固定性伴是男男性行为者的女性之相关健康问题及影响因素

目的:探讨固定伴侣是男男性行为者(MSM)的女性之相关身心健康状况和影响因素。方法:调查对象限定为其固定性伴是MSM的在婚、已离异或尚未结婚的女性。采用三种问卷,同时对受调查者均采用了流调中心用抑郁量表(CES-D)、症状自评量表(SCL-90)进行评定。主要依托同妻网站进行动员,数据收集通过互联网调查软件"问卷星"进行。结果:有效样本144例。与MSM有婚史者3/4遭遇过某种性冷淡;知道真相后略过2/5的人几乎或停止与MSM的性交;1/10曾经历肛交,1/10遭遇过性虐待。1/3曾被辱骂和/或殴打,1/5不止一次被殴打。在婚期间1/3有婚外男性伴。不足3/10做过HIV检测,5.6%阳性。有婚史者1/3出现过性病症状。约3/5与MSM性交时用过安全套,但为MSM口交、肛交时仅少数人用过,知道真相后用套率明显升高。多数人知道真相后心理发生变化,2/5曾有强烈自杀念头,近1/10有过自杀未遂行为。CES-D发现9/10有抑郁症状,SCL-90发现多种单项得分超过2分。3/10知道同性爱是正常现象。普遍认为MSM隐瞒真相是对女性权益的严重伤害。多数人希望得到专业人员帮助。绝大多数认为中国有关性教育严重不足,2/3认为保障MSM权益有助于女性权益,9/10认为应设立法律保护相关女性权益。结论:该女性群体是一个易患艾滋病及性病和抑郁症等心理障碍的高危人群,亟需帮助。医界有责任和义务在面向MSM和全社会的教育和权益保障方面采取行动。     

男男性接触者早期梅毒22例临床分析

目的探讨男男性接触者(MSM)早期梅毒的临床特点。方法回顾性分析22例MSM早期梅毒患者的临床资料。结果患者年龄18～43岁;未婚、学生、服务业从业者居多数;大学以上文化程度居多共14例;性伴侣普遍不固定,无防护性肛交、口交等高危性行为普遍存在。临床表现及化验室检测结果与普通梅毒无差异,青霉素正规驱梅治疗有特效。结论MSM人群中普遍存在高危性行为,且缺乏HIV/梅毒等性传播疾病防治知识,对HIV/梅毒等性传播疾病及自身的高危性行为的危害性认识不足;特定的人群和场所是MSM的高发区,应采取有针对性的行为干预措施。     

男男性接触者(MSM)梅毒

梅毒是由苍白密螺旋体感染引起的一种性传播性疾病，近年来发达国家男男性接触者（MSM）中梅毒的爆发导致这些国家梅毒发病率迅速上升，更值得注意的是在这些MSM中有很高比例是HIV阳性者。本文对MSM梅毒流行趋势、危险因素、预防和控制进行综述。     

男男性接触者性病后的医学人文关怀

随着我国社会的日趋开放,男男性接触者（men have sex with men,MSM）人群规模逐渐扩大,作为社会的特殊群体,为多数人所不接受和理解,受到来源于家庭和社会的双重压力,是心理障碍的高发人群,其群体的高危性行为,亦导致MSM是性传播疾病/艾滋病（STD/AIDS）的高发人群,如何有效地对MSM性病患者实施医学人文关怀,以加快其疾病的康复、减少STD/AIDS进一步的传播,将是面临的一个新课题。     

中国同性爱者、同性性行为者和相关女性群体人口数值估测

目的:在新的社会人口学和医学背景下,估测中国同性爱者、同性性行为者和相关女性群体人口数量,为当今中国的相关研究提供科学依据。方法:主要根据《2013年中国统计年鉴》提供的人口基数和潘绥铭2010年对中国成年人口的多层等概率性学抽样调查给出的相关数据进行计算。结果:估测我国男同性爱者(包括男双性爱者)总人口极可能明显超过2100万,性活跃期男男性行为者约922.4万;我国女同性爱者总人口可达1200万左右,性活跃期女女性行为者约816.7万;配偶是男同性爱的女性人口数约为1360万,配偶是男男性行为者的女性有近1000万。结论:我国有数量庞大的同性爱者和同性性行为者群体以及相关的女性群体,他(她)们的身心健康亟需医界等学界高度关注,在未来的10几年内,我国"可见的"同性爱者和同性性行为者群体数量会有所增加,而固定伴侣是男同性爱者及男男性行为者的女性数值将不断下降。     

青年学生男男性行为者的同性性取向成因初探

目的:探究青年学生男男性行为者(men who have sex with men,MSM)的同性性取向相关因素。方法:于2015年5月至7月,以天津市各区级疾控中心和社会组织为依托,招募青年学生MSM 50人,并从高校招募异性恋学生35人,对所有对象进行一般人口学特征、性格特征、家庭环境等问卷调查。使用SPSS17.0软件进行统计分析。结果:调查对象共85人,全部为男性、未婚,平均年龄(21.18!2.01)岁。MSM组的汉族、户籍所在地为本市、在本地居住两年以上、所学专业类别为理工类等依次为94.0%、38.0%、76.0%、52.0%,普通男大学生组依次为97.1%、31.4%、42.9%、65.7%。MSM组童年时与父母亲关系融洽的比例低于普通男大学生组,差异具有统计学意义(P<0.05);MSM组与普通男大学生组相比,小时候不爱活动、小时候不喜冒险、小时候喜欢扮作女孩、小时候不喜欢刀枪等玩具、18岁之前接触过有关同性恋的书籍或电影、从有关同性恋的书籍或电影中体验到性快感的比例均偏高,差异具有统计学意义(P<0.05)。结论:童年或未成年时的成长环境与青年学生同性性取向一定程度上相关。     

武汉市同性恋酒吧男-男性接触者HIV感染高危行为现状调查

目的:描述湖北省武汉市男-男性接触者HIV高危行为的现状,探讨其影响因素,为艾滋病的防治工作提供依据。方法:在武汉市同性恋酒吧对96名男-男性接触者进行问卷调查。结果:调查对象中21~30岁年龄段者占41.7%,高中及以上学历者占95.8%,职业以学生、企业职员和公务员为主;50.0%曾与一个女性有过性交,13.5%与1名以上的女性有过性交;44.8%第一次发生男-男性关系的年龄在16~18岁。全部的调查者在过去的6个月中有过同性性行为,其中77.1%有过口交行为,87.5%有过肛交行为。结论:武汉市男-男性接触者中的HIV相关行为存在高度的危险性。因此,需加强在该人群中的艾滋病防治工作,以阻止艾滋病从高危人群向一般人群扩散。     

男男性行为性病患者性行为特征分析

目的: 分析近一年曾患性传播感染(STI)的男男性行为者(men who have sex with men, MSM)性行为特征及感染STI的影响因素.方法: 对近一年曾患STI者的性行为及STI相关因素进行分析,并与未患STI者进行比较.结果: 近一年曾患STI的MSM同性性伴数、与同性性伴间的高危行为、网络寻找性伴并与网友发生性行为等方面均高于对照组.多因素分析,从事男男性工作和性交时出血与近一年患STI关系密切.结论: 应继续加强对MSM人群进行安全性行为健康教育,以降低STI和HIV感染风险.     

深圳地区男男性接触者性病艾滋病知识及相关高危性行为调查

目的:了解深圳地区男男性接触者性病艾滋病高危行为状况,为高危人群行为干预提供科学依据。方法:知情同意原则下填写调查问卷,收集整理资料后进行分析。结果:203例男男性接触者中,年龄最小15岁,最大57岁,平均年龄26岁。学历以高中/中专为主(38.9%),婚姻状况以未婚为主(86.7%),主要居住在罗湖(47.78%)、福田(23.65%)。首次性行为年龄最小12岁,最大30岁,52.2%的男男性接触者第一个性伴为男性,平均性伴数31个;双性恋占47.3%,同性恋占43.8%,异性恋占2.0%;过去6个月与男性肛交每次都用安全套仅41.4%;14.3%回答曾经与外国人发生性接触;12.3%回答曾有医生护士或保健人员告之得了某种性病;54.2%做过HIV检测。结论:男男性接触者普遍多性伴,安全套使用率相对较低,加强对MSM的性病艾滋病防治已刻不容缓。     

中国不同地区男男性接触者艾滋病高危性行为对比研究

目的 :　探讨中国不同地区男男性接触者 (MSM)艾滋病 (AIDS)高危性行为特点 ,为不同地区制定针对MSM的AIDS干预措施提供科学依据。方法 :　采用不记名问卷调查方式收集高危性行为资料。结果 :　东北三省的MSM近 1年性伴数、近 1年在外地男男性交发生率、曾群交的发生率显著高于其它地区 (P <0 .0 5 ) ;长江中下游地区的MSM男男性交时安全套总使用率及近 1年使用率显著低于其它地区 (P<0 .0 5或P <0 .0 1) ;渝云贵川粤桂闽琼的MSM近 1年在未使用安全套情况下肛门被插入的发生率显著高于其它地区 (P <0 .0 5 ) ;西北地区的MSM性传播感染的患病率显著高于其它地区 (P <0 .0 5 ) ,而检测抗HIV的比例显著低于其它地区 (P <0 .0 1)。结论 :　中国不同地区的MSM的AIDS高危性行为具有各自的特点 ,应针对不同的特点制定其相应的AIDS干预措施。     

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.     

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.     

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.     

Self‐resolving superficial primary cutaneous mucormycosis in a 7‐week‐old infant

A 7‐week‐old girl, born at 30 weeks' gestational age, presented to clinic for evaluation of a crop of vesicular lesions that were noted after removal of a bandage that had been in place for 4 days. A punch biopsy of the lesion revealed fungal elements that were later identified as Rhizopus spp. The lesion began to self‐resolve, and no further treatment was needed, with full resolution of the lesion by 1 month after presentation. Clinicians should be aware of the variable presentations of mucormycosis and consider fungal infection in the differential diagnosis when evaluating vulnerable patients with skin eruptions.     

Pathogenic role of IL-17 in psoriasis and psoriatic arthritis

Psoriasis is a chronic inflammatory skin disorder resulting from a complex network of cytokines and chemokines produced by various immune cell types and tissue cells. Emerging evidence suggests a central role of IL-17 and IL-23/T17 axis in the pathogenesis of psoriasis, giving a rationale for using IL-17-blocking agents as therapeutics.Three agents targeting IL-17 signaling are being studied in Phase III clinical trials: secukinumab and ixekizumab (IL-17 neutralizing agents), and brodalumab (IL-17 receptor antagonist). Preliminary results are highly promising for all anti-IL17 agents, creating fair expectations on this class of agents as the new effective therapeutic approach for the treatment of psoriasis.