计划生育门诊医务人员对开展主动提供HIV检测与咨询服务的可接受性及影响因素研究

目的：探讨在计划生育门诊中开展医务人员主动提供HIV检测与咨询（PITC）服务的可接受性及影响因素。方法：采用对计划生育门诊医务人员进行问卷调查和深入访谈的定性和定量相结合的描述性研究方法。结果：医务人员知识点知晓率差距较大,对艾滋病基础知识知晓率较高,正确率均在90．00％以上;而专业知识知晓率相对较低。85．00％的医务人员愿意主动为就诊患者提供艾滋病检测和咨询的服务,15．0HD％不愿意者其原因是因为“工作忙,没时间”（66．67％）和“没有必要”（33．33％）。医务人员认为在计划生育门诊开展PITC服务需要的条件有“独立的场所”（85．00％）,“经过艾滋病知识培训的专业人员”（80．00％）,“有国家政策支持和医院领导支持”（70．00％）等。90．00％的医务人员认为在计划生育门诊开展PITC服务的有利因素是就诊者以接受计划生育服务的常规方式了解自己的HIV感染状况,可以避免就诊者的“羞辱感”和“不方便”,减少歧视。医务人员认为在计划生育门诊开展PITC服务存在的困难依次是“缺乏艾滋病专业防治知识及咨询技巧”（80．00％）;“工作忙,没时间”（75．00％）;“无安全保密的环境”（70．00％）;“缺乏政策依据与操作规范”（70．00％）;“存在社会歧视”（50．00％）等。本中心门诊开展PITC服务一年,咨询率从44．26％提高到72．40％,HIV检测率从11．64％提高到23．15％,有显著性差异（P〈0．01）。结论：计划生育门诊医务人员开展PITC服务是可行的,能明显提高就诊者的HIV检测率;缺乏艾滋病专业防治知识及咨询技巧、医护人员的工作量大、无安全保密的环境、缺乏政策支持和专用经费等是不利于医务人员开展PITC服务的影响因素。     

PITC服务模式下孕妇预防HIV母婴传播认知现状及影响因素调查

目的 了解医务人员主动提供HIV检测咨询(PITC)服务模式下孕妇对预防艾滋病母婴传播认知现状,探索孕后检测HIV必要性的影响因素,为开展有针对性的预防母婴传播健康教育提供依据.方法 采用系统抽样方法,对2020年8月至全区4家助产机构进行产前检查的孕妇进行自填式问卷调查.内容包括一般人口学特征、艾滋病及预防艾滋病母婴...     

广东省HIV/AIDS患者主动检测HIV的影响因素

目的 了解广东省新报告HIV/AIDS患者在确诊HIV时主动寻求HIV检测的情况及其影响因素。方法 采用现况研究的方法,招募广东省新报告的HIV/AIDS患者作为调查对象,收集其社会人口学特征、HIV主动检测情况与HIV相关信息。采用χ²检验和多因素非条件Logistic回归模型分析HIV主动检测的相关因素。结果 1 071例新报告的HIV/AIDS患者中,HIV主动检测的比例为59.57%(638/1 071)。多因素分析结果显示,与确诊时年龄<34岁者相比,HIV诊断年龄≥51岁者主动进行HIV检测的可能性较小(aOR=0.47,95%CI:0.28～0.81);相较于样本来源为医疗机构者,检测咨询(aOR=2.91,95%CI:2.01～4.26)及其他(aOR=2.69,95%CI:1.51～4.91)来源者主动检测的可能性更大;既往有HIV检测想法(aOR=7.82,95%CI:4.80～13.31)、有过自我检测经历(aOR=2.73,95%CI:1.27～6.30)、知晓国家提供免费的抗病毒治疗(aOR=2.00,95%CI:1.48～2.71...     

昭阳区2008-2014年艾滋病自愿咨询检测(VCT)情况分析

目的 总结评价昭阳区(2008-2014)年艾滋病自愿咨询检测(VCT)情况,为今后更好的开展VCT服务,预防控制艾滋病提供依据.方法 从全国艾滋病综合防治系统导出昭阳区(2008-2014)年VCT求询者个案信息并采用Microsoft excel 2007进行整理,采用SPSS 22.0软件进行统计学分析.结果 昭阳区(2008-2014)年间,6042名求询者中,男性3526人,女性2416人;其中(20 ～40)岁青壮年占65.5％;绝大部分已婚或有配偶;检出HIV阳性者466人,阳性检出率达7.71％,呈现逐年上升趋势,以60岁以上者检出率最高,且有随着年龄增大而增高趋势;在不同求询者中以配偶/固定性伴阳性者最高,有男男性行为史者次之,且明显高于其他类型(x2=181.37,P＜0.001).结论 VCT是昭阳区发现HIV/AIDS病人的重要窗口,HIV阳性检出率达7.71％,在后续VCT工作中应根据不同人群特点有针对性提高服务质量,同时扩大咨询点的覆盖面,发挥VCT发现HIV感染者及病人的关键作用.     

性病门诊和艾滋病自愿咨询检测门诊就诊人群单纯疱疹病毒-2感染率及其危险因素研究

目的 分析性病门诊和艾滋病自愿咨询检测(VCT)门诊患者单纯疱疹病毒(HSV)-2感染率及感染危险因素,为相应防范对策的制定提供指导.方法 选取2016年6月至2019年6月广西科技大学第一附属医院性病门诊就诊的200例患者及艾滋病VCT门诊就诊的100例患者作为研究对象.采用酶联免疫吸附试验检测其HSV-2 IgG抗...     

广东省医疗机构和自愿咨询检测发现的HIV感染者/AIDS患者特征分析

目的 分析广东省医疗机构和艾滋病自愿咨询检测(voluntary counseling and testing, VCT)发现的HIV感染者/AIDS患者特征的差异,为促进HIV感染者/AIDS患者早检测、早发现提供参考依据。方法 选择广东省6个地市作为研究现场,采用方便抽样的方法招募2018年5月—2019年6月报告的HIV感染者/AIDS患者。采用自行设计的调查问卷并结合国家艾滋病综合防治数据信息管理系统的数据,收集研究对象一般人口学资料、HIV检测及相关信息。采用非条件Logistic回归分析比较两种检测途径的研究对象特征的差异及晚诊断情况。结果 在纳入分析的1 008例研究对象中,733例(72.72%)来自医疗机构,275例(27.28%)来自VCT门诊。多因素Logistic回归分析显示,从事家政及家务(aOR=1.58, 95%CI:1.01～2.51)、主动寻求检测(aOR=2.51, 95%CI:1.73～3.68)、通过同性性传播感染HIV(aOR=2.00, 95%CI:1.31～3.10)的研究对象在VCT门诊进行HIV检测的可能性更高;而无配偶(aOR=0.4...     

中老年男性性病门诊患者接受艾滋病自愿咨询检测的现状调查及影响因素研究

目的 调查分析中老年男性性病门诊患者接受艾滋病自愿咨询检测(VCT)的现状及影响因素,以期为提高VCT使用率提供参考。方法 选取2020年1月至2021年12月舟山医院性病门诊收治的200例中老年男性患者作为研究对象。采用面对面交流方式询问其是否接受过VCT服务,采用单因素及多因素Logistic回归分析影响性病门诊患者接受VCT服务的相关因素。结果 因问卷不满足要求、资料不全等剔除4例,最终196例纳入本研究。196例性病门诊患者中接受过VCT服务118例,占60.20%,其中因有商业异性性行为史接受服务25例(21.19%)。不同婚姻状况、个人月收入、艾滋病防治知识知晓、听说过VCT服务、知道VCT免费、知道VCT服务保密、担心自己感染艾滋病、艾滋病预防与自己相关、艾滋病患者都存在不良行为、艾滋病患者应被隔离、主动获得艾滋病知识、主动帮助艾滋病患者及其家属、若感染会主动寻求帮忙患者接受过VCT服务比例比较,差异具有统计学意义(P<0.05);多因素Logistic回归分析结果显示,婚姻状况(未婚、离异或丧偶)、艾滋病患者应被隔离、知道VCT服务保密、担心自己感染艾滋病、艾滋病...     

2010-2015年临沂市艾滋病自愿咨询检测资料分析

目的:分析临沂市2010-2015年艾滋病自愿咨询检测(HIV voluntary counseling and testing, VCT)情况,为及时调整艾滋病预防和控制策略提供依据。方法:从艾滋病综合防治信息系统中导出2010-2015年自愿咨询检测资料,对接受检测的求询者就一般人口学特征、求询原因以及HIV抗体筛查阳性情况进行流行病学分析。结果:　2010-2015年临沂市VCT共接受65 465人咨询,64 524人进行了HIV抗体检测,检出阳性者382例,阳性检出率0.59%,其中19～49岁344名（90.05%）、男性324名(84.82%)、初中及以下文化水平222名（58.12%）、有男男性行为史209名（54.71%）。结论:　VCT应重点加强中青年男性、男男性行为人群和低文化水平人群的宣传和干预工作。     

Platelet activating factor (PAF) and lyso-PAF in psoriasis

Previous studies have shown that scale from lesional psoriatic skin contains substantial amounts of platelet activating factor (PAF). In this study, PAF and its immediate precursor, lyso-PAF, were measured in exudates from abrasions on lesional and uninvolved psoriatic skin, and from skin of healthy subjects. The mean amounts of PAF recovered from lesional and uninvolved psoriatic skin (n=13) and from healthy skin (n=14) were not significantly different (range 0.05–2.14 pmol/sample). Mean recoveries of lyso-PAF from lesional psoriatic skin (n=9) and skin of healthy subjects (n=13) were also similar (9.5 ± 1.9 and 11.0 ± 1.9 pmol/sample, respectively), but significantly less lyso-PAF was found in exudates from the uninvolved psoriatic skin (n=9; 3.1 ± 0.4 pmol/sample; P<0.01 relative to both lesional psoriasis and healthy skin). The finding of reduced lyso-PAF in uninvolved psoriatic skin was unexpected because increased phospholipase-A₂ activity is associated with psoriasis. These results do not support the hypothesis that extracellular PAF contributes significantly to the inflammation associated with psoriasis.     

Immunohistochemical study of chondrolipoma: possible importance of transforming growth factor (TGF)-betas,latent TGF-beta binding protein-1 (LTBP-1), and bone morphogenetic protein (BMP) for chondrogenesis in lipoma

To clarify the pathogenesis of chondrolipoma, we examined the expressions and localizations of TGF-beta1, -beta2, -beta3, BMP, and LTBP-1 in our rare case by immunohistochemical staining, and compared them with the staining patterns seen in normal human tracheal cartilage tissue and osteochondroma (controls). In the present case, there was weak TGF-beta1 expression in both lacuna and spindle cells around the cartilage, intense TGF-beta2 expression in both lacuna and spindle cells, and weak-to-moderate TGF-beta3 expression in the spindle cells. In lacuna cells, LTBP-1 was expressed moderately and BMP intensely. In contrast, the normal cartilage showed weak-to-moderate expressions of TGF-beta2, -beta3, and BMP in the lacuna cells with zero-to-weak TGF-beta2 and zero-to-moderate TGF-beta3 expressions in the spindle cells, while LTBP-1 was negative in both lacuna and spindle cells. Osteochondroma cases showed moderate-to-intense expressions of TGF-beta2, -beta3, and BMP in the lacuna cells, while LTBP-1 was positive in the lacuna cells and negative in the spindle cells. These findings suggest that the pattern of expression of TGF-betas, LTBP-1, and BMP may be important in the pathogenesis of chondrolipoma.     

Evaluation of the Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (POSSUM) scoring system in elderly patients with pressure sores undergoing fasciocutaneous flap-reconstruction

The aim of the present study was to predict operative morbidity in elderly patients with deep pressure sores by using the Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (POSSUM) scoring system. Fifteen patients over 70 years old were retrospectively reviewed who had undergone gluteus maximus fasciocutaneous flap-reconstruction for pressure sores of the sacral region from 1 April 2005 to 31 March 2007. Complications were seen in six cases (40%) after operation. Four were wound infection, one was chest infection and another was septicemia. The subjects were divided into two groups by the presence (complicated group) or absence (non-complicated group) of postoperative complications. Each item of physiological scores, physiological score (PS), operative severity score (OS) and predicted morbidity rate (R) were calculated and compared between two groups. As a result, hemoglobin ( P  = 0.0276), PS ( P  = 0.0023) and R ( P  = 0.0078) differed significantly between the two groups. It is noteworthy that the PS were over 25 in all of the complicated group, but in only one of nine in the non-complicated group ( P  = 0.0014). Our study suggests that, for pressure sores in the sacral region in elderly patients, gluteus maximus fasciocutaneous flap-reconstruction can be employed in patients whose PS are under 24 in the POSSUM scoring system.     

祛银汤治疗血热证银屑病临床观察及其对外周血OPN和VEGF表达的影响

目的观察祛银汤治疗血热证型寻常性银屑病的临床疗效及其对外周血清中骨桥蛋白(osteopontin,OPN)和血管内皮细胞生长因子(vascular endothelial growth factor,VEGF)的影响。方法共入选24例血热证型寻常性银屑病患者,观察其治疗前、后皮损面积和严重性指数(psoriasis area and severity index,PA-SI)评分及中医症状评分的变化,并采用酶联免疫吸附试验(ELISA)检测患者治疗前、后外周血中OPN和VEGF的表达。结果祛银汤治疗8周后有效率为79.17%;治疗后PASI评分和各中医症状均较治疗前明显改善。治疗前银屑病患者外周血清OPN和VEGF表达明显升高,治疗后明显降低,差异均有统计学意义(P均<0.05),且OPN与PASI评分呈正相关关系(r=0.44,P<0.05)。结论血热证型寻常性银屑病患者OPN和VEGF异常表达,祛银汤可纠正外周血中异常的OPN和VEGF表达水平。     

Successful treatment for recurrence of primary cutaneous anaplastic large-cell lymphoma in elderly patient with etoposide, mitoxantrone, cyclophosphamide, vincristine, prednisolone and bleomycin (VNCOP-B) therapy

Primary cutaneous anaplastic large cell lymphoma (C-ALCL) is a malignant lymphoma with a relatively good prognosis, consisting of CD30-positive, undifferentiated, large cells. We report an elderly patient with C-ALCL which recurred after cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) therapy, but was effectively treated with the third-generation etoposide, mitoxantrone, cyclophosphamide, vincristine, prednisolone and bleomycin (VNCOP-B) regimen. It is characterized by the completion of treatment in 8 weeks, its applicability on an outpatient basis, and a low incidence of cardiotoxicity and mucosal symptoms. Although our patient had no side-effects during chemotherapy, patients should be carefully monitored for side-effects, especially infection. In conclusion, the VNCOP-B regimen might be an effective treatment for elderly patients with good performance status, CHOP-resistant patients or patients with aggressive non-Hodgkin's lymphoma.     

DaxibotulinumtoxinA for Injection has a prolonged duration of response in the treatment of glabellar lines: Pooled data from two multicenter,randomized, double-blind,placebo-controlled,phase 3 studies (SAKURA 1 and SAKURA 2)

1. Download : Download high-res image (144KB)
2. Download : Download full-size image