Recombinant Salmonella gallinarum (S. gallinarum) Vaccine Candidate Expressing Avian Pathogenic Escherichia coli Type I Fimbriae Provides Protections against APEC O78 and O161 Serogroups and S. gallinarum Infection.

Avian pathogenic Escherichia coli (APEC) is one of the leading pathogens that cause devastating economic losses to the poultry industry. Type I fimbriae are essential adhesion factors of APEC, which can be targeted and developed as a vaccine candidate against multiple APEC serogroups due to their excellent immunogenicity and high homology. In this study, the recombinant strain SG102 was developed by expressing the APEC type I fimbriae gene cluster (fim) on the cell surface of an avirulent Salmonella gallinarum (S. gallinarum) vector strain using a chromosome-plasmid-balanced lethal system. The expression of APEC type I fimbriae was verified by erythrocyte hemagglutination assays and antigen-antibody agglutination tests. In vitro, the level of the SG102 strain adhering to leghorn male hepatoma (LMH) cells was significantly higher than that of the empty plasmid control strain, SG101. At two weeks after oral immunization, the SG102 strain remained detectable in the livers, spleens, and ceca of SG102-immunized chickens, while the SG101 strain was eliminated in SG101-immunized chickens. At 14 days after the secondary immunization with 5 × 109 CFU of the SG102 strain orally, highly antigen-specific humoral and mucosal immune responses against APEC type I fimbriae protein were detected in SG102-immunized chickens, with IgG and secretory IgA (sIgA) concentrations of 221.50 µg/mL and 1.68 µg/mL, respectively. The survival rates of SG102-immunized chickens were 65% (13/20) and 60% (12/20) after challenge with 50 LD50 doses of APEC virulent strains O78 and O161 serogroups, respectively. By contrast, 95% (19/20) and 100% (20/20) of SG101-immunized chickens died in challenge studies involving APEC O78 and O161 infections, respectively. In addition, the SG102 strain effectively provided protection against lethal challenges from the virulent S. gallinarum strain. These results demonstrate that the SG102 strain, which expresses APEC type I fimbriae, is a promising vaccine candidate against APEC O78 and O161 serogroups as well as S. gallinarum infections.

Menopause and stress urinary incontinence: The risk factors of stress urinary incontinence in perimenopausal and postmenopausal women.

OBJECTIVE: The prevalence of stress urinary incontinence (SUI) increases around menopause. The quality of life of perimenopausal and postmenopausal women with SUI is significantly affected. This study aimed to investigate the prevalence of SUI and the associated risk factors in a population of Chinese perimenopausal and postmenopausal women. METHODS: A total of 273 perimenopausal and postmenopausal women were enrolled, and a cross-sectional study was conducted. SUI was defined as an involuntary loss of urine with increases in abdominal pressure. Data including personal characteristics, menopause information, estrogen levels, and pelvic floor muscle strength levels were statistically analyzed. RESULTS: The study enrolled 158 (57.9%) perimenopausal and 115 (42.1%) postmenopausal women. Sixty-six (41.8%) perimenopausal women and 56 (48.7%) postmenopausal women complained of SUI. The mean age was 49.42 ± 5.58 years. Body mass index over 24 kg/m2 (odds ratio [OR] 2.02, 95% confidence interval [CI] 1.07-3.81), vaginal delivery (OR 2.47, 95% CI 1.33-4.58), and diabetes (OR 4.65, 95% CI 1.23-17.62) were high-risk factors for SUI. Climacteric symptoms (evaluated by Kupperman index scores) were statistically related to SUI, and among the 13 symptoms, insomnia, nervousness, weakness and fatigue, arthralgia and myalgia, headache, palpitation, and sexual complaints were all correlated with SUI in perimenopausal and postmenopausal women. CONCLUSIONS: Several factors are associated with SUI in Chinese perimenopausal and postmenopausal women. Obesity, vaginal delivery, climacteric symptoms, and diabetes were identified as the most notable risk factors. The management strategy could focus on the prevention and management of risk factors.

Enhancement of Bonding and Mechanical Performance of Epoxy Asphalt Bond Coats with Graphene Nanoplatelets.

Improving bonding and mechanical strengths is important for the application of bond coats used in the construction of steel deck bridges. Graphene nanoplatelets (GNPs) are attractive nanofillers for polymer modification because of their low cost, ultra-high aspect ratio, and extraordinary thermal and mechanical performance. In this paper, GNPs were used to reinforce the epoxy asphalt bond coat (EABC). The morphology, viscosity-time behavior, contact angle, dynamic mechanical properties, and mechanical and bonding strengths of GNP-reinforced EABCs were investigated using laser confocal microscopy, a Brookfield rotational viscometer, a contact angle meter, dynamic mechanical analysis, a universal test machine, and single-lap shear and pull-off adhesion tests. GNP dispersed non-uniformly in the asphalt phase of EABC. The viscosity of the neat EABC was lowered with the inclusion of GNPs and thus the allowable construction time was extended. The existence of GNPs enhances the hydrophobicity of the neat EABC. When adding more than 0.2% GNP, the storage modulus, crosslinking density and glass transition temperatures of both asphalt and epoxy of the neat EABC increased. The mechanical and bonding properties of the neat EABC were greatly enhanced with the incorporation of GNPs. Furthermore, the mechanical and bonding strengths of the modified EABCs increased with the GNP content. GNP-reinforced EABCs can be utilized in the pavement of long-span steel bridges with long durability.

Multistimuli-responsive fluorescent probes based on spiropyrans for the visualization of lysosomal autophagy and anticounterfeiting.

Lysosomes, as the main degradative organelles, play an important role in a variety of cellular metabolic activities including autophagy and apoptosis, catabolism and transporting substances. Lysosomal autophagy is an important physiological process and causes a slight change in the intra-lysosomal pH to facilitate the breakdown of macromolecular proteins. Therefore, detecting the fluctuation of intra-lysosomal pH is of great significance in monitoring physiological and pathological activities in living organisms. However, few probes have enabled the ratiometric monitoring of lysosomal pH and lysosomal autophagy in dual channels. Fortunately, spiropyrans, as compounds with multistimuli-responsive discoloration properties, form two different isomers under acid induction and ultraviolet induction. To fill this gap, in this work, two novel multistimuli-responsive fluorescent probes with lysosomal targeting in dual channels based on spiropyrans were rationally designed and synthesized. Notably, the two probes exhibited different absorption wavelengths in their UV-responsive and pH-responsive moieties due to their different electron-donating groups. Moreover, bioimaging experiments clearly demonstrate that the probes Lyso-SP and Lyso-SQ monitor lysosomal autophagy by facilitating the visualization of fluctuations in intra-lysosomal pH. Meanwhile, their potential applications in the field of dual-anticounterfeiting were explored based on their photoluminescence ability. We expect that more multistimuli-responsive fluorescent probes can be developed by this design approach.

A fluorescent probe based on POSS for facilitating the visualization of HClO and NO in living cells and zebrafish.

The main production area of HClO and NO is the mitochondria and has modulatory effects on multiple human diseases. Simultaneous detection of signaling molecules such as HClO and NO is an important approach for exploring the complex relationship between HClO and NO in mitochondria. However, most probes can detect only one species or are unable to complete the monitoring of HClO and NO in the NIR channel. There are only few reports on reasonable tools that can simultaneously monitor the presence of HClO and NO in the NIR channel. In this work, to solve this difficulty, a POSS-assisted NIR fluorescent probe with dual-response was rationally devised and developed. The probe Mito-Cy possessed high specificity and responsiveness to HClO and NO in spectral experiments. Notably, the probe exhibited excellent responsiveness and sensitivity to HClO and NO in living cells and the zebrafish model.

Diagnostic value of combined detection of multiple tumor markers and blood lipid indexes in colorectal cancer and its prediction on adverse reactions of chemotherapy.

PURPOSE: The purpose of this study was to explore the clinical diagnostic value of combined detection of multiple tumor markers (CEA, CA242, CA19.9 and CA125) and blood lipid indexes in colorectal cancer, and to analyze their predictive effect on adverse reactions after chemotherapy. METHODS: The clinical data of 35 patients with colorectal adenoma, 64 patients with colorectal cancer I-II and 29 patients with colorectal cancer III-IV were retrospectively analyzed. All the patients were admitted to our hospital from April 2017 to December 2019. The antigen level of tumor markers and the plasma level in patients were detected before surgery to compare the expression difference of different tumor types. The Youden index, sensitivity and specificity of the four tumor markers were compared when used alone or in combination. RESULTS: After one year of follow-up, the levels of tumor markers in patients with tumor metastasis were significantly higher than those in patients without tumor metastasis, with a statistically significant difference (p<0.001). The combination of four markers was better than single tumor marker in the evaluation indexes of diagnostic effect. The combined detection of multiple tumor markers and blood lipid indexes was correlated with the occurrence of five adverse reactions of chemotherapy (p<0.05). CONCLUSION: The detection of multiple tumor markers and blood lipid indexes can effectively improve the diagnosis of colorectal cancer and enhance the predictive effect on adverse reactions of chemotherapy. HDL, LDL and ApoAI indexes can be used to diagnose the benign and malignant properties of tumors, and determine the clinical stages.

Functional Polysiloxane Enables Visualization of the Presence of Carbon Monoxide in Biological Systems and Films.

As an essential gasotransmitter, carbon monoxide (CO) had gradually become a research hotspot in that it possessed important physiological functions and unique pharmacological properties. However, to date, no report has focused on the topic of detecting CO both in vivo and using films. To open up a new field of CO probes, for the first time, we designed a probe (PMAH-CO) that showed a distinctive ratio emission characteristic and displayed the quantitative distribution of CO in HeLa cells and zebrafish with a higher signal-to-noise ratio. Meanwhile, the fluorescent polysiloxane-based film (PMF) containing PMAH-CO exhibited an excellent response to CO. Due to the addition of the Si-O bond, the probe exhibited a broad transparency in the visible light range and had excellent photostability. Moreover, the probe was economically viable, easy to handle, and suitable for biological research. Hence, PMAH-CO and PMF would open up the road to broaden the application of silicone materials in the field of fluorescence imaging.

A POSS-assisted fluorescent probe for the rapid detection of HClO in mitochondria with a large emission wavelength in dual channels.

Hypochlorous acid (HClO) is closely related to many diseases and is an inevitable part of the physiological processes. It is significant to detect HClO in mitochondria for getting meaningful physiological and pathological information. However, adequate tools to detect HClO with emissions in two channels are rarely reported. To achieve this target, in this work, a "turn-off" visual and near infrared (NIR) fluorescent dual emission probe D6 based on polyhedral oligomeric silsesquioxanes (POSS) was successfully designed and synthesized. D6 showed high selectivity and sensitivity to HClO. Notably, the emission wavelength of D6 reached 820 nm due to the assistance of the POSS cage. In addition, bioimaging experiments clearly showed that probe D6 promoted the visualization of exogenous and endogenous HClO in living HepG2 cells and zebrafish models.

Supervised Analysis of Hepatitis C Virus RNA-Positive Case Reporting in County-Level Hospitals - China, 2013-2018.

What is already known on this topic? To understand the status of the diagnosis and reporting of hepatitis C and standardize the reporting of hepatitis C cases in county-level hospitals, we conducted the first supervised analysis of hepatitis C cases in county-level hospitals in China from 2013 to 2018, covering all provincial-level administrative divisions (PLADs) except Tibet. What is added by this report? Through 6 years of supervision, we have obtained key data such as the nucleic acid detection rate and positive rate of hepatitis C virus (HCV) antibody positive cases in our county-level hospitals, the report rate and accuracy of HCV RNA positive cases, and standardized and improved the hepatitis C case reporting in county-level hospitals to improve data quality and provide data support for the judgment and estimation of hepatitis C in China. What are the implications for public health practice? By strengthening the management and supervision of hepatitis C case reporting, the reporting rate and accuracy of HCV RNA positive cases in county-level hospitals in China had been greatly improved. By combining the number of HCV antibody tests and the number of viral nucleic acid tests in medical institutions around the country, it was possible to effectively assess the current status of hepatitis C in China and to provide a scientific basis for the development of hepatitis C prevention and treatment measures.

Efficacy of radiotherapy on intermediate and advanced lung cancer and its effect on dynamic changes of serum vascular endothelial growth factor and matrix metalloproteinase-9.

The present study intended to investigate efficacy of radiotherapy in the treatment of intermediate and advanced stage lung cancer and the effects on serum vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9 (MMP-9). Serum levels of VEGF and MMP-9 of 77 patients with intermediate or advanced lung cancer were detected before and after the treatment. At the same time, 19 healthy people were selected as the control group. Gelatin zymography was applied to measure the activity of serum MMP-9, ELISA was performed to detect the VEGF and MMP-9 levels in the peripheral blood and reverse transcription-quantitative polymerase chain reaction (RT-qPCR) was used to measure the messenger RNA (mRNA) levels of VEGF and MMP-9 in serum. Results indicated that the overall response rate of radiotherapy on intermediate and advanced lung cancer reached 70.1%. Levels of serum VEGF and MMP-9 in the effective treatment group were significantly lower than those before the treatment (P<0.05). Furthermore, expression levels of VEGF and MMP-9 in the effective radiotherapy group were significantly lower than those in ineffective group (P<0.05), MMP-9 activity before treatment was significantly higher than that after treatment (P<0.05) and expression levels of VEGF and MMP-9 mRNA before treatment were significantly elevated compared with those after treatment (P<0.05). The results suggested that the expression levels of serum VEGF and MMP-9 may be useful indicators for the evaluation of the efficacy of radiotherapy in the treatment of intermediate and advanced lung cancer.

Loss to follow-up and HIV incidence in female sex workers in Kaiyuan, Yunnan Province China: a nine year longitudinal study.

BACKGROUND: Longitudinal studies of female sex workers (FSWs) are vulnerable to loss to follow-up (LTFU) due to this population's high mobility and low willingness to self-identify as FSWs. LTFU in cohort studies is a critical problem and may lead to bias in estimation of incidence and exposure-outcome associations. The aim of this study was to analyze LTFU and HIV incidence and their associated factors in a 9-year longitudinal study of FSWs in Kaiyuan, Yunnan Province, China. METHODS: This analysis includes all HIV-1 seronegative FSWs who were recruited into a prospective study in Kaiyuan with at least one follow-up visit after enrollment from March 2006 to November 2013. Participants were visited in 6-month intervals after enrollment. Their demographic and behavioral data and blood specimens for HIV and sexual transmitted disease testing were collected at enrollment and at each follow-up visit. The administrative censoring date was December 31, 2014. Participants were considered LTFU if their last visit occurred 1 year or more before the administrative censoring date. Univariate and multivariable Cox regression models with time-independent variables were used to investigate the hazard ratios (HR) and 95 % confidence intervals (CI) of the factors associated with LTFU and HIV acquisition. RESULTS: Of the 1158 FSWs, 950 were defined as LTFUs (LTFU rate: 29.69, 95 % CI: 27.85-31.62 per 100 person years [PYs]), and 33 experienced HIV seroconversions (cumulative incidence: 1.06, 95 % CI: 0.74-1.47 per 100 PYs). After adjustment, we found that FSWs who used drugs were less likely to be LTFU compared with non-drug users (adjust hazard ratio [AHR]= 0.62, 95 % CI: 0.51-0.76), though FSWs who used drug were associated with a higher risk of HIV acquisition (AHR = 3.06, 95 % CI: 1.49-6.30). Also, FSWs who always used condoms with clients in the previous month were associated with a higher risk of LTFU (AHR = 1.51, 95 % CI: 1.15-1.97), while they were negative associated with new HIV infection (AHR = 0.28, 95 % CI: 0.12-0.61). CONCLUSIONS: A high LTFU rate exists in the Kaiyuan FSW cohort study, and LTFU did not occur at random. Participants retained in the cohort tended to be at higher risk of HIV acquisition, which may result in an overestimate of the incidence of HIV infection from the Kaiyuan FSW cohort.

Helicoidal Organization of Chitin in the Cuticle of the Migratory Locust Requires the Function of the Chitin Deacetylase2 Enzyme (LmCDA2).

In the three-dimensional extracellular matrix of the insect cuticle, horizontally aligned microfibrils composed of the polysaccharide chitin and associated proteins are stacked either parallel to each other or helicoidally. The underlying molecular mechanisms that implement differential chitin organization are largely unknown. To learn more about cuticle organization, we sought to study the role of chitin deacetylases (CDA) in this process. In the body cuticle of nymphs of the migratory locust Locusta migratoria, helicoidal chitin organization is changed to an organization with unidirectional microfibril orientation when LmCDA2 expression is knocked down by RNA interference. In addition, the LmCDA2-deficient cuticle is less compact suggesting that LmCDA2 is needed for chitin packaging. Animals with reduced LmCDA2 activity die at molting, underlining that correct chitin organization is essential for survival. Interestingly, we find that LmCDA2 localizes only to the initially produced chitin microfibrils that constitute the apical site of the chitin stack. Based on our data, we hypothesize that LmCDA2-mediated chitin deacetylation at the beginning of chitin production is a decisive reaction that triggers helicoidal arrangement of subsequently assembled chitin-protein microfibrils.

Vaginal douching and association with sexually transmitted infections among female sex workers in a prefecture of Yunnan Province, China.

Vaginal douching is a common practice and has been hypothesised to increase a woman's risk for human of contracting HIV and sexually transmitted infections (STIs). Our objective was to assess the prevalence of douching and its association with STIs, genital symptoms and HIV/STI knowledge among female sex workers (FSWs). We conducted a cross-sectional study of 837 FSWs with interviews and laboratory tests for HIV/STIs in a prefecture of Yunnan Province in southern China. Vaginal douching was reported by 84% of the women. We found a higher prevalence of vaginal douching practice among FSWs of Han ethnicity, and who were single or cohabitating. Douching was also significantly more common among more educated FSWs and those with greater knowledge of HIV/STIs, and as well as in FSWs who had experienced clinical symptoms in the previous 12 months. Douching was linked to higher risks of HIV (adjusted odds ratio = 2.29; 95% confidence interval 1.01-5.23) and herpes simplex virus type 2 infections (adjusted odds ratio = 2.18; 95% confidence interval 1.46-3.24) after adjusting for confounding factors. Medical professionals and public health workers should correct women's misconception about the effectiveness of douching and discourage women from douching through educational activities. More prospective studies among FSWs are urgently required to identify the relationship between vaginal douching and HIV/STIs.

Prevalence and correlates of Trichomonas vaginalis infection among female sex workers in a city in Yunnan Province, China.

Sexual transmission is the fastest growing route of HIV transmission in China, and Trichomonas vaginalis(TV) can facilitate HIV transmission and acquisition. Our goal was to determine the prevalence and correlates of TV infection among female sex workers (FSWs). This cross-sectional study was conducted in a city of Yunnan Province in southern China, with confidential face-to-face interviews and laboratory tests for TV (wet mount) and other sexually transmitted infections. A total of 734 FSWs participated in the study. The prevalence of TV was 9.0% (95% confidence interval [CI] 7.02-11.30). In multivariate analyses, adjusted odds ratios of TV infection were 3.0 (95% CI 1.47-6.01) for herpes simplex virus type 2 seropositive, 2.4 (95% CI 1.37-4.14) for Chlamydia trachomatis infection, 2.6 (95% CI 1.30-5.31) for genital ulcer, 1.9 (95% CI 1.11-3.30) for starting age in commercial sex <20 years, and 0.5 (95% CI 0.27-0.87) for vaginal douching. We found a relatively high prevalence of TV infection among FSWs in Yunnan Province. A range of control strategies that include TV screening are recommended among FSWs, which could contribute significantly to the disruption of transmission by the provision of immediate treatment.

Analysis of HIV Correlated Factors in Chinese and Vietnamese Female Sex Workers in Hekou, Yunnan Province, a Chinese Border Region.

OBJECTIVES: To assess the prevalence and correlated factors of HIV-1 among Chinese and Vietnamese female sex workers (FSW) in the border county of Hekou, Yunnan province, China. METHODS: A cross-sectional survey was conducted collecting information on demographics, sexual behavior, medical history, and drug use. Blood samples were obtained to test for HIV/STIs. Multivariate logistic regression model was used to examine associations between factors and HIV-1 infection. RESULTS: Of 345 FSWs who participated in this study, 112 (32.5%) were Chinese and 233 (67.5) were Vietnamese. Vietnamese FSWs were significantly more likely to be HIV-1 positive (7.7%) compared with Chinese FSWs (0.9%) (p = 0.009). In multivariate analysis, sexual debut at age ≤ 16 (OR 3.8: 95% CI: 1.4, 10.6), last client's payment <150 RMB ($22 USD) (OR: 5.2, 95% CI; 1.7, 16.6), and HSV-2 (OR: 12.3; 95% CI: 1.6, 94.8) were significant for HIV-1 infection. CONCLUSIONS: Differences in HIV prevalence in Vietnamese and Chinese FSWs may be indicative of differential risk. It is important to characterize the nature of trans-border transmission in order to gain a better understanding of the potential impact on the international HIV epidemic. Understanding the correlated factors for HIV in Vietnamese and Chinese FSWs is important for designing interventions for this vulnerable population.

[Influencing factors for loss to follow-up in a longitudinal study on HIV incidence of female sex workers].

OBJECTIVE: To study the loss to follow-up (LTF) rate, HIV emerging incidence and influencing factors in the longitudinal study of female sex workers (FSWs) in Kaiyuan, Yunnan, and their influence on HIV emerging incidence estimate. METHODS: The open cohort study on FSWs was launched in March 2006 and ended in June 2013 in Kaiyuan, Yunnan. Investigations were made every six months and lasted for 7 years. 661 FSWs found as HIV negative in the baseline study in March 2006 were chosen to study their LTF in the 7 year follow-up investigation. The Cox regression model was used to explore risk factors for HIV emerging infection and those for LTF. In June 2013, a survey was also conducted to explore the detailed reasons for loss to follow-up by contacting FSWs themselves. RESULTS: During 1 238.5 person-years of follow-up among 661 HIV negative FSWs, the HIV incidence rate was 1.29 (95% CI: 0.74-2.10)/100 person-year, and the LFT incidence rate was 48.68 (95% CI: 44.88-52.73) /100 person-year. The multivariate analysis showed drug abuse as an independent risk factor for FSWs' infection of HIV (adjusted risk ratio = 4.15, 95% CI: 1.43-12.02); FSWs over 25 years old (adjusted risk ratio = 0.68, 95% CI: 0.57-0.81), and drug abuse (adjusted risk ratio = 0.52, 95% CI: 0.35-0.79) were found with lower LFT rate to remain in the cohort. CONCLUSION: High LFT rate was found in FSW cohort study in Kaiyuan, Yunnan, while the HIV infection risk exposure of the LFT group was lower than the groups of HIV follow-up. HIV prevalence of FSWs in the city might be overestimated. Causes of LFT of FSWs group required further study in the future, and the cohort follow-up retention strategy for FSWs needs to be developed.

Over-expression of a proline specific aminopeptidase from Aspergillus oryzae JN-412 and its application in collagen degradation.

A strain that exhibited intracellular proline-specific aminopeptidase (PAP) activity was isolated from soy sauce koji and identified as Aspergillus oryzae JN-412. The gene coding PAP was cloned and efficiently expressed in Escherichia coli BL21 in a biologically active form. The highest specific activity reached 52.28 U mg(-1) at optimum cultivation conditions. The recombinant enzyme was purified 3.3-fold to homogeneity with a recovery of 36.7% from cell-free extract using Ni-affinity column chromatography. It appeared as a single protein band on SDS-PAGE with molecular mass of approximately 50 kDa. The purified enzyme exhibited the highest activity at 60 °C and pH 7.5. The enzyme activity was inhibited by PMSF and ions like Zn2+ and Cu2+. DTT, ß-mercaptoethanol, EDTA, and ions like Co2+, Mg2+, Mn2+, and Ca2+ had no influence on enzyme activity, whereas Ni2+ enhanced the enzyme activity. By using collagen as a substrate, the purified recombinant prolyl aminopeptidase contributed to the hydrolysis of collagen when used in combination with neutral protease, and free amino acids in collagen hydrolysates was significantly increased.

HIV/AIDS epidemic among older adults in China during 2005-2012: results from trend and spatial analysis.

BACKGROUND: Recent studies have indicated an increasing burden of human immunodeficiency virus (HIV)/AIDS among older adults. METHODS: All identified people living with HIV/AIDS (PLWHA) recorded through the Chinese HIV/AIDS CRS during 2005-2012 were included in the study, except for the cases that lacked specific spatial information. Trend tests and spatial analyses were conducted. RESULTS: Information about 73,521 PLWHA (aged ≥50 years) was collected during 2005-2012. Three provinces-Guangxi, Henan, and Yunnan-accounted for 54.4% of the identified cases during the study period. Compared with 2005, the ratio between residents and migrants among the study population decreased to 40.1% in 2012. The ratio of HIV-infected patients to AIDS patients and the ratio of males to females increased gradually among older infected adults. Results of spatial analysis indicate a clustered distribution of HIV/AIDS among older adults throughout the country. Hot spots were observed in 4 provinces (Guangxi, Henan, Yunnan, and Sichuan) and 1 municipality (Chongqing). A trend from central provinces toward southern provinces was also identified. CONCLUSIONS: The number and proportion of HIV/AIDS among older adults have increased in recent years. The hot spots showed movement from central to southern China. A focused intervention strategy targeting the older PLWHA is urgently required in China.

A systematic review of cohort studies of the quality of life in HIV/AIDS patients after antiretroviral therapy.

The aim of this paper was to review cohort studies that analyze changes in the quality of life of people living with HIV/AIDS. We searched the PubMed and EmBase databases from inception to December 2012 for primary cohort studies of the quality of life of people living with HIV/AIDS after combination antiretroviral therapy (cART). Two independent reviewers screened and selected published studies of quality of life that had been followed up for more than 12 weeks after the beginning of cART. Data from the papers were analyzed to identify common characteristics of the effects of cART on the quality of life of HIV/AIDS patients. Eight cohort studies were found: only four were assessed as high quality and four were assessed as moderate quality. None of the studies described patient selection. Six studies followed the patients for one year or more, and the other studies for less than 6 months. Seven studies reported quality of life had been improved after initiation of cART, and one study reported no change. Previous research suggested that cART improved the quality of life of AIDS patients for a limited time, so further research for longer periods is needed to confirm this outcome.

Drug use and sex work: competing risk factors for newly acquired HIV in Yunnan, China.

OBJECTIVE: To investigate the HIV incidence and its related factors among female sex workers (FSWs) in a high prevalence area where injection drug use is also widely documented. METHOD: A cross-sectional study of 1642 female sex workers (FSWs) was conducted in Honghe Prefecture of Yunnan Province. Interviewed-questionnaires were administrated to collect information on sexual partnerships, condom use and illicit drug using behaviors etc. Blood samples were collected to test for HIV antibodies, and all HIV seropositive specimens were tested with the BED IgG capture-based enzyme immunosorbent assay (BED-CEIA) to distinguish between new and established HIV infection (<153 days). RESULTS: 15.9% (261/1642) of participants reported ever having used drugs, and 7.4% had injected in recent 3 months. The overall HIV prevalence was 10.2% (168/1642), among which 16.7% (28/168) were identified as recent infections using BED-CEIA. The crude HIV incidence estimated from BED-CEIA results was 4.4 (95%CI 2.8-6.0) /100 person years (PY). Multivariate logistic analysis showed that an illicit drug using history (by either self-reporting or urine opiates testing) was both significant risk factors both for HIV established and recent infection (each p<0.05). Drug using FSWs (DU-FSW) reported more male clients in the previous week, and had significantly higher prevalence of HIV, chlamydia trachomatis and HSV-2 as compared to non DU-FSW (each p<0.05). CONCLUSION: Our results show that a history of drug use poses significant risks for both new and established HIV infection among FSWs, and that HIV-incidence among Honghe FSWs is relatively high compared to similar populations. Comprehensive interventions targeted at DU-FSWs' injection drug using and high risk sexual behaviors are urgently needed to reduce the rapid spread of HIV epidemic.