Brain ; pathology ; Female ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Myotonic Dystrophy ; diagnosis ; pathology ; White Matter ; pathology

OBJECTIVETo explore the clinical presentation, pathologic characteristics, diagnosis and treatment of cutaneous T-cell lymphoma of the penis.

METHODSA 49-year-old man presented with painful swelling and inflammation of the foreskin, failed to respond to antibiotic treatment and dorsal incision, and was instead complicated by Fournier gangrene. Then he underwent debridement and pathological examination.

RESULTSPathological results indicated cutaneous T-cell lymphoma of the penis. Immunohistochemistry showed CD3 and CD45 RO to be positive, but CD30, CD79a, CD20 and HMB negative. The patient was treated by interferon alpha and ultraviolet B for 2 weeks, followed by total removal of the external genitalia because of necrosis of the corpus spongiosum, which involved the scrotum and right testis on pathological examination.

CONCLUSIONCutaneous T-cell lymphoma of the penis is a rare condition and easily mis diagnosed in the early phase. Definitive diagnosis depends on pathological study.

CD3 Complex ; analysis ; Diagnosis, Differential ; Fournier Gangrene ; etiology ; pathology ; Humans ; Immunohistochemistry ; Leukocyte Common Antigens ; analysis ; Lymphoma, T-Cell, Cutaneous ; complications ; metabolism ; pathology ; Male ; Middle Aged ; Penile Neoplasms ; complications ; metabolism ; pathology

OBJECTIVESTo access the prevalence of HIV infection and the associated factors among urban MSM in China.

METHODSParticipants were recruited using respondent driven sampling and snowball sampling method in Beijing, Harbin, Zhengzhou and Chengdu city. A face-to-face questionnaire was administrated to collect relevant demographic and ethological data; 5 ml venous blood sample was taken from each subject to measure HIV antibody in serum (samples were first screened by colloidal gold, latex chromatographic and double-antigen sandwich ELISA method, positive samples were further confirmed by immunoblotting method). The characteristics of HIV infection was described and the risk factors were analyzed.

RESULTSA total of 1864 MSM were recruited and the prevalence of HIV was 6.7% (125/1864). It was 9.5% (24/252) among MSM older than 39 years and it was 1.9% (2/105) among those less than 20 years old. The prevalence was 8.4% (31/371) among MSM with junior level education and was 4.8% (41/858) among those with college level education. It was 10.3% (35/340) among MSM with sexual partner old than him for over 10 years while it was 5.0% (58/1168) among those having sexual partner within 10 years older. The prevalence of HIV infection was 8.9% (61/695) among MSM with unprotected receptive anal sex and it was 5.5% (64/1169) among those without unprotected receptive anal sex. The risk factors independently associated with HIV infection included being older than 39 years (OR = 6.5, 95%CI: 1.5 - 28.7), with junior or lower level education (OR = 1.8, 95%CI: 1.2 - 2.7), having sexual partner older than himself for over 10 years (OR = 2.1, 95%CI: 1.3 - 3.3) and having unprotected receptive anal intercourse (OR = 1.6, 95%CI: 1.1 - 2.4).

CONCLUSIONMSM had a high rate of HIV infection. Older age, lower level education, having older sexual partner and unprotected receptive anal intercourse were related to HIV infection.

Adult ; China ; epidemiology ; HIV Infections ; epidemiology ; Homosexuality, Male ; Humans ; Male ; Prevalence ; Risk Factors ; Surveys and Questionnaires ; Young Adult

Objective To estimate the outpatient rate of influenza-related influenza-like illness (ILI) for children younger than 5 years in Suzhou municipal districts. Methods From October 2011 to March 2017, we conducted a prospective surveillance program on ILI for children under 5 years in outpatient settings of Soochow University Affiliated Children’s Hospital (SCH). The throat swabs were collected and tested for influenza viruses by RT-PCR. Based on the healthcare utilization surveys and population data, the number of visits and the outpatient rate of influenza-related ILI for children younger than 5 years in Suzhou municipal districts were estimated. Results During 2011-2017, in total, there were 45 930 estimated influenza-related ILI cases younger than 5 years in Suzhou municipal districts, which consisted of 7 490 influenza A/H1N1 cases, 17 843 influenza A/H3N2 cases and 20 597 influenza B cases. The estimated outpatient rate of influenza-related ILI was 6.4% in 2011-2017, which was highest in 2011-2012, 20.5%, and the lowest in 2012-2013, 2.4%. Conclusion The number of visits and the outpatient rate of influenza-related ILI in children younger than 5 years was high in Suzhou municipal districts.

OBJECTIVETo describe the characteristics and factors associated with long-term retention for methadone maintenance treatment (MMT) patients.

METHODSThis study was conducted in eight MMT clinics located in Sichuan, Yunnan, Guangxi, Guizhou and Zhejiang provinces. Five hundred and thirty-nine MMT patients who enrolled in MMT clinics in 2004 and retained in treatment by June 2010 were selected as study subjects. Chi-square tests were used to compare the demographics and drug abuse history at enrollment and treatment characteristics during the follow-up period between continuous treatment patients and discontinuous treatment patients.

RESULTSOf the 539 patients, 110 (20.4%) were continuous treatment patients whereas 429 (79.6%) were discontinuous treatment patients. Of these 429 discontinuous treatment patients, 84.1% (361/429) had 2-4 treatment episodes whereas 15.9% (68/429) had 5 or more episodes during follow-up period. When continuous treatment patients were compared with discontinuous treatment patients, living with family members or friends (88.2% (97/110), 78.5% (337/429)), age of first drug use under 25 (61.8% (68/110), 71.3% (306/429)), low urine morphine positive test results (67.3% (74/110), 38.2% (164/429)) and living within 5 kilometers of the MMT clinic (72.7% (80/110), 61.3% (263/429)) were positively associated with higher possibility of continuous treat retention (P < 0.05). Demographics and drug abuse characteristics at enrollment, including gender, age, employment status, family relationship, injection, needle sharing, criminal behavior, contacts with drug users, MMT daily dosage and family members receiving MMT were not significantly associated with treatment retention (P > 0.05).

CONCLUSIONIllicit drug use during the treatment and longer distance travelling to MMT clinic might have negative impact on patients' continuous treatment retention. Mobile MMT vehicles and expanded MMT service sites could be introduced to improve compliance of treatment retention of MMT patients.

Adult ; Female ; Humans ; Longitudinal Studies ; Male ; Methadone ; administration & dosage ; therapeutic use ; Patient Compliance ; statistics & numerical data ; Substance-Related Disorders ; drug therapy ; Treatment Outcome

OBJECTIVETo evaluate the effectiveness of the first eight pilot methadone maintenance treatment (MMT) clinics in China.

METHODSA questionnaire survey of the clients at the 8 pilot MMT clinics was performed at entry, 6 month and 12 month follow-up. Drug using behaviors, drug related crime behaviors, and relationships in families were compared among at entry, 6 and 12 months follow-up.

RESULTSThere were 585, 609 and 468 clients involved at baseline, 6 month and 12 month follow-up surveys, respectively. At entry, 6 month and 12 month follow-up, the proportion of clients whose injection of drugs reduced from 69.1% to 8.9% and 8.8%, and the frequency of injection in the past month had reduced from 90 times per month to 2 times per month. Employment rate increased from 22.9% to 43.2% and 40.6%, and self-reported criminal behaviors reduced from 20.7% to 3.6% and 3.8%. At 12 month follow-up, 65.8% of clients reported a healthy family relationship, increased from 46.8% at entry, 95.9% of clients reported that they were satisfied with the MMT service.

CONCLUSIONPilot MMT program reduced drug use, drug injecting behaviors, drug related criminal behaviors, and improved relationship with family members. Therefore, MMT clinic should be considered as a platform for providing comprehensive services to drug users.

Adult ; Analgesics, Opioid ; administration & dosage ; China ; Follow-Up Studies ; Humans ; Methadone ; administration & dosage ; Opioid-Related Disorders ; rehabilitation ; Outcome Assessment (Health Care) ; methods ; Program Evaluation ; methods ; Substance Abuse Treatment Centers ; organization & administration ; standards ; Surveys and Questionnaires

Objective To understand the distribution and epidemic characteristics of common pathogens of pneumonia among hospitalized children in Suzhou． Methods Nasopharyngeal secretions were collected from hospitalized children with clinical pneumonia admitted to the respiratory department of Children＇s Hospital Affiliated to Suzhou University from April 2011 to March 2018 to detect common viral and bacterial pathogens of children＇s pneumonia． Ｒesults The total positive rate of pathogens was 75. 6% in the 4 765 clinical pneumonia cases. The positive rate of bacterial pathogens was 57. 4%. Streptococcus pneumoniae ( SP) was the highest，followed by Haemophilus influenzae ( H. i) ; The positive rate of viral pathogens was 44. 1%. Ｒespiratory syncytial virus ( ＲSV) was the highest，followed by Bocavirus ( BoV) . The mixed infection rate of bacteria and virus was 25. 9%，and the most common types were ＲSV and SP，BoV and Streptococcus viride ( SV) ． Conclusions SP，H．i，ＲSV and BoV are the main pathogens of clinical pneumonia in children． There are statistical differences in different age groups and seasons of hospitalized children＇s pneumonia in Suzhou． The mixed infection rate of bacteria and virus is high．

OBJECTIVETo determine feasibility and effectiveness of the intervention on HIV/AIDS among MSM based on venues and peer network.

METHODSThe intervention trial was conducted in Mianyang and Yibin in Sichuan province, where the cultural and social environment were similar. These two cities have no HIV/AIDS intervention conducted yet before this study. The intervention was conducted in Mianyang, while Yibin was regarded as control, in which education materials related HIV/AIDS and VCT service were available. Intervention in Mianyang included MSM venue intervention distributing the education materials, condom and promoting HIV-test and STIs clinic referral by 40 MSM as Popular Opinion Leaders who received the knowledge and intervention skill training.Meanwhile, Popular Opinion Leader intervention was implemented in MSM peer network to advocate safe sex. After 6-month intervention the survey was conducted to assess the effectiveness of intervention.

RESULTSThe scores of knowledge related HIV/STDs and self-efficacy of condom use was 1.293 (95%CI: 0.657 - 1.292, P < 0.05) and 1.556 (95%CI: 0.656 - 2.456, P < 0.05) higher in post-intervention than in pre-intervention which was (12.42 +/- 0.232) and (10.25 +/- 0.327) respectively in Mianyang, while no significant changing in Yibin during the time. Score of knowledge related HIV/STDs increase 0.577 (95%CI: -0.173 - 1.327, P > 0.05) in post-intervention compared with (10.40 +/- 0.412) in pre-intervention and score of self-efficacy of condom use decreased 0.362 from 9.86 +/- 0.547 in pre-intervention (95%CI: -1.458 - 0.534, P > 0.05). In the six months prior to survey, the rate of unprotected sexual intercourse with male casual sexual partners in last 3 times decreased to 11.0% (22/200) (OR(adjusted) = 0.472, 95%CI: 0.265 - 0.841, P < 0.05) from 19.5% (39/200) baseline in Manyang, while in Yibin that increased to 19.0% (38/200) from 17.5% (35/200) in baseline (OR(adjusted) = 1.153, 95%CI: 0.660 - 2.014, P > 0.05). The rate of HIV-test increased significantly from 9.0% (18/200) to 22.0% (44/200) (OR = 2.852, 95%CI: 1.583 - 5.138, P < 0.05) in intervention city and Accordingly in the control, that was 24.5% (29/200) in baseline and 24.0% (28/200) in post-intervention (OR = 0.960, 95%CI: 0.548 - 1.682, P > 0.05). No difference was found in number of male sexual partner pre- and post-intervention both in intervention and control city.

CONCLUSIONThe intervention based on MSM venues and peer network among MSM is feasible and can increase knowledge related HIV/STDs and self-efficacy and as well as condom use and HIV testing.

Adolescent ; Adult ; China ; HIV Infections ; prevention & control ; Homosexuality, Male ; psychology ; Humans ; Male ; Risk-Taking ; Sexual Behavior ; Young Adult

Objective To determine the proportion of heroin use among patients who were involved in community-based methadone maintenance treatment (MMT) program and to identify the risk factors associated with heroin use. Methods This study was conducted in 9 MMT clinics within 3 provinces. Thirteen hundred and one patients who met the study criteria were selected from each of the five groups with different dosages of methadone users. An administrative questionnaire was applied to explore the demographics,drug abuse-related behaviors and MMT services received by the clients,etc. The prevalence of depression and anxiety among the clients were also collected by SAS and SDS. Urine samples were collected as a biological marker to indicate if heroin had been used. Results Of the 1301 patients,76.2% were males. The mean age was (34.6±6.5) years while 71.7% had an education level of primary school or below. The average daily dosage of methadone was (48.1±29.4) mg and self-satisfied evaluation score on treatment was 8.6. On average,27.7% urine samples showed positive opiate evidence. Marital status,employment status,treatment retention,self-satisfied evaluation score on dosage and dropout history were found to be significantly associatedwith heroin use,while gender,education level and dosage had no significant association with heroin use. It seemed that risk factors that associated with heroin use were different from areas to areas. Conclusion High quality MMT clinic services,high self-satisfied score,longer treatment retention and low dropout rate seemed to have the effects of reducing the risk of ongoing heroin abuse under the methadone maintenance treatment program.