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1.
Artigo em Inglês | MEDLINE | ID: mdl-32138263

RESUMO

While studies on human immunodeficiency virus self-testing (HIVST) continue to accumulate after the World Health Organization's recommendation of HIVST as an additional approach to HIV testing services in 2016, few studies have focused on men who have sex with men (MSM) in Chinese cities. A cross-sectional study was conducted to describe the HIVST status of MSM in Chongqing, China. MSM participants were recruited by random sampling, and qualified interviewers collected data, using confidential self-administered questionnaires. Blood specimens were collected for HIV antibody detection. The survey evaluated the uptake and accuracy of HIVST kits and identified factors that may be associated with HIVST. The proportion of HIVST uptake was 15.6%. The sensitivity and specificity of HIVST were 74.2% (95% confidence interval [CI] 66.6%-80.7%) and 99.0% (95% CI 96.9%-99.7%), respectively. The consistency between the HIVST kit and antibody detection results was 90.5% (95% CI 87.5%-93.0%), and the Kappa value was 0.777 (p < 0.001). The positive predictive value of self-testing kits is 80.9% and the negative predictive value is 17.7%. Having been tested ≥2 times in the last year, higher educational levels, and higher scores of basic HIV/AIDS knowledge facilitated higher uptake of HIVST. Self-reported existing barriers for HIVST uptake included older age, marital status, and having resided in Chongqing for more than two years.

2.
Artigo em Inglês | MEDLINE | ID: mdl-32019250

RESUMO

BACKGROUND: Male migrant workers (MMWs) have been reported to be vulnerable to human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs). Chongqing, China is one of the major migration destinations and hotspots of HIV. This study aims to explore the prevalence of HIV, syphilis, and hepatitis C virus (HCV), as well as HIV-related knowledge and behaviors, among MMWs in Chongqing. METHODS: Questionnaire surveys were conducted, and blood samples were collected and examined among MMWs selected by two-stage stratified sampling in Chongqing from 2010 to 2018. The Cochran-Armitage trend test was conducted to observe the trends in the prevalence of HIV, syphilis, and HCV, as well as HIV-related knowledge and behaviors. The Chi-square test and Binary Logistic Regression were conducted to observe the distinctions between different groups. RESULTS: The overall HIV prevalence was 0.6% with an increasing trend (0.2% to 0.9%, P < 0.001), whereas the overall HCV prevalence was 0.5% with a decreasing trend (0.5% to 0.4%, P < 0.001). The overall syphilis prevalence was 1.3% in the ≥50 age group, 1.0% in the 30-49 age group, and higher than 0.3% in the 16-29 group (X2 = 19.527, P < 0.001). An uptrend (80.2%-80.6%, P < 0.001) was observed in correct HIV-related knowledge. The 16-29 ((Odds Ratio) OR: 1.575; 95%CI (Confidence Interval): 1.380-1.798; P < 0.001) and 30-49 (OR: 1.697; 95%CI: 1.495-1.926; P < 0.001) age groups had 1.575 and 1.697 times correct HIV-related knowledge more than the ≥50 age group. The proportion of subjects engaged in commercial sex in the past year (7.7%-13.3%, P < 0.001), consistent condom use during this activity (20.5%-54.0%, P < 0.001), and condom use in the last commercial sex (48.6%-72.1%, P = 0.020) were increasing. The risk of engaging in commercial sex in the past year in the 16-29 age group was 0.768 times (OR: 0.768; 95%CI: 0.643-0.917; P = 0.003) less than that in the ≥50 age group. The risk of engaging in non-regular sex in the past year in the 16-29 (OR: 2.819; 95%CI: 2.317-3.431; P < 0.001) and 30-49 (OR: 1.432; 95%CI: 1.184-1.733); P < 0.001) age groups were 2.819 and 1.432 times more than that in the ≥50 age group. The risk of engaging in anal sex in the past year in the 16-29 age group was 6.333 times (OR: 6.333; 95%CI: 1.468-27.327); P < 0.013] more than that in the ≥50 age group. The proportion of consistent condom use during non-regular sex in the past year (10.9%-47.3%, P < 0.001) and condom use in the last non-regular sex (40.8%-71.1%, P < 0.001) increased remarkably. The possibilities of consistent condom use during commercial sex in the past year in the 16-29 (OR: 2.606; 95%CI: 1.847-3.677); P < 0.001) and 30-49 (OR: 1.632; 95%CI: 1.214-2.195; P = 0.001) age groups were 2.606 and 1.632 times more than that in the ≥50 age group. The possibilities of condom use in the last commercial sex in the 16-29 (OR: 1.805; 95%CI: 1.258-2.589; P = 0.001) and 30-49 (OR: 1.360; 95%CI: 1.016-1.821; P = 0.039) age groups were 1.805 and 1.360 times more than that in the ≥50 age group. The possibilities of consistent condom use during non-regular sex in the past year (OR: 1.628; 95%CI: 1.066-2.484; P = 0.024) and condom use in the last non-regular sex (OR: 1.671; 95%CI: 1.148-2.433; P = 0.007) in the 16-29 age group were 1.628 and 1.671 times more than those in the ≥50 age group, respectively. CONCLUSION: An upward trend of HIV and a downward trend of HCV were observed among MMWs in Chongqing from 2010 to 2018. We also found an increase in commercial sex and inadequate condom use during high-risk behaviors among this population. The overall syphilis prevalence in the middle-aged and elderly groups was higher than in the young group, and elderly MMWs were more likely to engage in unprotected high-risk behaviors. Thus, targeted STI prevention for MMWs in Chongqing, especially those aged 50 years and above, is urgently needed.

3.
BMC Infect Dis ; 20(1): 149, 2020 Feb 18.
Artigo em Inglês | MEDLINE | ID: mdl-32070297

RESUMO

BACKGROUND: HIV testing plays a central role in the combat against HIV. We aimed to determine if the availability of HIV self-testing (HIVST) would increase the frequency of testing among men who have sex with men (MSM) attending university in China. METHODS: A stepped wedge randomized controlled trial will be conducted in 4 provinces in China: Chongqing, Guangdong, Shandong, and Tianjin. Eligibility assessment will include (1) male, aged 16 years or older, (2) university student (technical diploma and undergraduate students), (3) MSM (sexual behaviors including mutual masturbation, oral sex, and anal sex), (4) HIV negative, and (5) willing to provide informed consent. Participants will be randomly allocated to HIV self-testing intervention with free HIVST kits in every 30 days according to the intervention waiting lists with a computer-generated randomized sequence. All participants will complete a self-administrated online questionnaire onsite at baseline and 12-month follow-up and complete an online questionnaire at 4- and 8-month. The primary outcome is the effect of HIVST on HIV testing frequency. Secondary outcomes include the change in sexual behaviors and HIV incidence. DISCUSSION: No previous study had measured the effect of social media based HIVST intervention on the change in HIV testing behaviors, sexual behaviors and incident HIV infection among MSM attending university in China. Findings from this study will provide evidence for further interventional practice promotions and prevention strategies scale-up, including HIV testing, pre-exposure prophylaxis (PrEP) or post-exposure prophylaxis (PEP), and sexual partner serosorting. TRIAL REGISTRATION: Chinese Clinical Trial Registry: ChiCTR1900020645. Registered 11 January 2019.

4.
Artif Cells Nanomed Biotechnol ; 47(1): 3664-3670, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31841394

RESUMO

This study aimed to explore the role of obestatin R gene-related protein (OB-RGRP) in autocrine signal transduction of adipocytes. Primary rat adipocytes were isolated and verified by microscopic observation and oil red O staining. OB-RGRP expression vector and OB-RGRP siRNA (si-OB-RGRP) were constructed and transfected into adipocytes. Adipocytes were then divided into five groups: (1) Control; (2) Vector (empty expression vector); (3) OB-RGRP (OB-RGRP expression vector); (4) si-OB-RGRP NC (si-OB-RGRP negative control); (5) si-OB-RGRP. mRNA and protein levels of OB-RGRP, JAK2, phosphorylated JAK2 (p-JAK2), STAT3 and phosphorylated STAT3 (p-STAT3) were examined using RT-PCR and western blot, respectively. Results showed that mRNA and protein levels of OB-RGRP in the Vector and si-OB-RGRP NC groups were similar to those in the Control group. Their levels in the si-OB-RGRP and OB-RGRP groups were significantly down-regulated and up-regulated (p < .05), respectively, in comparison with the control cells. There was no significant difference in the mRNA and protein levels of JAK2 and STAT3 among various groups. Moreover, the si-OB-RGRP NC and Vector groups induced similar ratios of p-JAK2 to JAK2 (p-JAK2/JAK2) and p-STAT3 to STAT3 (p-STAT3/STAT3) to the Control group. However, these two ratios in the si-OB-RGRP and OB-RGRP groups were significantly reduced and elevated (p < .05), respectively, in comparison with the Control group. These results suggested that OB-RGRP overexpression enhanced the levels of p-JAK2 and p-STAT3 while OB-RGRP silencing lowered their levels. In conclusion, OB-RGRP regulated the phosphorylation of JAK2 and STAT3 in primary rat adipocytes.

5.
BMC Public Health ; 19(1): 1314, 2019 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-31638943

RESUMO

BACKGROUND: Chongqing reportedly has a large MSM population and a high STI prevalence in previous studies. However, most studies are attributed to independent cross-sectional studies, few studies have investigated trends in the prevalence of syphilis and HIV, as well as behavioural characteristics among MSM using serial surveillance surveys. METHODS: Data were collected in Chongqing through face-to-face questionnaire interview and laboratory testing in Chongqing. The respondents were recruited among MSM by snowball sampling from May 2013 to December 2017. The self-report questionnaire primarily included socio-demographics, HIV knowledge, and HIV-related behaviour characteristics over the year. Blood specimens were tested to diagnose HIV and syphilis infection by Chongqing CDC. Cochran-Armitage trend test and multivariate logistic regression were conducted to compare the changes in STI prevalence and independent behavioural factors among MSM. RESULTS: There were 6568 eligible participants (98.4%). The overall HIV prevalence was 20.5% among MSM in Chongqing, with a decrease from 23.0% in 2013 to 19.2% in 2017. The overall syphilis prevalence was 5.8%, with an increase from 3.2% in 2013 to 6.7% in 2017. The proportion of consistent condom use (CCU) during anal intercourse (46.3 to 57.7%, P<0.001),CCU with regular male partners(47.7 to 59.7%, P<0.001), CCU with casual male partners (51.5 to 62.3%, P<0.001) and drug use during anal intercourse (0.3 to 1.4%, P<0.05) were increasing. By contrast, a significant decrease was reported in the percentage of MSM with more than two regular male partners (66.0 to 21.4%, P<0.001) and more than two casual male partners (38.3 to 20.7%, P<0.001). A significant difference was observed in syphilis infection, testing for HIV antibodies and drug use during anal intercourse in the past years between the HIV-positive and HIV-negative respondents. CONCLUSION: A decreasing trend of HIV prevalence was showed during among MSM from 2013 to 2017 in Chongqing. While gradual reduction of high-risk behaviors along with HIV prevalence supported development of STI counselling and testing, increasing syphilis infection and drug use during anal intercourse warrants further understanding.


Assuntos
Infecções por HIV/epidemiologia , Homossexualidade Masculina/psicologia , Homossexualidade Masculina/estatística & dados numéricos , Sífilis/epidemiologia , Adolescente , Adulto , Idoso , China/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Comportamento de Redução do Risco , Comportamento Sexual/psicologia , Comportamento Sexual/estatística & dados numéricos , Inquéritos e Questionários , Adulto Jovem
6.
AIDS Res Hum Retroviruses ; 35(11-12): 1095-1102, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31544479

RESUMO

Older people living with HIV (PLWH) may have delayed diagnosis and access to care and therefore have poorer disease outcomes. Little is known about HIV care and disease outcomes among older PLWH in China. This retrospective cohort study used data from all adult HIV/AIDS cases during 1988-2017 in Chongqing, China from two national databases. We compared demographic and behavioral profiles, HIV care, virologic suppression, and mortality between two age groups of 18-49 and ≥50 years. Multivariate logistic and cox regression analyses were used to calculate adjusted odds ratio (AOR) and adjusted hazard ratio (AHR) among older versus younger PLWH. Of 46,580 adult HIV/AIDS cases, 76.1% were men and 38.2% were 50 years of age or older. The proportion of older cases in men increased from 2.4% in 2002 to 51.8% in 2017, and in women from 3.3% to 57.9%. Older PLWH had a lower CD4 count than their younger counterparts at HIV diagnosis (median 323 vs. 391 cells/µL; p < .001). The average time from HIV diagnosis to initiation of antiretroviral therapy (ART) were 6.3 months among older and 12.8 months among younger PLWH (p < .001). Nearly one tenth (9.6%) had virologic failure within 12 months of ART initiation, and the odds of virologic failure among older PLWH was 80% higher [AOR 1.8; 95% confidence interval (CI), 1.1-3.0] than among younger ones after controlling for calendar year of initiating ART and other covariates. The mortality rate within 12 months of initiating ART was 9.8 deaths per 100 person years, and the risk of mortality among older PLWH was three times among younger ones (AHR, 3.1; 95% CI, 2.1-4.6). Older people represented an increasing proportion of new HIV/AIDS cases and were more likely to have virologic failure and mortality within 12 months of ART initiation.

7.
Sex Transm Infect ; 95(6): 428-436, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31073094

RESUMO

BACKGROUND: Men who have sex with men (MSM) are disproportionately affected by HIV and other STIs worldwide. Rectal douching, which is commonly used by MSM in preparation for anal sex, may increase the risk of HIV and other STIs by injuring the rectal mucosa. Results from individual studies reporting associations between rectal douching and HIV and other STIs among MSM are inconsistent. We performed a systematic review and meta-analysis to estimate the association between rectal douching and HIV and other STIs among MSM. METHODS: We searched PubMed, Embase, Scopus and Web of Science for studies published from January 1970 to November 2018. Studies that reported ORs and 95% CIs of associations between rectal douching and infection with HIV/STIs, or reported enough data to calculate these estimates, were included. We assessed risk of bias using the Newcastle-Ottawa Scale. ORs were pooled using a random effects model. RESULTS: Twenty-eight eligible studies were identified in our review, of which 24 (20 398 participants) were included in the meta-analysis. Rectal douching was associated with increased odds of infection with HIV (OR 2.80, 95% CI 2.32 to 3.39), and any STI other than HIV (including hepatitis B virus (HBV), hepatitis C virus (HCV), chlamydia, gonorrhoea, syphilis and human papillomavirus) (OR 2.46, 95% CI 1.95 to 3.11) among MSM. For specific STIs, douching was associated with increased odds of viral hepatitis (HBV, HCV) (OR 3.29, 95% CI 2.79 to 3.87), and chlamydia or gonorrhoea (OR 3.25, 95% CI 2.02 to 5.23). These associations remained significant in studies that adjusted for potential confounders. CONCLUSION: Rectal douching may put MSM at increased risk for infection with HIV and other STIs. Longitudinal studies are needed to clarify this association, and health education materials should inform men of the potential for increased risk of infection with rectal douching.


Assuntos
Infecções por HIV/prevenção & controle , Homossexualidade Masculina/estatística & dados numéricos , Doenças Sexualmente Transmissíveis/prevenção & controle , Irrigação Terapêutica , Adulto , Estudos de Casos e Controles , Estudos de Coortes , Infecções por HIV/epidemiologia , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Comportamento Sexual , Doenças Sexualmente Transmissíveis/epidemiologia , Irrigação Terapêutica/efeitos adversos , Adulto Jovem
8.
Nan Fang Yi Ke Da Xue Xue Bao ; 39(2): 192-200, 2019 02 28.
Artigo em Chinês | MEDLINE | ID: mdl-30890508

RESUMO

OBJECTIVE: To develop a digital breast tomosynthesis (DBT) imaging system with optimizes imaging chain. METHODS: Based on 3D tomography and DBT imaging scanning, we analyzed the methods for projection data correction, geometric correction, projection enhancement, filter modulation, and image reconstruction, and established a hardware testing platform. In the experiment, the standard ACR phantom and high-resolution phantom were used to evaluate the system stability and noise level. The patient projection data of commercial equipment was used to test the effect of the imaging algorithm. RESULTS: In the high-resolution phantom study, the line pairs were clear without confusing artifacts in the images reconstructed with the geometric correction parameters. In ACR phantom study, the calcified foci, cysts, and fibrous structures were more clearly defined in the reconstructed images after filtering and modulation. The patient data study showed a high contrast between tissues, and the lesions were more clearly displayed in the reconstructed image. CONCLUSIONS: This DBT imaging system can be used for mammary tomography with an image quality comparable to that of commercial DBT systems to facilitate imaging diagnosis of breast diseases.


Assuntos
Mama/diagnóstico por imagem , Mamografia/métodos , Imagens de Fantasmas , Intensificação de Imagem Radiográfica/métodos , Algoritmos , Artefatos , Feminino , Humanos
9.
Lancet Glob Health ; 7(4): e436-e447, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30879508

RESUMO

BACKGROUND: Men who have sex with men (MSM) are disproportionately affected by HIV and other sexually transmitted infections (STIs) worldwide. Previous reviews investigating the role of circumcision in preventing HIV and other STIs among MSM were inconclusive. Many new studies have emerged in the past decade. To inform global prevention strategies for HIV and other STIs among MSM, we reviewed all available evidence on the associations between circumcision and HIV and other STIs among MSM. METHODS: In this systematic review and meta-analysis, we searched PubMed, Web of Science, BioMed Central, Scopus, ResearchGate, Cochrane Library, Embase, PsycINFO, Google Scholar, and websites of international HIV and STI conferences for studies published before March 8, 2018. Interventional or observational studies containing original quantitative data describing associations between circumcision and incident or prevalent infection of HIV and other STIs among MSM were included. Studies were excluded if MSM could not be distinguished from men who have sex with women only. We calculated pooled odds ratios (ORs) and their 95% CIs using random-effect models. We assessed risk of bias using the Newcastle-Ottawa scale. FINDINGS: We identified 62 observational studies including 119 248 MSM. Circumcision was associated with 23% reduced odds of HIV infection among MSM overall (OR 0·77, 95% CI 0·67-0·89; number of estimates [k]=45; heterogeneity I2=77%). Circumcision was protective against HIV infection among MSM in countries of low and middle income (0·58, 0·41-0·83; k=23; I2=77%) but not among MSM in high-income countries (0·99, 0·90-1·09; k=20; I2=40%). Circumcision was associated with reduced odds of herpes simplex virus (HSV) infection among MSM overall (0·84, 0·75-0·95; k=5; I2=0%) and penile human papillomavirus (HPV) infection among HIV-infected MSM (0·71, 0·51-0·99; k=3; I2=0%). INTERPRETATION: We found evidence that circumcision is likely to protect MSM from HIV infection, particularly in countries of low and middle income. Circumcision might also protect MSM from HSV and penile HPV infection. MSM should be included in campaigns promoting circumcision among men in countries of low and middle income. In view of the substantial proportion of MSM in countries of low and middle income who also have sex with women, well designed longitudinal studies differentiating MSM only and bisexual men are needed to clarify the effect of circumcision on male-to-male transmission of HIV and other STIs. FUNDING: National Natural Science Foundation of China, National Science and Technology Major Project of China, Australian National Health and Medical Research Council Early Career Fellowship, Sanming Project of Medicine in Shenzhen, National Institutes of Health, Mega Projects of National Science Research for the 13th Five-Year Plan, Doris Duke Charitable Foundation.

10.
J Colloid Interface Sci ; 533: 190-197, 2019 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-30165296

RESUMO

Increased reliance on kill based approaches for disinfection raises concerns of antimicrobial resistance development and has significantly elevated the need for alternate approaches for skin and substrate disinfection. This study focuses on reducing harmful microbes from substrates primarily via removal and to a lesser extent by kill. HYPOTHESIS: Functional micro-particles designed to adhere to microbes, with a force greater than the force of microbial adhesion to the substrate, would result in enhanced removal-based disinfection of substrates when subject to an external force. EXPERIMENTS: Silica particles were functionalized with a cationic polymer to bind strongly with bacteria via Coulombic interactions. Disinfection efficacies of substrates with functional particles and control groups were evaluated under conditions relevant for handwashing. FINDINGS: Functionalized silica micro-particles result in ∼4 log reduction of E. coli from an artificial skin substrate in 30 s as compared to a maximum of 1.5 log reduction with control particles. Bacterial viability assays indicate a mechanism of action driven by enhanced removal of bacteria with minimal kill. Particle number density, size and suspension velocity along with strong particle - bacteria interactions have been found to be the primary factors responsible for the enhanced bacterial removal from surfaces.


Assuntos
Escherichia coli/isolamento & purificação , Polímeros/química , Dióxido de Silício/química , Aderência Bacteriana , Cátions/química , Escherichia coli/química , Viabilidade Microbiana , Tamanho da Partícula , Propriedades de Superfície
11.
BMC Public Health ; 18(1): 1235, 2018 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-30400787

RESUMO

BACKGROUND: In China, antiretroviral therapy (ART) clinics focus on treating people living with HIV and are not required to undertake testing of high-risk populations. To improve partner testing among MSM, we implemented a health communication pilot intervention integrating partner testing with ART services. We aimed to assess the feasibility of the partner referral service and identify the predictors of both successful partner referral for HIV testing and HIV-positive test results among referred partners. METHODS: This program ran from April 2014 through December 2015 at designated ART clinics in six cities. The index participants, men living with HIV enrolled at an ART clinic, were assigned a case manager who assumed responsibility for routine ART-related counseling and mobilization of HIV-positive index participants for partner referral testing. Case managers were either nurses or contract staff. The successful referral rate was the proportion of index participants who referred a sexual partner for HIV testing. The HIV-positive partner rate was the proportion of the newly referred contacts who tested HIV-positive. Factors associated with the successful referral rate and the HIV-positive partner rate were assessed. RESULTS: Two thousand three hundred eighty-two index participants were enrolled. The median age was 30 years (IQR 26-37). 829index participants (34.80%) successfully referred at least one sexual partner for screening, and 92 (11.10%) referred partners were HIV-positive. Having a hospital nurse as case manager was associated with both successful partner referral (AHR = 1.56, 95% CI = 1.36-1.80) and having a HIV-positive partner (AHR = 2.35, 95% CI = 1.45-3.92). Index participants who were married (AHR = 1.44, 95% CI = 1.20-1.73) or employed (AHR = 1.29, 95% CI = 1.11-1.49) were more likely to successfully refer a partner for testing. Stable male partner relations were more likely to result in a referred partner testing HIV-positive (AHR = 5.50, 95% CI = 1.85-16.39). CONCLUSION: Our findings indicated that integration of MSM partner testing with ART services via health communication was feasible. Nurses as case managers effectively encouraged index participants to refer their sexual partners for HIV testing.


Assuntos
Infecções por HIV/diagnóstico , Comunicação em Saúde , Homossexualidade Masculina , Programas de Rastreamento/métodos , Parceiros Sexuais , Adulto , Antirretrovirais/uso terapêutico , China , Estudos de Coortes , Infecções por HIV/tratamento farmacológico , Homossexualidade Masculina/estatística & dados numéricos , Humanos , Masculino , Avaliação de Programas e Projetos de Saúde
12.
Biomaterials ; 181: 15-34, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30071379

RESUMO

We have reported previously that bone marrow mesenchymal stem cell (MSC)-derived neural network scaffold not only survived in the injury/graft site of spinal cord but also served as a "neuronal relay" that was capable of improving the limb motor function in a complete spinal cord injury (SCI) rat model. It remained to be explored whether such a strategy was effective for repairing the large spinal cord tissue loss as well as restoring motor function in larger animals. We have therefore extended in this study to construct a canine MSC-derived neural network tissue in vitro with the aim to evaluate its efficacy in treating adult beagle dog subjected to a complete transection of the spinal cord. The results showed that after co-culturing with neurotropin-3 overexpressing Schwann cells in a gelatin sponge scaffold for 14 days, TrkC overexpressing MSCs differentiated into neuron-like cells. In the latter, some cells appeared to make contacts with each other through synapse-like structures with trans-synaptic electrical activities. Remarkably, the SCI canines receiving the transplantation of the MSC-derived neural network tissue demonstrated a gradual restoration of paralyzed limb motor function, along with improved electrophysiological presentation when compared with the control group. Magnetic resonance imaging and diffusion tensor imaging showed that the canines receiving the MSC-derived neural network tissue exhibited robust nerve tract regeneration in the injury/graft site. Histological analysis showed that some of the MSC-derived neuron-like cells had survived in the injury/graft site up to 6.5 months. Implantation of MSC-derived neural network tissue significantly improved the microenvironment of the injury/graft site. It is noteworthy that a variable number of them had integrated with the regenerating corticospinal tract nerve fibers and 5-HT nerve fibers through formation of synapse-like contacts. The results suggest that the transplanted MSC-derived neural network tissue may serve as a structural and functional "neuronal relay" to restore the paralyzed limb motor function in the canine with complete SCI.


Assuntos
Extremidades/inervação , Células-Tronco Mesenquimais/citologia , Traumatismos da Medula Espinal/terapia , Animais , Células Cultivadas , Imagem de Tensor de Difusão , Cães , Extremidades/fisiologia , Feminino , Humanos , Masculino , Células-Tronco Mesenquimais/fisiologia , Neurônios Motores/citologia , Neurônios Motores/fisiologia , Rede Nervosa , Regeneração Nervosa/fisiologia , Células de Schwann
13.
Biomaterials ; 160: 37-55, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29353106

RESUMO

The functional multipotency enables mesenchymal stem cells (MSCs) promising translational potentials in treating spinal cord injury (SCI). Yet the fate of MSCs grafted into the injured spinal cord has not been fully elucidated even in preclinical studies, rendering concerns of their safety and genuine efficacy. Here we used a rat spinal cord transection model to evaluate the cell fate of allograft bone marrow derived MSCs. With the application of immunosuppressant, donor cells, delivered by biocompatible scaffold, survived up to 8 weeks post-grafting. Discernible tubes formed by MSCs were observed beginning 2 weeks after transplantation and they dominated the morphological features of implanted MSCs at 8 weeks post-grafting. The results of immunocytochemistry and transmission electron microscopy displayed the formation of perineurium-like sheath by donor cells, which, in a manner comparable to the perineurium in peripheral nerve, enwrapped host myelins and axons. The MSC-derived perineurium-like sheath secreted a group of trophic factors and permissive extracellular matrix, and served as a physical and chemical barrier to insulate the inner nerve fibers from ambient oxidative insults by the secretion of soluble antioxidant, superoxide dismutase-3 (SOD3). As a result, many intact regenerating axons were preserved in the injury/graft site following the forming of perineurium-like sheath. A parallel study utilizing a good manufacturing practice (GMP) grade human umbilical cord-derived MSCs or allogenic MSCs in an acute contusive/compressive SCI model exhibited a similar perineurium-like sheath formed by surviving donor cells in rat spinal cord at 3 weeks post-grafting. The present study for the first time provides an unambiguous morphological evidence of perineurium-like sheath formed by transplanted MSCs and a novel therapeutic mechanism of MSCs in treating SCI.


Assuntos
Células-Tronco Mesenquimais , Nervos Periféricos , Tecidos Suporte , Animais , Feminino , Humanos , Células-Tronco Mesenquimais/citologia , Células-Tronco Mesenquimais/fisiologia , Regeneração Nervosa , Neuroproteção , Nervos Periféricos/citologia , Nervos Periféricos/fisiologia , Ratos Sprague-Dawley , Traumatismos da Medula Espinal/terapia , Engenharia Tecidual
14.
PLoS One ; 11(12): e0166812, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27906994

RESUMO

OBJECTIVES: To explore models to improve HIV testing, linkage to care and treatment among men who have sex with men (MSM) in cooperation with community-based organizations (CBOs) in China. METHODS: We introduced a new model for HIV testing services targeting MSM in six cities in 2013.These models introduced provision of rapid HIV testing by CBO staff and streamlined processes for HIV screening, confirmation of initial reactive screening results, and linkage to care among diagnosed people. We monitored attrition along each step of the continuum of care from screening to treatment and compared program performance between 2012 and 2013. According to the providers of two rapid tests (HIV screening), four different services delivery models were examined in 2013: Model A = first screen at CDC, second at CDC (Model A = CDC+CDC), Model B = first and second screens at CBOs (Model B = CBO+CBO), Model C = first screen at CBO, second at Hospital (Model C = CBO+Hosp), and Model D = first screen at CBO, second at CDC (Model D = CBO+CDC). Logistic regressions were performed to assess advantages of different screening models of case finding and case management. RESULTS: Compared to 2012, the number of HIV screening tests performed for MSM increased 35.8% in 2013 (72,577 in 2013 vs. 53,455 in 2012). We observed a 5.6% increase in proportion of cases screened reactive receiving HIV confirmatory tests (93.9% in 2013 vs. 89.2% in 2012, χ2 = 48.52, p<0.001) and 65% reduction in loss to CD4 cell count tests (15% in 2013 vs. 43% in 2012, χ2 = 628.85, p<0.001). Regarding linkage to care and treatment, the 2013 pilot showed that the Model D had the highest rate of loss between screening reactive and confirmatory test among the four models, with 18.1% fewer receiving a second screening test and a further 5.9% loss among those receiving HIV confirmatory tests. The Model B and the Model C showed lower losses (0.8% and 1.3%) for newly diagnosed HIV positives receiving CD4 cell count tests, and higher rates of HIV positives referred to designated ART hospitals (88.0% and 93.3%) than the Model A and Model D (4.6% and 5.7% for CD4 cell count test, and 68.9% and 64.4% for referring to designated ART hospitals). The proportion of cases where the screening test was reactive that were commenced on ART was highest in Model C; 52.8% of cases commenced on ART compared to 38.9%, 34.2% and 21.1% in Models A, B and D respectively. Using Model A as a reference group, the multivariate logistic regression results also showed the advantages of Models B, C and D, which increased CD4 cell count test, referral to designated ART hospitals and initiation of ART, when controlling for program city and other factors. CONCLUSIONS: This study has demonstrated that involvement of CBOs in HIV rapid testing provision, streamlining testing and care procedures and early hospital case management can improve testing, linkage to, and retention in care and treatment among MSM in China.


Assuntos
Serviços de Saúde Comunitária/estatística & dados numéricos , Infecções por HIV/diagnóstico , Programas de Rastreamento/métodos , Modelos Estatísticos , Flebotomia/métodos , Adulto , Contagem de Linfócito CD4 , Administração de Caso/organização & administração , China/epidemiologia , Cidades , Diagnóstico Precoce , Infecções por HIV/epidemiologia , Infecções por HIV/virologia , Homossexualidade Masculina/etnologia , Homossexualidade Masculina/estatística & dados numéricos , Humanos , Masculino , Projetos Piloto , Parceiros Sexuais , Fatores de Tempo
15.
AIDS Behav ; 20(12): 2976-2982, 2016 12.
Artigo em Inglês | MEDLINE | ID: mdl-26979418

RESUMO

HIV among men who have sex with men (MSM) with recent male-male sexual debut, such as within the past 5 years, may be a proxy for recent HIV infection. Using this definition, we explored factors associated with HIV infection in this group to understand the evolving HIV epidemic among MSM in Chongqing. We conducted a cross-sectional respondent-driven sampling survey among Chongqing MSM in 2011. Computer-assisted, self-administered questionnaires were used and blood specimens were collected for HIV and syphilis testing. Three hundred and ninety-one unique MSM were recruited of which 65.7 % (257) had their sexual debut with another man in the past 5 years. HIV prevalence among men with recent sexual debut was 18.7 % suggesting a possible HIV incidence of 3.7 %. Multivariable analysis among men with recent sexual debut suggests that lower education, having more than one male partner, and currently being infected with syphilis are associated with HIV among men with recent sexual debut. HIV prevalence is high among MSM with recent sexual debut in Chongqing, which may be a proxy a high incidence rate. HIV prevention efforts should focus on STD reduction among those MSM with lower educational attainment.


Assuntos
Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Comparação Transcultural , Infecções por HIV/etnologia , Infecções por HIV/epidemiologia , Homossexualidade Masculina/etnologia , Homossexualidade Masculina/estatística & dados numéricos , Adolescente , Adulto , China/epidemiologia , Estudos Transversais , Inquéritos Epidemiológicos , Humanos , Incidência , Masculino , Comportamento Sexual/estatística & dados numéricos , Fatores Socioeconômicos , Sífilis/epidemiologia , Adulto Jovem
16.
Alcohol ; 50: 1-7, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26632032

RESUMO

To estimate the prevalence of any alcohol use and heavy alcohol drinking using the Alcohol Use Disorders Identification Test (AUDIT) and its correlates among men who have sex with men (MSM), a cross-sectional study was conducted among 391 MSM in Chongqing, China to collect data about sociodemographic characteristics, alcohol use, sexual behaviors, and other related factors through a computer-assisted self-administered questionnaire. Heavy alcohol drinking in the past 12 months was defined as an AUDIT-C score ≥ 4. Blood was collected from each potential participant to test for HIV and syphilis status. Twenty three percent of MSM had consumed a drink containing alcohol in the previous year. 7.2% had an AUDIT-C score ≥ 4, defined as heavy alcohol drinkers. 23.5% were unmarried, but planning to marry, who were more likely to report any alcohol drinking (adjusted odds ratio [AOR], 2.38; 95% confidence interval [CI], 1.40-4.06) and to have AUDIT-C scores ≥ 4 (AOR, 3.58; 95% CI, 1.60-8.00). MSM who had used any alcohol in the previous year, and MSM who were heavy alcohol drinkers, were more likely to have had anal sex with male casual partners in the previous 6 months, to have been tested for HIV, and to have decreased scores on the scales of general self-efficacy, increased scores on the scales of stigma and discrimination. Our findings provided further evidence of the associations of any alcohol use and heavy alcohol consumption with HIV-risky behaviors, lowered sense of general self-efficacy, and higher sense of HIV/AIDS-related stigma and discrimination among MSM in the city with the highest HIV epidemic among MSM in China.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Homossexualidade Masculina/estatística & dados numéricos , Sexo sem Proteção/estatística & dados numéricos , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/psicologia , China/epidemiologia , Estudos Transversais , Infecções por HIV/diagnóstico , Infecções por HIV/psicologia , Homossexualidade Masculina/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Autoeficácia , Estigma Social , Sífilis/diagnóstico , Sífilis/psicologia , Sexo sem Proteção/psicologia , Adulto Jovem
17.
Am J Cancer Res ; 5(6): 1911-20, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26269753

RESUMO

Dysregulation of Wnt-mediated ß-catenin signaling is associated with carcinogenesis and progression of hepatocellular carcinoma (HCC). Our previous studies showed that the Wnt10B gene, a member of Wnt gene family, over-activated in HCC tissues and cells. Here we demonstrate that stable silencing of Wnt10B reduces the viability of HCC cells in culture. HepG2, a human HCC cell line, was cultured in vitro and Wnt10B gene in the cells stably silenced, as showed in Western blotting analysis, by the shRNA interference with lentivirus plasmid transfection. Compared to the control (HepG2 cells without Wnt10B silencing), the Wnt10B-silencing cells showed significant reductions in proliferation, colony formation, migration and invasion. Furthermore, serum deprivation-induced apoptotic death, assessed by Hoechst 33342 staining and fluorescent microscopy, increased significantly in the Wnt10B-silencing cells. FACScan analysis indicated an arrest of the cell cycle in the Wnt10B-silencing HCC cells, with significant increases in the number of cells in G0-G1 and S phases. Thus, we hypothesize that Wnt10B plays an oncogenic role in HCC and is a potential therapeutic target.

18.
Medicine (Baltimore) ; 93(27): e124, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25501047

RESUMO

The high and climbing human immunodeficiency virus (HIV) rates among Chinese men who have sex with men (MSM) bring huge pressure and challenge to acquired immune deficiency syndrome response work in China. This study examined HIV-testing behavior and describes the characteristics of recently tested MSM in Chongqing to address targeting HIV prevention interventions. Two consecutive cross-sectional surveys were conducted among Chongqing MSM using respondent-driven sampling in 2009 and 2010. Information was collected regarding details on demographic characteristics, sexual practices with male and female partners, and HIV-testing experiences. Univariate and multivariate logistic regression analyses were performed to identify factors independently associated with recent HIV testing.The final sample size included in our analyses was 992. The overall HIV prevalence was 13.4%, and HIV prevalence increased significantly from 11.6% in 2009 to 15.4% in 2010 (P = 0.08). The overall rate of HIV testing in the past 12 months was 44.6%, and the self-reported rates decreased significantly from 47.8% in 2009 to 41.1% in 2010 (P = 0.03). Factors independently associated with recent HIV testing included living in Chongqing >1 year (adjusted odds ratio [AOR] 1.8, 95% confidence interval [CI] 1.1-2.9), the age of most recent male partner ≤ 25 (AOR 1.5, 95% CI 1.1-2.1), not having unprotected insertive anal sex with most recent male partner in the past 6 months (AOR 1.5, 95% CI 1.1-2.0), disclosing HIV status to most recent male partner (AOR 2.8, 95% CI 2.0-3.8), and holding lower level of HIV-related stigma (AOR 1.1 per scale point, 95% CI 1.0-1.1). The extremely high HIV prevalence and low annual testing level put MSM at high risk of HIV infection and transmission, and it is a priority to promote regular HIV testing among this group in order to control the spread of HIV in Chongqing, China.


Assuntos
Infecções por HIV/diagnóstico , Comportamentos Relacionados com a Saúde , Programas de Rastreamento/estatística & dados numéricos , Adolescente , Adulto , Idoso , China , Estudos Transversais , Feminino , Homossexualidade Masculina , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
19.
PLoS One ; 9(5): e97527, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24878586

RESUMO

OBJECTIVES: To assess HIV incidence and its associated risk factors among young men who have sex with men (YMSM) in urban areas, China. DESIGN: The study used a prospective cohort study design and standard diagnostic tests. METHODS: A twelve-month prospective cohort study was conducted among YMSM (18-25 years old) in 8 large cities in China. The participants were recruited via snowball sampling. A total of 1102 HIV-negative YMSM completed baseline assessment, 878 YMSM participants completed 6-month follow-up, and 902 completed 12-month follow-up. HIV was screened by an enzyme-linked immunosorbent assay and confirmed with Western Blot. Syphilis was screened via rapid plasma reagent and confirmed by treponema pallidum particle agglutination assay. RESULTS: 78 HIV seroconversions were identified within 1168.4 person-year observations yielding an incidence rate of 6.7 per 100 person-years. HIV seroconversion was associated with non-student status (RR = 2.61, 90% CI = 1.3-5.26), low HIV transmission knowledge (RR = 8.87, 90% CI = 2.16-36.43), and syphilis infection (RR = 5.04, 90% CI = 2.57-9.90). CONCLUSIONS: Incidence of HIV among YMSM is high in urban areas of China. Interventions measures are required to contain the HIV epidemic within this population.


Assuntos
Infecções por HIV/epidemiologia , Homossexualidade Masculina/estatística & dados numéricos , Adolescente , Adulto , China/epidemiologia , Cidades/epidemiologia , Estudos de Coortes , Soropositividade para HIV/epidemiologia , Humanos , Incidência , Masculino , Estudos Prospectivos , Fatores de Risco , Adulto Jovem
20.
Biomed Res Int ; 2014: 174870, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24783195

RESUMO

OBJECTIVE: To investigate barriers and correlates of the use of HIV prevention services and HIV testing behaviors among men who have sex with men in Chongqing. METHODS: Three consecutive cross-sectional surveys provided demographic, sexual behavior, HIV/syphilis infection, HIV prevention service, and testing behavior data. RESULTS: Of 1239 participants, 15.4% were infected with HIV, incidence was 12.3 per 100 persons/year (95% CI: 9.2-15.3), 38% of the participants reported ever having unprotected insertive anal sex, 40% ever received free condom/lubricants in the past year, and 27.7% ever obtained free sexually transmitted infection examination/treatment in the past year. Multivariable logistic regression revealed that lower levels of HIV/AIDS related stigmatizing/discriminatory attitudes, full-time jobs, and sex debut with men at a younger age were independently associated with use of free condom/lubricants. Large social networks, higher incomes, and sexual debut with men at a younger age were associated with use of any HIV prevention and HIV testing services. Lower levels of stigmatizing/discriminatory attitudes were also associated with HIV testing. Fearing needles and being unaware of the venues for testing were top barriers for testing service utilization. CONCLUSION: It is imperative to address HIV/AIDS related stigmatizing/discriminatory attitudes and other barriers while delivering intervention and testing services.


Assuntos
Preservativos/estatística & dados numéricos , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Homossexualidade Masculina/estatística & dados numéricos , Programas de Rastreamento/estatística & dados numéricos , Sexo sem Proteção/prevenção & controle , Sexo sem Proteção/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , China , Emprego/estatística & dados numéricos , Infecções por HIV/diagnóstico , Promoção da Saúde/estatística & dados numéricos , Humanos , Incidência , Masculino , Saúde do Homem , Pessoa de Meia-Idade , Educação de Pacientes como Assunto , Fatores de Risco , Comportamento Sexual , Fatores Socioeconômicos , Revisão da Utilização de Recursos de Saúde , Adulto Jovem
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