[Evaluation of the effectiveness of the evidence base multi-discipline critical strategies on the temperature and clinical outcomes in very preterm infants].

To evaluate the effectiveness of intervention plans developed by the evidence base multi-discipline critical strategies (EBPCS) on temperature and clinical outcomes in very preterm infants (VPIs) born at<32 weeks. Clinical data were collected from VPIs born in the delivery room/operating room of Chengdu Women's and Children's Central Hospital from May 1, 2021, to May 31, 2022, who required immediate temperature management and were transferred to the neonatal intensive care unit (NICU) of the hospital. The study population was randomly divided into a control group and an intervention group based on the random number table method, with 108 cases in each group. The control group implemented the conventional temperature management recommended by domestic guidelines, while the intervention group adopted EBPCS interventions compared to the control group. The differences in body temperature and clinical outcomes between the two groups were compared after the implementation of different temperature management strategies. A total of 216 VPIs were included. The intervention group had a lower incidence of hypothermia (30.55% vs. 87.03%, P<0.001), higher mean body temperature admitted to the NICU [(36.56±0.31) ℃ vs. (35.77±0.53) ℃, P<0.001], a lower dose of pulmonary surfactant [(115.94±36.96) mg/kg vs. (151.41±54.68) mg/kg, P=0.014], shorter duration of mechanical ventilation [(5.77±1.26) days vs. (14.19±4.63) days, P=0.006], and lower incidence of intraventricular haemorrhage (12.04% vs. 23.15%, P=0.032). The implementation of temperature intervention strategies developed by the EBPCS for VPIs after birth could prevent and reduce the incidence of hypothermia and improve clinical outcomes.

[Transition and evolution of HIV-1 subtype among HIV-1 infections in Wuxi city, 2013-2016].

Objective: To understand the distribution of HIV-1 subtype in Wuxi city, to predict the local HIV-1 epidemics. Methods: Samples were collected from the 'CD(4)(+) T lymphocyte monitoring cohort study' in Wuxi from April 2013 to July 2016. HIV-1 gene was amplified, sequenced and with HIV-1 sequence database constructed, using both the ChromasPro 1.6 and MEGA 7.0 softwares. Bayesian phylogenetic inference was used to rebuild the history of HIV-1 transmission, while BEAST 1.7.2 and FastTree 2.1.10 software were used for data analysis. Statistical analysis using SPSS 22.0 software. Results: Among the 205 subjects of HIV-1 infection, 32.68%(67/205) of them were over 50 years old. Seven subtypes (including CRF01_AE, CRF07_BC, CRF67_01B, B, CRF08_ BC, CRF68_0B, CRF78_cpx) and one of the unique recombinant forms (URFs) were detected. The main subtypes were CRF01_ AE (51.67%, 93/180) and CRF07_BC (17.22%, 31/180). Differences between subtypes and ways of transmission were statistically significant ( χ(2)=16.99, P≤0.05). The proportion of CRF67_01B (12.78%, 23/180) was higher than before. Results from Bayesian phylogenetic inference analysis showed that the evolution rate was 2.29×10(-3) and Time to the Most Recent Common Ancestor (tMRCA) was 2 003.10. CRF67_01B was probably related to the reference strains from Jiangsu and Anhui provinces, and had been spreading in Wuxi since 2003. Conclusions: HIV-1 subtypes seemed complex and diverse in Wuxi city in 2013-2016, with CRF67_01B being pervasive. Continuous molecular monitor program was still needed to provide reference for the prediction of epidemics, from the molecular perspective.

[HIV genetic subtypes and HIV drug resistance in China: a Meta-analysis].

Objective: To assess the relationship between HIV genetic subtypes and HIV resistance in China. Methods: The literature retrieval was conducted by using Chinese Science-Technology Journal Database (VIP), Wanfang Data, Chinese Journal Full-text Database (CNKI), PubMed and Web of Science to select the papers on the relationship between HIV subtypes and HIV drug resistance in China during 2005-2015. Eligible papers were included according to the inclusion. Meta-analysis was performed by using software Stata 12.0. Results: A total of 43 papers were selected and the pooled rate of drug resistance was 15.1% and the rate of primary drug resistance was 9.5%, the subtypes associated drug resistance were CRF01_AE, CRF07_BC, CRF08_ BC, B/B'and C. The pooled rates of drug resistance of each subtype were 12.8%, 7.4%, 14.3%, 25.7% and 34.9% and the rates of primary drug resistance of each subtype were 7.3%, 5.7%, 11.5%,15.5% and 23.9%, respectively. Subgroup analysis showed that both treated and area subgroup showed a significant difference among groups (P<0.05). The rates of primary resistance of each subtype in northern China and southwestern China were higher than that in southern China. Conclusion: The distribution of HIV genotypes in China was complex and the prevalence of primary drug resistance of each subtype was high, together with a significant difference among subtypes. It is necessary to strengthen the monitoring of different subtypes of drug resistant strains in China to prevent the recombination and spreading of resistant strains.