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1.
Clin Exp Dermatol ; 2021 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-34750849

RESUMO

Oral papillary lesions represent a variety of developmental and neoplastic conditions. Early diagnoses of different papillary lesions are challenging for oral medicine specialists. Malignant acanthosis nigricans (MAN) is a rare cutaneous disorder and a potential marker of underlying hidden tumours. The disease is characterised by papillary lesions that always involve the oral mucosa. In oral medicine specialities, MAN is not well understood. When the early signs of MAN are extensive oral lesions and slight cutaneous pigmentation without obvious florid cutaneous papillomatosis, the diagnosis can be incorrect or delayed. Oral medicine specialists should ask affected patients to provide details of their medical history and conduct a timely systemic examination.

2.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 33(5): 513-517, 2021 Aug 24.
Artigo em Chinês | MEDLINE | ID: mdl-34791851

RESUMO

OBJECTIVE: To investigate the current prevalence of human soil-borne nematode infections in Yunnan province, so as to provide the scientific evidence for formulating the soil-borne nematodiasis control strategy in the province. METHODS: In 2015, a total of 20 survey sites were sampled in 10 counties (cities) of Yunnan Province using the stratified cluster random sampling method. Stool samples were collected from all local permanent residents at ages of one year and older in each survey site, and the soil-borne nematode eggs were identified using the modified Kato-Katz technique and the egg number was counted. In addition, the hookworm species was identified using the filter-paperculture method, and Enterobius vermicularis eggs were detected using the cellophane tape method in children at ages of 3 to 6 years. RESULTS: A total of 5 067 residents received stool examinations, and 950 residents were detected with soil-borne nematode infections, with an overall prevalence rate of 18.75%. The prevalence of Ascaris lumbricoides, Trichuris trichura and hookworm was 7.52%, 8.47% and 9.02%, respectively. Among 446 children detected using the cellophane tape method, 5 children were detected with E. vermicularis infections. Among the 160 residents with hookworm infections, there were 139 residents with Necator americanus infections (86.88%), 16 with A. duodenale infections (10.00%) and 5 with mixed infections (3.12%). Mild A. lumbricoides (67.98%, 259/381), T. trichura (88.58%, 380/429) and hookworm infections (94.53%, 432/457) were predominant. Among the four ecological zones, the highest prevalence of human soilborne nematode infections was found in the East Tibet-South Sichuan Ecological Zone (31.79%), and among the 10 survey counties (cities), the greatest prevalence was seen in Gongshan Derung and Nu Autonomous County (50.13%), while the lowest prevalence was found in Ninglang Yi Autonomous County (0.40%). The prevalence of human soil-borne nematode infections was 5.67% (43/759), 26.67% (610/2 287) and 14.70% (297/2 021) in high-, moderate- and low-economic-level regions, respectively. There were no significant differences in the prevalence of human soil-borne nematode infections in terms of ecological regions, survey counties (cities) or economic development levels (χ2 = 342.20, 814.60 and 201.34, all P < 0.05). There was no significantdifference in the prevalence of human soil-borne nematode infections between male (18.21%, 441/2 422) and female residents (19.24%, 509/2 645) (χ2 = 0.89, P > 0.05), and soil-borne nematode infections were detected in residents at all age groups, with the greatest prevalence found in residents at ages of 1 to 9 years (25.88%). In addition, the highest prevalence of soil-borne nematode infections was seen in residents with the Dulong Ethnic Minority (82.09%), in preschool children (25.06%) and in illiterate residents (24.80%), and there was no age-, ethnicity-, occupation- or education level-specific prevalence of soil-borne nematode infections detected (χ2 = 46.50, 1 016.96, 36.33 and 52.43, all P < 0.05). CONCLUSIONS: The prevalence of human soil-borne nematode infections remains high in Yunnan Province. The management of soil-borne nematodiasis requires to be reinforced among low-age children, farmers, old people and residents with low educations levels or ethnic groups.


Assuntos
Infecções por Nematoides , Solo , Animais , Criança , Pré-Escolar , China/epidemiologia , Estudos Transversais , Grupos Étnicos , Feminino , Humanos , Lactente , Masculino , Grupos Minoritários , Infecções por Nematoides/epidemiologia , Prevalência
3.
Bull Exp Biol Med ; 172(1): 26-32, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34792718

RESUMO

The anti-metastasis effect of oridonin in combination with oxaliplatin on colorectal cancer liver metastasis was studied using a BALB/c nude mouse model. The liver condition, bloody ascites, cholestasis, and liver metastasis scores in the three groups receiving oxaliplatin combined with oridonin were significantly milder than in the control group and importantly the anti-migratory effect of oxaliplatin combined with oridonin was obviously the strongest (p<0.05). Oridonin possessed no hepatotoxicity; instead, it effectively alleviated liver injury caused by oxaliplatin. Oridonin alone or in combination with oxaliplatin significantly decreased serum levels of α-fetoprotein and carcinoembryonic antigen. Therefore, oridonin combined with oxaliplatin displays great potential to markedly increase the anti-metastasis effect of oxaliplatin in the treatment of liver metastases of colorectal cancer.

4.
Zhonghua Zhong Liu Za Zhi ; 43(11): 1203-1208, 2021 Nov 23.
Artigo em Chinês | MEDLINE | ID: mdl-34794225

RESUMO

Objective: To analyze the prognostic factors of breast cancer patients with isolated chest wall recurrence (ICWR) after mastectomy, and investigate the optimal treatment. Methods: A total of 201 breast cancer patients with ICWR after mastectomy who were treated in Cancer Hospital, Chinese Academy of Medical Sciences and the Fifth Medical Center Chinese PLA General Hospital from October 1998 to April 2018 were retrospectively analyzed. The median follow-up was 92.8 months and survival data were obtained. Results: Among 201 patients with ICWR, 103 patients developed subsequent locoregional recurrence (sLRR) and 5-year cumulative sLRR rate was 49.1%; 134 patients developed distant metastasis (DM) and 5-year DM rate was 64.4%; 103 patients died, the median progression-free survival (PFS) was 17.4 months and the 5-year PFS rate was 23.2%; the median overall survival (OS) was 62.5 months and the 5-year OS rate was 52.1%. Multivariate analysis showed that the recurrence interval (HR=2.17, 95% CI: 1.26-3.73) and the locoregional treatment (HR=1.59, 95% CI: 1.05-2.40) were the independent prognostic factors for sLRR. The initial HER2 status (HR=1.60, 95% CI: 1.03-2.48) was the independent prognostic factor for DM. The recurrence interval (HR=1.99, 95% CI: 1.30-3.04), the locoregional treatment (HR=1.99, 95% CI: 1.43-2.76) and the treatment modalities after recurrence (HR=1.70, 95% CI: 1.18-2.46) were the independent prognostic factors for PFS. The initial HER2 status (HR=1.69, 95% CI: 1.02-2.81), the recurrence interval (HR=1.85, 95% CI: 1.15-2.98) and the treatment modalities after recurrence (HR=2.48, 95% CI: 1.56-3.96) were the independent prognostic factors for OS. Conclusions: Breast cancer patients after ICWR have an optimistic OS until now, but the risk of sLRR and DM is high. Comprehensive treatment modalities including surgery, radiotherapy and systemic therapy improve the outcome of breast cancer patients with ICWR after mastectomy.


Assuntos
Neoplasias da Mama , Parede Torácica , Neoplasias da Mama/cirurgia , Feminino , Seguimentos , Humanos , Mastectomia , Recidiva Local de Neoplasia , Prognóstico , Estudos Retrospectivos
6.
Poult Sci ; 101(1): 101402, 2021 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-34784515

RESUMO

Solid-state fermentation has been used to improve the nutritive value of feed ingredients. In the present study, we investigated the effects of solid-state fermented wheat bran (FWB) on growth performance and apparent digestibility in broiler chickens. We measured the growth performance (ADFI, ADG, feed conversion, livability, and European performance efficiency factor) over 38 d in chicks fed a corn-soybean meal control diet (CON) or CON plus wet FWB (25 g/kg [T1]; 50 g/kg [T2]); or T1 plus 3 g/kg (T3); or T2 plus 6 g/kg (T4) soybean oil). The same diets were used to determine nutrient availability in chicks aged 20 d. Regression equations for AME and AMEn were obtained using 20-day-old chicks fed either the corn-soybean meal basal diet only or basal diet partially substituted with 50, 150, or 300 g/kg DM FWB. Diets containing 25 or 50 g/kg wet FBW did not affect the growth performance of broiler chickens, nor the apparent DM, energy, and nitrogen digestibility of the feeds, compared with the control diets (all P > 0.05). Further supplementation with oil did not improve the growth performance of broiler chickens compared with controls or chickens fed FBW. However, chickens fed diets containing soybean oil (T3 or T4) had lower (P = 0.005 and P = 0.040, respectively) apparent DM and energy digestibility than the control and FWB groups. The regression equations for AME and AMEn with the substitution of FWB produced values of 1,854.3 and 1,743.9 kcal/kg DM, respectively, and the equations were Y = 1854.3X + 52.7 (R2 = 0.971, n = 24, P < 0.001), and Y = 1743.9X + 44.6 (R2 = 0.978, n = 24, P < 0.001), respectively. Supplementation with wet FWB did not affect the growth performance of broiler chickens. Therefore, FWB is a suitable feed component for broilers.

7.
ESMO Open ; 6(6): 100313, 2021 Nov 24.
Artigo em Inglês | MEDLINE | ID: mdl-34837744

RESUMO

BACKGROUND: The value of anti-angiogenesis antibody therapy in recurrent or metastatic nasopharyngeal carcinoma (R/M NPC) remains unknown. We carried out a phase II study to evaluate the addition of bevacizumab to paclitaxel plus carboplatin in R/M NPC. MATERIALS AND METHODS: A total of 80 patients with previously untreated R/M NPC were randomly assigned (1 : 1) to CPB or CP groups to receive carboplatin (area under the curve 6) and paclitaxel (175 mg/m2) intravenously every 3 weeks for a maximum of six cycles in combination with or without bevacizumab (7.5 mg/kg), respectively. The primary endpoint was progression-free survival (PFS) as per investigators, and the secondary endpoints were PFS as per independent review committee (IRC), overall survival (OS), objective response rate (ORR), and safety. This study was registered with ClinicalTrials.gov (NCT02250599). RESULTS: The median PFS as per investigators was 7.5 months [95% confidence interval (CI), 6.53-8.45 months] in the CPB group and 6.5 months (95% CI, 5.53-7.52 months) in the CP group (P = 0.148), which were similar to IRC-assessed PFS. The median OS was also alike between CPB and CP arms (21.0 versus 24.7 months; P = 0.326). ORRs were 87.2% and 72.5%, respectively (P = 0.105). However, the tumor-shrinking rate was higher in the CPB arm than in the CP arm (P = 0.035). No differences in grade 3 or higher adverse events between the groups were observed. CONCLUSIONS: Addition of bevacizumab to paclitaxel plus carboplatin as first-line treatment did not prolong PFS and OS in patients with R/M NPC but improved tumor-shrinking rate. These results indicated that bevacizumab plus chemotherapy might be an optional choice for NPC with heavy tumor load or those pursuing short-term efficacy in neoadjuvant and concurrent chemotherapy.

8.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(6): 1086-1091, 2021 Jun 10.
Artigo em Chinês | MEDLINE | ID: mdl-34814512

RESUMO

Objective: To investigate the immunogenicity and safety of a boost dose of measles, mumps, and rubella combined vaccine (MMR) for children 4 to 6 years old. Methods: Children, aged 4 to 6 years old, had vaccinated with 1 dose of measles and rubella combined vaccine(MR) at the age of 8 months and 1 dose of MMR vaccine at 18-months, were recruited in Shanxi, Inner Mongolia, and Beijing, respectively. All children were assigned into 4, 5 and 6-year-old group. The children who met inclusion and exclusion criteria were vaccinated with 1 dose MMR vaccine, and were collected blood samples before vaccination and 35 to 42 d after the vaccination. During the study period, adverse events were collected at 30 min, 1 d, 2 d, 3 d, 4-12 d, and 13 to 42 days after vaccination. Serum was tested for IgG antibodies against measles, mumps and rubella. Geometric mean concentrations (GMC) of measles, mumps, and rubella antibodies were compared among groups by analysis of variance or non-parametric test. Seropositive rates and adverse event rates were compared among groups by Chi-square test or Fisher exact test. Results: A total of 500 children were included in immunogenicity analysis and 535 children were included in safety analysis. The overall adverse event rate was 20.37%, the most of severity for adverse events was mild. The rates of local and systemic adverse events were 0.37% and 20.00%, respectively. Symptoms of local adverse events were redness. The main systemic adverse events were fever, followed by cough, rash and runny nose. Received a dose of MMR vaccine for booster immunization, the seropositive rates of measles antibody, mumps antibody and rubella antibody were above 99% for all 3 age groups, and there was no significant difference between groups. There were significant differences in mumps antibody GMC among groups (P=0.042), but no significant differences in measles and rubella antibodies GMC. Conclusion: The immunogenicity and safety of a boosted MMR vaccintion in children aged 4, 5 and 6 years were all similar good.


Assuntos
Sarampo , Caxumba , Rubéola (Sarampo Alemão) , Criança , Pré-Escolar , Humanos , Sarampo/prevenção & controle , Vacina contra Sarampo-Caxumba-Rubéola/efeitos adversos , Caxumba/prevenção & controle , Vírus da Caxumba , Rubéola (Sarampo Alemão)/prevenção & controle
9.
Zhonghua Yi Xue Za Zhi ; 101(44): 3643-3649, 2021 Nov 30.
Artigo em Chinês | MEDLINE | ID: mdl-34823281

RESUMO

Objective: To understand gender differences of cardiovascular risk factors in patients with acute myocardial infarction (AMI) in China. Methods: A total of 26 592 patients with AMI from 107 hospitals in 31 provinces in China from January 1, 2013 to September 30, 2014 were included. Self-designed questionnaire was used to collect patients' age, gender, height, weight, type of AMI, medical history of cardiovascular and cerebrovascular diseases, medication history, lifestyle and AMI risk factors, including high blood pressure, diabetes, dyslipidemia, overweight and/or obesity, smoking history and family history of early onset coronary artery disease. A total of 24 394 patients with complete clinical data were included in the analysis, and gender differences in cardiovascular risk factors were analyzed in all and subgroups with different characteristics. Results: The patients were (62.2±13.8) years old, including 18 162 (74.5%) males and 18 209 (74.6%) ST-segment elevation myocardial infarction (STEMI). The age of male patients was (60.2±13.7) years, which was younger than that of female patients [(68.2±12.3) years]. The body mass index of male patients was (24.2±3.0) kg/m2, which was higher than that of female patients [(23.8±3.4) kg/m2]. The proportions of patients with overweight and/or obesity, smoking history, dyslipidemia, family history of early onset coronary heart disease, fatty diet and history of AMI were 51.8%, 55.2%, 7.2%, 3.8%, 80.4% and 7.7%, which were higher than those of females (45.9%, 9.9%, 5.8%, 2.3%, 65.0% and 5.9%, respectively]. The proportions of hypertension, diabetes, physical inactivity and stroke history were 46.5%, 17.2%, 77.8% and 8.5%, respectively, which were lower than those in female patients [61.4% (3 829 cases), 24.8%, 81.7% and 11.1%, respectively] (all P values<0.05).The proportions of peripheral vascular diseases history in male and female patients were 0.6% and 0.7%, respectively, with no statistical significance in difference (P>0.05). Subgroup analysis showed inconsistent results comparing to analysis of all patients: there were no statistical significance in gender differences as for the proportion of dyslipidemia in the non-ST-segment elevation MI group, the proportion of family history of early onset coronary heart disease in the young and middle aged groups, the proportion of overweight and/or obesity, and the proportion of physical inactivity in the elderly group (all P values>0.05). Conclusions: There are gender differences in cardiovascular risk factors among Chinese patients with acute myocardial infarction. Hypertension and diabetes are more common in women, and overweight and/or obesity, fatty diet and smoking are more common in men.


Assuntos
Doenças Cardiovasculares , Infarto do Miocárdio , Idoso , China/epidemiologia , Feminino , Fatores de Risco de Doenças Cardíacas , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/epidemiologia , Fatores de Risco , Fatores Sexuais
10.
Zhonghua Fu Chan Ke Za Zhi ; 56(10): 677-683, 2021 Oct 25.
Artigo em Chinês | MEDLINE | ID: mdl-34823316

RESUMO

Objective: To speculate the effect of birth spacing on the pelvic floor type Ⅰ and Ⅱ fiber muscle strength of postpartum women with parities of two in different delivery modes. Methods: Totally 2 361 parturients who were investigated in Xuzhou Central Hospital from June 2016 to December 2020 were included in the questionnaire, clinical examination and pelvic floor surface electromyography assessment. According to the interval years between two parities and the pelvic floor typeⅠ and Ⅱ fiber muscle strength under different modes of delivery, curve fitting function equation was performed using curve regression method. The accuracy of the equation was verified by the receiver operating characteristic curve and the maximum area under the curve, and calculating the relative error rate. Results: A total of 2 357 parturients were included in the study and were divided into 4 groups based on delivery modes, women with both normal vaginal delivery were assigned to group A (589 cases); women with a first vaginal delivery and a second cesarean section were assigned to group B (480 cases); women with both cesarean deliveries were assigned to group C (1 273 cases); women with a first cesarean section and a second vaginal delivery were assigned to group D (15 cases). All of the curve fitting results were quadratic curves, and the appropriate interval years were selected when the muscle strength of type Ⅰ muscle fibers was>35 µV and that of type Ⅱ muscle fibers was>40 µV: 6-8 years in the group A, 5-10 years in the group B, and 1-11 years in the group C. The peak values of the quadratic curve were as follows: 7-8 years in the group A, 7-8 years in the group B, and 6 years in the group C. The maximum area under the curve of the function equations were all>0.6 (all P<0.05), the average relative error rate was 4.909%. Conclusions: The pelvic floor function of postpartum women with parities of two increases firstly and then decreases over time, showing a quadratic curve shape. In order to protect the pelvic floor function, the appropriate interval of birth spacing is 6-8 years.


Assuntos
Cesárea , Diafragma da Pelve , Intervalo entre Nascimentos , Parto Obstétrico , Feminino , Humanos , Fibras Musculares Esqueléticas , Força Muscular , Período Pós-Parto , Gravidez
11.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(3): 475-481, 2021 Mar 10.
Artigo em Chinês | MEDLINE | ID: mdl-34814416

RESUMO

Objective: To evaluate the consistency between bioelectrical impedance analysis (BIA) and dual-energy X-ray absorptiometry (DXA) in the measurement of body composition in children and adolescents aged 7-17 years. Methods: Fat-free mass (FFM) and fat mass (FM) were measured by both BIA and DXA in 1 431 children. The consistency between the methods was evaluated by intra-class correlation coefficients (ICCs) and Bland-Altman analysis. Logarithmic transformation of both measurements was performed before Bland-Altman analysis. Results: The ICCs for FFM were 0.986 and 0.974 and ICCs for FM were 0.854 and 0.926 in boys and girls respectively. In boys, the mean ratio of FFMs by BIA and DXA was 1.04, with limits of Agreement (LoA) of 0.95-1.14, and in girls, the mean ratio of FFMs by BIA and DXA was 1.02, with the LoA of 0.90-1.15. The LoA of FFM became narrower with age in both boys and girls. Both boys and girls had the wide LoAs for FM (0.40-1.27 and 0.48-1.48, respectively). Additionally, the LoA ranges for FFM and FM narrowed with the increase of BMI level in both boys and girls. Conclusion: For all children, BIA showed good consistency with DXA for FFM, whereas significant errors occurred in FM measurement. The consistency between BIA and DXA was better for obese children than for underweight or normal-weight children.


Assuntos
Obesidade Pediátrica , Absorciometria de Fóton , Adolescente , Composição Corporal , Índice de Massa Corporal , Criança , Impedância Elétrica , Feminino , Humanos , Masculino , Magreza
12.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(4): 632-637, 2021 Apr 10.
Artigo em Chinês | MEDLINE | ID: mdl-34814442

RESUMO

Objective: To explore the changing trends and influencing factors of AIDS-related and non-AIDS-related deaths after receiving antiretroviral therapy (ART) among HIV-positive individuals in Dehong Dai Jingpo autonomous prefecture (Dehong) from 2010 to 2019. Methods: Based on the Chinese National treatment database, HIV patients who initiated ART from 2010 to 2019 were included in the analysis. The cumulative incidence function was used to estimate the cumulative incidence of AIDS-related death and non-AIDS-related death, respectively. The Fine-Grey model was used to compare the differences between AIDS-related and non-AIDS-related deaths and analyze its influencing factors. Results: A total of 7 068 HIV-positive individuals were included, of which 388 were AIDS-related deaths and 570 were non-AIDS-related deaths. The cumulative mortality rate at years 1, 2, 3, 4, 5, 7 and 9 after receiving ART were 2.27%, 3.46%, 4.47%, 5.03%, 5.84%, 6.61%, 7.40% for AIDS-related deaths, and 1.63%, 3.11%, 4.68%, 6.02%, 7.42%, 10.49%, 12.75% for non-AIDS-related deaths, respectively. In the Fine-Grey model, older age at ART initiation, male, unmarried, injection drug use as the transmission route, lower baseline BMI, lower baseline CD4+ T cell counts, baseline FIB-4 score >3.25, and baseline anemia were risk factors for AIDS-related death. In contrast, age at ART initiation ≥45 years, male, Dai, and Jingpo minority ethnicities, unmarried, injection drug use as the transmission route, lower baseline BMI, baseline FIB-4 score >3.25, baseline eGFR <60 ml·min-1·1.73 m-2, and baseline anemia were risk factors for non-AIDS-related deaths. Conclusions: The cumulative mortality rate was low among HIV-positive individuals after receiving ART in Dehong during 2010-2019. The mortality of non-AIDS-related deaths was higher than that of AIDS-related deaths. There were also differences in the factors influencing AIDS-related and non-AIDS-related deaths and interventions should be intensified to target the influencing factors for non-AIDS-related deaths.


Assuntos
Síndrome de Imunodeficiência Adquirida , Infecções por HIV , Abuso de Substâncias por Via Intravenosa , Síndrome de Imunodeficiência Adquirida/tratamento farmacológico , Idoso , Grupos Étnicos , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Humanos , Incidência , Masculino
13.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(4): 683-689, 2021 Apr 10.
Artigo em Chinês | MEDLINE | ID: mdl-34814451

RESUMO

Objective: To study the prevalence and correlations of HIV infection among cross-border couples in the Dehong prefecture. Methods: A cross-sectional mass screening study with questionnaire interview and HIV testing was conducted among 17 594 registered cross-border couples from May 2017 through June 2018. Results: Among 32 400 participants, the overall prevalence of HIV infection was 2.27% (736/32 400), 2.44% (375/15 372) for Chinese citizens, and 2.12% (361/17 028) for foreign spouses. Among all the 13 853 couples with both spouses receiving HIV testing, 13 415(96.84%) were seroconcordant-negative couples, 142(1.03%) were serocondordant-positive couples, and 296(2.13%) were serodiscordant couples, including 167(1.20%) couples with positive husband and negative wife and 129(0.93%) couples with positive wife and negative husband. Multiple logistic regression analyses indicated that HIV infection was associated with drug use and risky sexual behaviors for male spouses. In contrast, HIV infection was associated with risky sexual behaviors for female spouses. Conclusion: The prevalence of HIV among cross-border couples in Dehong prefecture is high, underscoring the urgent need to scale up HIV testing, prevention, and behavioral intervention.


Assuntos
Infecções por HIV , Estudos Transversais , Feminino , Infecções por HIV/epidemiologia , Humanos , Masculino , Prevalência , Comportamento Sexual , Cônjuges
14.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(5): 886-890, 2021 May 10.
Artigo em Chinês | MEDLINE | ID: mdl-34814483

RESUMO

Objective: To understand influencing factors on the deaths of HIV/AIDS patients receiving antireviral treatment in Butuo county of Liangshan Yi Autonomous Prefecture (Liangshan) from 2010 to 2019, to provide data for drug replacement and sustainable antiviral treatment strategy. Methods: A matched case-control study was used to collect basic and follow-up information on AIDS death patients receiving antiviral treatment in Butuo county of Liangshan from 2010 to 2019. The control group was formed by sampling twice the number of cases. The logistic regression model was used to analyze the risk factors affecting mortality. Results: In 3 355 patients of HIV/AIDS treated with antiviral therapy, 1 179 cases in the death group and 2 176 cases in the control group. Including 81.34% were 30-49 years old, 69.09%males, 99.55% Yi nationality, 91.12% were married or cohabitated, 95.77% had junior high school education or below, and 88.41% peasants. Amultivariate logistic stepwise regression model showed that among the death risk factors, age ≥50 years old was 5.08 times (95%CI:3.05-8.48) that of the 18-29, female was 0.70 times (95%CI: 0.52-0.94) than male, the transmission rate of intravenous drug use was 1.43 times (95%CI: 1.06-1.91) that of heterosexual transmission, CD4+T lymphocyte (CD4) count ≥350 cells/µl before treatment was 0.38 times (95%CI: 0.30-0.48) that of CD4 <200 cells/µl before treatment, the most recent antiviral treatment regimen containing LPV/r was 0.04 times (95%CI: 0.01-0.18) than that of stavudine (d4T) + lamivudine (3TC) + nevirapine (NVP)/efavirenz (EFV) regimen, drug resistance was 3.40 times (95%CI: 2.13-5.42) of non-drug resistance, non-viral load and non-drug resistance test results were 12.98 times (95%CI: 10.28-16.40) of non-drug resistance. Conclusions: Age, gender, transmission route, CD4 before treatment, the latest antiviral treatment program, and drug resistance test after antiviral therapy were the influencing factors of HIV/AIDS death in Butuo county. It is necessary to expand the coverage of viral load and drug resistance test to change the antiviral therapeutic schedule scientifically and carry out publicity and education on the compliance of patients with antiviral treatment and medical staff training in order to reduce the mortality of patients with antiviral treatment.


Assuntos
Síndrome de Imunodeficiência Adquirida , Fármacos Anti-HIV , Infecções por HIV , Síndrome de Imunodeficiência Adquirida/tratamento farmacológico , Adulto , Fármacos Anti-HIV/uso terapêutico , Estudos de Casos e Controles , Feminino , Infecções por HIV/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Nevirapina/uso terapêutico
15.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(6): 983-991, 2021 Jun 10.
Artigo em Chinês | MEDLINE | ID: mdl-34814496

RESUMO

Objective: To rapidly evaluate the level of healthcare resource demand for laboratory testing and prevention and control of corona virus disease 2019 (COVID-19) in different epidemic situation, and prepare for the capacity planning, stockpile distribution, and funding raising for infectious disease epidemic response. Methods: An susceptible, exposed, infectious, removed infectious disease dynamics model with confirmed asymptomatic infection cases and symptomatic hospitalized patients was introduced to simulate different COVID-19 epidemic situation and predict the numbers of hospitalized or isolated patients, and based on the current COVID-19 prevention and control measures in China, the demands of resources for laboratory testing and prevention and control of COVID-19 were evaluated. Results: When community or local transmission or outbreaks occur and total population nucleic acid testing is implemented, the need for human resources is 3.3-89.1 times higher than the reserved, and the current resources of medical personal protective equipment and instruments can meet the need. The surge in asymptomatic infections can also increase the human resource demand for laboratory testing and pose challenge to the prevention and control of the disease. When vaccine protection coverage reach ≥50%, appropriate adjustment of the prevention and control measures can reduce the need for laboratory and human resources. Conclusions: There is a great need in our country to reserve the human resources for laboratory testing and disease prevention and control for the response of the possible epidemic of COVID-19. Challenges to human resources resulted from total population nucleic acid testing and its necessity need to be considered. Conducting non-pharmaceutical interventions and encouraging more people to be vaccinated can mitigate the shock on healthcare resource demand in COVID-19 prevention and control.


Assuntos
COVID-19 , Pandemias , Humanos , Laboratórios , Pandemias/prevenção & controle , Equipamento de Proteção Individual , SARS-CoV-2
16.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(6): 1050-1055, 2021 Jun 10.
Artigo em Chinês | MEDLINE | ID: mdl-34814505

RESUMO

Objective: To analyze the longitudinal characteristics of CD4+T lymphocytes (CD4) among the adult HIV/AIDS on antiretroviral therapy (ART) and the related factors. Methods: A retrospective cohort of adult HIV/AIDS starting ART in Dehong Dai and Jingpo Autonomous Prefecture (Dehong) in 2007-2016 was followed up to December 31, 2018. Group-based trajectory models were utilized to identify CD4 subgroups based on immune recovery (whether and when CD4 reached the average level of >500 cells/µl). The demographics and information at ART baseline were described, and the related factors were analyzed with polytomous logistic regression. The SAS 9.4 software was used for statistical analysis. Results: A total of 7 605 adults with HIV/AIDS were included, of which the median (P25,P75) age at ART were 36 (30,43) years old, 61.0% were male, 42.5% were Han nationality, and 60.8% with the education of primary school or below. The follow-up duration M (P25, P75) was 6.1 (4.1,8.1) years. HIV/AIDS in Dehong showed four CD4 trajectory subgroups from low to high: below the average level, primary recovery to a normal level, full recovery to a moderate level, and normal steady level, accounting for 34.4%, 39.8%, 20.6%, and 5.2%, respectively. When compared with corresponding control groups, age <35 years at ART, female, education of middle school or above, sexual transmission, no opportunistic infection, CD4 ≥200 cells/µl, baseline regimen with tenofovir (TDF) and time from HIV diagnosis to ART <1 year were the related factors facilitating the higher CD4 subgroups. Conclusions: The various CD4 immune recoveries of HIV/AIDS were changing patterns after ART. Starting ART with a high CD4 level was beneficial to CD4 recovery to normal level during the follow-up period. Early initiation of ART and exceptional attention to CD4 immune recovery should be encouraged after the ART.


Assuntos
Grupos Étnicos , Infecções por HIV , Adulto , Contagem de Linfócito CD4 , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Humanos , Masculino , Prevalência , Estudos Retrospectivos , Linfócitos T
17.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(7): 1218-1224, 2021 Jul 10.
Artigo em Chinês | MEDLINE | ID: mdl-34814534

RESUMO

Objective: To investigate the incidence of anemia and risk factors in HIV/AIDS patients with access to antiretroviral therapy (ART) during 2004-2018 in Dehong Jingpo and Dai Autonomous Prefecture (Dehong). Methods: A retrospective cohort study was conducted in HIV/AIDS patients receiving ART in Dehong during 2004-2018 based on the data extracted from the National HIV/AIDS antiretroviral therapy database. Cox proportional risk model was used to analyze the factors associated with the incidences of anemia and moderate or severe anemia in the HIV/AIDS patients. And the piecewise linear mixed-effects model was used to depict the trajectory of hemoglobin changes over time after initiating ART according to baseline level. Results: A total of 8 044 HIV/AIDS patients were included, in whom 6 337 (78.8%) were without anemia at baseline survey and had a median follow up time of 4.43 (P25, P75: 1.50, 6.71) years. The median follow up time for 1 291 new anemia cases and 293 new moderate or severe anemia cases was 0.16 (P25, P75: 0.07, 1.99) years and 0.48 (P25, P75:0.09, 2.97) years, respectively. The incidence rate of anemia and moderate or severe anemia was 4.40 per 100 person-years and 0.41 per 100 person-years respectively. In multivariable Cox regression analysis, older age, being female, being in Dai and Jingpo ethnic group, baseline BMI <18.5 kg/m2, baseline CD4+T lymphocyte cell counts (CD4) <200 cells/µl, and zidovudine (AZT) -based initial treatment regimen were factors significantly and positively associated with incidence of anemia after treatment. Factors as being female, being in Dai ethnic group, baseline BMI <18.5 kg/m2, mild baseline anemia, and AZT-based initial treatment regimen were significantly and positively associated with incidence of moderate or severe anemia after treatment. Conclusion: The risk for anemia was higher in HIV/AIDS patients with specific characteristics, such as age ≥60 years , being female, being in Dai and Jingpo ethnic groups, lower BMI, CD4 <200 cells/µl, and treatment of AZT, after initiation of ART in Dehong during 2004-2018. Additional efforts are needed to strengthen the screening, prevention and treatment of anemia in this population.


Assuntos
Anemia , Infecções por HIV , Idoso , Anemia/epidemiologia , China/epidemiologia , Grupos Étnicos , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Humanos , Incidência , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco
18.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(10): 1889-1894, 2021 Oct 10.
Artigo em Chinês | MEDLINE | ID: mdl-34814629

RESUMO

Objective: Data being missed is an unavoidable problem in cohort studies. This paper compares the imputation effect of eight common missing data imputation methods involved in cutting longitudinal data through simulation study to provide a valuable reference for the treatment of missing data in longitudinal studies. Methods: The simulation study is based on R language software and generates missing longitudinal data by the Monte Carlo method. By comparing the average absolute deviation, average relative deviation, and TypeⅠerror from the regression analysis of different imputation methods, the imputation effect of varying imputation methods on missing longitudinal data and the influence on subsequent multivariate analysis are evaluated. Results: The mean imputation, k nearest neighbor (KNN), regression imputation, and random forest all have a similar imputation effect, which is also steady. However, the hot deck is inferior to the above imputation methods. K-means clustering and expectation maximization (EM) algorithm are among the worst and unstable. Mean imputation, EM algorithm, random forest, KNN, and regression imputation can control TypeⅠerror. Still, multiple imputations, hot deck, and K-means clustering cannot effectively manage the TypeⅠerror. Conclusions: For missing data in longitudinal studies, mean imputation, KNN, regression imputation, and random forest can be used as better imputation methods under the mechanism of missing at random. When the missing ratio is not too large, multiple imputations and hot deck can also perform well, but K-means clustering and EM algorithm are not recommended.


Assuntos
Algoritmos , Estudos de Coortes , Simulação por Computador , Humanos , Estudos Longitudinais , Análise de Regressão
19.
Zhonghua Shao Shang Za Zhi ; 37: 1-9, 2021 Nov 25.
Artigo em Chinês | MEDLINE | ID: mdl-34839595

RESUMO

Objective: To analyze the changes and predict the metabolic function of intestinal microflora in severe burn patients at early stage by 16S ribosomal RNA (rRNA) sequencing. Methods: In the prospective observational study, 48 patients with severe burns who met the inclusion criteria and were admitted to Department of Burns and Plastic Surgery of Affiliated Hospital of Jiangsu University from January 2018 to December 2019 were included the burn group, and 40 healthy volunteers who met the inclusion criteria and underwent health examination at the Physical Examination Center of Affiliated Hospital of Jiangsu University in the same period were included in healthy group. Stool samples were collected from patients in burn group in about 1 week after admission and from healthy volunteers on the day of physical examination. The 16S rRNA V4 gene sequencing was performed in the stool of patients in burn group and volunteers in healthy group to analyze the relative abundance of various bacteria. The operational classification unit (OTU) was divided by Mothur software, and the thermal map of fecal micro flora structure was drawn. The OTU number, Chao1 index, Ace index, and Shannon index of stool microflora were analyzed by QIIME1.9.0 software. The principal component analysis (PCA) for relative abundance of stool microflora was preformed by Canoco Software 50. The metabolic function of stool microflora was predicted by Kyoto Encyclopedia of Genes and Genomes. Data were statistically analyzed with independent sample t test, Mann-Whitney U test, and Bonferroni correction. Results: The relative abundance of Bacteroides, Enterococcus, Acinetobacter, Macrococcus, and Staphylococcus in feces of patients in burn group was significantly higher than that of volunteers in healthy group (Z=-5.20, -2.37, -5.17, -4.41, -6.03, P<0.05 or P<0.01), and the relative abundance of unclassified-Helicobacillae, Prevotella, Cecobacteria, unclassified-Rumencocci, Pseudobutyrivibrio, Brautia, unclassified-Streptococcidae, unclassified-Digiestive and other 13 species of bacteria in the feces of volunteers in healthy group was significantly higher than that of patients in burn group (Z=-8.03, -3.21, -7.63, -5.88, -8.05, -8.05, -6.77, P<0.01). The diversity of fecal microflora of volunteers in healthy group was better than that of patients in burn group, the dominant microflora of volunteers in healthy group were Bacteroides, unclassified-Helicobacillae, Prevotella, unclassified-Enterobacteriaceae, Brucella, Parabacteroides, Escherichia coli, etc., and the dominant microflora of patients in burn group were Bacteroides, Prevotella, Enterobacteriaceae, and Parabacteroides. The OTU number, Ace index, Chao1 index, and Shannon index of fecal microflora of patients in burn group were 149±47, 199±45, 190±45, 2.0±0.9, which were significantly lower than 266±57, 323±51, 318±51, 3.8±0.5 of volunteers in healthy group (t=10.325, 11.972, 12.224, 11.662, P<0.01). The relative abundance of fecal microflora of patients in burn group and volunteers in healthy group was clearly divided into two groups by principal component 1, and the contribution rate of principal component 1 was 32.50%, P<0.01. The fecal samples of volunteers in healthy group were more concentrated on principal component 2, the fecal samples of patients in burn group were dispersed in principal component 2, and the contribution rate of principal component 2 was 13.44%, P>0.05. The metabolic levels of alanine-aspartate-glutamate, arginine-proline, cysteine-methionine, glycine-serine-threonine, phenylalanine, tryptophan, and tyrosine in amino acid, tricarboxylic acid cycle, glucose and mannose, galactolipin, glycolysis/gluconiogenesis, starch and sucrose in carbohydrate of fecal microflora of patients in burn group were significantly lower than those of volunteers in healthy group (Z=-4.75, -4.54, -4.75, -4.62, -3.71, -3.28, -4.19, -3.82, -4.72, -4.35, -4.75, -4.71, P<0.01). The levels of lipoic acid metabolism and coenzyme Q synthesis of fecal microflora of patients in burn group were significantly higher than those of volunteers in healthy group (Z=-6.07, -4.51, P<0.01). The metabolic level of arachidonic acid of fecal microflora of patients in burn group was similar to that of volunteers in healthy group (P>0.05). Conclusions: There were significant differences in intestinal microflora between severe burn patients at the early stage and healthy people. In burn patients, the species and diversity of microflora were decreased, and the nutrient metabolism level was decreased.

20.
J Bone Miner Res ; 2021 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-34738660

RESUMO

Romosozumab monoclonal antibody treatment works by binding sclerostin and causing rapid stimulation of bone formation while decreasing bone resorption. The location and local magnitude of vertebral bone accrual by romosozumab and how it compares to teriparatide remains to be investigated. Here we analysed the data from a study collecting lumbar CT spine scans at enrolment and 12 months post-treatment with romosozumab (210 mg SC QM, n = 17), open-label daily teriparatide (20 ug SC, n = 19) or placebo (SC QM, n = 20). For each of the 56 women, cortical thickness (CtTh), endocortical thickness (EcTh), cortical BMD (CtBMD), cancellous BMD (CnBMD) and cortical mass surface density (CMSD) were measured across the first lumbar vertebral surface. In addition, colour maps of the changes in the lumbar vertebrae structure were statistically analysed and then visualised on the bone surface. At 12 months Romosozumab improved all parameters significantly over placebo and resulted in a mean vertebral CtTh increase of 10.3% versus 4.3% for teriparatide, an EcTh increase of 137.6% versus 47.5% for teriparatide, a CtBMD increase of 2.1% versus a - 0.2% decrease for teriparatide, and a CMSD increase of 12.4% versus 3.8% for teriparatide. For all these measurements the differences between romosozumab and teriparatide were statistically significant (p < 0.05). There was no significant difference between the romosozumab-associated CnBMD gains of 22.2% versus 18.1% for teriparatide, but both were significantly greater compared to the change in the placebo group (-4.6%, p < 0.05). Cortical maps showed the topographical locations of the increase in bone in fracture-prone areas of the vertebral shell, walls and endplates. This study confirms widespread vertebral bone accrual with romosozumab or teriparatide treatment, and provides new insights into how the rapid prevention of vertebral fractures is achieved in women with osteoporosis using these anabolic agents. This article is protected by copyright. All rights reserved.

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