Objective To observe and evaluate the clinical effect of pure hemodialysis (HD﹚, hemodialysis combined with hemoperfusion (HD+HP﹚, hemodialysis combined with hemodiafiltration (HDF﹚ on onuremic patients. Methods All 90 patients with uremic in our hospital from January 2011 to May 2014 were randomly divided into HD group, (HD+HP﹚ group,HDF group according to the treatment methods, 30 cases in each group. After two months,the skin itching symptoms and blood toxin levels before and after treatment in each group of were compared. Results Before treatment,Pi, Scr and BUN levels were not significantly different between groups(P>0.05﹚. After treatment the Pi, Scr and BUN levels were significantly decreased compared with those before treatment(P<0.05﹚. No significant differences between groups(P>0.05﹚. Before treatment,three groups of PTH, β2-MG and Cys C level had no significant difference (P>0.05﹚.After treatment,three groups of PTH,β2-MG and Cys C levels were significantly decreased than before treat-ment(P<0.05﹚.Multiple comparisons between groups showed that the indexes of the level of (HD+HP﹚group was lower than that of the other two groups (P<0.05﹚.(HD+HP﹚ group,HDF group of skin pruritus symptom improvement rate were higher than those in HD group (P<0.05﹚,but (HD+HP﹚groups, HDF groups had no significant difference (P>0.05﹚. Conclusion Scavenging effects of HD,(HD+HP﹚and HDF to the small molecules are roughly the same,but scavenging effect of(HD+HP﹚and HDF for large, middle molecular substances are better than those of HD,so (HD+HP﹚ has the best effect.

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 study the HIV-1 drug resistance transmission level in HIV infected persons receiving no antiviral therapy in Dehong prefecture of Yunnan province in 2015.Methods A total of 72 plasma samples were collected from recently reported HIV-infected persons aged 16-25 years in Dehong from January to July 2015 for drug resistance gene detection.Results Forty eight samples were successfully sequenced and analyzed.Among them,31.2％ (15/48) were from Chinese,and 68.8％ (33/48) were from Burmese.Based on pol sequences,HIV genotypes included URF (52.08％,25/48),CRF01_AE (16.67％,8/48),RF07_BC (10.42％,5/48),subtype B (6.25％,3/48),subtype C (6.25％,3/48),CRF57_BC (6.25％,3/48) and CRF08_BC (2.08％,1/48).One drug resistant mutation site to non-nucleoside analog reverse transcriptase inhibitor (NNRTI) and two drug resistant mutation site to nucleoside analog reverse transcriptase inhibitor (NRTI) were detected in four sequences.Based on the statistical method of HIV drug resistance threshold survey,the prevalence of HIV-1 drug resistant strain was 5％-15％.Conclusions The proportion of Burmese among newly reported HIV-infected individuals aged 16-25 years in Dehong in 2015 was higher.HIV-1 genetic diversity was found in Dehong.The prevalence of HIV-1 drug resistant strain had reached a moderate level in Dehong.

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.

Objective:To investigate the distributions of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) genotypes among newly reported HIV/HCV co-infected Burmese patients in Dehong Dai and Jingpo Autonomous Prefecture, Yunnan Province from 2016 to 2019.Methods:A total of 1 289 newly reported HIV/HCV co-infected Burmese patients in Dehong Dai and Jingpo Autonomous Prefecture were collected through the National Acquired Immunodeficiency Syndrome Comprehensive Prevention and Control Data Information System From January 2016 to December 2019. Among them, 996 subjects with a plasma volume of ≥200 μL were selected to perform HIV and HCV genotyping. The HIV pol gene, the HCV core protein-binding envelope protein ( CE1) gene and non-structural protein 5B ( NS5 B) gene were amplified using the nested polymerase chain reaction.The phylogenetic tree was constructed by MEGA 7.0 software to classify the genotypes. Chi-square test was used for statistical analysis. Trend chi-square test was used to analyze the trend of HIV and HCV genotypes. Results:Among the 996 cases with HIV/HCV co-infection, HIV and HCV sequences from a total of 554 subjects (55.6%, 554/996) were successfully obtained, and the genotypes of HIV and HCV were diverse. HIV genotype C (40.3%, 223/554) and BC recombinant (33.6%, 186/554) were the most prevalent, followed by genotype B (6.5%, 36/554) and circulating recombinant form (CRF)01_AE (3.6%, 20/554). HCV genotype 3b was the most prevalent (31.2%, 173/554), followed by genotype 6u (19.5%, 108/554), 1a (17.5%, 97/554), 6n (11.4%, 63/554), 3a (8.7%, 48/554) and 6xg (6.3%, 35/554). The prevalence of HIV genotype C showed a downward trend ( χtrend2=7.23, P<0.001), while the prevalence of BC recombinant showed an upward trend ( χtrend2=5.97, P<0.001), and the proportion of BC recombinant was higher than genotype C in 2019 (54.9%(101/184) vs 21.7%(40/184)). However, there were no statistically significant differences in the proportions of genotype 3b, 6u and 1a from 2016 to 2019 ( χtrend2=1.43, 1.79 and 0.39, respectively, P=0.152, 0.074 and 0.695, respectively). The HIV genotype distribution among patients with different ethnic groups were significantly different ( χ2=22.06, P=0.037). Conclusions:The diversity of HIV and HCV genotypes is high and complex among HIV/HCV co-infected Burmese patients in Dehong Dai and Jingpo Autonomous Prefecture. BC recombinant shows a trend of becoming the predominant HIV genotype among these co-infected patients. Therefore, surveillance of the prevalence of HCV and HIV genotypes in Burmese population needs to be further strengthened.

Objective: To study the prevalence and correlates of diabetes among HIV/AIDS who were on antiretroviral therapy (ART) in Dehong Dai and Jingpo autonomous prefectures (Dehong), Yunnan province. Methods: The database of HIV/AIDS receiving ART in Dehong was downloaded by using the basic information system of AIDS prevention and control in China. In this cross-sectional study, HIV/AIDS patients who were currently on ART and aged 18 years or above, were consecutively recruited, between July 2017 and June 2018, in Dehong. All the subjects underwent hemoglobin A1c (HbA1c) testing. Patient with diabetes was defined as meeting any of these indicators (HbA1c ≥6.5%, baseline FPG ≥7.0 mmol/L, FPG ≥7.0 mmol/L in the most recent visit). Both univariate and multivariate logistic regression analysis were carried on to evaluate the correlates of diabetes among the HIV/AIDS patients. Results: In total of 4 376 HIV/AIDS patients were included for analysis, with the average age as (43.7±10.1) years, proportion of males as 53.8% (2 356/4 376) and the HCV positive rate as 24.1% (1 055/4 376). The mean years was (8.9±3.8) years after the HIV diagnosis was made, and the mean duration on treatment was (6.8±2.9) years. The prevalence of diabetes was 11.4% (500/4 376). Through multivariate logistic regression analysis, data showed that the risk factors of diabetes of HIV/AIDS on ART were: aged 40 years or above, being male, HCV positive, baseline body mass index ≥24.0 kg/m², elevated TG ≥1.70 mmol/L in the most recent visit and baseline antiretroviral regimens under Efavirenz (EFV). Conclusions Prevalence rate of diabetes appeared higher in HIV/AIDS patients who were on ART in Dehong. Prevention and control measures should be targeted on HIV/AIDS patients who were with risk factors of diabetes as being elderly, male, HCV positive, overweight and higher TG. Further esearch is needed to evaluate the association between the use of EFV and diabetes.

ObjectiveTo determine the trend and influencing factors of HIV subtypes in newly reported HIV/AIDS cases in Dehong Dai and Jingpo Autonomous Prefecture （Dehong Prefecture） from 2017 to 2019. MethodsRNA extraction was conducted among newly reported HIV/AIDS cases in Dehong Prefecture from 2017 to 2019 whose plasma volume was more than 200 μL. The gag， env and pol genes were amplified by using RT-PCR and then sequenced to determine the subtypes. ResultsA total of 3 287 HIV-infected cases were newly reported in Dehong from 2017 to 2019. The HIV gag， env and pol genotypes were determined in 1 813 cases. The major subtypes were subtype C （28.4%，515/1 813）， recombination form BC （22.0%，398/1 813） and CRF_01AE （18.1%，329/1 813）. Furthermore， the proportion of subtype B， subtype C and CRF01_AE decreased over years， whereas 01/BC， CRF07_BC and CRF08_BC increased over years in both Chinese and Burmese patients （χ²=75.212，P<0.001）. There were significant differences in gender， age， marital status， ethnicity， educational level and transmission route among Chinese and Burmese HIV-infected cases with diverse HIV genotypes （all P<0.05）. ConclusionHIV subtypes in Dehong change over time， which demonstrates that the proportion of BC recombinant subtypes and unique recombinant subtypes increased significantly.