男男性行为人群HIV暴露后预防服务的使用意愿调查

目的 分析MSM对HIV暴露后预防（PEP）服务的使用意愿及其相关因素。方法 采用横断面调查方法,2019年9-11月通过“i卫士”微信公众号招募年龄≥18岁、最近6个月发生同性肛交或口交的男性为研究对象。结果 研究对象MSM共1 517人,听说过PEP服务的研究对象占72.5%（1 100/1 517）,PEP服务的使用意愿为87.9%（1 333/1 517）。多因素logistic分析结果显示,更愿意使用PEP服务的因素包括年龄>25岁（OR=1.807,95%CI：1.090~2.995）、曾经做过HIV检测（OR=1.953,95%CI：1.171~3.256）、至少了解1条PEP知识（OR=2.163,95%CI：1.468~3.186）;不了解性伴HIV感染状况者（OR=0.602,95%CI：0.407~0.890）的PEP服务的使用意愿较低。在听说过PEP服务的MSM中,更愿意使用PEP服务的因素包括居住地为浙江省（OR=1.942,95%CI：1.097~3.438）、年龄>25岁（OR=2.431,95%CI：1.331~4.439）、至少了解1条PEP知识（OR=3.714,95%CI：1.532~9.007）、通过MSM社区组织/志愿者/卫生专业机构了解PEP服务（OR=1.902,95%CI：1.096~3.301）。结论 MSM对PEP服务的使用意愿较高,年龄、PEP知识、是否了解性伴HIV感染状况是其相关因素。MSM社区组织、志愿者及卫生专业机构是开展PEP服务宣传和推广的重要途径。     

Risk factors for measles virus infection and susceptibility in persons aged 15 years and older in China: A multi-site case-control study, 2012–2013

IntroductionEndemic measles persists in China, despite >95% reported coverage of two measles-containing vaccine doses and nationwide campaign that vaccinated >100 million children in 2010. An increasing proportion of infections now occur among adults and there is concern that persistent susceptibility in adults is an obstacle to measles elimination in China. We performed a case-control study in six Chinese provinces between January 2012 to June 2013 to identify risk factors for measles virus infection and susceptibility among adults.MethodsPersons ≥15 years old with laboratory-confirmed measles were age and neighborhood matched with three controls. Controls had blood specimens collected to determine their measles IgG serostatus. We interviewed case-patients and controls about potential risk factors for measles virus infection and susceptibility. Unadjusted and adjusted matched odds ratios and 95% confidence intervals (CIs) were calculated via conditional logistic regression. We calculated attributable fractions for infection for risk factors that could be interpreted as causal.Results899 cases and 2498 controls were enrolled. Among controls, 165 (6.6%) were seronegative for measles IgG indicating persistent susceptibility to infection. In multivariable analysis, hospital visit and travel outside the prefecture in the prior 1–3 weeks were significant risk factors for measles virus infection. Occupation and reluctance to accept measles vaccination were significant risk factors for measles susceptibility. The calculated attributable fraction of measles cases from hospital visitation was 28.6% (95% CI: 20.6–38.8%).ConclusionsExposure to a healthcare facility was the largest risk factor for measles virus infection in adults in China. Improved adherence to hospital infection control practices could reduce risk of ongoing measles virus transmission and increase the likelihood of achieving and sustaining measles elimination in China. The use of control groups stratified by serological status identified distinct risk factors for measles virus infection and susceptibility among adults.     

Oral health-related quality of life in tumour patients treated with patient-specific dental implants

Dental rehabilitation after surgically acquired bone deficiency related to tumour treatment remains a challenge. The insertion of patient-specific implants geared to the contour of the remaining bone is a feasible method of supporting fixed or removable dentures. As oral health-related quality of life (OHRQoL) is of great interest in these cases, 12 individuals treated with patient-specific implants for severe bone deficiency were surveyed and their Oral Health Impact Profile (OHIP) scores after dental rehabilitation were evaluated. The OHIP-G53 questionnaire was used to measure overall treatment outcomes. The distribution of OHIP sum-scores for participants treated with patient-specific implants was almost homogeneous when compared to those cited in the literature for patients treated with conventional dental implants. OHIP items related to functional impairment and physical pain showed the highest scores (occurring occasionally), and financial loss related to treatment was frequently stated. Moreover, higher scores were detected in almost all OHIP dimensions for participants with patient-specific implant-supported removable dentures. Conversely, those treated with patient-specific dental implants and fixed dentures showed lower psychosocial impact scores and equal or superior OHRQoL. Hence, patient-specific dental implants, especially combined with fixed dentures, can lead to a positive OHRQoL in patients with severe bone deficiencies related to tumour therapy.     

Homeopathic Agents or Vitamins in Reducing Ecchymosis after Oculofacial Surgery: A Report by the American Academy of Ophthalmology

PurposeTo review the published literature to determine the efficacy and safety of homeopathic agents or vitamins in reducing ecchymosis after oculofacial surgery or laser surgery.MethodsA literature search was conducted in the PubMed database initially in December 2019 and updated in March 2020 to identify all studies in the English language literature on the use of homeopathic agents or vitamins in oculofacial procedures, including laser surgery. The search yielded 124 citations, and 11 articles met all inclusion criteria for this assessment. A panel methodologist then assigned a level of evidence rating for each study. Eleven studies met inclusion criteria; 9 were rated level I, and 2 were rated level III.ResultsThe agents studied in the articles identified included oral or topical Arnica montana (AM), oral Melilotus extract, topical vitamin K oxide, and topical AM combined with Rhododendron tomentosum. Metrics to describe ecchymosis varied. In 7 controlled studies, perioperative AM provided no or negligible benefit versus placebo. In 2 studies, vitamin K cream was equivalent to placebo. One study of oral Melilotus extract had less ecchymosis compared with controls in paranasal and eyelid ecchymosis at postoperative day (POD) 7, but not at PODs 1 and 4. A lone cohort study of combined topical AM and R. tomentosum lacked objective metrics and adequate controls. No serious side effects from administration of homeopathic agents or vitamins were identified.ConclusionsThe current literature does not support the use of AM, vitamin K oxide, R. tomentosum, or Melilotus extract for reducing ecchymosis after oculofacial surgery or pulsed dye laser surgery.     

肝细胞生长因子抑制肿瘤细胞凋亡作用研究

 目的 探讨肝细胞生长因子（HGF）抑制凋亡诱导剂依托泊苷（etoposide,VP-16）诱导5种肿瘤细胞（B细胞淋巴瘤细胞系Raji、人急性粒细胞白血病细胞系HL-60、宫颈癌细胞系HeLa、前列腺癌细胞系PC-3、非小细胞肺癌细胞系A549）凋亡的作用及其分子机制的研究。方法 实验设正常对照组、药物组及肝细胞生长因子保护组,通过CCK-8法观察依托泊苷对5种肿瘤细胞增殖的抑制作用;通过流式细胞术,吖啶橙(AO)荧光染色,瑞氏染色（HE）,透射电镜定性及定量观察5种肿瘤细胞的凋亡情况,并进行相关分析。结果 CCK-8法显示依托泊苷可明显抑制Raji、HL-60、PC-3、HeLa、A549等5种细胞增殖的药物浓度分别是100、1、400、200、200 μg·mL^-1;透射电镜下可观察到典型的凋亡细胞。流式细胞仪检测结果表明,5种细胞的药物组凋亡率均明显高于对照组(P<0.01,P<0.05),其中肝细胞生长因子保护组凋亡率明显低于药物组(P<0.01,P<0.05);吖啶橙染色和HE染色结果表明,正常组细胞形态完好,药物组及肝细胞生长因子保护组凋亡率明显增高(P<0.01,P<0.05),其中肝细胞生长因子保护组凋亡率明显低于给药组(P<0.01,P<0.05)。结论 肝细胞生长因子可明显抑制依托泊苷诱导的5种肿瘤细胞凋亡,其作用机制有待进一步研究证实。     

Ticks: Physiological aspects with implications for pathogen transmission

Ticks have attracted a great deal of scientific attention primarily because of their role as vectors of numerous pathogens. The majority of tick researchers worldwide focus primarily on microbiological and clinical issues relating to these pathogens, and on methods (pesticidal and biological) for controlling tick populations. Unfortunately, it is often forgotten that ticks are also interesting in their own right to the general biologist because of their unusual physiological (and other) adaptations. Here I review some of these adaptations relating primarily to osmoregulation. (i) I outline their ability to take up water vapour directly from the atmosphere, an adaptation that enables them to withstand desiccation for extended periods while unfed and, in the case of larvae and nymphs, following engorgement. (ii) I present the remarkable filtration–resorption mechanism of the argasid tick coxal organ, analogous to that of the vertebrate glomerular kidney, that enables them to regulate haemolymph fluid volume and composition following the blood meal. (iii) I then turn attention to the salivary glands of female ixodid ticks, which serve the on-host osmoregulatory function in this family of ticks, (iv) and I discuss the pharmacological control of salivary fluid secretion. (v) Finally, I link the latter to the mechanism of pathogen transmission by the salivary glands, using the tick-borne Thogoto virus as a specific example.     

Evolution of drug resistance in multiple distinct lineages of H5N1 avian influenza

Some predict that influenza A H5N1 will be the cause of a pandemic among humans. In preparation for such an event, many governments and organizations have stockpiled antiviral drugs such as oseltamivir (Tamiflu^®). However, it is known that multiple lineages of H5N1 are already resistant to another class of drugs, adamantane derivatives, and a few lineages are resistant to oseltamivir. What is less well understood is the evolutionary history of the mutations that confer drug resistance in the H5N1 population. In order to address this gap, we conducted phylogenetic analyses of 676 genomic sequences of H5N1 and used the resulting hypotheses as a basis for asking 3 molecular evolutionary questions: (1) Have drug-resistant genotypes arisen in distinct lineages of H5N1 through point mutation or through reassortment? (2) Is there evidence for positive selection on the codons that lead to drug resistance? (3) Is there evidence for covariation between positions in the genome that confer resistance to drugs and other positions, unrelated to drug resistance, that may be under selection for other phenotypes? We also examine how drug-resistant lineages proliferate across the landscape by projecting or phylogenetic analysis onto a virtual globe. Our results for H5N1 show that in most cases drug resistance has arisen by independent point mutations rather than reassortment or covariation. Furthermore, we found that some codons that mediate resistance to adamantane derivatives are under positive selection, but did not find positive selection on codons that mediate resistance to oseltamivir. Together, our phylogenetic methods, molecular evolutionary analyses, and geographic visualization provide a framework for analysis of globally distributed genomic data that can be used to monitor the evolution of drug resistance.     

数字卫生在中国的发展

对近年来数字卫生在中国的发展状况并比较讨论了中西方数字卫生的差异性。着重讲述了数字卫生的概念、实施方法,并具体介绍了数字卫生在解决中国当前一些具体的医疗问题中所起的作用及意义。