Clinical value of serological screening combined with noninvasive prenatal testing for fetal aneuploidy / 中国基层医药

Objective To investigate the value of serological screening combined with fetal aneuploidy prenatal noninvasive DNA test ( NIPT) in prenatal diagnosis ,and provide guidance for reducing the birth of children with genetic defects in the future .Methods A retrospective analysis was conducted in 15282 pregnant women with prenatal counseling who performed serological screening and NIPT test .The high risk and critical TANG recommended NIPT test and severe abnormal karyotype children recommend termination of pregnancy .Results Down syndrome screening results showed that 804 cases of 15,282 cases of serological screening samples were detected in high risk , the high risk rate was 5.26％.A total of 804 patients with high risk of Don screen were further tested with noninvasive DNA,which was positive in 10 cases.Among them,8 cases were confirmed by amniocentesis ,including 5 cases of trisomy 21,1 case of trisomy 18 and 2 cases of sex chromosome abnormality (45,XO in one case and 47,XYY in one case),the consistency was 100.00％.Conclusion Noninvasive gene detection of fetal aneuploidy has the advantages of noninvasive ,safe and accurate .It has a wide range of clinical value in the diagnosis of fetal chromosomal abnormalities .

Novel Approaches for Visualizing and Analyzing Dose-Timing Data from Electronic Drug Monitors, or "How the 'Broken Window' Theory Pertains to ART Adherence".

Adherence to antiretroviral medications is usually expressed in terms of the proportion of doses taken. However, the timing of doses taken may also be an important dimension to overall adherence. Little is known about whether patients who mistime doses are also more likely to skip doses. Using data from the completed Adherence for Life randomized controlled trial, we created visual and statistical models to capture and analyze dose timing data collected longitudinally with electronic drug monitors (EDM). From scatter plots depicting dose time versus calendar date, we identified dominant patterns of dose taking and calculated key features [slope of line over calendar date; residual mean standard error (RMSE)]. Each was assessed for its ability to categorize subjects with 'sub-optimal' (<95 % of doses taken) using area under the receiver operating characteristic (AROC) curve analysis. Sixty eight subjects contributed EDM data, with ~300 to 400 observations/subject. While regression line slopes did not predict 'sub-optimal' adherence (AROC 0.51, 95 % CI 0.26-0.75), the variability in dose timing (RMSE) was strongly predictive (AROC 0.79, 95 % CI 0.62-0.97). Compared with the lowest quartile of RMSE (minimal dose time variability), each successive quartile roughly doubled the odds of 'sub-optimal' adherence (OR 2.1, 95 % CI 1.3-3.4). Patterns of dose timing and mistiming are strongly related to overall adherence behavior. Notably, individuals who skip doses are more likely to mistime doses, with the degree of risk positively correlated with the extent of dose timing variability.

Feasibility and Acceptability of a Real-Time Adherence Device among HIV-Positive IDU Patients in China.

We collected data on feasibility and acceptability of a real-time web-linked adherence monitoring container among HIV-positive injection drug users (IDU) in China. "Wisepill" uses wireless technology to track on-time medication dosing. Ten patients on antiretroviral therapy (ART) at the Guangxi CDC HIV clinic in Nanning, China, used Wisepill for one ART medication for one month. We monitored device use and adherence and explored acceptability of the device among patients. Mean adherence was 89.2% (SD 10.6%). Half of the subjects reported a positive overall experience with Wisepill. Seven said that it was inconvenient, supported by comments that it was large and conspicuous. Five worried about disclosure of HIV status due to the device; no disclosures were reported. Twelve signal lapses occurred (5.4% of prescribed doses), of which one was due to technical reasons, nine to behavioral reasons (both intentional and unintentional), and two to unclear reasons. Although the technical components must be monitored carefully, and acceptability to patients presents challenges which warrant further exploration, the Wisepill device has potential for adherence interventions that deliver rapid adherence-support behavioral feedback directly to patients, including IDU. The use of wireless technology appears uniquely promising for providing time-sensitive communication on patient behavior that can be harnessed to maximize the benefits of HIV treatment.

A comparison study on the detection of anti-human immunodeficiency virus type 1 (HTV-1) antibodies in different populations with a new rapid test using oral mucosal transudate samples versus enzyme linked immunosorbent assay (ELISA) using serum samples / 中华皮肤科杂志

Objective To evaluate the consistence in the detection of antibodies against HIV-1 between a new rapid test using oral mucosal transudate (OMT) samples and ELISA using serum samples. Methods Two-hundred patients who were positive for anti-HIV-1 antibodies by serum ELISA and confirmed by Western blot to be infected with HIV, and 600 healthy human controls negative for anti-HIV-1 antibodies by serum ELISA, were eligible for this study. OMT samples were collected from these subjects and subjected to a rapid test for anti-HIV-1 antibodies. The factors influencing the performance of the rapid test were analyzed. Results Of the 200 OMT specimens from HIV-infected patients, 198 showed positive reaction, 2 showed negative reaction. Among the 198 positive reactions, 192 (96%) were "clear" and easy to make decisions, 4 (2%) were "faint", 2(1%) were "very faint" and required professionals to make decisions. The rapid test was negative in all the 600 OMT specimens from the control group. Conclusions The consistence in the detection of anti-HIV-1 antibodies between the OMT rapid test and serum ELISA was 99% in HIV-positive specimens, 100% in HIV-negative specimens, and 99.75% in all the specimens.

Importance of dose timing to achieving undetectable viral loads.

Little is known about the importance of dose timing to successful antiretroviral therapy (ART). In a cohort comprised of Chinese HIV/AIDS patients, we measured adherence among subjects for 6 months using three methods in parallel: self-report using a visual analog scale (SR-VAS), pill count, and electronic drug monitors (EDM). We calculated two adherence metrics using the EDM data. The first metric used the proportion of doses taken; the second metric credited doses as adherent only if taken within a 1-h window of a pre-specified dose time (EDM 'proportion taken within dose time'). Of the adherence measures, EDM had the strongest associations with viral suppression. Of the two EDM metrics, incorporating dose timing had a stronger association with viral suppression. We conclude that dose timing is also an important determinant of successful ART, and should be considered as an additional dimension to overall adherence.

Barriers to adherence to antiretroviral medications among patients living with HIV in southern China: a qualitative study.

Although China's government is rapidly expanding access to antiretroviral therapy, little is known about barriers to adherence among Chinese HIV-infected patients, particularly among injection drug users. To better understand barriers to antiretroviral treatment adherence, we conducted a qualitative research study, using both focus group and key informant methods, among 36 HIV-positive men and women in Dali, in southwestern China. All interviews utilized semi-structured question guides and were conducted in Mandarin, audio-recorded and translated into English for analysis. The most commonly cited adherence challenges were stigma, including secondary stigma experienced by family members; mental health issues; and economic concerns, particularly related to finding and maintaining employment. Distinctive gender differences emerged, partly due to previous heroin use among male respondents. Optimizing adherence may require that antiretroviral therapy programs be linked to other services, including drug addiction treatment, mental health services and vocational treatment and support. HIV care and service providers and policy makers in China responsible for HIV treatment should be aware of these important barriers to adherence.

HIV and AIDS in the People's Republic of China: a collaborative review.

The number of individuals diagnosed with HIV in China has risen dramatically in the last two years coincident with increased awareness and an attitude change within government. UNAIDS has suggested that China could have 10 million HIV infected people by 2010. However, antiretroviral treatments and HIV testing are not yet widely available and infected individuals often live in remote areas. It is unlikely that cheaper, locally produced, generic antiretroviral formulations will be available in China in the near future. Consequently, alternative strategies to manage HIV infection are being considered including the use of hydroxyurea, chloroquine and traditional Chinese herbal medicines. It is recognized in China that prevention and educational strategies will need to be at the forefront of approaches to control this epidemic.

Assay for simultaneous detection of HIV p24 antigen and anti-HIV antibody / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To develop a rapid assay for simultaneous detection of HIV p24 antigen (Ag) and anti-HIV antibody (Ab).</p><p><b>METHODS</b>HIV-1 gp41 antigen and HIV-2 gp36 antigen were expressed by recombinant baculovirus insect system and purified by immunochromatography. p24 monoclonal antibody (mAb) was obtained from p24 hybridoma cell line. Purified antigen and mAb were dot blotted to nitrocellular membrane; 20 nm colloidal gold-anti-human IgG ab and p24 ab complex were used for this test. Previously detected 39 sera specimens were tested in this study to compare with the result of HIV test with commercial HIV test kit.</p><p><b>RESULTS</b>20 mg/L purified gp41 Ag and gp36 Ag were obtained from recombinant baculovirus-insect cell system; 1.5 mg/L p24 mAb was obtained from p24 mAb hybridoma cell line. Compared the test result of 39 sera with commercial HIV test kits, consistency rate was 100%.</p><p><b>CONCLUSIONS</b>The rapid assay for simultaneous detection of HIV p24 antigen and anti-HIV antibody provides a simple, sensitive and reliable test for HIV diagnosis.</p>

Study of Chlamydial Urogenital Infection and MOMP Gene Variants in Child- bearing Women in Beijing / 中华皮肤科杂志

Objective To investigate Chlamydia trachomatis infection and gene variants in child- bearing women in Beijing. Methods Endocervical samples were collected from 177 patients in a family planning clinic and a gynecologic clinic. C.trachomatis infection was screened with a fast diagnostic kit .Major outer membrane protein(MOMP) gene was amplified by a nested PCR . A 1.1kb amplified product was obtained and studied by restriction fragment length polymorphism analysis(RFLP). Variant domains of MOMP gene VS1,VS2,VS3,VS4 were sequenced with 373A automated sequencing system. Results C. trachomatis was found in 9 of 177 samples. Four samples were identified as F genotype, 3 E genotype and 2 D genotype. Variant domains of MOMP gene, VS1, VS2, VS3, VS4 were sequenced and the results were consistent with those of RFLP, however, mutations were found in MOMP gene in 4 samples. Conclusion C.trachomatis urogenital infection has been identified in a portion of child- bearing women in Beijing. C.trachomatis can be well genotyped with RFLP or gene sequencing of MOMP gene.

ONE EXPERIMENTAL STUDY OF PREVENTIVE EFFECT OF CHINA-MADE ISOCRYSTAL PIRENZEPINE ON RESERPINE-IN-DUCED ULCER / 中国药理学通报

Effect of China-made isocrystal pirenzepine ( IPRZ ) on experimental ulcer produced by reserpine in rats was studied & the antiulcer effect of China-made IPRZ was compared with that of China-made PRZ. Our results showed that China-made IPRZ given by either sc ( 25-100 mg/kg ) or ig ( 25-100 mg/kg ) exerted a marked antiulcer effect on reserpine-induced gastric ulcer in rats.The antiulcer effect was increased with the increase of dose of China-made IPRZ. When China-made IPRZ was given by sc, its antiulcer effect was as potent as China-made PRZ, but when it was given by ig, its antiulcer effect was lower than China-made PRZ .This result suggest that the bioavailabili-ty of China-made IPRZ given by ig was lower than China-made PRZ.

The Pharmacokinetics of Thyrotropin-releasing Hormone in Rabbits / 第二军医大学学报

The pharmacokinetics of thyrotropirrreleasing hormone (TRH) made in China was studied in rabbits. TRH concentrations in plasma, urine and various tissues were measured by RIA. After intravenous injection of TRH, the plasma concentration-time curve was shown to fit a two compartment open model with the following pharmacokinetic parameters: 0.8 mg/kg, T1/2?=0.551 min, T1/2? = 9.374 mm, VI = 3.018 ml/kg, Vb = 22.659 ml/kg and AUC = 0.479g. L-1. m-1; 2.0mg/kg, T1/2? = 0.629 mm, T1/2?= 9.734 min, VI = 5.135 ml/kg, Vt = 28.848 ml/kg, and AUC = 0.962g. L-1. m-1; 5.0mg/kg, T1/2? =0.720 min, T1/2?= 10.738 min, VI = 6.120 ml/kg, Vb = 31.928 ml/kg and AUC=2.540 g. L-1. m-1. TRH was distributed widely in tissues and concentrated mainly in the kidney and pituitary. TRH was eliminated partly by the kidney and 21.9% was excreted within 2h after intravenous injection.