宁波鄞州地区男男性接触人群艾滋病知晓率及感染状况调查分析

目的:了解宁波市鄞州区2011至2014年男男性接触(MSM)人群艾滋病防治知识知晓率、相关高危行为情况及艾滋病感染状况,为制定防治策略提供依据。方法:通过"滚雪球"法招募到样本,对MSM人群进行问卷调查,并进行HIV、梅毒的血清学检测。结果:2011至2014年共调查MSM 345人,年龄分布以20~49岁年龄段为主,占95.9%;婚姻状况以未婚为主,有223人,占64.6%;文化程度以大专及以上为主。调查对象对艾滋病防治知识知晓率较高,且总体呈上升趋势。2011至2014年HIV阳性检出率介于2.9%~12.5%之间,梅毒抗体阳性检出率介于4.5%~11.8%之间。结论:我区MSM人群艾滋病流行形势较为严峻,改变该人群知识行为偏离的现象,提高其安全性行为,才能有效地降低艾滋病在该人群中的流行。     

广州市520名男男性行为者HIV感染情况及影响因素分析

目的:了解广州市男男性行为者(MSM)的艾滋病知识、高危行为以及艾滋病、梅毒感染情况及影响因素,为针对性开展MSM人群艾滋病防治工作提供依据。方法:面对面问卷调查520名MSM人群的艾滋病知识、行为情况,并进行艾滋病、梅毒血清学检测。结果:艾滋病知识知晓率为90.19%(469/520);HIV抗体阳性率为9.23%(48/520),梅毒阳性检出率为5.77%(30/520);最近六个月同性肛交性行为时每次均用安全套比例为53.81%(240/446);多因素logistic回归分析结果显示,感染了性病[OR=3.333,95%CI:(1.146~9.696)]、最近六个月与同性发生肛交性行为使用安全套的频率较少[OR=3.460,95%CI:(1.770~6.763)]是HIV感染的危险因素(P0.05)。结论:广州市MSM人群艾滋病知识知晓率高、安全套使用率低、知行分离严重,艾滋病、梅毒感染率高,应加强有效的干预检测和性病诊治。     

建筑工地男性农民工艾滋病防治知识及性行为调查

目的：了解贵阳市2011年至2013年建筑工地男性农民工艾滋病防治知识、性行为情况及HIV、HCV和梅毒感染率。方法：采用整群随机抽样的方法对建筑工地1203名男性农民工进行问卷调查及HIV、HCV和梅毒检测。结果：2011年至2013年艾滋病知晓率分别为29.1%、42.1%、52.5%。年龄20～39岁、未婚、高文化程度者知晓率较高。感染HIV高危行为发生普遍,最近1年与暗娼每次都用安全套的分别为22.2%、16.7%、64.0%;最近1年与临时性伴每次用安全套的分别为27.3%、22.2%、17.9%;梅毒感染率2.5%、0.7%、1.0%;HCV感染率0.2%、0.5%、0.3%,2011年发现1例HIV阳性。结论：贵阳市建筑工地男性农民工知晓率和安全套使用率较低,今后要加强该人群宣传、干预及监测力度。     

天津市2011～2014年15～24岁人群HIV流行特征分析

目的:分析天津市2011~2014年15~24岁人群HIV的流行趋势,为在该人群中开展相关控制措施提供依据。方法:分析2011~2014年天津市监测中新发现的15~24岁HIV/AIDS病例情况,以及15~24岁男男性行为人群、青年学生横断面调查数据。结果:新发现HIV/AIDS病例中,15~24岁病例占有一定比例,并且2011~2014年病例报告显示15~24岁病例报告数量年均增长速度较同期全年病例报告数量年均增长快。15~24岁病例中男性占96.1%,流动人口占60.2%,高中及以上文化程度占87.1%,同性传播占84.7%,专项调查及检测咨询来源的病例所占的比例较高。横断面调查显示青年学生艾滋病知识知晓率的中位数为77.5%;15~24岁男男性接触者最近6个月同性发生肛交比例中位数为90.2%,最近一次肛交性行为安全套使用比例中位数为74.1%,最近6个月肛交性行为时每次都使用安全套的比例为34.9%,梅毒检出率的中位数为6.2%,HIV检出率的中位数为4.8%。结论:天津市15~24岁人群HIV流行形势严重,15~24岁男男性行为人群中危险行为比例高,HIV、梅毒感染率高,急需采取有效措施控制HIV在低年龄组人群中的传播。     

秦皇岛市男男性行为者艾滋病相关知识行为现状及血清学检测结果分析

目的了解秦皇岛市男男性行为者(MSM)知识行为及艾滋病/梅毒/丙肝感染状况,为制定该人群有效的干预措施和防治策略提供依据。方法 2009-2012年采用自愿招募和滚雪球的方法,对寻求艾滋病咨询的MSM进行面对面问卷调查和知情同意血清学检测。结果共有1 043例MSM接受调查,其平均年龄(26.9±7.16)岁,未婚占75.65%,高中及以上文化占84.75%,本地居住超过2年者占72.58%。艾滋病知识知晓率为88.11%。近6个月中86.10%有肛交行为,最近一次肛交安全套使用率69.38%,每次坚持使用安全套率为42.76%,从不使用安全套者主要是未婚大中专院校在校年龄段的学生。参与商业性行为者9.02%,29.82%的人有异性性行为。异性性行为中从不使用安全套者,在婚和同居者占69.70%。近1年中,6.81%报告有性病诊断史。检测发现HIV感染率为5.75%,梅毒感染率7.19%,HCV阳性感染率为0.19%。结论秦皇岛市MSM人群需要加强艾滋病全面相关知识的普及,同时要关注梅毒和丙肝防控宣传和及早发现治疗梅毒以有效降低HIV传播。     

西安地区流动人口艾滋病预防控制情况观察

目的:探究与分析西安地区流动人口艾滋病预防控制情况。方法:对2012年1月至2016年1月西安地区流动人口艾滋病预防控制情况进行调查,于2014年1月对西安地区流动人口实施了艾滋病预防及控制,对比该地区在实施艾滋病预防控制前后流动人口对艾滋病相关知识的知晓率、安全性行为认知情况、不同年龄层艾滋病病毒感染者年龄分布情况。结果:观察组与对照组相比干预艾滋病相关知识掌握情况(听说过艾滋病、艾滋病能否治愈、艾滋病可以预防、现在是否有预防艾滋病的药物、从外表可以看出此人是不是得了艾滋病、自愿接受艾滋病免费检测)人员所占比例均较高,差异具有统计学意义(P0.05)。观察组与对照组相比关于安全套使用情况中(最近一次性行为使用安全套、发生性行为时自动自愿使用安全套、坚持正确的使用安全套、随身携带安全套及同一只安全套不能使用两次)的人员所占比例均较高,差异具有统计学意义(P0.05)。观察组与对照组相比艾滋病发生率均较低,差异具有统计学意义(P0.05)。结论:西安地区在实施艾滋病预防控制后可提高流动人口对艾滋病相关知识的认知度,改善安全性行为,降低各个年龄层艾滋病发生率。     

重庆市门诊就诊嫖娼人群艾滋病知识和行为多中心调查

目的了解重庆市嫖娼者艾滋病相关知识、态度和行为,探索对该人群实施行为干预的模式。方法对重庆市10家医疗机构性病门诊就诊的嫖娼者进行问卷调查,同时采集血液标本进行HIV,梅毒感染状况检测。结果 HIV抗体检出率为1.36%,TPPA阳性检出率为12.26%;514名调查对象艾滋病知识回答正确率相对较低,知晓率为34.63%,51.82%最近1次与暗娼发生性行为时未使用安全套;41.62%近1年有过临时性伴,其中的62.53%与其最近1次发生性行为时未使用安全套。单因素分析结果显示,艾滋病知识知晓率与被调查者的年龄、文化程度、婚姻状况、是否存在歧视态度、最近1次与暗娼发生性行为时使用安全套有关。多因素Logistic回归分析显示,持不歧视态度、文化程度越高者,其艾滋病知识知晓率就越高;与暗娼最近1次性关系时使用安全套者,其知晓率高。结论有必要充分利用性病门诊的有利环境,对该人群开展艾滋病防治行为干预。     

青岛市吸毒者性行为特征及梅毒和艾滋病感染状况调查

目的:了解青岛市新型毒品吸食者的性行为特征并调查梅毒和艾滋病感染状况。方法:问卷调查新型毒品吸食者的性行为特征,并检测HIV和梅毒抗体。结果:共调查吸毒者564名,98.22%以吸食冰毒为主,54.09%最近1年有过临时性伴,55.14%最近1年发生过商业性性行为,15.60%最近1年提供过性服务;最近1个月有过性行为的人最近1次性行为安全套使用率为32.42%;HIV抗体阳性检出率为0.36%,梅毒阳性率为13.19%。结论:该人群以吸食新型毒品为主,梅毒流行率较高,应加强对该人群的宣传教育和行为干预,减少梅毒和艾滋病的发生率。     

离异/丧偶男男性行为者人类免疫缺陷病毒、梅毒感染状况及相关特征分析

目的了解离异/丧偶男男性行为者(MSM)人类免疫缺陷病毒(HIV)、梅毒感染现状,分析其人口学及性行为相关特征。方法采用滚雪球抽样法招募2018年1月至2019年12月江苏省疾病预防控制中心自愿咨询检测(VCT)门诊收取的MSM作为研究对象。采用问卷调查收集相关信息,采集其静脉血进行HIV和梅毒抗体检测。结果共完成合格问卷调查1 458人,其中离异/丧偶66人(4.53%)。离异/丧偶MSM的HIV感染率为24.24%,HIV合并梅毒现症感染率为3.03%,均高于其他婚姻状况,差异具有统计学意义(P0.05)。≥40岁、大专及以上文化程度以及自我认同为同性恋性取向的离异/丧偶发生率较高,差异具有统计学意义(P0.05)。离异/丧偶MSM最近6个月与同性发生肛交性行为时每次都用安全套的占33.33%,最近6个月中最近1次与同性固定性伴发生肛交性行为时使用安全套的占56.82%。78.79%知道国家有免费艾滋病检测政策,53.03%最近1年没有做过HIV检测,差异具有统计学意义(P0.05)。结论离异/丧偶MSM年龄较大,文化程度较高,艾滋病高危行为明显,是艾滋病防控的重点人群。     

上海市嘉定区性病门诊就诊者艾滋病高危行为特征及血清学监测结果分析

目的了解嘉定区性病门诊就诊者性病艾滋病知识、行为和态度,以及艾滋病/梅毒感染情况。方法对性病门诊就诊者进行问卷调查,同时采集血样进行HIV及梅毒血清学检测。结果共调查性病门诊就诊者437人,2例HIV抗体阳性,66例RPR初筛阳性,占15.1%。调查对象对性、血液、母婴三大传播途径的知晓率分别为89.5%,90.4%和87.4%。最近3个月内,35.9%发生过商业性行为,其中34.6%有1个以上商业性伴,商业性伴平均数(1.52±0.84)个。最近一次发生商业性行为时71.3%没有使用安全套。没有使用安全套的主要原因:51.8%为不愿使用,22.3%身边没有,11.6%忘记使用等。如果以后出现性病相关症状,92.0%会选择性病专科医院或综合性医院进行诊治。结论性病门诊就诊者性病艾滋病知识不足,高危行为的发生率高,安全套使用率低,梅毒检出率高,应加强健康教育,进一步推广安全套使用。     

Outcomes and adverse effects of ablative vs nonablative lasers for skin resurfacing: A systematic review of 1093 patients

It is generally believed that ablative laser therapies result in prolonged healing and greater adverse events when compared with nonablative lasers for skin resurfacing. To evaluate the efficacy of ablative laser use for skin resurfacing and adverse events as a consequence of treatment in comparison to other modalities, a PRISMA‐compliant systematic review (Systematic Review Registration Number: 204016) of twelve electronic databases was conducted for the terms “ablative laser” and “skin resurfacing” from March 2002 until July 2020. Studies included meta‐analyses, randomized control trials, cohort studies, and case reports to facilitate evaluation of the data. All articles were evaluated for bias. The search strategy produced 34 studies. Of 1093 patients included in the studies of interest, adverse events were reported in a total of 106 patients (9.7%). Higher rates of adverse events were described in nonablative therapies (12.2% ± 2.19%, 31 events) when compared with ablative therapy (8.28% ± 2.46%, 81 events). 147 patients (13.4%) reported no side effects, 68 (6.22%) reported expected, transient self‐resolving events, and five (0.046%) presented with hypertrophic scarring. Excluding transient events, ablative lasers had fewer complications overall when compared with nonablative lasers (2.56% ± 2.19% vs 7.48% ± 3.29%). This systematic review suggests ablative laser use for skin resurfacing is a safe and effective modality to treat a range of pathologies from photodamage and acne scars to hidradenitis suppurativa and posttraumatic scarring from basal cell carcinoma excision. Further studies are needed, but these results suggest that ablative lasers are a superior, safe, and effective modality to treat damaged skin.     

New fillers for the new man

ABSTRACT:  Two new collagen-based lidocaine-containing dermal fillers, ArteSense™/ArteFill™ (Artes Medical, San Diego, CA) and Evolence® (Colbar LifeScience Ltd., Herzliya, Israel), have proved to be of particular interest to men, many of whom seek a long-lasting or permanent correction. ArteFill™ has been available in the United States since 2006, and it is expected that Evolence® will reach the American market in 2008. The properties of the two products will be described, and experience based on the administration of many hundreds of syringes of both products by a Canadian dermatologist will be detailed here, with tips and precautions to optimize patient outcomes.     

Genetic alterations in RAS‐regulated pathway in acral lentiginous melanoma

Studies integrating clinicopathological and genetic features have revealed distinct patterns of genomic aberrations in Melanoma. Distributions of BRAF or NRAS mutations and gains of several oncogenes differ among melanoma subgroups, while 9p21 deletions are found in all melanoma subtypes. In the study, status of genes involved in cell cycle progression and apoptosis was evaluated in a panel of 17 frozen primary acral melanomas. NRAS mutations were found in 17% of the tumors. In contrast, BRAF mutations were not found. Gains of AURKA gene (20q13.3) were detected in 37.5% of samples, gains of CCND1 gene (11q13) or TERT gene (5p15.33) in 31.2% and gains of NRAS gene (1p13.2) in 25%. Alterations in 9p21 were identified in 69% of tumors. Gains of 11q13 and 20q13 were mutually exclusive, and 1p13.2 gain was associated with 5p15.33. Our findings showed that alterations in RAS‐related pathways are present in 87.5% of acral lentiginous melanomas.     

Occupational allergic contact dermatitis caused by decorative plants

12 cases of occupational allergic contact dermatitis caused by decorative plants were diagnosed in a 14-year period. The patients were middle-aged, and their average exposure time was 13 years. The plant families and plants causing occupational contact dermatitis were Compositae (5 patients: chrysanthemum, elecampane, gerbera, feverfew), Alstroemeriaceae (5 patients, Alstroemeria ), Liliaceae (4 patients; tulip, hyacinth). Amaryllidaceae (2 patients: narcissus) and Caryophyllaceae (2 patients; carnation, cauzeflower). The known chemical allergens causing dermatitis were tuliposide-A and sesquiterepene lactones, such as alantolactones and parthenolide, in the Liliaceae and Compositae families. 7 of the 12 patients were able to continue their work; 5 were not because of severe relapses of skin symptoms. The plant allergen and extract series currently available are of great help in the diagnosis.     

Deutliche Einschränkung der Lebensqualität bei Patienten mit Pemphigus vulgaris: Ergebnisse der deutschen Bullous Skin Disease (BSD)‐Studiengruppe

Background: Pemphigus vulgaris is a potentially life‐threatening autoimmune disorder of the skin and mucous membranes characterized by antibodies against epidermal adhesion molecules. Clinically characteristic are painful chronic blisters or erosions of mucous membranes and skin. There are no published studies on the impact o this disease on quality of life. Patients and methods: This registration was performed within the scope of the German BSD (Bullous Skin Disease) study group, from November 1997 until January 2002. A total of 36 patients with the first diagnosis of pemphigus vulgaris were registered at the university hospitals of Dresden, Erlangen, Kiel, Mannheim, München and Würzburg. Thirty of the 36 (83 %) patients participated in the quality of life questionnaire utilizing the German version of ‘Dermatology Life Quality Index’ (DLQI) provided by A. Y. Finlay. The DLQI varies from 0 to 30 with an increased DLQI score indicating a decrease in quality of quality. Results: The overall DLQI total score of 10 ± 6,7 in the investigated pemphigus patients was significantly increased in comparison to other skin diseases. Conclusions: These results suggest that the DLQI can be a very useful additional outcome criteria for clinical studies with pemphigus vulgaris and in the treatment of these patients.