ObjectiveTo investigate the therapeutic effects of direct-acting antiviral agents (DAAs) combined regimens for hepatitis C virus (HCV) patients in Dehong Prefecture, Yunnan Province from 2022 to 2024, to analyze the characteristics of treatment failure patients, so as to provide a basis for discovering more effective treatment regimens in the future. MethodsData on HCV prevention and treatment in Dehong Prefecture was extracted from the China Disease Control and Prevention Information System. A total of 617 patients with HCV antiviral therapy were included, and the differences in variable characteristics among patients with different genotypes were analyzed using comparative statistical tests, including basic socio-demographic characteristics, biochemical testing indicators, and information on previous treatment and current treatment. In addition, the cure rate of HCV patients with diverse characteristics was compared, and the potential causes of treatment failure were explored simultaneously. ResultsThe cure rate of HCV was 96.8%, and statistically significant differences were observed in aspartate transaminase (AST) and alanine transaminase (ALT) levels, previous antiviral therapy history and initial treatment regimens among patients with different HCV genotypes (all P<0.05). Among the multi-type combination regimens, the cure rate of sofosbuvir (SOF)-containing regimens was 97.00%, that of velpatasvir (VEL)-containing regimens was 95.45%, and the cure rate of other treatment regimens, including the regimens with ribavirin (RIB) intervention, was 93.10%. Among the patients with treatment failure, 45.00% had genotype 3, 40.00% had abnormal abdominal ultrasound results, and all presented with elevated baseline AST test levels. ConclusionThe clinical treatment of HCV patients should consider the differences in genotype and biochemical test results. DAAs combined regimens for HCV have achieved a high cure rate in Dehong Prefecture and are applicable to HCV patients with diverse clinical characteristics, providing research evidence for wider application.

ObjectiveTo determine the characteristics， viral load and immunological status of HIV-infected persons and their spouses who became HIV-positive， and the reasons for HIV seroconversion in 55 HIV discordant couples in Dehong Dai and Jingpo Autonomous Prefecture （Dehong Prefecture）， Yunan Province. MethodsData on the 55 couples meeting the criteria of having a previously positive spouse were retrieved from the AIDS Integrated Prevention and Control Data Information System of the China Disease Control and Prevention Information System during 2015-2021. General socio-demographic information， age at diagnosis， exposure history， CD4⁺T lymphocyte count， and antiviral treatment were collected. Descriptive analysis and chi-square test were used to compare the distribution of pre-HIV-positive spouses and their HIV seroconverted spouses. ResultsA total of 55 spouses from HIV discordant couples had HIV seroconversion. Of them， 72.7% （40/55） of pre-HIV-positive spouses were husbands. The most recent CD4⁺T lymphocyte count in the pre-HIV-positive spouses was （328.31±246.27） cells·μL^-1 at the time of diagnosis of their seroconverted spouses， of which 36.3% （20/55） had a CD4⁺T lymphocyte count of less than 200 cells·μL^-1. Furthermore， of those pre-HIV-positive spouses with low CD4⁺T lymphocyte count， 45.0% （9/20） had an undetectable viral load， 15.0% （3/20） <400 copies·mL^-1， and 25.0%（5/20） ≥400 copies·mL^-1. Additionally， 16.4% （9/55） of the pre-HIV-positive spouses did not have a viral load test. The main reasons for HIV seroconversion among HIV-negative spouses in the discordant couples were poor condom use， poor compliance with antiviral therapy， and treatment discontinuation. ConclusionThe follow-up management of HIV discordant couples should be strengthened in Dehong Prefecture， especially the monitoring of viral load levels and immunological status of pre-HIV-positive spouses， to improve their compliance with antiviral therapy and reduce treatment discontinuation， which would effectively prevent and control HIV transmission between spouses.

From September 2020 to August 2021, 34 general practice trainees in Xuanwu Hospital, Capital Medical University were were randomly divided into the control group and trial group with 17 in each group. The control group adopted the traditional clerkship method for outpatient clinical teaching; the trial group independently received patients with the supervision of clinical instructors, and the Leicester assessment package (LAP) was used for evaluation and training. The performance of two groups were assessed using the Beijing General Practitioner's Graduation Assessment and Admissions Patient Score Sheet. The LAP training was also given to control group at the late stage of the study, and the application of LAP was assessed with a questionnaire survey in two groups of trainees. The results showed that the performance of trial group was better than that of control group in terms of medical history collection [(23.12±1.05) vs. (21.18±0.88), t=-5.82, P<0.01 ], physical examination [(24.88±1.62) vs. (23.12±1.58), t=-3.22, P< 0.01 ], case analysis [(22.94±0.90) vs. (20.82±0.73), t=-7.55, P<0.01 ] and total score [(86.59±2.65) vs. (80.12±2.45) t=-7.40, P<0.01]. For assessment of LAP, all 34 trainees gave 5 points in items of improving patient care, knowledge and skills, communication skills, professional quality, reception skills, clinical thinking, clinical judgment, decision-making skills, and learning interest with the application of LAP in outpatient clinical teaching; the satisfaction of the trainees on the pertinence, teaching effect and LAP training method of the instructing physicians was 100% (34/34). It is suggested that the application of LAP for evaluation and implementation in general practice outpatient teaching will help to improve the teaching quality and the patient receiving ability of general practitioners.

ObjectiveTo determine the characteristics and influencing factors of hepatitis C virus （HCV） co-infection among HIV concordant couples in Dehong Prefecture. MethodsUsing the data of newly reported HIV concordant couples in Dehong Prefecture from 2016 to 2019， we collected the demographic characteristics， exposure history， and HCV infection to determine the characteristics of HCV co-infection among HIV concordant couples. ResultsAmong the 160 HIV concordant couples included in the study， 46 （28.8%） males and 14 （8.8%） females were co-infected with HCV. The prevalence of HIV-HCV co-infection was higher among the male spouses who were diagnosed less than 40， Jingpo ethnic， Burmese， illiteracy， farmers， and intravenous drug users. In contrast， the prevalence of HIV-HCV co-infection was higher among the female spouses who were diagnosed less than 40， Jingpo ethnic， and Burmese. Logistic regression analysis among male spouses showed that the Jingpo ethnic and intravenous drug users had higher risk of HCV co-infection. ConclusionHIV concordant couples in Dehong Prefecture have high prevalence of HIV-HCV co-infection. Effective intervention strategies should be developed based on ethnic-specific factors and exposure characteristics among male and female spouses of HIV concordant couples.

ObjectiveTo investigate the demographic characteristics， high-risk behavior and first CD4⁺T cell（CD4 cell） counts among newly reported HIV-infected Burmese in Dehong Dai Jingpo Autonomous Prefecture （Dehong Prefecture） from 2019 to 2020. MethodsA cross-sectional survey was conducted among newly reported HIV-infected Burmese cases in Dehong Prefecture from 2019 to 2020 to collect related information and measure their first CD4 cell counts. ResultsAmong 1 228 HIV-infected Burmese cases， 846 （68.9%） were males and 382 （31.1%） were females； 445 （36.2%） were from Kachin， and 210（17.1%） were from Shan. Of them， 960 cases （78.2%） had participated in the first CD4 cell counts testing， and 405 cases （42.2%） had a first CD4 cell counts <350 cells·μL^-1. In the multivariable logistic regression analysis， age ≥30 years （adjusted OR=1.44， 95%CI： 1.07‒1.92） and history of illicit drug use in Myanmar （adjusted OR=0.41， 95%CI： 0.21‒0.79） were independently associated with first CD4 cell counts <350 cells·μL^-1. ConclusionThe first CD4 cell counts are generally low among newly reported HIV-infected Burmese in Dehong Prefecture， especially those aged ≥ 30 years and with a history of intravenous drug use in Myanmar. Therefore， early detection of HIV infection should be strengthened for timely intervention and treatment management among Burmese.

Objective: To explore the entry points and monitoring points of individualized treatment for fracture surgery patients with ARDS.Methods: Clinical pharmacists comprehensively assessed the patient's conditions and looked up lots of literatures.Some suggestions on the anti-infection treatment efforts, glucocorticoid use dispute and rational use of ambroxol were offered.The efficacy and adverse reactions of drugs in the treatment process were monitored using some subjective and objective indicators.Results: The consensus about the pros and cons, dosages, as well as the possible dosage decrease of glucocorticoid therapy, the dosages of antimicrobial agents, and the dosages and treatment course of ambroxol was achieved between clinical pharmacists and doctors.As a result, the maximum benefits were obtained for the patient.Conclusion: Clinical pharmacists can explore the treatment and monitoring for specific diseases and find out intervention entry points of clinicians and patients to play a certain role in clinics, and accumulate treatment experience gradually.

Objective To investigate the comparison of rubber gloves collection bag, linear closing type plastic collection bags and plastic specimen collection bag is used for application effect of laparoscopic ovarian cyst resection. Methods From 2013 June to 2014 December underwent laparoscopic ovarian cyst resection in 90 cases, according to the first date of surgery were divided into 3 groups, from the standard sample collection bag for rubber gloves (A group) 30 cases, linear closing type plastic collection bag (B group) 30 cases, collecting bag plastic specimens (C group) 30 cases. Respectively calculate autologous peritoneal bag mouth opening into time, time to complete transection of tissue into the specimen collection bag time, specimen collection bag left abdominal contents to the in vitro observation time, specimen collection bags in use in the course of rupture occurrence rate of specimen content leakage. Results The 3 groups of patients with autologous abdominal time were (7.18 ± 0.61),(6.72 ± 0.57), (5.98 ± 0.30) s, the difference was not statistically significant (t=41.80, P>0.01). The 3 groups of specimens collected pouch specimens respectively (40.84± 6.27), (49.86 ± 6.10), (32.98 ± 3.93) s, group C open pocket to maintain state of distraction to amputated tissue fully into the specimen collection bag in the shortest time, with a group and B group, the difference was statistically significant (F=69.87, P<0.01). The 3 groups of specimens collected from the abdominal cavity were (498.39±55.60), (315.70±47.32), (448.65±54.90) s, the difference was statistically significant (F=96.18, P < 0.01). The 3 groups of specimens collected specimen bag collection bag rupture were 26.7% (8/ 30),10.0% (3/ 30),3.33% (1/ 30), group A of the most common (χ2=0.926, P < 0.05), The 3 groups of specimens collected the bag contents leakage were 23.30%(7/30), 6.67%(2/30)、3.33%(1/30), group A of frequency was the highest, and in group B and C, the difference had statistical significance (χ2=0.635, P<0.05). Conclusions Plastic type specimen collection bag for soft bag with built-in wire, the bag opening is a certain tension, easy operation by operation control, convenient and reliable safety, shorten operation time, reduce the occurrence of complications, reduce surgical risks and costs, and improve the office efficiency and quality of the operation.

Objective To develop and explore the clinical application effect of orthopedic protective trestle for post-operative patients with lower limb fracture.Methods Totally 60 patients with lower limb fracture that hospitalized in Osteopathic Department from March to June 2015 were randomly divided into the observation group(n=30) and the control group(n=30). Patients in the control group were given Thomas trestle for the fixation while patients in the observation group were given orthopedic protective trestle for the fixation. The pain score, average hospitalization days and patients′satisfaction degree in two groups were compared. Results The pain score of patients in the observation group after 48 h was (3.50±0.63) points, which was significantly lower than the score in the control group (5.53±0.82) points (t=10.78,P<0.05);the average hospitalization days in the observation group was (16.47±2.68) d, which was significantly lower than that in the control group (22.47± 7.32) d (t=4.22,P<0.05);the satisfaction score of patients in the observation group was (8.80±0.61) points, which was significantly higher than the score in the control group (6.93±1.36) points (t=-6.85,P<0.05). Conclusions Orthopedic protective trestle for patients with lower limb fracture can relieve the pain of patients, reduce the length of average hospitalization days and improve the satisfaction of patients.

Objective To construct eukaryotic expression vector of small hairpin RNA vector targeting hepatitis B virus core protein in HepG2.2.15 cells,and to verify the interfering effect.Methods To design and synthesize small interfering RNA sequence against HBc gene (ayw subtype) which locates between 2147 bp to 2165 bp in the HBV genome.The siRNA fragment were inserted into pSilencer3.1-H1 neo vector.The recombinants were transformed into E.coli DHSα successfully.The recombinant plasmids were identified by Eco RI enzyme digestion and sequenced.Finally,The HepG2.2.15 cells were transfected with the vector by using lipofectamine method to identify its interfering effect.Results The eukaryotic expression vector containing small hairpin RNA targeting HBV core protein was constructed successfully and named as pshRNA-HBc.The recombinant plasmids were identified by SalI or EcoRI enzyme digestion and sequenced.The silencing effect was detected by using revere transcription polymerase chain reaction (RTPCR) and the secretion of HBsAg and HBeAg in the supernatant of HepG2.2.15 cells.The result showed that the interfering effect was specific and efficient.Conclusion The small interfering RNA targeting HBV core protein in HepG2.2.15 cells was constructed successfully,which may be useful for studying the biological functions of HBc in the future.

OBJECTIVE: To investigate the effects of Shenshuning Recipe (SSNR) on gene expression of hepatocyte growth factor (HGF) in renal tissues in rats with glomerulosclerosis. METHODS: Glomerulosclerosis was induced in 42 rats by unilateral nephrectomy and intravenous injection of doxorubicin. Then these 42 rats were randomly divided into three groups: untreated group, SSNR-treated group and benazepril-treated group. Another eight rats were included into sham-operation group. The rats in the SSNR-treated group and the benazepril-treated group were fed SSNR or benazepril respectively for 8 weeks. The levels of 24 h urine protein (Upr), serum creatinine (Cr) and blood urea nitrogen (BUN) of rats in each group were examined. The renal morphological changes were observed under microscope, and the diameter of glomerular capillary, mesangial matrix and glomerulosclerosis index were analyzed by image analysis software. Reverse transcription-polymerase chain reaction (RT-PCR) method was used to detect the gene expression of HGF in the renal tissues. RESULTS: The levels of 24 h Upr, serum Cr and BUN in the untreated group were remarkably increased than those in the sham-operation group (P<0.01). The pathological morphological changes in the untreated group showed that the glomerulosclerosis was diffused around the renal tissue and the capillaries were shrunk. The expression level of mesangial matrix was up-regulated and the glomerulosclerosis index was 3.32+/-0.35. The expression level of HGF mRNA in the untreated group was obviously lower than that in the sham-operation group (P<0.05). The levels of 24 h Upr, serum Cr and BUN in the SSNR-treated group and the benazepril-treated group were remarkably decreased as compared with those in the untreated group, while the expression levels of HGF mRNA were both obviously higher than that in the untreated group (P<0.01). The pathological morphological changes in the SSNR-treated group and the benazepril-treated group were both alleviated. There was no significant difference in therapeutic effect between the SSNR-treated group and the benazepril-treated group. CONCLUSION: Shenshuning Recipe can up-regulate the expression of HGF mRNA, decrease the mesangial matrix, and improve the renal function, so that it may retard the development of glomerulosclerosis.