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Background: Coronary heart disease (CHD) coupled with hypertension presents a significant health challenge worldwide. Optimal management strategies for controlling blood pressure and improving outcomes in this patient population remain a topic of interest and investigation within the medical community. Objective: This study aimed to compare the efficacy of amlodipine alone versus amlodipine combined with valsartan in patients diagnosed with coronary heart disease and hypertension. Methods: A prospective cohort study was conducted, and a total of 80 patients diagnosed with coronary heart disease and hypertension who visited the hospital between August 2022 and May 2024 were selected as study participants. Patients were allocated into two groups based on admission order: the control group (n=40) received amlodipine treatment, while the research group (n=40) received combined therapy with valsartan and amlodipine. The clinical efficacy between the two groups was compared. Results: Patients in the research group exhibited significantly better blood pressure control compared to the control group (P < .05). Moreover, the overall treatment effectiveness was notably higher in the research group than in the control group (P < .05). After treatment, a statistically significant difference was observed in blood lipid levels between the two patient groups (P
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Objective To establish an allogeneic rat model of endometriosis and to evaluate the effects of gonadotropin-releasing hormone (GnRH) agonist GenSci006 on experimental rat endometriosis. Methods Endometrium from SPF grade donor female SD rats were transplanted onto the abdominal wall of recipient female rats to construct an allogeneic endometriosis model. The rats undergoing sham surgery were divided into the sham group. Three weeks later, the length, width and height of the ectopic endometrium were measured, and the volume of the endometrium (V1) was calculated before drug administration. The modeling rats were randomly divided into four groups: model group, triptorelin group (0.25 mg/kg), GenSci006-1 group (0.125 mg/kg) and GenSci006-2 group (0.25 mg/kg). Each group had 16 rats and received a single dose of the corresponding drug. The sham group and model group were administered an equal volume of solvent. Three weeks after administration, ectopic endometrium was measured to calculate the volume V2 and inhibition rate. The effect of GenSci006 on rat uterus and ovarian tissues was assessed by comparing organ coefficients and changes in pathological sections. Enzyme-linked immunosorbent assay (ELISA) was used to measure the levels of serum estradiol (E2), progesterone (P4), follicle stimulating hormone (FSH), and luteinizing hormone (LH). Real-time fluorescent quantitative PCR was used to detect the expression of GnRH receptor (GnRHR) mRNA in the hypothalamus and pituitary. Western blot was used to detect the expression of estradiol receptor alpha (ERα), beta (ERβ) and progesterone receptor (PR) in ectopic endometrium. Results Three weeks after administration, compared with the model group, the body weight of rats in the triptorelin and GenSci006-2 groups significantly increased (P < 0.05), while the volume of ectopic endometrium significantly decreased (P < 0.05). Compared with the sham group, the model group showed no significant changes in uterine and ovarian organ coefficients or endometrial thickness (P > 0.05). Compared with the model group, the uterine organ coefficients and endometrial thickness were significantly reduced in the triptorelin and GenSci006-2 groups (P < 0.05). Compared with the sham group, the serum levels of E2, P4, FSH and LH in the model group showed no significant changes (P > 0.05). Compared with the model group, the ovarian organ coefficient and serum P4 levels of rats in the Triptorelin, GenSci006-1, and GenSci006-2 groups were significantly reduced (P < 0.05), while the serum LH levels of rats in the GenSci006-1 group were significantly increased (P < 0.05). However, there were no significant changes in serum E2 and FSH levels in each group (P > 0.05). Compared with the model group, the expression levels of GnRHR mRNA in the pituitary tissue of rats in the triptorelin and GenSci006-2 groups were significantly downregulated (P < 0.05), with no significantly changes in the hypothalamus (P > 0.05). There were no significant changes in the expression level of GnRHR mRNA in the hypothalamus or the protein levels of ERα, ERβ and PR in the ectopic endometrial tissue in any group (P > 0.05). Conclusion The allogeneic endometriosis rat model is a suitable animal model for screening and evaluating drugs for treating endometriosis. The volume of ectopic endometrium, inhibition rate, uterine and ovarian organ coefficients, and serum E2 levels may serve as indicators for detecting drug efficacy.
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COVID-19 is caused by a novel coronavirus-severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), which has being spreading around the world, posing a serious threat to human health and lives. Neutralizing antibodies and small molecule inhibitors for virus replication cycle are the main antiviral treatment for novel coronavirus recommended in China. To further promote the rational use of antiviral therapy in clinical practice, the National Center for Infectious Diseases (Beijing Ditan Hospital Capital Medical University and the First Affiliated Hospital, Zhejiang University School of Medicine) invited experts in fields of infectious diseases, respiratory and intensive care to develop an Expert Consensus on Antiviral Therapy of COVID-19 based on the Diagnosis and Treatment Guideline for COVID-19 ( trial version 10) and experiences in the diagnosis and treatment of COVID-19 in China. The consensus is concise, practical and highly operable, hopefully it would improve the understanding of antiviral therapy for clinicians and provide suggestions for standardized medication in treatment of COVID-19.
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【Objective】 To analyze the clinical characteristics and prognostic differences between type Ⅰ and type Ⅱ papillary renal cell carcinoma (PRCC), and identify the prognosis-related independent predictors. 【Methods】 A total of 143 PRCC patients treated during Jan.2012 and Dec.2019 were involved, including 91 type Ⅰ patients and 52 type Ⅱ patients. The prognostic factors were analyzed with univariate and multivariate Cox regression analysis. The differences in cancer-specific survival (CSS) between the two groups were analyzed with Kaplan-Meier method and log-rank test. 【Results】 The patients’ age was 53.41±13.50 years. After a mean follow-up of 63.27±26.20 months, 14 patients died, and the overall CSS was 90.2%. The prognosis of type Ⅰ patients was better than type Ⅱ patients (94.5% vs. 82.7%, P=0.020). Cox regression suggested that PRCC subtype and stage were significantly associated with prognosis. There was no difference in prognosis between type Ⅰ and type Ⅱ patients in T1/T2 subgroup (P>0.05). However, in T3/T4 subgroup, type Ⅰ patients had a significant better prognosis than type Ⅱ patients (P=0.023), while the above trends were not observed in G1/G2 and G3/G4 subgroups (P>0.05). 【Conclusion】 PRCC subtype and stage are independent prognostic predictors. The impact of PRCC subtype on prognosis is mainly manifested in the subgroup of patients with T3 or higher stage.
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China is stepping up its standardized management of investigator initiated trials(IIT)carried out by medical and health institutions, spotlighting the establishment and improvement of the quality control system of IIT projects than ever before. The authors retrieved official websites of clinical research related units of medical institutions and research institutes at home and abroad, and by means of literature review analyzed the current quality management of IIT projects at home and abroad. They found such setbacks as lack of quality management standards and norms, imperfect quality control mechanism, poor awareness of quality risk, insufficient quality supervision and poor quality control ability of clinical researchers. Based on the above, the paper made the following recommendations for building an IIT project quality control system in China: developing quality management standards and norms, setting up a systematic quality control mechanism(i.e., exploring a three-level quality control mode composed of the project team/department-hospital-national supervision institution/peer review expert team, and implementing the whole process quality control mechanism), strengthening policy guidance and system construction, and strengthening the standardized training of clinical researchers.
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【Objective】 This paper screened the factors that may influence the spatial differentiation of Neutrophil-to-lymphocyte ratio （NLR） reference values in healthy adults in China and explored the trend of NLR reference values in China. 【Methods】 For this research， we collected the NLR of 162 681 healthy adults from 62 cities in China. Spearman regression analysis was used to analyze the correlation between NLR and 25 geography secondary indexes. We extracted 9 indexes with significant correlation， built a random forest （RF） model， and predicted the country’s urban healthy adults’ NLR reference value. By using the disjunctive Kriging method， we obtained the geographical distribution of NLR reference value of healthy adults in China. 【Results】 The reference value of NLR of healthy adults in China was significantly correlated with the 9 secondary indexes， namely， altitude， sunshine duration， annual average temperature， annual average relative humidity， annual temperature range， annual average wind speed， content of organic matter in topsoil， cation exchange capacity in topsoil （clay）， and total amount of CaSO4 in soil. The geographical distribution of NLR values of healthy adults in China showed a trend of being higher in Southeast China and lower in Northwest China， higher in coastal areas and lower in inland areas. 【Conclusion】 This study lays a foundation for further research on the mechanism of different influencing factors on the reference value of NLR index. A random forest model composed of significant influencing factors has been established to provide the basis for formulating reference criteria for the prognostic factors of the novel coronavirus using NLR reference values in different regions.
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Objective:To explore the optimal monochromatic level for the observation of coronary in-stent lumen by dual-layer spectral CT (DLCT).Methods:Forty-nine patients with 74 stents after percutaneous coronary intervention (PCI) who underwent coronary CTA (CCTA) examinations by a DLCT between January 2016 and September 2017 were retrospectively enrolled. A total of 12 groups of images including 60-120 keV (kilo electron voltage) images with 10 keV interval, 140-200 keV images with 20 keV interval and conventional images. In-stent lumen diameter of proximal, mid and distal portion was measured. Difference of CT values between in-stent lumen and ascending aorta was used to describe as blooming artifact, and noise of in-stent lumen as image noise. Then Likert 5-point scale was performed to evaluate images noise, enhancement of in-stent lumen, blooming artifact and diagnostic confidence. Differences of objective and subjective parameters among conventional and various monochromatic images were compared by Friedman test.Results:In the diameter measurement of the proximal, middle and distal segments of the stent, the difference between the images of each group was statistically significant (χ 2 = 427.270, 426.375, 400.981, P< 0.001). The diameter of the lumen measured by 120-200 keV single-level image was larger than that measured by 60-100 keV single-level image, and the difference was statistically significant ( P< 0.05). In the comparison of CT difference between the stent lumen and ascending aorta, the difference between the images of each group was statistically significant (χ 2 = 242.193, P< 0.001), and 100-200 keV single-level images were lower than the conventional images, the difference was statistically significant ( P< 0.05). In the comparison of noise values, the difference between the images of each group was statistically significant (χ 2 = 420.161, P< 0.001), and the difference was statistically significant ( P< 0.05). In the subjective scores of noise, enhancement, halo artifact and diagnostic confidence, there were statistically significant differences among the groups (χ2= 333.827, 455.989, 276.824, 399.497, P< 0.001). The noise score of 100-200 keV single-level image was higher than that of conventional image, the difference was statistically significant ( P< 0.05). The enhancement score of 60 keV was significantly higher than that of other images ( P< 0.05). The halo artifact score of 100-200 keV single level image was higher than that of 60-90 keV image, the difference was statistically significant ( P<0.05). The scores of 90-120 keV single-level images were higher than those of other single-level images, and the difference was statistically significant ( P< 0.05). Conclusions:CCTA examinations can be effectively performed by DLCT in patients after PCI in clinical settings, and 120 keV is recommended as the optimal monochromatic image for the observation of in-stent lumen.
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Objective To explore the effect and mechanism of Yes-associated protein (YAP) in hepatic ischemia-reperfusion injury (IRI) of mice. Methods Forty male C57BL/6 mice were randomly divided into the sham operation group (Sham group), lysophosphatidic acid (LPA) + Sham group, IRI group and LPA+IRI group, 10 mice in each group. Liver tissue and serum samples were collected at 6 h after ischemia-reperfusion. The levels of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were detected. Histopathological changes and macrophage infiltration of liver tissues were detected by hematoxylin-eosin (HE) staining and immunohistochemical staining. The protein expression level of YAP was detected by Western blot. The messenger ribonucleic acid (mRNA) expression levels of inflammatory cytokines including tumor necrosis factor (TNF)-α, inducible nitric oxide synthase (iNOS), interleukin (IL)-1 and IL-6 were quantitatively measured by reverse transcription polymerase chain reaction (RT-PCR). Results Western blot results demonstrated that the protein expression level of YAP in the LPA+IRI group was significantly up-regulated than that in the IRI group. Compared with the Sham group, the ALT and AST were significantly higher in the IRI group (both P < 0.05). The serum levels of ALT and AST in the LPA+IRI group were significantly lower than those in the IRI group (both P < 0.05). HE staining revealed that the morphology of hepatocytes was normal in the Sham group and LPA + Sham group. Pathological changes, such as liver congestion, liver cell swelling and structural abnormalities of hepatic lobule, occurred in the LPA+IRI group and IRI group. Compared with the IRI group, pathological changes were alleviated in the LPA+IRI group. RT-PCR indicated that the mRNA expression levels of TNF-α, iNOS, IL-1 and IL-6 in the LPA+IRI group were lower than those in the IRI group (all P < 0.05). Immunohistochemical demonstrated that LPA partially inhibited macrophage infiltration in ischemic tissues after IRI. Conclusions YAP can significantly mitigate hepatic IRI. The mechanism is associated with the regulation of macrophage recruitment and activation.
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Objective@#To explore the survival status and influencing factors on former plasma donors (FPD) living with HIV/AIDS after initiation of antiretroviral therapy (ART) during 2002-2017 in Henan province.@*Methods@#A retrospective study was conducted, using data from the ART database of national comprehensive HIV/AIDS information system. The inclusion criteria on patients would include HIV/AIDS cases with current residence in Henan province, route of infection being blood-borne (plasma collection), initiation of ART between 2002 and 2017, and 15 year-olds or above. According to the time of initation on antiviral treatment, observation was carried on between January 1, 2002 and December 31, 2017. Outcome of observation was defined as death caused by AIDS or related diseases. Life Table was used to estimate the survival rate and Kaplan-Meier method was used to draw the survival curve. Log-rank test was used to compare the univariate intergroup survival rates while Cox proportional hazards regression model was used to analyze the influencing factors on survival status among deaths due to AIDS or related diseases. Excel 2010 software and SPSS 23.0 software was used for data cleaning and statistical analysis.@*Results@#A total of 25 825 HIV/AIDS patients were enrolled in this study. During the follow-up period, the overall mortality was 3.9/100 person year (8 354/214 796.3), among all the patients. The accumulate survival rates of 1 year, 4 years, 8 years, 12 years and 16 years after the initiation of ART were 91.2%, 80.1%, 71.2%, 65.7% and 61.5%, respectively. The results from the multivariate Cox proportional hazards regression model analysis showed that male vs. female (aHR=1.46, 95%CI: 1.39-1.53); aged 45-49 years group and aged 60 and older years group of initiating ART vs. aged 15-44 years group of initiating ART respectively (aHR=1.47, 95%CI: 1.40-1.54; aHR=2.50, 95%CI: 2.22-2.81); other marital status vs. being married or under cohabitation (aHR=1.29, 95%CI: 1.21-1.36); baseline CD4+T cells counts (CD4)<50, 50-199 and 200-349 cells/μl respectively vs. baseline CD4≥350 cells/μl (aHR=4.50, 95%CI: 4.14- 4.89; aHR=2.49, 95%CI: 2.31-2.69; aHR=1.44, 95%CI: 1.33-1.56); number of opportunistic infections at baseline were one case, 2-3 cases and 4-5 cases respectively vs. non opportunistic infections cases at baseline (aHR=1.17, 95%CI: 1.06-1.29; aHR=1.47, 95%CI: 1.35-1.59; aHR=1.74, 95%CI: 1.60-1.89); taking TMP-SMZ vs. not taking TMP-SMZ (aHR=0.69, 95%CI: 0.65- 0.73).@*Conclusions@#The 16-year accumulate survival rate was 61.5% among FPD living with HIV/AIDS after initiation of ART, during 2002 to 2017 in Henan province. The risk factors for FPD death case would include: being males, aged 45 and older years at the initiation of ART, baseline CD4<350 cells/μl and the number of baseline opportunistic infections cases ≥1. The protective factors on FPD death appeared as: being married or cohabited as wel as on TMP-SMZ.
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Objective To optimize the method of the directional differentiation of adipose-derived stem cells into keratinocytes.Methods Adipose-derived stem cells (ADSCs),separated by collagenase digestion method,were isolated and cultured.Then the expression of surface specific markers CD34,CD44 and CD90 were detected by flow cytometer.The effect of different induced mediums cultured for two weeks on the differentiation of ADSCs into KCs was demonstrated:Group 1,the DMEM supplied with 2％ FBS and 49％ supertant of KCs;group 2,KSFM medium;group 3,DMEM medium supplied with 10％ FBS and 5 μM ATRA;10％ FBS DMEM as the control group.Immunofluorescene staining was applied to detect the expression of keratin CK14 and F-actin.Results A flattened fibroblast-like morphology was observed in cells,the positive expression rate of CD34 was 0.08％,while those of CD44 and CD90 were 99％.The cells that could differentiate into osteoblasts and chondrocytes,indicated that the cells were ADSCs.There was no significant change in the cell morphology in the group 1 under the induction medium;about 10％ of the cells in group 2 were altered;the morphological changes were obvious in group 3,and approximately 20％ of the cells showed irregular polygon.The immunofluorescene staining of the cells in group 3 indicated that the cells showed cobblestone-like phenotype and an organized cytoskeletal network with dense actin fibers at the edges;some cells were positive for CK14.Conclusions ADSCs show higher induction rate under ATRA stimulation.
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Overuse and misuse of antibiotics leads to rapid evolution of antibiotic-resistant bacteria and antibiotic resistance genes. Klebsiella pneumoniae has become the most common pathogenic bacterium accountable for nosocomial infections due to its high virulence factor and general occurrence of resistance to most antibiotics. The ß-lactamase signaling pathway has been suggested to be involved in antibiotic resistance against ß-lactams in Klebsiella pneumoniae. In the present study, the molecular mechanism of the antibiotic resistance of Klebsiella pneumoniae was investigated and the results indicated involvement of the ß-arrestin recruitment-induced ß-lactamase signaling pathway. Antimicrobial susceptibility of Klebsiella pneumoniae was assessed using automated systems and extended-spectrum ß-lactamase (ESBL) and ß-arrestin expression levels in Klebsiella pneumoniae were analyzed by reverse-transcription quantitative PCR. ß-lactam resistance in Klebsiella pneumoniae was determined using ß-lactam agar screening plates. The results demonstrated that ß-arrestin recruitment was increased in Klebsiella pneumoniae with antibiotic resistance (AR-K.P.) compared with that in the native Klebsiella pneumoniae strain (NB-K.P.). Increased production of ESBL was observed in AR-K.P. after treatment with the ß-lactam penicillin. Of note, inhibition of ß-arrestin recruitment significantly suppressed ESBL expression in AR-K.P. and in addition, genes encoding ß-arrestin and ESBL were upregulated in Klebsiella pneumoniae. Restoration of endogenous ß-arrestin markedly increased antibiotic resistance of Klebsiella pneumoniae to ß-lactam. Knockdown of endogenous ß-arrestin downregulated antibiotic resistance genes and promoted the inhibitory effects of ß-lactam antibiotic treatment on Klebsiella pneumoniae growth. In conclusion, the present study identified that ß-arrestin recruitment was associated with growth and resistance to ß-lactams, which suggested that ß-arrestin regulating ESBL expression may be a potential target for addressing antibiotic resistance to ß-lactams in Klebsiella pneumoniae.
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Objective To understand the major high risk behaviors and related factors among reported HIV/AIDS cases aged ≥60 years in some areas of Henan province.Methods In Dengzhou,Xunxian county of Hebi and Xiangcheng county of Xuchang,where the reported number and proportion of HIV/AIDS cases aged ≥60 years were high,a face to face interview was conducted among the cases aged ≥60 years during July-August in 2016.The information about the high risk behaviors before HIV infection confirmation were collected by using a semi-structured questionnaire.Results A total of 33 HIV/AIDS cases aged ≥60 years were interviewed,including 28 males and 5 females.Their average age was 67.4 years.The infection route was sexual contact.The main findings revealed that the main factor for HIV infection in elder males was commercial heterosexual behavior with local female sex workers.The condom use rate was low.The poor awareness of the knowledge about AIDS prevention could explain why the elderly could not recognize the risk of HIV infection.There were also homosexual and bisexual behaviors in elder male HIV/AIDS patients.Late detection of HIV transmission among couples was the main cause of HIV infection in elder women.Conclusions The major epidemiological related factors for HIV infection in the elderly in some areas of Henan were unsafe sex behavior and the poor awareness of knowledge about AIDS prevention.A targeted strategy should be taken to control the spread of HIV in the elderly.
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Objective To understand the major high risk behaviors and related factors among reported HIV/AIDS cases aged ≥60 years in some areas of Henan province.Methods In Dengzhou,Xunxian county of Hebi and Xiangcheng county of Xuchang,where the reported number and proportion of HIV/AIDS cases aged ≥60 years were high,a face to face interview was conducted among the cases aged ≥60 years during July-August in 2016.The information about the high risk behaviors before HIV infection confirmation were collected by using a semi-structured questionnaire.Results A total of 33 HIV/AIDS cases aged ≥60 years were interviewed,including 28 males and 5 females.Their average age was 67.4 years.The infection route was sexual contact.The main findings revealed that the main factor for HIV infection in elder males was commercial heterosexual behavior with local female sex workers.The condom use rate was low.The poor awareness of the knowledge about AIDS prevention could explain why the elderly could not recognize the risk of HIV infection.There were also homosexual and bisexual behaviors in elder male HIV/AIDS patients.Late detection of HIV transmission among couples was the main cause of HIV infection in elder women.Conclusions The major epidemiological related factors for HIV infection in the elderly in some areas of Henan were unsafe sex behavior and the poor awareness of knowledge about AIDS prevention.A targeted strategy should be taken to control the spread of HIV in the elderly.
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Objective To understand the factors associated with high risk behaviors among people newly diagnosed to be infected with HIV through heterosexual contact before and after diagnoses in some areas in Henan province,and evaluate the risk of secondary transmission.Methods A face to face interview was conducted among people infected with HIV through heterosexual contact by using self-designed questionnaires during January-May in 2015.Results Among 361 HIV infected persons,the proportions of those with commercial heterosexual behaviors or sex with irregular sex partners decreased from 77.3％(279/361) and 28.5％(103/361) before diagnosis to 13.6％ (49/361) and 2.5％(9/361) after diagnosis,the difference was significant (x2=16.66,P＜0.001;x2=4.80,P=0.03).The subjects surveyed always had more commercial heterosexual behaviors in Henan,Guangdong and Zhejiang provinces before and after diagnosis.After HIV infection confirmation,the condom use rates were 51.0％(25/49) for commercial heterosexual behaviors,88.5％ (184/208) for sex with regular partners and 88.9％(8/9) for sex with irregular partners,respectively.Multivariate logistic regression analysis indicated that risk behaviors associated with HIV transmission included commercial sexual behaviors,previous HIV detection and age of 35 years or older.Conclusions Extra-marital heterosexual behavior has posed serious challenge to the prevention and control of HIV spread.It is necessary to inform the HIV test results,improve the intervention and promote condom use in people with history of commercial sex and people aged ≥35 years.
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<p><b>OBJECTIVE</b>To investigate the survival rate of AIDS patients after receiving antiretroviral therapy(ART) in Henan province and to determine factors associated with survival status.</p><p><b>METHODS</b>Database of AIDS patients receiving ART were downloaded from China Information System for Disease Preventioin and Control-AIDS, retrospective study method was conducted to analyze the information.</p><p><b>INCLUSION CRITERIA</b>initially received national free ART during January, 2005 to December, 2014; aged 15 years or above; and with relatively complete baseline information and follow-up information. The accumulated survival rate of AIDS patients was calculated by life table method and the influencing factors were analyzed by Cox proportional hazard model.</p><p><b>RESULTS</b>Total 30 376 AIDS patients were enrolled in this study. During the follow-up period, a total of 3 927 cases died from HIV/AIDS related diseases. The mortality of all patients was 3.2/100 person year. After 1, 5, 10 years after the initiation of ART, the rates of accumulate survival rate were 93.7%, 85.3%, and 78.4%, respectively. Stepwise regression was used to conduct the time multiple factors analysis, the results showed that man (HR=1.28, 95%CI: 1.20-1.37), older age (HR=1.20, 95% CI: 1.16-1.24), others marital status except marrage or cohabitation (HR=1.20,95% CI: 1.12-1.29), more number of symptoms (HR=1.11, 95%CI: 1.07-1.14), initial treatment were main stavudine (D4T) or zidovudine (AZT)+ didanosine(DDI)+ nevirapine (NVP) or efevirenz (EFV) (HR=1.12, 95% CI: 1.04-1.20), missing drug in the past 7 days (HR=18.36,95%CI: 17.08-19.74) among AIDS patients had high mortality risk, homosexuality sexual transmission (HR=0.59, 95% CI: 0.40-0.87), higher baseline count of CD4(+)T lymphocyte (relative to 0-200 cells/µl group, HR (95%CI) were 0.57 (0.53-0.62), 0.43(0.37-0.49), 0.33 (0.27-0.40) in 201-350 cells/µl group, 351-500 cells/µl group, and ≥501 cells/µl group, respectively), higher educations (HR=0.89, 95% CI: 0.83-0.95) had low mortality risk.</p><p><b>CONCLUSION</b>Survival rate was higher after initial antiretroviral treatment among AIDS patients in Henan province. AIDS patient will have shorter survival time after antiviral treatment under one or more following conditions: higher age, male, initial treatment with D4T or AZT + DDI + NVP or EFV, lower baseline CD4 (+) T lymphocyte count, ever missed antiviral drugs in past 7 days of latest follow-up.</p>
Subject(s)
Female , Humans , Male , Acquired Immunodeficiency Syndrome , Drug Therapy , Epidemiology , Anti-Retroviral Agents , Therapeutic Uses , China , Epidemiology , Drug Therapy, Combination , Lymphocyte Count , Nevirapine , Therapeutic Uses , Proportional Hazards Models , Retrospective Studies , Risk Factors , Stavudine , Therapeutic Uses , Survival Analysis , Survival Rate , Zidovudine , Therapeutic UsesABSTRACT
<p><b>OBJECTIVE</b>To evaluate the network reporting quality of hepatitis C cases in Henan province in 2014.</p><p><b>METHODS</b>The data of hepatitis C case reporting was collected from selected medical institutions in Henan province in 2014. According to current reporting standards, the evaluation of reporting rate, the timely reporting rate, the underreporting rate, the false reporting rate and the anti HCV positive and HCV-RNA positive reporting rate of hepatitis C cases were evaluated.</p><p><b>RESULTS</b>A total of 2 778 hospitalized hepatitis C cases in 170 medical and health institutions were surveyed, the reporting rate was 84.10%, the timely reporting rate was 100.00%, the underreporting rate was 15.90%, the false reporting rate was 13.17% and the anti-HCV positive and HCV-RNA positive reporting rate was 91.06%. The coincidence rate of diagnosis and reporting was 58.61%, the coincidence rate of acute or chronic cases was 30.93%. More clinical diagnosed cases were underreported. The coincidence rate of laboratory confirmed cases reporting were low. The diagnosis and reporting coincidence rate was low in provincial medical institutions.</p><p><b>CONCLUSION</b>In Henan, the hepatitis C case reporting rate was high, the anti-HCV positive and HCV-RNA positive reporting rate needs to be improved. The coincidence rate of hepatitis C reporting was low. Underreporting and false reporting still existed. The quality of hepatitis C reporting in provincial medical and health institutions needs to be improved.</p>
Subject(s)
Humans , China , Epidemiology , Disease Notification , Hepacivirus , Hepatitis C , Epidemiology , Hospitalization , Surveys and QuestionnairesABSTRACT
PURPOSE: Rheumatoid arthritis (RA) is an inflammatory joint disorder, the progression of which leads to the destruction of cartilage and bone. Chemokines are involved in RA pathogenesis. In this study, we investigated the chemokine signaling pathway associated with CCL2 in peripheral blood (PB) and synovial tissues (ST) of RA patients based on our previous work about chemokine signaling pathway involved in the activation of CCL2 production in collagen-induced arthritis rat ST. MATERIALS AND METHODS: Total RNA was isolated from PB leukocytes and synovium of the knee joint in both RA patients and control populations. Real-time polymerase chain reaction was used to determine CCL4, CCR5, c-Jun, c-Fos, and CCL2 expressions. Serum level of CCL2 was assessed by enzyme-linked immunosorbent assay, and the production of CCL2 in ST was analyzed immunohistochemically. RESULTS: The expressions of CCL4, CCR5, c-Jun, c-Fos, and CCL2 messenger RNA in RA patients were significantly higher than those in healthy controls, both in ST and on PB leukocyte. Serum CCL2 levels were elevated in RA patients. Histological examination of rheumatoid joints revealed extensive CCL2 expression in RA ST. CONCLUSION: CCL2, CCL4, c-Jun, c-Fos, and CCR5 may play an important role in the recruitment of PB leukocytes into the RA joints. These data provide evidence that the chemokine signaling pathway is involved in CCL2 expression in RA patient tissues, which may contribute to chronic inflammation associated with RA. Targeting this signaling pathway may provide a novel therapeutic avenue in RA.
Subject(s)
Adult , Animals , Female , Humans , Male , Middle Aged , Rats , Arthritis, Rheumatoid/blood , Case-Control Studies , Chemokine CCL2/blood , Chemokines/metabolism , Enzyme-Linked Immunosorbent Assay , Gene Expression , RNA, Messenger/genetics , Real-Time Polymerase Chain Reaction , Signal Transduction , Synovial Membrane/metabolismABSTRACT
<p><b>OBJECTIVE</b>To study the condition of HIV-1 drug resistance mutation among failures of first-line antiretroviral therapy in Henan province.</p><p><b>METHOD</b>The sub platform of China's legal infectious disease monitoring information reporting system-HIV/AIDS integrated prevention and control data information management system was used to collect the information of patients experiencing first-line antiretroviral treatment failure (virus load ≥ 1 000 copies/ml) more than one year among nine cities of Henan in 2011. A total of 40 cases with no information and 212 cases with incomplete drug resistance results were deleted, and 1 922 cases were included in this study and genotype resistance testing was carried out. Non-conditional logistic regression analysis was used to analyse the influencing factors of drug resistance mutation.</p><p><b>RESULTS</b>A total of 1 922 cases were included in the analysis. 1 039 cases were males, 833 cases were females, the age was (45.7 ± 12.1) years, 82.73% (1 590) were married, and 87.93% (1 690) were transmitted by blood. 64.20% (1 234) patients acquired drug resistance. Nucleoside reverse transcriptase inhibitor (NRTI), non-nucleoside reverse transcriptase inhibitor (NNRTI) and protease inhibitor (PI) resistance mutations were found in 62.59% (1 203), 49.74% (956) and 0.94% (18) of subjects, respectively. 42.09% (809) of patients harbored NRTI and NNRTI resistance mutations synchronously. ≥ 1TAM was the most commonly emerged NRTI resistance mutation (41.94% (806)), the prevalences of TAM-1 and TAM-2 were 8.48% (163) and 4.24% (81), respectively. K65R/N and Q151M complex existed in 23 and 4 patients, respectively. K103N/S was the most commonly emerged NNRTI resistance mutation (34.32% (659)). Non-conditional logistic regression analysis showed that, factors associated with high drug resistance were the following: transmitted by mother to child (OR = 9.05, 95% CI: 1.14-72.12), clinical stage was IV (OR = 1.70, 95% CI: 1.09-2.66) and 5-year-treated (OR = 1.59, 95% CI: 1.03-2.47). Factors associated with low drug resistance were the following: 1-year-treated (OR = 0.19, 95% CI: 0.13-0.27).</p><p><b>CONCLUSION</b>Complex patterns of HIV-1 drug resistance mutations were identified among individuals experiencing failure of first-line antiretroviral therapy in Henan province. Factors associated with high drug resistance were lived in Luohe, Shangqiu, Nanyang, Xinyang, transmitted by mother to child, clinical stage was IV, and 5-year-treated.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , China , Drug Resistance, Viral , Genetics , Genotype , HIV Infections , Drug Therapy , HIV-1 , Genetics , Infectious Disease Transmission, Vertical , Prevalence , Protease Inhibitors , Therapeutic Uses , Reverse Transcriptase Inhibitors , Therapeutic UsesABSTRACT
<p><b>OBJECTIVE</b>To analyze the survival status and influencing factors of the AIDS patients under 14 years of age and receiving antiretroviral treatment in Henan Province.</p><p><b>METHODS</b>Database of children AIDS patients receiving ART were download from China information system for disease preventioin and control-AIDS, AIDS cases from January, 2003 to June, 2014 were selected to be analyzed. Demographic characteristics baseline laboratory inclusion criteria: F First time receive national free ART during study; aged 14 years or below; and with relatively complete baseline information and follow-up information. 1 037 cases were selected. Patient information about survival status, death, demographic characteristics, and baseline laboratory test results were analyzed. The accumulated survival rate of AIDS patients was calculated by life table method and the influencing factors were analyzed by COX proportional hazard model.</p><p><b>RESULTS</b>A total of 1 037 AIDS children-cases ((9.52 ± 3.56) years old) which included 628 boys and 409 girls were recruited in the study, 939 cases survived 1 to 9 years from starting ART treatment and 98 cases died. Accumulated survival rate of AIDS children receiving ART from 1 year to 9 years were 96.11%, 94.17%, 92.74%, 91.28%, 90.54%, 89.47%, 88.52%, 88.52%, 86.84%, respectively. Results of multivariate analysis showed baseline count of CD4⁺ T lymphocyte (HR = 0.51, 95% CI: 0.36-0.72), duration from confirmation to the initial ART time (HR = 0.85, 95% CI: 0.75-0.97) and hemoglobin level (HR = 2.26, 95% CI: 1.09-4.70) were influence factors for survival time of AIDS children patients receiving ART.</p><p><b>CONCLUSION</b>Survival rate of AIDS children aged 14 years or below and receiving ART in Henan Province was relatively high. Timely surveillance of CD4⁺ T and the hemoglobin level of the AIDS patients so as to timely launch HARRT could extend survival time of AIDS patients.</p>