1.Analysis of comprehensive intervention measures on reducing the mortality rate of infants born to human immunodeficiency virus-infected pregnant women
Dan HE ; Gang ZHANG ; Renxing XIE ; Weixin LIU ; Gang WANG ; Yan ZHANG ; Piao ZHANG
Chinese Journal of Infectious Diseases 2021;39(9):542-547
Objective:To evaluate the effect of comprehensive intervention measures on reducing the mortality rate of infants born to human immunodeficiency virus (HIV)-infected pregnant women.Methods:A total of 9 773 infants born to pregnant women with positive HIV antibody and confirmed HIV infection in Sichuan Province from 2005 to 2019 were included. The changes of infant mortality, death composition, time of death, and main causes of death in the whole province and different regions at baseline (2005 to 2016) and after comprehensive intervention measures (from 2017 to 2019) were analyzed. Statistical analysis was conducted by chi-square test and trend chi-square test.Results:After the intervention, the infant mortality rate born to HIV-infected mothers was 49.6‰ (221/4 455), which dropped 40.6% compared to the baseline (83.5‰ (444/5 318)), and that in Liangshan Yi Autonomous Prefecture was 53.3‰ (186/3 491), which dropped 48.3% compared to the baseline (103.1‰ (379/3 676)). Furthermore, the infant mortality rate in Sichuan Province and Liangshan Yi Autonomous Prefecture decreased with time (trend χ2=42.058 and 60.041, respectively, both P<0.01). The proportions of infant death of HIV-infected mothers among the total infant death in Sichuan Province and Liangshan Yi Autonomous Prefecture decreased from 29.3% (130/444) and 25.9% (98/379) to 13.6%(30/221) and 9.7%(18/186), respectively, and the differences were statistically significant ( χ2=19.918 and 20.020, respectively, both P<0.01). The infant death time was mainly delayed from less than one month (31.5%(140/444) and 28.5%(108/379), respectively) to 2-3 months (27.6%(61/221) and 28.5%(53/186), respectively) in Sichuan Province and Liangshan Yi Autonomous Prefecture, and the differences were statistically significant ( χ2=24.642 and 26.009, respectively, both P<0.01). The infant mortality rates due to pneumonia, diarrhea, suspected HIV infection, premature delivery or low birth weight decreased from 44.4‰ (236/5 318), 12.0‰ (64/5 318), 4.9‰ (26/5 318) and 4.3‰ (23/5 318) at baseline to 26.9‰ (120/4 455), 7.6‰ (34/4 455), 1.8‰ (8/4 455) and 0.7‰ (3/4 455), respectively, and the differences were statistically significant ( χ2=21.010, 4.734, 6.691 and 12.182, respectively, all P<0.05). Conclusions:Through the implementation of comprehensive intervention measures, the infant mortality rates of HIV-infected mothers in Sichuan Province and the high endemic areas decrease significantly. However, it is necessary to pay more attention to the high death risk and the infant death in the middle or low endemic areas. The infant health care of HIV-infected mothers within six months should be strengthened. The quality of follow-up and health care services targeted to the main cause of death should be improved.
2.Efficacy of superficial temporal artery-anterior temporal artery bypass combined with encephalo-duro-arterio-synangiosis in treatment of moyamoya disease
Renxing SONG ; Chunxiao PANG ; Lina WANG ; Zengwu WANG ; Kunming XIE ; Yifei LI ; Lemei CHEN ; Hui GUO
Chinese Journal of Neuromedicine 2020;19(8):805-809
Objective:To investigate the clinical efficacy of superficial temporal artery-anterior temporal artery bypass combined with encephalo-duro-arterio-synangiosis in the treatment of Moyamoya disease.Methods:A total of 42 patients with moyamoya disease, admitted to our hospital from January 2016 to January 2019, were selected and divided into observation group and control group according to surgical management. The patients in the observation group were treated with superficial temporal artery-anterior temporal artery bypass combined with encephalo-duro-arterio-synangiosis, and the patients in the control group were treated with superficial temporal artery-angular gyrus artery bypass combined with encephalo-duro-arterio-synangiosis. The clinical data of these patients were analyzed retrospectively, and the differences of efficacy and safety between the two groups were compared.Results:There was no significant difference in operation time between the two groups ([189.16±21.23] min vs. [179.46±16.95] min, P>0.05). One d after the operation, the patients in both groups were re-examined with CT angiography, and the anastomotic vessels were unobligated. Two patients in the observation group had cerebral infarction in the operative region and one patient in the control group had cerebral infarction in the operative region; no significant difference was noted in the incidence of postoperative complications between the two groups ( P>0.05). The modified Rankin scale (mRS) scores in both groups one month after surgery were significantly decreased as compared with those one d before surgery ( P<0.05); one month after surgery, the mRS scores in observation group (0.13±0.346) were significantly lower than those in the control group (0.42±0.515, P<0.05). Conclusion:The superficial temporal artery-anterior temporal artery bypass combined with encephalo-duro-arterio-synangiosis has definite clinical efficacy in the treatment of moyamoya disease.