[Effects of Corbrin Shugan capsule on dimethylnitrosamine-induced hepatic fibrosis in rats].

OBJECTIVE: To investigate the effects of Corbrin Shugan capsule on dimethylnitrosamine (DMN)-induced hepatic fibrosis in rats. METHODS: Hepatic fibrosis was induced by DMN in AD rats. The serum concentrations of III pro-collagen (III PC),laminin (LN) and tissue inhibitor of metalloproteinase-1(TIMP-1) were determined with ELISA. The concentration of albumin (ALB) in sera and the content of hydroxyproline (Hyp) in liver tissues were determined with chemical colorimetric and HPLC, respectively. The fibrosis area was measured with Motic Med 6.0 digital medical image analysis system. RESULTS: Compared to model group the high-dose (450 mg kg(-1)),mid-dose (270 mg kg(-1)) and low-dose (90 mg kg(-1)) groups of Corbrin Shugan capsule had significantly lower serum content of III PC [34.46 ± 13.95),(36.15 ± 9.46), and (40.58 ± 7.72)ng ml(-1) compared with (49.38 ± 10.95)ng ml(-1),P<0.05 or P<0.01],TIMP-1 [(16.65 ± 4.24),(16.66 ± 4.34),and (18.99 ± 6.05)ng ml(-1) compared with (30.84 ± 14.48)ng ml(-1), P<0.05 or P<0.01], LN [(12.94 ± 4.29), (12.96 ± 3.21),and (15.32 ± 8.00)ng ml(-1) compared with (30.22 ± 17.00)ng ml(-1),P<0.05 or P<0.01] and smaller hepatic fibrosis area [(0.02240 ± 0.01337), (0.02176 ± 0.01460) and (0.02384 ± 0.01405)µm(2) compared with vs (0.03929 ± 0.01732)µm2, P<0.05 or P<0.01]; the high-dose and mid-dose groups of Corbrin Shugan capsule had significantly lower content of Hyp in liver tissues [(0.77 ± 0.09) and (0.81 ± 0.09)µg µmg(-1) compared with (1.06 ± 0.33)µg mg(-1),P<0.05 or P<0.01]; and the high-dose group of Corbrin Shugan capsule significantly increased the content of ALB in sera [(34.02 ± 4.17)g L(-1) compared with (30.25 ± 4.21)g L(-1),P<0.05]. CONCLUSION: Corbrin Shugan capsule is effective in treatment of DMN-induced hepatic fibrosis in rats.

[Loss to follow-up and associated factors in a cohort study among men who have sex with men].

OBJECTIVE: To explore the associated factors on loss to follow-up among men who have sex with men (MSM) in a prospective cohort study. METHODS: We recruited eligible HIV-negative MSM at baseline in eight cities from June to October 2009. Interviewer-administrated questionnaire and blood testings for HIV, syphilis and human simplex virus type 2, were accomplished upon enrollment, 6-month and 12-month follow-up visits in the program. Loss to follow-up was recorded at each visit in this cohort. Univariate and multivariate statistical analysis were conducted to examine the associated factors on loss to follow-up. RESULTS: A total of 3196 eligible MSM were enrolled at the baseline study. During one year of follow-up, 894 (28.0%) of them dropped out thoroughly while 2302 (72.1%) showed up at least on one visit. Factors as MSM who were at age 25 or younger, resided locally less than 1 year, being unemployed, self-recognized as heterosexuality or bisexuality, never taking HIV testing in the past year, having had sex with women in the past 6 months etc., were more likely to withdraw from the follow-up visits. Conclusion Age, length of residency, sex orientation and history of HIV testing were associated with the loss of follow-up among MSM cohort in our study. These factors should be considered in this kind of study design in the future.

[Corbrin shugan capsule for treatment of alcoholic hepatic fibrosis in rats].

OBJECTIVE: To investigate the therapeutic effect of Corbrin shugan capsule for treatment of alcoholic hepatic fibrosis in rats. METHODS: The rat model of alcoholic hepatic fibrosis was induced by intragastric administration of alcohol repeatedly. The serum procollagen III (PC III), laminin (LN) and tissue inhibitors of metalloproteinase-1 (TIMP-1) levels were measured with ELISA, and the content of hydroxyproline (Hyp) in liver tissue were determined with colorimetric method. Collagen deposition in liver tissue was observed with Masson's staining, and the fibrosis area was measured with digital medical image analysis system (Motic Med 6.0). RESULTS: Compared with the model control group, the serum TIMP-1 and LN levels and hepatic fibrosis area in liver tissue significantly decreased in Corbrin shugan capsule groups with doses of 0.09,0.27 and 0.45 g*kg(-1), and the serum PC III and the Hyp contents in liver tissue also decreased of Corbrin shugan capsule groups with doses of 0.27 and 0.45g*kg(-1). CONCLUSION: Corbrin shugan capsule can decrease serum PC III, TIMP-1 and LN levels and Hyp levels in liver tissue and hepatic fibrosis area in rats, indicating it may have therapeutic effect on alcoholic hepatic fibrosis.

[Distribution of HIV-1 subtype and its relationship with HIV/AIDS epidemic in Guizhou province].

OBJECTIVE: To study the HIV-1 diversity and how did it promote the rapid spread of AIDS, in Guizhou province. METHODS: A total of 190 HIV-1 positive subjects were collected in different years and regions from Guizhou province. The env and gag genes were amplified with nested PCR and their sequences were determined. The subtypes were identified by the MEGA 4.0 software and the relationships between subtypes and AIDS epidemic were analyzed. RESULTS: The number of HIV/AIDS reported cases was increased from 66 in 1998 up to 8435 in 2009, a 16.38 time increase in 7 years. Subtypes B (9), B' (4), C (2), CRF07_BC (75), CRF08_BC (17), CRF01_AE (64) were identified in Guizhou province among the samples collected in various periods of time. The genetic diversities in env gene of CRF07_BC and CRF08_BC increased along with the spreading of HIV (from 0.035 ± 0.006 to 0.092 ± 0.011). Subtype B' (4/11) appeared the main subtype prevailed in Guizhou in 1998 as well as CRF07_BC (26/41) in 2002 and CRF01_AE (62/119) in 2007. The HIV/AIDS epidemic in Guizhou province showed an rapidly upward trend, with the main risk factors of HIV transmission as 2610 cases through injecting drug users (IDUs). and 176 cases due to sexually transmitted infections (STIs), from year 2001 to 2006. However, STIs began to increase rapidly, after 2006, with 1713 cases of IDUs and 1833 cases of STIs. Data indicated that the change of composition of different HIV-1 subtypes was correlated with the mode of transmission in Guizhou province (χ(2) = 41.253, P = 0.000). CONCLUSION: The types of HIV strains changed over time as well the turnover of the main risk factors. Sexual transmission, including both hetero- and homo-sexual became the main risk factors, suggesting the development of related prevention and control programs, on HIV/AIDS should be considered accordingly in the future.

[Impact of methadone maintenance treatment on HIV risk behaviors of heroin drug users].

OBJECTIVE: To evaluate HIV risk behaviors among heroin drug users who were treated in methadone maintenance treatment (MMT) clinics. METHODS: A prospective cohort study recruited and followed up clients of eight MMT clinics treated no more than two and half months in Guizhou province, China. Through face-to-face interviews, the baseline and following up informations were collected. And the baseline information included both demographic information and HIV risk behaviors, the following up informations included only HIV risk behaviors. The baseline investigation started in June, 2006 and the following up investigation finished in June, 2007. A total of 1003 heroin drug users were recruited at baseline, among them 666 (66.4%) were still at treatment by the end of follow up and 469 (70.4%) clients participated in the follow up interview. Wilcoxon two sample test and McNemar test were used to test for changes in HIV risk behaviors between baseline and following up investigation. RESULTS: Among the 469 MMT clients who were followed up, the average days of reported heroin use decreased from 26.4 to 0.9 in the past 30 days (Z = 27.21, P < 0.05). Average days of alcohol use at baseline were 3.3 but 3.7 at follow up (Z = 0.45, P = 0.96). Needle-sharing behavior reported in the past 30 days decreased from 1.3% at baseline to 0.2% at follow up (χ(2) = 5.00, P = 0.025). At baseline, 5.5% (26/469) subjects reported having multiple sex partners in the past 30 days compared to 3.4% (16/469) at following up (χ(2) = 3.18, P = 0.08).6.4% (30/469) subjects reported casual sex with non-regular sex partners in the past 30 days at baseline compared to 5.1% (24/469) at following up (χ(2) = 0.95, P = 0.33). Of those who reported having casual sex relationship in the past 30 days 56.7% (17/30) reported using condoms at baseline but 58.3% (14/24) reported using condoms at follow up (χ(2) = 1.96, P = 0.16). CONCLUSION: MMT was observed to decrease needle-sharing HIV risk behavior. However, decreased HIV sexual risk behaviors were not observed at statistical significant level.

[Factors influencing the rate on retention to methadone maintenance treatment program among heroin addicts in Guizhou, China].

OBJECTIVE: To understand the situation of client-retention to methadone maintenance treatment (MMT) program and related factors. METHODS: A cohort study was adopted. In total, 1003 heroin addicts who were treated at 8 local MMT clinics with less than one month period, were recruited under nominal informed consent from Guizhou province, southwest part of China, during June to October 2006. Face-to-face interview and questionnaire administered to collect relevant information from the clients who were also followed until June 2007 to understand the situation on retention. Data were analyzed with Kaplan-Meier method to estimate the retention rate at different time spans while factors related to retention were analyzed with Cox proportional hazard regression model. RESULTS: All the clients were followed-up for 14 months, with an average retention of ten months. The retention rates of the clients were 68.8% and 57.4% at 6th-month and 12th-month of the treatment program, estimated by Kaplan-Meier method. Results of Cox regression analysis showed that factors influencing retention rate on MMT among the clients, including their awareness on MMT, daily dose of methadone intake, and different MMT clinics which they were attached to. Risk influencing the withdrawal from MMT had a 20% decrease along with the increase when the daily dose of methadone intake reached 25 mg, with a hazard ratio of 0.80 (P < 0.01). If the clients were aware that methadone was a life-time treatment when they began the MMT program, the risk for withdrawal would be lower than those who were not and the hazard ratio became 0.66 (P < 0.05). CONCLUSION: Our data showed that about half of the clients who were at the MMT program would still stick to it after 12-months, suggesting that the retention rate was not satisfactory and need to be improved. Factors as the MMT clinics themselves that the clients visited, daily methadone dosage they took, and the awareness on MMT etc. were important predictors to the rate of retention on MMT program.

Government health workers as implementers of prevention of disability measures: an assessment of a prevention of disability project in selected counties of Guizhou Province, Peoples' Republic of China.

OBJECTIVE: The purpose of this study was to assess the effectiveness of government health workers as agents for the prevention of disability. DESIGN: A prevention of disability (POD) project for people affected by leprosy was conducted in nine counties of Guizhou Province, Peoples' Republic of China. The project was implemented by government health workers. In accordance with the principles and national criteria of the National Centre for Leprosy Control (NCLC) POD Pilot programme, 1215 people affected by leprosy were selected, followed up and assessed with the use of impairment summary forms through which essential indicators were routinely collected. RESULTS: Most improvements of disabilities occurred in the 1st year of the POD project. Fifty five people with neuritis were detected and treated with prednisolone out of 262 new patients; 47 of these improved; 1130 people completed a 3-year self-care programme; 88.5% of red eyes, 83.9% of hand ulcers and 62.8% of simple foot ulcer cases healed during that period. One hundred and ninety six people who presented with complicated ulcers were treated; of these 73 (37.2%) people presented with feet free of ulcers at the end of the project period. CONCLUSION: The POD project was a cost-effective method of preventing further disability occurrence among people affected by leprosy. Government health workers were generally able to implement and monitor the project effectively. Most of people affected by leprosy were satisfied that the improvements in their disabilities had been due to self-care. The programme had helped them to increase their confidence to implement self-care activities.

Reliability and validity of addiction severity index in drug users with methadone maintenance treatment in Guizhou province, China.

OBJECTIVE: To evaluate the reliability and validity of the Chinese version of addiction severity index (ASI)-5th version (ASI-C-5), in illegal drug users receiving methadone maintenance treatment (MMT) in China. METHODS: One hundred and eighty-six heroin addicts (144 men and 42 women) receiving MMT at three clinics in Guizhou province, southwest China, were recruited. They were all interviewed with a questionnaire of ASI-C-5 and 35 were re-interviewed at an interval of seven days to assess its test-retest reliability. RESULTS: Cronbach's alpha for internal consistency of CSs varied from 0.60 to 0.81 in all domains. Test-retest reliability of composite scores (CSs) of ASI-C-5 were satisfactory (r=0.38-0.97). Based on item analysis and expert's suggestions, five items were deleted and one item was modified in ASI-C-5. Criterion validity of ASI-C-5 was found acceptable, as compared to addicts' self-rating anxiety scale (SAS) and self-rating depression scale (SDS) (r=0.59 and 0.45) except for social support rating scale (SSRS). CONCLUSIONS: ASI-C-5 can be used for heroin addicts receiving MMT with acceptable reliability and validity.

[Risk factors associated with continued heroin use during methadone maintenance treatment in Guizhou province, China].

OBJECTIVE: To investigate the proportion of methadone maintenance treatment (MMT) clients continuing to use heroin and to explore its associated risk factors. METHODS: All 1003 heroin addictive patients were recruited from eight MMT clinics in Guizhou province and followed up for 14 months. During the 14 months, each MMT client received random urine tests. MMT clinics, gender, marital status, employment, ethnicity, religion, previous drug using method, having a history being in detoxification program, age, methadone dosage, education level and length of drug use were treated as potential predicting variables into the GEE model. RESULTS: The average age of the 1003 clients was (33.3 +/- 6.1) years old, the average length of drug use was (8.0 +/- 4.0) years, and the average daily methadone dosage was (38.0 +/- 16.6) mg. Among the 1003 clients, 26.0% were female drug users, 15.5% were divorced and 35.8% had a full time job. The rate of positive urine samples was approximately 30% for the first 10 months of follow-up, after which the positive rate decreased. The model found that different MMT clinics, the average daily methadone dosage (RR = 0.98, P = 0.003), treatment duration (RR = 0.95, P = 0.029) and years of education (RR = 0.94, P = 0.014) were associated with patients positive urine test. CONCLUSION: Continued heroin use was common in MMT clinics in Guizhou province; increasing the dosage of methadone and the duration in the treatment program might decrease the continued use of heroin among clients in MMT clinics.