.05; F = 160.27, P < 0.001) and IL-1β (0.13 ± 0.03 vs. 0.24 ± 0.01, t = -5.77, P < 0.05; 0.17 ± 0.01 vs. 0.22 ± 0.02, t = -9.18, P < 0.05; and 0.76 ± 0.05 vs. 0.48 ± 0.04, t = -13.12, P < 0.05; F = 77.29, P < 0.001), compared with light injury group.@*Conclusion@#The p-ERK1/2 inhibitor might protect the retina from light-induced photoreceptor degeneration and retinal inflammation.

Analysis on influencing factors of late detection for newly diagnosed HIV/AIDS positive patients in Guangxi in 2015 / 中华疾病控制杂志

Objective To explore the influencing factors of late diagnosis for newly diagnosed HIV/AIDS positive patients in Guangxi in 2015.Methods The CD4 + T lymphocytes count which was first detection for newly diagnosed HIV/AIDS positive patients in Guangxi during 2015 was collected.Data were statistically analyzed.Results We collected 8 586 newly diagnosed HIV/AIDS whose median CD4+ T lymphocytes counts was 237.5 cells/μl,and 43.12％ of them had less than 200 cells/μl.Gender,age,occupation,marriage,nation,education,route of transmission,types of testing and region had effects on late HIV diagnosis(all P ＜ 0.05).Logistic analysis found that risk factors associated with the late diagnosis of HIV were male(OR =1.851,95％ CI:1.673-2.048),migrant worker (OR =1.387,95％ CI:1.242-1.549),education below middle and secondary school(OR =1.619,95％ CI:1.400-1.873),currently married(OR =1.207,95％ CI:1.075-1.354),divorced or widowed(OR =1.508,95％ CI:1.309-1.738).Voluntary testing was a protective factor.Conclusions The prevalence the late diagnosis of HIV was high in Guangxi in 2015,it is crucial for related departments to enhance the testing and screening effort for HIV/AIDS.

Progress in researches on the sperm centrosome / 中华男科学杂志

In humans and most mammals, the sperm centrosome is primarily responsible for nucleating and organizing the sperm astar, which pushes the sperm head toward the oocyte center and guides the migration of the female pronucleus, completing the fertilization process. There are about 200 kinds of protein in the human sperm centrosome. Currently, most of the researches focus on the centrin protein. Further studies on the functions of different human sperm centrosomal proteins may contribute to the understanding of the causes of the failures in assisted reproductive technology (ART). And in ART, morphological observation of the sperm neck integrity is the only way for primary evaluation of the function of the sperm centrosome.

Small cell malignant tumors of bone: comparison between diagnosis using core needle biopsies and surgical specimens / 中华病理学杂志

<p><b>OBJECTIVE</b>To compare the pathologic diagnosis and immunohistochemistry of small cell malignant tumors (SCMT) of bone using both core needle biopsy and surgical specimen.</p><p><b>METHODS</b>Seventy-seven cases of SCMT with core needle biopsies and surgical specimens available were respectively analyzed by histologic examination and immunohistochemical study, with literature review.</p><p><b>RESULTS</b>The male-to-female ratio was 48:29. The age of the patients ranged from 6 to 73 years. The tumors studied included Ewing sarcoma/PNET (n = 38), myeloma (n = 23), lymphoma (n = 10), small cell osteosarcoma (n = 2), small cell carcinoma (n = 2) and mesenchymal chondrosarcoma (n = 2). The tumors involved limbs, axial skeleton and flat bones. Microscopically, the tumors shared similar histology, with small round cells and spindly cells arranged in diffuse sheets. The pathologic diagnosis by core needle biopsies correlated with that by surgical specimens in 84.4% (65/77) of the cases.</p><p><b>CONCLUSIONS</b>SCMT represents a heterogeneous group of malignancy. Correlations with clinicoradiologic findings and application of ancillary investigations including immunohistochemistry and molecular study are important for definitive diagnosis. Pathologic diagnosis using core needle biopsies shows good results and provides useful information for surgical planning.</p>