Objective:To know about the prevalence rates of depression and anxiety and its related factors a-mong human immunodeficiency virus (HIV)-infected men who have sex with men (MSM)in China.Methods:Under the help of MSM group,totally 600 HIV-infected MSM were recruited by snowballing sample among HIV-positive MSM,and 541 effective electronic questionnaire were received.Participants completed self-made question-naire of HIV-positive MSM healthy condition which included social demographic and health behavior et al.The Center for Epidemiologic Studies Depression Scale(CES-D)and Self-Rating Anxiety Scale (SAS)were used to survey the condition of depression (CES-D score ≥16)and anxiety (SAS score ≥50)respectively.Results:The percentage of having depression and anxiety symptoms was 44.7% (242 /541)and 25.1% (136 /541)respective-ly.Multiple unconditioned logistic regression analysis showed that the risk of having depressive symptoms included considered suicide in the past year (OR =3.31,95%CI:1.73 -5.34),nondisclosure their HIV infection to male primary sexual partners (OR =0.47,95%CI:0.30 -0.73),discrimination experience (OR =1.19,95%CI:1.11 -1.29).Compared with monthly income of 1500 yuan or less,participants who earned >5000 yuan monthly were less likely to have depressive symptoms (OR =0.34,95%CI:0.17 -0.71).Factors associated with anxiety symp-toms included considered suicide in the past year (OR =2.43,95%CI:1.40 -4.21),accepted antiviral therapy (OR=1.74,95%CI:1.06 ~2.84),discrimination experience (OR =1.12,95%CI:1.05 ~1.20).Participants earned >5000 yuan monthly (OR =0.44,95%CI:0.20 ~0.94)could decrease the risk of having anxiety symptom compared with whose monthly income of 1500 yuan or less.Conclusion:The prevalence rate of depression and anxiety symp-tom among HIV-infected MSM is high and need more attention.It may be helpful to call for the strategy of promo-ting mental health on decreasing social discrimination,communicating with sexual partners,and improving their eco-nomic status.

Corona Virus Disease 2019 (COVID-19) occurred in Wuhan in December, 2019, with the number of the infected cases gradually increasing. The pregnant women are susceptible to the virus due to their specific immune tolerance. Both the maternal and fetal safety will be imperiled if the pregnant women were infected with COVID-19. Therefore, antenatal care and perinatal management are crucial for guaranteeing the safety of the pregnant women infected with COVID-19.

Objective To understand the prevalence of HIV infection,syphilis and hepatitis C infection and related risk behaviors among club drug users in Zhejiang province.Methods The drug users were interviewed with questionnaires in 2011 to collect the information about their demographic characteristics,sexual behaviors,drug use behaviors and the utilization of intervention services.Blood samples were collected from them to detect HIV,syphilis and HCV antibodies.Results A total of 3 253 drug users were surveyed,in which 1 298 were club drug users,accounted for 39.9％.The proportion of club drug users was high in northern and central Zhejiang,in females,in age group ≤25 years,in local residents and in those having commercial sexual behaviors during previous 12 months.Of the 1 298 club drug users,91.2％ were methamphetamine users,0.1％ were infected with HIV(95％CI:0.0％-0.2％),8.1％ suffered from syphilis (95％CI:6.6％-9.6％),17.3％ were infected with HCV(95％CI:15.2％-19.4％).Among the interviewed club drug users,12.7％ were aware of AIDS,9.2％ had injecting drug use histories,29.6％ reported having commercial sex during the previous 12 months,only 33.4％ received free condom and counsel,14.0％ received HIV test.Multivariate logistic regression analysis indicated that living in central and southern Zhejiang was associated with syphilis prevalence,HCV infection and injecting drug use behavior,being female was associated with syphilis prevalence.Injecting drug use and commercial sex during the previous 12 months were associated with HCV infection,and injecting drug use and commercial sex during the previous 12 months were associated with each other.Among the 1 285 club drug users,males,local residents in Zhejiang and those who never received free condom or counsel were more likely to have commercial sex.Conclusion The prevalence of syphilis and HCV infection are high and unprotected sexual behaviors are common among the club drug users in Zhejiang,but less intervention services were received by them,suggesting that more attention should be paid to the prevention and control of HIV,HCV infections and syphilis in club drug users by taking effective intervention measures and increasing intervention coverage.

OBJECTIVETo understand the coverage of HIV related intervention and antiviral treatment among HIV-positive men who have sex with men (MSM) and to examine factors of initiating antiretroviral treatment.

METHODSA total of 501 HIV-positive MSM were recruited by "snowballing" sampling in Chengdu (160), Chongqing (168) and Guangzhou (173) from January to June, 2013. Participants who were older than18 years, had sex with men, HIV-infected, were living in these 3 cities when survey was conducted were eligible for subjects of this survey. The data were collected by computer assisted survey, including social demography, the coverage of HIV related follow-up intervention and ART, related knowledge level, sexual behaviors in the last 6 months, as well as notification to sexual partners and family. We analyzed the influence factors for initiating ART by Multiple Unconditioned Logistic Regression.

RESULTSAmong 501 HIV-positive MSM, the ratio of CD4 counting and HIV viral load testing were 90.8% (455) and 19.4% (97), respectively. The percentage of the latest CD4 counting not more than 350 per µl was 33.0% (150/455). The coverage of initiated ART among the participants who met the qualification was 56.0% (84/150). The multivariable Logistic regression analysis showed that the possibility of not on ART among participants who were migrants increased to 5.21(2.33-11.66) times of the local residents and the possibility among participants who were diagnosed STD in the last year increased to 2.70(1.12-6.55) times of those who were not infected STD, the possibility of not on ART among participants who had sex with male occasional or commercial partner in the last 6 months increased to 2.16(1.03-4.50) times of those who hadn't, and the possibility among participants who had anal sex with condom use in the past 6 months increased to 2.68(1.10-6.50) times of those who couldn't insist using condom.

CONCLUSIONThere were low coverage of series of HIV/AIDS related intervention services among HIV-positive MSM in Chengdu, Chongqi and Guangzhou. Migrants, had sex with male occasional or commercial partner, had anal sex with condom use in the past 6 months, not infected STD in the last year may be the independent risk factors for HIV-positive MSM to not initiating ART.

Anti-Retroviral Agents ; therapeutic use ; CD4 Lymphocyte Count ; China ; Cities ; Condoms ; Demography ; Emigrants and Immigrants ; Follow-Up Studies ; HIV Infections ; drug therapy ; epidemiology ; Health Knowledge, Attitudes, Practice ; Homosexuality, Male ; Humans ; Logistic Models ; Male ; Risk Factors ; Risk-Taking ; Safe Sex ; Sexual Behavior ; Sexual Partners ; Surveys and Questionnaires

OBJECTIVETo investigate the status of HIV disclosure to primary partners and to explore the correlates of HIV disclosure among HIV-infected men who have sex with men (MSM) in Guangzhou, Chongqing and Chengdu.

METHODSThis survey was conducted in Chengdu, Chongqing and Guangzhou by using "snowballing" sample from December, 2012 to May, 2013. Participants who were eighteen years old or elder, HIV-infected, had sex with men and lived in three cities when the survey was conducted were eligible for subjects of this survey. Primary partners and disclosure status of participants were investigated. Multiple Unconditioned Logistic Regression analysis was used to analyze the influence factors associated with HIV disclosure.Of 600 participants, 541 were excluded because of logical problem or incomplete items in questionnaire and the effective response rate was 90.2%.

RESULTSOf the 541 HIV-positive MSM participants, the mean age was (30.2 ± 7.7) years old, 78.2% (423/541) of the participants had male primary partners.Of the 423 participants who had male primary partner, 10.9% (46/423) had wife, 58.9% (249/423) had one primary partner, and 41.1% (174/423) had two or more. The proportion of HIV disclosure to all male primary sexual partners and wife was 41.8% (177/423) and 4.5% (19/423) respectively, 20.3% (86/423) of them disclosure to some of male primary partners and 37.8% (160/423) not disclosure to any male primary partners. Participants who had HIV-positive male partners in the past 6 months (accounting for 35.2% (149/423)) were more likely to disclose HIV infection to their primary sexual partners (70.5% (105/149)) than those who had non-HIV-positive sexual partners (26.3% (72/274)) (χ(2) = 77.46, P < 0.01). Participants who had male unknown HIV-status sexual partners in the past 6 months(accounting for 52.7% (223/423)) were less likely to disclosure HIV infection to primary sexual partners (22.4% (50/223) ) than those who had already known HIV-status sexual partners (63.5% (127/200)) (χ(2) = 73.11, P < 0.01). The possibility of HIV disclosure to primary sexual partner among participants who had HIV-positive sexual partner increase to 6.36 (3.75-10.80) times of those who had HIV -negative partners, and the possibility among participants who had sexual partners of unknown HIV status decreased to 0.44 (0.25-0.76) times of those who had sexual partners of already known HIV status. Compared with having non-anal sex behaviors with male primary partner, the possibility of HIV disclosure to primary sexual partner decreased to 0.46 (0.22-0.95) times among participants who had anal sex behavior with male primary partners.

CONCLUSIONThere were low proportion of HIV disclosure to primary sexual partners among HIV-infected MSM in Guangzhou, Chongqing and Chengdu.HIV disclosure to primary sexual partners may be associated with characteristics of their sexual partners, and participants who had HIV-positive male partners were more likely to disclose HIV infection to their primary sexual partners.

Adult ; China ; Cities ; Disclosure ; HIV Infections ; Homosexuality, Male ; Humans ; Male ; Sexual Behavior ; Sexual Partners

Objective: To compare the clinical efficacy and patient satisfaction of 755 nm semiconductor laser for hair removal during different stages of auricular reconstruction. Methods: From July 2016 to September 2018, 86 patients who had ear reconstruction underwent 755 nm semiconductor laser for auricle hair removal in plastic surgery department of Tongji hospital affiliated to Tongji medical college of Huazhong university of science and technology. There were 39 males and 47 females with an average age 12 years old(from 6 to 28 years old). 28 cases were left ear, 58 cases were right ear. With random grouping, 40 patients underwent auricle hair removal treatment after posterior ear tissue expander implantation (post-operation of stage Ⅰ depilation group) and 46 patients underwent treatment after auricular reconstruction (post-operation of stage Ⅱ depilation group). Auricle hair removal treatments(pulse width 10-20 ms, wave length 755 nm, spot size 10 mm×15 mm, energy density 4-8 J/cm²) were respectively started at different intervention time. Each treatment time were 5-10 minutes. The end of the treatment was slight redness or edema of the local hairy follicle. The treatment was repeated every 4 weeks with a total of 5 times. The number of adverse reactions was recorded as while as the hair density, hair clearance rate and patient satisfaction before treatment and 6 months after the 5th depilation. Results: Patients in both groups successfully were completed the treatment and were followed up to about 6 months (23 to 25 weeks) after the last depilation treatment. There were only 2 cases with scratch in skin preparation and 2 cases with blisters in the postoperative of stage Ⅱ group. None of the other patients had adverse reactions. Hair density after treatment (27.63±7.75 bar/cm²) was less than before treatment (84.55±13.68 bar/cm²) in post-operation of stage Ⅰ depilation group. Hair density after treatment was 40.52±5.92 bar/cm² in post-operation of stage Ⅱ depilation group, less than before treatment (74.78±11.19 bar/cm²). The differences were statistically significant (both P<0.001). After hair removal, the hair density of post-treatment in the post-operation of stage Ⅰ depilation group was less than the post-operation of stage Ⅱ depilation group. The difference was statistically significant (P=0.000). The hair clearance rate of the post-operation of stage Ⅰ (67.32%) was higher than the post-operation of stage Ⅱ(45.81%). The difference was statistically significant (P<0.001). Patients’ satisfaction was 87.5% in the post-operation of stage Ⅰ and 69.5% in the post-operation of stage Ⅱ. The former was superior to the latter. Conclusions Auricle hair removal with semiconductor 755 nm laserstarted at stage Ⅰ that posterior ear tissue expander was implanted has more favorable clinical efficacy, and higher patient’s satisfaction rate.

Objective To establish a scientific and rational narrative medical curriculum standards for clinical medicine postgraduates to improve their medical humanistic quality.Methods On the basis of literature review and group discussion,the standards of narrative medical curriculum for postgraduates majoring in clinical medicine were preliminarily constructed,and the Delphi method was used to evaluate and screen the indicators.An expert consultation questionnaire was drawn up for 40 selected experts to finalize the curriculum standards for narrative medicine.The small-scale teaching practice was carried out in postgraduates of the Department of Hepatobiliary Surgery in Southwest Hospital of Chongqing,and the problems in the process of teaching implementation were collected.Results Experts' opinions tended to be consistent after two rounds of consultation.Finally,the study confirmed a theoretical and practical narrative medical curriculum which consisted of introducing narrative medicine theory,reading narrative medicine related books,watching the medical narrative film and television works,and writing the narrative medical records.Through the small-scale teaching practice,we collected a variety of problems,for which,we sorted out and analyzed,and finally put forward the improvement scheme.Conclusion The narrative medical curriculum for clinical medicine postgraduates is reasonable,which can lay the foundation for the promotion of clinical medical postgraduates' medical humanistic quality and doctor-patient communication ability,and accelerate the popularization of narrative medicine idea in our country.

Objective:The study aimed to analyze the clinical and endoscopic characteristics of adult celiac disease (CD) to provide a scientific basis for more effective CD diagnosis and treatment.Methods:In this cross-sectional study, the clinical and endoscopic data of 96 adult CD patients treated in the Department of Gastroenterology of the People′s Hospital of Xinjiang Uygur Autonomous Region from March 2016 to December 2021 were retrospectively collected and analyzed.Results:A total of 96 CD patients were diagnosed, including 33 men and 63 women. The average age was 47±14 years (range, 18-81 years). The disease occurred mainly in the age group of 31-60 years. The median course of the disease was 2.0 (0.2-40.0) years. There were 41 (42.7%) classical and 55 (57.3%) non-classical CD patients. All patients with classical CD showed chronic diarrhea, often accompanied by abdominal pain (46.3%, 19/41), abdominal distension (17.1%, 7/41), anemia (65.9%, 27/41), and chronic fatigue (48.8%, 20/41). The main manifestations of non-classical CD were chronic abdominal pain (58.2%, 32/55), abdominal distension (32.7%, 18/55), anemia (40.0%, 22/55), and osteopenia/osteoporosis (38.2%, 21/55). Compared with non-classical CD, anemia developed more frequently in classical CD, and the difference was statistically significant ( P = 0.012). The incidence of complications in CD patients was 36.5% (35/96), and the main complications were thyroid disease (19.8%, 19/96), connective tissue disease (6.2%, 6/96), and kidney disease (6.2%, 6/96). There was no significant difference between classical and non-classical CD ( P>0.05). The frequency of endoscopic manifestations in CD patients was 84.4% (81/96). Duodenal bulb endoscopy showed nodular changes (72.9%, 70/96), grooved changes (10.4%, 10/96), and focal villous atrophy (9.4%, 9/96). The main manifestations of descending endoscopy were the decrease, flattening, or disappearance of duodenal folds (43.8%, 42/96), scallop-like changes (38.5%, 37/96), and nodular changes (34.4%, 33/96). Conclusions:Adult CD patients are mostly female. CD occurred mainly in the age group of 31-60 years. The clinical manifestations were mainly those of non-classical CD. Some patients often had other autoimmune diseases. Patients with characteristic endoscopic manifestations should be warned about the possibility of developing CD. Clinicians should strengthen the understanding of CD and reduce the related rates of missed diagnosis.

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