Adolescent ; Child ; Female ; Humans ; Inhibitor of Apoptosis Proteins ; Killer Cells, Natural ; pathology ; Leukocyte Common Antigens ; analysis ; Lymphoma, T-Cell ; genetics ; immunology ; Male ; Microtubule-Associated Proteins ; genetics

OBJECTIVETo evaluate the effectiveness of the first eight pilot methadone maintenance treatment (MMT) clinics in China.

METHODSA questionnaire survey of the clients at the 8 pilot MMT clinics was performed at entry, 6 month and 12 month follow-up. Drug using behaviors, drug related crime behaviors, and relationships in families were compared among at entry, 6 and 12 months follow-up.

RESULTSThere were 585, 609 and 468 clients involved at baseline, 6 month and 12 month follow-up surveys, respectively. At entry, 6 month and 12 month follow-up, the proportion of clients whose injection of drugs reduced from 69.1% to 8.9% and 8.8%, and the frequency of injection in the past month had reduced from 90 times per month to 2 times per month. Employment rate increased from 22.9% to 43.2% and 40.6%, and self-reported criminal behaviors reduced from 20.7% to 3.6% and 3.8%. At 12 month follow-up, 65.8% of clients reported a healthy family relationship, increased from 46.8% at entry, 95.9% of clients reported that they were satisfied with the MMT service.

CONCLUSIONPilot MMT program reduced drug use, drug injecting behaviors, drug related criminal behaviors, and improved relationship with family members. Therefore, MMT clinic should be considered as a platform for providing comprehensive services to drug users.

Adult ; Analgesics, Opioid ; administration & dosage ; China ; Follow-Up Studies ; Humans ; Methadone ; administration & dosage ; Opioid-Related Disorders ; rehabilitation ; Outcome Assessment (Health Care) ; methods ; Program Evaluation ; methods ; Substance Abuse Treatment Centers ; organization & administration ; standards ; Surveys and Questionnaires

OBJECTIVETo describe the characteristics and factors associated with long-term retention for methadone maintenance treatment (MMT) patients.

METHODSThis study was conducted in eight MMT clinics located in Sichuan, Yunnan, Guangxi, Guizhou and Zhejiang provinces. Five hundred and thirty-nine MMT patients who enrolled in MMT clinics in 2004 and retained in treatment by June 2010 were selected as study subjects. Chi-square tests were used to compare the demographics and drug abuse history at enrollment and treatment characteristics during the follow-up period between continuous treatment patients and discontinuous treatment patients.

RESULTSOf the 539 patients, 110 (20.4%) were continuous treatment patients whereas 429 (79.6%) were discontinuous treatment patients. Of these 429 discontinuous treatment patients, 84.1% (361/429) had 2-4 treatment episodes whereas 15.9% (68/429) had 5 or more episodes during follow-up period. When continuous treatment patients were compared with discontinuous treatment patients, living with family members or friends (88.2% (97/110), 78.5% (337/429)), age of first drug use under 25 (61.8% (68/110), 71.3% (306/429)), low urine morphine positive test results (67.3% (74/110), 38.2% (164/429)) and living within 5 kilometers of the MMT clinic (72.7% (80/110), 61.3% (263/429)) were positively associated with higher possibility of continuous treat retention (P < 0.05). Demographics and drug abuse characteristics at enrollment, including gender, age, employment status, family relationship, injection, needle sharing, criminal behavior, contacts with drug users, MMT daily dosage and family members receiving MMT were not significantly associated with treatment retention (P > 0.05).

CONCLUSIONIllicit drug use during the treatment and longer distance travelling to MMT clinic might have negative impact on patients' continuous treatment retention. Mobile MMT vehicles and expanded MMT service sites could be introduced to improve compliance of treatment retention of MMT patients.

Adult ; Female ; Humans ; Longitudinal Studies ; Male ; Methadone ; administration & dosage ; therapeutic use ; Patient Compliance ; statistics & numerical data ; Substance-Related Disorders ; drug therapy ; Treatment Outcome

OBJECTIVETo investigate the effects of rhubarb powder on serum complement 3 (C3), complement 4 (C4), and hypersensitive C-reactive protein (hs-CRP) levels in patients with hypertensive intracerebral hemorrhage (HICH) after operation.

METHODSForty inpatients with HICH after operation were recruited from Department of Cerebral Surgery, Affiliated Hospital of Shaanxi College of Traditional Chinese Medicine from July 2009 to March 2010. They were randomly assigned to the treatment group (20 cases) and the control group (20 cases). From the 4th day after surgery, all patients received routine Western medical treatment. The rhubarb powder, 5-10 g dissolving in 40 mL warm water, was administered or nasally fed to those in the treatment group, 2 -3 times daily for 10 successive days. The contents of serum C3, C4, and hs-CRP were detected in the two groups on the 7th day and the 14th day after operation. The serum hs-CRP content was detected using latex particle enhanced immunoturbidimetric assay. The Scandinavia Stroke Scale (SSS) scores were recorded in the two groups.

RESULTSCompared with the same group on the 4th day after operation, the levels of serum C3 and C4 increased on the 7th day after operation, and SSS score increased on the 14th day after operation in the control group (P < 0.05). The contents of C4 and hs-CRP decreased, and the SSS score increased on the 14th day after operation in the treatment group (P < 0.05). Compared with the same group on the 7th day after operation, the contents of C4 and hs-CRP decreased and the SSS score increased on the 14th day after operation in the treatment group (P < 0.05). Compared with the control group at the same time points, the contents of C4 and C3 decreased on the 7th day after operation; the contents of C3, C4, and hs-CRP decreased, and SSS score increased in the treatment group on the 14th day after operation (P < 0.05).

CONCLUSIONThe rhubarb powder could significantly decrease the serum levels of C3, C4, and hs-CRP, and improve the curative effect in patients with HICH after operation.

Adult ; C-Reactive Protein ; metabolism ; Cerebral Hemorrhage ; blood ; Complement C3 ; metabolism ; Complement C4 ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; Female ; Humans ; Male ; Middle Aged ; Postoperative Period ; Rheum ; chemistry

Objective To study the prevalence and characteristics of blood pressure (BP) among children and adolescents at normal weight but with abdominal obesity.Methods Using data from the ‘Student physical fitness and health surveillance 2010 project' in Shandong province,a total of 38 816 students aged 7-17 years were selected to participate in this study.Stature,body weight,waist circumference (WC),systolic blood pressure (SBP) and diastolic blood pressure (DBP) of these subjects were measured.Body weight status and abdominal obesity were defined by body mass index (BMI) and WC,respectively.Results In total,the proportions of thinness,normal weight,overweight and obesity defined by BMI were 5.37％,72.47％,12.92％ and 9.24％ respectively.5.86％ of the children and adolescents with normal weight had abdominal obesity,with normal weighted girls (7.19％) having higher prevalence of abdominal obesity than boys (4.33％) (P＜0.01).The Z-scores of SBP and DBP for both boys and girls were all significantly higher in the normal weight but with abdominal obesity groups than in both normal weight and WC groups (P＜0.01).Conclusion Children and adolescents under normal weight but with abdominal obesity had higher BP level need to be identified and considered as high-risk individuals.Related intervention programs should also be targeted to this population.

Objective To determine the adherence to and its determinants of methadone maintenance treatment (MMT) among heroin addicts in Dehong prefecture in Yunnan province from 2005 to 2009. Methods A dynamic cohort analysis was conducted with the time of treatment initiation as the time of cohort entry, to calculate the proportion of adhering to the treatment at different time points after initiation of the treatment, and to study the determinants of adherence.Results A total of 3758 had been treated. Among them, 95.8% were males, 75.8% aged between 20-39 years, 90.4% were peasants or unemployed, 57.0% were ethnic minorities, 35.0% were single and 55.5% were married with spouses, 43.9% were illiterate or educated at most primary school. The age of first using drugs averaged at 23.93 years. About 96.3% of the study subjects had used heroin and 21.7% were HIV-infected. The minimum time under MMT was less than 1 month and the maximum 61 months. The median methadone dose at first delivery was 25 ml, with the minimum 1 ml and the maximum 330 ml. By the end of the study or observation period, a total of 1798 patients had withdrawn from treatment and 1960 were still under treatment. The proportions of adherence to or still being under the treatment after 1,3,6,9, 12,24, 36,48 and 60 months treatment were 0.919,0.847,0.756, 0.690, 0.637, 0.519, 0.417, 0.360 and 0.321, respectively. Multiple regression analysis using Cox proportional hazard model indicated that withdraw from the methadone maintenance treatment was significantly associated with location of the treatment clinics, year of treatment initiation, marital status, HIV infection status, methadone dose of first delivery and the result of last urine test for heroin use. Conclusion MMT attendants in Dehong prefecture had a relatively high withdraw rate and low adherence rate. More efforts are needed to provide tailored counseling and education to MMT attendants, to provide family and community support, appropriate methadone dose at first delivery, and to better coordinate with local police department.

Objective To determine the incidence and risk factors of HIV infection among heroin addicts receiving methadone maintenance treatment(MMT)in Dehong prefecture,Yunnan province.Methods All heroin addicts who were HIV negative at the initiation of MMT in June 2005 and through June 2011,in Dehong prefecture were included in the cohort analysis.HIV incidence was calculated and related risk factors determined by using Cox proportional hazard regression model.Results A total of 3154 MMT clinic attendants were qualified for this cohort study.By June 2011,1023(32.4％)of them had never received any follow-up HIV testing so were thus referred as loss to follow-up.The other 2131(67.6％)members had received at least one follow-up HIV testing and were observed for a total of 4615.86 person-years.During the period,22 new HIV infections or seroconverters were identified,making the overall HIV incidence as 0.48/100 person-years.The HIV incidence was higher among those who were unemployed,never married,self-reported being injecting drug users(IDUs)and HCV positive at entry into the MMT program.None of those who were always negative on follow-up-urine-testing of morphine was discovered as HIV newly infected during the follow-up period.Data from multiple regression analysis under Cox proportional hazard model indicated that after controlling for confounding variables,non-IDUs at the entry point for the MMT program,were less likely to be HIV newly-infected or seroconverted than IDUs(HR=0.29,95％CI:0.11-0.76).Conclusion MMT prograqm in Dehong prefecture was demonstrated to be fairly effective in reducing HIV transmission through drug use.Those HIV negative attendants at the MMT clinic who were IDUs or keep using drugs during the treatment,were at higher risk of HIV seroconvertion.More efforts were needed to improve the follow-up and HIV testing programs for the MMT clinic attendants.

Objective To evaluate the long-term effectiveness of the first set 8 methadone maintenance treatment (MMT) clinics in China. Methods Repeated cross-sectional surveys were conducted on the first month after the enrollment and 5 years later,among drug users who received MMT,using a standard questionnaire.Data on demographic characteristics,HIV-related high-risk bchaviors,criminal records associatcd with drug use and related family/social functions were collected and analyzed.Results There were 252 and 195 participants being interviewed at the baseline and the 5-year surveys,respectively,.Of them,66 participants were involved in both surveys.There was no significant differences on factors as ethnicity,level of education,working status,marital status and living status (P＞0.05) between the baselinc and the 5-year surveys.Compared with data from the baseline survey,participants' behavior on drug abuse (100.0％ vs.24.1％,P＜0.001 ),needle sharing behavior ( 19.4％ vs.0.0％,P ＜ 0.001 ),and exchanging sex for drugs ( 34.5 ％ vs.0.0％,P＜0.001 ) had significant decreases at the 5-year survey.Rates on condom use ( 10.6％ vs.25.0％,P=0.004),and having jobs (27.8％ vs.47.7％,P＜0.001 ) had been improved significantly,while self-reported criminal cases related to drug use (15.1％ vs.1.5％,P＜0.001) and the contacts with drug users (88.9％ vs.31.3％,P＜0.001) had been significantly reduced after joining the MMT program.Conclusion MMT could play an active role in reducing the HIV-related high-risk behaviors,criminal cases associated with drug abuse as well as enhancing the family and social functions of the MMT patients.Providing high quality service to the MMT clinic and trying to keep the drug users stick to the program remain difficult.It was also important to improve the training programs for staff working at the MMT clinics.

To investigate the epidemiological characteristics of childhood type 1 diabetes mellitus in China, newly diagnosed cases of type 1 diabetes with an onset age under 15 years were retrospectively registered by 23 local centers in China following a standardized protocal on the basis of the nationwide registry established by the WHO DiaMond Project China Participating Center, Chinese Academy of Preventive Medicine (CAPM). A population of about 24 million children were covered in the defined areas . A two-sample capture-recapture method was used to estimate case ascertainment. Between 1988 and 1996, 903 diabetic cases were registered in 9 ethnic groups. The overall ascertainment corrected incidence rate (IR) was 0.59 per 100 000 person-year. The IR was 0.52/100,000（95%CI：0.50～0.54）for males and 0.66/100,000（95%CI：0.64～0.68）for females. The standardized ascertainment corrected IR by the national age-specific population in 1990 was 0.57 per 100,000 person-year. The incidence among various ethnic groups ranged from 0.25/100,000 to 3.06/100,000. The IRs increased with northern latitude, and the IR of Han population was significantly higher in North China compared with South China (0.67 versus 0.53 per 100,000 respectively, P<0.01). A correlation model of incidence and calendar time showed that the IR increased significantly between 1988 and 1996 (r=0.86, P=0.0027). The relative risk (RR) of type 1 diabetes mellitus for different age-groups estimated by a Poisson regression model showed that taking RR as 1.00 for age-group from 0 to 4 years, the RR for age-group from 5 to 9 year and from 10 to 14 year was 2.30 and 3.60 respectively. The standardized ascertainment corrected IR of childhood type 1 diabetes mellitus in China is much lower than in other countries. The geographic and ethnic variability of the incidence suggests that both genetic and environmental factors play a role in the development of childhood diabetes in China.