[A retrospective cohort study of case fatality rate of HIV/AIDS cases and influencing factors in Jingzhou, Hubei Province, 1996-2021].

Objective: To analyze the case fatality rate of HIV/AIDS cases and influencing factors in Jingzhou. Methods: The data were retrieved from HIV/AIDS Comprehensive Response Information System and the cases diagnosed with HIV/AIDS in Jingzhou during 1996-2021 and aged 15 years or older were selected for the study. The death curve was drawn with Kaplan-Meier method, and Cox proportional-hazards model was used to identify influencing factors for death. Results: A total of 3 304 HIV/AIDS cases were followed up for 16 091.5 person-years, and 893 cases died, with a case fatality rate of 5.5/100 person-years. The cumulative case fatality rates of 1, 5 and 10 years were 15.4%, 25.0% and 34.6% respectively, the cumulative case fatality rates of 1, 5 and 10 years were 6.9%, 14.4% and 23.7% in the cases with access to antiretroviral therapy (ART), and 68.0%, 90.1% and 98.7% in the cases without access to ART. The results of Cox proportional hazards regression model showed that the risk for death was higher in those without access to ART than in those with access to ART (aHR=9.85, 95%CI: 8.19-11.85). The risk factors for death in those with access to ART included being men (aHR=1.64, 95%CI: 1.29-2.08), age ≥60 years old at diagnosis (aHR=3.52, 95%CI: 2.38-5.20), being infected by injecting drug use/others (aHR=2.38, 95%CI:1.30-4.34), being detected by medical institution (aHR=1.53, 95%CI: 1.11-2.11), CD4+T lymphocytes(CD4) counts <50 cells/µl (aHR=2.58, 95%CI: 1.87-3.58). The protective factor for death was high education level (high school and technical secondary school: aHR=0.64,95%CI:0.46-0.90; college and above: aHR=0.42, 95%CI: 0.24-0.73). The risk factors for HIV/AIDS death in those without access to ART included older age at diagnosis (30-44 years old: aHR=2.32, 95%CI: 1.40-3.84; 45-59 years old:aHR=2.61, 95%CI: 1.59-4.27; ≥60 years old: aHR=3.31, 95%CI: 2.01-5.47), lower CD4 counts (<50 cells/µl: aHR=10.47, 95%CI: 6.47-16.56; 50-199 cells/µl: aHR=2.31, 95%CI: 1.08-4.94; 200-349 cells/µl: aHR=2.35, 95%CI: 1.46-3.79). Conclusions: The case fatality rate of HIV/AIDS was relatively high in Jingzhou from 1996 to 2021, the first CD4 counts, ART and age at diagnosis were the major factors affecting HIV/AIDS death, "Expanding testing" and "prompt treatment upon diagnosis" should be continued and enhanced to improve the efficacy of ART and HIV/AIDS case survival.

[A survey of performance of public health risk assessment in emergencies of institutions for disease control and prevention at different levels in China].

Objective: To understand the performance of public health risk assessment in emergencies of institutions for disease control and prevention at different levels in China, and provide suggestions for the improvement of public health risk assessment. Methods: A self-administered survey was conducted in professionals involved in public health risk assessment in emergencies from national institution, provincial institutions and some prefectural institutions for disease control and prevention (1-2 prefectural institutions were selected using convenience sampling in each province) between March and April in 2021. Results: A total of 79 institutions for disease control and prevention were investigated, including 1 national institution, 32 provincial institutions and 46 prefectural institutions. By April 2021, all the 79 institutions surveyed had conducted risk assessment of public health emergencies, in which 61 (77.2%) had established departments responsible for the public health risk assessment, i.e. emergency management office or communicable disease prevention and control office (section), and regular risk assessment mechanisms. The main sources of information for public health risk assessment were public health surveillance systems, including the National Notifiable Diseases Reporting System (100.0%) and Public Health Emergencies Management Information System (97.5%). Compared with the provincial institutions, the prefectural institutions were more likely to use specific disease surveillance systems (84.8% vs. 62.5%; χ2=5.09, P=0.024). The risk management recommendations made by 43 institutions for disease control and prevention (54.4%) after the risk assessment were accepted by the superior health administrative departments and used in epidemic prevention and control. Conclusions: Public health risk assessment in emergencies has been widely carried out by national, provincial and prefectural institutions for disease control and prevention in China. Specialized departments and mechanisms have been established, but the information sources are still confined to public health surveillance systems and the application of the risk assessment results still needs to be further improved.

[Emergency training need and effect evaluation analysis of novel coronavirus pneumonia in centers of disease control and prevention].

A questionnaire was used to investigate the emergency training needs of novel coronavirus pneumonia of disease prevention and control institutions in provinces, deputy provincial level regions and cities specifically designated in the state plan, and the effect evaluation of emergency training activities conducted by Chinese Center for Disease Control and Prevention (China CDC). The results showed that 67.4% of 47 disease prevention and control institutions (31/46) believed that the emergency training at the initial stage of the epidemic should be conducted as soon as possible, and the form of network training should be given priority. The training should focus on the urgently needed technologies such as epidemiological investigation, formulation and response of prevention and control strategies, laboratory testing, etc. The teaching materials should highlight pertinence and practicability and be presented in the form of electronic video. The average satisfaction score of the video training conducted by China CDC was (8.81±1.125) and the score of audio-video courseware was (8.97±0.893). The needs analysis and evaluation of novel coronavirus pneumonia prevention and control in disease prevention and control institutions could provide reference for the follow-up training and improve the emergency training management.

[Diagnostic and predictive values of three criterias of acute kidney injury in children with chronic kidney disease].

Objective: To compare the consistency in diagnosing and staging acute kidney injury (AKI) in children with chronic kidney disease (CKD) according to three criterias. Methods: Children with CKD hospitalized in the First Affiliated Hospital of Sun Yat sen University from January 2013 to December 2019 were analyzed retrospectively. These patients underwent serum creatinine examination more than twice during hospitalization. The AKI diagnosis and staging were performed for each patient according to the 2007 pRIFLE, 2012 KDIGO and 2018 pROCK criteria respectively. All the children were followed up for 1 year after discharge through outpatient visit, re-hospitalization or online consultation. The clinical characteristics and prognosis of CKD children with or without AKI that were diagnosed by 3 criteria were compared. Analysis of variance and chi-squared tests were used for the comparison among groups. Concordance between the different diagnostic criteria was evaluated using Cohen's kappa coefficient. Result: A total of 2 551 children with CKD were included in this study, with an age of (8±4) years. There were 1 628 boys and 923 girls. Nephrotic syndrome was the most prevalent primary disease (55.4%), followed by lupus nephritis (11.2%) and purpura nephritis (8.2%). Among all stages of CKD, CKD category G1 was the most common type (2 146 cases, 84.1%), followed by CKD category G2 (221 cases, 8.7%). AKI occurence rates according to pRIFLE, KDIGO and pROCK criteria were 33.9% (866/2 551), 26.2%(669/2 551) and 19.5% (498/2 551) respectively (χ²=136.3,P<0.01). The diagnostic consistency within three criteria for AKI was high in children with CKD (κ=0.702), but AKI staging consistency was low (κ=0.329). Both the diagnosis and staging consistency of three AKI criteria were poor in children with CKD category G5 (all κ<0.400). The length of hospital stay (LOS), hospitalization costs, the occurence of intensive care unit (ICU) admission and in-hospital mortality were significantly higher in children with AKI diagnosed by different criteria (P<0.05). After 1-year follow-up, the repeated admission rate and CKD staging progress significantly increased in children with AKI (P<0.05). In children with baseline serum creatinine≥200 µmol/L, compared with children who did not experience AKI during hospitalization, the LOS and the hospitalization costs in children who were diagnosed AKI according to pRIFLE or pROCK criteria was significantly higher (P<0.05). However, there was no significant difference in the LOS and hospitalization costs between children with or without AKI who were diagnosed according to KDIGO criteria (all P>0.05). Conclusions: AKI diagnosed by all of the three criteria (pRIFLE, KDIGO and pROCK criteria) was associated with the poor prognosis in children with CKD. However, in those whose baseline serum creatinine≥ 200 µmol/L, AKI diagnosed by pRIFLE and pROCK criteria could better reflect the poor outcomes than by KDIGO criteria.

Circ-ABCB10 promotes proliferation and invasion of esophageal squamous cell carcinoma cells by modulating microRNA-670-3p.

OBJECTIVE: Circ-ABCB10 is a non-coding RNA newly discovered in recent years. It has been observed to serve as an oncogene in a variety of tumors, but its biological function in esophageal squamous cell carcinoma (ESCC) is still unknown. The purpose of this study was to investigate the circ-ABCB10 expression in ESCC and its possible molecular mechanism. PATIENTS AND METHODS: Circ-ABCB10 expression in ESCC tissue samples and cell lines was detected by quantitative real-time polymerase chain reaction (qRT-PCR). The impacts of circ-ABCB10 on the biological functions of ESCC cells were examined by cell counting kit-8 (CCK-8) and transwell assays. Moreover, bioinformatics analysis was used to determine the binding sites between miRNAs and circ-ABCB10, and the binding relationship was verified by qRT-PCR and Luciferase assay. RESULTS: QRT-PCR analysis revealed that circ-ABCB10 expression in both ESCC tissues and cell lines was higher than that in the normal control group. Patients in high TNM stage exhibited a higher expression of circ-ABCB10 than those in low stage, and this high expression predicted a poor prognosis of ESCC patients. Inhibiting circ-ABCB10 expression remarkably inhibited the growth and metastasis of ESCC cells. In addition, it was demonstrated that circ-ABCB10 could bind to microRNA-670-3p and inhibit its expression. Downregulation of microRNA-670-3p partially reversed the inhibitory impact of low-expressing circ-ABCB10 on cell growth and migration rate. CONCLUSIONS: Circ-ABCB10 accelerates the metastasis and proliferation of ESCC cells by binding to microRNA-670-3p. This circ-ABCB10 / microRNA-670-3p axis may become a potential therapeutic target for ESCC therapy.

[Implementation of Beijing Tobacco Control Regulation in restaurants in Dongcheng and Chaoyang districts of Beijing, 2018].

Objective: To evaluate the implementation effect of the Beijing Tobacco Control Regulation. Methods: An observational study was conducted in a multi-stage randomly selected sample of 93 restaurants in Dongcheng and Chaoyang districts, Beijing. Undercover visits to the restaurants were paid by investigators at lunch or dinner time. The incidence of smoking behavior and the posters of no-smoking signs were observed, waiters were interviewed about awareness of the regulation, and comparisons with the baseline data of 6 months before and 1 month after regulation implementation were made. Results: The pasting rate of no-smoking signs was 76.3%. The awareness of the regulation in the waiters surveyed was high. The incidence rate of smoking in restaurants (29.0%) was lower than that before the regulation implementation (36.7%), but it was significantly higher than that one month after regulation implementation (14.8%). No active interventions from the restaurant staff were observed when smoking occurred. The incidence of smoking in restaurants within commercial buildings (3.3%) was significantly lower than that in non-commercial buildings (41.3%), the difference was significant (P<0.05). Conclusions: The effect of the regulation weakened 3 years after implementation compared with that in 1 month after the implementation. The enforcement degree of the regulation was conflicted with pasting rate of no-smoking signs and the regulation awareness level in waiters in restaurants in Dongcheng and Chaoyang districts.

[Survey on extramarital sexual behaviors and HIV infection in middle-aged and elderly people aged 50 and above in selected areas of Chongqing].

Objective: To know the situation of extramarital sexual behaviors and HIV infection in middle-aged and elderly people in Chongqing, and provide reference for AIDS prevention and treatment. Methods: From October to December 2017, a multi-stage sampling method was used to recruit middleaged and elderly people aged ≥50 years who lived in Dazu and Hechuan districts of Chongqing for at least one year, with a sample size of 410. Face-to-face questionnaires survey and HIV antibody test were conducted. Results: A total of 408 people were surveyed, including 313 males and 95 females aged 50-88 (64.93±9.03) years. The HIV infection rate was 1.47% (6/408), with the rate of 1.28% (4/313) in males and 2.11% (2/95) in females. The awareness rate of AIDS related knowledge was 37.50% (153/408). And 18.87% (77/408) of subjects surveyed reported extramarital sexual behaviors, 7.60% (31/408) reported extramarital sexual behaviors in the past half year, the constant condom use rate was 19.35% (6/31). The results of multivariate logistics model analysis on extramarital sexual behaviors showed that the prevalence in males were 39.51 times higher than that in females (OR=39.51, 95%CI: 5.03-310.30), 4.60 times higher in those who were unmarried, divorced or widowed than that in the married or cohabitants (OR=4.60, 95%CI: 1.50-14.05), 2.03 times higher in those with outside activities than those with individual activities (OR=2.03, 95%CI: 1.08-3.81) and 3.94 times higher in those with self-evaluation of emptiness of living state than that in those with engaged life (OR=3.94, 95%CI: 1.86-8.36). Conclusions: The prevalence of extramarital sexual behavior in middle-aged and elderly people in some counties and districts in Chongqing is high. The factors such as gender, marital status, leisure activities, and self-evaluation of living state were related to the prevalence of extramarital sexual behaviors in this population. The condom use rate in extramarital sexual behavior was low. It is necessary to take effective interventions in this population.

[Clinical observation on human alpha glucosidase in treatment of five patients with glycogen storage disease â ¡].

Objective: To evaluate the effect of enzyme replacement therapy (ERT) on glycogen storage disease typeⅡ(GSDⅡ). Method: The clinical data of three juvenile onset and two infant onset GSDⅡpatients were collected from First Affiliated Hospital of Sun Yat-sen University in October 2015 to July 2016.Patient 1 was female, the age of onset was 15 months. Patient 2 was male, the age of onset was 20 months. Patient 3 was female, the sister of patient 2, the age of onset was 47 months. Patient 4 was male, the age of onset was 5 months. Patient 5 was male, the age of onset was 1 month.The age at the start of ERT of the 5 patients was 32, 31, 56, 34, and 3 months respectively and the duration of ERT was 19, 9, 4, 5, 5 doses respectively.ERT was administered at 20 mg/kg every 2 weeks.Dexamethasone was regularly given before each infusion. Result: ERT was well tolerated, only one time, Patient 1 developed tachycardia and hypertension without using dexamethasone.Patient 2 underwent successfully ventilator weaning.Patient 1 underwent a tracheotomy, also needed mechanical ventilation treatment.Patient 4 noninvasive ventilation was tried. Conclusion: Recombinant human alpha-glucosidase treatment was effective and well tolerated in patients with GSDⅡ.

Cadmium toxicity is alleviated by AtLCD and AtDCD in Escherichia coli.

AIMS: Arabidopsis thaliana l- and d-cysteine desulfhydrases (AtLCD and AtDCD) are two important H(2) S-generating enzymes. This study determined the effects of H(2) S derived from AtLCD and AtDCD on cadmium (Cd) toxicity in Escherichia coli. METHODS AND RESULTS: AtLCD and AtDCD were cloned into pET28a vectors and transformed into wild-type E. coli strain BL21(DE3), named BL21(LCD) and BL21(DCD). In the induced BL21(LCD) and BL21(DCD) compared with wild type, significantly higher H(2) S generation rates were observed. Additionally, higher survival rates, reduced contents of malondialdehyde (MDA) and hydrogen peroxide (H(2) O(2)), decreased activities of superoxide dismutase and catalase under 220 µmol l(-1) Cd stress were noted. We obtained similar results in the wild type treated with NaHS, a H(2) S donor. The above changes were substantially counteracted by the mixture of ammonia and pyruvic acid potassium (NH(3) + C(3) H(3) KO(3)), a synthetic inhibitor of H(2) S. CONCLUSIONS: AtLCD and AtDCD catalyse the H(2) S production, generating an ameliorating effect against Cd-induced oxidative stress and resulting in E. coli resistance to Cd toxicity. SIGNIFICANCE AND IMPACT OF THE STUDY: H(2) S as a gasotransmitter is certified to have an ameliorating effect against Cd toxicity, thus providing information for further research regarding the role of H(2) S in regulating resistance to the heavy metal stress in organisms.

Selective digesta retention and coprophagy in Brandt's vole (Microtus brandti).

Digestive performance, gut morphology and rate of digesta passage were measured in Brandt's voles (Microtus brandti) offered pelleted diets of low (25% neutral-detergent fibre) and high (38%) fibre content. Digestion coefficients of dry matter, crude fat, crude protein, energy and fibre were all significantly lower on the higher fibre diet. Although not significantly higher, dry matter intakes were more than maintained when extra cellulose was included in the diet, so that intakes of digestible energy were only 22% lower on the higher fibre diet. Total length and total gut tissue weight increased significantly, and the length and tissue weight of the caecum, proximal colon, and distal colon were significantly greater on the higher fibre diet as well. Total tract mean retention time (MRT) of a solute marker (Co-EDTA) was significantly greater than that of a particle marker (Cr-cell walls) on the lower fibre diet, and in the same direction on the higher fibre diet. The ratio of solute to particle MRTs (the solute/particle differential retention ratio) was 1.45 on the lower fibre diet and 1.19 on the higher fibre diet. There were no significant differences in marker MRTs between diets. Examination of marker concentrations in the stomach, small intestine, caecum and colon of voles killed at 0.5-h intervals after a pulse dose of Co-EDTA indicated that the marker was recycled to the stomach by coprophagy. Thus, as in other microtine rodents, an increase in gut capacity, selective digesta retention and recycling of digesta via coprophagy enables Brandt's voles to utilise diets of higher fibre content than may be expected for such a small (45 g) mammalian herbivore.

Effects of dietary fibre on digesta passage, nutrient digestibility, and gastrointestinal tract morphology in the granivorous Mongolian gerbil (Meriones unguiculatus).

To investigate digestive tract performance in Mongolian gerbils (Meriones unguiculatus), food intake and digestibility, digesta passage rate, and gastrointestinal tract morphology were measured in captive animals fed low- or high-fibre diets. We used two markers (Co-ethylene diamine tetra-acetic acid for solutes and Cr-mordanted cell walls for particles) to measure differential passage rates of digesta fractions in order to test for the presence of a colonic separation mechanism (CSM). Although dry-matter intakes on the high-fibre diet did not differ from those on the low-fibre diet, digestibilities of dry matter, neutral-detergent fibre, acid-detergent fibre, crude protein, and crude fat were all significantly lower on the high-fibre diet. Gross energy intake on the high-fibre diet also did not differ from that on the low-fibre diet, but energy lost in faeces was much higher than on the low-fibre diet; thus, energy digestibility and digestible energy intake were significantly lower on the high-fibre diet. The lengths and dry-tissue masses of all segments of the gastrointestinal tract tended to enlarge in response to increased dietary fibre, but only the total tract contents, contents of the small intestine, and length and dry-tissue mass of the caecum increased significantly. The mean retention time (MRT) of the particle marker was significantly greater than that of the solute marker on the low-fibre but not the high-fibre diet; the solute/particle differential retention ratio was 0.62 on the low-fibre diet and 0.90 on the high-fibre diet. Thus, there was no evidence for selective retention of the solute marker on either diet. The MRT of the particle marker was significantly lower on the high-fibre diet and in the same direction as the MRT of the solute marker. These results suggest that the granivorous Mongolian gerbil has no CSM but can adjust its digestive tract capacity to accommodate greater quantities of low-quality food.