2015-2022年我国报告≥50岁经商业异性性行为感染的HIV/AIDS患者特征分析北大核心CSCD

目的 分析我国≥50岁经商业异性性行为感染的HIV/AIDS患者的特征，为艾滋病防控政策制定提供依据。方法 数据来源于中国疾病预防控制信息系统，选取2015-2022年报告年龄≥50岁、高危行为接触史为商业异性性行为的病例，应用SPSS 24.0软件进行描述性分析，采用SaTScan10.1.2软件选用Poisson分布模型进行时空聚集性分析。结果 我国报告经商业异性性行为感染HIV/AIDS患者中≥50岁所占比例从2015年45.4%上升至2022年67.8%(Cochran-Armitage趋势检验，Z=-73.96,P<0.001)。2015-2022年共报告≥50岁HIV/AIDS患者166 509例，其中男性157 214例（94.4%）、农民118 823例（71.4%）、已婚92 756例（55.7%）、小学及以下文化程度109 306例（65.6%），主要分布在西南地区84 940例（51.0%）和中南地区55 160例（33.1%）;119 417例（71.7%）发现方式为医疗机构检测，107 341例（64.5%）首次CD4细胞计数<350个/μL。地市级水平时空扫描分析发现，第一聚集区分布地域广泛，中心点坐标位于贵州六盘水市（26.13N,105.39E），半径达641.91 km，主要分布在西南和中南地区，聚集时段2019年（RR=5.59,P<0.001）。结论 2015-2022年我国报告≥50岁商业异性性行为感染HIV/AIDS患者占比逐年增加，主要分布在西南、中南地区。建议重点地区可在原有扩大检测基础上，进一步加大主动检测力度，并针对当地特点开展综合干预措施，阻断≥50岁人群商业异性性行为传播。     

云浮市2015-2019年新报告老年HIV/AIDS患者的流行病学特征

根据国内外有关HIV/AIDS患者的相关研究,常以50岁作为老年人的起点,将年龄≥50岁病例定义为老年病例¨-3].艾滋病已悄然进入老年人群,艾滋病向≥50岁人群蔓延已成为流行的新动向[4].截至2019年底,云浮市≥50岁HIV/AIDS患者占全人群比例为71.8％,远高于全国的34.66％[1].本研究通过分析云浮...     

扬州市HIV/AIDS病人中晚发现状况及其影响因素分析

目的了解扬州市报告艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人)中,晚发现病例的比例及相关影响因素。方法利用艾滋病综合防治信息系统数据,对2000年8月1日至2015年12月31日扬州市978例HIV/AIDS病人进行核实,共有771例调查对象符合要求,并对其行为史、个人主动检测意识等进行问卷调查,应用SPSS 19.0进行统计分析。结果 2000-2015年扬州市可随访的771例HIV/AIDS病人中,根据中国疾病预防控制中心2014年提出的定义,其中晚发现病例的比例为37.35%(288例)。2006年及之前的HIV/AIDS病人中,晚发现病例占25.00%(6/24),2015年晚发现率为40.21%(78/194),呈波动性上升。不同特征病例的晚发现比例不同:≥50岁、年收入1万~5万、离开过本地、异性性传播感染和样本来自临床就诊的病例,晚发现比例分别为47.44%(111/234)、37.12%(134/361)、46.91%(114/243)、41.59%(141/339)、52.11%(99/190)。结论扬州市HIV/AIDS病人晚发现比例较高,应加强"反歧视宣传",积极为各种高危人群提供主动检测,尽早发现感染者。     

贵阳市2005-2019年报告经男男性行为感染的HIV/AIDS患者首次CD4细胞检测情况

目的了解2005-2019年贵阳市新报告经男男性行为感染的HIV/AIDS患者特征,分析CD4细胞检测及时性和结果,探索相关影响因素。方法使用"艾滋病综合防治信息系统"截至2019年12月31日的病例报告历史卡片和随访数据库,运用卡方检验和二分类Logistic回归模型等方法,对HIV/AIDS患者首次CD4细胞检测情况进行分析比较。结果 2005-2019年贵阳市共报告2 151例经男男性行为感染的HIV/AIDS患者,其中HIV感染者和AIDS患者所占比例分别为72.6%和27.4%。HIV/AIDS患者确证后14天内检测CD4细胞所占的比例为48.3%,多因素分析结果显示,户籍地是外省(OR=1.54,95%CI:1.16～2.03)和本省其他地区(OR=1.55,95%CI:1.25～1.91),初中及以下(OR=1.34,95%CI:1.01～1.76),2005-2009年(OR=2.86,95%CI:2.08～3.93)和2010-2014年(OR=2.13,95%CI:1.75～2.59)报告的病例确证后及时进行CD4细胞检测的比例较低;来源于咨询检测病例(OR=0.44,95%CI:0.36～0.53)及时进行CD4细胞检测的比例较高。HIV/AIDS患者CD4细胞计数350个/μL比例为50.7%,多因素Logistic回归分析结果显示,35～44岁组(OR=2.05,95%CI:1.16～3.64)和45岁以上组(OR=2.57,95%CI:1.32～5.02),在婚(OR=1.71,95%CI:1.12～2.62)、来源于医疗机构(OR=1.92,95%CI:1.21～3.05)、2010-2014年(OR=1.41,95%CI:1.02～1.93)和2015-2019年(OR=1.95,95%CI:1.44～2.65)报告的HIV/AIDS患者晚发现比例更高。结论贵阳市报告经男男性行为感染HIV/AIDS患者数多,确证后及时进行CD4细胞检测的比例低,晚发现的比例高,针对相关影响因素,应继续扩大男男性行为者的HIV检测覆盖面,做到早发现,早管理和早治疗。     

2013年北京市新报告HIV/AIDS病人中晚发现病例的特征

目的了解北京市2013年新报告的艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人)中,晚发现病例的比例及相关影响因素。方法利用艾滋病综合防治信息系统数据,对北京市2013年1月1日至2013年12月31日期间新报告的病例进行分析。结果 2013年北京市共新报告HIV/AIDS病人2770例。根据中国疾病预防控制中心2014年提出的定义,其中晚发现病例的比例为22.38%。不同特征的病例晚发现比例不同:女性、已婚有配偶、异性性传播感染和样本来自医院的病例晚发现比例较高,分别为33.33%、36.78%、33.24%和34.46%。另外,随着年龄的增加和文化程度的降低晚发现比例有所上升。结论性别、婚姻状况、传播途径、样本来源、年龄和文化程度等,是影响北京市2013年新报告的HIV/AIDS病人晚发现比例的重要因素。     

江西省2014—2018年新报告HIV/AIDS病例晚发现情况及影响因素分析

目的分析江西省2014—2018年新报告艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人)晚发现情况及影响因素。方法利用艾滋病综合防治信息系统,选取2014—2018年新报告现住址为江西省的HIV/AIDS病例采用单因素和多因素Logistic回归模型进行分析。结果2014—2018年共报告HIV/AIDS病例11 557例,晚发现比例为45.23%,各年晚发现比例分别为40.35%、48.47%、51.10%、44.17%和42.56%。单因素分析显示,不同性别、年龄、文化程度、婚姻状况、职业、感染途径、样本来源和地区流动的晚发现差异有统计学意义(P0.05)。多因素Logistic回归分析显示,晚发现的危险因素为男性、≥50岁、小学及以下、有婚史、农民、异性性传播和样本来源于医疗机构者。结论江西省2014—2018年新报告HIV/AIDS病例中晚发现比例高,应积极推动各级医疗机构开展医务人员主动提供艾滋病检测咨询服务,同时扩大对重点人群的宣传教育及检测动员,促进病例的早期发现。     

杭州市萧山区2002-2013年老年HIV/AIDS病人特征分析

目的分析2002-2013年萧山区老年人艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人)的相关特征,为制定老年人艾滋病防治措施提供科学依据。方法收集萧山区2002-2013年的老年HIV/AIDS病人疫情报告资料,对病例人口学特点、传播途径构成、发现途径及相关信息进行分析。结果 2002-2013年累计报告HIV/AIDS病人299例,其中≥50岁占16.1%(48/299);平均年龄(58.8±8.21)岁,最大86岁。48例病人中,男性占75.0%(36人);85.4%(41人)为本地居民;农民占43.8%(21人);小学和初中占87.5%(42人);性传播感染占93.8%(45人);已婚有配偶占75.0%(36人)。已婚有配偶者中,28名配偶检测了HIV抗体,阳性率为28.6%(8人)。老年HIV/AIDS病人多来自临床医疗机构及阳性者配偶或性伴侣检测,其中临床医疗机构占72.9%(35/48)。结论萧山区老年人艾滋病报告病例数增长明显,性接触是主要传播途径,临床医疗机构及阳性者配偶或性伴侣检测在发现病例中占较大比例,应进一步加强老年人艾滋病预防宣传教育。     

2015-2019年我国接受抗病毒治疗成年HIV/AIDS患者病死率分析

目的 分析2015-2019年期间我国接受ART成年HIV/AIDS患者病死率变化情况.方法 采用连续横断面研究方法,以自然年为单位,描述性分析全国2015-2019年历年接受ART成年HIV/AIDS患者主要特征及粗病死率,并以2015年年龄构成为标准,计算历年年龄标化病死率.结果 2015-2019年历年纳入分析的...     

2008-2022年我国报告女性HIV/AIDS患者特征分析

目的 分析我国2008-2022年报告女性HIV/AIDS患者特征,为制定有针对性的女性群体艾滋病防控策略提供数据支撑。方法 选择中国疾病预防控制信息系统2008-2022年当年新诊断报告、性别为女性HIV/AIDS患者进行分析。采用Excel2016和SPSS 24.0软件进行数据整理和描述性统计分析。采用Joinpoint Regression Program4.9.0软件,选用对数线性模型进行发现率时间趋势分析,计算年均变化百分比（AAPC）和年度变化百分比（APC）,检验水准为α=0.05。结果 2008-2022年我国女性HIV/AIDS患者报告数先上升后下降,占全部报告数的20%以上。发现率从2008年2.7/10万上升至2019年5.0/10万,之后呈现下降趋势,2022年降至3.4/10万;时间趋势分析结果显示,2008-2015年APC=4.5%(3.3%～5.8%),2015-2019年APC=8.2%(4.3%～12.2%),2019-2022年APC=-12.8%(-16.2%～-9.3%);2008-2022年AAPC=1.5%(0.3%～2.8%)。20～2...     

天津市南开区2015-2019年新报告HIV/AIDS患者首次CD4细胞检测情况分析

目的了解天津市南开区2015-2019年新报告的HIV/AIDS患者首次CD4细胞检测情况,为制订有效的艾滋病防治措施提供科学依据。方法以全国艾滋病综合防治信息系统数据为基础,采用描述性流行病学方法,分析2015-2019年新报告的HIV/AIDS患者首次CD4细胞检测情况。结果 2015-2019年,天津市南开区共报告HIV/AIDS患者711例,首次CD4细胞计数低于200个/μL的比例由2015年的35.6%下降至2019年的23.5%,差异有统计学意义(χ~2=4.325,P 0.05)。文化程度是初中及以下、户籍是外地流动人口、样本来源是医疗机构和无偿献血发现的病例,其CD4细胞检测及时率较低,分别为68.5%、67.0%、83.5%和50.2%。年龄较大、本市人口、非定点医院发现的病例晚发现比例较高,分别为59.1%、47.8%、57.7%。结论在现有工作的基础上,加强首次随访管理工作,强调CD4细胞检测的重要性;扩大HIV检测覆盖面,特别是针对老年人的宣传防治工作,加大医疗机构主动开展HIV检测的力度,让更多的人尽早了解自己的感染状况。     

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.     

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.     

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.     

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.