[Morphological study of sexual reproductive disorders in Ligusticum chuanxiong].

Chuanxiong Rhizoma is a well-known Sichuan-specific herbal medicine. Its original plant, Ligusticum chuanxiong, has been cultivated asexually for a long time. L. chuanxiong has sexual reproductive disorders, which restricts its germplasm innovation. However, there is little research on the reproductive system of L. chuanxiong. This study is based on a comparative anatomical research approach, using morphological dissection, paraffin sectioning, staining and compression, and combined with scanning electron microscopy technology, to observe and compare the flowers, fruits, and seeds at various stages of reproductive growth of L. chuanxiong and its wild relative L. sinense. The results showed that the meiosis of pollen mother cells is abnormal in L. chuanxiong anthers, and the size and number of microspores are uneven and inconsistent in the tetrad stage. tapetum cells are not completely degenerated during anther development. During the pollen ripening stage, there are fine cracks in the anther wall, while most anthers could not release pollen normally. The surface of mature pollen grains is concave and partially deformed, and the pollens are all inactive and cannot germinate in vitro. The starch, polysaccharides, and lipids in the pollen were insufficient. The filaments of L. chuanxiong are short at the flowering stage and recurved downward. Double-hanging fruits were observed in the fruiting stage, being wrinkled; with shriveled seeds. Compared with L. sinense at the same stage, the anthers of L. sinense developed normally, and the pollen grains are vigorous and can germinate in vitro. The double-hanging fruits of L. sinense are full and normal; at the flowering period, the filaments are long and erect, significantly higher than the stigma. Mature blastocysts are visible in the ovary of both L. chuanxiong and L. sinense, and there is no significant difference in stigmas. The conclusion is that during the development of L. chuanxiong stamens, the meiosis of pollen mother cells is abnormal, and tetrad, tapetum, filament and other pollen structures develop abnormally. L. chuanxiong has the characteristic of male infertility, which is an important reason for its sexual reproductive disorders.

The complete chloroplast genome sequence of Phyllostachys incarnata Wen, 1982.

Phyllostachys incarnata Wen, 1982 is one of the important material and edible bamboo specie of high quality in China. We reported the complete chloroplast(cp) genome of P. incarnata in this study. The cp genome of P. incarnata (GenBank accession number: OL457160) was a typical tetrad structure with a full length of 139,689 bp, comprising a pair of inverted repeated (IR) regions (21,798 bp) separated by a large single-copy (LSC) region (83,221 bp) and a small single-copy (SSC) region (12,872 bp). And the cp genome contained 136 genes, including 90 protein-coding genes, 38 tRNA genes, and 8 rRNA genes. Phylogenetic analysis based on 19 cp genomes suggested that P. incarnata was relatively close to P. glauca among the species analyzed.

Transcutaneous electrical cranial-auricular acupoint stimulation versus escitalopram for mild-to-moderate depression: An assessor-blinded, randomized, non-inferiority trial.

AIM: Transcutaneous electrical cranial-auricular acupoint stimulation (TECAS) is a novel non-invasive therapy that stimulates acupoints innervated by the trigeminal and auricular vagus nerves. An assessor-blinded, randomized, non-inferiority trial was designed to compare the efficacy of TECAS and escitalopram in mild-to-moderate major depressive disorder. METHODS: 468 participants received two TECAS sessions per day at home (n = 233) or approximately 10-13 mg/day escitalopram (n = 235) for 8 weeks plus 4-week follow-up. The primary outcome was clinical response, defined as a baseline-to-endpoint ≥50% reduction in Montgomery-Åsberg Depression Rating Scale (MADRS) score. Secondary outcomes included remission rate, changes in the severity of depression, anxiety, sleep and life quality. RESULTS: The response rate was 66.4% on TECAS and 63.2% on escitalopram with a 3.2% difference (95% confidence interval [CI], -5.9% to 12.9%) in intention-to-treat analysis, and 68.5% versus 66.2% with a 2.3% difference (95% CI, -6.9% to 11.4%) in per-protocol analysis. The lower limit of 95% CI of the differences fell within the prespecified non-inferiority margin of -10% (P ≤ 0.004 for non-inferiority). Most secondary outcomes did not differ between the two groups. TECAS-treated participants who experienced psychological trauma displayed a markedly greater response than those without traumatic experience (81.3% vs 62.1%, P = 0.013). TECAS caused much fewer adverse events than escitalopram. CONCLUSIONS: TECAS was comparable to escitalopram in improving depression and related symptoms, with high acceptability, better safety profile, and particular efficacy in reducing trauma-associated depression. It could serve an effective portable therapy for mild-to-moderate depression.

Screw Pullout Strength After Pedicle Screw Reposition: A Finite Element Analysis.

RESEARCH DESIGN: Finite element analysis based on computed tomography images from the lumbar spine. OBJECTIVE: Determined the pullout strength of unsatisfactorily placed screws and repositioned screws after unsatisfactory place in lumbar spine surgery. BACKGROUND: Pedicle screws are widely used to stabilize the spinal vertebral body. Unsatisfactory screws could lead to surgical complications, and may need to be repositioned. Screw removal and reposition, however, may decrease pullout strength. METHODS: We conducted a three-dimensional finite element analysis based on high-resolution computed tomography images from a 39-year-old healthy woman. Pullout strength was determined with the screw placed in different orientations at the same entry point (as selected by the Magerl method), as well as after removal and reposition. The material properties of the vertebral body and the screw were simulated by using grayscale values and verified data, respectively. A load along the screw axis was applied to the end of the screw to simulate the pullout. RESULTS: The pullout strength was 1840.0 N with the Magerl method. For unsatisfactorily placed screws, the pullout strength was 1500.8 N at 20% overlap, 1609.6 N at 40% overlap, 1628.9 N at 60% overlap, and 1734.7 N at 80% overlap with the hypothetical screw path of the Magerl method. For repositioned screws, the pullout strength was 1763.6 N, with 20% overlap, 1728.3 N at 40% overlap, 1544.0 N at 60% overlap, and 1491.1 N at 80% overlap, with the original path. Comparison of repositioned screw with unsatisfactorily placed screw showed 14.04% decrease in pullout strength at 80% overlap, 5.21% decrease at 60% overlap, 7.37% increase at 40% overlap, and 17.51% increase at 20% overlap, with the screw path of the Magerl method. CONCLUSIONS: Removal and reposition increased the pullout strength at 20% and 40% overlap, but decreased the pullout strength at 60% and 80% overlap. For clinical translation, we recommend removal and reposition of the screw when the overlap is in the range of 20% to 40% or less. In vitro specimen studies are needed to verify these preliminary findings.

Analysis on survival time and influencing factors among reported HIV/AIDS in Yunnan Province, 1989-2021 / 中华流行病学杂志

Objective: To analyze the survival time of reported HIV/AIDS and influencing factors of Yunnan Province from 1989 to 2021. Methods: The data were extracted from the Chinese HIV/AIDS comprehensive response information management system. The retrospective cohort study was conducted. The life table method was applied to calculate the survival probability. Kaplan-Meier was used to draw survival curves in different situations. Furthermore, the Cox proportion hazard regression model was constructed to identify the factors related to survival time. Results: Of the 174 510 HIV/AIDS, the all-cause mortality density was 4.23 per 100 person-years, the median survival time was 20.00 (95%CI:19.52-20.48) years, and the cumulative survival rates in 1, 10, 20, and 30 years were 90.75%, 67.50%, 47.93% and 30.85%. Multivariate Cox proportional risk regression model results showed that the risk of death among 0-14 and 15-49 years old groups were 0.44 (95%CI: 0.34-0.56) times and 0.51 (95%CI:0.50-0.52) times of ≥50 years old groups. The risk for death among the first CD4+T lymphocytes counts (CD4) counts levels of 200-349 cells/μl, 350-500 cells/μl and ≥501 cells/μl groups were 0.52 (95%CI: 0.50-0.53) times, 0.41 (95%CI: 0.40-0.42) times and 0.35 (95%CI: 0.34-0.36) times of 0-199 cells/μl groups. The risk of death among the cases that have not received antiretroviral therapy (ART) was 11.56 (95%CI: 11.26-11.87) times. The risk for death among the cases losing to ART, stopping to ART, both losing and stopping ART was 1.66 (95%CI:1.61-1.72) times, 2.49 (95%CI:2.39-2.60) times, and 1.65 (95%CI:1.53-1.78) times of the cases on ART. Conclusions: The influencing factors for the survival time of HIV/AIDS cases were age at diagnosis in Yunnan province from 1989 to 2021. The first CD4 counts levels, antiretroviral therapy, and ART compliance. Early diagnosis, early antiretroviral therapy, and increasing ART compliance could extend the survival time of HIV/AIDS cases.

[Acupuncture with Tiaochong Shugan method by stages for menstrual headache based on syndrome differentiation: a randomized controlled trial].

OBJECTIVE: To compare the clinical efficacy between acupuncture with Tiaochong Shugan method by stages based on syndrome differentiation and oral administration of ibuprofen sustained-release capsule in patients with menstrual headache. METHODS: A total of 90 cases with menstrual headache were randomly divided into an acupuncture group (45 cases, 1 case excluded, 3 cases dropped off) and a medication group (45 cases, 3 cases dropped off). The patients in the acupuncture group were treated with acupuncture with Tiaochong Shugan method by stages based on syndrome differentiation; during period of pain attacks, Ganshu (BL 18), Qimen (LR 14), Hegu (LI 4), Taichong (LR 3), Sizhukong (TE 23) through Shuaigu (GB 8) were selected, once a day; during period of pain relief, Qichong (ST 30), Dahe (KI 12), Guanyuan (CV 4), Taixi (KI 3) were selected, once every 1-2 days. The patients in the medication group were treated with oral administration of ibuprofen sustained-release capsule during period of pain attacks. Each menstrual cycle was taken as a course of treatment, and both groups were treated for 3 courses. The headache comprehensive score (HCS), visual analogue scale (VAS) socre, dysmenorrhea symptom score (DSS) were compared before treatment, 1, 2 and 3 courses into treatment and 1, 2, 3 menstrual cycles after treatment; the clinical efficacy was also evaluated. RESULTS: The HCS score at each time point after treatment was lower than that before treatment in the two groups (P<0.05); 2 and 3 menstrual cycles after treatment, the HCS socres in the acupuncture group were lower than those in the medication group (P<0.05). Except for the 2 and 3 menstrual cycles after treatment in the medication group, the VAS score at each time point after treatment was lower than that before treatment in the two groups (P<0.05). Except for 1 menstrual cycle into treatment, the DSS scores in the acupuncture group at each time point after treatment was lower than that before treatment (P<0.05); the DSS socres at 2 and 3 menstrual cycles into treatment and 1 menstrual cycle after treatment were lower than those before treatment in the medication group (P<0.05). Except for 1 menstrual cycle into treatment, the VAS score and DSS score in the acupuncture group were lower than those in the medication group at each time point after treatment (P<0.05). The total effective rate was 82.9% (34/41) in the acupuncture group, which was higher than 73.8% (31/42) in the medication group (P<0.05). CONCLUSION: The analgesic effect of acupuncture with Tiaochong Shugan method by stages based on syndrome differentiation is superior to oral administration of ibuprofen sustained-release capsules, which could effectively prevent the recurrence of menstrual headache, and improve irregular menstruation-related symptoms.

Thrombotic thrombocytopenic purpura complicated with acute aortic dissection: A case report.

RATIONALE: Thrombotic thrombocytopenic purpura (TTP) is a critical thrombotic microangiopathy involving multiple organs. To the best of our knowledge, there are no reports of TTP complicated by acute aortic dissection. PATIENT CONCERNS: We herein described a 53-year-old male with TTP who did not have a significant medical history. After immediate plasma exchange and glucocorticoid therapy, the patient's clinical condition improved. However, the patient suddenly experienced chest pain with elevated blood pressure. DIAGNOSES: Computed tomography angiography suggested acute type B aortic dissection. INTERVENTIONS: The patient was immediately transferred to the cardiac aortic surgery department for thoracic aortic endovascular repair. OUTCOMES: The patient was discharged after successful thoracic aortic endovascular repair. Unfortunately, 3 months later, the patient experienced chest and back pain at home and died suddenly, possibly due to the recurrence of aortic dissection. LESSONS: Even if patients have no identifiable risk factors, physicians should be aware of this rare and life-threatening acute complication of TTP, which may have multiple causes, including preexisting connective tissue disease, abnormal blood pressure fluctuations, and increased risk of hemorrhage. Early identification and timely treatment of acute aortic dissection are critical for improving prognosis.

[Effects of growth stage and altitude on twig functional traits and biomass allocation of Rhododendron przewalskii in the headwater region of Minjiang River, China.] / å‘è‚²é˜¶æ®µå’Œæµ·æ‹”å¯¹å²·æ±ŸæºåŒºé™‡èœ€æœé¹ƒå°æžåŠŸèƒ½æ€§çŠ¶åŠç”Ÿç‰©é‡åˆ†é çš„å½±å“.

This study aimed at understanding the differences in traits of functional twigs and leaves of a typical alpine shrub species, Rhododendron przewalskii, at Kaka Mountain in the headwater region of Minjiang River. Leaf and twig traits were compared for shrubs at different growth stages (flower bud stage and flowering stage) and altitude (3600 m and 3800 m). The effects of spatial heterogeneity on their correlations and trade-offs were evaluated at leaf and twig levels, respectively. Our results showed that twig length was significantly longer at low altitude than high altitude for the shubs at the same growth stage. The number and mass of flowers at flowering stage were significantly higher at high altitude than those at low altitude. At the same altitude, twig mass, number of leaves, total leaf mass, total leaf area and total petiole mass were all significantly greater at the flower bud stage than those at the flowering stage, while the individual leaf mass and individual petiole mass at flower bud stage were significantly smaller than those at flowering stage. Compared with the flower bud stage, the proportion of leaf mass decreased by 13% at the flowering stage, while biomass proportion of twig significantly increased. At the flower bud stage, twig mass had a higher contribution to total twig mass. In contrast, the contribution of total leaf mass to total twig mass was higher at flowering stage. More biomass of leaf was allocated to individual leaf mass at flower bud stage. More biomass of leaf was allocated to individual petiole mass and individual leaf mass at flowering stage at low altitude and high altitude, respectively. At low altitude, allometric growth patterns presented between twig mass and total leaf area, total leaf mass. Similarly, individual petiole mass and individual leaf area had allometric growth. Our results indicated that the functional traits of twigs and leaves varied across both altitude and plant growth stage.

A foodborne disease event caused by Vibrio parahaemolyticus / 上海预防医学

Objective To investigate and analyze a food borne disease event caused by Vibrio parahaemolyticus (VP) which happened in a company in Shanghai, and to explore the significance of laboratory testing technology in event traceability analysis, then making suggestions on key directions for food-borne disease prevention. Methods On the basis of epidemiological and hygienic investigation, the virulence genes and molecular typing techniques were used for the VP strains detected in the incident. Results A total of 65 patients were consistent with the case definition.The restaurant had no food business license, and its employees had no health certificate.VP was detected in anal swabs of 5 patients and 2 employees, and the PFGE map showed the same. Conclusion The event is suspiciously caused by food contamination from restaurant employees during food processing, assembly or transportation.It is suggested that the management should be improved of all aspects of the restaurant after cooking, and restaurants providing takeaway should be strengthened.

Effect of External Phrenic Nerve Electrical Stimulation on Respiratory Function for Convalescent Stroke Patients / 中国康复理论与实践

Objective:To observe the effect of external phrenic nerve electrical stimulation on respiratory function for convalescent stroke patients. Methods:From October, 2017 to July, 2018, 27 convalescent stroke patients were randomly divided into control group (n = 14) and observation group (n = 13). Both groups received routine rehabilitation, while the observation group accepted external phrenic nerve electrical stimulation additionaly. Their ventilation and respiratory muscle strength were measured before and four weeks after treatment. Results:The forced vital capacity (FVC), forced expiratory volume in 1st second (FEV1), peak expiratory flow (PEF), maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) improved in both groups after treatment (t > 5.075, Z = -3.366, P < 0.001), and improved more in FVC, FEV1, PEF and MIP in the observation group than in the control group (t > 0.921, Z = -2.746, P < 0.05). Conclusion:External phrenic nerve electrical stimulation can improve ventilation and inspiratory muscle strength for convalescent stroke patients.

Effect of External Phrenic Nerve Electrical Stimulation on Respiratory Function for Convalescent Stroke Patients / 中国康复理论与实践

Objective:To observe the effect of external phrenic nerve electrical stimulation on respiratory function for convalescent stroke patients. Methods:From October, 2017 to July, 2018, 27 convalescent stroke patients were randomly divided into control group (n = 14) and observation group (n = 13). Both groups received routine rehabilitation, while the observation group accepted external phrenic nerve electrical stimulation additionaly. Their ventilation and respiratory muscle strength were measured before and four weeks after treatment. Results:The forced vital capacity (FVC), forced expiratory volume in 1st second (FEV1), peak expiratory flow (PEF), maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) improved in both groups after treatment (t > 5.075, Z = -3.366, P < 0.001), and improved more in FVC, FEV1, PEF and MIP in the observation group than in the control group (t > 0.921, Z = -2.746, P < 0.05). Conclusion:External phrenic nerve electrical stimulation can improve ventilation and inspiratory muscle strength for convalescent stroke patients.

Knowledge, related behavior and on AIDS/HIV infection among rural adults with Derung minority, in Yunnan province, 2016 / 中华流行病学杂志

Objective To understand the related risk behaviors,knowledge and status of HIV/ AIDS infection among rural adults of Derung minority,to provide relevant messages for the development of HIV/AIDS intervention strategy in this minority group.Methods We used system sampling method to conduct a cross-sectional survey in 6 administration villages of Derung Township,Gongshan Derung and Nu Autonomous County in Nujiang Lisu Autonomous Prefecture of Yunnan Province,with a sample size estimated as 383.Adult residents with Derung minority in six villages of Gongshan County were involved,with relevant information collected through door-to-door visit.HIV antibody was tested and SPSS 17.0 was used for statistical analysis.Results Information on 394 valid respondents was collected,with age as between 18 and 65 (34.39 ± 9.74),80.7％ (318/394) as married,54.0％ (213/394) having had primary school education,13.2％ (52/394) as migrant workers.In this population,the overall HIV infection rote appeared as 0.5％ (2/400),mainly through sexually transmission.The rate of awareness on HIV/AIDS was 69.8％ (275/394),mainly through free publicized materials 50.0％ (197/394).Rates on premarital sexual behavior on multiple sexual partners in the past year,on temporary sexual partners in the past year,having commercial sexual experiences in the past year and ever used condoms when engaging in casual sex,were 6.4％ (60/366),18.0％(66/366),5.7％(21/366),1.9％(7/366) and 8.0％(25/311),respectively.Conclusions Few numbers of HIV infections were identified among the migrating workers with Derung minority,with sexual transmission as the major route,along with the increased number of rural migrant workers and the low rates both on AIDS knowledge and condom use,accompanied by the high risk sexual behavior appeared in this rural adult residents of Derung minority.Relative strategies on HIV/AIDS intervention and control should be developed.

Knowledge, related behavior and on AIDS/HIV infection among rural adults with Derung minority, in Yunnan province, 2016 / 中华流行病学杂志

Objective To understand the related risk behaviors,knowledge and status of HIV/ AIDS infection among rural adults of Derung minority,to provide relevant messages for the development of HIV/AIDS intervention strategy in this minority group.Methods We used system sampling method to conduct a cross-sectional survey in 6 administration villages of Derung Township,Gongshan Derung and Nu Autonomous County in Nujiang Lisu Autonomous Prefecture of Yunnan Province,with a sample size estimated as 383.Adult residents with Derung minority in six villages of Gongshan County were involved,with relevant information collected through door-to-door visit.HIV antibody was tested and SPSS 17.0 was used for statistical analysis.Results Information on 394 valid respondents was collected,with age as between 18 and 65 (34.39 ± 9.74),80.7％ (318/394) as married,54.0％ (213/394) having had primary school education,13.2％ (52/394) as migrant workers.In this population,the overall HIV infection rote appeared as 0.5％ (2/400),mainly through sexually transmission.The rate of awareness on HIV/AIDS was 69.8％ (275/394),mainly through free publicized materials 50.0％ (197/394).Rates on premarital sexual behavior on multiple sexual partners in the past year,on temporary sexual partners in the past year,having commercial sexual experiences in the past year and ever used condoms when engaging in casual sex,were 6.4％ (60/366),18.0％(66/366),5.7％(21/366),1.9％(7/366) and 8.0％(25/311),respectively.Conclusions Few numbers of HIV infections were identified among the migrating workers with Derung minority,with sexual transmission as the major route,along with the increased number of rural migrant workers and the low rates both on AIDS knowledge and condom use,accompanied by the high risk sexual behavior appeared in this rural adult residents of Derung minority.Relative strategies on HIV/AIDS intervention and control should be developed.

Characteristics of HIV seropositive cases and related high risk behaviors in a community in Yunnan province, 2012-2015 / 中华流行病学杂志

Objective To understand the characteristics of newly detected HIV infection cases and related high risk behaviors in the areas with high HIIV infection prevalence in Yunnan province.Methods A questionnaire survey was conducted with census method during January to March 2016 among newly detected HIV infected persons in Dehong,Honghe,Lincang and Dali prefectures in Yunnan during 2012-2015.Results Among 451 HIV seropositive cases,the major transmission route of HIV was heterosexual contact,accounting for 92.5％ (417/451).The total awareness rate of AIDS related knowledge was 73.0％ (329/451).The rates of condom use at sex with regular sexual partners,occasional sexual partners,commercial sexual partners and men who have sex with men within 1 year before knowing their infection status were 48.7％ (167/343),4.2％ (7/165),9.9％ (15/151) and 0.0％ (0/3),respectively.The risk factors for using no condom at sex with regular sexual parmers included living at Dali,being farmer,unmarried,cohabitation,divorced and widowed,monthly income under 1 000 yuan (RMB),living in urban area before infection,knowing no AIDS related knowledge etc.The risk factors for using no condom at sex with occasional sexual partners included living in Dehong,Honghe and Lincang,aged ≤30 years and being farmer.The injecting drug users accounted for 8.2％ (37/450) and 75.5％ of these cases had received AIDS related intervention (340/450).Conclusion High prevalence of heterosexual transmission of HIV,poor AIDS related knowledge on awareness,high risk behavior and poor condom use and poor intervention service utilization were found among newly detected HIV infected persons in areas with high HIV infection prevalence in Yunnan.

A large scale cohort study on AIDS in communities in Dali, Yunnan province, 2014-2015 / 中华流行病学杂志

Objective To understand HIV incidence in community residents and epidemiological characteristics of newly detected HIV infection cases in Dali,Yunnan province.Methods A cohort study was conducted among 146720 community residents who were tested to be HIV negative during 2010-2011,they were followed-up from June 1,2014 to May 31,2015.Results A total of 136356 community residents received follow up (92.9％).The follow-up time was 0.23-5.40 years (medium:3.43 years),cumulatively 459675 person years,and 78 people were found to be HIV positive.The incidence rate of HIV infection was 0.170/1000 person years.The incidence rate was 0.037/1000 person years in age group 15-29 years,0.288/1000 person years in age group 30-44 years,0.210/1000 person years in age group 45-59 years,0.204/1000 person years in age ≥60 years;0.213/1 000 person years in males,0.130/1000 person years in females;0.248/1000 person years inHan ethnic group,0.149/1000 person years in Minorities;0.194/1000 in people with education level ≤junior middle school,0.046/1000 person years in people with education level ＞ junior middle school;0.070/1000 person years in the unmarried,0.194/1000 person years in the married and 0.425/1000person years in the divorced/widowed.Cox proportional hazards regression analysis showed that being male (HR=l.731),aged 30-44 years (HR=13.158),aged 45-59 years (HR=10.329),aged ≥60years (HR=8.291),unmarried (HR=3.162) and divorced/widowed (HR=2.689) were the risk factors for HIV infection,while the education level ＞ junior middle school (HR=0.132) was the protective factor for HIV infection.Conclusions By medium 3.43 years follow up,the cohort study showed that incidence rate HIV infection was 0.170/1000 person years in the community residents in Dali.Male,middle aged and old people,people with low education level,the unmarried and the divorced/widowed had relatively higher risk to be infected with HIV,Close attention should be paid to the prevention and control of AIDS in these populations.

Characteristics of HIV seropositive cases and related high risk behaviors in a community in Yunnan province, 2012-2015 / 中华流行病学杂志

Objective To understand the characteristics of newly detected HIV infection cases and related high risk behaviors in the areas with high HIIV infection prevalence in Yunnan province.Methods A questionnaire survey was conducted with census method during January to March 2016 among newly detected HIV infected persons in Dehong,Honghe,Lincang and Dali prefectures in Yunnan during 2012-2015.Results Among 451 HIV seropositive cases,the major transmission route of HIV was heterosexual contact,accounting for 92.5％ (417/451).The total awareness rate of AIDS related knowledge was 73.0％ (329/451).The rates of condom use at sex with regular sexual partners,occasional sexual partners,commercial sexual partners and men who have sex with men within 1 year before knowing their infection status were 48.7％ (167/343),4.2％ (7/165),9.9％ (15/151) and 0.0％ (0/3),respectively.The risk factors for using no condom at sex with regular sexual parmers included living at Dali,being farmer,unmarried,cohabitation,divorced and widowed,monthly income under 1 000 yuan (RMB),living in urban area before infection,knowing no AIDS related knowledge etc.The risk factors for using no condom at sex with occasional sexual partners included living in Dehong,Honghe and Lincang,aged ≤30 years and being farmer.The injecting drug users accounted for 8.2％ (37/450) and 75.5％ of these cases had received AIDS related intervention (340/450).Conclusion High prevalence of heterosexual transmission of HIV,poor AIDS related knowledge on awareness,high risk behavior and poor condom use and poor intervention service utilization were found among newly detected HIV infected persons in areas with high HIV infection prevalence in Yunnan.

A large scale cohort study on AIDS in communities in Dali, Yunnan province, 2014-2015 / 中华流行病学杂志

Objective To understand HIV incidence in community residents and epidemiological characteristics of newly detected HIV infection cases in Dali,Yunnan province.Methods A cohort study was conducted among 146720 community residents who were tested to be HIV negative during 2010-2011,they were followed-up from June 1,2014 to May 31,2015.Results A total of 136356 community residents received follow up (92.9％).The follow-up time was 0.23-5.40 years (medium:3.43 years),cumulatively 459675 person years,and 78 people were found to be HIV positive.The incidence rate of HIV infection was 0.170/1000 person years.The incidence rate was 0.037/1000 person years in age group 15-29 years,0.288/1000 person years in age group 30-44 years,0.210/1000 person years in age group 45-59 years,0.204/1000 person years in age ≥60 years;0.213/1 000 person years in males,0.130/1000 person years in females;0.248/1000 person years inHan ethnic group,0.149/1000 person years in Minorities;0.194/1000 in people with education level ≤junior middle school,0.046/1000 person years in people with education level ＞ junior middle school;0.070/1000 person years in the unmarried,0.194/1000 person years in the married and 0.425/1000person years in the divorced/widowed.Cox proportional hazards regression analysis showed that being male (HR=l.731),aged 30-44 years (HR=13.158),aged 45-59 years (HR=10.329),aged ≥60years (HR=8.291),unmarried (HR=3.162) and divorced/widowed (HR=2.689) were the risk factors for HIV infection,while the education level ＞ junior middle school (HR=0.132) was the protective factor for HIV infection.Conclusions By medium 3.43 years follow up,the cohort study showed that incidence rate HIV infection was 0.170/1000 person years in the community residents in Dali.Male,middle aged and old people,people with low education level,the unmarried and the divorced/widowed had relatively higher risk to be infected with HIV,Close attention should be paid to the prevention and control of AIDS in these populations.

Prevalence of high risk behaviors in HIV infected persons aged ≥50 years in selected counties of Yunnan province / 中华流行病学杂志

<p><b>OBJECTIVE</b>To understand the prevalence of high risk behaviors and influencing factors among HIV infected persons aged ≥50 years.</p><p><b>METHODS</b>Face to face questionnaire interview was conducted among the HIV infected persons selected in Jianshui, Gejiu and Mengzi counties in Yunnan province through random sampling in June 2015. The sample size was 450.</p><p><b>RESULTS</b>Among the HIV infected persons surveyed, 41.2% (122/296) had sexual behaviors with their spouses during past year, and the consistent condom use rate was 66.4% (81/122). Among the HIV infected males, 8.9% (28/313) had commercial sexual behaviors during past year, and the consistent condom use rate was 17.9% (5/28). Among the HIV infected females, 0.7% were still engaged in commercial sex service during past year. Among the 450 HIV infected persons, 32 (7.1%) reported having casual sex behaviors during past years, and the consistent condom use rate was 18.7% (6/32). The rate of commercial sexual behavior in urban residents (13.4%, 19/115) was higher than that in rural residents (4.5%, 9/198), the difference was statistically significant (χ(2)=11.715, P=0.001). The risk factors for commercial sex behaviors included lack of family and social support, aged 50-59 years, living in urban area, higher income and being male. The risk factors for using no condom included living in rural area, lower education level, lack of family and social support and higher income.</p><p><b>CONCLUSIONS</b>Risk sex behaviors are still prevalent in HIV infected people aged >50 years, which exacerbated HIV transmission. Further efforts should be focused on the education about AIDS prevention and control and promoting protected sexual behaviors. Additional effort should be done to improve the family and social support for HIV infected people aged >50 years. Moreover, comprehensive intervention for low-paid female sex workers also needs to be strengthened.</p>

Change trend of HIV/AIDS related risk factors and influencing factors among men who have sex with men in Yunnan, 2010-2013 / 中华流行病学杂志

<p><b>OBJECTIVE</b>To understand the change trend of the awareness rate of HIV/AIDS related knowledge, risk behaviors among men who have sex with men (MSM) in Yunnan and the factors influencing their condom use, and evaluate the effect of comprehensive intervention.</p><p><b>METHODS</b>The data about the MSM's demographic information, HIV/AIDS related knowledge awareness, and sex behavior, condom use, drug use and intervention receiving were obtained from AIDS sentinel surveillance among MSM in Yunnan province during 2010-2013 to conduct change trend and influencing factor analysis.</p><p><b>RESULTS</b>A total of 9 073 MSM were surveyed. The awareness rate of the HIV/AIDS related knowledge, homosexual behavior and condom use rate increased year by year (P < 0.01). The condom use rate was lower in heterosexual behavior, and the drug use rate and sexually transmitted disease prevalence declined with year (P < 0.01). Multivariate logistic regression analysis indicated that cohabiting, low awareness of HIV/AIDS related knowledge, being from other provinces, local residence for <1 year, low education level, receiving no intervention, frequent anal sex and receiving no HIV/AIDS detection were the risk factors influencing persistent condom use among MSM.</p><p><b>CONCLUSION</b>The effect of HIV/AIDS comprehensive intervention was observed after 4 years implantation, but most of the index were at low level. More attention should be paid to the intervention among MSM with cohabiting habit, low education level, frequent anal sex, and heterosexual sex. It is necessary to expand intervention coverage, strengthen HIV test and promote condom use among MSM.</p>