Characteristics of HIV-infected persons without long term disease progress and related factors in Guangxi Zhuang Autonomous Region / 中华流行病学杂志

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.

Dynamic variations of BMI and influencing factors among HIV/AIDS patients receiving highly active antiretroviral therapy in Liuzhou, Guangxi Zhuang Autonomous Region, 2013-2014 / 中华流行病学杂志

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.

Effect of baseline CD(4)(+) T cell count on drop-out of antiretroviral therapy in HIV infected persons in Guangxi Zhuang Autonomous Region, 2008-2015 / 中华流行病学杂志

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.

Ultrasonography of immature teratomas: 11 case reports

Ovarian immature teratoma is a very rare type of tumor associated with a high relapse rate and mortality. Correspondingly, early diagnosis is important for effective treatment. The goal of this study was to retrospectively analyze the ultrasound characteristics of 11 cases of immature teratomas. Between January 2002 and December 2010, 11 patients were diagnosed with pathologically confirmed immature teratomas. Patients enrolled in this study underwent a transabdominal ultrasound examination prior to surgery. Tumor size, shape, internal echo, calcification, cystic degeneration, and blood flow for each immature teratoma were analyzed. Levels of alpha fetal protein [alphaFP] were also evaluated. The average tumor size was 8 cm [range, 4-13]. Echo patterns obtained included mixed echo [n = 7], solid echo [n = 2], and cystic echo [n = 2]. Coarse calcifications were detected in five cases, while blood flow signal was detected in one case, and ascites were detected in three cases. Only one case had elevated levels of alphaFP. Ultrasound imaging of immature teratomas detected large tumors that were predominantly involved mixed-echo masses, cystic degeneration, and coarse calcification on the cavity wall. In some cases, blood flow signal was detected in the mass and ascites were present in the abdominal cavity

Key uncertainty sources analysis of water quality model using the first order error method

In this study, key uncertainty sources analysis was undertaken for a dynamic water model using a First order error analysis method. First, a dynamic water quality model for the Three Gorges Reservoir Regions was established using data after impoundment by the environmental fluid dynamics code model package. Model calibration and verification were then conducted using measured data collected during 2004 and 2006. Four statistical indices were employed to assess the modeling efficiency. The results indicated that the model simulated the variables well, with most relative error being less than 25%. Next, input and parameter uncertainty analysis were conducted for ammonia nitrogen, nitrate nitrogen, total nitrogen, and dissolved oxygen at 3 grid cells located in the upper, middle and downstream portions of the research area. For the nitrogen related variables, input from Zhutuo Station, the Jialingjiang River, and the Wujiang River were the main sources of uncertainty. Point and nonpoint sources also accounted for a large ratio of uncertainty. Moreover, nitrification contributed some uncertainty to the estimated ammonia nitrogen and nitrate nitrogen. However, reaeration was found to be a key source of uncertainty for dissolved oxygen, especially at the middle and downstream reaches. The analysis conducted in this study gives a quantitative assessment for uncertainty sources of each variable, and provides guidance for further pollutant loading reduction in the Three Gorge Reservoir Region