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OBJECTIVE@#To investigate the correlation of stress-inducible phosphoprotein 1 (STIP1) expression level with prognosis of different cancers and its potential role in immunotherapy.@*METHODS@#TCGA, TARGET and GTEx databases were used for bioinformatic analysis of STIP1 expression level and its prognostic value in different cancers. We also detected STIP1 expression immunohistochemically in 10 pairs of colorectal cancer and adjacent tissues. We further analyzed the correlation of STIP1 expression level with tumor mutational burden, microsatellite instability, immune cell infiltration, immune regulators and outcomes of different cancers. STIP1- related proteins were identified using protein- protein interaction (PPI) network analysis, and functional enrichment analysis was performed to analyze the regulatory pathways involving STIP1.@*RESULTS@#Bioinformatics analysis showed that STIP1 was highly expressed in most tumors compared with the normal tissues (P < 0.05), which was confirmed by immunohistochemistry of the 10 pairs of colorectal cancer tissues. STIP1 expression level was correlated with clinical stages of multiple cancers (P < 0.05), and in some cancer types, an upregulated STIP1 expression was correlated with a poor prognosis of the patients in terms of overall survival, disease-specific survival, disease-free survival and progression-free survival (P < 0.05). STIP1 expression was significantly correlated with tumor mutational burden, microsatellite instability, immune cell infiltration and immunomodulatory factors in most tumors (P < 0.05). PPI network analysis indicated that STIP1-related proteins included HSPA4, HSPA8, and HSP90AA1. KEGG enrichment analysis suggested that the high expression of STIP1 in liver cancer was related mainly with valerate metabolism, tryptophan metabolism, and butyrate metabolism pathways; HALLMARK enrichment analysis suggested high STIP1 expression in liver cancer was involved in bile acid and fatty acid metabolism.@*CONCLUSION@#STIP1 is up-regulated in multiple cancer types and its expression level is correlated with clinical tumor stage, tumor mutational burden, microsatellite instability, immune cell infiltration and immunomodulatory factors.
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Humanos , Inestabilidad de Microsatélites , Neoplasias Hepáticas , Inmunoterapia , Pronóstico , Biología Computacional , Proteínas de Choque Térmico , Neoplasias ColorrectalesRESUMEN
Rhabdomyosarcoma is a mesenchymal malignancy. It can occur anywhere in the body, but is extremely rare in the kidney. Here, we report a rare case of rhabdomyosarcoma of the kidney in a 19-year-old female who presented with right lumbar pain. Abdominal computed tomography (CT) suggested a huge retroperitoneal mass (approximately 18 × 14 cm). Preoperative neoadjuvant chemotherapy was performed through two preoperative cycle. After admission to our department for further evaluation, enhanced abdominal CT showed a mass of the right kidney (9.6 cm × 7.1 cm). The mass was successfully removed by surgery and the patient achieved a complete recovery.
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BackgroundThe healthcare system in China was largely overwhelmed during the unprecedented pandemic of coronavirus disease (COVID-19). HIV-related services have been unavoidably interrupted and impacted. However, the nature and scope of HIV service interruptions due to COVID-19 has rarely been characterized in China and how HIV service challenges affect the service interruptions are also unclear. The current study aimed at characterize HIV service interruption levels and analyzed its associated factors related to service challenges and institutional response from HIV healthcare providers viewpoint. MethodsA cross-sectional online survey was conducted among 1,029 HIV healthcare providers in Guangxi, China, from April to May 2020. Latent class analysis (LCA) was first used to identify HIV service interruption levels. Then hierarchical multinomial logistic regression was conducted to analyze the relationships of HIV care service challenges and institutional response with HIV service interruption levels. Simple slope analysis was employed to examine interaction effects between HIV service challenges and institutional response to COVID-19. ResultsFour classes of HIV service interruption were identified using LCA, with 22.0% complete interruption (class 1), 15.4% moderate interruption (class 2), 21.9% minor interruption (class 3) and 40.7% almost no interruption (class 4). Using class 4 as a reference group, HIV care service challenges were positively associated with the probabilities of service interruptions (Class 1: AOR=1.23, 95%CI: 1.19[~]1.26; Class 2: AOR= 1.10, 95%CI: 1.08[~]1.13; Class 3: AOR= 1.10, 95%CI: 1.08[~]1.12). Institutional response to HIV healthcare delivery was negatively associated with the probabilities of being classified into Class 1 ("Complete interruption") (AOR=0.97, 95%CI: 0.93[~]1.00) and Class 3 ("minor interruption [Outreach service]") (AOR=0.96, 95%CI: 0.93[~]0.99) as compared to Class 4 ("almost no interruption"). Institutional response to HIV healthcare delivery moderated the association of HIV service challenges with complete interruption, but not with the moderate or minor interruption when comparing with no interruption group. ConclusionsA substantial HIV service interruptions occurs due to the COVID-19 pandemic, particularly services that require face-to-face interactions, such as VCT counselling, follow up and outreach services. HIV service challenges largely hinder the HIV service delivery. Institutional response to HIV healthcare delivery could marginally buffer the negative effect of service challenges on complete HIV service interruptions. To maintain continuity of core HIV services in face of a pandemic, build a resilient health care system with adequate preparedness is necessary.
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Objective:To investigate the effect and influencing factors of anti-retroviral therapy (ART) in human immunodeficiency virus (HIV)-positive female commercial sex workers (CSW) in Guangxi Zhuang Autonomous Region.Methods:A retrospective cohort study was used in this study. A total of 661 HIV-positive CSW receiving ART from the Guangxi Zhuang Autonomous Region′s municipal and county-level Centers for Disease Control and Prevention (CDC) reported to Guangxi Zhuang Autonomous Region CDC from January 1, 2009 to December 31, 2018 were included.The demographic information of the patients, marital status, past medical history, acquired immunodeficiency syndrome (AIDS)-related diseases after six to 12 months of ART, medications, CD4 + T lymphocytes, virological and immunological effects after receiving ART for six to 12 months were collected. Logistic regression model was used to analyze the influencing factors of virological failure and immunological failure of HIV-positive CSW after six to 12 months of ART. Results:Among 661 HIV-positive CSW, 50(7.6%) cases experienced virological failure, 80(12.1%) cases experienced immunological failure, and 13(2.0%) had both virological failure and immunological failure.There were 85 cases (12.9%) who had a history of sexually transmitted diseases. Multivariate logistic regression analysis showed that unmarried (adjusted odds ratio (a OR)=3.298, 95% confidence interval ( CI) 1.285 to 8.461), AIDS-related diseases after six to 12 months of ART (a OR=4.391, 95% CI 1.555 to 12.402) and missed medications in the last seven days (a OR=3.731, 95% CI 1.942 to 7.166) were risk factors for virological failure. Compared with CD4 + T lymphocytes<200.00/μL at baseline, 350.00≤CD4 + T lymphocytes <500.00/μL (a OR=3.543, 95% CI 1.631 to 7.701) and CD4 + T lymphocytes≥500.00/μL (a OR=2.358, 95% CI 1.002 to 5.547) were risk factors for immunological failure. Conclusions:HIV-positive CSW in Guangxi Zhuang Autonomous Region have a better treatment effect, with low rates of virological failure and immunological failure. Marital status, baseline CD4 + T lymphocyte counts, AIDS-related diseases after six to 12 months of ART, and missed medication in the last seven days are factors influencing the effect of six to 12 months of ART.
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Objective: To understand the characteristics of HIV infected persons without long term disease progress [also known as long term non-progressors (LTNPs)], and related factors in Guangxi Zhuang Autonomous Region (Guangxi). Methods: Data of persons living with HIV and receiving no antiretroviral therapy in Guangxi by the end of 2016 were collected from the national HIV/AIDS comprehensive control and prevention information system of China. Results: By the end of 2016, there were 313 LTNPs in Guangxi, accounting for 2.3% of those being reported for more than 10 years, 5.4% of those being reported for more than 10 years and surviving, and 26.6% of those being reported for more than 10 years, surviving and receiving no antiretroviral therapy. Among the LTNPs, 87.2%(273) were men, 94.9% (297) were aged ≤ 40 years, 32.3% (101) were farmers, 55.6% (174) were single, divorced or widowed, 69.3% (217) were of Han ethnic group, 68.1% (213) were injecting drug users, and 52.1% (163) were from custody facilities. Multiple logistic regression analysis indicated that factors associated with delayed disease progression included age ≤40 years (compared with age >40 years, aOR=1.55, 95%CI: 1.31-3.12) and injection drug use (compared with sexual transmission, aOR=1.23, 95%CI: 1.10-1.74). Conclusions: A number of LTNPs existed in HIV-infected individuals in Guangxi. Further research are needed to identify the related factors, and it is necessary to conduct large sample size studies on host immunology, genetics and the virology of HIV to explore the related mechanism.
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Adolescente , Adulto , Humanos , Masculino , Distribución por Edad , China/epidemiología , Consumidores de Drogas/estadística & datos numéricos , Etnicidad/estadística & datos numéricos , Infecciones por VIH/etnología , Factores SocioeconómicosRESUMEN
Objective To understand the characteristics of HIV infected persons without long term disease progress [also known as long term non-progressors (LTNPs)],and related factors in Guangxi Zhuang Autonomous Region (Guangxi).Methods Data of persons living with HIV and receiving no antiretroviral therapy in Guangxi by the end of 2016 were collected from the national HIV/AIDS comprehensive control and prevention information system of China.Results By the end of 2016,there were 313 LTNPs in Guangxi,accounting for 2.3 % of those being reported for more than 10 years,5.4% of those being reported for more than 10 years and surviving,and 26.6% of those being reported for more than 10 years,surviving and receiving no antiretroviral therapy.Among the LTNPs,87.2%(273) were men,94.9% (297) were aged ≤ 40 years,32.3% (101) were farmers,55.6% (174) were single,divorced or widowed,69.3% (217) were of Han ethnic group,68.1% (213) were injecting drug users,and 52.1% (163) were from custody facilities.Multiple logistic regression analysis indicated that factors associated with delayed disease progression included age ≤40 years (compared with age >40 years,aOR=1.55,95% CI:1.31-3.12) and injection drug use (compared with sexual transmission,aOR=1.23,95% CI:1.10-1.74).Conclusions A number of LTNPs existed in HIV-infected individuals in Guangxi.Further research are needed to identify the related factors,and it is necessary to conduct large sample size studies on host immunology,genetics and the virology of HIV to explore the related mechanism.
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Objective@#To understand the characteristics of HIV/AIDS epidemic in Guangxi Zhuang Autonomous Region (Guangxi) with a purpose to accurately provide scientific basis for prevention and control measures, 2010-2017.@*Methods@#Data were retrieved from case reporting cards of Guangxi during 2010 to 2017 through National HIV/AIDS Comprehensive Response Information Management System. Data was analyzed using epidemiological methods such number of cases, proportion and rate. χ2 test was used for statistical analysis.@*Results@#The HIV positive rate was 12.53 per ten thousand (85 182/67 959 000) in Guangxi during 2010 to 2017. The number of newly diagnosed HIV/AIDS cases and the number of death yearly respectively increased by 22.34%(2 602/11 648) and 32.83% (952/2 900) in 2011 compared with 2010, and both showed a six-year continuous downward trend (the number of newly diagnosed cases respectively 12 229 cases, 10 877 cases, 9 460 cases, 9 190 cases, 8 848 cases, 8 680 cases, and the number of death respectively 3 888 cases, 3 316 cases, 2 914 cases, 2 717 cases, 2 595 cases, 2 600 cases) from 2012 to 2017. But proportion of late discovery remained above 50.00% (50.53%-57.06%) for eight-years continuously. The ratio of male and female was 2.47 ∶ 1 (60 639/24 543). The ratio of males and females aged 50 and over was 2.71∶1 (28 654/10 557). Proportion of the cases in 25-49 years old group and 50 years old group accounting for 47.40%(40 377/85 182) and 46.03% (39 211/85 182) respectively. The occupation was farmers accounting for 68.40% (58 262/85 182), housekeeping, housework and unemployment accounting for 11.21% (9 546/85 182), student accounting for 0.86% (729/85 182). Heterosexual transmission accounted for 90.60% (77 171/85 182, homosexual transmission accounted for 3.13% (2 669/85 182), injection drug use transmission accounted for 4.60%(3 924/85 182) and mother-to-child transmission accounted for 0.73% (619/85 182).@*Conclusions@#The number of newly diagnosed cases and the number of death yearly showed a continuous downtrend for six-years from 2012 to 2017. However, proportion of late discovery remained above 50.00% for eight-years. The major route of infection was heterosexual transmission. With the change of HIV/AIDS newly epidemic mode in Guangxi, there are many new challenges for HIV/AIDS prevention and control work. Strategy of targeted intervention modes should be innovated for a new breakthrough.
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Objective@#To analyze the change trend of HIV genetic subtypes and compare the first CD4+T cell counts of newly diagnosed HIV infected patients in Liuzhou from 1998 to 2012, and provide a reference for AIDS prevention and control.@*Methods@#Newly diagnosed HIV-infected patients from 1998 to 2012 in Liuzhou were selected through national HIV/ADIS comprehensive response information management system. Their plasma samples were used for RNA gene extraction, amplification, sequencing and genotyping. Coharan-Armitage trend test was used to analyze the ratio trend of genetic subtypes and phylogenetic clusters of HIV and Wilcoxon Rank Sum Test was used to compare the first CD4+T cell counts (CD4) of the different subtype HIV infected patients.@*Results@#A total of 1 877 newly diagnosed HIV infected patients were included in the study. From 1998 to 2012, the proportions of CRF01_AE and CRF01_AE (Cluster 1) increased from 78.4% (76/97) to 91.5% (1 441/1 574), from 63.9% (62/97) to 74.0% (1 164/1 574), and the proportion of CRF07_BC decreased from 17.5% (17/97) to 4.6% (72/1 574), respectively (Z=4.632, P<0.001; Z=2.455, P=0.014; Z=-5.943, P<0.001). The median and interquartile range of the first CD4 of the patients infected with subtype CRF01_AE (Cluster 1), CRF01_AE (Cluster 2), CRF07_BC and CRF08_BC were 230 (83-375), 215 (48-351), 365 (254-503) and 334 (206-479) cell/μl, respectively. The first CD4 levels of the patients infected with subtype CRF01_AE (Cluster 1) or CRF01_AE (Cluster 2) were significantly lower than those of CRF07_BC (Z=-4.795, P<0.001; Z=-4.238, P<0.001).@*Conclusion@#The genetic subtypes of HIV were mainly CRF01_AE in newly diagnosed HIV-infected patients and this subtype proportion was in increase and the first CD4 levels of the patients were low in Liuzhou during 1998 to 2012.
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To assess human immunodeficiency virus (HIV), syphilis, and behavioral risk factors among men who have sex with men (MSM) in southwestern China, where HIV started as a drug-driven epidemic, and shifted to mainly heterosexual transmission.These cross-sectional studies were conducted yearly in 2013, 2014, and 2015 in Guangxi, China. A total of 1,996, 1,965, and 1,697 participants were recruited in 2013, 2014, and 2015, respectively. The data included demographic and sexual behavioral variables. Other variables included individuals who used illegal drugs, and who received HIV counseling, testing, and free condoms, and peer education. Participants were tested for HIV, syphilis, and hepatitis C virus (HCV) with whole blood specimens. Questionnaires and laboratory testing data were double entered, and validated with EpiData software. The data were then transferred into SPSS software (SPSS Inc, Chicago, IL) and Chi-square test performed.The prevalence of HIV was 6.6% in 2013, 8.4% in 2014, and 11.2% in 2015. The prevalence of syphilis was 9.3% in 2013, 9.8% in 2014, and 6.1% in 2015. And HCV prevalence was 0.5% in 2013 and remained stable at 0.4% in 2014, and 2015. HIV infection, and associated factors among MSM in these 3 annual cross-sectional survey showed that HIV-infected MSM were significantly, more likely, to perform unprotected anal intercourse with any commercial male partners in the past 6 months (adjusted odds ratio [AOR]â=â1.81, 95% CI: 1.50-2.20), had sex with any female partners in the past 6 months (AORâ=â1.31, 95% CI: 1.01-1.71), used drugs in the past (AORâ=â2.73, 95% CI: 1.30-5.71), and are syphilis infected (AORâ=â3.53, 95% CI: 2.77-4.49).There is an urgent need for intervention strategies like condom distribution, HIV counseling, free testing, and education regarding safe sex, HIV, and other sex-related diseases in Guangxi to curb, and prevent HIV among MSM.
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Infecciones por VIH/epidemiología , Homosexualidad Masculina/estadística & datos numéricos , Conducta Sexual/estadística & datos numéricos , Trastornos Relacionados con Sustancias/epidemiología , Sífilis/epidemiología , Adulto , China/epidemiología , Estudios Transversales , Infecciones por VIH/prevención & control , Infecciones por VIH/transmisión , Hepatitis C/epidemiología , Humanos , Masculino , Prevalencia , Factores de Riesgo , Sífilis/prevención & control , Sífilis/transmisión , Adulto JovenRESUMEN
Objective: To understand the dynamic variation of BMI and influencing factors among HIV/AIDS patients receiving highly active anti-retroviral therapy (HAART) in Liuzhou, Guangxi Zhuang Autonomous Region (Guangxi). Methods: HIV/AIDS patients receiving HAART for the first time since 1 January 2013 were selected. Data on BMI was analyzed among patients receiving HAART at baseline,6 months and 12 months after treatment. By using the general linear model repeated measures of analysis of variance, BMI dynamic variations and influencing factors were described and analyzed. Results: The average BMI of 2 871 patients at baseline, 6th months and 12th months appeared as (20.65±3.32), (20.87±3.22) and (21.18±3.20), respectively, with differences all statistically significant (F=18.86, P<0.001). BMI were increasing over time with treatments (F=37.25, P<0.001). Main influencing factors were noticed as: age, sex, marital status, baseline data of CD(4)(+)T cells and the WHO classification on clinical stages. Conclusions: Higher proportion of BMI malnutrition counts was seen among patients before receiving HAART in Liuzhou. BMI of the patients that were on HAART seemed being influenced by many factors. It is necessary to select appropriate treatment protocols on different patients so as to improve the nutritional status of the patients.
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Humanos , Síndrome de Inmunodeficiencia Adquirida , Terapia Antirretroviral Altamente Activa , Índice de Masa Corporal , Recuento de Linfocito CD4 , China/epidemiología , Infecciones por VIH/tratamiento farmacológico , Modelos Lineales , Estado Civil , Estado Nutricional , Linfocitos TRESUMEN
Objective: To investigate the effect of baseline CD(4)(+) T cell count (CD(4)) on drop-out of antiretroviral therapy (ART) in HIV infected persons. Methods: Retrospective cohort was conducted in this study. HIV infected persons aged≥18 years and receiving free ART for the first time in Guangxi Zhuang Autonomous Region (Guangxi) from 2008 to 2015 were selected from the antiretroviral treatment database of National Comprehensive HIV/AIDS Information System, with follow-up conducted till May 30, 2016. Cause-specific Cox proportional hazard models were used to evaluate effect of different CD(4) on the drop-out of ART in the HIV infected persons. Results: A total of 58 502 eligible study participants were included in this retrospective cohort study. The average drop-out ratio was 4.8/100 person-years. After controlling the following baseline covariates: age, sex, marital status, route of HIV infection, WHO clinical stage before ART, initial/current ART regiment, ART regiment adjustment, and year of initiating ART for potential confounding, the adjusted HR of drop-out for HIV infected persons with 200- cells/μl, 351-cells/μl and ≥500 cells/μl were 1.110 (95%CI: 1.053-1.171, P<0.001), 1.391 (95%CI: 1.278-1.514, P<0.001) and 1.695 (95%CI: 1.497-1.918, P<0.001), respectively, in risk for drop-out compared with those with baseline CD(4)<200 cells/μl. Among the HIV infected persons, 56.0% (1 601/2 861) of drug withdrawal was due to poor compliance with medication. Conclusions: With the increase of baseline CD(4) when initiating ART, the risk for the drop-out in HIV infected persons increased significantly. To further reduce the drop-out of ART, it is important to take CD(4) into account in initiating ART and to strengthen the health education on treatment compliancy and training for healthcare providers.
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Adolescente , Humanos , Antirretrovirales/administración & dosificación , Recuento de Linfocito CD4 , China/epidemiología , VIH , Infecciones por VIH/virología , Incidencia , Cumplimiento de la Medicación , Estudios Retrospectivos , Linfocitos TRESUMEN
Objective To analyze the changes in follicular helper T (Tfh) cells during HIV-1 in-fection, to investigate the influences of Tfh cells and Tfh-related molecules on HIV-1 progression and to pro-vide references for further research on using Tfh cells in highly active antiretroviral therapy ( HAART) and vaccines. Methods This study enrolled 33 patients with HIV-1 infection, including 11 long-term nonpro-gressors (LTNP), 10 rapid progressors (RP) and 12 typical progressors (TP), and 11 healthy subjects (normal controls, NC). Peripheral blood mononuclear cells were isolated from each subject. Multicolor flow cytometry was performed to detect CD4+CD45RA-CXCR5+Tfh and CD4+CD45RA-CXCR3-CXCR5+PD-1+Tfh subsets and the levels of inducible costimulatory molecule (ICOS), IFN-γ and IL-21. Moreover, the levels of IL-10 and the percentages of CD19+B cells in plasma samples of each group were also analyzed. Relationships among Tfh, CD4 and B cells were analyzed. Results The percentages of both Tfh subsets were higher in patients with HIV-1 infection than in NC. Compared with NC, LTNP had the highest percent-age of CD4+CD45RA-CXCR3-CXCR5+PD-1+Tfh cells (P<0. 05). Expression of Tfh-related molecules ICOS, IFN-γ and IL-21 were enhanced significantly upon Staphylococcus enterotoxin B ( SEB) stimulation, ICOS+Tfh cells were negatively related with HIV-1 progression, but had a positive correlation with CD19+B cells (r=-0. 49, P<0. 01; r=0. 60, P<0. 05). IL-10 level in plasma increased significantly in patients withHIV-1 infection , especially in TP and RP ( TP vs NC : P<0. 01 ; RP vs NC : P<0. 05 ) . Conclusion HIV-1 patients and NC had significant differences in the expression of Tfh cells and Tfh-related molecules in peripheral blood. ICOS+Tfh cells were closely related to the progression of HIV-1 infection and the function of B cells.
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Objective To understand the dynamic variation of BMI and influencing factors among HIV/AIDS patients receiving highly active anti-retroviral therapy (HAART) in Liuzhou,Guangxi Zhuang Autonomous Region (Guangxi).Methods HIV/AIDS patients receiving HAART for the first time since 1 January 2013 were selected.Data on BMI was analyzed among patients receiving HAART at baseline,6 months and 12 months after treatment.By using the general linear model repeated measures of analysis of variance,BMI dynamic variations and influencing factors were described and analyzed.Results The average BMI of 2 871 patients at baseline,6th months and 12th months appeared as (20.65 ±3.32),(20.87 ± 3.22) and (21.18 ± 3.20),respectively,with differences all statistically significant (F=18.86,P<0.001).BMI were increasing over time with treatments (F=37.25,P<0.001).Main influencing factors were noticed as:age,sex,marital status,baseline data of CD4+T cells and the WHO classification on clinical stages.Conclusions Higher proportion of BMI malnutrition counts was seen among patients before receiving HAART in Liuzhou.BMI of the patients that were on HAART seemed being influenced by many factors.It is necessary to select appropriate treatment protocols on different patients so as to improve the nutritional status of the patients.
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Objective To investigate the effect of baseline CD4+T cell count (CD4) on drop-out of antiretroviral therapy (ART) in HIV infected persons.Methods Retrospective cohort was conducted in this study.HIV infected persons aged≥ 18 years and receiving free ART for the first time in Guangxi Zhuang Autonomous Region (Guangxi) from 2008 to 2015 were selected from the antiretroviral treatment database of National Comprehensive HIV/AIDS Information System,with follow-up conducted till May 30,2016.Cause-specific Cox proportional hazard models were used to evaluate effect of different CD4 on the drop-out of ART in the HIV infected persons.Results A total of 58 502 eligible study participants were included in this retrospective cohort study.The average drop-out ratio was 4.8/100 person-years.After controlling the following baseline covariates:age,sex,marital status,route of HIV infection,WHO clinical stage before ART,initial/current ART regiment,ART regiment adjustment,and year of initiating ART for potential confounding,the adjusted HR of drop-out for HIV infected persons with 200-cells/μl,351-cells/μl and ≥500 cells/μl were 1.110 (95%CI:1.053-1.171,P<0.001),1.391 (95%CI:1.278-1.514,P<0.001) and 1.695 (95%CI:1.497-1.918,P< 0.001),respectively,in risk for drop-out compared with those with baseline CD4 <200 cells/μ 1.Among the HIV infected persons,56.0% (1 601/2 861) of drug withdrawal was due to poor compliance with medication.Conclusions With the increase of baseline CD4 when initiating ART,the risk for the drop-out in HIV infected persons increased significantly.To further reduce the drop-out of ART,it is important to take CD4 into account in initiating ART and to strengthen the health education on treatment compliancy and training for healthcare providers.
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Objective To investigate the etiological and antibiotic resistance profile in the old patients with bloodstream infection (BSI).Methods Microbiological and clinical data were collected and reviewed retrospectively for the patients with confirmed bloodstream infection and at least 65 years of age who were treated as inpatients in Tongling People′s Hospital from January to December 2015.Results A total of 107 strains of pathogen were isolated from the blood samples of 107 patients with bloodstream infections, of which community-acquired BSI accounted for 57.9 % (62/107), and hospital-acquired BSI 42.1 % (45/107). Gram negative bacilli accounted for 67.7 % in the pathogens of community-acquired BSI and gram positive cocci accounted for 55.5 % in the pathogens of hospital-acquired BSI. More male BSI patients were secondary to respiratory tract infection than female patients (P<0.001), while more female BSI patients were secondary to urinary tract infection than male patients (P<0.001). Of the 107 isolates, gram negative bacilli, gram positive cocci and fungi accounted for 55.1 % (59/107), 42.1 % (45/107) and 2.8 % (3/107), respectively. The top six pathogens were E. coli (30.9 %), coagulase negativeStaphylococcus (CNS) (20.6 %), S. aureus (10.3 %),K. pneumoniae (6.5 %),Enterococcusspp. (6.5 %) and Acinetobacter spp. (4.7 %). About 51.5 % of the E. coli isolates and 28.6 % of the K. pneumoniae isolates produced extended-spectrum β-lactamases (ESBLs).E. coli isolates showed low resistance rate (< 10 %) to amikacin,cefoxitin and piperacillin-tazobactam. No E. coli isolate was found resistant to carbapenem. About 14.3 % to 28.6 % of K. pneumoniae isolates were resistant to carbapenems. No tigecycline-resistant K. pneumoniae was found. The prevalence of MRSA and MRCNS was 36.4 % and 72.7 %, respectively. No staphylococcal isolates were found resistant to vancomycin, teicoplanin or linezolid. One strain of E. faecium was identified as resistant to vancomycin (VRE).Conclusions This surveillance data indicate that gram negative bacilli play an important role in the BSI of old patients. E. coli and CNS are the most common pathogens. We should pay more attention to the effect of gender and site of infection on the BSI in old patients.
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Objective To explore the influencing factors of late diagnosis for newly diagnosed HIV/AIDS positive patients in Guangxi in 2015.Methods The CD4 + T lymphocytes count which was first detection for newly diagnosed HIV/AIDS positive patients in Guangxi during 2015 was collected.Data were statistically analyzed.Results We collected 8 586 newly diagnosed HIV/AIDS whose median CD4+ T lymphocytes counts was 237.5 cells/μl,and 43.12% of them had less than 200 cells/μl.Gender,age,occupation,marriage,nation,education,route of transmission,types of testing and region had effects on late HIV diagnosis(all P < 0.05).Logistic analysis found that risk factors associated with the late diagnosis of HIV were male(OR =1.851,95% CI:1.673-2.048),migrant worker (OR =1.387,95% CI:1.242-1.549),education below middle and secondary school(OR =1.619,95% CI:1.400-1.873),currently married(OR =1.207,95% CI:1.075-1.354),divorced or widowed(OR =1.508,95% CI:1.309-1.738).Voluntary testing was a protective factor.Conclusions The prevalence the late diagnosis of HIV was high in Guangxi in 2015,it is crucial for related departments to enhance the testing and screening effort for HIV/AIDS.
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Objective To assess the safety and efficacy of the local nerve block anesthesia procedure in daysurgery inguinal herniorrhaphy practice.Methods Fifty-eight inguinal herniorrhaphy were performed under the local nerve block anesthesia in the form of day surgery between April 2014 and April 2015 other 58 inguinal hemiorrhaphy were performed under general anesthesia.Time of operation,hospitalization stay,complications and costs were evaluated.Results The average operating time of the day-surgery group was (47 ± 12) min.All operations were completed successfully.Fifty-six patients were discharged in 24 hours and 2 patients were discharged in 48 hours after the surgery.The average costs were 8437 yuan.The rate of postoperative complications was approximately 6.6% (4/58),including hematoma(3 cases),urinary relention(1 case),and chronic pain (1 case).The VAS scores of 6 hours after the operation were (2.4 ± 0.8).Conclusions It suggests that preperitoneal hemiorrhaphy under the local nerve block anesthesia in the form of day-surgery was safe and effective.Also,it could significantly shorten the time of hospitalization and reduce medical costs.
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Objective To establish the normal reference ranges of T lymphocyte subsets in healthy Zhuang ethnic minority across different age/ gender groups in Guangxi for providing the scientific guidance for clinical diagnosis and treatment evaluation of immunodeficiency diseases and viral infections as well as relat-ed researches. Methods Peripheral blood samples were collected from 405(196 male and 209 female) healthy subjects of Zhuang ethnic group including 82 adolescents and 323 adults. Single platform FACSCali-bur flow cytometry analysis was performed to detect the absolute counts of T lymphocyte subsets(CD45+, CD3+,CD4+ and CD8+)in peripheral blood samples. Results Reference ranges of T lymphocyte absolute counts in healthy Zhuang Chinese aged 14 to 59 were 2 377±696,1 503±459,802±253,581±243 and 1. 52±0. 57 for CD45+,CD3+,CD4+,CD8+ and CD4+ / CD8+. Significant differences in CD45+,CD3+ and CD8+ T lymphocytes were found between adolescents and adults(t = 0. 000,P﹤0. 05),but no significant difference in CD4+ T lymphocytes was observed between the two groups of people(t = 0. 373,P﹥0. 05). Significant difference between male and female groups was observed only in the absolute counts of CD8+ T lymphocytes(t= 0. 036,P﹤0. 05). The absolute counts of T lymphocyte subsets were on the decline along with the growth of the age. Conclusion This study indicates that the counts of T lymphocyte subsets vary with ethnic group,age and gender. Therefore,it is important to establish normal reference ranges of T lym-phocyte subsets for local healthy people based on gender and age for accurate evaluation of local patients' im-mune system status and treatment efficacy.
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<p><b>OBJECTIVE</b>To understand the efficacy of antiviral therapy on prevention of HIV transmission and to assess the feasibility of treatment-as-prevention strategy in public health practice, among sero-discordant couples in Guangxi Zhuang autonomous region (Guangxi).</p><p><b>METHODS</b>Data was gathered through the AIDS prevention and control information system in Guangxi from January 1, 2008 to December 31, 2014, on HIV sero-discordant couples. Time-dependent Cox Model was used to analyze the efficacy of antiviral treatment.</p><p><b>RESULTS</b>A total of 7 694 sero-discordant couples were followed and 394 appeared positive from those negative spouses. The overall HIV positive seroconversion rate was 2.5 (2.2-2.7) /100 person-year. The HIV positive sero-conversion rates were 4.3 (3.7-4.8) /100 person-year in the untreated cohort and 1.6 (1.4-1.9) per 100 person-year in the treated cohort. Rate of HIV transmission declined by 51% in the treated cohort (HR=0.49, 95%CI: 0.40-0.60) but appeared as 45% (AHR=0.55, 95%CI:0.43-0.69) after adjusting for factors as sex, age, education, marital status, occupation, transmission route and baseline CD4(+)T lymphocyte cell count. The rate of reduction in transmission was significant among couples in which the HIV-positive spouses showing the following features as: aged ≥25 years, married, farmers, with educational level of junior high school or below, baseline CD4(+)T lymphocyte cell count <500 cells/mm(3) and infection was through heterosexual intercourse.</p><p><b>CONCLUSION</b>Antiviral therapy as a prevention strategy among sero-discordant couples seemed feasible and effective in Guangxi. Expansion of the coverage on antiviral therapy would reduce the spread of HIV in married couples.</p>
Asunto(s)
Adulto , Humanos , Antivirales , Usos Terapéuticos , Recuento de Linfocito CD4 , China , Estudios de Factibilidad , Infecciones por VIH , Seronegatividad para VIH , Seropositividad para VIH , Heterosexualidad , Factores Socioeconómicos , Esposos , Resultado del TratamientoRESUMEN
Objective To understand dynamic variation of CD4-Positive T-Lymphocytes counts and influencing factors among patients receiving highly active anti-retroviral therapy (HAART) in Guangxi.Methods Adult patients who received antiviral treatment for the first time after 1 January 2013 were selected.Their CD4-Positive T-Lymphocytes counts at baseline,6 months and 12 months after treatment were analyzed.By using the general linear model repeated measures ANOVA,CD4-Positive T-Lymphocytes dynamic variations and influencing factors were described and analyzed.Results The average CD4 cell counts of 4 082 patients at baseline,6th months and 12th months were (195.3 ± 155.7) cells/mm3,(331.9 ± 202.6) cells/mm3 and (380.9 ± 221.3) cells/mm3,respectively.The time specific differences in CD4-Positive T-Lymphocytes count among them were statistically significant (F=3 161.124,P=0.000).CD4-Positive T-Lymphocytes counts increased over time after treatment.The main influencing factors were sex,age,baseline CD4 cell count,medication,discontinuation of treatment or dose miss.Influenced by sex,age,medication,discontinuation of treatment or dose miss,the increased CD4-Positive T-Lymphocytes count showed a linear trend.Influenced by baseline CD4-Positive T-Lymphocytes counts and dose miss,the increase of CD4-Positive T-Lymphocytes count showed a trend which was conformed to quadratic curvilinear equation.Conclusion CD4-Positive T-Lymphocytes counts among patients receiving HAART in Guangxi were influenced by many factors.It is necessary to select the time to start treatment according to patient' s characteristics to get good outcome.