The prevention and control of chronic and non-communicable diseases is an important public health problem in China. The general environment in the northwestern China is unique, and the health and disease status of local population is distinctive. In order to meet the urgent need for in-depth research of the causes, mechanisms and prognosis of chronic and non-communicable diseases in this area, a general population cohort in Shaanxi Province, Gansu Province and Qinghai Province, Ningxia Hui Autonomous Region and Xinjiang Uygur Autonomous Region was established during 2017-2019. A total of 117 644 general individuals aged 35-74 years in the multi-ethnic groups (Han, Hui, Uygur, Kazak and Tibetan) were recruited according to the special ecological environment, population size and ethnic distribution. The baseline information about individual exposure, environment and society were collected. More than 900 000 biological samples, including whole blood, plasma, serum and buffy coat, were collected and stored at -80 ℃ in standardized biobank. The long-term observation has started in forms of routine monitoring and active follow-up. The average age of the cohort members was 52.43 years, and 70 391 cohort members were women (59.8%). There were some differences in socio-economic status and lifestyle among different ethnic groups. Although the cohort members in different ethnic groups had similar health status, different characteristics still existed. The cohort can serve as a platform for in-depth research of the relationship between major chronic and non-communicable diseases and environment, people's lifestyle and genetic factors, and the research results can be used as important epidemiological evidence for clarifying the causes of chronic and non-communicable diseases and long-term health hazards in different ethnic groups in this area and reference for the national chronic and non-communicable disease prevention and control. This paper briefly introduces the design and practice of general population cohort in northwestern China.

Objective:To understand the prevalence of Neisseria gonorrhoeae (NG) infection and related factors in outpatients of sexually transmitted disease (STD) in Shenzhen and provide scientific evidence for targeted intervention. Methods:A cross-sectional study was conducted in STD outpatients who were aged 18-49 years, had had sexual intercourse, had not received antibiotics in the last 2 weeks and sought medical cares in 22 medical institutions in 6 districts of Shenzhen from 15 April, 2018 to 16 May, 2018, their basic information and urine samples were collected, and NG in urine sample was detected by nucleic acid amplification test. Logistic regression analysis was conducted to identify the related factors for NG infection.Results:The information collection and sample collection were completed for 8 324 STD outpatients, among these STD outpatients, 196 were NG positive, with a positive rate of 2.4% (196/8 324). The positive rate of NG in men (5.8%, 148/2 567) was higher than that in women (0.8%, 47/5 742) ( χ2=189.43, P<0.05). Aged 24 years or below ( OR=2.11, 95% CI: 1.44-3.09), single/divorced/widowed ( OR=1.98, 95% CI:1.38-2.84), having casual sex in the last 3 months ( OR=1.77, 95% CI:1.29-2.43) were the related factors for NG infection. Conclusions:We found that NG infection rate was high in STD outpatients in Shenzhen. The infection rates in men and in women differed obviously. It is necessary to conduct gonorrhea screening and intervention in STD outpatients with high-risk behaviors, such as extramarital and casual sex behaviors, and standardize the treatment to reduce the incidence and spread of gonorrhea and other STDs.

Objective: To investigate the factors associated with syphilis/HIV infection among men who have sex with men (MSM) maintaining a single sexual partner in Shenzhen. Methods: Respondent driven sampling and snowball sampling method were used to recruit MSM receiving voluntary counseling and testing in Shenzhen Rainbow clinic from 2011 to 2016. Inclusion criteria: aged 18 years and above; reported having one or more anal sexual partners in the recent 6 months. A total of 3 109 men who have sex with men (MSM) were involved in the study. Questionnaire-based interviews were conducted on a one-on-one basis. Data were collected including socio-demographic information, human immunodeficiency virus (HIV) testing history, history of blood donation and drug abuse in the recent two years, self-identified sexual orientation, role in homosexual behavior, ever being money boys (MB) and clients of MB, female sexual partners in the recent 6 months. 5 ml blood samples were taken after questionnaires. Syphilis was screened using toluidine red unheated serum test for the antibody of treponema pallidum and then confirmed by treponema pallidum particle assay. The enzyme-linked immunosorbent assay (ELISA) was used for screening HIV and western blot was used to confirm the HIV screening results. The difference of condom use among MSM between female sexual partners and male sexual partners were compared. Multivariate unconditional stepwise logistic regression model was used to analyze factors associated with syphilis infection and HIV positive among MSM. Results: A total of 3 109 eligible participants with mean (SD) age of 31.49 (8.64) years were enrolled in this study. Among them, 565 cases were infected with syphilis (18.17%), 330 cases were infected with HIV (10.61%), and 165 cases (5.31%) were syphilis co-infected with HIV. 791 (25.44%) reported maintaining a single sexual partners in the recent 6 months. Compared to MSM with multiple sexual partners, the prevalence of syphilis and HIV infection among MSM with a single sexual partner were lower, and the OR (95%CI) were 0.64 (0.51-0.81) and 0.66 (0.49-0.90), respectively. Conclusion The proportion of fixed single sexual partner was much lower among MSM in Shenzhen. Maintaining a single sexual partners can reduce the risk of syphilis/HIV infection among MSM.

Objective To analyze the differential expression of caveolin-2 in the psoriasis vulgaris and normal skin tissues, and investigate the relationship between caveolin-2 and the development of psoriasis vulgaris. Methods The expression of caveolin-2 mRNA and protein in psoriasis vulgaris patients and normal skin tissues were detected by quantitative PCR, immunohistochemistry and Western blot respectively. Results The quantitative PCR showed that the expression of caveolin-2 mRNA significantly decreased in the psoriasis vulgaris skin tissues when compared with the normal skin tissues (P < 0.01). The immunohistochemistry demonstrated that the caveolin-2 protein was mainly expressed in the cytoplasm of the basal layer cells in the normal skin tissues, but the caveolin-2 protein was not expressed in the lesions of psoriasis vulgaris. And the results of Western blot showed that the expression of caveolin-2 protein was significantly reduced in the psoriasis vulgaris skin tissues compared with the normal skin tissues. Conclusion The expression of caveolin-2 was reduced or lost in lesional epidermis of psoriasis vulgaris patients, which may serve as an aetiological factor in the development and or progression of psoriasis.

Objective To detect the expression of Th17 pathway-related genes in patients with syphilis serofast reaction and to investigate the mechanism of Th17 cells in syphilis serofast reaction. Meth-ods Peripheral blood samples were collected from patients with syphilis serofast reaction ( n=8 ) , patients who were syphilis-seronegative after treatment (n=8) and healthy subjects (n=8). Total RNA was extrac-ted from each blood sample and then reversely transcribed into cDNA. PCR-Array analysis was performed to quantify the expression levels of Th17 pathway-related genes. Results The expression levels of genes with a fold change >2 (up or down regulated) were defined as differentially expressed. (1) Compared with the control group, the patients with syphilis serofast reaction showed increased expression of genes encoding fork-head box protein 3 (Foxp3) and IL-10, but decreased expression of genes encoding C-C motif chemokine 22 (CCL22), colony stimulating factor 2 (CSF2), CSF3, chemokine (C-X-C motif) ligand 6 (CXCL6), IL-17A, IL-17D, IL-21, IL-23R, IL-9, interferon regulatory factor 4 (IRF4), RAR-related orphan receptorα( RORα) , RAR-related orphan receptor γ ( RORγ) and signal transducer and activator of transcription 3 (STAT3). (2) Compared with the seronegative syphilis group, the expression levels of genes encoding Foxp3 and IL-10 in patients with syphilis serofast reaction were up-regulated, while the expression of genes encoding CCL22, CSF2, CSF3, IL-17A, IL-21, IL-23R, IRF4, RORγ and STAT3 were down-regulated. (3) The expression levels of genes encoding CXCL6 and IL-9 in seronegative syphilis group were lower than those in control group. Conclusion The abnormal expression of Th17 pathway-related genes might relate to the pathogenesis of serofast state of syphilis.

Objective To investigate the status and factors associated with commercial sexual behavior among men who have sex with men (MSM) in Shenzhen.Methods A convenience sampling method was used to recruit MSM in Shenzhen from 2011 to 2015.Questionnaire-based interviews were conducted on a one-on-one basis.Data were collected,including socio-demographic information,HIV testing history,history of blood donation and drug abuse in the last 2 years,self-reported sexual orientation,role in homosexual behavior,and experience serving as a male sex worker and/or as a client of male sex workers.Blood samples (5 ml) were taken and tested for treponema pallidum and HIV antibodies.The rate of MSM serving as male sex workers among different age groups was analyzed using the Cochran-Armitage trend test.Factors associated with commercial sexual behavior were analyzed by univariate logistic regression and multivariate unconditional logistic regression.Results Among the 3 040 MSM recruited,341 (11.2％)reported having served as male sex worker.The prevalence rates of syphilis,HIV,and syphilis-HIV co-infection among all recruited MSM were 18.3％ (556/3 040),9.8％ (297/3 040),and 5.1％ (154/3 040),respectively.The prevalence rates of syphilis,HIV,and syphilis-HIV co-infection among those who served as male sex worker were 27.0％ (92/341),16.4％ (56/341),and 8.8％ (30/341),respectively,and the prevalence rates among MSM with no experience as male sex worker were 17.2％ (464/2 699),8.9％ (241/2 699),and 4.6％ (124/2 699),respectively.Compared with non-male sex worker MSM,male sex worker had a significantly higher prevalence rates of syphilis,HIV,and syphilis-HIV co-infection (with x2 values of 19.41,19.28,and 11.12,and P-values of ＜0.001,＜0.001,0.001,respectively).The results of the multivariate logistic regression analysis indicate that＞30-year-old MSM or education level of college or above,reside in Shenzhen for 0.5-3.0 years or the living years above 3.0 years are less likely to serve as male sex worker compared with＜30-year-old MSM,education level of high school or below,who reside in Shenzhen for less than 0.5 years;the OR (95％CI) values were 0.55 (0.42-0.71),0.10 (0.06-0.14),0.46 (0.31-0.68),and 0.23 (0.16-0.33),respectively.MSM having a monthly income of ＞5 000 yuan,drug abuse history,experience as male sex worker clients,and self-reported insertive and receptive anal sex behaviors were more likely to have experience serving as male sex worker compared with those having a monthly income of ＜3 000 yuan (OR=2.57,95％CI:1.85-3.57),no drug abuse history (OR=3.23,95％ CI:2.14-4.87),no experience as male sex worker clients (OR =1.50,95％ CI:1.04-2.15) and who engage in predominantly insertive anal sex behaviors (OR=1.77,95％ CI:1.34-2.35).Conclusion Age,education level,duration of residence in Shenzhen,monthly income,history of drug abuse,role in homosexual activity,and had experience commercial sex activity were associated with serving as a male sex worker among MSM.These factors need to be considered when designing syphilis/HIV prevention programs for MSM.

Objective To investigate the status and factors associated with commercial sexual behavior among men who have sex with men (MSM) in Shenzhen.Methods A convenience sampling method was used to recruit MSM in Shenzhen from 2011 to 2015.Questionnaire-based interviews were conducted on a one-on-one basis.Data were collected,including socio-demographic information,HIV testing history,history of blood donation and drug abuse in the last 2 years,self-reported sexual orientation,role in homosexual behavior,and experience serving as a male sex worker and/or as a client of male sex workers.Blood samples (5 ml) were taken and tested for treponema pallidum and HIV antibodies.The rate of MSM serving as male sex workers among different age groups was analyzed using the Cochran-Armitage trend test.Factors associated with commercial sexual behavior were analyzed by univariate logistic regression and multivariate unconditional logistic regression.Results Among the 3 040 MSM recruited,341 (11.2％)reported having served as male sex worker.The prevalence rates of syphilis,HIV,and syphilis-HIV co-infection among all recruited MSM were 18.3％ (556/3 040),9.8％ (297/3 040),and 5.1％ (154/3 040),respectively.The prevalence rates of syphilis,HIV,and syphilis-HIV co-infection among those who served as male sex worker were 27.0％ (92/341),16.4％ (56/341),and 8.8％ (30/341),respectively,and the prevalence rates among MSM with no experience as male sex worker were 17.2％ (464/2 699),8.9％ (241/2 699),and 4.6％ (124/2 699),respectively.Compared with non-male sex worker MSM,male sex worker had a significantly higher prevalence rates of syphilis,HIV,and syphilis-HIV co-infection (with x2 values of 19.41,19.28,and 11.12,and P-values of ＜0.001,＜0.001,0.001,respectively).The results of the multivariate logistic regression analysis indicate that＞30-year-old MSM or education level of college or above,reside in Shenzhen for 0.5-3.0 years or the living years above 3.0 years are less likely to serve as male sex worker compared with＜30-year-old MSM,education level of high school or below,who reside in Shenzhen for less than 0.5 years;the OR (95％CI) values were 0.55 (0.42-0.71),0.10 (0.06-0.14),0.46 (0.31-0.68),and 0.23 (0.16-0.33),respectively.MSM having a monthly income of ＞5 000 yuan,drug abuse history,experience as male sex worker clients,and self-reported insertive and receptive anal sex behaviors were more likely to have experience serving as male sex worker compared with those having a monthly income of ＜3 000 yuan (OR=2.57,95％CI:1.85-3.57),no drug abuse history (OR=3.23,95％ CI:2.14-4.87),no experience as male sex worker clients (OR =1.50,95％ CI:1.04-2.15) and who engage in predominantly insertive anal sex behaviors (OR=1.77,95％ CI:1.34-2.35).Conclusion Age,education level,duration of residence in Shenzhen,monthly income,history of drug abuse,role in homosexual activity,and had experience commercial sex activity were associated with serving as a male sex worker among MSM.These factors need to be considered when designing syphilis/HIV prevention programs for MSM.

OBJECTIVETo investigate the current status of contact tracing among pregnant women infected with syphilis and to analyze the associated factors from patients' perspective.

METHODSPregnant women who aged 18 years old, receiving prenatal care services in Shenzhen, diagnosed with syphilis according to national diagnostic criteria (WS 273-2007) from 2008 to 2011 were recruited and the total number was 3 551. Information of both pregnant women (including demographic information, laboratory results, syphilis diagnosis, and personal life history) and their partners (including results of partner tracing and laboratory examination) were collected with structured questionnaire by face-to-face interview. Multivariate non-conditional logistic regression model was applied to analyze the factors associated with partners' contract tracing. Odds ratio (OR) and its 95% confidential interval (95%CI) were calculated.

RESULTSThe average age was 28.72 among recruited 3 551 syphilis-infected pregnant women, with standard deviation of 5.21 and range of 18 to 40. Totally 2 550 partners attended antenatal clinics and received syphilis examination, with a contact tracing rate of 71.81%. The OR(95%CI) was 1.70(1.26-2.30) for pregnant women with college or above education when comparing with those with senior high school or below education. The OR(95%CI) was 0.57(0.45-0.71) for those unmarried or divorce when comparing with those married. The OR (95% CI) was 0.73(0.56-0.94) and 0.65(0.53-0.81) for those screened in 28-36 gestational weeks and those screened in >36 gestational weeks or right before delivery separately, when comparing with those screened in ≤27 gestational weeks. The OR (95% CI) was 1.45(1.14-1.84) for those having received sufficient treatment before pregnancy when comparing with those diagnosed with latent syphilis. The OR(95%CI) was 0.31 (0.24-0.39) for those having no treatment or not standardized treatment when comparing with those having standardized penicillin treatment. The OR(95%CI) was 0.53 (0.43-0.65) for those terminating the pregnancy when comparing with those giving birth to a baby. The OR(95%CI) was 1.24 (1.05-1.46) for those having two or more love histories when comparing with those having only one love history. The OR(95%CI) was 4.74 (3.54-6.35) for those intending to disclose the serostatus to their partner when comparing with those showing unwillingness to disclose the serostatus.

CONCLUSIONThe successful rate of contact tracing among pregnant women infected with syphilis was high. The implementation of contact tracing may be affected by many factors, including patients' education levels, marital status, gestational weeks of screening, stage of syphilis, treatment status, outcome of pregnancy, number of love histories, and willingness of serostatus disclosure.

Ambulatory Care Facilities ; China ; epidemiology ; Contact Tracing ; Female ; Humans ; Logistic Models ; Odds Ratio ; Pregnancy ; Pregnancy Complications, Infectious ; epidemiology ; Prenatal Care ; Sexual Partners ; Syphilis ; epidemiology

OBJECTIVETo investigate the distribution and factors associated with HIV and syphilis infection among Men who have sex with men blood donors (MSMBD) in Shenzhen.

METHODSA total of 813 MSMBD were recruited using snowball sampling and respondent driven sampling from 2009 to 2012 in Shenzhen. Questionnaire-based interviews were conducted on a one-on-one basis. Data were collected including socio-demographic information, HIV testing history, self-identified sexual orientation, role in homosexual behavior, information about having sex with male sexual partners in the past six months and information about having sex with female sexual partners in the past six months.5 ml blood samples were taken and tested for treponema pallidum and HIV antibodies. Comparisons of syphilis and HIV infection among different years were analyzed by the Cochran-Armitage trend test. Factors associated with syphilis and HIV infection were analyzed by the univariate logistic regression and multivariate unconditional logistic regression.

RESULTSThe prevalence of syphilis, HIV, and syphilis-HIV co-infection among 813 participants were 22.0% (179/813), 8.0% (65/813), and 4.2% (34/813), respectively. In the multivariate logistic regression analysis, ever tested for HIV (versus without HIV testing history, OR (95%CI) = 0.369(0.213-0.641)) will decrease the risk of HIV infection among MSMBD in comparison with never tested for HIV (OR (95%CI) = 0.37 (0.21-0.64) ); having five or more anal sexual partners in the past six months and co-infected with syphilis will increase the risk of HIV infection among MSMBD in comparison with having 0-1 sexual partners (OR (95%CI) = 2.04 (1.03-4.06) ) and negative syphilis (OR (95%CI) = 4.52(2.64-7.73)), respectively, bisexual orientation, having 2-4 anal sexual partners and having five or more anal sexual partners in the past six months, using condoms not for every act of anal sex, co-infected with HIV will increase the risk of syphilis infection among MSMBD in comparison with homosexual orientation (OR (95%CI) = 1.60(1.12-2.27)), having 0-1 sexual partner in the past six months (OR (95%CI) = 1.77 (1.09-2.87) and OR (95%CI) = 1.84(1.09-3.08) ) , using condoms for every act of anal sex (OR (95%CI) = 1.61 (1.10-2.36) ) and negative HIV (OR (95%CI) = 4.02 (2.33-6.96)), respectively.

CONCLUSIONThe prevalence of HIV and syphilis among MSMBD in Shenzhen are much higher with complex influence factors. The relevant government should pay great attention to it and ensure the blood safety.

Adult ; Blood Donors ; China ; epidemiology ; Cross-Sectional Studies ; HIV Infections ; blood ; epidemiology ; Homosexuality, Male ; Humans ; Male ; Risk Factors ; Surveys and Questionnaires ; Syphilis ; blood ; epidemiology

Objective To analyze the status quo of sexually transmitted diseases (STDs) of the elderly in recent years in Shenzhen, to explore the characteristics of temporal and spatial distribution,and to establish prediction model of STDs of the elderly in Shenzhen. MethodsUsing the surveillance system data of STDs from 2005 to 2009 in Shenzhen city, the incidence, temporal and spatial distribution of syphilis and gonorrhea were analyzed in the elderly aged 50 years and over by SaTScan. The incidence prediction model of STDs was established by Eviews 5.0.Results (1)The incidences of the two kinds of STDs from 2005 to 2009 in Shenzhen were on the rise and on more marked increase in male than in female. The rising velocity in over-60 year age group was similar with in 50-59 year age group. The rising velocity of syphilis was faster than gonorrhea. (2)The space-time distribution analysis showed there were clusters of the STDs in elderly men in 2005 in Lianhua and Meilin districts (P = 0. 026, RR= 2.13). (3) ARIMA (0, 1,1) (0,0, 1) 12 model was a suitable forecasting model for STDs in elderly men in Shenzhen. Conclusions