天津市吸毒人群HIV和梅毒感染现状及影响因素

目的通过对天津市吸毒人群艾滋病病毒(HIV)、梅毒(SP)感染状况及HIV危险因素的调查,为在该人群中开展相关控制措施提供依据。方法采用横断面调查,对2008-2009年新进入戒毒所的821名吸毒人员进行问卷调查,同时抽取血样进行梅毒和HIV的实验室检测。结果天津市吸毒人员梅毒感染率为2.9%(24/821),HIV感染率为3.8%(31/821),多因素分析表明,外省籍(OR=13.222,95%CI:3.665～47.703)、少数民族(OR=5.046,95%CI:1.541～16.522)、注射毒品(OR=9.151,95%CI:2.301～36.397)、艾滋病知识知晓率高(OR=0.363,95%CI:0.136～0.969)与HIV感染关系有统计学意义。结论天津市吸毒人群HIV感染率较高,危险行为普遍存在,急需采取有效措施控制HIV的传播蔓延。     

乌鲁木齐市静脉吸毒人群HIV感染及危险因素研究

目的了解乌鲁木齐市静脉吸毒人群艾滋病病毒(HIV)感染情况。方法于2004年9~10月,调查戒毒所等机构内静脉吸毒人群的社会人口学、静脉吸毒和性行为方式,并采集血样检测HIV和梅毒抗体。结果在调查的静脉吸毒者509人中,HIV感染率为37.3%(190人)。多因素logistic回归模型分析结果显示,维族(OR 7.91,95%CI 4.92~12.72)、近3个月内共用注射器具静脉吸毒5次及以上(OR 2.61,95%CI 1.48~4.60)和静脉吸毒5年以上(OR 1.64,95%CI 1.09~2.48)与HIV感染关系有统计学意义。结论乌鲁木齐市静脉吸毒人群HIV感染率高,高危行为普遍,需采取有效的措施来控制HIV的传播流行。     

保山市强制戒毒人员HIV和HCV感染状况及影响因素

目的了解云南省保山市强制戒毒人员艾滋病病毒(HIV)和丙型肝炎(简称丙肝)病毒(HCV)感染现状及相关影响因素,为制定针对吸毒人群的艾滋病和丙肝防控措施提供依据。方法对保山市强制隔离戒毒所吸毒人群开展行为学调查及血清学检测,通过χ2检验和多因素Logistic回归方法分析HIV和HCV感染危险因素。结果800名吸毒者的HIV感染率为2.4%,HCV感染率为27.6%,HIV和HCV合并感染率为1.9%。吸毒人群HIV感染影响因素为与别人共用针具[比值比(OR)=15.669,95%可信区间(CI):3.122～78.615],HCV感染影响因素为使用传统毒品(OR=2.076,95%CI:1.194～3.608)、注射吸毒(OR=17.289,95%CI:8.469～35.295)。结论保山市吸毒人群HIV和HCV感染率较高,共用针具是HIV感染的危险因素。使用传统毒品和注射吸毒是HCV感染的危险因素。     

广西壮族自治区婚检人群婚前感染HIV危险因素调查

目的了解适婚年轻人群婚前感染艾滋病病毒(HIV)的危险因素及保护因素,以探寻有针对性的防控措施。方法在全区重点市县的婚检人群中,采用1∶1病例对照的方法,根据性别匹配选择婚检时感染和未感染HIV的婚检人员,采用单因素和Logistic多因素分析方法,分析与感染HIV相关的因素。结果调查HIV感染者和非HIV感染者共290人(145对),男性180人(62.1%),女性110人(37.9%)。多因素回归分析结果显示,在其他因素相同的情况下,年龄越大感染率越高[比值比(OR)=2.169,95%可信区间(CI):1.198~3.929],曾有外出史者较无外出史者感染率高(OR=2.831,95%CI:1.517~5.284),此次婚检前结过婚或有过长期同居的异性性伴较此前无该行为者感染率高(OR=4.273,95%CI:2.336~7.816),曾经吸毒者较无吸毒史者感染率高(OR=21.801,95%CI:2.752~172.700);听说过艾滋病者较未听说过者感染率低(OR=0.150,95%CI:0.027~0.817),从电视(OR=0.501,95%CI:0.271~0.926)及学校教育(OR=0.423,95%CI:0.219~0.814)获得艾滋病预防信息者较未从这两个途径获取预防信息者感染率低,差异均有统计学意义。结论曾有外出史、此次婚检前结过婚或有过长期同居的异性性伴及曾经吸毒是造成年轻人群感染HIV的主要危险因素,听说过艾滋病、从电视及学校教育获得艾滋病预防信息则是减少该类人群感染HIV的保护因素。     

HIV抗体阳性MSM的性病感染状况及其影响因素

目的了解艾滋病病毒(HIV)抗体阳性的男男性行为者(MSM)的性病感染状况及其影响因素,为MSM的艾滋病防治策略提供科学依据。方法 2016年8-11月,采用方便抽样的方法,在上海、济南两地两家医院内,抽取正在进行抗病毒治疗的HIV阳性MSM进行问卷调查和实验室检测。结果共调查380例HIV阳性MSM,其中梅毒感染者63例,感染率16.6%[95%可信区间(CI):12.9%~20.5%];尖锐湿疣50例,感染率13.2%(95%CI:10.0%~17.1%);生殖器疱疹和淋球菌感染各1例,感染率各为0.3%(95%CI:0~0.8%);未检出生殖道衣原体阳性者。总的性病感染者有98例,感染率为25.8%(95%CI:21.6%~30.0%)。影响性病感染的多因素Logistic回归分析显示,年龄≤29岁[比值比(OR)=4.94,95%CI:1.02~24.47]、CD4~+T淋巴细胞水平低于正常值(OR=2.20,95%CI:1.34~3.60)和不知晓性病知识(OR=1.82,95%CI:1.15~3.25),是感染性病的危险因素。结论抗病毒治疗门诊中的HIV抗体阳性MSM的性病感染率相对较高,建议进一步加强对该人群的性病防范宣传教育以及性病的筛查和诊疗服务,将有助于降低性病感染率,从而减少HIV的传播。     

深圳市龙岗区男男性行为者HIV感染状况及其高危行为特征分析

目的了解深圳市龙岗区男男性行为者(MSM)的艾滋病病毒(HIV)感染状况及其高危行为特征,分析HIV感染的影响因素,为在龙岗区MSM中采取针对性的干预措施提供参考依据。方法 2015年1月至2016年12月,在龙岗区MSM聚集场所,采用时间场所抽样(TLS)和"滚雪球"的抽样方式获取样本,并进行单因素和多因素Logistic回归分析,双侧P0.05为检验水准,显示差异有统计学意义。结果共调查研究801人,平均(26.5±4.3)岁,青壮年为主;高中/中专及以上占58.80%。HIV感染率为18.48%(148例),梅毒感染率为16.48%(132例),丙型肝炎病毒感染率为0.37%(3例)。梅毒感染[比值比(OR)=3.44,95%可信区间(CI):1.40~8.46)]、发生肛交(OR=1.86,95%CI:1.07~3.23)是HIV感染的危险因素;肛交时坚持使用安全套(OR=0.34,95%CI:0.17~0.69)是HIV感染的保护因素。结论龙岗区MSM中HIV感染率较高;梅毒感染、发生肛交是导致HIV感染的危险因素。提示应继续强化性病治疗转介服务,提高安全性行为比例,降低MSM艾滋病的发病率。     

低档暗娼人口社会行为学特征与HIV感染状态

目的了解低档暗娼艾滋病病毒（HIV）感染现状,分析相关危险因素。方法按照广西低档暗娼人群专项调查工作方案要求进行问卷、采血、检测。资料经Epidata 3.1进行双录入,用SPSS 19.0进行统计分析。结果共调查低档暗娼7 936人,HIV感染率为1.88%（149例）。其中〉40岁年龄段者HIV感染率为4.63%,文盲者HIV感染率4.54%,离异/丧偶者HIV感染率4.91%,有吸毒行为者HIV感染率达6.42%,流动性暗娼（没有固定场所）的HIV感染率为4.02%。从未使用安全套者,HIV感染率明显高于每次使用者（P〈0.05）;艾滋病知识知晓率低分组,HIV感染也明显高于艾滋病知识知晓率高分组（P〈0.01）。经多因素Logistic回归分析,影响低档暗娼HIV感染率的主要危险因素有：无固定场所、有吸毒行为、〉40岁、越南籍。结论广西低档暗娼HIV感染率较高,不同人口社会学和行为特征的暗娼HIV感染率不同,需对影响感染及传播的因素实施有效的干预措施,加大健康教育、监测与干预力度,做到早干预、早发现、早治疗,有效减少艾滋病在这类人群中和向其他人群的传播。     

2010-2016年云南省德宏州艾滋病哨点吸毒人员丙型肝炎病毒感染状况及影响因素北大核心CSCD

目的分析云南省德宏州艾滋病监测哨点吸毒人群丙型肝炎病毒（HCV）感染情况及影响因素,为制定HCV防治策略提供依据。方法 2010-2016年,采用重复横断面调查方法,对德宏州吸毒人群进行问卷调查和血清学检测,以艾滋病病毒（HIV）感染状态分层,使用χ~2检验和多因素Logistic回归模型分析HCV感染的影响因素。结果 2010-2016年,德宏州共对11 248名吸毒者采血检测HCV,检出阳性者2 549例,HCV平均阳性率为22.7%,HIV阴性人群的HCV阳性率为18.6%（1 906/10 248）,HIV阳性人群的HCV阳性率为64.3%（643/1000）,注射吸毒人群为74.7%（1 202/1 610）。多因素分析结果显示：年龄、未婚和离异或丧偶、使用传统毒品和混合毒品和最近一年有商业性行为,在HIV阴性人群中与HCV感染有正性关联;年份、男性和缅甸籍,在HIV阳性人群中与HCV感染有正性关联;注射吸毒在HIV阴性人群[比值比（OR）=15.51,95%可信区间（CI）：13.17~18.27]和HIV阳性人群（OR=4.03,95%CI：2.88~5.62）均是HCV感染危险因素。结论德宏州注射吸毒人群HCV感染率较高,HIV阳性人群HCV感染率随年份呈上升趋势,注射吸毒和性行为尤其是HIV阴性人群HCV传播的主要危险因素,应根据吸毒人群不同特征针对性开展健康教育和行为干预。     

开远市社区吸毒暗娼艾滋病相关高危行为调查分析

目的 了解社区吸毒暗娼的吸毒及高危性行为特征,为对她们开展行为干预提供参考依据.方法 通过外展招募的方式,对云南省开远市101名社区吸毒暗娼进行了访谈式问卷调查.结果 吸毒暗娼中,92.1%自报有过注射吸毒经历,17.2%的注射吸毒暗娼在最近6个月曾与别人共用过针具,65.4%的吸毒暗娼最近12个月中曾出现过性病症状.70.4%和14.9%的暗娼在与其固定性伴及嫖客的最近一次性行为中,未使用安全套.结论 吸毒暗娼共用针具吸毒的高危行为,使其处在艾滋病病毒(HIV)感染的巨大危险中,而其与嫖客人群及固定性伴的无保护性行为,很容易造成HIV通过性途径向其他人群的传播,加大对此类高危人群的干预力度势在必行.     

新疆某男性监管场所羁押人群HIV感染现状及影响因素分析

目的了解新疆某男性监管场所羁押人群HIV感染的最新现状及可能的影响因素,为做好高危人群的健康宣传教育提供参考资料。方法收集新疆某男性监管场所截止2014年12月全部在押人员2 024人的年龄、性别、民族、婚姻状况、户籍、文化程度等信息,同时对他们进行HIV抗体筛查。结果 2 024名男性羁押人群中检出HIV感染者324例,HIV感染率16.01%;不同年龄(χ2=38.564)、民族(χ2=170.577)、地区(χ2=220.282)、学历(χ2=20.544)及婚姻状况(χ2=134.170)羁押者的HIV感染率差异均有统计学意义(均P0.05);影响HIV感染的独立因素为吸毒(OR=8.018,95%CI=3.009~15.178)与婚姻状况(OR=6.787,95%CI=1.025~9.336)。结论该监管场所男性羁押人群HIV感染率明显高于新疆地区总HIV感染率,仍以性传播与吸毒传播为主;对高危人群应加强艾滋病防治知识的宣传教育,减少艾滋病的传播机会,降低发病率。     

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.     

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.     

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.     

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.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.