1.Characteristics of newly reported HIV/AIDS cases with non-marital but non-commercial heterosexual transmission in Hangzhou, 2015-2017.
J F CHEN ; H WU ; X L ZHANG ; Y LUO ; J M DING
Chinese Journal of Epidemiology 2018;39(12):1602-1606
Objective: To describe the characteristics of newly reported HIV/AIDS cases via non-marital or non-commercial heterosexual transmission and to find out the relative factors in Hangzhou, from 2015 to 2017. Methods: Data were collected through the national HIV/AIDS comprehensive control and prevention data system. Study subjects would include those reported HIV/AIDS cases who were residents of Hangzhou and were infected via non-marital heterosexual transmission, between January 1, 2015 and December 31, 2017. Demographic characteristics and behavioral information were collected. χ(2) test was used to compare different characteristics of the non-married heterosexual transmission subjects. Logistic regression was used to assess factors that associated with non-marital but non-commercial HIV heterosexual transmission with SPSS. 20 software used to analyze statistically. Results: Non-marital HIV heterosexual transmission accounted for 38.03% (1 393/3 663) of the total new reported HIV/AIDS cases in 2015-2017. Out of the 1 393 HIV/AIDS cases, those infected through non-marital but non-commercial heterosexual transmission accounted for 50.83% (708/1 393), and those through non-martial commercial transmission was accounted for 49.17% (685/1 393). Male to female ratio was 3.51 ∶ 1 (1 084/309). Male HIV cases reported that their major way of infection was via non-marital commercial transmission (670/1 084, 61.81%), while female patients reported the way was via non-marital non-commercial (294/309, 95.1%). Results from multivariate logistic analysis showed that the related risk factors and ORs for non-marital but non-commercial transmission appeared as: female (aOR=48.25, 95%CI: 26.94- 88.44),<30 year olds (aOR=2.43, 95%CI: 1.31-4.51), 30-39 year olds (aOR=1.92, 95%CI: 1.11- 3.33), 40-49 year olds (aOR=1.80, 95%CI: 1.08-3.00), married or unmarried (vs. divorced or widowed, aOR=1.57, 95%CI: 1.10-2.24; aOR=1.78, 95%CI: 1.15-2.78), high school and above of education level (vs. primary school and under of education level, aOR=1.82, 95%CI: 1.18-2.80), administrative officers or employee (vs. farmers, aOR=2.03, 95%CI: 1.04-1.91). Number of non- marital partners less than 5 (vs. number of non-marital partners more than 5, aOR=10.65, 95%CI: 6.41-17.42). Conclusions: HIV/AIDS cases with non-marital heterosexual transmission accounted for considerable proportion regarding the HIV transmission in Hangzhou from 2015 to 2017. Differences were found in the following factors as non-marital and non-commercial heterosexual transmission with diverse gender, age, marital status, educational level and occupation among of the HIV/AIDS patients.
Female
;
HIV
;
HIV Infections/transmission*
;
Heterosexuality
;
Humans
;
Male
;
Risk Factors
;
Sexual Behavior/psychology*
;
Sexual Partners
;
Single Person
2.The Impact of Perforator Number on Deep Inferior Epigastric Perforator Flap Breast Reconstruction.
Ritwik GROVER ; Jonas A NELSON ; John P FISCHER ; Stephen J KOVACH ; Joseph M SERLETTI ; Liza C WU
Archives of Plastic Surgery 2014;41(1):63-70
BACKGROUND: Perforator flaps minimize abdominal site morbidity during autologous breast reconstruction. The purpose of this study was to assess whether the number of perforators harvested influences the overall deep inferior epigastric perforator (DIEP) flap survival and flap-related complications. METHODS: A retrospective review was performed of all DIEP flaps performed at the Hospital of the University of Pennsylvania from 2006 to 2011. The outcomes assessed included flap loss and major complications. We compared flaps by the number of total perforators (1-4) and then carried out a subgroup analysis comparing flaps with one perforator to flaps with multiple perforators. Lastly, we conducted a post-hoc analysis based on body mass index (BMI) categorization. RESULTS: Three hundred thirty-three patients underwent 395 DIEP flaps. No significant differences were noted in the flap loss rate or the overall complications across perforator groups. However, the subgroup analysis revealed significantly higher rates of fat necrosis in the case of one-perforator flaps than in the case of multiple-perforator flaps (10.2% vs. 3.1%, P=0.009). The post-hoc analysis revealed a significant increase in the flap loss rate with increasing BMI (<30=2.0%, 30-34.9=3.1%, 35-39.9=3.1%, >40=42.9%, P<0.001) in the DIEP flaps, but no increase in fat necrosis. CONCLUSIONS: This study demonstrates that the number of perforators does not impact the rate of flap survival. However, the rate of fat necrosis may be significantly higher in DIEP flaps based on a single perforator. Multiple perforators should be utilized if possible to decrease the risk of fat necrosis.
Body Mass Index
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Breast*
;
Fat Necrosis
;
Female
;
Humans
;
Mammaplasty*
;
Microsurgery
;
Outcome Assessment (Health Care)
;
Pennsylvania
;
Perforator Flap*
;
Retrospective Studies
3.Expression of phosphorylated ERK1/2 induced by crocidolite fibers in BEAS-2B cells.
Xin-chao WANG ; Yi-ming WU ; James M SAMET ; Adrew J GHIO
Chinese Journal of Industrial Hygiene and Occupational Diseases 2006;24(10):597-600
OBJECTIVETo explore the characteristic of the signal transduction in BEAS cells induced by the crocidolite fibers.
METHODSThe human respiratory airway epithelial cells BEAS-2B were cultured in vitro. The final 100 microg/ml crocidolite concentration and lOnM of epidermal growth factor were cocultured with BEAS-2B cells for 30 minutes and 120 minutes. Phosphorylated ERKl/2 and MEKl/2 were detected by Western Blotting using specific antibodies.
RESULTSA rapid phosphorylation expression of ERK1/2 (molecular weight at 44 kD and 42 kD, also called as p44 and p42) was observed by treatment of the BEAS-2B cells with 100 microg/ml crocidolite or 100 ng/ml EGF (the proven activator of the ERK signaling pathway) at 30 minutes. This phosphorylation could be still detected by incubation the cells at 2 hours. However no expression was changed for the total ERKl/2 expression at 30 minutes or 120 minutes. Treatment of BEAS cells with 100 microg/ml crocidolite fiber or 100 ng/ml EGF led to the rapid increased phosphorylation of MEK1/2 at 30 minutes; similarly, the overexpression of MEK1/2 could last 2 hours.
CONCLUSIONThe crocidolite induces the MAPK (ERK1/2 and MEK1/2) phosphorylation within a shorter time. It indicates that the MAPKs signals are involved in the process of crocidolite induced damage.
Asbestos, Crocidolite ; toxicity ; Bronchi ; cytology ; Cells, Cultured ; Epidermal Growth Factor ; pharmacology ; Epithelial Cells ; drug effects ; metabolism ; Humans ; MAP Kinase Kinase 1 ; metabolism ; Mitogen-Activated Protein Kinase 1 ; metabolism ; Mitogen-Activated Protein Kinase 3 ; metabolism ; Phosphorylation
4.Direct-to-Consumer Telemedicine Practices in the Health and Fertility of Men: A Systematic Review of the Literature
Christopher LIM ; Winston WU ; Justin LA ; Vincent CHAN ; Kathryn M. SCHUBACH ; Glenn DUNS ; Daniel LANTSBERG ; Darren J. KATZ
The World Journal of Men's Health 2024;42(1):148-156
Purpose:
Men are increasingly turning toward online direct-to-consumer (DTC) men’s health platforms to fulfill their health needs. Research surrounding these platforms is lacking and the motivations and predictors underlying this online health-seeking behavior is largely unknown. This review scopes the existing literature concerning DTC men’s health and identifies factors influencing engagement, as well as health outcomes of this platform.
Materials and Methods:
A structured search was performed following PRISMA guidelines. CINAHL via EBSCO, Embase, MEDLINE via Ovid, PsycINFO, PubMed and Web of Science were searched.
Results:
Peer-reviewed quantitative and qualitative studies with a focus on demographics and characteristics of those using DTC men’s health platforms, as well as studies related to patient outcomes using such platforms, were included. Ten of the 3,003 studies identified met the inclusion and exclusion criteria. Four cross-sectional descriptive studies evaluated the motivations behind men’s engagement with DTC platforms. Convenience, embarrassment and health motivation were identified as predominant factors associated with DTC platform use. The review identified a lack of qualitative studies, and major limitations were noted in the quantitative studies that impacted the accuracy of findings. Six further quantitative studies explored the quality of care provided by DTC platforms. DTC platforms were found to have a varying level of adherence to established clinical guidelines, but appeared to provide satisfactory patient outcomes with low levels of patient-reported side effects and adverse events.
Conclusions
There is a lack of research within the DTC men’s health space given the infancy of the field. Important predictors and motivations underlying men’s choices in accessing these platforms have been noted across several studies. However, further studies need to be conducted to investigate the psychosocial underpinnings of this behavior. Studies across a wider variety of male health conditions treated by these platforms will also help to provide insights to guide patient-centered care within the DTC landscape.
5.Estimation on the health life expectancy of adults in Zhejiang province, 2016.
F R FEI ; R Y HU ; X Y WANG ; J M ZHONG ; W W GONG ; J PAN ; H B WU ; M WANG ; H WANG ; M YU
Chinese Journal of Epidemiology 2018;39(9):1249-1254
Objective: To estimate the health-adjusted life expectancy (HALE) of adults in Zhejiang province and evaluate the health status of the adults. Methods: This study was based on the mortality data collected from Zhejiang Chronic Disease Surveillance Information and Management System, and mortality rates from the underreporting survey and self-reported health data in 2016. Hierarchical Ordered Probit (HOPIT) model was used to estimate the severity-weighted prevalence of disability. Sullivan's method was used to calculate the HALE. Results: After adjustment by HOPIT model, the severity-weighted prevalence of disability increased significantly with age (χ(2)=5 795.81,P<0.001), and it was higher in females than in males (χ(2)=5 353.27, P<0.001). The life expectancy and self-evaluated HALE were 59.08 years and 48.68 years, respectively, in those aged ≥20 years, the difference was 10.40 years due to disability. The proportion of HALE loss due to disability in the total life expectancy was 17.61%, and it increased with age. HALE was higher in males than in females (49.21 years vs. 48.14 years), and in urban residents than in rural residents (49.92 years vs. 47.43 years). Conclusion: The proportion of loss of HALE in the total life expectancy in adults was high in Zhejiang, and it higher in males than in females, in urban residents than rural residents. Programs on improving health care in women and rural residents should be promoted.
Adult
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China/epidemiology*
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Chronic Disease/epidemiology*
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Disabled Persons/statistics & numerical data*
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Female
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Health Status
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Humans
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Life Expectancy/ethnology*
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Male
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Middle Aged
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Prevalence
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Sex Distribution
6.Study on the super-antigen genes of group A Streptococcus pyogenes strains isolated from patients with scarlet fever and pharyngeal infection, in Beijing, 2015-2017.
C N MA ; X M PENG ; S S WU ; D T ZHANG ; J C ZHAO ; G L LU ; Y PAN ; S J CUI ; Y M LIU ; W X SHI ; M ZHANG ; Q Y WANG ; P YANG
Chinese Journal of Epidemiology 2018;39(10):1375-1380
Objective: To analyze the characteristics of super-antigen (SAg) of group A Streptococcus pyogenes (GAS), isolated from patients with scarlet fever or pharyngeal infections in Beijing between 2015-2017. Methods: Throat swab specimens from patients with scarlet fever or pharyngeal infections were collected and tested for GAS. Eleven currently known SAg genes including SpeA, speC, speG, speH, speI, speJ, speK, speL, speM, smeZ and ssa were tested by real-time PCR while M protein genes (emm genes) were amplified and sequenced by PCR. Results: A total of 377 GAS were isolated from 6 801 throat swab specimens, with the positive rate as 5.5%. There were obvious changes noticed among speC, speG, speH and speK in three years. A total of 45 SAg genes profiles were observed, according to the SAgs inclusion. There were significant differences appeared in the frequencies among two of the highest SAg genes profiles between emm1 and emm12 strains (χ(2)=38.196, P<0.001; χ(2)=72.310, P<0.001). There also appeared significant differences in the frequencies of speA, speH, speI and speJ between emm1 and emm12 strains (χ(2)=146.154, P<0.001; χ(2)=52.31, P<0.001; χ(2)=58.43, P<0.001; χ(2)=144.70, P<0.001). Conclusions: Obvious changes were noticed among SAg genes including speC, speG, speH and speK from patients with scarlet fever or pharyngeal infections in Beijing between 2015-2017. SAg genes including speA, speH, speI and speJ appeared to be associated with the emm 1 and emm 12 strains. More kinds of SAg genes profiles were isolated form GAS but with no significant differences seen in the main SAg genes profiles, during the epidemic period.
Antigens, Bacterial/genetics*
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Bacterial Outer Membrane Proteins
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Bacterial Proteins
;
Beijing/epidemiology*
;
China/epidemiology*
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Exotoxins
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Female
;
Humans
;
Membrane Proteins
;
Pharyngitis/microbiology*
;
Pharynx/microbiology*
;
Pregnancy
;
Pregnancy Complications, Infectious/microbiology*
;
Real-Time Polymerase Chain Reaction
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Scarlet Fever/microbiology*
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Streptococcal Infections
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Streptococcus pyogenes/isolation & purification*
;
Superantigens/genetics*
7.Impact of novel P2Y12 receptor inhibitors on platelet reactivity in acute coronary syndrome patients undergoing percutaneous coronary intervention.
T J Chong TOU ; P M LIU ; J F WANG ; Z C Sio CHAM ; Y F O U ; Z W Lei SIO ; P Z Lei PUT ; S M Lei SOK ; S X ZHOU ; W WU
Chinese Journal of Cardiology 2016;44(2):138-143
OBJECTIVETo investigate the impact of novel P2Y(12) receptor inhibitors including prasugrel or ticagrelor on platelet reactivity in patients with acute coronary syndrome (ACS) receiving percutaneous coronary intervention (PCI), and provide clinical data for novel oral P2Y(12) receptor inhibitors use among Chinese patients.
METHODSBetween October 2011 to February 2014, 174 consecutive patients (135 males; (67.8±11.8) years old) with ACS undergoing PCI in Kiang Wu Hospital, Macau were prospectively enrolled in this study. Oral aspirin and one P2Y(12) receptor inhibitor were administered for 5 days or above after PCI, patients were divided into clopidogrel, prasugrel and ticagrelor groups in accordance with the agent administered. Platelet reactivity of the patients was detected by VerifyNow P2Y(12) reaction unit (PRU); and the high on-treatment platelet reactivity (HPR) and non-HPR were defined as PRU≥208 and PRU<208 respectively. Patients with HPR during clopidogrel therapy were switched either to prasugrel or ticagrelor, or continued the same treatment; and then the platelet reactivity was monitored again.
RESULTSThere were 113 clopidogrel cases (64.9%), 20 prasugrel cases (11.5%) and 41 ticagrelor cases (23.6%). Fifty-seven cases (32.8%) were defined as HPR post P2Y(12) receptor inhibitor use, in which 55 cases (55/113, 48.7%) were treated with clopidogrel. The degree of inhibition of platelet reactivity was significantly different in patients on clopidogrel, prasugrel and ticagrelor therapy, percent inhibition assayed by the VerifyNow P2Y(12) system was 28.2%±23.5%, 61.4%±26.7% and 81.3%±19.8% respectively (P<0.05). Different degree of platelet reactivity was achieved by the 3 P2Y(12) receptor inhibitors at multiple time points. The among-group differences in platelet reactivity became apparent at the early treatment stage (P<0.05). Platelet aggregation decreased significantly in patients switched from clopidogrel to prasugrel or ticagrelor (P<0.05).
CONCLUSIONNovel oral P2Y(12) receptor inhibitors are more effective in inhibiting platelet reactivity in ACS patients, and our results show that novel oral P2Y(12) receptor inhibitors provide a new option for ACS patients with HPR post clopidogrel or high-risk features of ischemic complications, including stent thrombosis and post-PCI ischemic events.
Acute Coronary Syndrome ; Adenosine ; analogs & derivatives ; Aged ; Aspirin ; Blood Platelets ; Female ; Humans ; Male ; Percutaneous Coronary Intervention ; Platelet Aggregation ; Platelet Aggregation Inhibitors ; Platelet Function Tests ; Prasugrel Hydrochloride ; Prospective Studies ; Ticlopidine ; analogs & derivatives
8.Clinicopathological features of thyroid-like low-grade nasopharyngeal papillary adenocarcinoma.
M ZHU ; J LI ; W H ZHENG ; M J WU
Chinese Journal of Pathology 2023;52(8):820-826
Objective: To investigate the clinicopathological features, immunophenotype and gene alterations of thyroid-like low-grade nasopharyngeal papillary adenocarcinoma (TL-LGNPPA). Methods: Fifteen case of TL-LGNPPA diagnosed at Zhejiang Cancer Hospital (5 cases) and the First Affiliated Hospital, Zhejiang University School of Medicine (10 cases) from November 2011 to August 2020 were collected. Clinical and pathological examinations, immunohistochemical staining and next-generation sequencing were performed. The clinicopathological and molecular characteristics were summarized, and relevant literature was reviewed. Results: Fifteen patients were identified and included. Their median age was 36 years (range, 20-60 years). The male-female ratio was 1.0∶1.1. The most common symptoms were epistaxis and nasal obstruction. The neoplasms were located on the roof of the nasopharynx or the posterior margin of the nasal septum. The pathological features included complex papillary and glandular structures mainly composed of single or pseudostratified cubic and columnar cells, with mild to moderate cytological atypia. In some cases, spindle cell features, nuclear grooves, ground glass nuclei, squamous metaplasia, or scattered psammoma bodies were identified. In addition, nuclear polar reversal cells, hobnail cells and micropapillary structures were found, but have not been reported in previous literature. Immunohistochemistry showed that the tumor cells were diffusely positive for TTF1, CK7, vimentin and CKpan; focally positive for p40, CK5/6 and p16; and negative for Tg, NapsinA, CK20, CDX2, S-100 and PAX8. The Ki-67 positive rates ranged from 1% to 20% and were≤10% in thirteen cases (13/15). EBER in situ hybridization was negative in all cases. DNA sequencing of 6 specimens was performed and all specimens were found harboring gene mutations (EWSR1, SMAD2, ROS1, JAK3, GRIN2A, ERRCC5, STAT3, and TET2), but no hot spot gene alterations were found. No MSI-H and MMR related gene changes were detected. All tumors showed low tumor mutation burden. All 15 patients underwent endoscopic surgery, and only 1 of them underwent radiotherapy postoperatively. All patients were recurrence free and alive at the end of follow-up periods (range: 23 to 129 months). Conclusions: TL-LGNPPA is a rare indolent tumor of the nasopharynx and exhibits a unique morphology and immunophenotype. Endoscopic resection is an effective treatment for TL-LGNPPA with excellent overall prognosis.
Humans
;
Male
;
Female
;
Adult
;
Thyroid Gland/pathology*
;
Adenocarcinoma, Papillary/pathology*
;
Nasopharyngeal Neoplasms/pathology*
;
Protein-Tyrosine Kinases
;
Proto-Oncogene Proteins
;
Nasopharynx/pathology*
;
Biomarkers, Tumor
9.Impact of Multiphase Computed Tomography Angiography for Endovascular Treatment Decision-Making on Outcomes in Patients with Acute Ischemic Stroke
Johanna M. OSPEL ; Ondrej VOLNY ; Wu QIU ; Mohamed NAJM ; Moiz HAFEEZ ; Sarah ABDALRAHMAN ; Enrico FAINARDI ; Marta RUBIERA ; Alexander KHAW ; Jai J. SHANKAR ; Michael D. HILL ; Mohammed A. ALMEKHLAFI ; Andrew M. DEMCHUK ; Mayank GOYAL ; Bijoy K. MENON
Journal of Stroke 2021;23(3):377-387
Background:
and Purpose Various imaging paradigms are used for endovascular treatment (EVT) decision-making and outcome estimation in acute ischemic stroke (AIS). We aim to compare how these imaging paradigms perform for EVT patient selection and outcome estimation.
Methods:
Prospective multi-center cohort study of patients with AIS symptoms with multi-phase computed tomography angiography (mCTA) and computed tomography perfusion (CTP) baseline imaging. mCTA-based EVT-eligibility was defined as presence of large vessel occlusion (LVO) and moderate-to-good collaterals on mCTA. CTP-based eligibility was defined as presence of LVO, ischemic core (defined on relative cerebral blood flow, absolute cerebral blood flow, and cerebral blood volume maps) <70 mL, mismatch-ratio >1.8, absolute mismatch >15 mL. EVT-eligibility and adjusted rates of good outcome (modified Rankin Scale 0–2) based on these imaging paradigms were compared.
Results:
Of 289/464 patients with LVO, 263 (91%) were EVT-eligible by mCTA-criteria versus 63 (22%), 19 (7%) and 103 (36%) by rCBF, aCBF, and CBV-CTP-criteria. CTP and mCTA-criteria were discordant in 40% to 53%. Estimated outcomes were best in patients who met both mCTA and CTP eligibility-criteria and were treated with EVT (62% to 87% good outcome). Patients eligible for EVT by mCTA-criteria and not by CTP-criteria receiving EVT achieved good outcome rates of 53% to 57%. Few patients met CTP-criteria and not mCTA-criteria for EVT.
Conclusions
Simpler imaging selection criteria that rely on little else than detection of the occluded blood vessel may be more sensitive and less specific, thus resulting in more patients being offered EVT and arguably benefiting from it.
10.Impact of Multiphase Computed Tomography Angiography for Endovascular Treatment Decision-Making on Outcomes in Patients with Acute Ischemic Stroke
Johanna M. OSPEL ; Ondrej VOLNY ; Wu QIU ; Mohamed NAJM ; Moiz HAFEEZ ; Sarah ABDALRAHMAN ; Enrico FAINARDI ; Marta RUBIERA ; Alexander KHAW ; Jai J. SHANKAR ; Michael D. HILL ; Mohammed A. ALMEKHLAFI ; Andrew M. DEMCHUK ; Mayank GOYAL ; Bijoy K. MENON
Journal of Stroke 2021;23(3):377-387
Background:
and Purpose Various imaging paradigms are used for endovascular treatment (EVT) decision-making and outcome estimation in acute ischemic stroke (AIS). We aim to compare how these imaging paradigms perform for EVT patient selection and outcome estimation.
Methods:
Prospective multi-center cohort study of patients with AIS symptoms with multi-phase computed tomography angiography (mCTA) and computed tomography perfusion (CTP) baseline imaging. mCTA-based EVT-eligibility was defined as presence of large vessel occlusion (LVO) and moderate-to-good collaterals on mCTA. CTP-based eligibility was defined as presence of LVO, ischemic core (defined on relative cerebral blood flow, absolute cerebral blood flow, and cerebral blood volume maps) <70 mL, mismatch-ratio >1.8, absolute mismatch >15 mL. EVT-eligibility and adjusted rates of good outcome (modified Rankin Scale 0–2) based on these imaging paradigms were compared.
Results:
Of 289/464 patients with LVO, 263 (91%) were EVT-eligible by mCTA-criteria versus 63 (22%), 19 (7%) and 103 (36%) by rCBF, aCBF, and CBV-CTP-criteria. CTP and mCTA-criteria were discordant in 40% to 53%. Estimated outcomes were best in patients who met both mCTA and CTP eligibility-criteria and were treated with EVT (62% to 87% good outcome). Patients eligible for EVT by mCTA-criteria and not by CTP-criteria receiving EVT achieved good outcome rates of 53% to 57%. Few patients met CTP-criteria and not mCTA-criteria for EVT.
Conclusions
Simpler imaging selection criteria that rely on little else than detection of the occluded blood vessel may be more sensitive and less specific, thus resulting in more patients being offered EVT and arguably benefiting from it.