[Analysis of HIV-1 genetic subtype and pretreatment drug resistance among men who have sex with men infected with HIV-1 from 19 cities of 6 provinces in China].

Objective: To investigate the distribution of HIV-1 genetic subtypes and pretreatment drug resistance (PDR) among men who have sex with men (MSM) from 19 cities of 6 provinces in China. Methods: From April to November 2019, 574 plasma samples of ART-naive HIV-1 infected MSM were collected from 19 cities in Hebei, Shandong, Jiangsu, Zhejiang, Fujian, and Guangdong provinces, total ribonucleic acid (RNA) was extracted and amplified the HIV-1 pol gene region by nested polymerase chain reaction (PCR) after reverse transcription. Then sequences were used to construct a phylogenetic tree to determine genetic subtypes and submitted to the Stanford drug resistance database for drug resistance analysis. Results: A total of 479 samples were successfully amplified by PCR. The HIV-1 genetic subtypes included CRF01_AE, CRF07_BC, B, CRF55_01B, CRF59_01B, CRF65_cpx, CRF103_01B, CRF67_01B, CRF68_01B and unrecognized subtype, which accounted for 43.4%, 36.3%, 6.3%, 5.9%, 0.8%, 0.8%, 0.4%, 0.4%, 0.2% and 5.5%, respectively. The distribution of genetic subtypes among provinces is statistically different (χ2=44.141, P<0.001). The overall PDR rate was 4.6% (22/479), the drug resistance rate of non-nucleoside reverse transcriptase inhibitors, nucleoside reverse transcriptase inhibitors, and protease inhibitors were 3.5% (17/479), 0.8% (4/479) and 0.2% (1/479), respectively. The PDR rate of recent infections was significantly higher than that of long-term infections (χ2=4.634, P=0.031). Conclusions: The HIV-1 genetic subtypes among MSM infected with HIV-1 from 19 cities of 6 provinces in China are diverse, and the distribution of subtypes is different among provinces. The overall PDR rate is low, while the PDR rate of recent infections was significantly higher than that of long-term infections, suggesting the surveillance of PDR in recent infections should be strengthened.

[Application of limiting antigen avidity enzyme immunoassay for estimating HIV-1 incidence in men who have sex with men].

Objective: To estimate the incidence of HIV-1 infection in men who have sex with men (MSM) in key areas of China through HIV-1 limiting antigen avidity enzyme immunoassay (LAg-Avidity EIA), analyze the deviation from the actual results and identify influencing factors, and provided reference for improving the accuracy of estimation results. Methods: Based on the principle of the cohort randomized study design, 20 cities were selected in China based on population size and the number of HIV-positive MSM. The sample size was estimated to be 700 according to the HIV-1 infection rate in MSM. MSM mobile phone app. was used to establish a detection appointment and questionnaire system, and the baseline cross-sectional survey was conducted from April to November 2019. LAg-Avidity EIA was used to identify the recent infected samples. The incidence of HIV-1 infection was calculated and then adjusted based on the estimation formula designed by WHO. The influencing factors were identified by analyzing the sample collection and detection processes. Results: Among the 10 650 blood samples from the participants, 799 were HIV-positive in initial screening, in which 198 samples (24.78%) missed during confirmation test. Only 621 samples were received by the laboratory. After excluding misreported samples, 520 samples were qualified for testing. A total of 155 samples were eventually determined as recent infection through LAg-Avidity EIA; Based on the estimation formula , the incidence of HIV-1 infection in MSM in 20 cities was 4.06% (95%CI:3.27%-4.85%), it increased to 5.53% (95%CI: 4.45%-6.60%)after the adjusting for sample missing rate. When the sample missing rate and misreporting rate were both adjusted, the incidence of HIV-1 infection in the MSM increased to 5.66% (95%CI:4.67%-6.65%). The actual incidence of HIV-1 infection in MSM in the 20 cities might be between 4.06% and 5.66%. Conclusions: Sample missing and misreporting might cause the deviation of the estimation of HIV-1 infection incidence. It is important to ensure the sample source and the quality of sample collection and detection to reduce the deviation in the estimation of HIV-1 infection incidence.

[Effects of dexmedetomidine on injury of lungs and CHOP protein expression in elderly patients with lung cancer during one-lung ventilation].

Objective: To evaluate the effect of dexmedetomidine on lung injury and CCAAT/enhancer-binding protein homologous protein (CHOP) expression in elderly patients with lung cancer undergoing thoracoscopic lobectomy. Methods: A total of 120 elderly patients with lung cancer who underwent elective thoracoscopic lobectomy were selected from the Second Affiliated Hospital of Zhengzhou University from October 2018 to March 2019. The random phenotype was divided into dexmedetomidine group (group D, n=60) and control group (group C, n=60). The elapsed time before postoperative awake and spontaneous breathing recovery and agitation occurrence were recorded. The mean arterial pressure (MAP), heart rate (HR), oxygen saturation (SPO(2)), oxygen partial pressure (PaO(2)), alveolar-arterial oxygen partial pressure difference[P(A-a)O(2)], end-tidal carbon dioxide partial pressure (P(ET)CO(2)), and airway pressure peak (P(peak)) were recorded before the anesthetic induction (T(0)), immediately after tracheal intubation (T(1)), immediately after unilateral pulmonary ventilation(T(2)), 1 hour after unilateral pulmonary ventilation (T(3)), immediately after bilateral pulmonary ventilation (T(4)), and at the end of surgery(T(5)). The levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), IL-8, IL-10, super oxide dismutase (SOD) and malondialdehyde (MDA)were compared at the time of T(0), T(1), T(2), T(3), T(4) and T(5) in two groups. The ratios of alveolar damage (IQA), apoptotic index (AI), and the expression of CHOP mRNA and their protein in lung tissue were detected. Results: The recovery time of conscious and spontaneous breathing in group D were significantly shorter than that in group C (P<0.05). The MAP and HR of the two groups at T(1)-T(5) were significantly lower than those at T(0)(P<0.05).The levels of P(peak) in group C at T(3)-T(5) was significantly higher than those in group D (P<0.05). The SpO(2) values in the group D at T(1)-T(5) were significantly higher than those in group C (P<0.05). The P(A-a)O(2) values in the group D at T(1)-T(5) was significantly lower than those in group C (P<0.05).The levels of IL-6, IL-8 and MDA in group D at T(1)-T(5) were significantly lower than those in group C(P<0.05). The levels of IL-10 and SOD in group D at T(1)-T(5) were significantly higher than those in group C (P<0.05). The values of IQA, AI, and the expression of CHOP mRNA and their protein in the two groups at T(4) were significantly higher than those at T(2) (P<0.05). The values of IQA, AI, and the expression of CHOP mRNA and their protein in group D at T(4) were significantly lower than those in group C (P<0.05). Conclusions: Dexmedetomidine could attenuate the extent of lung injury in elderly patients with lung cancer undergoing thoracoscopic lobectomy. The pulmonary protective mechanism could be related to the inhibition of inflammatory factors in dexmedetomidine, improving oxidative stress and reducing Chop-mediated apoptosis of lung tissue by the protein.

[Effect of penehyclidine hydrochloride injection on pulmonary ischemia-reperfusion in aortic dissection surgery].

Objective: To evaluate the effect of Penehyclidine Hydrochloride Injection on pulmonary ischemia-reperfusion in aortic dissection surgery. Methods: This study was a prospective randomized controlled trial. Between September 2015 and October 2017 in the Second Affiliated Hospital of Zhengzhou University, 60 patients with aortic dissection underwent total arch replacement surgery were randomly divided into penehyclidine hydrochloride group (group A 30 cases) and control group (group B 30 cases). Patients in group A were infused with penehyclidine hydrochloride 0.05 mg/kg after entering the operating room. Patients in group B were infused with the same dose of 0.9% normal saline. Serum tumor necrosis factor (TNF-α), interleukin-6 (IL-6), interleukin-1 (IL-1) and oxygenation index (OI) before anesthesia (T1), before cardiopulmonary bypass (T2), 1 h after cardiopulmonary bypass (T3), the end of cardiopulmonary bypass (T4), 4 h after surgery (T5) and 24 h after surgery (T6) were measured. The time of postoperative ventilator support and ICU staywas recorded. Results: At the time of T4, T5 and T6, the serum levels of TNF-α[(0.10±0.08), (0.13±0.02), (0.23±0.17) mg/L], IL-6[(0.23±0.08), (0.34±0.07), (0.54±0.17) mg/L]and IL-1[(0.62±0.14), (1.02±0.27), (1.44±0.40) mg/L]in group A were significantly lower than those in group B[(0.30±0.09), (0.51±0.19), (0.86±0.02) mg/L; (0.73±0.19), (1.33±0.13), (1.98±0.13) mg/L; (0.93±0.19), (1.43±0.66), (2.04±0.45) mg/L]. The OI was higher in group A[(446.7±267.0), (386.7±169.5), (391.7±227.9) mmHg]than that of group B[(341.2±145.2), (299.5±98.7), (275.0±127.3) mmHg](P<0.05). The time of ventilator support and ICU stay after operation was (3.6 ±1.2)d, (8.4 ± 2.0) d in group A, which was shorter than that in group B[(4.3 ± 1.8), (10.0 ± 2.2) d], and there were statistical differences between the two groups (all P<0.05). Conclusions: In total arch replacement, intravenous penehyclidine hydrochloride injection may decrease the release of serum TNF-α, IL-6, IL-1, improve oxygenation index, reduce lung ischemia-reperfusion injury, shorten the time of ventilator support and ICU stay after operation, and thus improve the prognosis of patients.

Effect of dexmedetomidine on immune function of patients undergoing radical mastectomy: a double blind and placebo control study.

OBJECTIVE: To observe and evaluate the effect of dexmedetomidine on the perioperative immune function of patients undergoing a radical mastectomy. PATIENTS AND METHODS: 124 patients undergoing radical mastectomy were divided into the observation group (treated with dexmedetomidine) and the control group (treated with saline) by randomized digital table and double blinded and randomized design. 10 min before anesthesia induction, the patients in the observation group were injected with dexmedetomidine 0.1 ug.kg-1.min-1. The injection of 0.9% sodium chloride solution was given to the control group at the same rate. In the experiment, the medications of anesthesia induction and anesthesia maintain were identical. Venous blood at five times: T0 (before anesthesia), T1 (6 h after surgery), T2 (24 h after surgery), T3 (48 h after surgery), T4 (72 h after surgery) were collected. ELISA (Enzyme Linked Immunosorbent Assay) was used to detect concentrations of IL-2, IFN-γ, IL-4, IL-6 and IL-10; FACS flow cytometry was used to determine the level of T-lymphocyte subsets (CD3+, CD4+, CD8+) and NK cells. RESULTS: Compared with the control group, the cell levels of CD3+ and CD4+ in the observation group rose remarkably at T3 and T2 (p<0.05). The cell level of CD8+ fell at T2 with significant difference; NK cell level increased noticeably at T1 and T2, and CD4+/CD8+ rose dramatically at all postoperative time points. Obviously, the patients' immune function, to some extent, has been affected; in addition, the concentration of INF-γ in observation group increased prominently at T1, T2 and T3 (p<0.05), and the concentration of IL-2 at T2, IL-10 at T1 and T2, and IL-6 at T2 and T3 in the observation group all rose significantly (p<0.05), and less cytokine Th1 drifted to Th2. CONCLUSIONS: The dexmedetomidine can effectively maintain the homeostasis of cell immune function of patients undergoing a radical mastectomy.

Propofol suppresses proliferation and invasion of pancreatic cancer cells by upregulating microRNA-133a expression.

Propofol is a commonly used intravenous anesthetic. We evaluated its effects on the behavior of human pancreatic cancer cells and the underlying molecular mechanisms. The effects of propofol on Panc-1 cell proliferation, apoptosis, and invasion were determined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, caspase-3 activity measurement, and Matrigel invasion assay. Quantitative polymerase chain reaction (qPCR) was used to assess microRNA-133a (miR-133a) expression. Anti-miR-133a was transfected into Panc-1 cells to assess the role of miR-133a in propofol-induced antitumor activity. Propofol significantly inhibited Panc-1 cell proliferation and invasion, and promoted apoptosis. Propofol also efficiently elevated miR-133a expression. Moreover, transfection of anti-miR-133a reversed the effects of propofol on the biological behavior of Panc-1 cells. Propofol can effectively inhibit proliferation and invasion, and induce apoptosis of pancreatic cancer cells, at least partly through the upregulation of miR-133a expression.

Hybrid method of scattering from a dielectric target above a rough surface: TM case.

A hybrid method, combining analytic Kirchhoff approximation (KA) and numerical method of moment (MoM), is developed to solve the 2D scattering problem of a dielectric target with arbitrary cross section above a moderate perfect electric conductor (PEC) rough surface under TM-polarized tapered wave incidence. Consider the target as the MoM region and the rough surface as the KA region, the induced current on the rough surface is obtained through the KA method, which depends on the incident tapered wave and the field illuminating by current distribution on the target, leaving only unknowns on the target region. In order to reduce the computational costs further, the rough surface is truncated to speed up computation of the scattering contribution from the rough surface to the target. Compared with the conventional MoM, the hybrid method is very efficient to solve the composite scattering problem of target above rough surface, especially for long underlying rough surface. Simulation results validate the effectiveness and accuracy of the hybrid method.