中国HIV感染者/AIDS 患者服用抗病毒治疗药物后耐药性的系统综述

目的了解接受抗病毒治疗（ART）后,人类免疫缺陷病毒（HIV）感染者/艾滋病（AIDS）患者耐药性。方法检索中国知网,万方数据资源系统和PubMed数据库,收集中国HIV感染者/AIDS患者ART后耐药性相关文献,进行Meta分析。结果最终纳入15篇文献（1篇英文和14篇中文）,其中3篇质量评分6分,4篇为7分,8篇为8分。异质性检验显示,差异有统计学意义（Q=45.98,P＜0.001）,存在异质性,所以采用随机效应模型进行Meta分析,结果显示中国HIV感染者/AIDS患者ART后总耐药率为4%（4%～5%）。Begg’s检验P=0.012,说明存在发表偏倚。通过敏感度分析删除文献后,合并效应量仍为4%（4%～5%）。结论中国HIV感染者/AIDS 患者经ART 后总耐药率不高。     

温州地区艾滋病感染者和病人合并感染乙肝、丙肝、梅毒等疾病的研究

目的:研究艾滋病感染者和病人(HIV/AIDS)合并感染乙型病毒性肝炎(HBV)、丙型病毒性肝炎(HCV)、梅毒(TP)的流行现状及其特点,为HIV/AIDS的防控和治疗提供科学依据。方法:选取2008年-2010年期间在温州实验室确认阳性的艾滋病感染者和病人的标本共678例,采用ELISA法,分别对标本进行乙肝表面抗原、丙肝抗体、梅毒抗体项目检测。结果:其中,合并感染乙肝的有102例(15.04%),感染丙肝84例(12.38%),感染梅毒145例(21.38%);同时感染乙肝、丙肝的有13例(1.91%),感染乙肝、梅毒有31例(4.57%),感染丙肝、梅毒的有13例(1.91%),同时感染乙肝、丙肝、梅毒的2例(0.29%)。结论:1、HIV感染者中HBV感染率略高于普通人群;HIV与HCV合并感染率显著高于普通人群,但低于国内外报道的HIV/HCV的30%以上;HIV与TP合并感染的比例显著高于普通人群以及其他地区艾滋病患者。2、合并感染的总体趋势有所控制。     

北京市朝阳区老年HIV感染者和AIDS患者生存状况分析

目的 分析北京市朝阳区老年人类免疫缺陷病毒（human immunodeficiency virus,HIV）感染者和获得性免疫缺陷综合征（acquired immunodeficiency syndrome,AIDS）患者（HIV感染者/AIDS患者）的生存率及影响因素。方法 通过全国“艾滋病综合防治信息管理系统”,收集1999年5月25日—2020年12月31日报告的现住址为北京市朝阳区且确诊时年龄≥50岁的HIV感染者/AIDS患者的传染病报告卡、随访调查和抗反转录病毒治疗（antiretroviral therapy,ART）等信息,采用回顾性队列分析方法分析研究对象的生存率及影响因素。结果 共489例老年HIV感染者/AIDS患者纳入研究。截至2020年12月31日,死亡57例,失访53例,累计观察时间1 819.96人年,观察时间中位数2.92人年。总死亡率为3.13/100人年,1、5、10、15、20年的生存率分别为91.98%、85.44%、76.53%、76.53%和76.53%。多因素Cox比例风险回归分析结果显示,与对照组相比,确诊时年龄≥70岁、性病史不详、基...     

苏州市艾滋病抗病毒治疗效果分析

目的评价苏州市艾滋病免费抗病毒治疗(ART)的效果。方法收集苏州市2012年前纳入治疗的576例艾滋病病毒感染者/艾滋病病人(HIV/AIDS)的临床随访资料,分析评价其病毒学和免疫学应答情况。结果 576例接受ART者中,治疗后HIV完全抑制率为84.2%,随着治疗时间延长,病毒完全抑制率上升(χ2趋势=10.331,P=0.001)。治疗后CD4+T淋巴细胞计数增加中位数为220/μL(QR:213/μL),免疫学失败率为10.2%,治疗时间越长,治疗后CD4+细胞计数增加数越大(F=48.475,P0.01)。治疗6个月后,79.3%的HIV/AIDS病毒学和免疫学均应答,5.4%的均失败。结论苏州市接受ART的HIV/AIDS抗病毒治疗效果较好,应重视失访和死亡者的分析和监测。     

贵州省两县不同艾滋病诊断治疗服务模式效果分析

目的 比较贵州省两县不同艾滋病诊断治疗服务模式效果。方法 利用D、P两县综合防治信息,以D县实施艾滋病诊断治疗“一站式服务”（简称“一站式服务”）前一年和后一年为观察时间,实行常规服务的P县为对照县,两县新报告且现住址在本地的成年人类免疫缺陷病毒（human immunodeficiency virus,HIV）感染者/获得性免疫缺陷综合征（acquired immunodeficiency syndrome,AIDS）患者（简称HIV/AIDS）为研究对象,比较确证到抗病毒治疗（antiretroviral therapy,ART）时间、CD4+T淋巴细胞（简称CD4）检测比例、ART比例等指标。结果 D县实行“一站式服务”后,确证到ART时间由55.00 d缩短为4.00 d,CD4检测比例由65.52%上升到100.00%,全部病例ART比例由31.03%上升到87.88%,差异均有统计学意义（均有P<0.05）。同期,P县确证到ART时间由68.00 d变为43.50 d,CD4检测比例由90.91%变为88.24%,全部病例ART比例由45.45%变为58.82%,差异均无统计学意义（均有P>0.05）。D县实行“一站式服务”后,与P县相比,全部病例ART比例上升,确证到ART时间缩短。结论 “一站式服务”优化了检测流程,缩短了确证到ART时间,减少HIV/AIDS的丢失。     

艾滋病感染者/患者合并感染乙肝病毒、丙肝病毒、梅毒的检测与分析

目的 通过实验室检测146例艾滋病感染者/患者(HIV/AIDS)合并感染乙肝病毒(HBV)、丙肝病毒(HCV)、梅毒螺旋体(TP)的状况及多重感染对HIV/AIDS的影响,为HIV/AIDS的防控和综合治疗提供科学依据. 方法 采用酶联免疫法(ELISA)检测HIV/AIDS血液中HBV、HCV、TP的相应抗体;用流式细胞仪检测HIV感染者全血中的CD4/CD8细胞,检测结果分组,组间比较采用卡方检验. 结果 146例HIV/AIDS合并HCV感染98例,感染率(67.12％);合并梅毒感染47例,感染率(32.19％);合并HBV感染33例,感染率(22.60％).122例多重合并感染者发病74例,发病率60.66％;单纯HIV感染者24例,发病5例,发病率20.83％. 结论 HCV是HIV/AIDS常见合并感染的病原体,在其治疗的同时要做好护肝保肝的工作,综合治疗.     

吉林市HIV/AIDS患者病程及抗病毒效果评价

目的研究吉林市93例HIV感染者/AIDS病人疾病进展情况;采用高效抗逆转录病毒治疗(HAART)的疗效,为HIV/AIDS综合防治措施提供科学依据。方法通过现场流行病学调查分析HIV感染者/AIDS病人一般情况,检测抗丙型肝炎病毒(HCV)抗体,定期进行CD4+、CD8+T淋巴细胞绝对计数检测以监测疾病进展,用HAART治疗HIV感染者/AIDS病人,监测病毒学及免疫学变化,观察抗病毒药物的毒副作用及服药依从性。结果吉林市93例HIV感染者/AIDS病人中86例(92.5%)经血液感染且合并HCV感染。估计感染时间在8年以上者88例,其中20.5%CD4+T淋巴细胞数<200/mm3,50%为200~500/mm3,29.5%>500/mm3。接受HAART治疗的23例HIV感染者/AIDS病人治疗前平均病毒载量为5.06 log拷贝/ml(4.39×105拷贝/ml),治疗12个月后平均下降3.47log拷贝/ml(P<0.001),其中16例达到检测不出的水平(<400拷贝/ml),CD4+T淋巴细胞数平均上升48个/mm3(P<0.05)。结论吉林市存在部分疾病进展缓慢的HIV感染者;HAART治疗取得了较好的疗效,但司他夫定和去羟肌苷联合应用使周围神经病变发生率较高;加强对感染者疾病进展和抗病毒疗效及不良反应监测,有助于确定开始抗病毒治疗的时机和及时调整治疗方案。     

西安地区接受抗病毒治疗的HIV感染者/AIDS患者服药依从性调查分析

目的 调查西安地区接受抗病毒治疗（ART）的艾滋病病毒（HIV）感染者/艾滋病（AIDS）患者的服药依从性情况,并分析影响服药依从性的相关因素,为改善依从性提供科学依据。方法 于2021年7月至2022年6月在西安地区HIV感染者/AIDS患者ART定点机构（西安市第八医院）进行现场调查,内容包括接受ART的HIV感染者/AIDS患者的社会人口学特征、感染途径、ART治疗时间、药物不良反应情况以及服药依从性。采用Logistic回归模型对患者服药依从性的影响因素进行分析。结果 763例接受ART的HIV感染者/AIDS患者中,男622例,女141例,平均年龄（48.52±9.26）岁,平均ART服药时长（9.15±2.71）年。共627例服药依从性好,服药依从率为82.18%。多因素Logistic回归分析显示,年龄（OR=0.773）、ART服药时长（OR=0.685）、文化程度（OR=1.204）、每日服药次数（OR=0.624）、感染HIV途径（OR=1.893、1.540、1.422）、既往脱失（OR=0.561）均是接受ART的HIV感染者/AIDS患者服药依从性的独立影响因...     

HIV/AIDS患者合并机会性感染 与卫生服务利用现状分析

摘要:目的　分析HIV/AIDS患者合并机会感染与卫生服务利用的现状。方法　采用随机整群抽样对HIV/AIDS患者进行合并机会性感染及卫生服务利用问卷调查。结果　HIV/AIDS患者合并机会性感染率为57.78%;HIV/AIDS未合并机会性感染者和合并机会性感染者两周患病率分别为38.60%和73.08%,差异有统计学意义（P＜0.05）;HIV/AIDS未合并机会性感染者和合并机会性感染者两周就诊率分别为49.12%和76.92%,差异有统计学意义（P＜0.05）;HIV/AIDS患者家庭经济困难占64.71%,是他们未就诊的主要原因;HIV/AIDS患者选择医疗机构就诊差异有统计学意义（P＜0.05）;HIV/AIDS未合并机会性感染者和合并机会性感染者年住院率分别为15.79%和20.51%,差异无统计学意义（P＞0.05）;HIV/AIDS患者选择医疗机构住院差异无统计学意义（P＞0.05）。结论　HIV/AIDS合并机会感染者卫生服务利用量大于未合并机会感染者,HIV/AIDS患者卫生服务利用与医疗机构、病程、居住地、经济条件有关。     

某精细化工企业化学毒物职业病危害风险评价

[摘要]?衰弱综合征（衰弱）是一种由机体退行性改变和多种慢性疾病引起的机体易损性增加的综合征，与临床不良结局密切相关，严重影响HIV/AIDS患者的身体功能和生存质量。抗反转录病毒治疗（anti-retroviral therapy, ART）有效抑制了HIV复制，延长了感染者寿命，加速了HIV/AIDS患者的老龄化趋势。本文围绕老年HIV/AIDS患者衰弱的流行病学特征、可能机制以及应对措施进行综述，为老年HIV/AIDS患者衰弱的早期识别和及时干预提供参考。     

企业职工高尿酸血症与血压、血脂、血糖的相关性研究

目的探讨企业职工高尿酸血症（HUA）与血压、血脂、血糖的相关性,为企业进行健康管理提供依据。方法以中国石油长庆油田公司各下属企业为抽样单位,整群随机抽取2个单位,每个单位中所有的HUA者作为HUA组,共720人;同时在尿酸水平正常者中随机选取620人为正常组。通过Logistic回归分析HUA与年龄、性别、血压、血脂、血糖的关系。结果HUA合并高血压、高血脂、空腹m糖受损任意一项、两项、三项的比例均远高于正常组（OR值分别为：4．036,2．562,4．174）。多因素Logistic回归发现：男性、收缩压、总胆固醇、三酰甘油、低密度脂蛋白胆固醇是HUA的危险因素（OR值分别为7．736,2．309,1．721,2．761,1．411）;高密度脂蛋白胆固醇为HUA的保护因素（OR值为0．211）。结论HUA存在性别差异,且与血压、血脂密切相关。企业对职工的健康管理应充分考虑多危险因素的综合作用,全面的进行健康教育及干预。     

癌缺氧病因及预防和治疗

目的 探讨癌及安阳林州市食管癌高发原因及癌病因预防和治疗措施.方法 对林州市食管癌等疾病现场进行调查,在进行10余年统计分析基础上,综合分析了全国156篇文献成果.结果 提出癌缺氧病因学说,使用制氧机、按摩器、饮用纯净水治疗恶性肿瘤,取得良好效果,改水能够大幅降低林州市居民食管癌发病率、死亡率.结论 癌可能是由于机体长...     

Recruitment and retention challenges and successes

Objective: Addressing health disparities requires well designed, culturally adapted research. However, recruiting/retaining minority participants has often been challenging. We present strategies used to successfully recruit and retain rural Hispanic women during a breastfeeding education intervention.

Design: This study involved a two-group repeated measures quasi-experimental design with assessments at seven intervals between enrollment and 6 months postpartum. Participants (Hispanic women?≥?15 years old) were recruited through a regional hospital.

Results: We successfully met our recruitment goals, most women contacted were enrolled (46 of 58), and 100% completed the study.

Discussion: Research staff with ties within the community helped establish trust. Using bilingual study materials, simple language, and an interpreter addressed language/literacy concerns. Phone assessments facilitated participation as transportation was an issue. Accommodating requests to deliver or mail study materials and providing incentives were important. Extra effort was needed to maintain contact when phone service was disrupted or participants moved. Keys to success were persistence, flexibility, and alleviating barriers to participation.     

初产妇与经产妇焦虑抑郁状态分析及干预

目的：分析初产妇、经产妇心理状态特点,以便采取更有效的干预措施。方法筛选2014年6月至2015年1月在咸阳市旬邑县妇幼保健院产科门诊产前检查的健康初产和经产妇各60名,孕周为28~40周。入组时用焦虑自评量表( SAS)、抑郁自评量表(SDS)对两组孕妇进行心理评定,并给1次支持性心理干预(40~60分钟),1周后再次用SAS、SDS对两组孕妇进行评定分析。结果经产妇干预前SAS(50.73±3.45)、SDS(49.13±3.86)评分明显高于初产妇SAS(42.45±2.08)、SDS(41.77±2.21),差异均有统计学意义(t值分别为-15.921、-12.817,均P<0.01);干预后两组SAS、SDS评分均比干预前明显降低,差异均有统计学意义(t值分别为14.999、15.413;15.724、15.832,均P<0.01);干预后经产妇 SAS(38.61±5.02)、SDS(39.10±3.03)评分明显高于初产妇SAS(34.88±3.31)、SDS(32.01±4.27),差异均有统计学意义(t值分别为-4.805、-10.489,均P<0.01)。结论初产妇和经产妇均伴有焦虑、抑郁情绪,干预前后经产妇抑郁、焦虑情绪均较初产妇明显,支持性心理干预能有效改善孕妇的不良情绪。     

Continuity and change in neighborhood disadvantage and adolescent depression and anxiety

We used data from the Fragile Families and Child Wellbeing Study which includes a sample of adolescents of age 15 at the most recent wave (between 2014 and 2017) from mainly low-income urban families in the United States, to examine the association between neighborhood poverty entries and exits and adolescent depression and anxiety. In addition, we examined whether these associations differed by gender. Adolescents who consistently lived in disadvantaged neighborhoods had the highest level of depression and anxiety. Those who entered poor neighborhoods were more depressed than those who never lived in poor neighborhoods. Those who exited poor neighborhoods showed no significant difference in depression and anxiety compared to those never lived in poor neighborhoods. Furthermore, these associations applied to adolescent girls only and were not statistically significant for boys. The results suggest that neighborhood poverty has cumulative negative impacts on adolescent mental health and disproportionally affects adolescent girls. Reducing neighborhood poverty would substantially improve the health of adolescents, especially girls, which would reduce health disparities.     

Enabling positive change: Progress and setbacks in HIV and sexual and reproductive health and rights

At a point in history when the future of sexual and reproductive health including HIV looks particularly uncertain, it is helpful to recognise that many of the challenges currently faced are neither new nor insurmountable. Reflecting on past achievements and lessons learned helps us to have confidence that positive change is feasible. This paper reflects on some of the changes observed in countries like India and Mozambique and identifies a range of factors which need to coalesce to enable these developments, along with specific contextual factors. It is the combination of these influences rather than any one of them alone that brought about the change in the three instances described – fostering a positive political response to HIV in its early years in India; bringing about policy reform on abortion in Mozambique; and increasing contraceptive prevalence and age at marriage in some districts in Bihar, India. Change is always fragile and susceptible to setbacks, but change-seekers can learn in the process and gain renewed hope that progress can and often does take place if they persevere.     

儿童青少年超重肥胖评价方法及SPSS和SAS实现

超重肥胖已成为世界各国儿童青少年面临的重大公共卫生问题之一。现行的儿童青少年超重肥胖筛查标准不统一,逐条评价或自行编写程序容易出错且效率较低。本研究以中国学龄儿童青少年超重与肥胖筛查标准为例,详细介绍了国际和中国共四种评价儿童青少年超重肥胖的方法和步骤,结合具体案例详细介绍其应用方法,同时编制SPSS和SAS程序包和解...     

Car ownership and the association between fruit and vegetable availability and diet

Objective

Nearly all research on the food environment and diet has not accounted for car ownership — a potential key modifying factor. This study examined the modifying effect of car ownership on the relationship between neighborhood fruit and vegetable availability and intake.

Methods

Data on respondents' (n = 760) fruit and vegetable intake, car ownership, and demographics came from the 2008 New Orleans Behavioral Risk Factor Surveillance System. Shelf space data on fresh, frozen, and canned fruits and vegetables were collected in 2008 from a random sample of New Orleans stores (n = 114). Availability measures were constructed by summing the amount of fruit and vegetable shelf space in all stores within defined distances from respondent households. Regression analyses controlled for demographics and were run separately for respondents with and without a car.

Results

Fruit and vegetable availability was positively associated with intake among non-car owners. An additional 100 m of shelf space within 2 km of a residence was predictive of a half-serving/day increase in fruit and vegetable intake. Availability was not associated with intake among car owners.

Conclusions

Future research and interventions to increase neighborhood healthy food options should consider car ownership rates in their target areas as an important modifying factor.