Current situation related to antiretroviral therapy and related influential factors on HIV infected injection drug users in the methadone maintenance treatment clinics / 中华流行病学杂志

<p><b>OBJECTIVE</b>To find out the current coverage of antiretroviral therapy (ART) among HIV positive subjects and to identify the major influential factors associated with the participation in ART among them.</p><p><b>METHODS</b>291 HIV positive subjects from 6 methadone maintenance treatment (MMT) clinics in Guangxi and Yunnan province were surveyed by questionnaires.</p><p><b>RESULTS</b>217 males (74.6%) and 74 females (25.4%) were under investigation, with the average age of 38.4 +/- 5.9. Most of them received less than senior high school education, married and unemployed. Results from the single factor logistic regression analysis showed that: working status, living alone, self-reported history of drinking alcohol in the last month, negative attitude towards MMT among family members,poor self-reported compliance to MMT in the last month,lack of incentives in the MMT clinics, reluctance on disclosure of their own HIV status, good self-perception on their health status, lack of communication on ART related topics among family members in the last 6 months, lack of correct attitude and knowledge on ART etc. appeared as the main factors that influencing the participation in ART program among the patients. Data from the multivariate logistic regression analysis showed that factors as: living alone, unwilling to tell others about the status of HIV infection, poor self-perception on HIV infection, lack of discussion of ART related topics within family members in the last 6 months and poor awareness towards ART among the family members etc., were associated with the low participation rate of ART. Conclusion Strengthening the publicity and education programs on HIV positive patients and their family members at the MMT clinics seemed to be effective in extending the ART coverage. Attention should also be paid to increase the family support to the patients.</p>

Factors associated with overdose-caused mortality of HIV-positive patients who were on methadone maintenance treatment program / 中华流行病学杂志

Objective To study the factors that associated with the mortality of overdose on methadone maintenance treatment (MMT) among HIV-positive patients.Methods A 1 ∶ 1 matched case-control design was used to identify the relationship between factors related to demography,drug use,characteristics of treatment and the mortality of overdose.110 HIV-positive patients who died of drug overdose from March 2004 to September 2012 were defined as cases.Controls were another 110 patients who were still alive and paired with the cases,according to the same gender,similar date of MMT initiation and from the same clinics.Results Multivariate conditional logistic regression analyses indicated that risk factors as sharing needles before enrolled in the MMT program (OR=5.19,95％ CI:1.39-19.33),HIV infection because of injecting drug-use (OR=3.08,95％ CI:1.16-8.21),and off from the treatment before the end point of the program (OR=2.54,95％CI:1.23-5.23) were associated with mortality caused by overdose.Higher adherence (OR=0.31,95％CI:0.10-0.95) appeared to be associated with lower mortality when compared with the control group.Conclusion In order to reduce the mortality rate,comprehensive intervention could be introduced to improve the compliance of retention on MMT among patients.Intervention efforts should be focused on those patients who shared needle / syringes.

Research of determination methods of fluorouracil injection / 中国药学杂志

OBJECTIVE: To confirm the best content determination method of fluorouracil injection. METHODS: The contents of 95 batches of fluorouracil injection were determined by UV spectrophotometry absorption coefficient method and high performance liquid chromatography (HPLC), respectively. Through investigation of method recoveries, the reasons for difference in the content determination results were further analyzed. RESULTS: The HPLC determination results were slightly higher than those of the UV method (P<0.05), The intervonversion of double alcohol type structure and double ketone type structure of fluorouracil might lead to the lower recovery and determination results of UV method. CONCLUSION: The HPLC method is more accurate and reliable than UV method qualitatively and quantitatively.

Evaluation on the long-term effectiveness among the first set eight methadone maintenance treatment clinics in China / 中华流行病学杂志

Objective To evaluate the long-term effectiveness of the first set 8 methadone maintenance treatment (MMT) clinics in China. Methods Repeated cross-sectional surveys were conducted on the first month after the enrollment and 5 years later,among drug users who received MMT,using a standard questionnaire.Data on demographic characteristics,HIV-related high-risk bchaviors,criminal records associatcd with drug use and related family/social functions were collected and analyzed.Results There were 252 and 195 participants being interviewed at the baseline and the 5-year surveys,respectively,.Of them,66 participants were involved in both surveys.There was no significant differences on factors as ethnicity,level of education,working status,marital status and living status (P＞0.05) between the baselinc and the 5-year surveys.Compared with data from the baseline survey,participants' behavior on drug abuse (100.0％ vs.24.1％,P＜0.001 ),needle sharing behavior ( 19.4％ vs.0.0％,P ＜ 0.001 ),and exchanging sex for drugs ( 34.5 ％ vs.0.0％,P＜0.001 ) had significant decreases at the 5-year survey.Rates on condom use ( 10.6％ vs.25.0％,P=0.004),and having jobs (27.8％ vs.47.7％,P＜0.001 ) had been improved significantly,while self-reported criminal cases related to drug use (15.1％ vs.1.5％,P＜0.001) and the contacts with drug users (88.9％ vs.31.3％,P＜0.001) had been significantly reduced after joining the MMT program.Conclusion MMT could play an active role in reducing the HIV-related high-risk behaviors,criminal cases associated with drug abuse as well as enhancing the family and social functions of the MMT patients.Providing high quality service to the MMT clinic and trying to keep the drug users stick to the program remain difficult.It was also important to improve the training programs for staff working at the MMT clinics.

Characteristics and associated factors of long-term retention for methadone maintenance treatment patients / 中华预防医学杂志

<p><b>OBJECTIVE</b>To describe the characteristics and factors associated with long-term retention for methadone maintenance treatment (MMT) patients.</p><p><b>METHODS</b>This study was conducted in eight MMT clinics located in Sichuan, Yunnan, Guangxi, Guizhou and Zhejiang provinces. Five hundred and thirty-nine MMT patients who enrolled in MMT clinics in 2004 and retained in treatment by June 2010 were selected as study subjects. Chi-square tests were used to compare the demographics and drug abuse history at enrollment and treatment characteristics during the follow-up period between continuous treatment patients and discontinuous treatment patients.</p><p><b>RESULTS</b>Of the 539 patients, 110 (20.4%) were continuous treatment patients whereas 429 (79.6%) were discontinuous treatment patients. Of these 429 discontinuous treatment patients, 84.1% (361/429) had 2-4 treatment episodes whereas 15.9% (68/429) had 5 or more episodes during follow-up period. When continuous treatment patients were compared with discontinuous treatment patients, living with family members or friends (88.2% (97/110), 78.5% (337/429)), age of first drug use under 25 (61.8% (68/110), 71.3% (306/429)), low urine morphine positive test results (67.3% (74/110), 38.2% (164/429)) and living within 5 kilometers of the MMT clinic (72.7% (80/110), 61.3% (263/429)) were positively associated with higher possibility of continuous treat retention (P < 0.05). Demographics and drug abuse characteristics at enrollment, including gender, age, employment status, family relationship, injection, needle sharing, criminal behavior, contacts with drug users, MMT daily dosage and family members receiving MMT were not significantly associated with treatment retention (P > 0.05).</p><p><b>CONCLUSION</b>Illicit drug use during the treatment and longer distance travelling to MMT clinic might have negative impact on patients' continuous treatment retention. Mobile MMT vehicles and expanded MMT service sites could be introduced to improve compliance of treatment retention of MMT patients.</p>

Conserved motifs in voltage sensing proteins / 生理学报

This paper was aimed to study conserved motifs of voltage sensing proteins (VSPs) and establish a voltage sensing model. All VSPs were collected from the Uniprot database using a comprehensive keyword search followed by manual curation, and the results indicated that there are only two types of known VSPs, voltage gated ion channels and voltage dependent phosphatases. All the VSPs have a common domain of four helical transmembrane segments (TMS, S1-S4), which constitute the voltage sensing module of the VSPs. The S1 segment was shown to be responsible for membrane targeting and insertion of these proteins, while S2-S4 segments, which can sense membrane potential, for protein properties. Conserved motifs/residues and their functional significance of each TMS were identified using profile-to-profile sequence alignments. Conserved motifs in these four segments are strikingly similar for all VSPs, especially, the conserved motif [RK]-X(2)-R-X(2)-R-X(2)-[RK] was presented in all the S4 segments, with positively charged arginine (R) alternating with two hydrophobic or uncharged residues. Movement of these arginines across the membrane electric field is the core mechanism by which the VSPs detect changes in membrane potential. The negatively charged aspartate (D) in the S3 segment is universally conserved in all the VSPs, suggesting that the aspartate residue may be involved in voltage sensing properties of VSPs as well as the electrostatic interactions with the positively charged residues in the S4 segment, which may enhance the thermodynamic stability of the S4 segments in plasma membrane.

Risk factors which were associated with heroin use during the methadone maintenancetreatment among 1301 patients in 9 cities of China / 中华流行病学杂志

Objective To determine the proportion of heroin use among patients who were involved in community-based methadone maintenance treatment (MMT) program and to identify the risk factors associated with heroin use. Methods This study was conducted in 9 MMT clinics within 3 provinces. Thirteen hundred and one patients who met the study criteria were selected from each of the five groups with different dosages of methadone users. An administrative questionnaire was applied to explore the demographics,drug abuse-related behaviors and MMT services received by the clients,etc. The prevalence of depression and anxiety among the clients were also collected by SAS and SDS. Urine samples were collected as a biological marker to indicate if heroin had been used. Results Of the 1301 patients,76.2% were males. The mean age was (34.6±6.5) years while 71.7% had an education level of primary school or below. The average daily dosage of methadone was (48.1±29.4) mg and self-satisfied evaluation score on treatment was 8.6. On average,27.7% urine samples showed positive opiate evidence. Marital status,employment status,treatment retention,self-satisfied evaluation score on dosage and dropout history were found to be significantly associatedwith heroin use,while gender,education level and dosage had no significant association with heroin use. It seemed that risk factors that associated with heroin use were different from areas to areas. Conclusion High quality MMT clinic services,high self-satisfied score,longer treatment retention and low dropout rate seemed to have the effects of reducing the risk of ongoing heroin abuse under the methadone maintenance treatment program.

Evaluation of first 8 pilot methadone maintenance treatment clinics in China / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To evaluate the effectiveness of the first eight pilot methadone maintenance treatment (MMT) clinics in China.</p><p><b>METHODS</b>A questionnaire survey of the clients at the 8 pilot MMT clinics was performed at entry, 6 month and 12 month follow-up. Drug using behaviors, drug related crime behaviors, and relationships in families were compared among at entry, 6 and 12 months follow-up.</p><p><b>RESULTS</b>There were 585, 609 and 468 clients involved at baseline, 6 month and 12 month follow-up surveys, respectively. At entry, 6 month and 12 month follow-up, the proportion of clients whose injection of drugs reduced from 69.1% to 8.9% and 8.8%, and the frequency of injection in the past month had reduced from 90 times per month to 2 times per month. Employment rate increased from 22.9% to 43.2% and 40.6%, and self-reported criminal behaviors reduced from 20.7% to 3.6% and 3.8%. At 12 month follow-up, 65.8% of clients reported a healthy family relationship, increased from 46.8% at entry, 95.9% of clients reported that they were satisfied with the MMT service.</p><p><b>CONCLUSION</b>Pilot MMT program reduced drug use, drug injecting behaviors, drug related criminal behaviors, and improved relationship with family members. Therefore, MMT clinic should be considered as a platform for providing comprehensive services to drug users.</p>