[miR-146a-3p is down-regulated and IL-17 is up-regulated in peripheral blood CD4+ T cells of children with neonatal sepsis].

Objective To investigate the expression of microRNA-146a-3p(miR-146a-3p) and interleukin 17 (IL-17) in peripheral blood CD4+ T cells of neonates with sepsis (NS) and its regulation mechanism. Methods The expression of miR-146a-3p and IL-17 mRNA in CD4+ T cells of 66 children with sepsis (septicemia group), 40 children with infectious diseases (infection group), and 40 healthy newborns (control group) were detected by real-time quantitative PCR, and the level of IL-17 in peripheral blood was detected by ELISA. The targeting effect of the miR-146a-3p on IL-17 was verified by the dual luciferase reporter assay. After isolation of the CD4+ T cells, the expression of miR-146a-3p in CD4+ T cells was promoted or inhibited by miR-146a-3p mimic or miR-146a-3p inhibitor. The proportion of Th17 cells was detected by flow cytometry, and the methylation of miR-146a-3p gene was detected by methylation specific PCR. The changes of Th17 cell proportion and IL-17 expression were observed after adding methylation inhibitor 5-Aza-2'-deoxycytidine (5-Aza-dC) to CD4+ T cells. Results Compared with those in the infection group and the control group, the expression of miR-146a-3p in peripheral blood CD4+ T cells decreased, while the expression of IL-17 mRNA and the level of IL-17 in peripheral blood increased in septicemia group. Transfection of miR-146a-3p mimic in CD4+ T cells significantly inhibited the activity of wild-type luciferase in the 3'UTR of IL-17. After transfection of miR-146a-3p mimic, the expression of IL-17 mRNA in CD4+ T cells, and the level of IL-17 and the proportion of Th17 cells in the supernatant were significantly decreased. After transfection of miR-146a-3p inhibitor, the expression of IL-17 mRNA, and the level of IL-17 and the proportion of Th17 cells in the supernatant were increased. The methylation rate of miR-146a-3p gene promoter in the peripheral blood of the septicemia group was significantly higher than those of the control group and the infection group. After the addition of 5-Aza-dC in CD4+ T cells, the expression of miR-146a-3p was increased and the expression of IL-17 mRNA was decreased, and in the supernatant, the level of IL-17 was decreased and the proportion of Th17 cells was significantly reduced. Conclusion The expression of miR-146a-3p is down-regulated and the expression of IL-17 is up-regulated in peripheral blood CD4+ T cells of children with neonatal sepsis.

Methadone maintenance treatment participant retention and behavioural effectiveness in China: a systematic review and meta-analysis.

BACKGROUND: Methadone maintenance treatment (MMT) has been scaled up by the Chinese government alongside persistent compulsory drug user detention, but the extent to which detention interferes with MMT is unknown. The study systematically reviews Chinese MMT retention rates, reasons for drop out, and behavioural changes. METHOD: Chinese and English databases of literature are searched for studies reporting retention rates, drug use and sexual behaviours among MMT participants in China between 2004 and 2013. The estimates are summarized through a systematic review and meta-analysis. RESULTS: A total of 74 studies representing 43,263 individuals are included in this analysis. About a third of MMT participants drop out during the first three months of treatment (retention rate 69.0% (95% CI 57.7-78.4%)). Police arrest and detention in compulsory rehabilitation was the most common cause of drop out, accounting for 22.2% of all those not retained. Among retained participants, changing unsafe drug use behaviours was more effective than changing unsafe sexual behaviours. At 12 months following MMT initiation, 24.6% (15.7-33.5%) of MMT participants had a positive urine test, 9.3% (4.7-17.8%) injected drugs and only 1.1% (0.4-3.0%) sold sex for drugs. These correspond to 0.002 (<0.001-0.011), 0.045 (0.004-0.114) and 0.209 (0.076-0.580) times lower odds than baseline. However, MMT participants did not have substantial changes in condom use rates. CONCLUSION: MMT is effective in drug users in China but participant retention is poor, substantially related to compulsory detention. Reforming the compulsory drug user detention system may improve MMT retention and effectiveness.

HIV and HCV prevalence among entrants to methadone maintenance treatment clinics in China: a systematic review and meta-analysis.

BACKGROUND: Methadone maintenance treatment (MMT) was implemented in China since 2004. It was initiated in 8 pilot clinics and subsequently expanded to 738 clinics by the end of 2011. Numerous individual research studies have been conducted to estimate HIV and HCV prevalence among MMT clients but an overview of the epidemics in relations to MMT remains unclear. The aim of this study is to estimate the magnitude and changing trends of HIV, HCV and HIV-HCV co-infections among entry clients to MMT clinics in China during 2004-2010. METHODS: Chinese and English databases of literature were searched for studies reporting HIV, HCV and co-infection prevalence among MMT clients in China from 2004 to 2010. The prevalence estimates were summarized through a systematic review and meta-analysis of published literatures. RESULTS: Ninety eligible articles were selected in this review (2 in English and 88 in Chinese). Nationally, pooled prevalence of HIV-HCV and HIV-HCV co-infection among MMT clients was 6.0% (95%CI: 4.7%-7.7%), 60.1% (95%CI: 52.8%-67.0%) and 4.6% (95%CI: 2.9%-7.2%), respectively. No significant temporal trend was found in pooled prevalence estimates. Study location is the major contributor of heterogeneities of both HIV and HCV prevalence among drug users in MMT. CONCLUSIONS: There was no significant temporal trend in HIV and HCV prevalence among clients in MMT during 2004-2010. Prevalence of HCV is markedly higher than prevalence of HIV among MMT clients. It is recommended that health educational programs in China promote the earlier initiation and wider coverage of MMT among injecting drug users (IDUs), especially HIV-infected IDUs.

Risk factors associated with HIV/HCV infection among entrants in methadone maintenance treatment clinics in China: a systematic review and meta-analysis.

BACKGROUND: Methadone maintenance treatment (MMT) has rapidly expanded in China, from 8 pilot sites to 696 clinics covering 27 provinces, during 2004-2010. This study evaluates the demographic characteristics and drug use behaviors associated with Human Immunodeficiency Virus (HIV) and Hepatitis C Virus (HCV) infections among MMT entrants through a systematic review and meta-analysis of published literature. METHODS: Thirty-nine eligible articles (1 in English and 38 in Chinese) were selected for this review. We extracted the relevant indicator information from all eligible studies and performed meta-analyses, by stratifying according to sex of the participants, age groups and drug use behaviors. Five provinces (i.e., Yunnan, Guizhou, Sichuan, Guangxi and Xinjiang) with the population size of HIV-infected drug users greater than 10,000 were defined as high transmission areas (HTAs) for HIV infection; whereas the remaining twenty-six Chinese provinces were considered as low transmission areas (LTAs). RESULTS: The odds of being infected by HIV among male drug users were significantly higher than for females in high transmission areas (OR=1.49, 95% CI: 1.11-1.99, k=9), while the opposite results were observed in low transmission areas (OR=0.46, 0.27-0.79, k=11). In comparison, no significant differences in risk behaviors were found between sexes in HTAs and LTAs. Younger age was not associated with risk of HIV infection, but was associated with higher risk of HCV infection (<30 years OR=1.88; 30-40 years OR=2.21, compared with >40 years, k=17). Risk of HIV infection was higher among injectors than non-injectors (OR=4.29, 2.70-6.79, k=14) and for those who inject, there was greater risk among sharers than non-sharers (OR=2.47, 1.44-4.23, k=4). Similar patterns were also observed in HCV infection (injectors: OR=10.82, 7.60-15.40; sharers: OR=3.41, 2.56-4.54, k=7). CONCLUSIONS: Characteristics of MMT entrants positive for HIV or HCV in China vary by disease types, geographical region, sex, age, and injecting behavior. These factors need to be considered in targeted interventions for MMT participants, such as age-specific health education and psychological treatment, antiretroviral therapy and needle-syringe exchange programs.

[High-risk behaviors related to AIDS/STDs infections among fishermen in Lü-si harbor, Jiangsu province].

OBJECTIVE: To investigate the high-risk behaviors related to acquired immune deficiency syndrome/sexually transmitted disease (AIDS/STDs) infection among fishermen in Lü-si harbor, Jiangsu province. METHODS: A cross-sectional study was designed to investigate the research participants' demographic characteristics, high-risk behaviors that related to AIDS/STDs. Logistic regression was performed to measure the associations between potential risk factors and reported potential high-risk sexual behavior. RESULTS: 817 fishermen participated in the study and casual or commercial sex activities appeared to be the main high-risk behavior for AIDS/STDs infection in the target population. The rates of casual and commercial sex reported were 18.1% and 28.9% among fishermen. Risk factors associated with AIDS/STDs related high-risk behaviors among fishermen were high mobility (OR = 1.516, P = 0.038), higher lifetime sex frequency (OR = 1.422, P = 0.002) and unmarried status (OR = 7.527, P = 0.014). Protective factors against high-risk behaviors were low intake of alcohol (OR = 0.803, P = 0.053), negative STD history (OR = 0.268, P = 0.001), age of initial sexual intercourse at or older than 22 years (OR = 0.440, P = 0.000) of age, as well as negative attitude toward multiple sexual partners (OR = 0.662, P = 0.023) and legitimation for commercial sex (OR = 0.612, P = 0.007). CONCLUSION: There were risk behaviors of AIDS/STDs in those infected fishmen. Casual and commercial sex were common high-risk behaviors.