BACKGROUND: Sevoflurane permits the rapid induction and control of anesthetic depth, and its lack of pungency permits anesthesia to be induced by administering it using a face mask. The goal of this study was to evaluate the possibility of induction and tracheal intubation without neuromuscular blocking drugs in adult patients given high inspired concentrations of sevoflurane (8%). METHODS: Fifty adult patients received 8% sevoflurane with nitrous oxide (2 L/min) and oxygen (2 L/min) by face mask until tracheal intubation. Patients exhaled to residual volume and deeply inspired the gas mixture following introduction. The time of response loss from introduction was noted as the induction time. The change of blood pressure, heart rate and bispectral index (BIS) value during induction and tracheal intubation were also determinated. Jaw relaxation, vocal cords position, and intubating response were used to assess intubation condition. RESULTS: Mean time for induction of anesthesia was 42.4+/-4.7 seconds and mean time to acceptable intubating conditions was 300.5+/-32.7 seconds. The average BIS values at the time of induction and at the time of intubation were 79.3+/-22.0 and 23.8+/-10.6 respectively. The average time for a BIS value under 40 was 105.5+/-30.8 seconds. Systolic blood pressure, heart rate and BIS values were decrease significantly during the induction of anesthesia (P < 0.05). A significant increase was observed in systolic blood pressure, diastolic blood pressure, heart rate and BIS values were noted after tracheal intubation (P < 0.05). In response to intubation, the incidence of good tracheal intubation was 16%, acceptable 69% and poor 15%. CONCLUSIONS: The induction of anesthesia in adult patients administered sevoflurane at highconcentration (8%), by face mask, approached the speed of intravenous induction. But the technique did not always make produce satisfactory tracheal intubating conditions without neuromuscular blocking drugs.
Adult* ; Anesthesia* ; Blood Pressure* ; Heart Rate* ; Heart* ; Humans ; Incidence ; Intubation* ; Jaw ; Masks ; Neuromuscular Blockade ; Nitrous Oxide ; Oxygen ; Relaxation ; Residual Volume ; Vocal Cords

Due to the latent characteristics of HIV infection, exceptionality of HIV high-risk population, social discrimination and insufficient awareness of AIDS prevention, timely testing and diagnosis of HIV infection is still a challenge worldwide. Until recently, it is difficult to exactly understand the overall HIV epidemic only using routine surveillance data. Therefore, epidemiological and statistical modeling is widely used to address this issue. Almost at the same time when AIDS was firstly discovered firstly, scientists also began to study the methods for the estimation and prediction of HIV infection epidemic. This article summarizes the development of global and domestic HIV epidemic estimation for the further understanding of its current performance and methods applied to provide reference for the future work.
Acquired Immunodeficiency Syndrome/epidemiology* ; Epidemics ; HIV Infections/epidemiology* ; Humans ; Models, Statistical

Objective: To construct a multi-state Markov model and analyze the disease outcomes and its influencing factors in HIV infected individuals receiving antiretroviral therapy. Methods: A retrospective cohort analysis was conducted in HIV infected individuals receiving antiretroviral therapy in Luzhou of Sichuan province from 2010 to 2021. The disease status was divided into CD4⁺T lymphocytes (CD4) counts >500 cells/μl, 350-500 cells/μl, 200-349 cells/μl, ≤199 cells/μl and death indicated by S1-S5 in turn. A reversible continuous-time discrete-state multi-state Markov model was constructed for the analysis of disease progression features. Results: A total of 7 542 HIV infected individuals receiving antiretroviral therapy were included, and the median age (Q₁, Q₃) was 53.4 (41.2, 64.5) years old. The transition intensity of S3→S2 was higher. During follow-up, the transition probability of S4→S5 increased gradually. Influencing factors analysis of disease outcomes in HIV infected individuals receiving antiretroviral therapy showed that compared with individuals 15-24 years old, the transition intensities of S2→S1, S3→S2 and S4→S3 were lower and the transition intensity of S3→S4 was higher in individuals ≥45 years old. Compared with single individuals, the transition intensities of S3→S2 and S4→S3 were higher and the transition intensities of S3→S4 and S4→S5 were lower in married individuals. The transition intensity of S1→S2 was higher in individuals with baseline CD4 counts ≤500 cells/μl than in individuals with baseline CD4 counts >500 cells/μl. The transition intensity of S3→S4 in individuals diagnosed during 2011-2015 was lower than that in individuals diagnosed in 2010 and before. Conclusions: HIV infected individuals receiving antiretroviral therapy tended to shift to the previous disease status, suggesting that antiretroviral therapy was conducive to immune reconstitution. Older age (≥45 years old), being married, low baseline CD4 counts and being diagnosed in 2010 and before were the risk factors for disease progression.
Adolescent ; Adult ; CD4 Lymphocyte Count ; China/epidemiology* ; Disease Progression ; HIV Infections/drug therapy* ; Humans ; Middle Aged ; Retrospective Studies ; Young Adult