Construction and prospect of healthy enterprises in the new era / 中华劳动卫生职业病杂志

The construction of health enterprises practice the concept of big health. It is an important solution to protect the overall health of occupational groups in the new era, which is of great significance to promoting a healthy city and helping to build a healthy China. This paper clarifies the connotation of healthy enterprises in the new era, discusses the key points of healthy enterprise construction around the "four in one" construction content, "PDCA" construction procedures, and evaluation methods of healthy enterprises. It focuses on the progress of healthy enterprise construction, analyzes the problems faced by the construction of health enterprises in China, and puts forward suggestions to improve the construction efficiency, with a view to providing ideas for further promoting the construction of health enterprises in China.

Countermeasures for the construction of occupational health information standard system / 中华劳动卫生职业病杂志

As an important part of health information standard system, occupational health information standard system is the foundation and guarantee of promoting the construction of occupational health information. This article is based on the literature research about current situation of domestic and foreign health information standards and occupational health information standard system, thus take "the National Health Information Standardization System" and "the National Public Health Information Construction Standards and Norms" into account, focus on the requirements of occupational health information construction and related work. Thus, put forward suggestions on the construction of occupational health information standard system, to accelerate the occupational health information construction, data collection, transmission and application.

Effect and safety of intraarticular infusion combined with intravenous injection of tranexamic acid on hemorrhage in patients underwent total knee replacement / 新乡医学院学报

Objective To assess the effect and safety of intraarticular infusion combined with intravenous injection of tranexamic acid on hemorrhage in patients underwent total knee replacement (TKR).Methods A total of 180 patients who underwent TKR in the People's Hospital of Hebi City from January 2014 to January 2017 were selected.The patients were divided into control group,low dose group and high dose group according to the tranexamic acid dose,60 cases in each group.All patients were treated with tranexamic acid 10 mg · kg-1 by intravenous drip within one hour before operation.After the incisions were sutured,the patients in the control group were treated with physiological saline 100 mL by intraarticular infusion,the patients in the low dose group and high dose group received intraarticular infusion of tranexamic acid 1 and 2 g respectively,the drainage tube was opened after one hour's occlusion.The operation time,hemoglobin level,postoperative blood loss,total blood loss and complications were observed and recorded.Results There was no significant difference in hemoglobin level in the three groups before operation (P ＞ 0.05).The hemoglobin level in the high dose group was significantly higher than that in the low dose group and the control group (P ＜ 0.05),but there was no significant difference in hemoglobin level between the low dose group and the control group at one day after operation (P ＞ 0.05).The hemoglobin level in the low dose group and the high dose group was significantly higher than that in the control group (P ＜ 0.05),and it in the high dose group was significantly higher than that in the low dose group at two days after operation (P ＜ 0.05).There was no significant difference in the operation time in the three groups (P ＞ 0.05).The postoperative blood loss and total blood loss in the low dose group and the high dose group were significantly lower than those in the control group (P ＜ 0.05),and them in the high dose group were significantly lower than those in the low dose group (P ＜ 0.05).The incidence of complications in the control group,low dose group and high dose group was 8.33％ (5/60),10.00％ (6/60) and 8.33％ (5/60) respectively,there was no significant difference in the incidence of complications among the three groups (x2 =0.100,P ＞ 0.05).Conclusion Intraarticular infusion combined with intravenous injection of tranexamic acid can effectively reduce blood loss in patients with TKR.Increasing the dose of intraarticular infusion of tranexamic acid within a certain range can further improve the hemostatic effect,and it does not increase the complications.

How Work Organization Affects the Prevalence of WMSDs: A Case-control Study / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>In this study, we aimed at exploring the association between work-related musculoskeletal disorders (WMSDs) and work organization based on a case-control study.</p><p><b>METHODS</b>A total of 1938 workers who claimed to suffer from WMSDs were selected from Beijing, Henan, Hubei, and the Guangdong province. The control group consisted of 2009 workers employed in similar industries without severe disease or musculoskeletal discomforts. We used a modified version of the questionnaire developed by the NMQ and the DMQ to investigate individual and work-related factors.</p><p><b>RESULTS</b>A total of 13 variables (P<0.1) were selected by the chi-square test and finally, 7 variables entered into the equation, with 6 variables reaching statistical significance (P<0.05). The odds ratios (OR) of 'work changing with season' and 'sufficient rest time' did not reach 1 (0.749 and 0.441, respectively). In addition, 'sufficient rest time' seemed to be the stronger protective factor according to its higher standardized coefficient. And 'repetitive work every minute', 'constantly repetitive work' (every day), 'shortage of site personnel', and 'often switching shifts with others' seemed to be the risk factors.</p><p><b>CONCLUSION</b>Work organization may have comprehensive effects on the occurrence of WMSDs. This pattern of associations suggests that further investigation into the mechanism of how work organization affects the prevalence of WMSDs is required.</p>

Distribution of HIV-1 subtypes in Guangxi Zhuang Autonomous Region, 2008-2009 / 中华流行病学杂志

<p><b>OBJECTIVE</b>To understand the distribution of HIV-1 subtypes in Guangxi Zhuang Autonomous Region.</p><p><b>METHODS</b>294 participants who were infected by HIV-1 in 2008 - 2009 and residing in 13 cities in Guangxi were enrolled into this study. Epidemiological information showed that heterosexual transmission was the main transmitting route. 1584 bp full length gag gene, 3147 bp full length pol gene and 558 bp env (C2V3) fragments were amplified by using RT-PCR and then directly sequenced. NCBI genotyping tool and Mega 5.03 software were used to determine the HIV subtypes. Simplot and Recombinant HIV-1 Drawing Tool were used for the analysis of recombination.</p><p><b>RESULTS</b>A total of 739 sequences, including 270 gag, 246 pol and 223 env (C2V3), were successfully obtained from 294 plasma specimens. Genotypes of HIV from 272 participants were determined. CRF01_AE was found the dominant (77.6%), followed by CRF08_BC (10.7%) and CRF07_BC (7.4%). 7 unique recombinant forms, 4 subtype B (B') and 1 subtype G were also identified. No significant difference on the distribution of subtypes among different regions and ethnics was found. Among the 7 unknown recombinant forms, 6 strains were mosaic B and/or C fragments with CRF01_AE genome as the backbone, while one strain originated from CRF07_BC and CRF08_BC.</p><p><b>CONCLUSION</b>Currently, CRF01_AE was found the major subtype of HIV epidemic in Guangxi. New recombinant forms with CRF01_AE as backbones had been emerging, which called for serious attention.</p>

A cross-sectional study on the prevalence of HIV drug resistance in patients receiving antiretroviral treatment in Shenqiu county, Henan province / 中华流行病学杂志

Objective To understand the prevalence of drug resistance in AIDS patients who had been receiving HAART in a long run,in Shenqiu county,Henan province.Methods This crosssectional study included 120 HIV infected patients who began receiving ART (antiretroviral therapy) in 2003.Viral loads and CD4 +T cells counts were measured,and In-house drug resistance test was performed in VL ＞ 1000 copies/ml patients.Results 114 cases out of 120 patients had complete viral load data.Among them,33 cases having viral loads less than 50 copies/ml,and the remaining viral loads showed an average of lg (4.09 ± 1.10) copies/ml.The average of CD4+ T cell counts was (377 ±2 1 8) cells/ml,with 64 (53.3％) cases showing their CD4+ T cell counts higher than 350 cells/ml.In 67 patients,58 of them showed genotypic resistance,and 40 cases showed reverse transcriptase inhibitors (RTIs) resistance.The ratios of nucleoside reverse transcriptase inhibitors (NRTIs) and nonnucleoside reverse transcriptase inhibitors (NNRTIs) resistance were 53.4％ (31/58) and 67.2％ (39/58),respectively.There were no differences of drug resistance ratio in the three treatment programs.The highest drug resistance rates in NRTIs and NNRTIs were zidovudine,lamivudin,nevirapine.However,protease inhibitors (PIs) resistance variants were not found.Conclusion The prevalence of drug-resistant strains seemed to be high in Shenqiu country,Henan province.Long-term follow-up monitoring strategy should be developed to optimize the timely treatment programs.

The assessment of reliability and validity of musculoskeletal questionnaire / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To evaluate the reliability and validity of musculoskeletal questionnaire.</p><p><b>METHODS</b>A self-administered modified musculoskeletal questionnaire was used to investigate 12 098 workers from eight occupations, i.e. coal mining, petroleum, metallurgical, mechanical manufacturing, chemical, garment and railroad transportation industries and education. The Cronbach's α coefficient, analysis of covariance and multiple logistic regression were used to assess the reliability and validity of musculoskeletal questionnaire.</p><p><b>RESULTS</b>The consistent test between total items of Musculoskeletal Questionnaire and each factor showed that the range of Cronbach's α was 0.52 ∼ 0.92, except from vibration factor, other Cronbach's α was more than 0.7. All 55 items of Musculoskeletal Questionnaire were subjected to factor analysis, and ten latent factors were identified, which explained 55.17% of the total variance. The potentially hazardous working conditions could be categorized into seven dimensions (force, dynamic load, static load, repetitive load, climate factors, vibration exposure and environmental ergonomic factor), which consisted with the theory model. The results of covariance analysis indicated that there were significant difference among 7 dimension indices in different jobs (P < 0.01).</p><p><b>CONCLUSION</b>The modified Musculoskeletal Questionnaire is a valid and reliable tool for measuring musculoskeletal workload.</p>

Men who have sex with men and its relationship with HIV-1 strains prevailing in the paid blood donors from Zhengzhou city, Henan / 中华流行病学杂志

Objective To clarify the genetic characteristics of human immunodeficiency virus (HIV) circulated in the population of men who have sex with men (MSM) in Zhengzhou,Henan and to analyze its relationship with HIV-1 prevailing in the paid blood donors (PBDs).Methods Thirty-one MSM who were confirmed as HIV positive individuals in 2010 together with 41 HIV-positive former PBDs were enrolled in the study.Information on related epidemiological characteristics and their plasma were collected.RT-PCR was used to amplify HIV-1 full length gag (1584 bp),pol (3147 bp) genes and partial env gene (C2V3 segment,558 bp) followed by sequencing on those subjects.Online software available at LosAlamos HIV Database was used to identify the HIV subtypes based on the findings of the sequences.Phylogenetic tree was used to identify thc possible relationship of transmission.Results Fifty-three full length gag,38 full length pol and 48 partial env (C2V3) genes were collected from 72 participants.Among the 31 HIV ( + )MSM individuals,14 CRF01_AE strains,5 CRF07BC_ strains and 12 subiype B ( 1 subtype B and 11B' ) strains were identified respectively.All of the 41 strains identified from former PBDs were infected by B' strains.The CRF01_AE strains identified in MSM showed a close relationship to those identified from both Hebei and Liaoning provinces.The CRF07 BC strains showed a close relationship with those from Shijiazhuang and Beijing cities.Among the 12 subtype B strains,8 sequences grouped into 1 cluster with 1 sequence from the former PBDs.Two sequences grouped with 02HNseq4 suggested that B' had been prevailed in the MSM population might come from the former PBDs and were closely related to the strains identified in the MSM population.Conclusion Complicated genetic background and multiple introductions of HIV in the MS population in Zhengzhou,were found.This was also the first report which noticed that the subtype B epidemic among Zhengzhou MSM was mainly originated from the B' among the former PBDs.

HIV-1 subtype and the distribution in Yunnan province / 中华流行病学杂志

Objective To understanding the genetic subtype and its population and regional distribution of HIV-1 strains circulating in Yunnan province.Methods 788 plasma specimens collected in 2008-2009 from 15 distracts of Yunnan,were enrolled.Viral RNA were extracted and subjected to RT-PCR.1584 bp full length gag gene,3147 bp full length pol gene and 558 bp env (C2V3) fragment were amplified and directly sequenced.Full length gag and pol genes were connected together as a complete genetic region (location on HXB2:790-5096) for genotyping.Results Of the 788 plasma specimens,a total number of 1728 genomic sequences including 599 gag,564 pol and 525 env (C2V3) were successfully amplified and sequenced,with genotype of 617 samples identified.The subtypes of HIV-1 strains circulated in Yunnan were with the order of constituent ratio CRF08_BC ( 50.2％ ),CRF01_AE (25.0％),unknown recombinant forms ( 10.2％ ),CRF07_BC (9.2％),subtype C (2.9％) and subtype B (B') (2.4％).The distributions of subtypes showed significant regional differences and could be roughly divided into two forms:the CRF08_BC predominant areas represented by Lincang and Kunming,and the areas with CRF08_BC together with CRF01_AE coexistence,represented by Dehong and Xishuangbanna.The unknown recombinant forms accounted for more HIV infection in ethnic minorities (17.0％) than in ethnic Han (6.7％,P＜0.01 ).The distribution of subtypes varied significantly in the two primary routes of transmission for those infected through heterosexual contact.CRF08_BC and CRF0 1_AE were the dominant subtypes,accounting for 52.7％ and 29.1％ respectively.However,in IDUs,CRF08_BC strains accounted for half of the infection,while only 4.5％ of the infections were caused by CRF01_AE,CRF07_BC while the unique recombinant forms were responsible for 15.5％ infections.Of the 63 unknown recombinant forms,most (74.6％) were B (B' ) recombinant with C,while 25％ were mosaic B and/or C fragments on the bases of CRF01_AE genome.Conclusion The subtypes of HIV-1 strains circulated in Yunnan were complicated under the significant differences of regions,ethnics or routes of transmission.

Risk factors of low back pain among the Chinese occupational population: a case-control study / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To explore the risk factors of low back pain among the Chinese occupational population in several major industries.</p><p><b>METHODS</b>A total of 7200 subjects (3600 cases and 3600 controls) were randomly sampled from a cross-sectional study, and they were investigated for individual and occupational factors of low back pain. The potential risk factors were first selected by using chi-square tests. Secondly, collinearity diagnosis proceeded by using the Kendall's rank correlation. Finally, binary logistic regression model was used for multi-factor analysis.</p><p><b>RESULTS</b>Collinearity diagnosis showed that there was a severe collinearity problem among the potential risk factors of low back pain. Logistic regression model included 20 variables with statistical significance. Bending neck forward or holding neck in a forward posture for long periods (OR=1.408) was the most important risk factor inducing low back pain in this study, followed by bending heavily with the trunk (OR=1.402), carrying out identical work almost for the whole day (OR=1.340). Additionally, sufficient normal break was a protective factor of low back pain.</p><p><b>CONCLUSION</b>Low back pain among the Chinese occupational population was associated with body height, occupation, work organization, physical work, working posture, and others. All these risk factors could be regarded as the indicators of low back pain, and some relevant preventive measures should be taken to reduce low back pain risk.</p>

Quantify work load and muscle functional activation patterns in neck-shoulder muscles of female sewing machine operators using surface electromyogram / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Work-related musculoskeletal disorders (WMSDs) have high prevalence in sewing machine operators employed in the garment industry. Long work duration, sustained low level work and precise hand work are the main risk factors of neck-shoulder disorders for sewing machine operators. Surface electromyogram (sEMG) offers a valuable tool to determine muscle activity (internal exposure) and quantify muscular load (external exposure). During sustained and/or repetitive muscle contractions, typical changes of muscle fatigue in sEMG, as an increase in amplitude or a decrease as a shift in spectrum towards lower frequencies, can be observed. In this paper, we measured and quantified the muscle load and muscular activity patterns of neck-shoulder muscles in female sewing machine operators during sustained sewing machine operating tasks using sEMG.</p><p><b>METHODS</b>A total of 18 healthy women sewing machine operators volunteered to participate in this study. Before their daily sewing machine operating task, we measured the maximal voluntary contractions (MVC) and 20%MVC of bilateral cervical erector spinae (CES) and upper trapezius (UT) respectively, then the sEMG signals of bilateral UT and CES were monitored and recorded continuously during 200 minutes of sustained sewing machine operating simultaneously which equals to 20 time windows with 10 minutes as one time window. After 200 minutes' work, we retest 20%MVC of four neck-shoulder muscles and recorded the sEMG signals. Linear analysis, including amplitude probability distribution frequency (APDF), amplitude analysis parameters such as roof mean square (RMS) and spectrum analysis parameter as median frequency (MF), were used to calculate and indicate muscle load and muscular activity of bilateral CES and UT.</p><p><b>RESULTS</b>During 200 minutes of sewing machine operating, the median load for the left cervical erector spinae (LCES), right cervical erector spinae (RCES), left upper trapezius (LUT) and right upper trapezius (RUT) were 6.78%MVE, 6.94%MVE, 6.47%MVE and 5.68%MVE, respectively. Work load of right muscles are significantly higher than that of the left muscles (P < 0.05); sEMG signal analysis of isometric contractions indicated that the amplitude value before operating was significantly higher than that of after work (P < 0.01), and the spectrum value of bilateral CES and UT were significantly lower than those of after work (P < 0.01); according to the sEMG signal data of 20 time windows, with operating time pass by, the muscle activity patterns of bilateral CES and UT showed dynamic changes, the maximal amplitude of LCES, RCES, LUT occurred at the 20th time window, RUT at 16th time window, spectrum analysis showed that the lower value happened at 7th, 16th, 20th time windows.</p><p><b>CONCLUSIONS</b>Female sewing machine operators were exposed to high sustained static load on bilateral neck-shoulder muscles; left neck and shoulder muscles were held in more static positions; the 7th, 16th, and 20th time windows were muscle fatigue period that ergonomics intervention can protocol at these periods.</p>

Development of China Musculoskeletal Questionnaire and item selection / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To develop a draft questionnaire (China Musculoskeletal Questionnaire, CMQ) for evaluating of musculoskeletal workload and associated potential hazardous working conditions as well as musculoskeletal symptoms of workers in Sitting Posture.</p><p><b>METHODS</b>Multi-methods, which include the reviewing references, the summarizing results of preliminary studies, the reviewing ergonomic tools, the consulting experts and occupational health workers and the interviewing or discussing with individual workers in sitting posture, were used in developing item pool. The experts and epidemiologists of occupational health scored the importance of every single item in the item pool, and then the survey and sampling were carried out in 325 workers of sitting posture who completed the questionnaire. On the basis of these data, the methods including experts scoring, item analysis, Cronbach's α analysis and factor analysis were synthetically used to select the reliable items which consisted of the formal questionnaire.</p><p><b>RESULTS</b>The standard of the CMQ, which consists of 34 items on musculoskeletal workload and associated potentially hazardous working conditions, can be divided into nine indices (dynamic loads, static loads, repetitive loads, forces-exertion, prolong time, climatic factors, vibration, position and ergonomic environmental factors).</p><p><b>CONCLUSION</b>The CMQ possesses good content validity, and the items of CMQ are divergent, reliable and typical. However, the reliability and validity of CMQ should be validated.</p>

A field study on the work load and muscle fatigue at neck-shoulder in female sewing machine operators by using surface electromyography / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To study neck and shoulder work-related muscle fatigue of female sewing machine operators.</p><p><b>METHODS</b>18 health female sewing machine operators without musculoskeletal disorders work in Beijing garment industry factory as volunteers in participate of this study. The maximal voluntary contraction (MVC) and 20% MVC of bilateral upper trapezium and cervical erectors spinae was tested before sewing operations, then the whole 20 time windows (1 time window = 10 min) sewing machine operations was monitored and the surface electromyography (sEMG) signals simultaneously was recorded after monitoring the 20%MVC was tested. Use amplitude analysis method to reduction recorded EMG signals.</p><p><b>RESULTS</b>During work, the median load for the left cervical erector spinae (LCES), right cervical erector spinae (RCES), left upper trapezium (LUT) and right upper trapezium (RUT) respectively was 6.78 ± 1.05, 6.94 ± 1.12, 5.68 ± 2.56 and 6.47 ± 3.22, work load of right is higher than the left; static load analysis indicated the value of RMS(20%MVC) before work was higher than that value after work, the increase of right CES and UT RMS(20%MVC) was more; the largest 20%MVE of bilateral CES occurred at 20th time window, and that of bilateral UT happened at 16th.</p><p><b>CONCLUSIONS</b>The work load of female sewing machine operators is sustained "static" load, and work load of right neck-shoulder is higher than left, right neck-shoulder muscle is more fatigable and much serious once fatigued.</p>

Studying on the prevalence and mutation pattern of N348I which related to the resistance of HIV-1 / 中华流行病学杂志

Objective To elucidate the prevalence and the mutation pattern of N348I that related to the resistance seen in the AIDS patients, in China. Methods Partial pol gene of HIV-1 comprising of full protease (PR) and reverse transeriptase (RT) was obtained from plasma samples of therapy-failure individuals (n=614) and therapy-naive individuals (n=619) by using reverse transcription polymerase chain reaction(RT-PCR). 1233 sequences were then submitted to the HIV-1 drug resistance database of the Stanford University to analyze the prevalence and the emergence pattern of N348I. Results The prevalence of N348I was 6.5％ in the therapy-failure patients and 0.8％ in the naive individuals, respectively. The prevalence of N348I was more popular among those patients whose ART regimens containing zidovudine (AZT or ZDV) than those without AZT in regimens( 14.1％ vs. 4.7％, x2=10.21, P＜0.01 ). N3481 always emerged, and combined with others mutations among patients of ART, whose frequencies were: 85.0％ in combination with thymidine analog mutations (TAMs) and 52.5％ with M184V/I, respectively. Conclusion N348I was somehow prevalent in the therapy-failure patients when using the first-line antiretroviral drugs,and it emerged as unique patterns. This study laid the ground in improving the techaology of drug resistance genotypes detection and providing theoretical basis to study the mechanism of resistance and the law of molecular evolution.

Comparison between recombinant virus assay and live virus assay on evaluating anti-HIV-1 drugs / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To compaire results of recombinant virus assay and live virus assay on evaluateing anti-HIV-1 drugs.</p><p><b>METHODS</b>The pseudoviruse was generated by cotransfection of the plasmid B01 containing gp160 genes and pSG3 delta env plasmid. After co-incubation of pseudovirus with serially diluted drug, the EC50 and ED50 were calculated according to RLU(relative light unit) for each drug. After co-incubation of live virus with serially diluted drug, the EC50 was calculated according to cytopathic effect.</p><p><b>RESULTS</b>EC50 of IDV measured by the recombinant virus assay and live virus assay was 88.9 nmol/L, 89.5 nmol/L, respectively, while EC50 of NVP measured by the recombinant virus assay and live virus assay was 0.36 micromol/L, 0.23 micromol/L, respectively. The recombinant virus assay showed good reproducibility with coefficient variation of 0, however coefficient variation of live virus assay reached to 60%. ED50 of IDV and NVP measured by the recombinant virus assay were 70.6 nmol/L and 0.62 micromol/L, respectively. Coefficient variations for IDV and NVP were 14.3% and 9.7%, respectively.</p><p><b>CONCLUSION</b>The pseudoviruses could be used in evaluating anti-HIV-1 drugs. The recombinant virus assay showed good reproducibility and could calculate not only the EC50 but also the ED50 of drugs.</p>

Screening program on novel drug resistance mutations of subtype B' in human immunodeficiency virus type 1 in China / 中华流行病学杂志

Objective To screen the level of novel drug resistance mutations in subtype B' in China. Methods 451 pol sequences collected from the previous study, which including 354 AIDS patients who had received antiretroviral treatment(ART)and 97 the untreated patients. Entire protease gene(codous 1-99)and full-length reverse transcriptase gene(codons 1-560)were included.Variation of mutations between the treated and the untreated patients with consensus/ancestral sequences were compared and the mutations with higher frequencies in the treated patients than in the untreated patients were screened before submitting the mutations to the Stanford HIV Drug Resistance Database(SHDB)(http://hivdb.stanford.edu/). Relation between the mutations and resistance preliminarily was then analyzed, according to the information including SHDB. Results Frequencies of 7 mutations at 6 positions, DI23E, V292I, K366R, T369A, T369V, A371V and 1375V, 2 at DNA polymerase domain and 5 at connection domain of reverse transcriptase(RT)were higher in the treated patients than in the untreated patients. The information of 7 mutations including the SHDB showed that 7 mutations were major variants at corresponding positions, and theirs frequencies were higher in the treated patients using some drugs, than in the untreated patients. Conclusion 7mutations being screened from the China subtype B were possibly associated with the resistance,which called for the construction of mutated viruses by site-directed mutagenesis to identify their effects on the susceptivity of different drugs.

Antiviral effect of lamivudine on HIV-1 targeting MT2 cells influenced by morphine / 中华流行病学杂志

Objective To determine whether morphine having the ability to influence the antiviral effect of lamivudine(3TC)in vitro study.Methods MT2 cells were randomly assigned into morphine+3TC treatment group,morphine+naloxone+3TC treatment group,naloxone+3TC treatment group.Both 3TC and virus control groups were set up.The corresponding MT2 cells were treated with opiates antagonist(naloxone)for 0.5 hours before the 24-hours morphine treatment program was implemented while all of the groups were then infected with equal amounts of cell-free HIV-1 ⅢB strain and 3TC.HIV-1 p24 antigen in culture supernatants collected at days 3,4,5 and 6after infection status was tested and the inhibition of 3TC anti-HIV-1 p24 antigen of various treatment groups calculated.Results Inhibition of 3TC anti-HIV-1 p24 antigen of Morphine+3TC treatment group was the lowest when HIV-1 infected cells at 3rd and 4th day and showed significant difierence (P<0.05)when compared to the 3TC control.However,there was no statistically significant difference among them(P>0.05),when virus was infected the cells at 5th and 6th day.The difference of 3TC anti-HIV-1 p24 antigen inhibition between the morphine+naloxone+3TC treatment group and the naloxone+3TC treatment group was not significant(P>0.05).Similar results were obtained when these two groups were compared to the 3TC control group(P>0.05),respectively.The 3TC anti-HIV-1 p24 antigen inhibition of each treatment group reduced as the time of infection prolonged,showing a significant and time-course effbct.Conclusion The 3TC antiviral effect was reduced by morphine in the early stage of infection,and could be blocked by naloxone.

Evaluation on HIV antibody testing strategy currently used in China / 中华流行病学杂志

Objective To evaluate the yield of HIV antibody testing strategy currently used on different populations, in China. Methods (1) The following samples were collected and tested according to the currently used HIV antibody testing strategy in China. 103 133 samples from the general populations (outpatients, new recruits and blood donors), 1276 people under high risk (spouses of the HIV infected individuals, intravenous drug users) and 2323 biochemical or immunological abnormal samples. (2) Retrospective analysis was done on data from the HIV testing among outpatients in General Hospital of People's Armed Police Forces, from Jan., 2002 to Dec.,2008 and in three provincial central HIV test and confirmatory laboratories. Results (1) The yields of HIV antibody screening were significantly different in different populations. The probability of screening reactive to be true positive was 50% in high risk population, significantly higher than in the general population. The probability of screening reactive to be true positive was 19.58% in the confirmatory laboratory mainly towards the general population, but significantly lower than results from the confirmatory laboratories done on the high risk population. (2) From 2002 to 2008, in the General Hospital of People's Armed Police Forces, the probability of screening reactive to be true positive in the clinical HIV test was increasing from 3.7% to 16.0%, where as the efficiency of the repeat screening testing decreased from 92.6% to 61.5%. Conclusion The predictive value of HIV antibody screening reactive was significantly greater in high risk population than in general population. The precision of HIV antibody initial screening was substantially increased with the improvement of HIV antibody test kits and of quality control in the HIV test laboratories in recent years. It is suggested that different HIV test strategies to be implemented in different populations.

Allele-specific real-time PCR testing for minor HIV-1 drug resistance mutations: assay preparation and application to reveal dynamic of mutations in vivo / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>It is very important for the clinical management to test for minor HIV-1 resistance mutations accurately and sensitively. The conventional genotypic assays of HIV drug resistance detection based on sequencing can only discriminate the mutations which present in more than 20% - 30%. The aim of this study was to evaluate allele-specific real-time PCR (ASPCR) to detect the resistance-related mutations located at positions 103, 184 and 215.</p><p><b>METHODS</b>We developed the allele-specific PCR assay, using the most common drug resistance mutations in Chinese AIDS patients, K103N, M184V/I, T215F/Y as a model system. The standards were constructed by cloning the wild-type and mutant DNA fragments into the T-vector. We designed specific primers to discriminate mutant templates in the real-time PCR using SYBR green as a fluorescence reporter. And then we evaluated the ASPCR assay and tested 140 clinical samples using this method.</p><p><b>RESULTS</b>The sensitivities of ASPCR assay were 0.04% for K103N, 0.30% for M184I, 0.40% for M184V, 0.03% for T215F and 0.02% for T215Y. The intra-assay and inter-assay coefficients of variation were less than 0.42. One hundred and forty plasma samples were tested by ASPCR and dynamic resistance curves of ten patients were obtained.</p><p><b>CONCLUSIONS</b>Drug resistance emerged half a year after the start of antiretroviral therapy. The mutation of T215Y emerged 1 to 1.5 years after starting treatment and then increased rapidly. The ASPCR assay we developed was a sensitive, accurate and rapid method to detect the minor HIV-1 variants and it can provide earlier and more drug-resistance information for HIV research and AIDS antiretroviral therapy.</p>

In vitro selection and identification of HIV strain which is resistance to two new HIV-1 nonnucleoside reverse transcriptase inhibitors / 药学学报

JB25 and JB26 are new HIV-1 nonnucleoside reverse transcriptase inhibitors, and show potent anti-HIV activities. Sequential passage experiments with wild-type virus were performed to select and identify mutations induced by these two compounds in vitro. For the initial passage, compounds were present at approximately 2-fold IC50 in MT-2 cells. When cytopathic effect (CPE) was observed in more than 75% of the cells, the culture supernatants were collected. For the subsequent passages, fresh MT-2 cells were infected with 1 mL supernatants from the previous passage (regardless of the virus titer) and cultured in the presence of the compounds at concentrations that were increased 2-fold compared with that in the previous passage. This procedure was repeated with increasing concentrations for 12 passages. JB25 had amino acid substitution L100I (TTA-->ATA) at passage 6, and then changed into 100 M (ATA-->ATG) at passage 12, which was rare mutation form and had not been reported. At the same time, Y188C (TAT-->TGT) mutation appeared at passage 10. For JB26, there was a L100I (TTA-->ATA) mutation at passage 10. In a word, JB25 and JB26 showed a low genetic barrier to the development of resistance, and the resistance to JB26 developed slower than JB25. The mutations selected by JB25 and JB26 were mainly associated with codons 188 and 100 of HIV-1 reverse transcriptase.