Nd:YAG激光加BCG膀胱灌注治疗浅表性膀胱癌

本文将45例经Nd:YAG激光治疗的膀胱癌患者随机分组,对33例做了卡介苗(BCG)膀胱灌注,12例做了噻替派(thiotepa)膀胱灌注,并分别随访了3～18个月,平均9.8个月,BCC组膀胱癌再发率3％(1/33),噻替派组膀胱癌再发率为25％(3/12)(P<0.01)。     

Macroscopic hematuria in wasp sting patients: a retrospective study

BackgroundMacroscopic hematuria after wasp sting has been reported in Asia to occur before acute kidney injury (AKI), and is often used by clinicians as a sign indicating the need for intensive care and blood purification therapy. However, there is no study on the clinical characteristics and prognosis of this symptom.MethodsThe clinical data of 363 patients with wasp sting admitted to Suining Central Hospital from January 2016 to December 2018 were retrospectively analyzed. At admission, the poisoning severity score (PSS) was used as the criterion for severity classification. According to the presence of macroscopic hematuria, the patients were divided into macroscopic hematuria and non-macroscopic hematuria group.ResultsOf the 363 wasp sting patients, 219 were male and 144 were female, with a mean age of 55.9 ± 16.3 years. Fifty-one (14%) had macroscopic hematuria, 39 (10.7%) had AKI, 105 (28.9%) had rhabdomyolysis, 61 (16.8%) had hemolysis, 45 (12.4%) went on to received hemodialysis, and 14 (3.9%) died. The incidence of AKI in macroscopic hematuria group was 70.6%, and oliguric renal failure accounted for 72.2%. Patients with macroscopic hematuria had significantly higher PSS (2.2 ± 0.5 vs. 1.1 ± 0.3, p < .001).ConclusionMacroscopic hematuria can be regarded as a surrogate marker of deteriorating clinical outcome following wasp stings. In wasp sting patients with symptoms of macroscopic hematuria or serum LDH higher than 463.5 u/L upon admission, the risk of AKI increases significantly, therefore hemodialysis should be considered. The PSS is helpful in early assessment of the severity of wasp sting patients.     

Comparing Immune Responses to Inactivated Vaccines against SARS-CoV-2 between People Living with HIV and HIV-Negative Individuals: A Cross-Sectional Study in China

This study compared the immunogenicity of inactivated SARS-CoV-2 vaccines between people living with HIV (PLWH) and HIV-negative individuals. We recruited 120 PLWH and 53 HIV-negative individuals aged 18–59 years who had received an inactivated SARS-CoV-2 vaccine in two Chinese cities between April and June 2021. Blood samples were tested for immunogenicity of the inactivated SARS-CoV-2 vaccines. The prevalence and severity of adverse events associated with SARS-CoV-2 vaccines were similar between PLWH and HIV-negative individuals. The seropositivity of neutralizing activity against authentic SARS-CoV-2, of the total amount of antibody (total antibody) and of S-IgG were 71.3%, 81.9%, and 92.6%, respectively, among fully vaccinated PLWH. Among all participants, PLWH had lower neutralizing activity, total antibody, S-IgG, and T-cell-specific immune response levels, compared to HIV-negative individuals, after controlling for types of vaccine, time interval between first and second dose, time after receiving the second dose, and sociodemographic factors. PLWH with a longer interval since HIV diagnosis, who received their second dose 15–28 days prior to study commencement, and who had an interval of ≥21 days between first and second dose had higher neutralizing activity levels. The immunogenicity of the inactivated SARS-CoV-2 vaccines was lower among PLWH as compared to HIV-negative individuals. Vaccination guideline specific for PLWH should be developed.     

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。     

Kinetic interactions of dopamine and dobutamine with human catechol-O-methyltransferase and monoamine oxidase in vitro

Dopamine and dobutamine are often infused together into acutely ill patients requiring temporary support of cardiac and renal function, but whether these catecholamines affect the metabolic clearance of each other is not established. We determined the kinetics of dopamine and dobutamine as substrates and inhibitors of each other, i.e., apparent V(max), K(m), and K(i), with crude preparations of human blood mononuclear cell catechol-O-methyltransferase (COMT) and platelet monoamine oxidase (MAO) at pH 7.4 and 37 degrees C. Values of V(max) for dopamine and dobutamine as substrates for COMT were 0.45 and 0.59 nmol of 3-O-methyl product formed per milligram of protein per minute, whereas those for K(m) were 0.44 and 0.05 mM, respectively. Dopamine and dobutamine were competitive inhibitors of each other in this reaction. The K(i) for dopamine as an inhibitor of dobutamine methylation was 1.5 mM, whereas that for dobutamine as an inhibitor of dopamine methylation was 0.015 mM. Dopamine but not dobutamine was a substrate for MAO. The V(max) for dihydroxyphenylacetaldehyde formation from dopamine was 0.29 nmol/mg protein/min and the K(m) for dopamine was 0.38 mM. Dobutamine was a noncompetitive inhibitor of dopamine oxidation in this reaction (K(i) congruent with 1.19 mM). The high apparent K(m) and K(i) values derived for dopamine and dobutamine when tested with these two human enzymes in vitro suggest that these catecholamines do not interfere with the metabolism of each other when both are infused together at therapeutic concentrations.     

男男性行为人群艾滋病病毒新发感染风险的队列研究

目的 了解与分析影响MSM人群HIV新发感染的危险因素。方法 通过MSM队列研究,随访调查目标人群在随访期间HIV相关行为暴露情况,进而通过广义估计方程,分析该人群HIV新发感染影响因素。结果 2013－2015年对4 305名HIV阴性MSM进行了随访观察。网络交友的MSM发生被动插入性肛交的比例和肛交坚持使用安全套的比例高于会所酒吧和浴池交友的MSM。随访研究期间HIV平均阳转密度为4.3/100人年,被动接受肛交性行为者发生HIV新发感染的风险是主动插入方的2.20倍（95%CI：1.49～3.24）;使用助性剂（aRR＝1.55, 95%CI：1.10～2.17）、不能坚持使用安全套（aRR＝2.24,95%CI：1.62～3.08）和梅毒感染（aRR＝2.95,95%CI：2.00～4.35）是HIV新发感染的主要危险因素;而控制了其他因素后,3种交友方式与HIV新发感染的关联不再有统计学意义。结论 MSM人群中造成HIV流行的因素较为复杂,亟需多角度开展研究,为制定有针对性的防治措施提供依据。     

钚锶对大鼠复合作用的实验研究

本文探讨低剂量硝酸钚与硝酸锶对大鼠复合作用的实验研究。系统观察了体重、死亡率, 平均存活时间、X线片、病理组织学等项目指标的改变。通过三年左右的终生观察表明: (1)钚、锶复合作用对诱发骨肉瘤有相加效应, 并且潜伏期短, 多发性骨肉瘤也高于单一核素作用组, (2)复合作用组的死亡率高于单一核素组, (8)复合作用组的平均寿命比单一核素组缩短。     

我国男男性行为人群猴痘知识知晓率及相关因素现况调查

目的 了解我国MSM猴痘知识知晓率及相关因素。方法 调查对象为最近1年发生男男性行为的年龄≥18岁男性。采用方便抽样方法,估计样本量为4 312人。在我国30个省份MSM社会组织协助下,2023年8月10-14日,自行设计匿名调查问卷,采用问卷星进行在线问卷调查,收集调查对象的社会人口学特征、猴痘知识知晓、旅居史和性行为等信息。采用SAS 9.4软件进行统计学分析。结果 调查对象为7 725人,年龄（31.6±9.0）岁。猴痘知识知晓率为50.1%（3 872/7 725）。猴痘知识的主要获取途径是微信、微博、抖音和Blued社交软件等新媒体（88.4%,6 827/7 725）,猴痘知识的期望途径主要是官方媒体报道（79.3%,6 129/7 725）。多因素logistic回归分析结果显示,MSM猴痘知识知晓率较高的因素包括现住址地区为西部和东部地区、≥26岁青壮年、大专及以上文化程度、现居住地为城镇和城乡接合部、性取向为同性恋和双性恋、最近3个月发生男男性行为频次1~5次/月、知晓HIV感染状况为阴性和阳性、最近3个月对猴痘信息关注程度为经常、偶尔和极少关注、通过新媒体和社会组织获取猴痘知识。结论 我国MSM猴痘知识知晓率较低,应重点关注低年龄组、低文化程度和性行为活跃者,借助新媒体和社会组织力量,开展精准的健康教育。     

Willingness to Receive COVID-19 Vaccination Among People Living With HIV and AIDS in China: Nationwide Cross-sectional Online Survey

BackgroundHIV infection is a significant independent risk factor for both severe COVID-19 presentation at hospital admission and in-hospital mortality. Available information has suggested that people living with HIV and AIDS (PLWHA) could benefit from COVID-19 vaccination. However, there is a dearth of evidence on willingness to receive COVID-19 vaccination among PLWHA.ObjectiveThe aim of this study was to investigate willingness to receive COVID-19 vaccination among a national sample of PLWHA in China.MethodsThis cross-sectional online survey investigated factors associated with willingness to receive COVID-19 vaccination among PLWHA aged 18 to 65 years living in eight conveniently selected Chinese metropolitan cities between January and February 2021. Eight community-based organizations (CBOs) providing services to PLWHA facilitated the recruitment. Eligible PLWHA completed an online survey developed using a widely used encrypted web-based survey platform in China. We fitted a single logistic regression model to obtain adjusted odds ratios (aORs), which involved one of the independent variables of interest and all significant background variables. Path analysis was also used in the data analysis.ResultsOut of 10,845 PLWHA approached by the CBOs, 2740 completed the survey, and 170 had received at least one dose of the COVID-19 vaccine. This analysis was performed among 2570 participants who had never received COVID-19 vaccination. Over half of the participants reported willingness to receive COVID-19 vaccination (1470/2570, 57.2%). Perceptions related to COVID-19 vaccination were significantly associated with willingness to receive COVID-19 vaccination, including positive attitudes (aOR 1.11, 95% CI 1.09-1.12; P<.001), negative attitudes (aOR 0.96, 95% CI 0.94-0.97; P<.001), perceived support from significant others (perceived subjective norm; aOR 1.53, 95% CI 1.46-1.61; P<.001), and perceived behavioral control (aOR 1.13, 95% CI 1.11-1.14; P<.001). At the interpersonal level, receiving advice supportive of COVID-19 vaccination from doctors (aOR 1.99, 95% CI 1.65-2.40; P<.001), CBO staff (aOR 1.89, 95% CI 1.51-2.36; P<.001), friends and/or family members (aOR 3.22, 95% CI 1.93-5.35; P<.001), and PLWHA peers (aOR 2.38, 95% CI 1.85-3.08; P<.001) was associated with higher willingness to receive COVID-19 vaccination. The overall opinion supporting COVID-19 vaccination for PLWHA on the internet or social media was also positively associated with willingness to receive COVID-19 vaccination (aOR 1.59, 95% CI 1.31-1.94; P<.001). Path analysis indicated that interpersonal-level variables were indirectly associated with willingness to receive COVID-19 vaccination through perceptions (β=.43, 95% CI .37-.51; P<.001).ConclusionsAs compared to PLWHA in other countries and the general population in most parts of the world, PLWHA in China reported a relatively low willingness to receive COVID-19 vaccination. The internet and social media as well as interpersonal communications may be major sources of influence on PLWHA’s perceptions and willingness to receive COVID-19 vaccination.     

New-onset crescent IgA nephropathy following the CoronaVac vaccine: A case report

Rationale:Although coronavirus disease 2019 (COVID-19) remains a global threat, administering effective and safe vaccines is currently the most promising strategy to curb the ongoing pandemic and decrease the number of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. However, there remains some uncertainty regarding the safety of vaccines for patients with kidney disease.Patient concerns:A 58-year-old man presented at our institution with gross hematuria 48 hours after receiving his first dose of the CoronaVac (Sinovac) vaccine.Diagnoses:Analysis of a renal biopsy sample led to the diagnosis of crescentic immunoglobulin A nephropathy (IgAN), which we considered an adverse event of receiving the CoronaVac vaccine in China.Interventions:The patient’s serum creatinine and albumin levels were 1.20 mg/dL and 31.3 g/L, respectively; as such, he was administered a diuretic. His serum creatinine level had risen to 7.45 mg/dL 1 month later, and he developed high blood pressure. The patient then received conventional doses of hormone therapy but developed recurrent fever, which led to the suspicion of active tuberculosis (which he had a history of) and suspension of the hormone therapy.Outcomes:The patient’s renal function deteriorated further, and he ultimately underwent dialysis.Lessons:The patient’s course of events of apparent IgAN exacerbation should prompt nephrologists to closely follow patients with glomerular disease after they receive a COVID-19 vaccine, especially if persistent gross hematuria occurs.