Objective: To investigate the detection of HIV/AIDS cases in medical institutions in Tianjin Municipality from 2005 to 2021, so as to provide insights into optimization of HIV antibody testing strategies in medical institutions. Methods: All data pertaining to individuals receiving HIV antibody tests in medical institutions in Tianjin Municipality from 2005 to 2021 were collected from the information systems in medical institutions and the HIV/AIDS Prevention and Control Information System of Chinese Disease Prevention and Control Information System. The positive rate of HIV antibody and epidemiological characteristics of HIV/AIDS cases in medical institutions were analyzed. Results: The number of HIV antibody tests increased from 86 102 person-times in 2005 to 1 369 345 person-times in 2021 in medical institutions in Tianjin Municipality, with annual increase by 18.88%. The positive rate of HIV antibody increased from 2.44/104 to 2.85/104 (P<0.05), with annual increase by 2.79/104. Both the proportion of the number of HIV antibody tests and the number of HIV/AIDS cases detected by medical institutions in the whole city appeared a tendency towards a rise (P<0.05). A high positive rate of HIV antibody was seen in sexually transmitted disease clinics (53.69/104) and other testing services (12.25/104), and the highest positive rate of HIV antibody was seen in individuals at ages of 20 to 39 years (5.40/104), while the positive rate of HIV antibody was higher in men (5.84/104) than in women (0.53/104) (P<0.05). A total of 3 610 HIV/AIDS cases were detected in medical institutions in Tianjin Municipality from 2005 to 2021, with a median age of 38 (interquartile range, 24) years. Of all HIV/AIDS patients, there were 3 277 men (90.78%), and men who have sex with men was the predominant transmission route (63.46%), while the proportion of late identification of HIV/AIDS cases was 65.60%. In addition, the proportion of timely detection for the first CD4+T lymphocyte count testing increased from 23.81% in 2005 to 71.54% in 2021 (P<0.05). Conclusions The number of HIV antibody tests and positive rate of HIV antibody appeared a tendency towards a rise in medical institutions in Tianjin Municipality from 2005 to 2021. The HIV/AIDS cases were predominantly identified in sexually transmitted disease clinics and other testing services, and were predominantly men.

Objective To study the clinical risk factors and the characteristics of cerebral magnetic resonance imaging (MRI) of hypoxic-ischemia encephalopathy (HIE) in full-term infants in high-altitude area.Method From January 2014 to December,2016 full-term Tibetan infants with HIE and healthy full-term Tibetan infants admitted to our hospital were enrolled in the study.General conditions and perinatal status were retrospectively analyzed.Univariate analysis and multivariate analysis were used to determine the risk factors of the HIE.MRI characteristics,location of the brain injuries and the correlation between HIE clinical grading and MRI grading were analyzed.Result During the study period,5 172 full-term Tibetan neonates were born in our hospital,198 of them were diagnosed of HIE and the incidence was 3.8％.According to HIE clinical grading,31 were mild,110 were moderate and 57 were severe.MRI grading included 34 mild,131 moderate and 33 severe.The main manifestations of MRI included white matter injury,especially subcortical white matter injury of frontal,parietal and occipital lobes,gray matter injury and diffuse cerebral edema.Mild HIE had a certain correlation with MRI grading,however,severe HIE had poor correlation with MRI grading.Multivariate Logistic regression analysis showed that abnormal birth weight (＜2 500 g or＞4 000 g) and intrauterine distress were independent risk factors of HIE in full-term Tibetan neonates[OR (95％ CI):3.663 (1.961～6.843) and 5.419 (2.487～11.807)].Conclusion Macrosomia at birth,low birth weight and intrauterine distress are independent risk factors of HIE in Tibetan full-term neonates in Lhasa.White matter injury is the main MRI manifestation of HIE.Clinical grading of Mild HIE has good consistency with the MRI grading,but MRI grading is milder than the clinical grading for those with moderate and severe HIE.

Objective: To explore the fitting and its influencing factors of ICU nurses. Methods: There were 268 nurses recruited from the First Affiliated Hospital of Xi′an Jiaotong University, the Ninth Hospital of Xi′an, Shaanxi Provincial People′s Hospital by convenience sampling between April and June 2018. The Fitting Scale, Social Undermining Scale, Perceived Organizational Support Scale and Supportive Communication Scale were used in the investigation. Results: The score of person-organization fit was (32.20±5.17). The score of person-job fit was (55.14±8.24), with the lowest score of supply-value fit subscale (2.58±0.48). The score of perceived organizational support, social undermining and supportive communication were (45.36±9.64), (46.27±7.48) and (68.47±11.25) respectively. Perceived organizational support, social undermining, contract nurses, and educational level could influence person- organization fit, which could explain 59.3% of the total variation. Working time, supportive communication and perceived organizational support could influence person- job fit, which could explain 47.6% of the total variation. Conclusions Nursing managers should improve the core value system of human resources management and organizational culture construction, enhance organizational support, construct humanities environment and coping strategy of undermining, provide the relevant training of interpersonal communication, and increase their organizational and job fitting.

Objective To explore the relocation stress in families of patients transferred from ICU, and the influence of social comparison orientation and family function on it. Methods There were 168 participants recruited from Critical Medical Department of the First Affiliated Hospital of Xi′an Jiaotong University by convenience sampling method between June 2017 and February 2018. The ICU patients′Family Relocation Stress Scale, Chinese version of the Iowa-Netherland Social Comparison Orientation Measure and Family Adaptation and Cohesion Evaluation Scale Ⅱ were used. Results The score of relocation stress and social comparison orientation were 58.47±7.66 and 37.83±9.11. The score of family real cohesion was 65.85 ± 7.83, which was higher than norms (t=-2.067, P<0.05). The score of dissatisfaction of adaptation was 9.22±4.41, which was higher than norms (t=-3.093, P<0.05). The results of regression analysis showed that the time of patient staying in ICU, education level, religion, social comparison orientation, family real cohesion and dissatisfaction of adaptation could influence relocation stress. Conclusion Health professionals should pay attention to the relocation stress in families, provide emotional support and effective information support, guide family members to correctly understand the patients′ condition and prognosis, respect their religious beliefs, give full play to their family functions, help them adapt to the role changes quickly and reduce the level of relocation stress.

Objective:To investigate the value of transperineal ultrasound assessment of levator hiatal antero-posterior (LHap) diameter changes in the diagnosis of pelvic floor dysfunction.Methods:The clinical data of 246 patients with suspected pelvic floor dysfunction who received treatment in Yuyao People's Hospital of Zhejiang Province from October 2020 to June 2021 were retrospectively analyzed. All these patients underwent clinical examination and modified Oxford score (MOS) evaluation. They were divided into observation group (low pelvic floor muscle contractility) and control group (normal pelvic floor muscle contractility) according to MOS. All patients were subjected to ultrasound examination and LHap diameter measurement under three conditions (at rest, pelvic floor muscle contraction, and maximal Valsalva maneuver). The percentage of shortening of LHap diameter (PDC%) and the percentage of elongation of LHap diameter (PIV%) were calculated. The differences of PDC% and PIV% were compared between the observation and control groups. The receiver operating curve was used to evaluate the values of PDC% and PIV% in the diagnosis of pelvic floor dysfunction.Results:Age, body mass index, the proportion of parturient women among included patients, and the proportion of patients who underwent vaginal delivery were significantly higher in the observation group than those in the control group (all P < 0.001). LHap diameters measured when patients were at rest, pelvic floor muscle contraction, and maximal Valsalva maneuver as well as PIV% in the observation group were (45.23 ± 5.74) mm], (37.71 ± 8.44) mm, (51.03 ± 7.41) mm and (11.42 ± 4.79)%, respectively, which were significantly higher than those in the control group [(41.78 ± 4.56) mm, (29.15 ± 4.64) mm, (44.28 ± 4.87) mm, (6.05 ± 2.13)%, t = -4.62, -8.29, -7.26, -9.36, all P < 0.001]. PDC% in the observation group was significantly lower than that in the control group [(17.52 ± 5.58)% vs. (32.19 ± 4.27)%, t = 20.39, P < 0.001]. MOS was positively correlated with PDC% ( r = 0.56, P < 0.001) and it was negatively correlated with PIV% ( r = -0.49, P < 0.001). Taking PDC% < 35.36% as the cut-off value, the area under the receiver operating curve was 0.85, the sensitivity, specificity and accuracy values were 66.40%, 97.38%, and 73.90%, respectively. Taking PIV% > 5.18% as the cut-off value, the area under the curve was 0.70, and the sensitivity, specificity and accuracy values were 71.45%, 57.90% and 68.15%, respectively. When PDC% and PIV% were used together, the area under the curve was 0.73 and the sensitivity, specificity and accuracy values were 84.57%, 55.05% and 77.32%, respectively. Conclusion:Transperineal ultrasound assessment of LHap diameter changes are of certain value in the prediction of pelvic floor dysfunction and can provide objective and quantitative data support for clinicians to diagnose pelvic floor dysfunction. This study is highly innovative and scientific.

The newly reported HIV infected cases was collected, and HIV blood samples were detected to identify recent HIV infection in Tianjin during 2008-2015. Factors associated with HIV-1 infection were analyzed by the univariate and multivariate unconditional logistic regression. The recent HIV-1 infection proportion of homosexuals increased from 37.70% in 2008 to 83.68% in 2015. Those cases who aged ≤30 years (OR=1.53, 95%CI: 1.30-1.79), in han ethnic group (OR=1.40, 95%CI: 1.02-1.91), students (OR=1.79, 95%CI: 1.28-2.51) were more likely to be recent infected. The cases who had a high school education (OR=1.28, 95%CI: 1.05-1.56) or collage education (OR=1.23, 95%CI: 1.00-1.50) were more likely to be recent infected than those who had a primary school education. Compared with patients identified by hospitals, the recent HIV infections were more likely to be found through voluntary counseling and testing (VCT), STD outpatients, men who have sex with men (MSM) investigation and unpaid blood donors. Homosexual transmission has become the major route of HIV-1 recent infection in Tianjin.

Objective To evaluate the auxiliary diagnostic value of viral load test for samples with indeterminate HIV antibody detection results.Methods Thirty-two samples with indeterminate HIV antibody detection results collected from MSM were used for two viral load tests in Tianjin in 2015.Follow up was conducted for this population to confirm their HIV infection status.Results Virus loads were detected in the 2 viral load tests.In the follow-up survey,the results of HIV antibody test of all the samples were positive.The results of viral load test were completely consistent with those of HIIV antibody confirmation test.Conclusion The viral load test was effective in the auxiliary diagnosis of HIV infection in window phase,which can be used for the samples with indeterminate HIV antibody detection results.

Objective To understand the characteristics on the diversity of HIV subtypes and related transmission in Tianjin.Methods A total of 77 newly diagnosed ART-na(i)ve HIV infectors in 2015 were screened by CD4 +T cell counts ≥200 cells/μl.Viral RNAs were extracted from plasma samples.Reverse transcription PCR and nested PCR were used to analyze the amplification of pol and env gene fragments,sequencing,and related bioinformatics information.Results 46.03％ (29/63),30.16％ (19/63),11.11％ (7/63),4.76％ (3/63) and 7.94％ (5/63) of the individuals were infected under HIV subtypes CRF01_AE,CRF07_BC,B,CRF55_01B and URFs,with sexual transmission as the major mode of infection.CRF01_AE and CRF07_BC strains were predominant in both MSM and HST populations.The patterns of subtype distribution did not show statistical differences other than subtype B and CRF55_01B strain among HSTs.The proportion of CRFs increased significantly to 88.89％.8 new second-generation recombinant forms were identified the first time,including 3 CRF55_01B,2 AE/BC,1 AE/B and 1AE/B/C among MSMs and 1 AE/BC among HSTs.5.3％ of the NNRTI L100I HIV infectors transmitted the drug-resistant-mutation strain.3 linkages related to HIV transmission were confirmed through phylogenetic analysis with Bootstrap ≥98％ of pol and ≥80％of env.Conclusion The increasing complexity of HIV had been noticed in Tianjin,including the prevalence and transmission of second-generation recombinant and drug-resistant strains through different routes of transmission and in different regions.

OBJECTIVE: To explore the genetic basis for a child with mental retardation. METHODS: Whole exome sequencing was carried out for the child. Candidate variant was screened based on his clinical features and verified by Sanger sequencing. RESULTS: The child was found to harbor a c.995_1002delAGACAAAA(p.Asp332AlafsTer84) frameshift variant in the SYNGAP1 gene. Bioinformatic analysis suggested it to be pathogenic. The same variant was not detected in either parent. CONCLUSION The c.995_1002delAGACAAAA(p.Asp332AlafsTer84) frameshift variant of the SYNGAP1 gene probably underlay the mental retardation in this child. Above finding has expanded the spectrum of SYNGAP1 gene variants and provided a basis for the diagnosis and treatment for this child.
Child ; Humans ; Intellectual Disability/genetics* ; Frameshift Mutation ; High-Throughput Nucleotide Sequencing ; Computational Biology ; Heterozygote ; Mutation ; ras GTPase-Activating Proteins/genetics*

Objective:To analyze the influenza vaccination status of chronic disease management patients in Qingpu district of Shanghai and the vaccination characteristics of different characteristic populations, so as to provide scientific basis for improving the influenza vaccination rate of chronic disease patients in the community.Methods:By comparing the data of Shanghai chronic disease management information system, immunization planning information system and medical association platform, 89 453 subjects who met the inclusion and exclusion criteria in Qingpu district were selected as the research objects. The vaccination coverage rate of the study subjects was calculated according to gender, age group, urban and rural distribution, occupation, chronic disease type and quantity, and the vaccination coverage rate of different subgroups was compared to analyze the influencing factors of vaccination coverage rate.Results:Most of the 89 453 patients with chronic diseases were 60 years old and above (71.93%). Patients with hypertension, diabetes, chronic obstructive pulmoriary disease (COPD) and three chronic diseases accounted for 87.12%, 28.67%, 8.71% and 1.83%, respectively. Influenza vaccination coverage in the 2016/2017 flu season was low, at 0.32%. Influenza vaccination coverage rate of women (0.37%) was higher than that of men (0.27%), which was 1.41 times respectively(95% CI: 1.16, 1.72) that of men patients. The coverage rate of influenza vaccination for the 70-79 year-old group was the highest (0.74%), which was 1.74 times respectively(95% CI: 1.39, 2.19) that of 60-69 year-old patients. The vaccination coverage rate of government departments and institutions was the highest (1.14%), which was 12.58 times respectively(95% CI: 4.52, 34.99) that of retirees. The vaccination rate of COPD patients (3.68%) was 2.50 times (95% CI: 1.66, 3.77) higher than that of patients without COPD.Conclusions:Influenza vaccination rate for chronic disease management patients in Qingpu district of Shanghai is low. Gender, occupation, age and types of chronic diseases are the influencing factors. Patients with chronic disease management should be included in the priority vaccination targets for influenza vaccines, and vaccination intervention for occupational chronic diseases such as non-retired agriculture and forestry patients, especially male patients, should be strengthened to improve influenza vaccination coverage rate.