Clinical characteristics and short-term prognosis of 22 cases with SARS-CoV-2 infection associated acute encephalopathy / 中华儿科杂志

Objective: To investigate the clinical features and short-term prognosis of patients with SARS-CoV-2 infection associated acute encephalopathy (AE). Methods: Retrospective cohort study. The clinical data, radiological features and short-term follow-up of 22 cases diagnosed with SARS-CoV-2 infection associated AE in the Department of Neurology, Beijing Children's Hospital from December 2022 to January 2023 were retrospectively analyzed. The patients were divided into cytokine storm group, excitotoxic brain damage group and unclassified encephalopathy group according to the the clinicopathological features and the imaging features. The clinical characteristics of each group were analyzed descriptively. Patients were divided into good prognosis group (≤2 scores) and poor prognosis group (>2 scores) based on the modified Rankin scale (mRS) score of the last follow-up. Fisher exact test or Mann-Whitney U test was used to compare the two groups. Results: A total of 22 cases (12 females, 10 males) were included. The age of onset was 3.3 (1.7, 8.6) years. There were 11 cases (50%) with abnormal medical history, and 4 cases with abnormal family history. All the enrolled patients had fever as the initial clinical symptom, and 21 cases (95%) developed neurological symptoms within 24 hours after fever. The onset of neurological symptoms included convulsions (17 cases) and disturbance of consciousness (5 cases). There were 22 cases of encephalopathy, 20 cases of convulsions, 14 cases of speech disorders, 8 cases of involuntary movements and 3 cases of ataxia during the course of the disease. Clinical classification included 3 cases in the cytokine storm group, all with acute necrotizing encephalopathy (ANE); 9 cases in the excitotoxicity group, 8 cases with acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) and 1 case with hemiconvulsion-hemiplegia syndrome; and 10 cases of unclassified encephalopathy. Laboratory studies revealed elevated glutathione transaminase in 9 cases, elevated glutamic alanine transaminase in 4 cases, elevated blood glucose in 3 cases, and elevated D-dimer in 3 cases. Serum ferritin was elevated in 3 of 5 cases, serum and cerebrospinal fluid (CSF) neurofilament light chain protein was elevated in 5 of 9 cases, serum cytokines were elevated in 7 of 18 cases, and CSF cytokines were elevated in 7 of 8 cases. Cranial imaging abnormalities were noted in 18 cases, including bilateral symmetric lesions in 3 ANE cases and "bright tree appearance" in 8 AESD cases. All 22 cases received symptomatic treatment and immunotherapy (intravenous immunoglobulin or glucocorticosteroids), and 1 ANE patient received tocilizumab. The follow-up time was 50 (43, 53) d, and 10 patients had a good prognosis and 12 patients had a poor prognosis. No statistically significant differences were found between the two groups in terms of epidemiology, clinical manifestations, biochemical indices, and duration of illness to initiate immunotherapy (all P>0.05). Conclusions: SARS-CoV-2 infection is also a major cause of AE. AESD and ANE are the common AE syndromes. Therefore, it is crucial to identify AE patients with fever, convulsions, and impaired consciousness, and apply aggressive therapy as early as possible.

A cohort study of incidence of club drug abuse in men who have sex with men in Qingdao / 中华流行病学杂志

Objective: To understand and analyze the incidence of club drug abuse and influencing factors in men who have sex with men (MSM) in Qingdao, and provide reference for the AIDS prevention and intervention in this population. Methods: From March 2017 to July 31, 2022, MSM who did not abuse club drug were recruited by snowball sampling of MSM social organizations in Qingdao, a prospective cohort was established, and a follow-up survey was conducted every 6 months. The survey collected the information about the MSM's demographic characteristics, sexual characteristics, club drug abuse and others. The incidence of club drug abuse was the outcome dependent variable and the interval between the recruitment into the cohort and the incidence of club drug abuse was the time dependent variable. Cox regression analysis was conducted to identify the influencing factors for club drug abuse. Results: A total of 509 MSM were recruited at baseline survey, and 369 eligible MSM were enrolled in this cohort. A total of 62 MSM began to abuse club drug during the study period, and the cumulative follow-up time was 911.54 person-years, the incidence of club drug abuse was 6.80/100 person-years. All the club drug abusers shared drugs with others in the first club drug abuse, and 16.13% (10/62) had mix-use of club drugs. The multivariate Cox proportional risk regression analysis showed that being students (aHR=2.17, 95%CI: 1.15-4.10), receiving no HIV testing or receiving 1 HIV testing during past 6 months (aHR=4.57, 95%CI:1.80-11.60; aHR=5.15, 95%CI: 2.83-9.36), having sex only with regular sexual partners during past 6 months (aHR=4.75,95%CI:2.32-9.75), having more than 4 homosexual partners (aHR=1.70, 95%CI:1.01-2.87) and abuse of club drug of sexual partners during past 6 months (aHR=12.78, 95%CI:3.06-53.35) were significantly associated with club drug abuse in the MSM. Conclusions: The incidence of club drug abuse was at a high level in the MSM cohort in Qingdao, indicating a high risk for HIV infection. Being student, receiving less HIV testing, having sex only with regular sexual partners, having more homosexual partners and abuse of club drug of sexual partners during past 6 months were risk factors for the incidence of club drug abuse in the MSM. Targeted surveillance and intervention measures should be strengthened to reduce the risk of club drug abuse in MSM.

HIV self-testing and related factors in men who have sex with men in Shijiazhuang / 中华流行病学杂志

Objective: To understand HIV self-testing and related factors in men who have sex with men (MSM) in Shijiazhuang. Methods: From August to September 2020, convenient sampling was used to recruit MSM in Shijiazhuang. Online questionnaires were used to collect information about their demographic characteristics, sexual behaviors and HIV self-testing. logistic regression model was used to analyze the related factors associated with HIV self-testing. Results: In the 304 MSM respondents, 52.3% (159/304) had HIV self-testing in the past 6 months, and 95.0% (151/159) used fingertip blood HIV detection reagent. Self-purchase was the main way to obtain HIV testing reagents (45.9%, 73/159), followed by supply from MSM social organization (44.7%, 71/159). The reasons for having HIV self-testing were non-specific testing time (67.9%, 108/159) and privacy protection (62.9%,100/159), the reasons for having no HIV self-testing included inability of using (32.4%, 47/145), being unaware of HIV self-testing reagent (24.1%, 35/145), and worry about inaccurate self-testing results (19.3%, 28/145). Multivariate logistic regression analysis showed that being 18-29 years old (aOR=2.68, 95%CI: 1.20-5.94), obtaining free HIV self-testing kits in recent 6 months (aOR=8.61, 95%CI: 4.09-18.11) and making friends through Internet and social software (aOR=2.68, 95%CI: 1.48-4.88) were positive factors for having HIV self-testing. Conclusion: HIV self-testing is a more flexible and convenient way to detect HIV in MSM, and the promotion of HIV self-testing in MSM should be strengthened to further increase the HIV detection rate in this population.

Schisandra chinensis Oil Attenuates Aristolochic Acid I-Induced Nephrotoxicity in vivo and in vitro / 中国结合医学杂志

OBJECTIVE@#To investigate the protective effects of Schisandra chinensis oil (SCEO) against aristolochic acid I (AA I)-induced nephrotoxicity in vivo and in vitro and elucidate the underlying mechanism.@*METHODS@#C57BL/6 mice were randomly divided into 5 groups according to a random number table, including control group, AA I group, and AA I +SCEO (0.25, 0.5 and 1 g/kg) groups (n=5 per group). Pretreatment with SCEO was done for 2 days by oral administration, while the control and AA I groups were treated with sodium carboxymethyl cellulose. Mice of all groups except for the control group were injected intraperitoneally with AA I (5 mg/kg) from day 3 until day 7. Histopathological examination and apoptosis of kidney tissue were observed by hematoxylin and eosin and TdT-mediated dUTP nick-end labeling (TUNEL) staining, respectively. The levels of serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood urea nitrogen (BUN), and serum creatinine (SCr), as well as renal malondialdehyde (MDA), glutathione, r-glutamyl cysteingl+glycine (GSH), and superoxide dismutase (SOD) were analyzed using enzyme-linked immunosorbent assay (ELISA). Expressions of hepatic cytochrome P450 1A1 (CYP1A1), CYP1A2, and nad(p)hquinonedehydrogenase1 (NQO1) were analyzed using ELISA, quantitative real-time polymerase chain reaction (qPCR) and Western blot, respectively. In vitro, SCEO (40 µ g/mL) was added 12 h before treatment with AA I (40 µ mol/mL for 48 h) in human renal proximal tubule cell line (HK-2), then apoptosis and reactive oxygen species (ROS) were analyzed by flow cytometry.@*RESULTS@#SCEO 0.5 and 1 g/kg ameliorated histopathological changes and TUNEL+ staining in the kidney tissues of mice with AA I-induced nephrotoxicity, and reduced serum levels of ALT, AST, BUN and SCr (P<0.01 or P<0.05). SCEO 0.5 and 1 g/kg alleviated the ROS generation in kidney, containing MDA, GSH and SOD (P<0.01 or P<0.05). SCEO 1 g/kg increased the expressions of CYP1A1 and CYP1A2 and decreased NQO1 level in the liver tissues (P<0.01 or P<0.05). Besides, in vitro studies also demonstrated that SCEO 40 µ g/mL inhibited apoptosis and ROS generation (P<0.05 or P<0.01).@*CONCLUSIONS@#SCEO can alleviate AA I-induced kidney damage both in vivo and in vitro. The protective mechanism may be closely related to the regulation of metabolic enzymes, thereby inhibiting apoptosis and ROS production.

Landscape of Hepatobiliary Adverse Drug Reactions Related to Preparations Containing Psoraleae Fructus and Its Application in Pharmacovigilance / 中国结合医学杂志

OBJECTIVE@#To analyze clinical feature and information of medication to explore the risk signals of preparations containing Psoraleae Fructus (BGZP) related with hepatobiliary adverse drug reactions (ADR), in order to reinforce pharmacovigilance.@*METHODS@#A retrospective study was conducted based on hepatobiliary ADR related with BGZP from the China Adverse Drug Reaction Monitoring System in years from January 2012 to December 2016. Serious and general ADRs were analyzed and assessed.@*RESULTS@#There were 355 cases of hepatobiliary ADR related to BGZP. Both the amount of cases and the proportion of serious ADR showed an increasing growth by years (P<0.05). It was found that 10.43% of 355 cases may be involved with irrational drug use, including overdose, repeated medication, and combination of multiple drugs. There were 190 cases which used BGZP (non-combination), and they were mainly for common in diseases caused by abnormal immune activation (accounting for 40.53% of the total cases). Especially at the age group with the most cases with age of 41-50 years, the cases associated with immunological diseases of female were obviously more than that of male (P<0.05). The latency of hepatobiliary ADR related to BGZP ranged from 1 to 386 days, and the median latency was 27.5 days, along with the range of cumulative dose (0.45-520.02 g) as well as the daily dose (0.09-2.64 g/d) after the conversion.@*CONCLUSIONS@#Cases of hepatobiliary ADR related to BGZP showed significant individual differences, and there was no correlation between drug usage duration and dosage and the occurrence of hepatobiliary ADR. It may be similar with idiosyncratic drug-induced liver injury, and recommended that BGZP should be used with more caution under monitoring liver function, especially in female patients with immunological diseases.

Effect of Modified Yiweitang on Fatigue Symptom of Primary Sjörgren′s Syndrome / 中国实验方剂学杂志

Objective:To observe the effect of modified Yiweitang on fatigue symptom and immunological indicators in primary Sjörgren′s Syndrome (pSS). Method:By random, control, single-blind method, 116 cases of patients with pSS were divided into treatment group and control group, with 58 cases in each group. The treatment group was given modified Yiweitang, a dose a day, twice a day， and the control group was given hydroxychloroquine sulfate (HCQ) 200 mg/time, twice a day. The treatment lasted for six months. Visual analogue scale (VAS) of fatigue symptoms, total traditional Chinese medicine (TCM) syndrome score, TCM fatigue score, rheumatoid factor (RF) and serum immunoglobulin G (IgG) were used to compare two groups before and after treatment. Result:After treatment, the treatment group had a better efficacy on TCM syndromes than control group (Z=3.712, P<0.05). After treatment, the treatment group were superior to control group in improvement of TCM fatigue score and VAS score of fatigue symptom (P<0.05). After 6 months of treatment, IgG level in treatment group decreased significantly compared with before treatment, with statistical differences (P<0.05), but no difference between treatment group and control group. After treatment, RF in two groups showed no significant decrease compared with before treatment. The incidence of adverse reactions in the treatment group and the control group were 1.75%（1/57） and 25.49%（13/51）, respectively. Conclusion:Compared with HCQ, modified Yiweitang can significantly alleviate fatigue and overall symptoms of patients of pSS, both of which can reduce serum IgG, and the efficacy of modified Yiweitang is more obvious than hydroxychloroquine sulfate. Both drugs had no significant effect on RF level of pSS patients. After long-term administration, modified Yiweitang is safer than hydroxychloroquine sulfate in the treatment of pSS.

Analysis of epidemiological characteristics of drug induced liver injury associated with Baixianpi Preparations / 中国中药杂志

A retrospective study was performed in drug-induced liver injury(DILI) cases associated with Dictamni Cortex(Baixianpi,BXP) Preparations,which were treated at grade Ⅲ class A liver disease hospitals from 2008 to 2016 and spontaneously reported for adverse reactions between 2012 and 2016 at HILI Cloud(hilicloud.net). The results showed 25 DLII cases associated with BXP Preparations treated at grade Ⅲ class A liver disease hospitals during the 9 years,including only 14 cases in line with the clinical diagnostic criteria of Guidelines for the Diagnosis and Treatment of Herb-Induced Liver Injury. And 74 DILI cases associated with BXP Preparations spontaneously reports adverse reactions,and 18. 92% of them had unreasonable medication,including polypharmacy(21. 43%),overdose(28. 57%) and repeated dosage(50%). And 47 DILI cases used BXP Preparations to treat psoriasis and vitiligo(a total of59. 57%). The time range of taking BXP Preparations until liver injury occurred was 1-366 d,with the median of 18 d. The dose of BXP Preparations was estimated to be 0. 09-12 g·d-1. And the cumulative dosage of taking drugs until liver injury occurred was 1. 1-336 g. Obvious associations with time-toxicity as well as quantity-toxicity could not be found based on the wide range of time-toxicity relations and quantity-toxicity relations. On the basis of the study,we found that DILI cases associated with BXP Preparations commonly occurred in patients with immune diseases,such as psoriasis and vitiligo,indicating specific individual differences. The results suggested that DILI cases associated with BXP Preparations would be correlated with the property of idiosyncratic drug-induced liver injury. In conclusion,the risk of liver injury clinically caused by BXP Preparations should be paid more attention,and the studies on the mechanism of idiosyncratic drug-induced liver injury must be enhanced,and those on risk factors,like irrational drug use,should be strengthened. Moreover,the evaluation of the risk-to-benefit ratio is supposed to be performed for the sake of improving the risk prevention and control standards for BXP preparations,and ensuring safe and rational clinical application of BXP Preparations.

Regularity of prescription and medication of Jiang Quan in treating rheumatoid arthritis / 中国中药杂志

The data mining method was used to analyze and summarize the prescription and medicate regularities of chief physician Jiang Quan in the treatment of rheumatoid arthritis,in order to provide references for the clinical treatment of rheumatoid arthritis. Totally 121 prescriptions of rheumatoid arthritis treated by chief physician Jiang Quan from 2007 to 2017 were collected and input into the Chinese medicine inheritance auxiliary system. The " prescription statistics" function of the software " statistical report" system,and the " prescription analysis" function of the " data analysis" system,the data mining methods such as rule analysis,integration correlation,complex system entropy clustering,and unsupervised entropy hierarchical clustering,were used to analyze the prescription regularity of chief physician Jiang Quan. A total of 121 prescriptions were included,involving 144 herbs,in which 30 herbs had a higher frequency of more than 20 times,20 two-herb combinations had a frequency of more than 59 times; after evolution,14 core combinations and 7 new prescriptions were obtained. Among the prescriptions in the treatment of rheumatoid arthritis,those for clearing heat and dampness,promoting blood circulation and removing blood stasis had a higher frequency,and the core prescriptions were modified " Qingre Huoxue Decoction" and modified " Ermiao Pills". The newly evolved prescriptions not only reflected director Jiang Quan' s method of treating rheumatoid arthritis by clearing away heat and dampness and promoting blood circulation by the,but also included the treatment methods of removing wind and removing dampness,dredging collaterals and removing phlegm,nourishing Yin and clearing heat,nourishing Yin and nourishing kidney,nourishing blood and nourishing Qi. The method can be used to analyze the pathogenetic changes of the mutual knot of phlegm and blood stasis,injury of Qi and blood,long-term implication on liver and kidney. At the same time,it also reflects the treatment principles of treating phlegm and strengthening the evil.

Analysis on condom use negotiation with sex partners and condom use in female sex workers / 中华流行病学杂志

Objective@#To know condom use negotiation with clients and regular sex partners and condom use in female sex workers (FSWs), and provide reference for the development of comprehensive HIV/AIDS intervention for FSWs.@*Methods@#The cross sectional survey was conducted in Jianshui county and Mengzi county in Honghe Hani and Yi autonomous prefecture. A total of 476 FSWs aged 16 years and above were recruited from entertainment venues, and the information about their demographic characteristics, condom use negotiation and condom use were collected by using questionnaires. Logistic regression model was used to analyze related factors of condom use after negotiation between FSWs and clients unwilling use condom.@*Results@#A total of 852 FSWs who aged (24.29±8.44) years old participated in the survey. In past month, 499 FSWs had negotiation for condom use with unwilling clients (58.6%, 499/852), after negotiation, 441 FSWs (88.4%, 441/499) had consistent condom use in each sex with the clients. In the past one month, 99 FSWs had negotiation for unwilling use condom with regular sex partners (14.4%, 99/687), after negotiation, 54 FSWs (54.5%, 54/99) had consistent condom use in each sex with regular sex partners. Among the FSWs, 266 (53.3%, 266/499) reported that they could say "It is a mandatory requirement" to persuade clients who were unwilling to use condom. 97(19.4%, 97/499) reported that they could say "There is risk for infection" to persuade clients who were unwilling to use condoms. 115 (23.1%,115/499) reported that they could say "It is a mandatory requirement" and "there is risk for infection" to persuade their unwilling clients to use condoms. 21 (4.2%, 21/499) reported that they used other strategies. 22 (4.4%, 22/499) felt that it was difficult to persuade clients to use condoms. Multivariate logistic regression analysis showed that compared with FSWs who felt difficult in persuading clients to use condoms, FSWs who felt moderate difficulty were more likely to have consistent condom use after negotiation (OR=4.00, 95%CI: 1.55-10.32) and FSWs who felt easy in persuading clients to use condoms were also more likely to have consistent condom use (OR=30.17, 95%CI: 3.22-282.44). Compared with FSWs used other strategies to persuade their clients to use condoms, FSWs who said it was a mandatory requirement were more likely to have consistent condom use after negotiation (OR=4.44, 95%CI: 1.41-14.01) and FSWs who said it was a mandatory requirement and there was risk for infection were also more likely to have consistent condom use (OR=5.52, 95%CI: 1.55-19.73).@*Conclusions@#Negotiation for condom use increased the rate of condom use in FSWs in sex with clients who were unwilling to use condom. The negotiation strategy of "It is a mandatory requirement" would promote condom use in FSWs in sex with clients who were unwilling to use condom. Besides, the negotiation strategy of saying "there is risk for infection" had additional effects.

Study on the prevalence of HIV infection and related risk behaviors among male new-type drug users in Qingdao, Shandong province / 中华流行病学杂志

Objective To understand the characteristics of new-type drug consumption,sexual behaviors and the prevalence of HIV infection among male new-type drug users in Qingdao,Shandong province.Methods A cross sectional survey was conducted from 2015 to 2016.Participants were recruited from MSM community-based organizations (CBO) and general community through snowball method,relying on volunteers and male peer educators who were on new-type drugs themselves.Face-to-face interview was carried to collect information on drug use and sexual behaviors.Blood samples were collected to test HIV,syphilis and HCV antibodies.Urine samples were collected to test the evidence of new-type drugs.Qualitative variables and quantitative variables were analyzed using Chi-square test/Fisher's exact test and Student's t-test respectively.Multivariate logistic regression was used to analyze related factors of binary variables.Results A total of 1 034 new-type drug users were recruited,including 431 (41.7％) MSM population and 603 (58.3％) who were not MSM.Compared with the the group of people who were not MSM,people in the the MSM group were younger,unmarried and with higher level of education.The proportion of methamphetamine users were 49.7％ (214/431) and 100.0％ (603/603) among the groups of MSM or not MSM,respectively.People in the MSM group,66.8％ (288/431) used 5-Methoxy-N,N-diisopropyltryptamine (5-MeO-DIPT,"foxy") in the last six months.However,none from the not-MSM group ever used 5-MeO-DIPT.In the last six months,proportions of sharing new-type drugs with more than two people in the MSM or not groups were 87.9％ (379/431) and 97.7％ (588/602),respectively (x2=39.84,P＜0.01).Proportions of unprotected sexual behavior among the MSM or not groups were 47.5％ (285/600) and 7.4％ (32/430) respectively (x2=190.10,P＜0.01).The proportions of ‘group sex’ after using drugs among the two groups were 78.1％ (335/429) and 5.5％ (33/600) respectively (x2=573.73,P＜0.01).The prevalence rates of HIV,syphilis and HCV antibody positive among the MSM or not groups were 2.1％ and 0.2％,3.3％ and 6.3％,0.0％ and 0.3％,respectively.Conclusion The prevalence of sharing new-type drugs with more than two people was high among male new-type drug users in Qingdao city.Male new-type-drug-users who were MSM,presented both high prevalence of group sex and HIV infection,and with less condom use.Intervention measures towards this sub-population should be strengthened.

Prevalence of HIV infection and syphilis and related behaviors in clients in Ya'an of Sichuan province / 中华流行病学杂志

Objective To understand the prevalence of HIV infection and syphilis in clients in Ya'an of Sichuan province.Methods A survey was conducted in clients recruited through snowball method in Ya'an of Sichuan from April 2014 to December 2015.The information of the clients,including basic demography characteristics,AIDS knowledge awareness,high-risk behaviors and others,were collected through face-to-face interviews.Blood sample (5 ml) was taken from each client to test antibodies against HIV and syphilis.Statistical software SPSS 18.0 was used for data analysis.Results Among the 708 clients,the constituent ratio of those aged ≥50 years was 51.27％ (363/708),those in Han ethnic group was 99.72％ (706/708),those with junior high school educational level or below was 90.11％ (638/708),those who got married or cohabitated with others was 74.15％ (525/708),and those who used condoms at each sex was 27.40％ (194/708).Seven HIV positive cases were detected and 4 cases were aged ≥50 years.Seven syphilis cases were detected and all the cases were aged ≥ 50 year.No HIV-syphilis co-infection case was detected.The prevalence of HIV infection and syphilis were all 0.99％ (95％CI:0.30％-1.70％).Results from the multivariate logistic regression analysis showed that the clients who had their first commercial sex behavior at age ＜30 years (OR=6.61,95％CI:1.09-40.18) would have higher HIV positive rate.Conclusion The rate of condom use was low in the clients in Ya'an and they didn't pay enough attention to their self-protection in sexual activities.Especially the clients aged ≥50 years were with low educational level and had high risk commercial sexual behaviors for HIV infection and syphilis.Close attention needs to be paid to them.

A preliminary study of the difference in composition of intestinal bifidobacteria between healthy infants and infants with allergic diseases / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the association between intestinal bifidobacteria and allergic diseases in infants by comparing the composition of intestinal bifidobacteria between healthy infants and infants with allergic diseases.</p><p><b>METHODS</b>A total of 48 infants were enrolled, and fecal samples were collected on days 0, 2, 7, and 15 and at months 1, 6, and 12 after birth. Among these infants, 22 who experienced allergic diseases before the age of 1 year were enrolled as allergic group and 26 healthy infants were enrolled as healthy group. Quantitative real-time PCR was used for the qualitative and quantitative analyses of Bifidobacterium and 8 species of bifidobacteria in fecal samples.</p><p><b>RESULTS</b>There was a difference in the composition of intestinal bifidobacteria between the two groups within 1 month after birth: the healthy group showed a reduction in bifidobacteria on day 2, while this feature was not observed in the allergic group. Compared with the healthy group, the allergic group had a significantly lower detection count of Bifidobacterium at month 1 (P<0.05) and a significantly lower detection rate of B.breve on day 15 (P<0.05), with delayed colonization of B.infantis.</p><p><b>CONCLUSIONS</b>Intestinal bifidobacteria and their composition within 1 month after birth may be associated with the development of allergic diseases, and this period of time may be a critical period for the prevention and treatment of allergic diseases in infants.</p>

Effect of paclitaxel liposomes scheme combined with bevacizumab in the treatment of advanced gastric cancer and its influence on immune function / 中国基层医药

Objective@#To explore the effect of paclitaxel liposomes scheme combined with bevacizumab in the treatment of advanced gastric cancer and its effect on immune function.@*Methods@#A total of 90 patients with middle-late gastric cancer were selected, and they were randomly divided into control group and observation group according to the digital table, with 45 cases in each group.The control group was given paclitaxel liposome combined with capecitabine chemotherapy, and the observation group was treated with beacizumab on the basis of the control group.The clinical curative effect, incidence rate of adverse reaction, quality of life(QL-index) score and immune function change were compared between the two groups.@*Results@#The total effective rate of the observation group was 64.44%, which was significantly higher than 51.11% of the control group (χ2=7.67, P<0.05). Compared with before treatment, the quality of life scores in the two groups after treatment were improved(all P<0.05), which in the observation group were improved more significantly compared with the control group(t=5.89, P<0.05). Compared with before treatment, the CD3+ , CD4+ , CD8+ levels in the two groups after treatment were reduced(all P<0.05), which in the observation group were reduced more significantly compared with the control group(t=3.35, 4.25, 3.78, all P<0.05).@*Conclusion@#The paclitaxel liposomes scheme combined with bevacizumab in the treatment of advanced gastric cancer is prominent and safe, which can promote the quality of life of patients and improve the immune function.

Study on the prevalence of HIV infection and related risk behaviors among male new-type drug users in Qingdao, Shandong province / 中华流行病学杂志

Objective To understand the characteristics of new-type drug consumption,sexual behaviors and the prevalence of HIV infection among male new-type drug users in Qingdao,Shandong province.Methods A cross sectional survey was conducted from 2015 to 2016.Participants were recruited from MSM community-based organizations (CBO) and general community through snowball method,relying on volunteers and male peer educators who were on new-type drugs themselves.Face-to-face interview was carried to collect information on drug use and sexual behaviors.Blood samples were collected to test HIV,syphilis and HCV antibodies.Urine samples were collected to test the evidence of new-type drugs.Qualitative variables and quantitative variables were analyzed using Chi-square test/Fisher's exact test and Student's t-test respectively.Multivariate logistic regression was used to analyze related factors of binary variables.Results A total of 1 034 new-type drug users were recruited,including 431 (41.7％) MSM population and 603 (58.3％) who were not MSM.Compared with the the group of people who were not MSM,people in the the MSM group were younger,unmarried and with higher level of education.The proportion of methamphetamine users were 49.7％ (214/431) and 100.0％ (603/603) among the groups of MSM or not MSM,respectively.People in the MSM group,66.8％ (288/431) used 5-Methoxy-N,N-diisopropyltryptamine (5-MeO-DIPT,"foxy") in the last six months.However,none from the not-MSM group ever used 5-MeO-DIPT.In the last six months,proportions of sharing new-type drugs with more than two people in the MSM or not groups were 87.9％ (379/431) and 97.7％ (588/602),respectively (x2=39.84,P＜0.01).Proportions of unprotected sexual behavior among the MSM or not groups were 47.5％ (285/600) and 7.4％ (32/430) respectively (x2=190.10,P＜0.01).The proportions of ‘group sex’ after using drugs among the two groups were 78.1％ (335/429) and 5.5％ (33/600) respectively (x2=573.73,P＜0.01).The prevalence rates of HIV,syphilis and HCV antibody positive among the MSM or not groups were 2.1％ and 0.2％,3.3％ and 6.3％,0.0％ and 0.3％,respectively.Conclusion The prevalence of sharing new-type drugs with more than two people was high among male new-type drug users in Qingdao city.Male new-type-drug-users who were MSM,presented both high prevalence of group sex and HIV infection,and with less condom use.Intervention measures towards this sub-population should be strengthened.

Prevalence of HIV infection and syphilis and related behaviors in clients in Ya'an of Sichuan province / 中华流行病学杂志

Objective To understand the prevalence of HIV infection and syphilis in clients in Ya'an of Sichuan province.Methods A survey was conducted in clients recruited through snowball method in Ya'an of Sichuan from April 2014 to December 2015.The information of the clients,including basic demography characteristics,AIDS knowledge awareness,high-risk behaviors and others,were collected through face-to-face interviews.Blood sample (5 ml) was taken from each client to test antibodies against HIV and syphilis.Statistical software SPSS 18.0 was used for data analysis.Results Among the 708 clients,the constituent ratio of those aged ≥50 years was 51.27％ (363/708),those in Han ethnic group was 99.72％ (706/708),those with junior high school educational level or below was 90.11％ (638/708),those who got married or cohabitated with others was 74.15％ (525/708),and those who used condoms at each sex was 27.40％ (194/708).Seven HIV positive cases were detected and 4 cases were aged ≥50 years.Seven syphilis cases were detected and all the cases were aged ≥ 50 year.No HIV-syphilis co-infection case was detected.The prevalence of HIV infection and syphilis were all 0.99％ (95％CI:0.30％-1.70％).Results from the multivariate logistic regression analysis showed that the clients who had their first commercial sex behavior at age ＜30 years (OR=6.61,95％CI:1.09-40.18) would have higher HIV positive rate.Conclusion The rate of condom use was low in the clients in Ya'an and they didn't pay enough attention to their self-protection in sexual activities.Especially the clients aged ≥50 years were with low educational level and had high risk commercial sexual behaviors for HIV infection and syphilis.Close attention needs to be paid to them.

Clinical manifestations and prenatal diagnosis of congenital muscular dystrophy / 中华围产医学杂志

Objective To summarize the clinical features of 22 probands diagnosed with congenital muscular dystrophy (CMD),and to provide genetic counseling and prenatal diagnosis for 23 fetuses of these pedigrees.Methods Data of 22 CMD patients who were treated in the Pediatric Department of Peking University First Hospital during October 2006 to March 2016 were analyzed.Informed written consents for participation in this study were obtained from the parents or guardians.Prenatal diagnosis was performed using DNA samples extracted from fetal villus cells of 12 cases at 11-13 gestational weeks and amniotic fluid of 11 cases at 18-22 gestational weeks.Direct DNA sequencing by polymerase chain reaction (PCR) and multiplex ligation-dependent probe amplification (MLPA) were used to detect CMD-related gene mutations.Linkage analysis of short tandem repeats (STRs) was used to identify maternal blood contamination and biological parents.Results Thirteen out of the 22 probands with CMD were diagnosed with congenital muscular dystrophy type 1 A (MDC1A),and all of them carried compound heterozygous mutations in LAMA2 gene.Prenatal diagnosis of 13 fetuses from these pedigrees found that four fetuses were wild-type,seven were heterozygotes and two carried the same mutations as their proband.Three probands with LMNA-related congenital muscular dystrophy (L-CMD) carried de novo mutations in LMNA gene.In these pedigrees,two fetuses were wild-type and one whose mother was mosaicism carried the same mutations as the proband.One proband with Ullrich congenital muscular dystrophy carried compound heterozygous mutations in COL6A2 gene and the fetus of the same pedigree was wild-type.Five probands were diagnosed with α-dystroglycanopathies.And among them,two cases of muscle-eye-brain disease (MEB) carried compound heterozygous mutations in POMGnT1 gene and the fetuses of the two peidgrees were heterozygotes;one case of congenital muscular dystrophy type 1C (MDC1C) had compound heterozygous mutations in FKRP gene and the fetus carried the same mutations;one patient diagnosed with POMGnT1-related congenital muscular dystrophy with mental retardation (CMD-MR) carried compound heterozygous mutations in POMGnT1 gene,and the fetus was positive for the same mutations;one proband with POMT1-related CMD-MR was positive for compound heterozygous mutations in POMT1 gene and the results of prenatal diagnosis for two fetuses of this pedigree showed that the first fetus had the same mutations as the proband,while the second was heterozygote.Conclusions No effective therapeutic method is available for CMD.Therefore,accurate genetic counseling and prenatal diagnosis are necessary to prevent CMD child from birth.

Characteristics of HIV infections among over 50-year-olds population in China / 中华流行病学杂志

Objective To analyze the characteristics on demographical,spatial distribution and transmission mode of HIV infections among 50-year-old population.Methods Related information on demography,spatial distribution,high risk behavioral and history of HIV infections among 50-year-old population were collected and analyzed.Possible time of infection based on their first CD4 testing results right after the HIV diagnoses,was estimated.Results Since 2008,the number of new HIV/AIDS cases among the over-50-year-olds was reported increasing annually.The number of aged 50 and above in 2014 was 4.2 times than the number in 2008.50-year-old or older population were infected mainly through heterosexual behavior (88.0％).Among these cases,83.9％ self-reported as having histories on extramarital sex intercourse and the number was increasing yearly.Among male cases who admitted as having heterosexual experience,95.1％ of them reported as having histories of extramarital sex intercourse while 53.4％ of the female cases reported as having the same experiences.46.6％ of spouses of the females or with fixed partners were HIV positive.Through estimating the time of infection and the time interval between infection and diagnosis,we found that the proportion was 15.5％,from infection to diagnosis as 3 years among the 50 and older age groups,but the proportion of 8 years from infection to diagnosis was 43.6％.We estimated that 66.5％ of the new HIV cases who were at age 50 and over,were infected when they were at that age span.The average time from infection and being tested was (6.8 ± 2.7) years.Conclusion The increasing number of being diagnosed on HIV among the 50-year-olds population might be related to both high risk exposure and belated diagnoses among this population,calling for the necessity of deriving the sources of HIV infection and tailoring the HIV prevention strategies in this population.

Characteristics of HIV infections among over 50-year-olds population in China / 中华流行病学杂志

Objective To analyze the characteristics on demographical,spatial distribution and transmission mode of HIV infections among 50-year-old population.Methods Related information on demography,spatial distribution,high risk behavioral and history of HIV infections among 50-year-old population were collected and analyzed.Possible time of infection based on their first CD4 testing results right after the HIV diagnoses,was estimated.Results Since 2008,the number of new HIV/AIDS cases among the over-50-year-olds was reported increasing annually.The number of aged 50 and above in 2014 was 4.2 times than the number in 2008.50-year-old or older population were infected mainly through heterosexual behavior (88.0％).Among these cases,83.9％ self-reported as having histories on extramarital sex intercourse and the number was increasing yearly.Among male cases who admitted as having heterosexual experience,95.1％ of them reported as having histories of extramarital sex intercourse while 53.4％ of the female cases reported as having the same experiences.46.6％ of spouses of the females or with fixed partners were HIV positive.Through estimating the time of infection and the time interval between infection and diagnosis,we found that the proportion was 15.5％,from infection to diagnosis as 3 years among the 50 and older age groups,but the proportion of 8 years from infection to diagnosis was 43.6％.We estimated that 66.5％ of the new HIV cases who were at age 50 and over,were infected when they were at that age span.The average time from infection and being tested was (6.8 ± 2.7) years.Conclusion The increasing number of being diagnosed on HIV among the 50-year-olds population might be related to both high risk exposure and belated diagnoses among this population,calling for the necessity of deriving the sources of HIV infection and tailoring the HIV prevention strategies in this population.

DUOX2 mutations in children with congenital hypothyroidism / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the features of DUOX2 mutations and genotype-phenotype relationship in children with congenital hypothyroidism (CH), in order to provide evidence for gene diagnosis and gene treatment of CH.</p><p><b>METHODS</b>Blood samples were collected from 10 CH children with thyromegaly. Genomic DNA was extracted from peripheral blood leukocytes. All exons of DUOX2 gene were analyzed using PCR and direct sequencing.</p><p><b>RESULTS</b>G3632A mutation in the exon 28 of DUOX2 that may result in arginine to histidine substitution at codon 1211 was found in one patient. T2033C mutation in the exon 17 of DUOX2 that may result in histidine to arginine substitution at codon 678 was found in three patients. They were all heterozygous mutations.</p><p><b>CONCLUSIONS</b>Heterozygous mutations in DUOX2 may affect protein function and cause CH. The relationship between DUOX2 genotypes and clinical phenotypes is unclear and needs further studies.</p>

Implementation of intervention programs on AIDS-related sexual transmission in China / 中华流行病学杂志

Objective To analyze the implementation of intervention programs targeted on AIDS high risk sexual transmission groups since 2008,when the relative prevention and control information systems on HIV/AIDS were developed.Methods Data from both aggregated interventions and sentinel surveillance programs from 2008 to the end of 2014 were used.Descriptive statistics were performed to analyze the trends of implementation on high risk groups including men who have sex with men,female sex workers (FSW) and migrant workers.Results From 2008 to 2012,the monthly average numbers receiving intervention programs and the average monthly coverage rate on intervention for MSM,increased from 49000 to 252000,and from 8.6％ to 78.5％ respectively.The FSW related indicators increased from 329 000 to 625 000,and from 30.9％ to 87.0％ respectively.Above indexes on the two populations had dropped slightly in 2013 and 2014.Sentinel surveillance data showed that knowledge and behavior indicators observed from the MSM and FSW populations increased annually.The coverage of intervention programs on migrant workers increased from 4.7％ to almost 10.0％,but the surveillance data on migrant men showed that the knowledge and behavior indicators were still lower than the other high-risk groups.Conclusion Intervention related to sexual transmission on HIV/AIDS among high-risk populations were effectively implemented,with some achievements seen.However,as sexual contact currently became the main route of AIDS epidemic,new challenges called for serious attention.