Objective:To provide data support for acquired immunodeficiency syndrome (AIDS) clinical treatment by evaluating the antiviral therapy effect of integrase inhibitors (INIs) and analyzing the drug resistant mutations.Methods:Patients who exposed to INIs more than 1 year were analyzed retrospectively. Virus suppression failure subjects(viral load ≥1 000 copies/ml) were sequenced for drug resistance analysis.Results:Of 408 patients, 12 cases(2.9%) were virologic failure, 8 cases had drug resistance mutations. The proportion of drug resistance was 2.0%(8/408). Among them, only 1 case(0.2%, 1/408) was resistant to INIs with associated mutations: T66I, G118R and E138K; 7 cases(1.7%, 7/408) were resistant to nucleoside reverse transcriptase inhibitors(NRTIs) with major mutations: M184V/I, D67N for NRTIs; 5 cases(1.2%, 5/408) were resistant to non-nucleoside reverse transcriptase inhibitors(NNRTIs) with major mutation: K103N; 1 case(0.2%, 1/408) was resistant to protein inhibitors (PIs), and associated mutations was I50L.1 case was resistant simultaneously to INIs, NRTIs and NNRTIs, Dual-class mutations were observed in 4 cases(3 cases to NRTIs and NNRTIs, 1 case to PIs and NNRTIs).Conclusions:The study result showed that the drug resistance rate of INIs was low in Hunan province, however, the INIs drug resistance surveillance was necessary.

Objective:To understand the status of HIV-2 infection and the epidemiological characteristics of HIV-2 infected individuals in Hunan province.Methods:The stock blood samples with HIV-2 indicative bands in the original records of 15 AIDS confirmation laboratories in Hunan province from 2003 to 2020 were collected. The samples were tested by Mikrogen GmbH (HIV 1+ 2) antibody comfirmatory kit (Germany). And meanwhile the epidemiological data of the first HIV test and the epidemiological follow-up records of the cases who could be contacted were collected.Results:A total of 378 samples with HIV-2 indicative bands were collected, involving 363 individuals. Serological test result showed that 326 cases (89.81%) were HIV-1 antibody positive, 18 cases (4.96%) were HIV-2 antibody positive, 12 cases (3.31%) were HIV antibody positive but could not be typed, 6 cases (1.65%) were HIV antibody uncertain and 1 case (0.28%) was negative for HIV-1/2 antibody. There were 15 cases from Xiangtan city and the other 3 cases from Changsha city among the 18 HIV-2 antibody positive individuals. The result of epidemiological investigation showed that there were 12 males (66.67%) and 6 females (33.33%), with a male-to-female ratio of 2∶1. The average age of the first detection was (56.94±12.52) years, in the males the age ranged from 33 to 76 years and in the females the age ranged from 44 to 66 years. The male age span was larger than that of the female. There were 10 married cases (55.56%) including one couple, 6 divorced or widowed cases (33.33%), 2 cases (11.11%) with unknown marital status. There were 13 cases from hospital monitoring (72.22%), 2 cases each from prison detention and blood screening in volunteer donors (22.22%), and 1 case from spouse screening (5.56%). These samples were tested for the first time in 2005, 2009, 2013, 2014, 2018, and 2020, with 1 case each, 6 cases in 2016, 2 cases in 2017, and 4 cases in 2019. By the end of 2020, 9 cases were alive and 9 cases were dead or missing. Three cases have accepted antiviral treatment. Of the 7 cases that could be followed up, all admitted heterosexual transmission, 6 cases denied any history of traveling abroad, and 1 case denied any history of foreign sexual intercourse.Conclusions:HIV-2 epidemic has lasted for a long time in Hunan province, local infection is not an occasional case, and there is a possibility of long-term clustering epidemic spread. This suggests that the country should strengthen the surveillance, detection, diagnosis and treatment of HIV-2 research and pay attention to the risk of HIV-2 transmission.

OBJECTIVE: To study the working experience of COVID-19 care nurses. METHODS: Twenty two nurses taking care of COVID-19 patients were interviewed by means of descriptive phenomenology. All the data were transcribed and recorded, and then processed into WORD documents. The Colaizzi 7 footwork was used to classify, encode, establish nodes and extract themes based on Nvivo11.0 software. RESULTS: Two main themes were extracted: one is the positive feelings of nurses, including the sense of professional mission and pride, the sense of achievement and happiness, the improvement of self-worth and ability, the powerful support system and the power of role models; the other is the negative experience of nurses, including the worry and anxiety at work, the lack of experience and trust, the difficulty of work, and the inconvenience of isolating life. CONCLUSIONS s While fully affirming the work value of nurses, it is necessary for the society, hospitals and patients to give extensive and continuous support, care and respect to nurses, so as to stimulate their working enthusiasm and sense of professional achievement. Hospital managers need to implement all kinds of security work, meet the safety needs of nurses, pay attention to the physical and mental health of nurses, strengthen the training of nursing talents for critical and severe diseases and infectious diseases, improve the allocation of human resources, and enhance the ability of material allocation and reserve for major health events, so as to make adequate preparations for coping with public health events in the future.
Betacoronavirus ; Coronavirus Infections ; Hospitals ; statistics & numerical data ; Humans ; Nurses ; statistics & numerical data ; Pandemics ; Pneumonia, Viral ; Qualitative Research ; Workplace ; statistics & numerical data

Objective: To assess the quality of syphilis case reporting from hospitals in Hunan Province .Methods The syphilis cases reported by 126 middle second-class and above hospitals in the year 2010 and 2017 were retrieved from unified infectious case reporting network and compared with original reporting cards,medical records and laboratory testing records according to the Diagnostic Criteria for Syphilis （WS 273-2018）and the Guidelines for the Clinical Diagnosis and Treatment of Sexually Transmitted Diseases. The accuracy of syphilis diagnosis and classification were evaluated between different reporting years,types of hospitals,levels of hospitals and departments . Methods: The syphilis cases reported by 126 middle second-class and above hospitals in the year 2010 and 2017 were retrieved from unified infectious case reporting network and compared with original reporting cards,medical records and laboratory testing records according to the Diagnostic Criteria for Syphilis （WS 273-2018）and the Guidelines for the Clinical Diagnosis and Treatment of Sexually Transmitted Diseases. The accuracy of syphilis diagnosis and classification were evaluated between different reporting years,types of hospitals,levels of hospitals and departments . Results: There were 8 947 syphilis cases reported in 2010 and 13 552 syphilis cases reported in 2017. The accuracy of syphilis diagnosis and classification were 98.81% and 98.66% in 2017,which were higher than 36.39% and 36.10% in 2010 （P<0.01）. The accuracy of syphilis diagnosis in the provincial,municipal and county-level hospitals in 2017 were 99.07%,99.20% and 98.17%;the accuracy of syphilis classification were 98.91%,99.03% and 97.99%;the accuracy of syphilis diagnosis and classification were significantly different in different levels of hospitals（P<0.01）. The accuracy of syphilis diagnosis in the general hospitals,traditional Chinese medicine hospitals and maternal & child health hospitals in 2017 were 99.25%,96.92% and 97.57%;the accuracy of syphilis classification were 99.13%,96.72% and 97.30%;the accuracy of syphilis diagnosis and classification were significantly different in different types of hospitals（P<0.01）. The accuracy of syphilis diagnosis in the department of dermatology and non- dermatology in 2017 were 99.13% and 98.74%;the accuracy of syphilis classification were 99.02% and 98.58%;the accuracy of syphilis diagnosis and classification were not significantly different in different departments（P>0.05） . Conclusion The accuracy of syphilis diagnosis and classification have been improved in 2017,which varies in different levels and types of hospitals.

European psychiatric specialist training system has been maturely developed for 6 decades.The institutional framework for psychiatric training during specialization has been conformed to European standards,including training content,assessment and training base.In Europe,psychiatry specialist education lasts 5-7 years.Trainees should have experience of psychiatric internships and get assessed prospectively.After the training,trainees will receive the qualifications of the association for psychiatric training in Europe.While in China,the training time of psychiatrists is 3 years,the training of related departments is nearly 1 year,and psychiatric training is only 2 years.The training time of psychotherapy and clinical practice of psychiatry is still not enough.There is also a lack of consistency in the implementation of theoretical and practical training in all the bases in China.Therefore,by comparing the advantages and disadvantages of the Chinese and European psychiatry training system,this paper proposes optimizing the training program in China,increasing the students' humanistic cultivation and psychological care,and further improving the input of special training funds.

Objective: To understand the depressive disorders prevalence and related risk factors among new drug users in a male drug rehabilitation center. Methods: The cross-sectional study was used. A total of 250 new drug users from a male drug rehabilitation center were recruited during March, 2017. The drug users who only use new type of drugs single or use traditional drugs at the same time were collected as the new drug users. Their general information and drug-related information were collected by self-made questionnaire, and depressive disorders and sleep quality information were collected by the self-reported Patient Health Questionnaire-9 (PHQ-9) and the self-reported Pittsburgh Sleep Quality Index Questionnaire respectively. Logistic regression test was used to establish associations between variables. Results: Of all 250 drug users, the mean age (P₂₅, P₇₅) was 30 (26, 35) years old, and 32.8% (82) had the depressive disorders. The individuals taking drug dose over 0.4 g daily before entering drug rehabilitation center had significantly more risk of the depressive disorders for 3.18 (1.71-5.90) than those not over 0.4 g daily.The individuals who bad sleep quality had significantly more risk of the depressive disorders for 6.07 (95%CI:3.31-11.12) than those had good sleep quality.The individuals who were depressive patients before the first drug use for 2.39 (95%CI: 1.12-5.10) than those were not depressive patients before the first drug use. Conclusion There were a high rate of the depressive disorders among new drug users in the rehabilitation center; In addition, several risk factors including the individuals taking drug dose over 0.4 g daily and bad sleep quality, history of the depressive disorders were negatively associated with depressive disorders.

Objective: To investigate the HCV genotypes distribution of 107 HIV/HCV co-infection individuals in Hunan province. Methods: HCV antibodies positive plasma samples were collected from HIV-1 antibodies positive plasma bank in Hunan Provincial Center for Disease Control and Prevention and carried out the nucleic acid amplification, the PCR products were used for the HCV genotypes analysis. Results: For 107 samples, 77.5%(83/107) were from intravenous drug users and 25.2%(27/107) were underwent spontaneous clearance of HCV. The HCV genotypes distribution varied greatly in different routes of HIV infection. The non-1/non-2 types exceeded 70% in intravenous drug use and unknown route of transmitted infection populations, while the types 1 and 2 mainly occurred in blood transfusion or aphaeresis plasma populations, accounted for 83.3%. There was no statistical significant differences of immune and liver function among the three groups. Conclusions Among 107 HIV/HCV co-infection individuals in Hunan province, most of them were intravenous drug users and the distribution of HCV genotypes varied greatly in different routes of HIV infection.

Objective To evaluate the effect of self-management education based on nurse-leading on the quality of life in patients with chronic heart failure (CHF).Methods Eighty patients with CHF in a tertiary hospital were enrolled in this study,and were divided into the intervention group and the control group randomly,with 40 cases in each group. Patients in the control group received conventional health education, while patients in the intervention group received the self-management education based on nurse-leading. The score of self-management behavior and the quality of life in two groups were evaluated and compared after six months.Results After six months,the score of self-management in the intervention group was (70.83±12.02), and was significantly higher than that in the control group (55.58±6.46) (t=9.675,P<0.05). The score of total quality of life and self-management in the intervention group was significantly higher than that in the control group (P<0.05).Conclusions Self-management education based on nurse-leading can improve the self-management and the quality of life of patients with CHF.

OBJECTIVETo observe the difference for type 2 diabetes between acupoint injection of human placenta tissue fluid combined with oral administration of metformin and simple metformin.

METHODSSixty patients with type 2 diabetes were randomly assigned into a medication group and an injection group,30 cases in each one. In the oral medication group,metformin hydrochloride enteric-coated tablets was applied orally for continuous eight weeks,0.25 g a time,twice a day. In the injection group,based on the same oral administration,human placenta tissue fluid was injected into Diji(SP 8) and Yishu(EX-B 5) for two courses(four weeks as one course),once every other day and three times a week. Fast blood glucose(FBG),postprandial blood glucose(PBG),glycosylated hemoglobin(HbAlc) and clinical effect were observed in the two groups before and after treatment.

RESULTSCompared with those before treatment,FBG,PBG and HbAlc were decreased in the two groups after treatment (all<0.05),with more apparent change in the injection group(all<0.05). The total effective rate of the injection group was 90.0%(27/30),which was obviously better than 63.3%(19/30) of the medication group (<0.05).

CONCLUSIONSAcupoint injection of human placenta tissue fluid combined with metformin hydrochloride enteric-coated tablets for type 2 diabetes can better lower blood glucose than simple metformin hydrochloride enteric-coated tablets.

Objective To observe the changes of the depressive behavior and amygdaloid nucleus nerve growth factor(NGF)expression in estro?gen?deprived female rats and explore the possible mechanism and targets of estradiol in depression treatment. Methods A total of 30 adult SD fe?male rats were randomly assigned to 3 groups:sham operation group(SHAM,n=10);ovariectomized group(OVX,n=10)and ovariectomized rats treated with estradiol group(OVX+E,n=10). The behavior changes were observed by tail suspension test(TST)and sucrose preference test (SPT) after 8?week estradiol treatment. Subsequently ,immunohistochemical staining detect NGF expression in amygdaloid nucleus. Results Compared with the SHAM group rats,sucrose preference ratio significantly decreased in SPT(P<0.01),immobile time prolonged in TST(P<0.01),serum estradiol level and amygdaloid NGF expression significantly decreased(all P<0.01). 8?week estradiol treatment ameliorated depres?sion?like behavior and increased serum E2 level and NGF expression in amygdaloid nucleus in OVX+E group rats when compared with the OVX group(all P<0.01). Conclusion Estradiol treatment can improve the depressive behavior of ovariectomized rats ,which may be related to the in?crease of serum estradiol level and the expression of NGF in amygdaloid nucleus.