Analysis of HIV-1 subtypes and pretreatment drug resistance in newly reported HIV/AIDS cases in Hangzhou, 2020-2022 / 中华微生物学和免疫学杂志

Objective:To analyze the HIV-1 subtypes and drug resistance among newly reported HIV/AIDS cases before antiretroviral therapy (ART) in Hangzhou.Methods:Blood samples were collected from newly diagnosed HIV-1/AIDS cases not receiving ART in Hangzhou from 2020 to 2022. HIV-1 pol gene was amplified and then sequenced. A phylogenetic tree was construct using MEGA7.0 software to analyse the HIV-1 subtypes, The sequences were submitted to the Stanford University drug resistance database to identify drug resistance mutation sites and drug sensitivity. Results:A total of 2 700 sequences were obtained. Twelve subtypes were identified, and the predominant subtypes were CRF07_BC (46.8%, 1 263/2 700) and CRF01_AE (34.6%, 933/2 700). The overall drug resistance rate before ART was 8.1% (220/2 700) and the resistance rates to protease inhibitors (PIs), nucleoside reverse transcriptase inhibitors (NRTIs) and non-nucleoside reverse transcriptase inhibitors (NNRTIs) were 2.8% (75/2 700), 1.3% (36/2 700) and 4.4% (119/2 700), respectively. Among the 220 drug-resistant cases, mutations conferring resistance to PIs (Q58E), NRTIs (M184V/I) and NNRTIs (K103N/S and E138A/G/K/Q) were detected in 47 (21.4%), 13 (5.9%), 42 (19.1%) and 41 (18.6%) patients, respectively.Conclusions:HIV-1 genotypes were highly complex in newly reported HIV/AIDS cases in Hangzhou from 2020 to 2022. There were cases showing moderate or high resistance to backbone drugs before ART, indicating that HIV-1 monitoring should be strengthened to avoid treatment failure and reduce the spread of drug-resistant strains.

AIDS knowledge,attitudes and practices among freshmen of a university in Hangzhou / 预防医学

Objective@#To understand the AIDS knowledge,attitudes and practices of freshmen in Hangzhou and to provide evidence for prevention and control of AIDS in university students.@*Methods@#Freshmen who enrolled in 2015 in a comprehensive university in Hangzhou were recruited by convenience sampling method and surveyed by a questionnaire about AIDS knowledge,attitudes and practices. Logistic regression model was used to analyze the influencing factors for awareness of AIDS knowledge among freshmen.@*Results@#There were 1 999 respondents recruited,with a response rate of 95.19%. The awareness rates of basic and extend AIDS knowledge were 97.90% and 30.67%,respectively. The results of multivariate logistic regression analysis showed that residence（OR=1.210,95%CI：1.006-1.456）,average or good family economic status（OR：1.874-3.027,95%CI：1.255-7.300）,receiving AIDS/STD related education（OR=1.717,95%CI：1.407-2.097）and receiving AIDS/STD related counselling in the past year（OR=1.786,95%CI：1.033-3.088）were the promotive factors for awareness of AIDS knowledge among freshmen. About 48.50% of freshmen thought they were impossible to be infected with AIDS,and 47.10% of them thought they were less likely to be infected with AIDS. About 0.90% of freshmen had sexual experience,fifteen,two and one of them experienced their first sex with girlfriend/boyfriend,homosexual partners and casual sex partners,respectively;nine of them used condoms in their first sex. The proportions of receiving AIDS/STD related services among freshmen ranged 2.00% from 37.77%.@*Conclusion@#The freshmen have a poor understanding of AIDS,weak awareness of HIV infection risk,high-risk behaviors for STDS/AIDS and receive insufficient AIDS prevention and intervention measures.

Development of the fiscal input model for public hospitals and calculation of subsidy standard / 中华医院管理杂志

Objective To explore a scientific and reasonable fiscal input mechanism for public hospitals, in order to fully leverage the policy guidance and efficiency of such funding.Methods With literature review, expert consultation and demonstration, a basic subsidy model for public hospitals was established.According to the past operation data of 4 public hospitals in Baoshan district of Shanghai, the study figured out specific subsidy standards.Results The basic subsidy for public hospitals should be determined according to the number of approved beds, the number of outpatients and emergency visits, hospital bed days, surgeries, key services, and the quality and efficiency of work.In Baoshan district, the standard reference value of subsidy for each approved bed, each outpatient and emergency visit, each bed-day, each surgical operation is 42 096 yuan, 27.9 yuan, 104.9 yuan and 244 yuan respectively.The standard value of subsidy is 100 yuan per bed for critically ill inpatients.For patients under clinical pathway management, the subsidy is 300 yuan per case, and for hospital maternal care, it is 150 yuan per person.Conclusions The basic subsidy model for public hospitals has overcome the shortcomings of fiscal input based on hospital scale or hospital workload, and established an incentive mechanism to promote the implementation of key services.These measures can improve the operation mechanism of public hospitals and encourage them to play their role of public welfare as designed.

Hemodialysis membrane：its biocompatibility and application in severe pancreatitis / 中国组织工程研究

BACKGROUND: Continuous blood purification can remove cytokines and inflammatory mediators, maintain homeostasis and prevent the occurrence of multiple organ dysfunction syndrome in patients with severe pancreatitis, which has become the main therapy for severe pancreatitis. Since the hemodialysis technology began to be applied clinical y, the biological and physicochemical properties of hemodialysis membrane materials have been studied. A variety of hemodialysis membranes have been developed in order to improve the biocompatibility and anticoagulant effect in vitro. OBJECTIVE: To investigate the application effect of hemodialysis membranes on severe pancreatitis. METHODS: Ten Wistar rats were selected to make rat models of severe pancreatitis and then were randomized into two groups (n=5 per group): homophone membrane group and polysulfone membrane group. Hemodialysis- related biochemical parameters were detected in the two groups. RESULTS AND CONCLUSION: Compared with the homophone membrane, ultrafiltration coefficient, creatinine clearance, blood urea nitrogen clearance, phosphorus clearance, number of circulating endothelial cel s, and levels of plasma nitric oxide and asymmetric dimethylarginine were significantly lower in the polysulfone membrane group (P < 0.05). Vitamin B12 clearance and amount of pre-congestion increased significantly in the polysulfone membrane group as compared with the homophone membrane (P < 0.05). These findings indicate that the polysulfone membrane for hemodialysis has good biocompatibility, and keeps a stable environment in vivo for severe pancreatitis patients.

Effect of hand intrinsic muscle exercise on the postoperative recovery of fine movement in children with hand injury / 现代临床护理

Objective To study the effect of hand intrinsic muscle exercise on postoperative recovery of fine movement in children with hand injury.Methods From January 2009 to December 2011,64 children with hand injury were randomly divided to exercise group and control group equally.Hand intrinsic muscle exercise and rehabilitative care were conducted in the exercise group while traditional rehabilitative therapies in control group.After 3-month therapy,MMDT(Minnesota Manual Dexterity Test)and PPT(Purdue Pegboard Test)were conducted to evaluate the functional recovery of hands.Result The results of MMDT and PPT were obviously better in the exercise group than in the control group(P<0.01).Conclusion Hand intrinsic muscle exercise may be effectively in promoting the recovery of fine movement in children with hand injury.

Selective blockage of abnormal Wnt pathway inhibits the growth and invasion of hepatocarcinoma cells / 复旦学报（医学版）

Objective To construct the recombinant expression vector encoding antisense Tcf fragment for the blockage of abnormal Wnt pathway, and to investigate its effect on the biological behaviors of human hepatocarcinoma cells. Methods Antisense expression vector was transfected into hepatocarcinoma cells SMMC-7721 with GeneJammer. RT-PCR and Western blot were used to detect Tcf expression. Cell proliferation and motility were compared by growth curves and Transwell plate assay. Cell apoptosis was determined by Annexin V and cell cycle was examined by fluorescent staining. Results The stable transfection of antisense Tcf in SMMC-7721 cells significantly reduced Tcf expression at both mRNA and protein levels. Compared with parental and mock-transfected 7721 (7721-vector) cells, antisense Tcf RNA transfected cells 7721-pTas showed much decreased activities of proliferation, migration and invasion in vitro. Furthermore, the apoptosis rate of 7721-pTas cells [(26.34±2.07)%] was significantly higher than that of 7721-vector cells [(6.53±1.02)%] and parental SMMC-7721 cells [(4.33±0.68)%] (P<0.001). The percentages of G0-G1 phase antisense transfected cells were 20.24% and 20.95%, higher than parental SMMC-7721 and 7721-vector cells, and percentages of S phase antisense transfected cells were 11.8% and 11.38%, lower than parental SMMC-7721 and 7721-vector cells, respectively. Conclusions Antisense RNA suppress the growth ability of liver cancer cells by inducing cell apoptosis and impeding the progress of cell cycle, which suggests that selective blockage of abnormal Wnt signal pathway by antisense Tcf RNA may be a potential new gene therapy for liver cancer.