OBJECTIVETo investigate whether trajectory model can be used to explore the trend of anal human papillomavirus (HPV) infection status among HIV-negative men who have sex with men (MSM).

METHODSHIV-negative MSM were recruited by using the "snowball" method from 1st September 2016 to 30th September 2017 in Urumqi. The subjects were followed-up every six months since enrollment. The cell samples in anal canal were collected and the 37-type HPV test kits were used for identification and classification of HPV infection at both baseline and follow-up visits. Taking the cumulative number of different types of HPV as the dependent variable and follow-up visits as the independent variable, the trajectory model was established for the study subjects who completed baseline, 6 months and 12 months follow-up. The model was used to simulate the trend of HPV infection status when the subjects were divided into 1, 2, 3 and 4 subgroups. Bayesian information criterion (BIC), log Bayes factor and average posterior probability (AvePP) were used to evaluate the fitting effect.

RESULTSA total of 400 HIV-negative MSM were recruited at baseline and 187 subjects completed baseline and two follow-ups. The fitting effect attained best when the variation trend was divided into two subgroups. The first subgroup accounted for 54.5%(102/187) of the total, and the curve of change in HPV infection was decreasing; the second subgroup accounted for 45.5%(85/187) of the total, and the curve of change in HPV infection was increasing.

CONCLUSIONSTrajectory model can effectively distinguish the trend of HPV infection status in HIV-negative MSM to identify the high-risk group of HPV infection.

Anal Canal ; Bayes Theorem ; HIV Infections ; Homosexuality, Male ; Humans ; Male ; Papillomavirus Infections ; Prevalence ; Risk Factors ; Sexual and Gender Minorities

The brain of neonates is growing and developing rapidly in perinatal period.Treatments in this period can have a direct or indirect effect on the developing brain.Steroids,indomethacin,magnesium sulphate,hypothermia,caffeine citrate,exogenous surfactant,nitric oxide,erythropoietin are common treatments administered during perinatal period.All those treatments are closely related to neurodevelopmental outcomes.We review these treatments on the developing brain.

Objective To understand the human papilloma virus (HPV) infection status in men who have sex with men (MSM) recruited from gay bathhouses and HIV voluntary counseling and testing (VCT) clinics in Urumqi,Xinjiang Uygur autonomous region,and identify the associated risk factors.Methods A total of 200 MSM aged ≥≥ 18 years were recruited by using the "snowballing" sampling method from gay bathhouses and VCT clinics in Urumqi during March-May,2016.The MSM recruited completed questionnaires after filling in the informed consent form.The information about their demographic characteristics and sexual behaviors were collected,and anal swabs were collected from them for HPV genotyping.Results The overall HPV infection rate was 54.0％.The HPV infection rate was 66.7％(74/111) in MSM from gay bathhouses and 38.2％(34/89) in MSM from VCT clinics and the high risk type HPV infection rate was 39.6％ (44/111) in MSM from gay bathhouses and 14.6％(13/89) in MSM from VCT clinics,the differences were significant (x2=16.112,P＜0.05;x2=15.190,P＜0.05).Multiple logistic regression analysis indicated that the major risk factors for HPV infection included activity in gay bathhouse (OR=3.732,95％CI:1.950-7.141) and anal sexual behavior (OR=2.555,95％ CI:1.329-4.912).Conclusion The prevalence of HPV in MSM from gay bathhouses was higher than that in MSM from VCT clinics,indicating that close attention should be paid to the behavior intervention in MSM.

Objective: To investigate the clinical characteristics of early term and full term neonates, and analyze the risk factors associated with short term outcomes in early term neonates. Method: Neonates with birth weight (BW) ≥2 500 g from year 2013 were analyzed retrospectively based on American Congress of Obstericians & Gynecologists (ACOG) latest definition of term infants. According to inclusion and exclusion criteria, early term (gestational age 37-38 weeks) and full term(gestational age 39-40 weeks) neonates were included, whose morbidity constituent proportion was analyzed by χ² test or Fisher accuracy test or t test or Wilcoxon test. Risk factors associated with short term outcomes in early term population were analyzed by Logistic regression analysis. Result: There were 3 002 discharged term infants being investigated, among whom 1 303 cases were included(768 males and 535 females), and 37, 38, 39 and 40 weeks′ gestational age newborns were 160, 324, 450 and 369 respectively. Compared with full term neonates(n=819), early term neonates (n=484) had longer length of hospital stay (LOS)(6.0(5.0, 9.0) vs. 6.0(4.0, 8.0), Z=2.830, P=0.005), higher usage rate of intravenous antibiotics(86.4%(418/484) vs. 80.1%(656/819), χ²=8.009, P=0.005), higher assisted ventilation rate(9.5%(46/484) vs. 2.9%(24/819), χ²=25.528, P<0.01), higher pulmonary surfactant administration rate(4.3%(21/484) vs. 1.1%(9/819), χ²=14.006, P<0.01), as well as higher hypoglycemia incidence(3.9%(19/484) vs. 1.2%(10/819), χ²=10.226, P=0.001). There were no statistically significant differences in 1 min Apgar score (9(9, 10)vs. 9(9, 10), Z=0.860, P=0.390), 5 min Apgar score (10(9, 10) vs. 10(9, 10), Z=0.810, P=0.418), white blood cell count (15 (11, 21) ×10⁹ /L vs.15 (11, 22) ×10⁹ /L, Z=0.880, P=0.379), hemoglobin count(180 (159, 205) vs. 182 (160, 204) g/L, Z=0.560, P=0.576), or platelet count(303(234, 372) ×10⁹/L vs. 301(237, 391) ×10⁹/L, Z=0.550, P=0.584). BW between 2 500 g and 2 999 g(OR 1.69, 95% CI: 1.10-2.62, χ² =5.614, P=0.018), wet lung(OR=2.61, 95% CI: 1.61-4.24, χ²=15.023, P=0.000)and pneumonia(OR 1.88, 95% CI: 1.14-3.08, χ²=6.192, P=0.013) were risk factors in early term neonates′ short term adverse outcomes. Conclusion Early term newborns are still at their "immature" state, and respiratory disorders are major risk factors associated with short term outcomes. Hence, early delivery during 37-38 weeks should be avoided as possible as we can.

Objective: To observe two methods of cardioplegia under intrograde and retrograde, using mixed hypothemic blood in 59 patients receiving coronary artery bypass graft (CABG). Method:During perioperation and postoperation 24 hours,hemodynamie parameters were recorded. Myocardial enzyme level,the changes of ECG on 12 leads in postoperation,the frequency of using inotrope,time of staying in ICU and automatical reovery heart beat rate after openning aortic clamp were tested. Result: Cardioplegia by mixed hypothemie blood had better protective effects to the heart function, all patients could left the ICU safely,without significant differences between the two methods of cardioplegia,but in the retrograde group,there was obvious reduce in the change of myocardial enzyme level and less change of ECG in postoperation compared with those in the intrograde group. Conclusion:Both methods of mixed hypothemic blood for cardioplegia in CABG can protect effetively myocardium, but retrograde eardiaoplegia has better effect.

Objective To assess the lung inflammatory response to cardiopulmonary bypass (CPB). Methods Twenty ASAⅡ-Ⅲ patients of either sex (9 male, 11 female) aged (43 ? 12)yr, undergoing elective cardiac valve replacement were studied. Patients with liver or kidney dysfunction and lung inflammatory diseases were excluded. Premedication included intramuscular morphine 5mg and atropine 0.1mg. Anesthesia was induced with propofol 1.5-2.0mg? kg-1, fentanyl 5?g?kg-1 and vecuronium 0. 1mg?kg-1 and maintained with isoflurane (

12g/dl. The patients were premedicated with intramuscular atropine 0.01 mg ? kg-1 and midazolam 0.06 mg?kg-1 . Anesthesia was induced with fentanyl 3-5?g?kg-1, propofol 1.5-2.0 mg?kg-1 and vecuronium 0.1 mg ? kg-1 and maintained with inhalation of 60%-65% N2O-O2 and 1%-3% isoflurane. The patients were mechanically ventilated after tracheal intubation and PETCO2 was maintained at 4.67-5.33 kPa. Radial artery was cannulated for intra-arterial pressure monitoring and blood sampling and internal jugular or subclavian vein was cannulated for CVP monitoring and blood sampling. Before anesthesia 5% glucose-normal saline 6-8 ml?kg-1 was infused to compensate for preoperative fluid restriction after midnight. 6% HES 200/0.5 15 ml?kg-1 was infused before operation in 25 min. The inhalation concentration of isoflurane was adjusted to maintain CVP, BP and HR and avoid circulatory overload. Small dose of nitroglycerin (NTG) was given iv if necessary. During operation blood loss was replaced with equal volume of 6 % HES 200/0.5. Blood transfusion was considered when Hb 25% . Diureties was used at the end of surgery. ECG, BP, CVP, SaO2 and cardiac output (using non-invasive NCCOM-3) were continuously monitored throughout operation. Arterial and centralvenous blood samples were taken for blood gas analysis and determination of lactic acid concentration (LA) before (T0) and 15 min (T1) after AHHD, before homologous blood transfusion (T2 ) and at the end of surgery (T3) . Oxygen consumption (VO2 ) and oxygen extraction ratio (ERO2) were calculated. Results (1) There were no significant changes in BP and HR after AHHD and during operation. CVP increased significantly after AHHD at T1-3 but within normal range. Cardiac output increased by 22.9% (T1), 17.0% (T2) and 30.5% (T3) after AHHD. (2)Hct and Hb decreased gradually after AHHD as hemodilution continued and five patients received homologous RBC transfusion because of low Hb. DO2 increased by 11% after AHHD. In five patients DO2 and VO2 prior to homologous RBC transfusion were lower than baseline value (T0). ERO2 increased by 13.5% (T1), 34.9% (T2) and 24.9% (T3) respectively. (3) Electrolytes, pH and LA were kept stable throughout operation. Conclusions 6% HES 200/0.5 can be used safely for AHHD in terms of hemodynamic changes and oxygen transport and ERO2.

Objective: To study the effect of the bolus propofol on myocardial ? adrenergic receptor. Method: Twenty-one,aging 4-6 weeks,male health SD rats,were divided randomly into three groups:low dose group (L)with propofol of 5mg/kg,high dose group(H)with 12mg/kg of propofol and control group(C) with NS alone. The drugs were administered through the rat's tail vein in conscious state. 3 minutes after administration,the raps heart were totally taken out to investigate rat's myocardial ? adrenergic receptors with radioligand binding assay. Result:Compared with those in control group,in L group there was a decrease in ? adrenergic receptor density(Bmax),but no change in the affinity of ? adrenergic receptor (KD); In H group,Bmax decreased,KD value increased. The Bmax and KD were significantly different between L and H group. Conclusion:Intravenous bolus doses of propofol may cause down-regulation on myocardial ? adrenergic receptor of rats in dose-related way.

Objective To investigate the peri operative changes and anesthetic management during orthotopic liver transplantation (OLT) Methods General anesthesia or general anesthesia combined with epidural anesthesia was applied During the anhepatic phase, extracorporeal veno venous bypass (EVVB) was established Hemodynamics, respiratory function, blood gas, biochemistry, blood coagulation function, body temperature, blood glucose, urinary output and bleeding output were monitored According to the different characteristics of the pre anheptic phase, anheptic phase and neoheptic phase during OLT, the corresponding anesthetic management was supplied Results Applying EVVB during the anheptic phase could keep hemodynamics stable, but in 15 min of the primary anheptic and neoheptic stages a transient circulatory instablity occurred,and the rapid blood volume expansion was required Through comprehensive management, there was no obvious acid base disturbance during the phases The hypocalcemia, hypokalemia and hyperglycemia occurred and thebody temperature changed greatly,to require timly corrective measures Certain coagulative disturbances occurred, to require the supplement of coagulation factors, proper hemostatic drugs and protamine for neutralizing heparin Intraoperatively, anti rejection drugs were required Peri operatively, the blood glucose levels were higher than normal Conclusions Utilizing EVVB during the anheptic phase can be helpful to maintain hemodynamics stable, prevent obvious acidosis and hyperkalemia The anesthetic management during the neoheptic phase should be required to correcte hypothermia, hypocalcemia, hypokalemia, hyperglycemia and disturbence of coagulation