[Clinicopathological features of gastric alpha-fetoprotein-producing adenocarcinoma with SWI/SNF complex deletion].

Objective: To investigate the clinicopathological features and treatment of gastric alpha-fetoprotein (AFP)-producing adenocarcinoma with SWI/SNF complex deletion. Methods: Four cases of gastric AFP-producing adenocarcinoma with SWI/SNF complex deletion diagnosed in Zhongshan Hospital of Fudan University from January 2021 to December 2022 were collected, and their histomorphological characteristics, immunohistochemical (IHC), in situ hybridization of Epstein-Barr virus-encoded RNA (EBER), next-generation sequencing results, clinicopathological features and treatment were summarized, and literature review was conducted. Results: Among the 4 patients, there were three males and one female. They presented with abdominal pain, belching and melena. Serum AFP was significantly elevated in three patients, and endoscopy showed ulcerative lesions. Microscopically, the tumor cells showed mainly diffuse flaky or nest-like growth and typical characteristics of hepatoid adenocarcinoma. In two cases there were adenoid growth, and the tumor cells in these areas possessed clear cytoplasm, suggesting enteroblastic differentiation. The tumor cell nuclei were pleomorphic with large nucleoli and brisk mitoses. The IHC results showed that the tumor cells expressed AFP, GPC3 and SALL4, and there was retained expression of broad-spectrum keratin (CKpan) and E-cadherin. IHC detection of SWI/SNF complex subunits, namely INI1 (SMARCB1), BRG1 (SMARCA4), BRM (SMARCA2), ARID1A protein was performed. In all four cases the hepatoid adenocarcinoma region and enteroblastic differentiation region showed SMARCA2 deletion, and one case with enteroblastic differentiation also showed ARID1A deletion. SMARCB1 and SMARCA4 deletions were not seen. All the four cases were diffusely positive for p53 protein, and the Ki-67 proliferation index was 80%-90%. There were no mismatch repair deletion detected; one cases showed HER2 was strongly positive (3+), and EBER was negative. None of the four cases had mutations in the SWI/SNF complex-related subunits detected by next-generation sequencing. Among the four patients, two underwent palliative surgery due to distant metastasis at the time of surgery, two underwent radical resection. Postoperative adjuvant chemotherapy was given to three patients. Conclusions: AFP-producing adenocarcinoma is a rare subtype of gastric cancer, which can be combined with SWI/SNF complex deletion, and the pathomorphological manifestations are different from the classical SWI/SNF complex deletion of undifferentiated carcinoma with rhabdoid phenotype.

[Characteristic analysis of molecular subtypes and recombinant structure of HIV-1 infection in Zhejiang Province, 2015].

Objective: To understand the molecular subtypes and recombinant structure of HIV-1 infection in Zhejiang Province. Methods: According to the method of stratified random sampling method, a total of 302 newly HIV infected people (excluding AIDS patients) were selected as the subjects of the investigation from April to June, 2015, who were all newly HIV positive patients reported in Zhejiang Province and were diagnosed as HIV positive and had not received antiretroviral treatment. Questionnaires were used to collect information such as gender, residency, marital status, route of transmission and case reporting area. At least 8 ml of venous blood was collected from HIV infected people, reverse transcription-polymerase chain reaction (RT-PCR) and nested PCR were used to amplify the pol gene sequence of HIV-1 strains and circulating recombination forms (CRF) and unique recombinant form (URF) strains were screened using phylogenetic tree, and molecular subtype analysis and recombinant analysis were performed. Results: Of the 302 HIV infected people, 18 cases were infected with new CRFs or URFs, among which 15 were male (83.3%), 3 were heterosexual transmission (17.7%); 8 cases (44.4%) were infected with new CRFs, which included CRF55_01B 5(27.8%), CRF67_01B 2 (11.1%), CRF69_01B 1 (5.6%); 10 cases (55.6%) were infected with URFs, in which 6 cases were infected with two groups of recombinant strains composed of CRF01_AE subtype and CRF07_BC subtypes in pol region, 3 cases were infected with three groups of recombinant strains of the two subtypes in pol region, and 1 case could not be accurately determined of the recombinant structure. The results of recombinant source analysis showed that the newly recombinant strains found from Zhejiang province were highly homologous to the strains from Guangdong, Anhui, Hebei, Yunnan, Liaoning province, and the sequence similarity was 94.4%-98.0%. Conclusion: The new recombinant strains of Zhejiang province included CRFs strains and URFs strains with CRF01_AE and CRF07_BC as the main recombinant structure mode, and all of them were introduced from other places and formed a trans-regional chain of HIV transmission.

Effect of MSTN propeptide protein on the growth and development of Altay lamb muscle.

Prokaryotic expression technology was used to express maltose-binding protein binding myostatin (MSTN) propeptide fusion protein. Six disease-free Altay lambs were used in this study. The right leg gastrocnemii were injected with MSTN recombinant propeptide protein. The left leg gastrocnemii (the control group) were injected with the same dose of phosphate based saline. The lambs were fed during four months under the same conditions and then slaughtered. Gastrocnemius samples were hematoxylin-eosin stained and the size of the muscle fibers was measured. A real-time polymerase chain reaction (RT-PCR) showed that single gastrocnemius cells in the experimental group had an average area of 1163.01 µm(2), while it was 845.09 µm(2) in the control group (P < 0.05). This indicates that the MSTN propeptide biological agents had an inhibitory effect on MSTN. In order to reveal its mechanism, RT-PCR was conducted to detect the expression of the differentiation-associated genes MyoD, Myf5, Myogenin, p21, and Smad3. The results showed that, in the MSTN propeptide biological agent injected group, expression levels of MSTN, Smad3, and p21 were lower than the control group, while Myf5, MyoD, and Myogenin were higher compared to the control group. This indicates that, when expression of the MSTN gene was inhibited, muscle cell differentiation and growth can be promoted by Smad3 up-regulated expression of Myf5, MyoD, and Myogenin.

Identification of QTLs for resistant starch and total alkaloid content in brown and polished rice.

An F3 population consisting of 117 F2:3 families derived from a cross between two varieties of rice, Gongmi No. 3 and Diantun 502, with a large difference in their resistant starch and total alkaloid content, was used for quantitative trait locus (QTL) mapping. Two QTLs of resistant starch for rice (qRS7-1, qRS7-2) were identified in a linkage group on chromosome 7, which could explain phenotypic variance from 7.6 to 17.3%, due to additive effects for resistant starch from Gongmi No. 3 or over-dominance effects for qRS7-2 of the marker interval (RM3404-RM478) on chromosome 7 from Gongmi No. 3, accounting for 13.8-17.3% of the phenotypic variance. Two QTLs of total alkaloids for brown rice (qALb7-1, qALb7-2) were identified in the same linkage group, which could explain phenotypic variance from 7.7 and 19.3%, respectively, due to dominance or over-dominance effects for total alkaloids on chromosome 7 from Diantun 502. To our knowledge, these are the first QTLs to be identified, which are related to resistant starch and total alkaloid content in rice. These results are beneficial for understanding the genetic basis of, as well as for developing markers linked with, resistant starch and total alkaloids of functional components for marker-assisted selection breeding in rice.

Identification of quantitative trait loci for mineral elements in grains and grass powder of barley.

Mineral elements in barley (Hordeum vulgare) play an important physiological role in global human health. In this study, quantitative trait loci (QTLs) for concentration of nine mineral elements in barley grain and grass powder were detected in a population of 193 recombinant inbred lines of the barley cross Ziguangmangluoerling x Schooner and the parents. We observed large genetic variation contributing to element concentrations in both grains and grass powder. The mean K, Ca, and Fe concentrations in grass powder were 6.67, 12.00, and 4.58 times that of regenerating barley grains. In grains, 17 QTLs that accounted for 6.36-64.08% of the phenotypic variation in Zn, Mg, Ca, K, Na, Mn, Fe, and P concentrations were identified. In grass powder, seven QTLs were identified; these accounted for 6.03-21.86% of the variation in Ca, Zn, Mg, K, Fe, and Cu concentrations. These QTLs affecting elements in grain and grass powder are so far unreported in barley. To our knowledge, QTLs with pleiotropic effects for three elements were also identified for the first time in barley. The qK1/qMg1/qCa1 region between markers Bmag0211 and GBMS0014 on chromosome 1H was shown to have large additive effects for Mg, Ca, and K concentrations in grains. These additive effects indicated that the high element (Mg, Ca, Zn, Mn, and K) alleles were contributed by Ziguangmangluoerling. These results will further our understanding of the genetic basis of mineral elements and help us develop markers linked with mineral elements for marker-assisted selection breeding in barley.

Primary small cell carcinoma of the vagina with pulmonary metastasis: a case report.

Primary small cell carcinoma of the vagina is extremely rare; no standard treatment has been established despite it being highly aggressive. Here, the authors report on a 43-year-old patient who had a mass on the clitoris and no uterine or bilateral adnexal involvement. Vaginal wall biopsy revealed malignant small cell carcinoma. The carcinoma was composed of epithelial cells with round, hyperchromatic nuclei containing few distinct nucleoli, and scanty cytoplasm. Chest computerized axial tomography and pathological bronchoscopy revealed bilateral pulmonary metastases. She received radiotherapy combined with six cycles of chemotherapy (paclitaxel plus cisplatin), and achieved complete response, with complete suppression of the mass and lung metastases. There was no sign of tumor recurrence or distant metastases after 21 months of follow-up.

Anatomical information for intercostobrachial nerve preservation in axillary lymph node dissection for breast cancer.

This study aimed to provide additional anatomical information for axillary lymph node dissection (ALND) through in vivo anatomy studies of intercostobrachial nerve (ICBN) preservation in order to provide theoretical and practical experience for clinicians. A total of 156 patients with breast cancer underwent ALND at the Department of Gynecology of Baotou Tumor Hospital between June 2009 and March 2010. The origin, destination, main source, length, branch type, and direction of ICBN in axilla were observed, as well as its relationship with adjacent major blood vessels and nerves within the axilla. There were 120 cases of single trunk, 23 cases of double trunks, 9 cases of multiple trunks, and 4 cases without trunks in 156 patients with ICBN preservation. The transverse diameter at the origin of the ICBN was 1.89 ± 0.44 mm with a length of 94.45 ± 12.08 mm; the distances were 77.19 ± 21.04 mm, 29.34 ± 6.73 mm, 90.04 ± 13.13 mm, and 28.63 ± 13.01 mm from origin to the inferior margin at the midpoint of the clavicle, inferior margin of the axillary vein, the bottom of axilla, and branch point, respectively. The identification, dissection, and preservation of ICBN was simple and easy in a modified radical mastectomy for breast cancer and breast-conserving surgery, which only took 10-20 min, but effectively reduced the incidence of post-mastectomy pain syndrome and significantly improved the quality of life for patients after surgery.

[Syphilis infection and related factors among HIV-infected patients in Zhejiang Province].

Objective: To investigate syphilis infection and related factors among HIV-infected patients being followed up for more than one year in Zhejiang Province. Methods: Data were collected from the China Disease Control and Prevention Information System, and information such as demographic characteristics, viral load levels, and syphilis serologic test results was collected from HIV-infected persons who were diagnosed with HIV more than 1 year, aged ≥15 years with a current address in Zhejiang Province through December 31, 2022. The logistic regression model analyzed the prevalence of syphilis and the related factors. The SPSS 19.0 software was used for statistical analysis. Results: A total of 33 734 HIV-infected patients, with the prevalence of syphilis was 5.6% (1 879/33 734). Among the syphilis cases, the prevalence of syphilis was 6.4% (1 774/27 934) of males, 7.5% (640/8 543) of 25-34 years old age group, 7.6% (1 025/13 423) of unmarried, 8.3% (1 239/14 862) of homosexual transmission, 6.9% (214/3 080) with a non-local registered residence and 9.6% (602/6 267) with a history of STD before the HIV diagnosis. Multivariate Logistic regression analysis showed that participants who were male (aOR=2.19, 95%CI:1.77-2.72), 25-34 years old age group (aOR=1.80, 95%CI:1.47-2.20), homosexual transmission (aOR=1.67, 95%CI:1.49-1.88), with other provinces registered residence (aOR=1.26, 95%CI:1.09-1.47), and with a history of sexually transmitted disease (STD) before the HIV diagnosis (aOR=1.98, 95%CI:1.78-2.20) were associated with increased risk of syphilis. Being married (aOR=0.79, 95%CI:0.68-0.92) was associated with a decreased risk of syphilis. Conclusions: Syphilis infections were high in HIV-infected patients followed up more than one year in Zhejiang Province. It is recommended that syphilis surveillance and screening frequency should be strengthened among HIV-infected persons with characteristics such as male, homosexual transmission, and STD history.

[Prevalence of syphilis in HIV-infected patients with transmission risk and influencing factors in Zhejiang Province].

Objective: To investigate the prevalence of syphilis in HIV-infected patients with transmission risk and influencing factors in Zhejiang Province. Method: The information about the HIV-infected patients, who were alive, had been diagnosed with HIV for >1 year, had received no antiviral treatment or had HIV viral load ≥50 copies/ml, and were aged ≥15 years, reported in Zhejiang as of December 31, 2018 were collected from China Information System for Disease Control and Prevention. The information included general demographic characteristics, sexual behavior characteristics and antiretroviral therapy and syphilis serological test results. The prevalence of syphilis and the influencing factors were analyzed by logistic regression model. The SPSS 19.0 software was used for statistical analysis. Results: A total of 2 275 HIV-infected patients were at risk of HIV transmission, and 75.5% (1 717/2 275) of them were tested for syphilis, the prevalence rate of syphilis was 8.7% (150/1 717). Among the HIV-infected patients with syphilis, 11.3% (17/150) received no antiviral treatment, 38.7% (58/150) had viral load of 50-999 copies/ml and 50.0% (75/150) had ≥1 000 copies/ml. Multivariate logistic regression analysis showed that being men (aOR=2.04, 95%CI:1.06-3.96), homosexual transmission (aOR=1.53, 95%CI:1.04-2.27), history of sexually transmitted diseases (STDs) before HIV diagnosis (aOR=1.98, 95%CI:1.35-2.92) and HIV viral load ≥1 000 copies/ml (aOR=1.90, 95%CI:1.09-3.30) were the risk factors for syphilis. Marriage (aOR=0.47, 95%CI: 0.29-0.76) was a protective factor for syphilis. Conclusions: The prevalence of syphilis was high in HIV-infected patients with transmission risk in Zhejiang. It is urgent to carry out classified management and targeted intervention in HIV-infected patients, explore multi-disease prevention and treatment mechanism, strengthen syphilis screening and treatment in HIV-infected patients to reduce the transmission of HIV and syphilis.

MicroRNA-191-5p promotes the development of osteosarcoma via targeting EGR1 and activating the PI3K/AKT signaling pathway.

The article "MicroRNA-191-5p promotes the development of osteosarcoma via targeting EGR1 and activating the PI3K/AKT signaling pathway, by B. Chen, Z.-Y. Zheng, J.-Z. Yang, X.-G. Li, published in Eur Rev Med Pharmacol Sci 2019; 23 (9): 3611-3620-DOI: 10.26355/eurrev_201905_17783-PMID: 31114985" has been withdrawn from the authors due to some disagreements over the drafting of the manuscript. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/17783.

[Epidemiological characteristic of newly reported HIV/AIDS cases with non-martial and non-commercial heterosexual behaviors in Zhejiang province, 2017-2019].

Objective: To understand the epidemiological characteristics and transmission routes of newly reported HIV/AIDS cases with non-martial and non-commercial (NMNC) heterosexual behaviors in Zhejiang province. Methods: A retrospective survey was conducted among HIV/AIDS cases that had NMNC heterosexual behavior history and diagnosed with HIV infection in Zhejiang between January 1st, 2017 and September 30th, 2019. The multiple correspondence analysis (MCA) was used to explore the association of social demographic characteristics with NMNC heterosexual partner types in the cases. Results: A total of 406 participants with NMNC heterosexual behaviors before HIV diagnoses were recruited in this study. Most of them were males (67.2%, 273/406), aged 25-49 years at HIV diagnoses (59.1%, 240/406). Prior to HIV infection confirmation, 36.0% (146/406) participants only had casual sexual partners, 52.0% (211/406) only had regular sexual partners, and 12.0% (49/406) had both. Statistical differences in marital status, occupation and income level were found among participants with different types of NMNC heterosexual partners (all P<0.05). Result of MCA indicted that monthly income ≤3 000 yuan RMB, self-employed, being married were only associated with casual NMNC heterosexual partner; working in service industry, education level of junior high school were only associated with regular heterosexual partner; working in enterprise, high school education level or above, monthly income ≥5 000 yuan RMB were associated with both casual and regular sexual partner. Conclusion: The HIV/AIDS cases with NMNC heterosexual behaviors before HIV diagnoses accounted for a large proportion in Zhejiang province during 2017-2019. Active intervention efforts should be made to improve the health awareness of the public to reduce the risk behaviors for HIV transmission.

[Explorative study of the immobilizing effect of full-thickness skin subcutaneous grafting on allogeneic full-thickness skin graft in rats].

Objective: To investigate the immobilizing effect of full-thickness skin subcutaneous grafting on allogeneic full-thickness skin graft in rats. Methods: The experimental research method was used. The inbred male Brown-Norway rats (n=10) and Lewis rats (n=10) were used as donors and recipients respectively. After subcutaneously full-thickness separation of a 2.2 cm×2.2 cm area on the nape of the recipient rat, a full-thickness skin of 2.0 cm×2.0 cm taken from the abdomen of the donor rat was subcutaneously grafted, and the donor site was pulled together and sutured. The autologous skin over the allograft in the recipient rat was excised 5-6 d after grafting, and the stitches were removed 7 d after excision. Within 2 months after grafting, the feeding, activity, and survival of the donor and recipient rats, behavior of tearing and scratching the wounds of the recipient rats, the wound condition after autologous skin excision in recipient rats, and the survival and hair growth of the grafted allogeneic skin were observed. Results: Within 2 months after grafting, the donor and recipient rats all ate normally and could move freely with no abnormal death. No tearing or scratching of the wounds occurred in recipient rats. There was a small amount of exudation and partial epidermal desquamation after autologous skin excision in recipient rats. All transplanted allografts survived, which were free of infection and necrosis, with new hairs growing out smoothly. Conclusions: The immobilizing method of full-thickness skin subcutaneous grafting of allogeneic full-thickness skin graft in rats is simple and time-saving without postoperative dressing change, with reliable pressure fixation and high survival rate of skin grafts, which can be promoted for animal skin grafting models.

MicroRNA-191-5p promotes the development of osteosarcoma via targeting EGR1 and activating the PI3K/AKT signaling pathway.

OBJECTIVE: MicroRNA-191 (miR-191) has been reported to be abnormally expressed in human cancers and other diseases. The function of miR-191 was contradictory in different cancers. In the present study, we confirmed the specific function of miR-191-5p in osteosarcoma (OS). PATIENTS AND METHODS: The effects of miR-191-5p on cellular behaviors of OS cells were investigated through MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide) and transwell assay. The quantitative Real-time-polymerase chain reaction (qRT-PCR) was applied to examine the expressions of miR-191-5p and early growth response gene 1 (EGR1). Western blot and immunocytochemical assay were used to detect the protein expression of EGR1. The binding relationship between miR-191-5p and EGR1 was confirmed by Dual-Luciferase reporter gene assay. Xenograft tumor formation assay was conducted to examine the in vivo effect of miR-191-5p on tumor growth of OS. RESULTS: MiR-191-5p was upregulated in OS tissues, which was related to poor prognosis of OS patients. Moreover, miR-191-5p promoted cell proliferation, migration and invasion by regulating EGR1 in OS. Furthermore, EGR1 was downregulated in OS tissues, which was associated with poor prognosis of OS patients. MiR-191-5p was found to promote epithelial-mesenchymal transition (EMT) and PI3K/AKT pathway, thus promoting the development of OS. CONCLUSIONS: MiR-191-5p promoted the development of OS via targeting EGR1 and positively regulated the PI3K/AKT signaling pathway.

MiR-550a-3p promotes non-small cell lung cancer cell proliferation and metastasis through down-regulating TIMP2.

OBJECTIVE: MicroRNAs (miRNAs) have been identified to play a crucial regulatory role in the development and progression of malignant tumors, including lung cancer. However, the function of miR-550a-3p on the progression of non-small cell lung cancer (NSCLC) remains poorly understood. PATIENTS AND METHODS: Quantitative Real-time polymerase chain reaction was employed to estimate the expression level of miR-550a-3p in NSCLC tissue and cell samples. Cell proliferation was measured by using MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide) and colony formation assays. Transwell assay was recruited to demonstrate the abilities of cell invasion and migration. Luciferase analysis and Western-blot assay were performed to elucidate the underlying mechanism of miR-550a-3p in NSCLC. RESULTS: The level of miR-550a-3p expressed in NSCLC tissues was significantly higher than that in para-tumor control tissues. Over-expression of miR-550a-3p significantly promoted proliferation, invasion, and migration of A549 cells while knockdown of miR-550a-3p inhibited growth and metastasis of H460 cells. TIMP2 was verified as a direct target of miR-550a-3p in NSCLC. Restoration of TIMP2 rescued the influence of miR-550a-3p over-expression. CONCLUSIONS: We demonstrated that miR-550a-3p regulated the progression of NSCLC cells through TIMP2. Thus, miR-550a-3p axis could serve as a potential therapeutic target for NSCLC treatment.

[Sources and characteristics of newly reported HIV/AIDS cases in Yiwu, Zhejiang province, 2015-2016].

Objective: To understand the sources and characteristics of newly reported HIV/AIDS cases in Yiwu, Zhejiang province, from 2015 to 2016. Methods: From January 1, 2015 to December 31, 2016, newly reported HIV/AIDS cases in Yiwu were recruited in the study and they were asked to complete an in-depth field epidemiology questionnaire. Information related to their previous sexual behaviors and infection sources or routes were collected in the survey. The data were processed and analyzed with EpiData 3.0 and SPSS 19.0 software. Results: A total of 320 participants from 393 newly reported HIV/AIDS cases in Yiwu during this period were surveyed and recruited in the study. Most of them were males (268, 83.8%), unmarried (141, 44.1%), aged between 25-44 years (166, 51.9%), had census register in other provinces (217, 67.8%) and educational level of junior high school (128, 40.0%). Among 305 cases whose infection times could be determined, 107 (35.1%) were newly infected within one year, and among 267 cases whose infection location could be determined, 200 (74.9%) were infected in Yiwu. New infections were mainly detected in those who had homosexual behaviors or causal sex partners (during the past year) and through active detection approach. Local infections were mainly among those who had local residence and commercial heterosexual behavior in Yiwu. Conclusions: Most newly reported HIV/AIDS cases in Yiwu from 2015-2016 were infected for more than one year and locally infected. Census registration of other provinces, homosexual sexual behavior, and casual sexual behavior give major contribution to HIV/AIDS epidemic in Yiwu.

Electrochemical characteristics of amorphous silicon carbide film as a lithium-ion battery anode.

The electrochemical reactions of SiC film with Li+ have been investigated by electrochemical characterization and X-ray photoelectron spectroscopy. The SiC film is prepared by inductively-coupled-plasma chemical-vapor-deposition (ICP-CVD) technique and displays an amorphous state due to the low processing temperature (∼350 °C). An irreversible reaction of SiC with Li+ occurs with the formation of lithium silicon carbide (Li x Si y C) and elemental Si, followed by a reversible alloying/dealloying reaction of the elemental Si with Li+. The 500 nm SiC film shows an initial reversible specific capacity of 917 mA h g-1 with a capacity retention of 41.0% after 100 cycles at 0.3C charge/discharge current, and displays much better capacity retention than the Si film (5.2%). It is found that decreasing the SiC thickness effectively improves the specific capacity by enhancing the reaction kinetics but also degrades the capacity retention (for 250 nm SiC, its initial capacity is 1427 mA h g-1 with a capacity retention of 25.7% after 100 cycles). The better capacity retention of the 500 nm SiC anode is mainly because residual SiC exists in the film due to its incomplete reaction caused by its lower reaction kinetics, and it has high hardness and can act as a buffer matrix to alleviate the anode volume change, thus improving the mechanical stability and capacity retention of the SiC anode.

[Molecular epidemiology and transmission of HIV-1 infection in Zhejiang province, 2015].

Objective: To understand the distribution of HIV-1 subtype diversity and its transmission characteristics in Zhejiang province. Methods: A total of 302 newly diagnosed HIV-1 positive patients were selected through stratified random sampling in Zhejiang in 2015. HIV-1 pol genes were sequenced successfully with reverse transcription PCR/nested PCR and phylogenetic analysis was conducted for 276 patients. Then a molecular epidemiologic study was performed combined with field epidemiological investigation. Results: Of 276 sequence samples analyzed, 122 CRF07_BC strains (44.2%), 103 CRF01_AE strains (37.3%), 17 CRF08_BC strains (6.1%), 9 B strains (3.2%), 6 CRF55_01B strains (2.2%), 5 C strains (1.8%), 1 CRF59_01B strain (0.4%), 1 CRF67_01B strain (0.4%), 1 A1 strain (0.4%), and 11 URFs strains (4.0%) were identified. Phylogenetic analysis revealed 16 clusters with only 15.1% (34/225) sequences involved among CRF07_BC and CRF01_AE strains. The clustered cases in MSM were higher than that in populations with other transmission routes. And clusters existed between the populations with different transmission routes. Conclusion: The major strains of HIV-1 in Zhejiang are CRF07_BC and CRF01_AE. The HIV subtypes showed more complexity in Zhejiang. It is necessary to strengthen the surveillance for HIV subtypes, carry out classified management and conduct effective prevention and control in the population at high risk.

[Analysis on HIV-1 subtypes and transmission clusters in newly reported HIV/AIDS cases in Yiwu, Zhejiang Province, 2016].

Objective: To understand the characteristics of distribution on HIV-1 subtypes and the transmission clusters in Yiwu in Zhejiang province. Methods: A cross-sectional study of molecular epidemiology was carried out on newly reported HIV/AIDS cases in Yiwu. RNA was extracted from 168 plasma samples, followed by RT-PCR and nest-PCR for pol gene amplification, sequencing, phylogenetic tree construction used for analyzing the subtypes and transmission clusters. Mutations on drug resistance was analyzed by CPR 6.0 online tool. Results: Subjects were mainly males (86.3%, 145/168), with average age as (39.1±13.4) years old and most of them were migrants (66.7%, 112/168). The major routes of transmission included homosexual (51.2%, 86/168) and heterosexual (48.8%, 82/168) contacts. The rate of success for sequence acquisition was 89.9% (151/168). The dominant subtypes showed as CRF01_AE (74, 49.0%) and CRF07_BC (64, 42.4%), followed by CRF08_BC (5, 3.3%), CRF55_01B (3, 2.0%), each case of subtype B, CRF45_cpx, CRF59_01B, CRF85_BC and URF (B/C). CRF45_cpx and CRF85_BC were discovered the first time in Zhejiang province. Twenty-six transmission clusters involving 65 cases were found, with the total clustered rate as 43.0% (65/151), in which the CRF01_AE clustered rate appeared as 54.1% (40/74), higher than that of CRF07_BC (21/64, 32.8%). The average size of cluster was 2.5 cases/cluster, with average size of cluster in CRF01_AE patients infected through heterosexual transmission as the largest (3.5 cases/cluster). The prevalence of transmitted drug resistance was 4.6% (7/151). Seven cases with surveillance drug resistant mutations (SDRM) were found, including 5 cases of M46L (3.3%), and one case of F77L or Y181C. Conclusion: HIV genetic diversity and a variety of transmission clusters had been noticed in this study area (Yiwu). Programs on monitoring the subtypes and transmission clusters should be continued and strengthened.

[Analysis on antiretroviral therapy efficacy for HIV/AIDS in Zhejiang province, 2009-2014].

OBJECTIVE: To analyze the efficacy of highly active antiretroviral therapy(HAART)for HIV/AIDS in Zhejiang province from 2009 to 2014. METHODS: A retrospective cohort study was conducted among patients with access to HAART aged <15 years from 2009 to 2014 through descriptive epidemiological analysis on the patients' demographic characteristics, HAART efficacy. The immune recovery Kaplan-Meier curves were drawn by using baseline CD(4) T lymphocytes cell(CD(4))data. The influencing factors for virus suppression were analyzed by using logistic regression model. RESULTS: There were 9 594 patients with access to HAART in Zhejiang from 2009 to 2014. The' average age of the patients was 38.7 years old, the male to female ratio was 4.11∶1. Heterosexual(55.9%)and homosexual(40.0%)contacts were the main transmission routes. Baseline CD(4) count 200-349 cells/µl was found in 45.4% of the patients, the median of the CD(4) count was 221(IQR: 123-298). The median of time for CD(4) recovery in patients with baseline CD(4) count <200 cells/µl was 3.48 and 11.58 times higher than the patients with baseline CD(4) count 200-349 cells/µl and baseline CD(4) count ≥350 cells/µl. Univariate and multivariate logistic regression analyses showed that marital status, HAART regimen, treatment miss in last week and CD(4) recovery were major influencing factors for HAART efficacy. CONCLUSIONS: HAART had good treatment effecacy in HIV/AIDS patients in Zhejiang. The baseline CD(4) count and adherence to HAART were the most important influencing factors. It is recommended to take measures to expand HIV screening and HAART coverage, conduct HAART adherence education, and strengthen the special care for high-risk groups to improve the HAART efficacy in Zhejiang province.

[Willingness for HIV test and associated factors among 535 college students who had sex in Zhejiang province].

Objective: To understand the willingness of HIV test uptake and associated factors among sexual active college students. Methods: A cross-sectional study were conducted among college students from 11 cities in Zhejiang province, and those who had sexual behaviors were included in this study. Results: A total of 9 615 students completed the questionnaire, and 6.5% (619/9 468) of them had sexual behaviors. A total of 535 students were recruited in this study. And 77.2% of them were willing to receive HIV test. Hospitals and CDC were commonly accepted testing sites. Being sophomore and junior (aOR=2.618, 95%CI: 1.511-4.536), being aware of rapid growing HIV epidemic among students who are men who have sex with men (MSM) (aOR=1.879, 95%CI: 1.153-3.060) and being aware of HIV infection risk (aOR=1.701, 95% CI: 1.041-2.780) were associated with HIV test willingness. Conclusions: Future effort should be made to increase the awareness of HIV infection, including the severity of AIDS epidemic in college students and infection source, in order to increase their willingness to receive HIV test. School-based HIV counsel and test sites should be set up to provide convenient and private HIV test service.