We built rats model of endometriosis applying autologus endometrial transplants to compare the graft vol-ume of the modeling rats before and after dosing,serum tumor necrosis factor alpha(TNF-α)levels in rats,and the expressions of vascular endothelial cell growth factor(VEGF)in ectopic endometrium.To compare with the control group,the graft volume of DingKunDan group was reduced and the serum TNF-αlevel declined ,and also the ex-pression of VEGF in ectopic endometrium was reduced.Their differences were statistically significant (P <0.05). DingKunDan can inhibit the growth of ectopic endometrium in endometrosis model rats.The mechanism may be re-lated to the decrease of the serum TNF-αlevel and the VEGF expression.

Objective To explore the effect of nursing procedure on pressure sore in patients with brain tumor.Methods The nursing procedures were used in the nursing of 86 brain tumor patients.The procedures included assessment of pressure ulcer risk factors and regulations of nursing objective and the measures for preventing pressure ulcer.Result None of the patients contracted pressure ulcer during operation.Conclusion The nursing procedures for brain tumor patients can enable the nurses to plan nursing activities for specific purpose,avoid the occurrence of pressure sore and thus improve the quality of nursing.

Objective To understand the current status of receiving no methadone maintenance treatment (MMT) and influencing factors in HIV infected injecting drug users (IDUs) in Dehong Dai and Jingpo autonomous prefectures,Yunnan province.Methods Data of survival of IDUs with AIDS in Dehong were collected from "Chinese National Comprehensive HIV/AIDS and Care Information System" in December,2014.Results There were 987 IDUs who should receive MMT,the majority of them were males (94.6％,934/987),aged 35-44 years (53.0％,523/987) and farmers (77.2％,762/987).Among the 987 IDUs,60.2％ (592/987) received no MMT.Multivariate logistic regression analysis showed that being female (OR=2.66,95％CI:1.21-5.87),in Jingpo ethnic group (OR=3.05,95％CI:1.97-4.71) were the major risk factors for receiving no MMT;not being farmers (OR=0.46,95％CI:0.31-0.70),in Dai ethnic group (OR=0.53,95％CI:0.36-0.79),diagnosed HIV infection history ≥ 10 years (OR=0.60,95％CI:0.45-0.81) were the major protective factors for receiving no MMT.The reasons for receiving no MMT included long distance journey (289,48.8％),fear of exposure (124,20.9％),poor daily medication compliance (59,10.0％),fear of side effects (47,7.9％),others (73,12.3％).Conclusions The proportion of receiving no MMT in IDUs with AIDS in Dehong was high.Being female and farmer,in Jingpo ethnic group,low educational level,short diagnosed HIV infection history were influencing factors for receiving no MMT.The effective intervention measures should be taken to further improve MMT coverage according to the different characteristics of the patients.

Objective:To explore the changing trends and influencing factors of AIDS-related and non-AIDS-related deaths after receiving antiretroviral therapy (ART) among HIV-positive individuals in Dehong Dai Jingpo autonomous prefecture (Dehong) from 2010 to 2019.Methods:Based on the Chinese National treatment database, HIV patients who initiated ART from 2010 to 2019 were included in the analysis. The cumulative incidence function was used to estimate the cumulative incidence of AIDS-related death and non-AIDS-related death, respectively. The Fine-Grey model was used to compare the differences between AIDS-related and non-AIDS-related deaths and analyze its influencing factors.Results:A total of 7 068 HIV-positive individuals were included, of which 388 were AIDS-related deaths and 570 were non-AIDS-related deaths. The cumulative mortality rate at years 1, 2, 3, 4, 5, 7 and 9 after receiving ART were 2.27%, 3.46%, 4.47%, 5.03%, 5.84%, 6.61%, 7.40% for AIDS-related deaths, and 1.63%, 3.11%, 4.68%, 6.02%, 7.42%, 10.49%, 12.75% for non-AIDS-related deaths, respectively. In the Fine-Grey model, older age at ART initiation, male, unmarried, injection drug use as the transmission route, lower baseline BMI, lower baseline CD4 + T cell counts, baseline FIB-4 score >3.25, and baseline anemia were risk factors for AIDS-related death. In contrast, age at ART initiation ≥45 years, male, Dai, and Jingpo minority ethnicities, unmarried, injection drug use as the transmission route, lower baseline BMI, baseline FIB-4 score >3.25, baseline eGFR <60 ml·min -1·1.73 m -2, and baseline anemia were risk factors for non-AIDS-related deaths. Conclusions:The cumulative mortality rate was low among HIV-positive individuals after receiving ART in Dehong during 2010-2019. The mortality of non-AIDS-related deaths was higher than that of AIDS-related deaths. There were also differences in the factors influencing AIDS-related and non-AIDS-related deaths and interventions should be intensified to target the influencing factors for non-AIDS-related deaths.

Objective:To investigate the incidence of anemia and risk factors in HIV/AIDS patients with access to antiretroviral therapy (ART) during 2004-2018 in Dehong Jingpo and Dai Autonomous Prefecture (Dehong).Methods:A retrospective cohort study was conducted in HIV/AIDS patients receiving ART in Dehong during 2004-2018 based on the data extracted from the National HIV/AIDS antiretroviral therapy database. Cox proportional risk model was used to analyze the factors associated with the incidences of anemia and moderate or severe anemia in the HIV/AIDS patients. And the piecewise linear mixed-effects model was used to depict the trajectory of hemoglobin changes over time after initiating ART according to baseline level.Results:A total of 8 044 HIV/AIDS patients were included, in whom 6 337 (78.8%) were without anemia at baseline survey and had a median follow up time of 4.43 ( P 25, P 75: 1.50, 6.71) years. The median follow up time for 1 291 new anemia cases and 293 new moderate or severe anemia cases was 0.16 ( P 25, P 75: 0.07, 1.99) years and 0.48 ( P 25, P 75:0.09, 2.97) years, respectively. The incidence rate of anemia and moderate or severe anemia was 4.40 per 100 person-years and 0.41 per 100 person-years respectively. In multivariable Cox regression analysis, older age, being female, being in Dai and Jingpo ethnic group, baseline BMI <18.5 kg/m 2, baseline CD4 +T lymphocyte cell counts (CD4) <200 cells/μl, and zidovudine (AZT) -based initial treatment regimen were factors significantly and positively associated with incidence of anemia after treatment. Factors as being female, being in Dai ethnic group, baseline BMI <18.5 kg/m 2, mild baseline anemia, and AZT-based initial treatment regimen were significantly and positively associated with incidence of moderate or severe anemia after treatment. Conclusion:The risk for anemia was higher in HIV/AIDS patients with specific characteristics, such as age ≥60 years , being female, being in Dai and Jingpo ethnic groups, lower BMI, CD4 <200 cells/μl, and treatment of AZT, after initiation of ART in Dehong during 2004-2018. Additional efforts are needed to strengthen the screening, prevention and treatment of anemia in this population.

Objective:To explore the dynamic change of platelet count and related factors in HIV-infected patients with access to antiretroviral therapy (ART) in Dehong Dai and Jingpo autonomous prefecture of Yunnan province.Methods:A longitudinal analysis was used to analyze the dynamic change of platelet count in HIV-infected patients with access to ART. Linear mixed model (LMM) was used to analyze factors associated with the dynamic change of platelet count. Stratified analysis and sensitivity analysis were also conducted.Results:A total of 761 HIV-infected patients were recruited and 608 cases had at least one follow-up record (80.0%,608/761). 374, 555 and 233 cases were investigated in follow-up visits at month 6, 12 and 24, respectively. The mean platelet count and the proportion of higher platelet count (>300×10 9/L) were significantly higher in women than in men at both baseline survey and each follow-up visit ( P<0.05). Among patients with no obvious liver fibrosis, the mean platelet count was significantly higher in women than in men at baseline survey and each follow-up visit; while in the patients with liver fibrosis, the mean baseline platelet count was still significantly higher in women than in men, but the difference had no significance at follow-up visits. Results of LMM revealed that follow-up platelet count was positively correlated with gender ( β=5.90, 95% CI: 1.09-10.70, P=0.016), baseline platelet count ( β=0.82, 95% CI: 0.79-0.86, P<0.001) and time ( β=1.76, 95% CI: 1.52-2.01, P<0.001). Sensitivity analysis among 220 cases who had both 12- and 24-month follow-up visits further confirmed that follow-up platelets count was still positively associated with gender ( β=10.50, 95% CI: 2.24-18.74, P=0.013), baseline platelet count ( β=0.71, 95% CI: 0.65-0.77, P<0.001) and time ( β=1.60, 95% CI: 1.20-1.99, P<0.001) but negatively associated with age ( β=-0.42, 95% CI: -0.78--0.06, P=0.021). Conclusions:The platelet count of HIV-infected patients gradually increased after ART. The mean platelet count was consistently higher in women than in men. Attention should be paid to the gender specific difference in platelet count in HIV-infected patients and timely intervention should be given to reduce the morbidity and mortality of platelet-related diseases.

Objective To determine the prevalence of human immunodeficiency virus (HIV) primary drug resistance (HIV-PDR) in newly reported HIV-infected individuals in Dehong Prefecture,Yunnan Province in 2015.Methods Newly reported HIV-positive patients who had viral load ≥ 1 000 copies/mL from January to November in 2015 were tested for HIV-PDR by reverse transcriptionpolymerase chain reaction (RT-PCR) and HIV pol gene sequencing.HIV-PDR was determined according to the Surveillance Drug Resistance Mutations (SDRM) list of Stanford University,which was recommended by World Health Organization (WHO) in 2009.Results A total of 322 newly reported HIV-infected cases whose pol gene was successfully amplified were included in the final analysis.Of them,211 (65.5％) were male,and 229 (71.1％) were sexually transmitted.A total of 152 (47.2％) were Chinese.A total of 29 HIV subtypes were found,including type B (12.1％),type C (28.0％),type CRF01_AE (24.5％),type CRF07_BC (5.9％),type CRF08_BC (5.6％),type 62_BC (7.5％),type BC-new breakpoint (3.4％) and other subtypes (13％).Six patients (1.9％) were defined as primary resistance to HIV according to the WHO standard.Conclusions The prevalence of HIV-PDR is 1.9％ among newly reported HIV-infected individuals,which is relatively low in the studied area.But HIV-PDR surveillance should be strengthened in this area with the scaling up of antiretroviral therapy.

Objective To explore the distribution of HIV subtype in newly detected people living with HIV from January to November,2015 in Dehong Dai and Jingpo Autonomous Prefecture,Yunnan province.Methods DNA extraction,reverse transcription polymerase chain reaction (RT-PCR) for gag,env,and pol amplification and amplification product sequencing were conducted by using plasmas of newly detected HIV-infected persons.The subtypes were confirmed by analyzing the sequences of 3 genes.Results A total of 963 HIV infection cases were reported during this period,the HIV subtype was confirmed in 499 cases.Unique recombinant form (URF) was the most common subtype (27.1％,135/499),followed by C (26.7％,133/499),CRF01_AE (19.2％,96/499) and others.URF included 4 kinds of combination,of which combination of subtype B and C was most common.HIV subtype distribution differed between the Chinese HIV infection cases and the Burmese HIV infection cases,the proportion of B and C combination was higher in the Chinese cases.Transmission route was the only factor influencing H1V subtype distribution.Conclusions HIV subtype distribution in Dehong was complex.URF was predominant.The HIV subtype distribution differed between Chinese and Burmese under different transmission route.

Objective To understand the epidemiological characteristics of newly reported HIV infections in Chinese and Burmese residents during 2012-2016 in Dehong Dai and Jingpo Autonomous Prefecture of Yunnan province (Dehong) and to provide evidence for the development of related programs on prevention and control.Methods All the HIV infections who were newly reported during 2012-2016 in Dehong,were recruited as the study subjects,with epidemiological characteristics of the cases analyzed by using the software SPSS 22.0.Results A total of 5 692 HIV infections were newly reported between 2012 and 2016 (including 5 592 in this study),in which the Chinese patients accounted for 43.3％ (2 419) and the rest 56.7％ (3 173) were Burmese.Differences in age,gender and other social characteristics of these newly reported HIV infections were statistically significant between the Chinese and the Burmese (all p-values ＜0.05).Most cases were males and between the age of 20-49 years old.Other characteristics of the patients would include:having had primary school education,married,being farmers,and with CD4+ T cells counts ≥350 cells/μl.HIV infection was mainly transmitted through sexual contact among the Chinese patients but through injecting drug use among the Burmese patients.Conclusions Epidemiological characteristics of the newly reported HIV infections were different between the Chinese and the Burmese,between 2012 and 2016 in Dehong.Targeted prevention and control programs should be taken.

Objective: To obtain HIV incidence among injection drug users (IDU) and female sex workers (FSW) in Dehong Prefecture, Yunnan Province during 2009-2017. Methods: We recruited drug users and female sex workers from all sentinel surveillance sites across Dehong Prefecture during 2009-2017. A total of 10 480 IDU and 18 126 FSW in Dehong Prefecture were recruited by fingerprint technique. Data about drug uses, commercial sexual behavior, sociodemographic characteristics was collected by structured questionnaire. HIV-positive patients who were long-term infected or with CD4⁺ T cell count was ≤200 were not included for further HIV incidence testing. Also, those who self-identified as on antiretroviral treatment (ART) or AIDS cases were also excluded. A total of 841 and 157 plasma specimens from IDU and FSW that met the inclusion criterion were finally included, respectively. Limiting antigen avidity enzyme immunoassay(LAg-Avidity EIA) were performed to calculate the HIV incidence among these two sub-populations. Results: A total of 3 444 IDU were HIV-positive, among which 884 (25.7%) were Burmese with age of (30.4±7.7), and 2 560 were Chinese with age of (36.6±7.3). Among 228 HIV-positive FSW, 109 (47.8%) were Burmese with age of (27.1±6.3), 119 (52.5%) were Chinese with age of (29.9±11.1). For IDU, the estimated HIV incidence among Burmese in 2009-2010, 2011-2012, 2013-2014, 2015-2017 was 4.20% (95%CI: -0.55%-8.95%), 7.75% (95%CI: 2.95%-12.55%), 11.79% (95%CI: 5.38%-18.20%), 10.30% (95%CI: 5.67%-14.94%), respectively, while Chinese were 3.11% (95%CI: 1.59%-4.64%), 0.03% (95%CI: -0.03%-0.08%), 1.55% (95%CI: 0.54%-2.57%), 0.58% (95%CI: -0.06%-1.04%), respectively. In 2009-2011, 2012-2014, 2015-2017, estimated HIV incidence among Burmese FSW was 0.22% (95%CI: -0.21%-0.64%), 1.24%(95%CI: 0.15%-2.32%), 0.55%(95%CI: 0.01%-1.08%). Whereas, estimated HIV incidence among Chinese FSW was 0.62% (95%CI: 0.25%-0.98%), 0.11% (95%CI: -0.04%-0.26%), 0.22% (95%CI: 0-0.44%). Conclusion HIV incidences among Chinese IDU and FSW are on the downward trend, while Burmese IDU and FSW seem to be gaining momentum.