Changes of proportion regarding consistent condom use and syphilis infection among low-fee female sex workers aged 35 and above / 中华流行病学杂志

Objective: To investigate the changes of proportion on both consistent condom use and syphilis infection among low-fee female sex workers aged 35 and above (LFSW), in order to provide evidence for targeted intervention strategies. Methods: A total of six cities-Liuzhou city and Pingnan couty of Guigang city of Guangxi Zhuang Autonomous Region, Jinghong city of Xishuangbanna Dai autonomous prefecture and Dali city of Dali Bai autonomous prefecture of Yunnan province, Zhangjiajie city and Jianghua Yao autonomous county of Yongzhou city Hunan province were involved in this study, with 60 eligible participants needed in each city, estimated through a pre-study. The first cross-sectional survey was completed from October 2012 to January 2013. Face-to-face questionnaire interview was carried out to collect information on socio-demography, work-related information and condom use situation. Blood was collected for syphilis testing. The second cross-sectional survey was carried out from June to September, 2015 under the same procedure. Results: A total of 371 and 403 eligible participants were included in the first and second survey, respectively. When comparing the two surveys, we noticed that the average age showed a slight change, from 42.4 years to 43.8 years old (t=3.537, P<0.001) and the average price for every commercial sex exchange increased from 36.8 RMB to 49.5 RMB (t=11.961, P<0.001). In the first survey, 46.9% (174/371) of the participants had more than two years of experience working as LFSW, compared to 61.3% (247/403) in the second survey (χ(2)=16.125, P<0.001). Also, 46.9% (174/371) of the participants consistently used condoms with clients in the past month in the first survey versus 64.3% (259/403) (χ(2)=23.641, P<0.001) in the second one. Rates of syphilis infection were found from 15.9% (59/371) in the first survey reduced to 7.2% (29/403) in the second survey (χ(2)=14.533, P<0.001). Conclusion: Compared with the first survey, the proportion of consistent condoms use showed an increase. Although the proportion of syphilis infection decreased in the second survey, the scope did not meet the criteria on syphilis, set by the government. Targeted intervention strategies on condom promotion and syphilis control should be implemented consistently in this population.

Liver transplantation in patients with portal vein thrombosis: comparing pre-MELD and MELD era

Portal vein thrombosis [PVT] used to be a relative contraindication for liver transplantation [LT]. This obstacle has been dealt with following the improvement of LT-related techniques. To compare the outcome of adult patients with PVT who underwent LT before and after adopting MELD. We retrospectively searched our database for deceased donor LT recipients who had PVT, were operated between 1990 and 2009, and were 18 years old or more. The outcome of patients operated in pre-MELD era [1990-2001] was then compared with that of those operated in MELD era [2002-2009]. The incidence of patients undergoing LT with PVT has increased from 1.2% [491/40,730] in pre-MELD era to 6% [2540/42,601] in MELD era [p<0.01]. Patients with PVT in MELD era were older [53.6 vs 50.5], had higher calculated MELD [21.3 vs 18.9], shorter length of hospital stay after LT [25 vs 21.7 days], more likely to develop HCC [14.8% vs 0], and more likely to receive DCD allograft [3.9% vs 0.8%]. Donor risk indices were comparable in both groups [1.9 vs 1.9]. The median waiting time before transplantation decreased during MELD era [71 vs 99 days]. Allograft and patients survival was comparable between the two eras. However, allograft and patients survival rates were lower in patients with PVT compared to those without. In Cox regression analysis, PVT was associated with worse allograft [HR=1.3, 95% CI: 1.2-1.4, p<0.001] and patient survival [HR=1.3, 95% CI: 1.2-1.5, p<0.001] compared to non-PVT patients. The incidence of patients with PVT has increased in MELD era without improvement in outcomes. Donor and recipients characteristics changed in MELD era. PVT is still associated with poor outcomes compared to patients without PVT