Objective To evaluate the effects of pulmonary recruitment (RM) in severe acute respiratory distress syndrome (ARDS) with different body position and positive end-expiratory pressure (PEEP) mode in stage of mechanical ventilation. Methods From June 2013 to June 2016, 80 cases of ICU hospitalized patients with clinical data were enrolled, and they lay in the prone or supine position (prone position group and supine position group, each of 40 cases). The hemodynamic parameters including heart rate (HR), central venous pressure (CVP) and peripheral arterial pressure, respiratory mechanics index including respiratory rate (RR), respiratory system compliance (Crs) and platform pressure (Pplate), and the changes of blood gas analysis index were monitored to observe the effects of RM in different positions with positive end expiratory pressure increasing method. Results The levels of oxygenation index and arterial partial pressure of oxygen (PaO2) were improved 3, 5 and 7 d after treatment compared with those 1 d after treatment (P<0.05), and they were improved significantly in prone position group than those in supine position group 3 and 5 d after treatment (P<0.05). The levels of RR, Crs and Pplate 15 min, 30 min, 1 h, 6 h, 12 h and 24 h after RM had significant differences compared with those before RM (P<0.01). The levels of HR, CVP, peripheral arterial pressure 15 min, 30 min, 1 h, 6 h, 12 h and 24 h after RM had no significant differences compared with those before RM (P>0.05). Conclusions For patients with severe ARDS, early implementation of prone position ventilation combined with PEEP increasing method re-expansion treatment is safe and reliable. It can effectively improve oxygenation level and help to improve the survival rate.

Objective:To explore the status of HIV infection, time trends and related factors of MSM in Harbin from 2009 to 2018 and provide evidences for comprehensive prevention and control strategies of MSM HIV/AIDS.Methods:From April to July during 2009-2018, continuous cross-sectional studies were conducted on MSM recruited through snowball sampling. The unified questionnaire was used to collect demographic, behavioral, and serological information. The SPSS 23.0 software was used for statistical analysis, and the Joinpoint 4.8.0.1 software was applied to the annual percent change (APC) for time trends analysis using the Joinpoint regression model.Results:A total of 4 813 MSM were surveyed in Harbin from 2009 to 2018. The overall HIV antibody positive rate was 11.3 % ( 543/4 813). Joinpoint regression analysis showed that there was an increase in the HIV antibody positive rate from 2009 to 2015, while the segmentation point was in 2015 ( Z=4.2, P<0.05) but, there was a decrease from 2015 to 2018( Z=-1.3, P=0.3). The positive rate of syphilis antibody was 12.9% (621/4 813). There was a decrease in the positive rate of syphilis antibodies from 2009 to 2013 ( Z=-2.8 ,P<0.05). There was a decrease in the positive rate of syphilis antibodies from 2013 to 2018 ( Z=-0.7, P=0.5). Results from multiple logistic aggression analysis showed that the risk factors associated with the prevalence of HIV infection including network recruitment (a OR=1.307, 95% CI: 1.057-1.617), age 30 and above (a OR=1.905, 95% CI: 1.235-2.939) and syphilis antibody positive (a OR=4.728, 95% CI: 3.751-5.961). Protective factors appeared: knowledge of HIV/AIDS (a OR=0.598, 95% CI: 0.433-0.825) and consistent use of condom during anal sex in the past six months (a OR=0.683, 95% CI: 0.550-0.850). Conclusions:The HIV antibody positive rate peaked in 2015 among MSM in Harbin from 2009 to 2018, first increased and then decreased. The positive rate of syphilis antibody showed a decreasing trend. Intervention models based on social media software, age 30 and above and syphilis antibody-positive need to be explored. It also promotes condom use and referral for syphilis among MSM.