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Objective:To assess the association between warm ischemia time (WIT) and renal function in patients undergoing laparoscopic partial nephrectomy.Methods:A total of 344 patients treated with laparoscopic partial nephrectomy in Peking University People’s Hospital were included. There were 240 males (69.8%) and 104 females (30.2%) with a median age of 57 (23-89) years.The median BMI was 25.6 (16.7-36.0) kg/m 2.213 cases (61.9%) were associated with hypertension.There were 66 (19.2%) patients with diabetes mellitus. There were 92 cases (26.7%) with smoking history. The median preoperative creatinine was 73 (32-170) μmol/L. The median preoperative estimated glomerular filtration rate (eGFR) was 95 (33-142) ml/(min·1.73m 2). The maximum diameter of the tumor was 2.5 (7-9) cm.314 (91.3%) patients with renal cancer stage T 1. All patients underwent warm ischemia during the operation. The patients were divided into three groups for analysis. Restricted cubic spline regression analysis was used to assess the association between WIT as a continuous variable and percentage change of eGFR. Analysis of covariance was used to compare postoperative eGFR among the three groups, and to adjust for preoperative eGFR and tumor diameter. Results:There were statistically significant differences in the percentage change of postoperative eGFR ( P=0.009) and tumor diameter ( P<0.001) among the three groups. Restricted cubic spline regression analysis showed that with the prolongation of WIT, the percentage change of postoperative eGFR gradually decreased, and the curve began to stabilize after 30 minutes (R 2=0.044, P=0.015). The results of covariance analysis showed that after adjusting for baseline preoperative eGFR and tumor size, the effect of WIT on postoperative eGFR was significantly different among the three groups ( F=3.864, P=0.022). The postoperative eGFR in the WIT<20 min group was significantly higher than that in 20 min≤WIT<30 min group( P=0.009) and WIT≥30 min group( P=0.017). There was no significant difference in postoperative eGFR between the two groups with longer WIT( P=0.806). Conclusions:In partial nephrectomy, patients with WIT less than 20 minutes had higher postoperative eGFR levels than those with WIT greater than 20 minutes. However, when WIT exceeded 20 minutes, prolonged ischemia time did not lead to further decline in renal function.
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Objective:To analyze the risk factors of pelvic organ prolapse (POP) and to establish the prediction model.Methods:A study was conducted on the prevalence of POP among 2 247 parturient women at 6 weeks postpartum in Peking University People′s Hospital from December 2018 to October 2019, and relevant influencing factors were analyzed to construct a prediction model of early postpartum POP using logsitic regression, which was validated internally. Data from November 2019 to December 2019 (403 parturient women) were collected for external validation of the prediction model. In addition, the obstetrical factors affecting the occurrence of early postpartum POP in 885 primiparas with vaginal delivery (from January 2019 to November 2019) were further discussed.Results:A total of 2 247 cases were included in the modeling group, and 403 cases were included in the external validation data set. POP accounted for 24.3% (545/2 247). Age, parity, body mass index before pregnancy, vaginal delivery and newborn birth weight were negative factors for early postpartum POP (all P<0.05). The nomogram was established based on the above factors, and internal and external verification indicated that the model had a good discrimination (C-index were 0.759 and 0.760, respectively). In addition, this study found that age and newborn birth weight were the main causes of early postpartum POP in primiparas with vaginal delivery ( P=0.044, P=0.004). Conclusions:The incidence of early postpartum POP is high. The prediction model of POP constructed in this study could be used to guide clinical practice to a certain extent and give corresponding treatment suggestions to pregnant women scientifically, so as to provide theoretical support for primary prevention.
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Background@#African swine fever virus (ASFV), classical swine fever virus (CSFV), and porcine reproductive and respiratory syndrome virus (PRRSV) are still prevalent in many regions of China. Co-infections make it difficult to distinguish their clinical symptoms and pathological changes. Therefore, a rapid and specific method is needed for the differential detection of these pathogens. @*Objectives@#The aim of this study was to develop a multiplex real-time quantitative reverse transcription polymerase chain reaction (multiplex qRT-PCR) for the simultaneous differential detection of ASFV, CSFV, and PRRSV. @*Methods@#Three pairs of primers and TaqMan probes targeting the ASFV p72 gene, CSFV 5′untranslated region, and PRRSV ORF7 gene were designed. After optimizing the reaction conditions, including the annealing temperature, primer concentration, and probe concentration, multiplex qRT-PCR for simultaneous and differential detection of ASFV, CSFV, and PRRSV was developed. Subsequently, 1,143 clinical samples were detected to verify the practicality of the assay. @*Results@#The multiplex qRT-PCR assay could specifically and simultaneously detect the ASFV, CSFV, and PRRSV with a detection limit of 1.78 × 10 0 copies for the ASFV, CSFV, and PRRSV, but could not amplify the other major porcine viruses, such as pseudorabies virus, porcine circovirus type 1 (PCV1), PCV2, PCV3, foot-and-mouth disease virus, porcine parvovirus, atypical porcine pestivirus, and Senecavirus A. The assay had good repeatability with coefficients of variation of intra- and inter-assay of less than 1.2%. Finally, the assay was used to detect 1,143 clinical samples to evaluate its practicality in the field. The positive rates of ASFV, CSFV, and PRRSV were 25.63%, 9.36%, and 17.50%, respectively. The co-infection rates of ASFV+CSFV, ASFV+PRRSV, CSFV+PRRSV, and ASFV+CSFV+PRRSV were 2.45%, 2.36%, 1.57%, and 0.17%, respectively. @*Conclusions@#The multiplex qRT-PCR developed in this study could provide a rapid, sensitive, specific diagnostic tool for the simultaneous and differential detection of ASFV, CSFV, and PRRSV.
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Objective To introduce a combined operation for treating chronical peroneal tendon dislocation and to evaluate the clinical outcomes of patients.Methods Data of 12 ankles in 12 patients (male 9,female 3) with chronical peroneal tendon dislocation who underwent the fibular groove deepening procedure with transposition of the peroneal longus muscle from June 2006 to August 2013 were retrospectively analyzed.The mean age was 24.6±4.3 years (range,18-34 years),and there were 3 cases on left side,9 on right side.The mechanism of peroneal tendon injury consisted of sports injuries in 8 and sprains in 4.There were 8 cases of flat fibula sulcus and 4 cases of convex.All patients met the inclusion criteria of a painful snapping or popping sensation or palpable clicking and positive provocation maneuver and without fracture and were treated with peroneal sulcus deepening and peroneal longus tendon transposition.The duration of preoperative popping and pain symptoms ranged from 12 to 23 weeks,with an average of 16.9±4.0 weeks.All cases were treated conservatively 3-4 weeks before operation and were not effective.The clinical outcomes were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale,visual anologue scale (VAS).Results Twelve patients were followed up with an average period of 37.3± 7.0 (range,25-50)months.The mean VAS scale score of all patients reduced from 5.6±0.9 to 0.5±0.7 at the latest follow-up.The mean AOFAS scale score improved from 61.4±5.6 to 92.6±4.2 at the latest follow-up.The difference between preoperative and postoperative was statistically significant.(t=16.250,-18.475;P=0.000).According to the evaluation of symptom and function scoring system,10 cases were excellent and 2 cases were good,with an excellent rate of 100％.The mean postoperative return-sport time was 26.42±3.06 weeks (range,23-32 weeks).All patients healed primarily and no infection,skin necrosis and residual redislocation occurred.The osteotomy healed completely without displacement,which was confirmed by imaging examination in three months postoperation.No patients had intractable pain after surgery,and they were able to perform daily activities at 3 months and physical exercise at 6 months after surgery.No slip occurred in all patients at the latest follow-up.Conclusion The fibular groove deepening procedure with transposition of the peroneal longus muscle can effectively treat chronical peroneal tendon dislocation and obtain good medium-term results.
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Objective@#To introduce a combined operation for treating chronical peroneal tendon dislocation and to evalu-ate the clinical outcomes of patients.@*Methods@#Data of 12 ankles in 12 patients (male 9, female 3) with chronical peroneal ten-don dislocation who underwent the fibular groove deepening procedure with transposition of the peroneal longus muscle from June 2006 to August 2013 were retrospectively analyzed. The mean age was 24.6±4.3 years (range, 18-34 years), and there were 3 cas-es on left side, 9 on right side. The mechanism of peroneal tendon injury consisted of sports injuries in 8 and sprains in 4. There were 8 cases of flat fibula sulcus and 4 cases of convex. All patients met the inclusion criteria of a painful snapping or popping sen-sation or palpable clicking and positive provocation maneuver and without fracture and were treated with peroneal sulcus deepen-ing and peroneal longus tendon transposition. The duration of preoperative popping and pain symptoms ranged from 12 to 23 weeks, with an average of 16.9±4.0 weeks. All cases were treated conservatively 3-4 weeks before operation and were not effec-tive. The clinical outcomes were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale, visual anologue scale (VAS).@*Results@#Twelve patients were followed up with an average period of 37.3±7.0 (range, 25-50) months. The mean VAS scale score of all patients reduced from 5.6±0.9 to 0.5±0.7 at the latest follow-up. The mean AOFAS scale score improved from 61.4±5.6 to 92.6±4.2 at the latest follow-up. The difference between preoperative and postoperative was statis-tically significant. (t=16.250,-18.475; P=0.000). According to the evaluation of symptom and function scoring system, 10 cases were excellent and 2 cases were good, with an excellent rate of 100%. The mean postoperative return-sport time was 26.42±3.06 weeks (range, 23-32 weeks). All patients healed primarily and no infection, skin necrosis and residual redislocation occurred. The osteotomy healed completely without displacement, which was confirmed by imaging examination in three months postoperation. No patients had intractable pain after surgery, and they were able to perform daily activities at 3 months and physical exercise at 6 months after surgery. No slip occurred in all patients at the latest follow-up.@*Conclusion@#The fibular groove deepening procedure with transposition of the peroneal longus muscle can effectively treat chronical peroneal tendon dislocation and obtain good medi-um-term results.
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Lead time bias might exist in observational study for clinical outcomes.This paper summarizes the concept of lead time bias,causes and control of lead time bias by using the studies of influences of screening diagnostic test on cancer patients' survival and highly active antiretroviral therapy on HIV/AIDS patients' survival as examples for the purpose of providing thinking and methods in the control of lead time bias for the accurate evaluation of the effects of interventions,such as test and treatment,on the diseases with multi courses or phases.
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Lead time bias might exist in observational study for clinical outcomes.This paper summarizes the concept of lead time bias,causes and control of lead time bias by using the studies of influences of screening diagnostic test on cancer patients' survival and highly active antiretroviral therapy on HIV/AIDS patients' survival as examples for the purpose of providing thinking and methods in the control of lead time bias for the accurate evaluation of the effects of interventions,such as test and treatment,on the diseases with multi courses or phases.
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Objective Base on the requirements of national science and technology system reform,to optimize the information system of scientific research management in hospital,improve the level of scientific research management and service.Methods According to the requirements of the national science and technology system reform and the current situation of our hospital,Peking University People's Hospital had formulated and implemented the optimization scheme of the information system of scientific research management.The questionnaire survey was used to understand the optimization effect of information system.Results The hospital had established a whole process coverage and real-time dynamic information system of scientific research management,which improved the efficiency and quality of scientific research management.The survey results showed that the hospital users have a good evaluation of the information system,and the system construction has a strong advantage in the Beijing district hospitals.Conclusions The whole process and real-time dynamic information system of scientific research management established by the hospital accords with the relevant requirements of national science and technology system reform,and effectively improves the level of scientific research management and service in our hospital.
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Objective@#To analyze the correlation between the changes of fibrinogen and the treatment effect of all-frequency sudden deafness, and to explore the individualized treatment strategy for the use of Batroxobin.@*Methods@#Patients with all-frequency sudden deafness who were admitted to Department of Otorhinolaryngology, People′s Hospital of Peking University, from January 2010 to September 2016 were selected. All patients were given standard treatment and regular use of Batroxobin. Value of fibrinogen on D1 (before treatment) / D3 / D7 (±1) and D14 (±2) were recorded, at the same time, the correlation between the changes of fibrinogen and prognosis of all-frequency sudden deafness by the audiograms of onset and after-treatment of all patients were analyzed. Independent t-test was used to analyze normal distributed measurement data and chi square linear trend test was used to analyze the curative effect of different fibrinogen groups.@*Results@#A total of 148 patients were included, the outcomes were worst when the patient′s fibrinogen was below 2 g/L or above 4 g/L before treatment, ineffective rate were both 50%. The fibrinogen was lowest when the treatment came to the third day. Normally, the patient′s prognosis was best when this value waved between 0.7 and 0.9 g/L, with a total effective rate between 73.9% and 83.3%. The fibrinogen value of the 7th day was a good indicator of the outcome, and Fib7 value was significant lower in patients of effective group than ineffective ones ((1.25±0.37)g/L vs (1.38±0.35) g/L, t=-0.27, P=0.04). Patients found a best recovery when Fib7 was below 1 g/L, and the higher the Fib7 value, the higher the inefficiency (χ2=7.55, P=0.01). Batroxobin showed safety during the treatment and found no complications.@*Conclusion@#The change of fibrinogen in the process of all-frequency sudden deafness is closely related to the curative effect.
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Objective Promote the management and service of scientific research platforms and make sure their supporting role in hospital.Methods The demand of service object and service evaluation of scientific research platforms were obtained in Peking University People's Hospital,and the demand-oriented service mode for scientific research platforms was established and applied.Results With the implementation of this mode in hospital,the service strategies of scientific research platforms were optimized continuously,the awareness rate and service satisfaction were promoted in some extent.Conclusions This mode based on demand survey can promote the management and service of scientific research platforms in some extent and the better support and service can be provided for the sustainable development of scientific research in hospital.
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Objective To investigate the clinical characteristics and prognosis of rheumatic disease-associated episcleritis and scleritis. Methods The clinical and laboratory features of 20 in-patients with episcleritis or scleritis from September 2005 to July 2016 in Peking University People's Hospital were analyzed retrospectively. The data of 11 rheumatoid arthritis (RA) patients were compared with 33 RA patients without episcleritis or scleritis of similar gender composition and age presented in the same period. T test, Mann-Whitney U test, chi-square test and rank sum test were used for statistical analysis. Results Among the 20 patients, the average age was (58±15) years old. Episcleritis and scleritis each accounted for half. The spectrum of rheumatic diseases included, in the order of disease frequency, RA, systemic lupus erythematosus (SLE), systemic vasculitis, relapsing polychondritis (RP), ankylosing spondylitis (AS) and undifferentiated connective tissue disease (UCTD). RA and SLE patients accounted for 55% and 20% cases respectively. Episcleritis and scleritis occurred significantly earlier in lupus patients than RA patients [(2.1 ±1.4) year vs (16.3 ±12.7) year, t'=3.598, P<0.01]. RA patients with episcleritis or scleritis had higher platelet (PLT) count [(330 ±138)]× 109/L vs (234±91)×109/L, t=2.652, P<0.05), higher X-ray scores (P<0.01), more bone erosion [(90%(10/11) vs 52%(17/33),χ2=3.9, P<0.05] and frequent pulmonary interstitial involvement [46%(15/33) vs 9%(1/11),χ2=5.1, P<0.05]. Among 20 patients, 18 patients received systemic glucocorticosteroid. Patients with sclera involvement received a significantly higher dose of corticosteroid than patients without sclera involvement [(17.1 ±16.8) mg/d vs (2.2 ±4.2) mg/d, t'=2.907, P<0.01]. Patients with scleritis received a significantly higher dose of cortico-steroid than patients with episcleritis [(31 ±14) mg/d vs (5 ±6) mg/d, t=-3.959, P<0.01]. Disease-modifying anti-rheumatic diseases (DMARDs) and immunosuppressive agents prescribe dincluded methotrexate (MTX), leflunomide (LEF), hydroxychloroquine (HCQ), cyclosporine A (CsA) and cyclophosphamide (CTX). One refractory case of scleritis recovered after the administration of TNF inhibitor agent. Steroids and NSAIDs eye-drops were administered as well. Conclusion Episcleritis and scleritis are relatively rare ocular diseases, which are commonly associated with rheumatic diseases. In patients with RA, the occurrence of episcleritis or scleritis may suggest severe diseases and other co-existing extraarticular manifestations. The scleral invol ve-ment in RA patients ismore resistant to treatment compared to SLE. Consideration must be given to both rheumatic diseases and ocular disorders when dealing with the treatment strategy.
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Objective To investigate the clinical characteristics and prognosis of rheumatic disease-associated episcleritis and scleritis. Methods The clinical and laboratory features of 20 in-patients with episcleritis or scleritis from September 2005 to July 2016 in Peking University People's Hospital were analyzed retrospectively. The data of 11 rheumatoid arthritis (RA) patients were compared with 33 RA patients without episcleritis or scleritis of similar gender composition and age presented in the same period. T test, Mann-Whitney U test, chi-square test and rank sum test were used for statistical analysis. Results Among the 20 patients, the average age was (58±15) years old. Episcleritis and scleritis each accounted for half. The spectrum of rheumatic diseases included, in the order of disease frequency, RA, systemic lupus erythematosus (SLE), systemic vasculitis, relapsing polychondritis (RP), ankylosing spondylitis (AS) and undifferentiated connective tissue disease (UCTD). RA and SLE patients accounted for 55% and 20% cases respectively. Episcleritis and scleritis occurred significantly earlier in lupus patients than RA patients [(2.1 ±1.4) year vs (16.3 ±12.7) year, t'=3.598, P<0.01]. RA patients with episcleritis or scleritis had higher platelet (PLT) count [(330 ±138)]× 109/L vs (234±91)×109/L, t=2.652, P<0.05), higher X-ray scores (P<0.01), more bone erosion [(90%(10/11) vs 52%(17/33),χ2=3.9, P<0.05] and frequent pulmonary interstitial involvement [46%(15/33) vs 9%(1/11),χ2=5.1, P<0.05]. Among 20 patients, 18 patients received systemic glucocorticosteroid. Patients with sclera involvement received a significantly higher dose of corticosteroid than patients without sclera involvement [(17.1 ±16.8) mg/d vs (2.2 ±4.2) mg/d, t'=2.907, P<0.01]. Patients with scleritis received a significantly higher dose of cortico-steroid than patients with episcleritis [(31 ±14) mg/d vs (5 ±6) mg/d, t=-3.959, P<0.01]. Disease-modifying anti-rheumatic diseases (DMARDs) and immunosuppressive agents prescribe dincluded methotrexate (MTX), leflunomide (LEF), hydroxychloroquine (HCQ), cyclosporine A (CsA) and cyclophosphamide (CTX). One refractory case of scleritis recovered after the administration of TNF inhibitor agent. Steroids and NSAIDs eye-drops were administered as well. Conclusion Episcleritis and scleritis are relatively rare ocular diseases, which are commonly associated with rheumatic diseases. In patients with RA, the occurrence of episcleritis or scleritis may suggest severe diseases and other co-existing extraarticular manifestations. The scleral invol ve-ment in RA patients ismore resistant to treatment compared to SLE. Consideration must be given to both rheumatic diseases and ocular disorders when dealing with the treatment strategy.
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Objective To provide helpful experiences for the development,construction,and evaluation of RRP through constructing the evaluation system.Methods The study of literature and comprebensive analysis were employed.Results Putting forward the principle of establishing the evaluation system and finally,attempting to build an evaluation system that specifically aiming at the RRP system.Conclusions The evaluation methods should be updated.
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Objective:To investigate the association between metabolic factors,such as obesity,blood pressure,blood glucose,serum lipid profile,and the histopathological characteristics of renal cell carci-noma.Methods:The medical records of 382 consecutive renal cell carcinoma patients who underwent radical or partial nephrectomy at Peking University People’s Hospital from January 2009 to January 2015 were retrospectively reviewed.Metabolic factors were collected from the records,including weight,body mass index,waist circumstance,blood pressure,fasting blood glucose,serum total triglyceride,serum total cholesterol,serum low-density lipoprotein-cholesterol and serum high-density lipoprotein-cholesterol. The patients were divided into different groups according to tumor grade,stage and diameter.Statistics analysis,such as t test,Mann-Whitney U test and Logistic analysis,were performed to investigate the as-sociation between metabolic factors and grade,stage and tumor diameter of renal cell carcinoma.Re-sults:A total of 80 (20.94%)of the tumors were classified as high grade disease,63 (16.49%)were classified as advanced disease and 153 (40.05%)tumor diameter more than 4 cm.The patients in high grade group were found to have lower high-density lipoprotein-cholesterol level than in low grade group (P =0.015),body mass index,total cholesterol and high-density lipoprotein-cholesterol were found to be lower in advanced disease than in localized disease (P =0.022,P =0.005 and P =0.006,respec-tively),and low-density lipoprotein-cholesterol was found to be lower in larger tumors (P =0.030). Other factors were comparable between the different groups.The results of Logistic analyses showed that, body mass index (OR =0.906,95%CI:0.852 -0.986,P =0.023)and total cholesterol (OR =0.660,95%CI:0.492 -0.884,P =0.005)were associated with the tumor stage,high-density lipopro-tein-cholesterol level was significantly associated with tumor grade (OR =0.293,95% CI:0.108 -0.797,P =0.016)and stage (OR =0.204,95%CI:0.065 -0.635,P =0.006),and low-density lipoprotein-cholesterol level was significantly associated with tumor diameter (OR =0.756,95% CI:0.586 -0.975,P =0.031).Conclusion:The results of our study indicate that metabolic factors,espe-cially obesity and serum lipid profile,are closely related with the histopathological characteristics of renal cell carcinoma.
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Objective To predict the potential geographic distribution of Lyme disease in Qinghai by using Maximum Entropy model (MaxEnt).Methods The sero-diagnosis data of Lyme disease in 6 counties (Huzhu,Zeku,Tongde,Datong,Qilian and Xunhua) and the environmental and anthropogenic data including altitude,human footprint,normalized difference vegetation index (NDVI) and temperature in Qinghai province since 1990 were collected.By using the data of Huzhu Zeku and Tongde,the prediction of potential distribution of Lyme disease in Qinghai was conducted with MaxEnt.The prediction results were compared with the human sero-prevalence of Lyme disease in Datong,Qilian and Xunhua counties in Qinghai.Results Three hot spots of Lyme disease were predicted in Qinghai,which were all in the east forest areas.Furthermore,the NDVI showed the most important role in the model prediction,followed by human footprint.Datong,Qilian and Xunhua counties were all in eastern Qinghai.Xunhua was in hot spot area Ⅱ,Datong was close to the north of hot spot area Ⅲ,while Qilian with lowest sero-prevalence of Lyme disease was not in the hot spot areas.The data were well modeled in MaxEnt (Area Under Curve=0.980).Conclusions The actual distribution of Lyme disease in Qinghai was in consistent with the results of the model prediction.MaxEnt could be used in predicting the potential distribution patterns of Lyme disease.The distribution of vegetation and the range and intensity of human activity might be related with Lyme disease distribution.
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Objective To clone and express the outer surface protein C ( OspC) from a Chinese Borrelia afzelli FP1 strain and to evaluate the immune protectivity of the recombinant OspC protein ( rOspC) . Methods The gene encoding OspC protein of Borrelia afzelli FP1 strain was amplified by polymerase chain reaction (PCR) and then inserted into pET-30a plasmid to construct the recombinant expression plasmid pET-30a-OspC. The transformed E. coli BL21 strains carrying pET-30a-OspC plasmid were induced by IPTG to express OspC protein. The expressed proteins were purified by Ni-IDA resin chromatography and analyzed by SDS-PAGE and Western blot assay. Indirect immunofluorescence assay ( IFA) was performed to detect anti-rOspC protein antibodies in serum samples from rabbits immunized with rOspC protein. In vitro neutral-ization test was performed for evaluation the immune protectivity of rOspC protein. Results The recombi-nant expression plasmid pET-30a-OspC was successfully constructed and highly expressed in E. coli BL21. A strong antigen-antibody reaction between the rOspC protein and polyclonal antibody against Borrelia afzelli FP1 strain was detected by Western blot assay. The titers of IgG in serum samples from rabbits immunized with rOspC protein were significantly elevated. The in vitro neutralization test indicated that 106/ml of Borre-lia afzelli FP1 strains were neutralized by every anti-OspC protein serum sample from the experiment group. Conclusion The rOspC protein showed a strong immune protectivity against Borrelia afzelli, which could be used in the development of polyvalent subunit vaccine against lyme disease.
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<p><b>OBJECTIVE</b>To study the loss to follow-up (LTF) rate, HIV emerging incidence and influencing factors in the longitudinal study of female sex workers (FSWs) in Kaiyuan, Yunnan, and their influence on HIV emerging incidence estimate.</p><p><b>METHODS</b>The open cohort study on FSWs was launched in March 2006 and ended in June 2013 in Kaiyuan, Yunnan. Investigations were made every six months and lasted for 7 years. 661 FSWs found as HIV negative in the baseline study in March 2006 were chosen to study their LTF in the 7 year follow-up investigation. The Cox regression model was used to explore risk factors for HIV emerging infection and those for LTF. In June 2013, a survey was also conducted to explore the detailed reasons for loss to follow-up by contacting FSWs themselves.</p><p><b>RESULTS</b>During 1 238.5 person-years of follow-up among 661 HIV negative FSWs, the HIV incidence rate was 1.29 (95% CI: 0.74-2.10)/100 person-year, and the LFT incidence rate was 48.68 (95% CI: 44.88-52.73) /100 person-year. The multivariate analysis showed drug abuse as an independent risk factor for FSWs' infection of HIV (adjusted risk ratio = 4.15, 95% CI: 1.43-12.02); FSWs over 25 years old (adjusted risk ratio = 0.68, 95% CI: 0.57-0.81), and drug abuse (adjusted risk ratio = 0.52, 95% CI: 0.35-0.79) were found with lower LFT rate to remain in the cohort.</p><p><b>CONCLUSION</b>High LFT rate was found in FSW cohort study in Kaiyuan, Yunnan, while the HIV infection risk exposure of the LFT group was lower than the groups of HIV follow-up. HIV prevalence of FSWs in the city might be overestimated. Causes of LFT of FSWs group required further study in the future, and the cohort follow-up retention strategy for FSWs needs to be developed.</p>
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Adulto , Femenino , Humanos , Adulto Joven , China , Epidemiología , Estudios de Cohortes , Estudios de Seguimiento , Infecciones por VIH , Epidemiología , Incidencia , Estudios Longitudinales , Prevalencia , Factores de Riesgo , Trabajo Sexual , Trabajadores Sexuales , Trastornos Relacionados con SustanciasRESUMEN
Objective To provide information on the geographical distribution of HIV-1 genotypes and subtypes in the population of China. Methods A comprehensive search was carried out in China Hospital Knowledge Database(CHKD),Wanfang(Chinese),CBMDisc and PubMed databases to identify all studies published related to HIV-1 genotypes in China. All studies were grouped according to the sites,period and objects for analyzing the distribution of HIV genotypes. Results A total of 175 studies were included in this Meta-analysis,which contained 285 records. We found that the predominate genotypes in China were B’ subtype,CRF01_AE,CRF07_BC and CRF08_BC,but the subtype distribution of HIV-1 was different in the western and southern parts of the country. CRF01_AE had a significant increase while subtype B’ showed a decrease. There were various HIV-1 subtypes among individuals who acquired HIV through sexual contacts and CRF01_AE was most commonly identified in this group of people. Conclusion The distribution of HIV-1 genotypes in Chinese people significantly changed,together with high complexity of the HIV-1 epidemics noticed in China.
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Objective To analyze the prevalence rates and associated risk factors on HIV, syphilis,herpes simplex virus-2(HSV-2)among female sex workers(FSWs)in Jiaozhou,Shandong province. Methods Through convenient sampling,an anonymous questionnaire survey was conducted on female sex workers to collect related information. Blood specimens were drawn for serological tests on HIV,syphilis and HSV-2 antibodies,respectively. Patients with positive results from both treponema pallidum and HSV-2 tested by ELISA method,were defined as being superinfected. Results A total of 460 FSWs were recruited in this study. The prevalence rates of HIV,syphilis,HSV-2,and syphilis/HSV-2 superinfection were 0.22%,5.9%,43.0%,and 11.7%, respectively. Among the methamphetamine users,the prevalence rates of syphilis,HSV-2,and syphilis/HSV-2 superinfection were 12.4%,55.2%,and 22.9%,respectively. Results from multivariate analysis showed that factors that significantly associated with syphilis infection would include:methamphetamine use(OR=3.61,95%CI:1.62-8.06),having first commercial sex intercourse at under 20 years of age(OR=2.80,95% CI:1.15-6.85),more than 2 establishments that the FSWs worked in the last month(OR=4.37,95%CI:0.83-22.83). Factors associated with HSV-2 infection were methamphetamine use(OR=2.30,95%CI:1.43-3.70),having first commercial sex intercourse at under 20 years of age (OR=1.77,95%CI:1.16-2.69),working at low-end establishments (OR=2.61,95%CI:1.66-4.10),working at the local sex-work venues for more than one year(OR=2.01,95%CI:1.28-3.14),with low education backgrounds(OR=2.27,95%CI:1.18-4.36),using methamphetamine(OR=3.95,95%CI:2.09-7.44),low education background(OR=2.43,95%CI:1.10-5.36),21-30 year-olds(OR=2.95,95%CI:1.08-8.03),older than 31 years of age(OR=7.05, 95%CI:2.48-20.01) etc.,were independent risk factors associated with the superinfection of syphilis and HSV-2. Conclusion The prevalence rates of syphilis,HSV-2 and syphilis/HSV-2 superinfection were relatively high among FSWs in Jiaozhou,especially among the FSWs who were methamphetamine users.
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Objective To provide information on the geographical distribution of HIV-1 genotypes and subtypes in the population of China. Methods A comprehensive search was carried out in China Hospital Knowledge Database(CHKD),Wanfang(Chinese),CBMDisc and PubMed databases to identify all studies published related to HIV-1 genotypes in China. All studies were grouped according to the sites,period and objects for analyzing the distribution of HIV genotypes. Results A total of 175 studies were included in this Meta-analysis,which contained 285 records. We found that the predominate genotypes in China were B’ subtype,CRF01_AE,CRF07_BC and CRF08_BC,but the subtype distribution of HIV-1 was different in the western and southern parts of the country. CRF01_AE had a significant increase while subtype B’ showed a decrease. There were various HIV-1 subtypes among individuals who acquired HIV through sexual contacts and CRF01_AE was most commonly identified in this group of people. Conclusion The distribution of HIV-1 genotypes in Chinese people significantly changed,together with high complexity of the HIV-1 epidemics noticed in China.
