OBJECTIVETo understand the influencing factors on the death of infants born to HIV infected mothers in areas with high prevalence of HIV/AIDS in China.

METHODSBased on the follow-up cohort study targeting at HIV/AIDS infected pregnant women and their babies initiated in 2004, a survey on the death status and influencing factors on the infants born to HIV/AIDS infected mothers enrolled in this cohort from Jan.2004 to Nov.2007 was carried out during Aug.to Nov.2008 in seven counties of four provinces in China. A total of 498 pairs of HIV-infected mothers and their infants were enrolled and their related information was collected. Single factor and multiple factors Cox model methods were adopted for data analysis.

RESULTSThe total observed person-years of 498 infants was 406.22, among which, 45 infants died, and the mortality density was 110.78 per 1000 child-year. A single factor Cox model showed, the pregnancy in pre-period of HIV/AIDS and HIV/AIDS period (RR = 1.971, 95%CI: 1.143 - 3.396), living status of the pregnancy (RR = 3.062, 95%CI: 1.097 - 8.550), multipara women (RR = 0.517, 95%CI: 0.278 - 0.961), natural childbirth (RR = 0.561, 95%CI: 0.345 - 0.910), premature labor (RR = 5.302, 95%CI: 2.944 - 9.547), low birth weight (RR = 4.920, 95%CI: 2.691 - 8.994), mother-child pairs taking antiretroviral drugs (RR = 0.227, 95%CI: 0.121 - 0.428) and infants infected HIV (RR = 5.870, 95%CI: 3.232 - 10.660) could affect the infants death. The death of HIV-exposed infants was influenced by various factors. The death risk of infants born to HIV infected mothers who were in the danger of pre-period of HIV/AIDS and HIV/AIDS period was greater than the infants delivered by HIV infected mothers who were in preclinical period of HIV/AIDS (RR = 6.99, 95%CI: 1.92 - 25.64). The death risks were greater in the group that the women whose CD4(+)TLC count number lower than 200 cells/microl (RR = 2.05, 95%CI: 1.01 - 4.15). The infants whose mothers had no ARV treatment had higher possibility to die than the others (RR = 6.17, 95%CI: 1.62 - 23.26). The death risk of premature delivered infants was 2.87 times of mature delivered infants (95%CI: 1.12 - 7.35). The death risk of HIV/AIDS infected infants was 9.87 times of the HIV/AIDS uninfected infants (95%CI: 3.81 - 25.62).

CONCLUSIONSome measurements including improving HIV-infected pregnant women's immunity, reducing mother to child transmission of HIV and premature birth, low birth weight are beneficial to reducing infant mortality.

Acquired Immunodeficiency Syndrome ; epidemiology ; mortality ; transmission ; Cause of Death ; China ; Female ; Follow-Up Studies ; Humans ; Infant ; Infant Mortality ; Infant, Newborn ; Mothers ; Pregnancy ; Pregnancy Complications, Infectious ; epidemiology ; Proportional Hazards Models

OBJECTIVE: To investigate the reproductive health status of female workers,so as to provide reference for establishing prevention measures to protect the reproductive health of female workers. METHODS: Using the cross-sectional investigation method,14 614 female workers were selected and investigated by Reproductive Health Survey Questionnaire.Workers were from 7 provinces in different industries( including medical and health, petrochemical engineering,metallurgy,railway,machine manufacturing,electronic and shoemaking,and so on). The investigation was from June to August of 2015. RESULTS: The proportion of female workers with a long time sitting position at work accounted for 48. 68%( 7 114 /14 614),and the proportion of female workers with regular change of sitting positions accounted for 23. 45%( 3 427 /14 614). There were 40. 84%( 5 968 /14 614) of female workers who were exposed to harmful occupational factors at work. The abnormal rate of reproductive health,the rate of menstrual abnormalities and the infertility rate in female workers were 18. 29%( 1 633 /8 930),28. 14%( 4 113 /14 614) and 24. 26%( 1 834 /7 559),respectively. In the 7 industries,the abnormal rate of reproductive health and the infertility rate among the female workers of the railway industry were the highest( P < 0. 01),while the rate of menstrual abnormalities among the female workers of the electronic industry was the highest( P < 0. 01). Among the 4 kind of working posture,the abnormal rate of reproductive health,the rate of menstrual abnormalities and the infertility rate among the female workers with a long time standing position at work was the highest( P < 0. 01). The above 3 indexes of the female workers who were exposed to harmful occupational factors at work were higher than those of the ones who were not( P < 0. 01). CONCLUSION: The reproductive health status of female workers is not optimistic. The occupational health protection should be strengthened and regular gynecological examination should be given to female workers during child-bearing period,so as to improve their reproductive health status.

Objective:To evaluate the efficacy of acute T-cell lymphoblastic leukemia(T-ALL)in children and explore the prognostic risk factors.Methods:The clinical data of 127 newly diagnosed children with T-ALL admitted to five hospitals in Fujian province from April 2011 to December 2020 were retrospectively analyzed,and compared with children with newly diagnosed acute precursor B-cell lymphoblastic leukemia(B-ALL)in the same period.Kaplan-Meier analysis was used to evaluate the overall survival(OS)and event-free survival(EFS),and COX proportional hazard regression model was used to evaluate the prognostic factors.Among 116 children with T-ALL who received standard treatment,78 cases received the Chinese Childhood Leukemia Collaborative Group(CCLG)-ALL 2008 protocol(CCLG-ALL 2008 group),and 38 cases received the China Childhood Cancer Collaborative Group(CCCG)-ALL 2015 protocol(CCCG-ALL 2015 group).The efficacy and serious adverse event(SAE)incidence of the two groups were compared.Results:Proportion of male,age ≥ 10 years old,white blood cell count(WBC)≥ 50 × 109/L,central nervous system leukemia,minimal residual disease(MRD)≥ 1％during induction therapy,and MRD ≥ 0.01％at the end of induction in T-ALL children were significantly higher than those in B-ALL children(P＜0.05).The expected 10-year EFS and OS of T-ALL were 59.7％and 66.0％,respectively,which were significantly lower than those of B-ALL(P＜0.001).COX analysis showed that WBC ≥ 100 x 109/L at initial diagnosis and failure to achieve complete remission(CR)after induction were independent risk factors for poor prognosis.Compared with CCLG-ALL 2008 group,CCCG-ALL 2015 group had lower incidence of infection-related SAE(15.8％vs 34.6％,P=0.042),but higher EFS and OS(73.9％vs 57.2％,PEFS=0.090;86.5％vs 62.3％,PoS=0.023).Conclusions:The prognosis of children with T-ALL is worse than children with B-ALL.WBC ≥ 100 × 109/L at initial diagnosis and non-CR after induction(especially mediastinal mass has not disappeared)are the risk factors for poor prognosis.CCCG-ALL 2015 regimen may reduce infection-related SAE and improve efficacy.