Objective To evaluate the performance of the third generation ELISA and the fourth generation ELISA for HIV-1 diagnosis assays on acute and early HIV-1 infected samples.Methods Sixtyseven acute/early HIV-1 infected samples were collected from the follow-up gays with seroconversion in Shen Yang city and from clinical patients in the First Affiliated Hospital of China Medical University with incomplete HIV-1 specific bands in western blot between 2008 and 2010.Third generation ELISA,fourth generation ELISA,western blot and HIV-1 viral load detecting were used for detecting these samples.The sensitivity,consistency were compared between third generation ELISA and fourth generation ELISA to detect the seroconversion samples and the window periods were abserved.Chi square test was used for statistical analysis.Results In the 67 acute/early HIV-1 infected samples,56 were HIV positive and 11 were HIV negative by the third generation ELISA.The sensitivity of the third generation ELISA was 83.6％ (95％ CI:72.5％ -91.5％); 63 were HIV positive,1 was at gray zone and 3 were HIV negative by the fourth generation ELISA.The sensitivity of the fourth generation ELISA was 94.0％ (95％ CI:85.4％ -98.3％),higher than the third generation ELISA(x2 =16.1,P ＜0.01).The consistency of the third generation ELISA and the fourth generation ELISA was 86.6％ ( 95％ CI:76.0％ - 93.7％).The earliest third generation ELISA positive sample was the sample collected 16 days after HIV infection and the earliest fourth generation ELISA positive sample was the sample collected 9 days after HIV infection.There was significantly different on the window periods between the third generation ELISA and the fourth generation ELLSA Conclusion The fourth generation ELISA had a higher sensitivity and shorter window period on acute/early HIV infected samples than the third generation ELISA,which is more suitable for the HIV early infection screening on high risk populations.

Objective To investigate the effect of HCV RNA on virological and immunological response to highly active antiretroviral therapy (HAART),liver function and blood lipid levels in HIV/HCV co-infected patients.Methods In a cohort study,275 HIV/HCV co-infected former blood donors receiving HAART were followed up every six month in Henan province in China.HCV RNA,HIV RNA,CD+4 T cell counts,indexes of liver function and lipid levels were periodically tested.The differences of HIV viral load suppression,immunological response,liver injury and blood lipid levels between HCV RNA positive group and negative group were compared by x2 test and two independent-samples tests.Result There was no significant difference of HIV viral load suppression between HCV RNA positive group and HCV RNA negative group six-month treatment (45.6% vs.38.5% ,X2=1.150,P>0.05) and CD+4 T cell counts before (286 cells/μ1 vs.209 cells/μ1,Z=0.734,P=0.463)and after 6-month (310 cells/μ1 vs.362 cells/μl,Z=0.562,P=0.574) ,12-month(378 cells/μ1 vs.289 cells/μ1,Z=1.091,P=0.275),18-month(363 cells/μ1 vs.288 cells/μl,Z=1.435,P=0.151) ,24-month(413 cells/μ1 vs.348 cells/μ1,Z=0.939,P=0.348) HAART.The mean levels of serum ALT (55.0 U/L vs.29.5 U/L,Z=6.789,P<0.01),AST(46.0 U/L vs.33.0 U/L,Z=4.890,P<0.01)、TBIL(9.3 mmol/L vs.7.2 mmol/L,Z=3.748,P<0.01)were significantly higher in HCV RNA positive group than that in HCV RNA negative group.HCV RNA was the independent variables associated with liver injury after HAART (aOR=3.8,P<0.01).The serum triglyceride level was higher in HCV RNA positive group than that in HCV RNA negative group(1.2 mmoL/L vs.1.4 mmol/L,Z=1.936,P=0.043) .The serum HDL level was higher in HCV RNA positive group than that in HCV RNA negative group (1.5 mmol/L vs.1.3 mmol/L,Z=2.251,P=0.024).Conclusions HCV RNA does not affect HIV virological responses to HAART and CD+4 T recovery.HCV RNA is an independent risk factor associated with liver injury in HIV/HCV co-infected patients receiving HAART,but appears to provide significant protection against HAART-ieduced hyperlipidemia.

Objective? To explore the effect of standardized psychological intervention on quality of life in patients with medium or advanced cancer. Methods? By convenience sampling, a total of 60 patients with medium or advanced cancer were selected and divided into control group (n=30) and observation group (n=30) according to random number table, the patients were numbered based on their order of admission. The control group received supportive nursing intervention while the observation group received the standardized psychological intervention. The Quality of Life Core Questionnaire was used before and after the intervention to evaluate the life quality of the two groups. During the research process, 9 cases were lost in the observation group and the rest 21 cases were enrolled into the study while 10 cases were lost in the control group with 20 cases left. Results? Before intervention, the overall cognitive function and quality of life of the observation group were different with statistical significance (P＜0.05), and there were no statistical differences in the rest dimensions between the two groups (P＞ 0.05). After intervention,the observation group scored differently from the control group in the dimensions of emotional function, cognitive function,overall quality of life, pain symptoms,Insomnia symptoms, and loss of appetite with statistical significance (P＜ 0.05). The observation group scored higher than the control group in emotional function and overall quality of life, but lower than the control group in cognitive function, pain symptoms, insomnia symptoms and loss of appetite. The differences of scores before and after intervention between the two groups in emotional function, pain symptoms, nausea and vomiting, insomnia symptoms and loss of appetite, constipation symptoms and diarrhea symptoms were statistically significant (P＜ 0.05). After intervention, the observation group showed improvement in terms of the symptoms including emotional function, pain, nausea and vomiting, insomnia and loss of appetite. Conclusions The adoption of the standardized psychological intervention for patients with medium or advanced cancer could improve their negative emotions, enhance their confidence in treatment, and improve their quality of life.

Objective To investigate the acceptability and related factors of an "on-demand"pre-exposure prophylaxis (PrEP) to prevent HIV transmission among MSM in Shenyang.Methods MSM recruited by non-probability sampling method and questionnaire survey conducted by investigators to collect information on social and behavioral characteristics,awareness of PrEP,Truvada and the acceptability of two different PrEP-based trials.Multivariate logistic regression was employed for statistical analysis.Results Among the 292 respondents,34.2％ had heard of PrEP and 58.2％ (170/292) reported were interested in participating a PrEP trial-"on-demand" use or 48.3％ (141/292) interested on "daily" use (x2=5.785,P=0.02).Factors independently associated with those "on-demand" would include:having more than 2 male sexual partners during the past 6 month (aOR=1.7,95％CI:1.1-2.7),concerning on the positive effect of PrEP (vs.side effects) (aOR=6.4,95％CI:2.2-18.9),having an HIV-infected sexual partners (aOR=8.1,95％ CI:1.0-63.3) and self-reported high risk for HIV (aOR=2.6,95％CI:1.2-6.0).The last two factors were only associated with the "on-demand" group.Conclusions "On-demand" PrEP (as opposed to daily) seemed a more feasible prevention strategy on HIV and particularly in those having high risk behavior of HIV.For those who could not follow the daily medication or having HIV risk perception,"On-demand" basis PrEP trial should be recommended for them to follow.

Objective To investigate the risk factors on antiretroviral therapy (ART) among HIV/AIDS positive students in Shenyang.Methods A cross-sectional study was conducted among HIV/AIDS positive students aged between 15 and 30,in an HIV-treatment-designated hospital in Shenyang city,during 2007-2015.Data were analyzed by multivariate logistic regression mode to identify the risk factors related to ART.Results A total of 2 379 HIV/AIDS patients attended the hospital and 6.1％ (146/2 379) of them were students,during 2007-2015.All of the HIV/AIDS positive students were males,with homosexual transmission accounted for 93.2％ (136/146).The overall rate on delayed diagnosis was 52.7％ (77/146),when at diagnosis of CD4 + T lymphocyte counts ≤350 cells/μl.The proportion of ART was 67.1％ (98/146).Factors as:year that the HIV diagnosis was made (aOR=1.21,95％CI:1.02-1.44),age between 24-30 (compared with age below 18-year-old,aOR=8.15,95％CI:1.46-45.52),and delayed diagnosis (aOR=2.22,95％CI:1.05-4.71),appeared independently related to ART among HIV/AIDS positive students.Conclusions Factors as the year that HIV diagnosis was made,age and delayed diagnosis of the patients seemed to be at higher risk for ART among HIV/AIDS positive students.

Objective:To understand the current status of HIV self-testing reagent use in pre-exposure prophylaxis (PrEP) and related factors in men who have sex with men (MSM).Methods:From December 2018 to December 2019, "Gold data" online platform (www.jinshuju.com) was used to conduct multicenter PrEP studies in Shenyang, Beijing, Chongqing and Shenzhen of China.Results:A total of 1 222 MSM PrEP users were included in the multicenter study. The average age of the participants was (31.5±8.7) years, and the number of sexual partners in the past three months was 3 ( P 25, P 75:2,6). The proportions of those who did not use condoms in anal sex with fixed, casual and commercial partners were 62.7% (456/727), 56.3% (440/781) and 41.0% (16/39), respectively. Up to 74.5% (910/1 222) of participants had used HIV self-testing reagents, and the number of HIV self-testing during last year was 3 ( P 25, P 75:2,5). The multivariate logistic regression analysis indicated that compared with age group >40 years, those with education level of junior high school or below, those with psychological identity as female, event driven PrEP users, those never using new type drugs in past 3 months, the participants aged 18- years (a OR=2.06, 95% CI: 1.35-3.14), 26- years (a OR=2.72, 95% CI: 1.77-4.17), 31- years (a OR=1.76, 95% CI: 1.19-2.59), undergraduates (a OR=2.18, 95% CI: 1.35-3.49), graduate students and above (a OR=3.06, 95% CI: 1.69-5.54), those with psychological identity as male (a OR=3.22, 95% CI: 1.55-6.70), daily PrEP users (a OR=1.35, 95% CI: 1.03-1.78), and new type drug users in the past three months (a OR=1.72, 95% CI: 1.30-2.28) had higher proportions of HIV self-testing behaviors. Conclusions:The proportion of HIV self-testing in MSM PrEP users was high, while it was relatively low in older age group, event driven PrEP users and MSM never using new type drugs. To assess and improve the effectiveness and compliance of PrEPs, it is necessary to provide better HIV self-testing service for MSM with low HIV self-testing rate.

【Objective】 To learn the production efficient of platelet components among prefecture-level blood stations in China, to provide supporting data for those blood stations to optimize the production mode of platelet components and continuously improve production efficiency and supply capacity. 【Methods】 The data from 2017 to 2020 was obtained from 24 prefecture-level blood stations who were the members of the practice comparison network for blood institutes in China. The collection units of apheresis platelets, the number of dual-collections of apheresis platelets and plasma, the average apheresis units of one platelet apheresis procedure, the discarded rate of apheresis platelets, the amount of expired apheresis platelets and the amount of apheresis platelets issued were collected. For concentrated platelets, the prepared amount of platelet concentrates and the amount of expired platelet concentrates were collected; both the quantity of qualified and issued concentrated platelets were submitted for statistical analysis.The total output and efficiency of platelet components were calculated based on the collected data. 【Results】 The average annual growth rate of apheresis platelets collection in 24 prefecture-level blood stations was 12.23%, accounting for 99.80% of the total platelet output; the average collection unit of one platelets apheresis procedure was 1.75; from 2019 to 2020, only 5 blood stations performed dual-collection of platelet and plasma during one apheresis procedure; the discarded rate of apheresis platelets was 0.28%, of which 0.007% was due to expiration. A total of 1 621.2 therapeutic units of concentrated platelets were prepared, and 13.03% of them was discarded due to the expiration. The production efficiency of platelet components was 97.56%, of which the production efficiency of apheresis platelets was 97.61% and the production efficiency of concentrated platelets was 74.43%. 【Conclusion】 There are large regional differences in the supply capacity of platelet components in prefecture-level blood stations. Apheresis platelets are the main resource of platelet components product, and the collection capacity is increasing over the years with the characteristics of high production efficiency and low expiration scrapping rate. However, the preparation of concentrated platelets are still limited with relatively low production and high expiration discarded rate.