[Factors associated with death and attrition in HIV-infected children under initial antiretroviral therapy in Guangxi Zhuang Autonomous Region, 2004 - 2019].

Objective: To investigate death and attrition in HIV-infected children under initial antiretroviral therapy (ART) and associated factors in Guangxi Zhuang autonomous region. Methods: This retrospective cohort study was conducted in HIV-infected children under initial ART in Guangxi from 2004 to 2019, data from ART information system of National comprehensive AIDS prevention and treatment information system. Cox proportional hazards models were used to assess factors associated with the death and attrition. Results: In 943 HIV-infected children, the overall mortality and attrition rates were 1.00/100 person-years and 0.77/100 person-years, respectively. The mortality and attrition rates within the first year of ART were 3.90/100 person-years and 1.67/100 person-years, respectively. The cumulative survival rate during the first, second, fifth and tenth year after ART was 96.14%, 95.80%, 93.68% and 91.54%, respectively. Multivariate Cox proportional hazards models results showed that being female (aHR=2.00, 95%CI: 1.17-3.40), CD4+T lymphocytes (CD4) counts before ART <200 cells/µl (aHR=2.79, 95%CI: 1.54-5.06), weight-for-age Z score before ART <-2 (aHR=2.38, 95%CI: 1.32-4.26), hemoglobin before ART <80 g/L (aHR=2.47, 95%CI: 1.24-4.92), initial ART with LPV/r (aHR=5.05, 95%CI: 1.15-22.12) were significantly associated with death; being female (aHR=2.23, 95%CI: 1.22-4.07) and initial ART with LPV/r (aHR=2.02, 95%CI: 1.07-3.79) were significantly associated with attrition. Conclusions: The effect of ART in HIV-infected children in Guangxi was better, but the mortality and attrition rates were high within the first year of treatment. It is necessary to strengthen the training in medical staff and health education in HIV-infected children and their parents in order to improve the treatment effect.

[Triamcinolone acetonide deep fornix injection for the treatment of upper eyelid retraction in patients with thyroid-associated ophthalmopathy].

Objective: To evaluate the efficacy of triamcinolone acetonide deep fornix injection for the treatment of upper eyelid retraction caused by thyroid-associated ophthalmopathy (TAO). Methods: Case-control study. A retrospective analysis was conducted on 64 eyes in 53 patients with upper eyelid retraction caused by TAO from October 2015 to December 2018. Thirty-nine eyes in 33 patients diagnosed with TAO with upper eyelid retraction were treated with triamcinolone acetonide deep fornix injection (20 mg), once per month until the therapeutic effect was stable, as the treatment group. Twenty-five eyes in 20 patients were not treated (the observation group). The ocular examination indexes of the two groups were compared. Paired t-test and independent sample t-test were used for statistical analysis. Results: There were 6 males and 27 females in the treatment group, aged (43±12) years, and 5 males and 15 females in the observation group, aged (40±13) years. There was no significant difference in gender, age, history and baseline ocular examination indexes between the two groups (all P>0.05). In the treatment group, the number of injections was (2.18±0.94) times (range, 1 to 5 times). After (6.74±3.89) months of follow-up, the marginal reflex distance (MRD1) was reduced from (6.85±0.88) mm to (4.38±1.04) mm, the score of quality of life in thyroid eye disease (TED-QOL) was reduced from 22.03±4.33 to 7.91±3.25, and the clinical activity score (CAS) was reduced from 2.82±0.39 to 0.97±0.39 (t=14.68, 21.36, 20.92; all P<0.01). There was no statistically significant difference in the degree of exophthalmos, intraocular pressure, the diameter of the rectus muscle measured by B-ultrasound before and after treatment (all P>0.05). After (8.65±5.15) months of follow-up, the eyelid retraction also improved in the observation group, but the improvement was more obvious in the treatment group. The differences of MRD1, TED-QOL and CAS before and after treatment in the treatment group were (2.46±1.05) mm, 14.06±3.80 and 1.85±0.51 respectively, which were significantly higher than those before and after the follow-up in the observation group [(0.32±0.75) mm, 3.24±2.86 and 0.56±0.58, respectively; t=8.86, 11.90, 8.98; all P<0.01]. There was no recurrence in the two groups. In the treatment group, 5 patients (6 eyes) showed a transient intraocular pressure rise, which was controlled after medication; 3 women had menstrual changes. Conclusions: Deep fornix injection of triamcinolone acetonide for treating upper eyelid retraction is convenient and effective. It can significantly reduce symptoms and improve patients' quality of life. (Chin J Ophthalmol, 2020, 56:524-529).

[Influence on physical development of children aged 18 months from HIV-positive mothers for prevention mother to child transmission of HIV].

Objective: To explore influence on physical development of children aged 18 months from HIV-positive mothers for prevention mother to child transmission of HIV (PMTCT) in Guangxi Zhuang autonomous region, and provide evidence for the improvement PMTCT program. Methods: This retrospective case control study was conducted in 554 HIV negative infants aged 18 months whose HIV positive mothers had received PMTCT services reported through PMTCT system database from January 1, 2010 to December 31, 2017 and 1 109 healthy infants born in 2017, whose mothers were healthy, in Lingshan, Luzhai, and Hengxian counties, ranking top three counties with high HIV infection prevalence, in Guangxi. PMTCT data and physical development data such as height, weight and head circumference of children aged 18 months were collected. The physical dysplasia in the infants was defined as at least one of the three main indicators of height, weight and head circumference below the normal range. Results: The number of HIV-positive mother and their infants in the case group were 667 and 554 respectively, and the PMTCT rates were 91.15% (608/667) and 96.57% (535/554) respectively. HIV positive rate, mortality rate and mother to child transmission rate of the infants aged 18 months were 1.44% (8/554), 3.07% (17/554) and 1.91% (8/418) respectively, and the physical examination results of the infants aged 18 months showed that the physical dysplasia rate was 30.51% (169/554). Among the 1 109 infants in the control group, the physical dysplasia rate was 9.83% (109/1 109). The difference between the case group and the control group was significant (P<0.01). Conclusion: The PMTCT rates of HIV positive mother and their children were more than 90.00%, respectively. However, poor physical development rate of infants aged 18 months were more than 30.00%. The possible influence of PMTCT on physical development of the infants aged 18 months of HIV positive mother's needs to be further studied.

[Dynamic variations of BMI and influencing factors among HIV/AIDS patients receiving highly active antiretroviral therapy in Liuzhou, Guangxi Zhuang Autonomous Region, 2013-2014].

Objective: To understand the dynamic variation of BMI and influencing factors among HIV/AIDS patients receiving highly active anti-retroviral therapy (HAART) in Liuzhou, Guangxi Zhuang Autonomous Region (Guangxi). Methods: HIV/AIDS patients receiving HAART for the first time since 1 January 2013 were selected. Data on BMI was analyzed among patients receiving HAART at baseline,6 months and 12 months after treatment. By using the general linear model repeated measures of analysis of variance, BMI dynamic variations and influencing factors were described and analyzed. Results: The average BMI of 2 871 patients at baseline, 6th months and 12th months appeared as (20.65±3.32), (20.87±3.22) and (21.18±3.20), respectively, with differences all statistically significant (F=18.86, P<0.001). BMI were increasing over time with treatments (F=37.25, P<0.001). Main influencing factors were noticed as: age, sex, marital status, baseline data of CD(4)(+)T cells and the WHO classification on clinical stages. Conclusions: Higher proportion of BMI malnutrition counts was seen among patients before receiving HAART in Liuzhou. BMI of the patients that were on HAART seemed being influenced by many factors. It is necessary to select appropriate treatment protocols on different patients so as to improve the nutritional status of the patients.

Value of microsurgical varicocelectomy for severe oligo-asthenospermia patients failed in fertilization assisted by in vitro fertilization.

OBJECTIVE: To investigate the clinical effect of microsurgical varicocelectomy on severe oligo-asthenospermia patients failing in fertilization assisted by intracytoplasmic sperm injection. PATIENTS AND METHODS: From January 2013 to August 2014, forty-nine patients with severe oligo-asthenospermia and serious varicoceles were treated by microsurgical varicocelectomy after failing in fertilization assisted by intracytoplasmic sperm injection (ICSI), eleven of whom had varicoceles on the left side and thirty-eight had bilateral varicoceles. Patients were followed up for the natural pregnancy condition, changes of routine semen parameters and reproductive hormone level and the embryonic development and outcome of next IVF-ET (ICSI) cycles within 6 months. RESULTS: After surgery, 61.2% (30/49) of spouses obtained clinical pregnancy. Among whom 22.4% (11/49) were naturally pregnant, 32.65% (16/49) were conceived after second IVF-ET assistance, and 6.1% (3/49) were conceived with the third or further assistance of ICSI-ET. The overall miscarriage rate was 16.7% (5/30). All of the patients had improvement in the sperm concentration and forward motility. The sperm concentration increased from (10.53 ± 8.76) × 106/ml to (20.23 ± 11.76) × 106/ml. The ratio of forward motile sperm was increased to (30.52 ± 18.78) % from (8.75.52 ± 6.36) % (p < 0.01). The serum total testosterone (T) improved from (2.19 ± 1.03) ng/ml to (4.05 ± 0.64) ng/ml (p < 0.05). Serum follicle-stimulating hormone (FSH) changed from (5.23 ± 1.26) mIU/ml to (3.76 ± 2.22) mIU/ml after the procedure. Luteinizing hormone (LH) changed from (4.38 ± 1.36) to (3.98 ± 1.38) mIU/ml. Estrogen (E2) changed from 40.28 ± 7.26 pg/ml to 35.24 ± 5.75 pg/ml. Prolactin (PRL) level elevated from (18.24 ± 4.28) to (17.16 ± 2.16) ng/ml (p > 0.05). The fertility rate of in vitro fertilization significantly improved to (83.36 ± 19.36) % from (72.36 ± 17.88) % (p < 0.05). The rate of 2PN ratio increased from (66.73 ± 17.93) % to (75.96 ± 20.39) %. The cleavage rate increased from (83.26 ± 32.33) % to (90.35 ± 23.66). The abnormal fertility rate were (5.36 ± 12.58) % and (7.26 ± 13.89) % before and after the procedure (p > 0.05), while the rate of high-quality embryos increased significantly from (34.36 ± 33.27) % to (55.67 ± 23.36) % (p < 0.05). The rate of transferable embryos remained without significant change (70.67 ± 30.6% before and 60.53 ± 30.27% after the procedure). The anabiosis rate of frozen embryo increased from (66.32 ± 30.69) % to (89.72 ± 29.69) %. The further blastocyst rate improved from (10.98 ± 9.7) % to (30.27 ± 15.33) % (p < 0.01). CONCLUSIONS: The microsurgical varicocelectomy effectively improved sperm parameters, the fertility rate of oocyte fertilized in vitro and the anabiosis rate and blastocyst rate of the frozen embryo for on patients with severe oligo-asthenospermic, and further increased the odds of natural pregnancy, the rate of high-quality embryos and the success rate of in vitro fertilization.

Abnormal motor reflexes and dormant facial motor neurons in rats with facial-facial anastomosis.

After facial nerve injury, some post-paralysis sequelae, such as synkinesis, hemispasm and 'crocodile tears' syndrome appear. The psychosocial impact of these sequelae is unavoidable. Despite recent advances and the growing popularity of this field, the pathophysiological mechanisms of facial nerve injury and regeneration are still not well understood. In this report, an abnormal motor reflex coincident with synkinetic facial movement was examined in a rat model using the blink reflex technique. Some dormant facial motor neurons were found which could not innervate through the suture site but remained alive. These results suggest that such dormant neurons might exert roles distinct from those of re-innervated neurons during facial nerve injury and regeneration. Further study is required to elucidate the biomolecular structure and electrophysiological features of such neurons.

[Development of a portable electrocardiogram(ECG) and respiration monitor].

This paper is to research into a kind of portable automatic ambulatory system, which is used to monitor electrocardiograph (ECG) and respiration signals. And in the interest of meeting the requirements of continuously monitoring the patients, comprehensive consideration is given to the overall structure of the system (including the display mode and the management of power supply). With the characteristics of higher sensitivity and preferable anti-interference, this system realizes minialurization and low power dissipation.

Point mutations in glycoprotein gene of vesicular stomatitis virus (New Jersey serotype) selected by resistance to neutralization by epitope-specific monoclonal antibodies.

Antigenic variants of the New Jersey serotype of vesicular stomatitis virus (VSV-NJ) were isolated and cloned by selecting virus plaques resistant to neutralization by high-titered monoclonal antibodies (MAbs) directed to glycoprotein (G) epitopes V, VI, VII, or VIII. The G proteins of each neutralization-resistant virus variant also exhibited markedly reduced antigenic reactivity with each corresponding epitope-specific MAb as determined by enzyme-linked immuno-absorbent assay and by Western blot analysis. Loss of antigenic reactivity of certain mutant G proteins to a MAb other than the one used to select the mutant virus suggested close antigenic proximity, particularly for epitopes VI and VII. The virion RNAs coding for the entire G gene of the wild-type virus and 10 MAb-induced mutants were sequenced by primer DNA extension using the dideoxy method. Each mutant G gene exhibited only a single nucleotide change, leading in each case to a single amino acid substitution, as follows: Glu210----Lys for all three mutants selected by MAb14 (epitope VII); Pro268----Thr for one mutant selected by MAb12 (epitope VI); Ser277----Lys for all three mutants selected by MAb15 (epitope VIII); and Glu364----Lys for all three mutants selected by MAb11 (epitope V). These neutralizing MAb-selected mutations are clustered in the middle third of the 517-amino acid VSV-NJ G protein, presumably resulting in conformational changes that alter recognition of one or more antigenic determinants by a specific monoclonal antibody.