新疆吸毒人群第二轮艾滋病相关危险行为监测调查分析

目的了解新疆吸毒人群艾滋病相关高危行为和知识知晓现状及变化趋势,为制定有效干预措施、评估干预措施效果提供依据.方法选择乌鲁木齐、伊犁、昌吉和阿克苏4个吸毒情况较严重地、州的吸毒人群作为调查对象,以地、州为单位,按上轮行为监测调查所获的共用针具比例计算本轮监测调查样本量,再按吸毒人口构成比分配每个地、州所辖重点县、市、区调查人数.现场调查采取面对面匿名问卷调查形式. 结果 70.9% 的吸毒者为注射吸毒者,其最近一次的共用针具比例和最近6个月的共用针具比例(有时共用和经常共用)分别为28.9%和37.16%,有地区和民族差异(P<0.05).近6个月共用针具比例较2001年有所下降;吸毒者与其配偶或性伴最近一次性生活时的安全套使用率和最近6个月的安全套使用率(有时使用、经常使用和每次使用)分别为19.2%和25.51%,有民族差异(P<0.05);艾滋病相关态度和传播途径知晓率均较2001年有所改进和提高. 结论与2001年相比,吸毒人群艾滋病相关知识知晓率有所提高,共用针具比例有所下降,针对吸毒人群的干预工作已显现一定效果,但仍需加大干预力度;吸毒人群与其配偶或性伴的安全套使用率极低, HIV从高危人群向一般人群传播的潜在风险很大.减少毒品危害和安全套推广是今后开展吸毒人群干预的两项关键措施,缺一不可.     

新疆喀什地区2004年艾滋病综合调查分析

目的摸清各类人群艾滋病病毒（HIV）感染率和行为学指标,弥补监测数据不足,掌握喀什地区艾滋病（AIDS）流行现状,为制定可行的防治策略提供科学依据.方法随机抽取吸毒者、暗娼、性病门诊就诊者、孕产妇和调查时医院就诊者等5类人群,进行行为危险因素问卷调查和HIV抗体、梅毒和吸毒人群的丙型肝炎病毒（HCV）抗体检测.结果调查的400名吸毒者中,注射吸毒者占36.75%,近1个月内的共用针具率为15%.吸毒者最近一次与其配偶或性伴有性行为时安全套的使用率仅为10.78%,其HIV、HCV和梅毒感染率分别为24.25%、42.00%和42.25%,共用注射器吸毒者的HIV、HCV感染率均高于非共用者.暗娼、性病患者、孕产妇和调查时医院就诊者的HIV和梅毒感染率分别为0.67%和8.00%、0和5.75%、0.12%和4.61%、0.19%和1.45%.被调查人群艾滋病知识水平较低,普遍存在高风险行为.结论当地吸毒人群艾滋病的流行处于较高水平,流行的危险因素广泛存在,扩大流行的可行性极大.     

新疆塔城地区2005年高危人群艾滋病综合调查分析

目的 了解塔城地区各类高危人群艾滋病(HIV)感染率和行为学指标,并掌握艾滋病流行现状,为防治策略提供资料依据.方法 在调查期间,尽可能对社区吸毒者、暗娼、性病门诊就诊者、收教羁押人员,即往有偿采血人员及可能找到的已感染者的配偶及子女,进行行为危险因素问卷调查和HIV抗体检测.结果 在调查的65名吸毒者中,注射吸毒占24.62%;最近一次共用注射器率为26.67%,吸毒者最近一次与其配偶或性伴有性行为时安全套使用率为23.53%,暗娼及性病门诊就诊患者安全套使用率较高;被调查人群中艾滋病知识水平较底,自我防护意识较差.结论 本地区艾滋病流行水平较低,但危险因素广为存在,进一步流行的可能性依然存在.     

2004年深圳市艾滋病哨点监测分析

目的 为了解深圳市高危人群中艾滋病流行趋势及危险因素,为决策部门评估深圳市艾滋病防治工作效果及制定防治策略措施提供科学依据.方法 2004年在深圳市分别对245名暗娼、1 100名性传播疾病（STD）门诊就诊者和852名吸毒哨点进行HIV哨点监测的对象,应用酶联免疫吸附试验（ELISA）对样本进行HIV筛查.结果2004年,STD门诊就诊者主要为男性和已婚的省外流动人员,其STD的病种构成以非淋、梅毒、尖锐湿疣等溃疡性性病为主,检出HIV抗体阳性者3例,检出率为0.27%（3/1100）;暗娼主要为未婚的省外流动人员,安全套使用率分别为73.9%,0.8%的暗娼为吸毒者,无静脉吸毒和共用注射器史,在两轮监测中,未检出HIV抗体阳性者,感染率为0;吸毒人群主要为未婚的省外流动人员,安全套使用率为27.7%,66.3%的吸毒者承认曾接受/提供有偿性服务,55.5%采用静脉吸毒和共用注射器,检出HIV抗体阳性者10例,感染率为1.2%.结论 监测结果表明,HIV在深圳市性病患者、吸毒者等高危人群中流行,存在HIV传播的多种危险性因素.     

湖南省吸毒人群中HIV感染及其危险因素调查

目的 了解湖南省吸毒人群HIV感染及其相关危险因素,为制定预防吸毒传播HIV提供依据。方法 采用血清流行病学和问卷方法,对湖南四地戒毒所809名吸毒者进行调查。结果 检出HIV感染者23例,HIV感染与共用注射器、每日吸毒的频率、职业、共用注射器对象不固定、经济状况和艾滋病知识缺乏有一定关系。结论 在吸毒人群中应加强健康知识教育和行为干预。     

吸毒人群和美沙酮维持治疗人群AIDS高危行为干预效果评价

在吸毒人群中开展艾滋病(AIDS)行为干预尤其重要.流行病学调查显示,现有的艾滋病病毒(HIV)感染者和AIDS病人中,经共用注射器静脉注射毒品传播占44.3%.通过对吸毒人群采取综合干扰措施,提高了静脉吸毒人群艾滋病防治知识,降低了危险行为,效果明显.现将干预情况总结如下.     

社区多资源参与的减少吸毒人群HIV感染危险行为干预模式及效果研究

目的探索社区多资源开展减少吸毒人群艾滋病病毒（HIV）感染危险行为干预模式,评价其效果。方法由卫生医药部门、公安部门、街（村）委和吸毒人群共同参与。干预活动主要是健康教育,免费提供和销售注射器,改变吸毒人群不安全注射行为和性行为。结果建立了社区多资源参与的减少吸毒人群HIV感染危险行为的干预模式。干预后,吸毒人员对艾滋病传播途径和预防知识的知晓率分别提高约35%和23%;吸毒注射次数明显减少,共用针具、共用清洗水和共用容器或棉球比例分别下降了49.93%、46.84%和81.08%。性伴数量减少,性伴有吸毒者的比例下降30%。结论社区多资源参与开展减少吸毒人群HIV感染危险行为干预可行,有效。     

2009～2011年新疆巴音郭楞蒙古自治州少数民族静脉吸毒人群哨点监测分析

目的分析新疆巴音郭楞蒙古自治州(巴州)少数民族静脉吸毒人群相关行为变化特征及艾滋病知识的知晓情况,为开展综合干预工作提供依据。方法采用国家艾滋病哨点监测方案对2009～2011年巴州戒毒所吸毒人员进行问卷和血清学调查。结果 2009～2011年监测结果表明,高危行为总体水平变化不大;少数民族静脉吸毒人群最近一个月注射吸毒共针率为44.4%,最近一次商业性行为安全套使用率为56.49%,艾滋病防治知识知晓率为54.73%,接收有关预防艾滋病服务率27.54%～40.10%,HIV抗体阳性率8.6%,梅毒抗体阳性率5.0%,HCV抗体阳性率19.8%。结论巴州少数民族静脉吸毒人群共针率较高,安全套使用率、艾滋病知识知晓率较低,这一人群存在共用注射器和性乱行为感染HIV的双重危险,对该人群的行为干预还要进一步加强。     

苏州市强制戒毒人群HIV梅毒HCV感染情况与相关行为调查

目的了解苏州市强制戒毒人群艾滋病病毒(HIV)、梅毒及丙型肝炎病毒(HCV)感染状况及相关因素,为在该人群中开展监测和行为干预提供依据。方法 2010年4月和7月,分两次对苏州市强制戒毒所内所有吸毒者进行调查。结果 460名强制戒毒人员的HIV感染率为0.43%(2/460),梅毒感染率为13.26%(61/460),HCV感染率为47.17%(217/460)。吸毒者中注射吸毒比例为44.13%(203/460),其中有过与别人共用注射器吸毒的比例为36.45%(74/203)。共用注射器吸毒人群HIV、HCV感染率与其他吸毒人群感染率有显著性差异。42.17%(194/460)的吸毒者有商业性行为,最近一次使用安全套的只有39.69%(77/460)。结论苏州市强制戒毒所内的吸毒者HIV感染率较低,但梅毒和HCV感染率较高,共用注射器吸毒是HIV和HCV感染的高危因素,不安全的性行为增加了HIV、梅毒等性传播疾病向一般人群传播的机会,应对吸毒人群开展有针对性的干预措施。     

福建省吸毒人群中HIV感染情况及其危险因素分析

目的分析和探讨福建省吸毒人群中艾滋病病毒(HIV)流行情况及其相关危险行为。方法在福州市、泉州市和厦门市设立吸毒者艾滋病监测哨点,通过社区药物维持治疗门诊和强制戒毒所招募监测对象,收集吸毒者血清学和行为学相关信息。结果福州市、泉州市和厦门市吸毒人群中估计HIV感染率和95%可信区间(CI)分别为0.5%(95%CI:0.087～1.995)、0.5%(95%CI:0.087～1.995)和0(95%CI:0.022～1.143)。吸毒者艾滋病防治知识知晓率为80.3%,而且随着文化程度的提高,其知识知晓率也在不断增加。Logistic回归分析表明,与外省籍吸毒者相比,福建籍吸毒者曾经共用注射器吸毒的比值比(OR)是0.543(95%CI:0.327～0.900);与社区吸毒者相比,强制戒毒所中吸毒者曾经共用注射器吸毒的OR值是6.181(95%CI:3.611～10.582)。结论福建省吸毒人群中存在一些HIV蔓延扩散的危险因素,必须密切关注吸毒人群中相关危险行为的动态变化情况,采取积极有效的干预措施。     

Three layer functional model and energy exchange concept of aging process

Relying on a certain degree of abstraction, we can propose that no particular distinction exists between animate or living matter and inanimate matter. While focusing attention on some specifics, the dividing line between the two can be drawn. The most apparent distinction is in the level of structural and functional organization with the dissimilar streams of ‘energy flow’ between the observed entity and the surrounding environment. In essence, living matter is created from inanimate matter which is organized to contain internal intense energy processes and maintain lower intensity energy exchange processes with the environment. Taking internal and external energy processes into account, we contend in this paper that living matter can be referred to as matter of dissipative structure, with this structure assumed to be a common quality of all living creatures and living matter in general. Interruption of internal energy conversion processes and terminating the controlled energy exchange with the environment leads to degeneration of dissipative structure and reduction of the same to inanimate matter, (gas, liquid and/or solid inanimate substances), and ultimately what can be called ‘death.’ This concept of what we call dissipative nature can be extended from living organisms to social groups of animals, to mankind. An analogy based on the organization of matter provides a basis for a functional model of living entities. The models relies on the parallels among the three central structures of any cell (nucleus, cytoplasm and outer membrane) and the human body (central organs, body fluids along with the connective tissues, and external skin integument). This three-part structural organization may be observed almost universally in nature. It can be observed from the atomic structure to the planetary and intergalactic organizations. This similarity is corroborated by the membrane theory applied to living organisms. According to the energy nature of living matter and the proposed functional model, the decreased integrity of a human body's external envelope membrane is a first cause of the structural degradation and aging of the entire organism. The aging process than progresses externally to internally, as in single cell organisms, suggesting that much of the efforts towards the restoration and maintenance of the mechanisms responsible for structural development should be focused accordingly, on the membrane, i.e., the skin. Numerous reports indicate that all parts of the human body, like: bones, blood with blood vessels, muscles, skin, and so on, have some ability for restoration. Therefore, actual revival of not only aging tissue of the human body's membrane, but the entire human body enclosed within, with all internal organs, might be expected. We assess several aging theories within the context of our model and provide suggestions on how to activate the body's own anti-aging mechanisms and increase longevity. This paper presents some analogies and some distinctions that exist between the living dissipative structure matter and inanimate matter, discusses the aging process and proposes certain aging reversal solutions.     

Unusual responses of nocturnal pineal melatonin synthesis and secretion to swimming: Attempts to define mechanisms

Abstract: The effect of swimming at night on rat pineal melatonin synthesis was compared with that of light exposure at night. Rats were forced to swim at 0030 hr (lights out at 2000 hr) and sacrificed by decapitation 15 and 30 min later, immediately after swimming. Other groups of animals were exposed to white light (650μW/cm²) for 15 and 30 min at same time. Swimming caused a rapid and highly significant drop in the melatonin content in the pineal gland; however, the activity of N-acetyltransferase (NAT), the supposed rate limiting enzyme in the melatonin production, was not changed. Despite the drop in pineal melatonin levels, serum concentrations of the indole remained elevated in the rats that swam. In contrast, melatonin levels in the pineal and serum of light exposed rats fell precipitously, accompanied by a significant suppression of NAT activity. Since we anticipated that the strenuous exercise associated with swimming may induce release of artrial natriuretic peptide (ANP) from the heart, which in turn could cause the release of pineal melatonin, in a second study we injected physiological saline intravenously to stretch the cardiac muscle and release ANP. Three milliliters of normal saline was injected during the day into the jugular vein of anesthetized rats that were pretreated with isoproterenol to stimulate pineal melatonin production. Animals were killed 15 min after the saline injection, and pineal NAT activity and pineal melatonin levels were measured. The saline injections caused no alteration in the elevated levels of either NAT or melatonin. These data suggest that the disparity in pineal NAT activity (which was high) and pineal melatonin (which was low), in animals swum at night, may not be caused by ANP which is released during strenuous exercise such as swimming.     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Melatonin and photoperiodic time measurement: Seasonal breeding in the sheep

Abstract: Well-established circadian physiology supports the view that photoperiodic time measurement utilizes the coincidence between the presence of light and a photosensitive phase of a 'biological clock' to alter reproductive status—the so-called external coincidence model of seasonal breeding. In this review, we examine the mechanism whereby photoperiod interacts with presumed suprachiasmatic nuclei activity to allow endogenous melatonin to normally synchronize reproductive activity to the optimal time of year. The Romney Marsh sheep is particularly explored as an experimental model. It is suggested that the on/off activity of seasonal reproduction may be a robust mechanism able to be predictably manipulated by the judicious use of the light/dark cycle and exogenous melatonin, but firmly based on circadian principles.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Language of CTO interventions – Focus on hardware

The knowledge of variety of chronic total occlusion (CTO) hardware and the ability to use them represents the key to success of any CTO interventions. However, the multiplicity of CTO hardware and their physical character and the terminology used by experts create confusion in the mind of an average interventional cardiologist, particularly a beginner in this field. This knowledge is available but is scattered. We aim to classify and compare the currently used devices based on their properties focusing on how physical character of each device can be utilized in a specific situation, thus clarifying and simplifying the technical discourse.