Objective To investigate the effect of spirolactone on cardiac function and serum brain natriuretic peptide in patients with chronic heart failure( CHF). Methods Eighty-four patients with CHF were randomly divided into control group( n=42 )and observation group( n=42 ). The patients in the control group were given conventional therapy,while in the observation group were given spirolactone( 20 mg/times,2 times/day)based on treatment of the control group for six months. The clinical effects and left ventricular end diastolic diameter( LVEDd ),left ventricular ejection fraction( LVEF ) and serum brain natriuretic peptide( BNP ) of pretherapy and post-treatment between the two groups were recorded and compared. Results The total effective rate of observation group was 95. 2%(40/42),obviously higher than that of control group(80. 9%(34/42),χ2=6. 468,P=0. 028). The levels of LVEDd and BNP in two groups after treatment were(57. 8 ± 6. 2)mm and (62. 4 ± 7. 8)mm,(364. 4 ± 32. 8)ng/L and(457. 4 ± 43. 2)ng/L,significantly lower than those at before treatment((64. 6 ± 7. 4)mm and(64. 8 ± 7. 6)mm,(867. 8 ± 78. 5)ng/L and(864. 4 ± 74. 8)ng/L),while LVEF in two groups after treatment were( 49. 8 ± 5. 4 )% and( 42. 6 ± 4. 6 )%,significantly higher than those before treatment((35. 2 ± 3. 9)% and(35. 4 ± 3. 5)%),and the differences were significant(t = -3. 264, 4. 626,-5. 373,-3. 932,5. 438,-6. 548;P﹤0. 05). Moreover the changes in observation group were obvious than those in control group in terms of LVEDd,BNP and LVEF( t = -3. 425,3. 644,-2. 846;P ﹤0. 05 ) . Conclusion Spironolactone can effectively decrease the serum brain natriuretic peptide levels,improve the cardiac function in patients with chronic heart failure,and it is worthy of popularization and application.

OBJECTIVEThis study aimed to investigate the status of multiple sexual partners and unprotected sexual behaviors and related influencing factors among HIV-positive men who have sex with men (MSM).

METHODSHIV-positive men having sex with men aged 18 years or older, living in Chengdu, Chongqing or Guangzhou were recruited by using the " snowballing" sampling method. Participants completed the questionnaire on computers, after filling in the Informed Consent Form. Content of the study would include social demographic characteristics, number of sexual partners, sexual behaviors, and the symptoms assessment on depression and anxiety.χ(2)-test,t-test and non-conditional Multiple logistic Regression methods were used to examine the risky sexual behaviors with multiple sexual partners among the participants engaged in this project.

RESULTSMean age of the 501 participants was (30.24±7.70) years old. In the past 6 months, 17.4% (87/501) of them had engaged in unprotected sexual behavior with two or more sexual partners. Factors at risk would include: being married (OR=1.93, 95%CI: 0.77-4.84), divorced or widowed (OR=3.94, 95%CI: 1.66-9.36), having primary male sexual partners (OR=5.04, 95%CI: 1.08-23.54) and casual or commercial male sexual partners (OR=2.54, 95%CI: 1.34-4.80) in the past 6 months, drinking alcohol (OR=3.00, 95%CI: 1.37-6.62) or Rush (alkyl nitrite) (OR=3.53, 95%CI: 1.72-7.23) during sexual acts, sharing their HIV-infection status to their partly primary male sexual partners (OR=1.84, 95%CI:0.78-4.33) or not (OR=2.68, 95% CI: 1.25-5.73), and having high sexual sensation seeking scores (OR=1.09, 95%CI: 1.03-1.15).

CONCLUSIONSUnprotected sexual behaviors with multiple sexual partners among HIV-positive MSM played an important role in expediting the HIV transmission. Development of intervention programs to minimize the risk sexual behaviors and setting up efficient medical and biological measures in controlling the HIV transmission were in urgent need.

Adult ; Coitus ; Depression ; Depressive Disorder ; Family Characteristics ; Homosexuality, Male ; psychology ; statistics & numerical data ; Humans ; Infection ; epidemiology ; transmission ; Male ; Marriage ; Middle Aged ; Risk ; Risk-Taking ; Sexual Behavior ; Sexual Partners ; Surveys and Questionnaires ; Unsafe Sex ; psychology ; statistics & numerical data ; Young Adult

OBJECTIVETo investigate the sexual transmission behaviors among HIV-positive MSM population engaging in unprotected sexual behaviors, as well as the relationship with health conditions and partner notification.

METHODSA total of 308 HIV-positive MSM participants engaged in unprotected sexual behaviors were recruited by "snowballing" sampling in Shanghai and Chengdu. The questionnaire covered such items as the time of HIV infection diagnosis, CD4⁺ T cells count, viral load, antiviral therapy, anxiety and depressive symptoms, sexual partner types and sexual behaviors in the past six months, disclosure to fixed sexual partners and casual sexual partners among others.

RESULTSOf the 308 participants surveyed, the report rate of those having at least one-time sexual transmission behaviors during the past 6 months was 70.1% (216/308). Participants who had primary sexual partners and casual sexual partners following their HIV infection diagnosis accounted for 89.0% (274/308) and 68.2% (210/308) respectively. Of the aforementioned participants, 59.1% (162/274) and 94.3% (198/210) respectively had not disclosed their HIV infection to primary and casual sexual partners. Of thoes who did not disclose their HIV infection to primary sexual partners, 91.9% (147/162) reported sexual transmission behaviors. Of thoes who did not disclose their HIV infection to casual sexual partners, 89.9% (178/198) continue sexual transmission. As found in a multi-factor analysis, the infection risk exposure of those with heterosexual sexual orientation and engagement in sexual transmission behaviors was six times higher than those with homosexual orientation (aOR = 5.896, 95% CI: 1.808-19.232). For those who did not, or partially disclose their HIV infection to male casual sexual partners or commercial sexual partners, the risk exposure of further transmission was 29 times and 19 times higher than those disclose it to their sexual partners (no disclosure: aOR = 28.957, 95% CI: 7.511-65.004; partial disclosure: aOR = 18.956, 95% CI: 6.995-57.417). The highest risk came from those who continue their sexual transmission behavior within six months of their HIV infection diagnosis; the lowest risk came from those continue such behavior more than one year and within two years of their diagnosis (aOR = 0.048, 95% CI: 0.033-0.788); such risk rose to some extent for those continue such behavior over two years of their diagnosis. Compared to those without antiviral therapy, participants with the therapy pose less risk in sexual transmission behaviors.

CONCLUSIONMore than two-thirds of HIV-positive MSM population who engage in unprotected sexual behaviors reported sexual transmission behaviors. In this regard, increasing antiviral therapy and promoting sexual partner disclosure constituted an effective strategy to minimize further transmission among HIV-positive MSM population. Intervention of sexual transmission behaviors should be addressed to those diagnosed of HIV infection within six months.

China ; HIV Infections ; transmission ; HIV Seropositivity ; Homosexuality ; Homosexuality, Male ; Humans ; Male ; Risk ; Risk-Taking ; Sexual Behavior ; Sexual Partners ; Surveys and Questionnaires ; Viral Load