Anopheles sinensis from Shanghai and Guangxi were experimentally infected with Ha-inan and Guangxi strains of Plasmodium vivax. It was found that both anopheline mos-quitoes had a very low susceptibility to the Guangxi strain, the gland infection rate being 0 and 12.3% (43.2% for Are, minimus serving as control), while they showed distinctly higher susceptibility to the Hainan strain, the respective gland infection rate being 36.4% and 43.6% (100% for An. minimus).Two lots of An. sinensis from Wuhan were experimentally infected with Guangxi strain of P. vivax from two patients. It was shown that they had just the same low susceptibility as An. sinensis from Guangxi. The gland infection rate of the two lots of mosquitoes was 4.6% and 30.6% respectively, although it has already been confirmed that An. sinensis from Wuhan was highly susceptible to the indigenous strain of P vivax. From the present experimental results and literature, it is evident that there exist in China different geographic strains of P. vivax with varied infectivity to Are. sinensis.

39 healthy volunteers were experimentally inoculated with Plasmodium vivax from Guangxi by mosquito bite, and 32 of them were successfully infected. 25 of the infected volunteers (78.1%) had a short incubation period (mean: 16.4 days) prior to the onset of malaria attack, while seven individuals had long-term incubation period of 238 to 314 days (mean: 274.7?29.3 days). Relapses occurred in all cases with short-term incubation period after a long latency without exception; most of them had l to 2 relapses, some, 3 relapses. Among the seven cases with long incubation period, only one relapse occurred in five, and the remaining two had no relapse at all. It was shown that although Guangxi was situated in subtropical zone, Plasmodium vivax there was characteristie of the temperate zone type. A comparison of Plasmodium vivax from Guangxi with those from south Yunnan and Henan suggested that they differ in the composition of sporozoite subpopulations classified arbitrarily according to the duration of development of bradysporozoites in hepatic cells.

This study was aimed to observe the clinical efficacy of Highly Active Antiretroviral Therapy (HAART) combined withPing-Ai(PA) Mixture in the treatment of Human Immunodeficiency Virus / Acquired Immunodeficiency Syndrome (HIV/AIDS) patients with non-infectious skin lesions, in order to study the advantages of integrative medicine in AIDS prevention and treatment. A total of 9 cases, who met the inclusion criteria of AIDS-associated non-infectious skin lesion with the pattern ofqi-yin deficiency and internal obstruction of phlegm-stasis, were selected. The combination of HAART and number 1 and 4 prescription of PA Mixture were used in the treatment for 3 months. The observations were made on changes of clinical symptoms, body signs, Karovsky integral and CD4+ T cells of patients before and after treatment. Stata 12.0 was used in the statistical analysis. The results showed that after integrative therapy, the single integral of clinical symptoms and body signs, such as skin spot papula, subcutaneous nodules, skin itching, fatigue was obviously reduced compared to that of the pretreatment. The total score decreased than that of the pretreatment. The patients’ quality of life (QOL) significantly increased. The Karovsky integral increased compared with that of pretreatment. The CD4+ T cells values were higher than that of the pretreatment. It was concluded that the integrative therapy had a certain effect in the treatment of AIDS-associated non-infectious skin lesions, which can improve the clinical symptoms, body signs, obviously increase the patients’ QOL and immune function.

Objective To analyze insulin resistance (IR) level and pregnancy outcomes in women with gestational diabetes mellitus (GDM) complicated by chronic hypertension (CHT).Methods This is a retrospective case-control study involving 2 457 singleton pregnant women complicated by GDM who received regular prenatal examinations and participated in the one-day-care clinic of GDM in Peking University First Hospital from January 1,2014 to December 31,2016.Clinical data were collected and homeostasis model assessment insulin resistance (HOMA-IR) was calculated.All subjects were divided into two groups:GDM with CHT group (CHT group,n=47) and GDM without CHT group (non-CHT group,n=2 410).Based on their pre-pregnancy body mass index (BMI),they were also grouped into normal pre-pregnancy BMI group (n=1 590) and overweight and obese group (n=863).Two-sample independent t test and Chi-square test were used to compared the age,HOMA-IR,pre-pregnancy BMI,weight gain during pregnancy and glucose levels between groups,and logistic regression model was used to analyze the effects of HOMA-IR on pregnancy outcomes.Results HOMA-IR (3.5± 1.8 vs 2.6± 1.5,t=-3.290),fasting plasma glucose [(5.4±0.5) vs (5.2 ±0.5) mmol/L,t=-3.005],pre-pregnancy BMI [(26.7 ±4.7) vs (23.3± 3.4) kg/m2,t=-4.842] and the incidence of preeclampsia [14.9％ (7/47) vs 2.5％ (61/2 410),x2=21.790] were significantly higher in GDM women with CHT than those without (all P＜0.01).The weight gain during pregnancy was less[(9.6±5.8) vs (12.2±4.7) kg,t=3.790,P＜0.001].The incidence of preeclampsia was higher in GDM with CHT group than the non-CHT group [15.2％ (5/33) vs 4.2％ (35/830),x2=6.290,P=0.012] among overweight and obese pregnant women,but no significant difference in HOMA-IR was shown (P＞0.05).For pregnant women with normal pre-pregnancy BMI,HOMA-IR (3.0± 1.5 vs 2.3± 1.2,t=-2.217),fasting plasma glucose [(5.4±0.5) vs (5.1±0.5) mmol/L,t=-2.299] and the incidence of preeclampsia [2/14 vs 1.6％ (26/1 576),x2=6.545] were higher in the CHT group than the non-CHT group (all P＜0.05).HOMA-IR did not significantly increase the risk of caesarean section,premature birth,large for gestational age,small for gestational age or macrosomia in the CHT group (all P＞0.05).After adjusting for age,fasting plasma glucose,pre-pregnancy BMI and weight gain during pregnancy,the elevated HOMA-IR level increased the risk of preterm birth (OR=1.223,95％CI:1.093-1.369,P＜0.001) in GDM women without CHT.Conclusions GDM gravida complicated by CHT have severe insulin resistance and a higher incidence of preeclampsia,but the risk of other pregnancy outcomes are not increased.

The management of hospital volunteers is one of the main tasks of medical social workers. In practical work， they are often in a dilemma due to ethical problems， which restricts the scientific development of hospital volunteer organizations. Based on the experience of frontline medical social workers in the “Guangji Boat” Volunteer Service Alliance of the Second Affiliated Hospital Zhejiang University School of Medicine， while investigating other public hospitals， this paper summarized and organized ethical issues， analyzed their causes， and proposed improvement strategies. The ethical dilemma of hospital volunteer service was mainly in the conflict between the dual relationship of human emotion and norm， the conflict between incentive mechanism and non-reward value， as well as the conflict between participation motivation and organizational goal. The ethical dilemma in the management of hospital volunteers was attributed to the lack of standardized practical operation systems. Based on the above ethical dilemmas， combined with the development experience of volunteer service in public hospitals， this paper proposed reasonable countermeasures to provide a reference for the management of hospital volunteers.