青岛低龄女性性工作者HIV/STD相关因素调查和血清学监测

目的:了解青岛地区娱乐场所低龄女性性工作者(FSWs) HIV/STD相关因素和血清学状况,为有效干预提供依据.方法:对青岛地区娱乐场所FSWs进行匿名问卷调查,并采取末梢血检测抗HIV、梅毒和生殖器疱疹病毒2型抗体(抗HSV2-IgG).结果:共回收有效问卷336份,其中<20岁问卷132份,平均年龄(18.5±1.2)岁,首次性交年龄(16.8±1.5)岁,首次商业性行为年龄(17.9±1.3)岁.HIV/STD相关知识知晓率为59.7%, HIV/STD知识与年龄、受教育水平及与固定性伴带套率呈正相关.66.7%最近一次与固定性伴性交时未使用安全套.血清TRUST、TPPA、抗HSV2-IgG阳性率分别为3.8%、7.6%、28.8%,抗HIV抗体均阴性.结论:对低龄FSWs需要有效的干预措施以减少感染 HIV/STD的危险.     

058 1994～1998年美国6城市年轻黑人男男性接触者中未识别的HIV感染、危险行为和认识危险

美国年轻黑人男男性接触者(BMSM)中的HIV感染在所有危险人群中发病最高。在年轻BMSM中减少HIV传播的两项重要对策是:增加男性察觉到自己已感染HIV的比例及在性活跃男性中坚持使用安全套。但帮助BMSM开展HIV试验并推广安全套计划的信息很少。针对这些需要,以CDC对年轻男性调查得到的资料来评估未识别HIV感染     

广东省淋病就诊者安全套使用现状及其影响因素分析

目的:了解广东省淋病就诊者安全套使用情况并探讨其影响因素,为相关决策部门制定干预措施提供依据。方法:通过横断面调查,在广东省21个地级市的医疗机构招募近6个月有性接触史的淋病就诊患者进行问卷调查,收集一般人口学特征、性行为学等信息,通过单因素和多因素Logistic回归分析安全套使用的影响因素。结果:本研究共纳入1 695例患者,平均年龄为(31.17±9.86)岁。研究对象与商业性伴发生阴道交性行为时安全套使用率为80.39%,与配偶/固定性伴为64.25%,与非固定非商业性伴为69.11%,差异有统计学意义(χ~2=48.99,P0.01);多因素Logistic回归显示年龄、文化程度、婚姻状况、既往HIV感染/性病史是淋病就诊患者发生性行为时安全套使用的影响因素。结论:淋病就诊患者安全套使用率较低,与配偶/固定性伴发生性关系时使用率最低。文化程度低、既往无HIV感染/性病史是不使用安全套的危险因素,因此需要加强此类人群的干预,减少淋病等性病的传播。     

广州地区女性性工作者梅毒感染率及影响因素分析

目的:调查广州地区女性性工作者(FSWs)梅毒感染率及危险因素,指导针对该人群的梅毒防治工作。方法:采用方便抽样法,知情同意后填写结构式问卷,并采集2 m L静脉血分离血清,TRUST、TPPA分别检测梅毒非特异性、特异性抗体,结果和问卷资料用SPSS 13.0分析。结果:共调查FSWs279名,血清TPPA阳性率为8.2%,梅毒感染率为1.43%。按照服务场所分类,中低档场所服务FSWs的血清TPPA阳性率为9.4%,梅毒感染率为1.64%;高档场所FSWs梅毒血清阳性率及感染率为0。多因素分析发现婚姻状态单身者(OR=14.85,95%CI 1.69~130.71)、既往有非梅毒STD史(OR=19.54,95%CI 4.21~90.61)是危险因素。结论:广州地区FSWs梅毒血清阳性率比国内其他城市略低,且主要是中低档FSWs为主,结合其特点开展针对该人群的梅毒防治工作非常必要。     

广州地区MSM和FSWs的性病知晓情况及梅毒艾滋病感染因素分析

目的:了解广州地区男男同性性行为者(MSM)、女性性工作者(FSWs)的性病知晓情况及梅毒、艾滋病病毒感染现况,并分析感染因素。方法:经知情同意后,2017年4-8月对广州地区MSM和FSWs两类高危人群进行面对面问卷调查,采集静脉血检测梅毒及HIV抗体,并进行统计学分析。结果:314例MSM的性病相关疾病知晓率、性病传播途径知晓率、性病防止感染方式知晓率分别为62.10%、44.59%、41.08%,408例FSWs以上知晓率分别为49.02%、22.06%、31.13%。264例MSM参与梅毒及HIV抗体检测,梅毒感染率为1.52%,HIV感染率为10.23%;多因素Logistic逐步回归分析结果显示,学历高中及以上(OR=0.360,95%CI:0.131~0.989),知晓性病相关疾病(OR=0.373,95%CI:0.157~0.881)是感染HIV的保护因素,认为自己可能感染艾滋病(OR=3.440,95%CI:1.401~8.443)和梅毒检测结果阳性(OR=14.151,95%CI:1.745~114.736)是危险因素。FSWs梅毒感染率为3.92%,HIV感染率为0.25%;场所为中高档是感染梅毒的保护因素(OR=0.166,95%CI:0.052~0.526)。结论:广州地区MSM和FSWs的梅毒、艾滋病病毒感染率高,性病知识知晓率低,应扩大高危人群梅毒、艾滋病病毒筛查范围,并加强性病知识宣教。     

402名女性性工作者HIV、梅毒感染状况及危险因素调查分析

目的了解我市城区女性性工作者HIV和梅毒感染状况及其危险因素,为更好的在女性性工作者中,有针对性地开展行为干预工作提供依据。方法采用随机抽样法随机抽取卡拉OK厅、歌舞厅等场所,对女性性工作者采取一对一问卷调查并采取血液样本检测HIV和梅毒。结果调查女性性工作者402名,HIV阳性13例,感染率3.2%,梅毒阳性9例,感染率2.2%,其中有固定性伴43.1%,最后一次与固定性伴性交时,使用和不使用安全套HIV阳性率及梅毒阳性率的差异有显著性意义。文盲与高中以上相比HIV阳性率差异有显著性意义,而不同年龄、不同婚姻状况无显著差异。结论女性性工作者是HIV感染的重要人群,不安全性行为是其感染HIV和梅毒的主要原因,与固定性伴安全套使用低,存在HIV通过高危人群向一般人群传播的危险。     

广州市520名男男性行为者HIV感染情况及影响因素分析

目的:了解广州市男男性行为者(MSM)的艾滋病知识、高危行为以及艾滋病、梅毒感染情况及影响因素,为针对性开展MSM人群艾滋病防治工作提供依据。方法:面对面问卷调查520名MSM人群的艾滋病知识、行为情况,并进行艾滋病、梅毒血清学检测。结果:艾滋病知识知晓率为90.19%(469/520);HIV抗体阳性率为9.23%(48/520),梅毒阳性检出率为5.77%(30/520);最近六个月同性肛交性行为时每次均用安全套比例为53.81%(240/446);多因素logistic回归分析结果显示,感染了性病[OR=3.333,95%CI:(1.146~9.696)]、最近六个月与同性发生肛交性行为使用安全套的频率较少[OR=3.460,95%CI:(1.770~6.763)]是HIV感染的危险因素(P0.05)。结论:广州市MSM人群艾滋病知识知晓率高、安全套使用率低、知行分离严重,艾滋病、梅毒感染率高,应加强有效的干预检测和性病诊治。     

天津市中职在校学生艾滋病知识知晓及性行为特征

目的:了解天津市中职学生艾滋病知晓及性行为特征。方法:采用2011~2014年天津市青年学生艾滋病监测哨点数据,对中职学生发生性行为的比例及影响因素进行统计分析。结果:2011~2014年共调查1641名中职在校学生,其中1例HIV确认结果阳性,为男男同性性接触感染;受访学生总体艾滋病知识知晓率低;8.5%(140/1641)的学生自述发生过性行为;最近1年坚持使用安全套比例低(16.4%)。结论:中职学生性行为比例高,艾滋病知晓率低,安全套使用率低,感染艾滋病风险高,应该加强中职学生群体的艾滋病检测宣传等工作。     

江苏省建湖县农村地区出国务工返乡人员STD/HIV专题调查情况分析

目的:了解建湖县农村地区出国务工返乡人员STD/HIV感染情况、危险行为,为实施农民工健康教育工作提供依据.方法:对目标人群作STD/HIV监测,同时采用问卷调查,调查目标人群的人口学、艾滋病相关知识、安全套使用、自愿咨询检测,STD患病史、求医行为、是否接触宣传工作等.结果:在被调查的409人中,36-45岁为主占55.5%,初中文化占72.25%,梅毒、HIV、丙肝感染率分别为7.1%、0.7%、4.4%.正确认识艾滋病预防、传播知识的比例分别为62.1%、50.1%,每次用安全套、自愿HIV检测、接触健康教育措施1条以上人员总体较低,比例分别为31.3%、55.3%和21.5%.结论:只有通过综合措施,针对性地强化高危行为的认知,建立良好的行为方式,才能有效遏制性病、艾滋病在出国务工人员中的流行.     

中低档场所女性性工作者梅毒艾滋病感染调查

目的:了解中低档场所女性性工作者(服务小姐)梅毒和艾滋病感染状况,以便开展有针对性的综合干预.方法:对娱乐场所服务小姐进行梅毒和艾滋病血清学筛查,并对中低档小姐进行问卷调查.结果:共筛查了742名性服务小姐,梅毒检出率平均20.2%,其中低档38.0%;中低档21.3%;中档8.9%.HIV检出率低档和中档为0,中低档2.1%(3例HIV抗体阳性).中低档小姐年龄低于低档小姐,接客量大,并较少使用安全套.结论:中低档系女性性工作者中的重点干预对象.     

Characteristics of cutaneous adverse drug reactions caused by triple-combination drug therapy used for Helicobacter pylori eradication

Cutaneous adverse drug reactions (cADR) should be appropriately managed in drug administration. LANSAP^®, Rabecure^® and VONOSAP^® are currently used for Helicobacter pylori eradication therapy. Here, we examined the characteristics of cADR caused by these drugs using data from the Pharmaceuticals and Medical Devices Agency (PMDA). Periods subject to analyses were set according to the year of release of these drugs: (i) from 2008 to 2017 for LANSAP; (ii) from 2014 to 2017 for Rabecure; and (iii) 2017 for VONOSAP. Among all cADR reported to the PMDA, those attributed to LANSAP, Rabecure and VONOSAP accounted for 2.3%, 1.0% and 3.6% of cases, respectively. cADR occurred in patients aged in their 20s or older, with the oldest patients aged in their 60s. Numbers of male and female patients were 28 and 70 for LANSAP, eight and 14 for Rabecure and three and 16 for VONOSAP, respectively. Statistical analyses revealed significant sex differences for LANSAP (P = 0.022) and VONOSAP (P = 0.012), but not for Rabecure (P = 0.729). LANSAP, Rabecure or VONOSAP caused erythema multiforme in the largest population of patients and Stevens–Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) in three patients. Ratios of SJS/TEN were 0.0–5.3% for LANSAP, Rabecure or VONOSAP, but 11.5–44.8% for the corresponding single constituent drugs other than vonoprazan. In conclusion, female sex appears to represent a risk factor for cADR attributed to H. pylori eradication therapy using LANSAP or VONOSAP, although H. pylori eradication therapy without these drugs rarely causes severe cADR.     

Cutaneous Manifestations of HIV/AIDS in the Era of Highly Active Antiretroviral Therapy: Evidence from Bangladesh

Objective: Skin diseases are common and striking features of patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and may vary considerably by ethnic and geographic regions and by the influence of highly active antiretroviral therapy (HAART). However, little information exists regarding the cutaneous manifestations of patients with HIV/AIDS in Bangladesh. This study was performed to elucidate the spectrum of cutaneous disorders in patients with HIV/AIDS in the...     

Alpha‐Glucosylrutin: ein hochwirksames Flavonoid zum Schutz vor oxidativem Streß

The flavonoid alpha‐glucosylrutin (AGR) is a potent antioxidant with a high epidermal bioavailability. This makes this substance particularly suitable for various dermato‐cosmetic applications. Flavonoids are phytamines with a common chemical structure and a broad range of activities, the most prominent being their radical scavenging ability. Reactive oxygen species (ROS) damage cells by different mechanisms. Direct cytotoxic effects include destruction of the cell membrane by causing radical chain reactions or induction of mutagenic changes in the nuclear and mitochondrial DNA. Indirect changes involve modification of intracellular signal transduction pathways that regulate inflammatory or proliferative activities. The excellent antioxidant efficacy of AGR has been shown in various experimental studies, both in vitro and in vivo. Subsequent clinical studies have demonstrated that AGR is also effective in the prevention of dermatologic diseases in which oxidative stress is of pathogenetic relevance, e.g. in polymorphous light eruption (PLE). Other promising dermato‐cosmetic areas for AGR application are aging of the skin, especially photoaging. All in vivo evaluations indicate that AGR in the applied concentrations is a very well‐tolerated ingredient for medical skin care preparations.     

Cutaneous Manifestations and Treatment Advances of Adult T-Cell Leukemia/Lymphoma

Adult T-cell leukemia/lymphoma (ATLL) is an aggressive peripheral T-cell lymphoma caused by the human T lymphotropic virus type-1. The skin is affected in approximately half of ATLL patients, and skin lesions may be the first manifestation of the disease. The skin lesions of ATLL are polymorphous, and depend on the type of skin eruption, which makes it possible for doctors to predict the prognosis of the disease based on the characteristics of skin lesions. In this review article, we describe th...     

Phenotypic heterogeneity of lymphoma of the skin

We studied surface markers present in 56 cases of lymphoma of the skin by immunohistochemical staining, using the ABC (avidin-biotin-peroxidase complex) and PAP (peroxidase-antiperoxidase complex) methods. Of these cases, 49 were T-cell lymphoma and 7 were B-cell lymphoma. Ten of the 49 cases of T-cell lymphoma were adult T-cell leukemia/lymphoma (ATL). Twenty-five of 31 cases of T-cell lymphoma except ATL analyzed by the ABC method showed a helper/inducer phenotype (Leu2a-,Leu3a+), two cases showed a suppressor/cytotoxic phenotype (Leu2a+, Leu3a-), one case showed Leu2a+Leu3a+, one case showed an inducer phenotype (Leu2a-, Leu3a+, Leu9+), and one case showed OKT11+, Leu2a-, Leu3a-, Leu1-, Leu9+, CD25+, Leu10+, CD30+. One CD8+ lymphoma was Pagetoid reticulosis, and a CD4+, CD8+ lymphoma was lymphomatoid papulosis with erythematous plaque. Cutaneous T-cell lymphoma (CTCL), previously described by Edelson et al., is defined as a helper T-cell lymphoma with marked affinity for the skin. In our study, 5 cases of T-cell lymphoma of the skin were not CTCL as described by Edelson et al. These results show that T-cell lymphoma of the skin is heterogeneous in nature. In other words, CTCL is one type but represents a major proportion of T-cell lymphomas of the skin.     

PI3K/AKT信号转导通路和VEGF在子宫内膜异位症中的表达

目的:探讨子宫内膜异位症(EMs)患者中磷脂酰肌醇-3激酶/蛋白激酶B(PI3K/AKT)和血管内皮生长因子(VEGF)表达水平。方法:采用EMs患者32例,取在位子宫内膜和异位内膜,无EMs患者34例,取子宫内膜,作为对照组。采用半定量RT-PCR法检测PI3K/AKT与VEGFmRNA表达,ELISA法检测PI3K/AKT蛋白和VEGF蛋白表达。结果:正常子宫内膜、异位子宫内膜和在位子宫内膜PI3K、AKT和VEGF mRNA和蛋白表达水平差异有统计学意义(P0.01)。异位内膜PI3K、AKT和VEGF的mRNA和蛋白的表达均高于在位内膜及正常内膜(P0.01)。EMs中,Ⅰ、Ⅱ期PI3K、AKT和VEGF mRNA和蛋白的表达与Ⅲ、Ⅳ期异位内膜相比,均无显著性差异(P0.05)。结论:PI3K/AKT信号转导通路和VEGF共同参与EMs的发生和发展。     

尖锐湿疣及湿疣样病变中HPV6／11DNA原位杂交的观察

对４８例生殖道尖锐湿疣（ＣＡ）及湿疣样病变常规石蜡包埋组织切片进行人乳头瘤病毒（ＨＰＶ）６／１１型ＤＮＡ原位分子杂交及病理组织学观察，在１２例ＣＡ中９例（７５％）和湿疣样病变中１例（２．７％）检出ＨＰＶ６／１１ＤＮＡ，阳性细胞位于鳞状上皮中表层的凹空细胞及其周围细胞核内。在ＣＡ与湿疣样病变的鉴别诊断中，ＨＰＶ６／１１ＤＮＡ原位杂交检测具有重要的价值。     

A Case of Chronic GVHD Following Bone Marrow Transplantation from a Phenotypically HLA-Matched Unrelated Donor

A 45-year-old male with chronic myelocytic leukemia who received a bone marrow transplantation from a phenotypically HLA-matched unrelated donor developed chronic GVHD on day 100 post transplantation. He developed a slight fever, malaise, hepatic dysfunction and extensive itchy erythema with scaling over his entire body. The inflammatory skin lesion developed into erythroderma in about two weeks. H&E staining of a skin biopsy revealed eosinophilic bodies and a lymphocytic infiltration in the dermis and epidermis, which were compatible with the early phases of chronic GVHD. Immunohistochemistry revealed that keratinocytes expressed dense HLA-DR and ICAM-1 epitopes. Langerhans cells (CD1a⁺ cells) had disappeared from the epidermis. Many T cells (CD3⁺ cells) had migrated into the epidermis as well as into the reticular dermis. The majority of the T cells in the epidermis were CD8⁺ cells, while almost all the T cells in the dermis were CD4⁺ cells. These immunohistochemical features were similar to those previously reported for acute cutaneous GVHD. Despite the corticosteroid therapy, the eruptions did not disappear. The patient was then treated with whole body bath-methoxsalen (Oxsoralen®) plus ultraviolet A (UVA). The bath-psoralen plus UVA therapy was effective in this patient.     

Hemophagocytic lymphohistiocytosis with advanced malignant melanoma accompanied by ipilimumab and nivolumab: A case report and literature review

Combination therapy with nivolumab + ipilimumab was recently approved for treating unresectable cases of malignant melanoma. In spite of the high response rate, it is associated with a high incidence of serious adverse events, including immune‐related hemophagocytic syndrome/hemophagocytic lymphohistiocytosis (irHPS/HLH), a difficult to diagnose rare disease. This is the first report of this disease in an Asian malignant melanoma patient treated with nivolumab + ipilimumab. A 69‐year‐old Japanese woman with unresectable malignant melanoma was treated with nivolumab + ipilimumab. Following the combined therapy, her fever and symptoms of malaise occurred, and she visited to our hospital's emergency department. Blood tests revealed significant liver dysfunction, anemia, and thrombocytopenia. We suspected irHPS/HLH, based on tests revealing decreased fibrinogen and significantly increased ferritin. Bone marrow biopsy revealed numerous macrophages and high hemophagocytosis levels. After 50 mg prednisolone (1 mg/kg per day) was administered, fever and cytopenia markedly improved. irHPS/HLH has a high rate of coagulation abnormalities accompanied by hypertriglyceridemia and hypofibrinogenemia, which are unlikely to occur in adult HPS/HLHs. Because irHPS/HLH responds better to steroids than other secondary HPS/HLHs, we expect a complete cure with steroids. Quick diagnosis and appropriate treatment based on clinical symptoms and laboratory tests are needed in suspected cases.