This study explored a novel systemic community-based model for detecting and managing people living with HIV/AIDS (PLWHA). Both quantitative and qualitative research methods were used in this study. A quantitative questionnaire investigation was conducted in a sample of 1192 subjects which were randomly selected from two areas with high HIV prevalence, Xiangfan City and Shiyan City of Hubei Province, China. Twenty-two medical and health service staffs were interviewed by semi-structured questionnaire focusing on awareness, status, problems, and suggestions about community-based Voluntary Counseling and Testing and Provider Initiated Testing and Counseling (VCT/PITC). And they were organized to discuss about the aforementioned issues in Xiangfan City and Shiyan City, respectively. Our results showed that the accessibility and availability of the general VCT/PITC were bad. About 28.3% had known and only 4.9% had made use of VCT/PITC. Developing community-based VCT/PITC had some special advantages that can overcome some existing problems to remedy the aforementioned defects. We are led to conclude that, to maximize the availability and uptake rate of the VCT/PITC, we plan to detect PLWHA by developing the community-based VCT/PITC through 4 paths. Then we establish the community HIV health care center constituted of 8 sectors to provide an overall management. Thus, we can effectively detect and manage the PLWHA with a new systemic community-based model.

Objective To discuss the clinical characteristics of acute myocardial infarction (AMI) and coronary artery lesion fea-tures for Uygur nationality and Han nationality in Xinjiang Dushanzi area .Methods The AMI patients during hospitalization from January 2005 to January 2012 were divide into two groups ,Group A(Uygur nationality ,n=40) and Group B(Han nationality ,n=130) ,and compared the aspects of risk factors ,morbidity situation and electrocardiogram changes etc ,carried out the coronary an-glography and analyzed the coronary artery lesion features of patients in two groups .Results The two groups of patients are male-dominated ,the AMI incidence of Uygur patients was higher than Han nationality before 60 years old(P<0 .01);More morbidities of Uygur nationality were related with the alcohol drinking (32 .5% ) ,mood disorders (40 .0% ) ,diabetes (52 .5% ) and hyperlipi-demia(72 .5% )(P<0 .01) ,and mainly coronary artery lesions were three blood vessels (P< 0 .05) .The Han nationality patients with high blood pressure have more proportion (P<0 .05) ,mainly coronary artery lesions were single blood vessel (P<0 .05) .No significant differences were observed after comparing the location of infarction and related infarction blood vessels of patients in two groups .Conclusion The onset age of Uygur AMI patients in Xinjiang Dushanzi area is younger ,and the coronary artery disease is worse .It is necessary to improve the lifestyles and change unhealthy eating habits and to carry out the active intervention in early stage .

Objective To investigate the correlation between TCF7L2 gene rs3814570 polymorphisms with type 2 diabetes mellitus(T2DM) in Uygur population of Xinjiang area.Methods By adopting the case-control study design,949 cases of T2DM were recruited as the observation group and 963 individuals Undergoing healthy physical examination were selected as the control group.The TCF7L2 gene polymorphism was detected by matrix-assisted laser desorption/ionization-time of flight(MALDI-TOF).Results The statistical differences in frequencies of CC,CT and TT genotypes and the C and T allele frequencies on TCF7L2 rs3814570 were found between the T2DM group and control group(P＜0.05).The risk of suffering from T2DM in the carriers of CT genotype was 0.331 times of that in the carriers of CC genotype(OR =0.331,95 ％ CI:0.166-0.661,P =0.002),the risk of suffering from T2DM in the carriers of TT genotype was 0.539 times of that in the carriers of CC genotype(OR=0.539,95％CI:0.348-0.834,P=0.005),and the risk of suffering from T2DM in the carriers of T allele was 0.501 times of that in the carriers of C allele(OR=0.501,95 ％ CI:0.377-0.664,P＜ 0.01).Among all subjects,the FPG level of the CT + TT genotype group on TCF7L2 gene rs3814570 locus was significantly lower than that of the CC genotype group(P＜0.05).Conclusion The rs3814570 locus in TCF7L2 gene may be associated with T2DM occurrence in Uygur population of Xinjiang area,the T allele and TT genotype might be protective factors of T2DM.

AIM: To investigate whether rs7903146 polymorphisms in transcription factor 7-like 2 (TCF7L2) gene are associated with susceptibility to type 2 diabetes mellitus (T2DM) in Chinese Uygur population.METHODS: In this case-control study, 935 cases of T2DM patients were recruited in T2DM group, and 971 healthy examination individuals were selected as normal control.The TCF7L2 gene polymorphism was detected by matrix-assisted laser desorption/ionization time-of-flight mass spectrum.RESULTS: Significant differences in the frequencies of CC, CT and TT genotypes and the frequencies of C and T alleles on TCF7L2 rs7903146 were found between T2DM group and control group(P<0.05).As compared with C allele, the patients with T allele had a significantly higher risk of T2DM with OR of 1.190 (95% CI: 1.034~1.371).As compared with CC genotype, the patients with CT genotype had a significantly higher risk of T2DM with OR of 1.374 (95% CI: 1.122~1.683), and the patients with CT+TT genotype had a significantly higher risk of T2DM with OR of 1.307 (95% CI: 1.090~1.567).The levels of fasting plasma glucose, serum creatinine and blood urea nitrogen were higher in all participants with CT+TT genotype of rs7903146 than those with CC genotype, which showed a significant difference (P<0.05).CONCLUSION: The polymorphisms of rs7903146 in TCF7L2 gene may be associated with T2DM in Uygur population from Xinjiang region.The T allele and CT genotype of rs7903146 are the risk factors for T2DM.

This study explored a novel systemic community-based model for detecting and managing people living with HIV/AIDS (PLWHA). Both quantitative and qualitative research methods were used in this study. A quantitative questionnaire investigation was conducted in a sample of 1192 subjects which were randomly selected from two areas with high HIV prevalence, Xiangfan City and Shiyan City of Hubei Province, China. Twenty-two medical and health service staffs were interviewed by semi-structured questionnaire focusing on awareness, status, problems, and suggestions about community-based Voluntary Counseling and Testing and Provider Initiated Testing and Counseling (VCT/PITC). And they were organized to discuss about the aforementioned issues in Xiangfan City and Shiyan City, respectively. Our results showed that the accessibility and availability of the general VCT/PITC were bad. About 28.3% had known and only 4.9% had made use of VCT/PITC. Developing community-based VCT/PITC had some special advantages that can overcome some existing problems to remedy the aforementioned defects. We are led to conclude that, to maximize the availability and uptake rate of the VCT/PITC, we plan to detect PLWHA by developing the community-based VCT/PITC through 4 paths. Then we establish the community HIV health care center constituted of 8 sectors to provide an overall management. Thus, we can effectively detect and manage the PLWHA with a new systemic community-based model.
Acquired Immunodeficiency Syndrome ; diagnosis ; drug therapy ; China ; Community Health Services ; HIV Infections ; diagnosis ; drug therapy ; Health Knowledge, Attitudes, Practice ; Humans

Objective:To report the surgical techniques and clinical outcomes of multi-dimensional fixation of patellar multi-fragmentary fractures with locking plates.Methods:A retrospective study was performed in the 26 patients with patellar multi-fragmentary fracture who had undergone open reduction and 3-D internal fixation with locking plates from November 2016 to July 2020 at Department of Orthopaedic Surgery, The Sixth People's Hospital Affiliated to Shanghai Jiao Tong University. There were 17 males and 9 females, with an average age of 62.6 years (from 31 to 90 years). The patellar fractures were exposed and reduced via the longitudinal anterior midline incision of the knee. After the reduction was initially maintained with a cerclage wire, a trimmed and pre-contoured 3.5 mm locking plate was applied onto the patellar surface. After-wards, locking screws were inserted from the lower pole to the upper pole of the patella, from the anterior to the posterior and from the lateral to the medial, respectively, to complete the multi-planar fixation. Follow-ups assessed the B?stman score, knee pain visual analogue scale (VAS), radiographic image and fracture healing, range of motion of the knee, and complications.Results:All the 26 patients were followed up for 12 to 56 months (average, 28 months). Crutches were used while walking until an average of 1.6 months (from 1 to 3 months) after operation in all patients. At the last follow-up, the B?stman score averaged 27.5 points (from 17 to 30 points), yielding 12 excellent, 13 good and 1 poor case with an excellent to good rate of 96.2% (25/26); the knee pain VAS averaged 1.2 points (from 0 to 5 points); the active knee flexion averaged 125° (from 100° to 150°). No breakage, loosening or displacement of the patellar plates or screws was observed during follow-up, but cerclage wire breakage occurred without any symptom in 11 cases. Four patients complained of hardware irritation, and 4 patients underwent hardware removal after fracture union.Conclusion:Multi-dimensional fixation with locking plates is a viable and safe surgical option for patellar multi-fragmentary fractures, due to its satisfactory therapeutic outcomes.

Objective To understand the incidence and mortality of gastric cancer in middle-aged and elderly population after Helicobacter pylori eradication , and provide theoretical guidance for the prevention of this disease in Luzhou area. Methods A total of 541 patients with Helicobacter pylori eradication from 2019 to 2021 were selected , they were divided into control group and observation group according to whether they developed gastric cancer in later stage, patients with gastric cancer due to Helicobacter pylori infection were selected as positive control group (N=205) . In addition, the expression of tumor markers such as CEA, CA199, CA125 and proliferation-related factor Ki67 were compared among the three groups, binary Logistic regression was used to analyze the risk factors of gastric cancer in the middle-aged and elderly population after Helicobacter pylori eradication. Results Among the 39(7.21%) of 541 patients developed gastric cancer after HP eradication , including 23males and 16females, with no gender difference (P>0.05) .The positive rate of moderate and severe atrophy of gastric mucosa and the ratio of PPI ≥1 year in the observation group were higher than those in the control group (P<0.05) . In addition , serum CEA , CA199 , CA125 levels were the highest in the positive control group , followed by the observation group , Ki67 expression was also the same. Logistic regression analysis showed that PPI ≥1 year (OR=1.642) , gastric mucosal atrophy (OR=1.459) or severe (OR=3.271) and presence of IM (OR= 3.669) were independent risk factors for gastric cancer after Hp eradication. Conclusion The risk of developing gastric cancer was higher in the middle-aged and elderly after Helicobacter pylori eradication , and the risk of developing gastric cancer was higher in patients with moderate or severe atrophy of gastric mucosa , PPI ≥1 year and having IM , gastroscopic screening should be strengthened to prevent gastric cancer..