Background The prevalence and epidemiology of pre-treatment drug resistance (PDR) and acquired drug resistance (ADR) among HIV-infected individuals vary considerably in different regions of China. Both types of drug resistance have adverse effects on the antiviral treatment outcomes for patients, potentially exacerbating their poor prognosis. Currently, there is a paucity of research on the prevalence and epidemiology of PDR and ADR among HIV-infected individuals in Southwest China. Objective This study investigated the prevalence and epidemiology of pre-treatment drug resistance and acquired drug resistance among people living with HIV (PLWH) in Southwest China. Methods This was a large cross-sectional study that enrolled PLWH who visited Guiyang Public Health Clinical Center between January 1, 2021, and June 30, 2023, and underwent drug resistance gene testing. HIV-1 genotype and drug resistance were analyzed using HIV-1 pol sequence. The Stanford University HIV Drug Resistance Database was used to analyze major drug resistance mutations in the reverse transcriptase and protease Sanger sequences. Risk factors associated with pre-treatment drug resistance were evaluated using a Logistic regression model. Results A total of 1 613 individuals were included in the study, with 824 ART-naive and 789 ART-experienced. The most common genotype among ART-naive patients was B+C (47.0%), and the drug resistance rate was 18.7% (154/824) with non-nucleoside reverse transcriptase inhibitors (NNRTIs) accounting for 14.9% (123/824), nucleoside reverse transcriptase inhibitors (NRTIs) accounting for 1.7% (14/824), protease inhibitors (PIs) accounting for 2.7% (22/824), and integrase strand transfer inhibitors (INSTIs) accounting for 1.9% (16/824). Among the ART-experienced patients, the most common genotype was CRF01-AE (37.4%), with a drug resistance rate of 27.8% (219/789). The mutation rates for NNRTIs, NRTIs, PIs, and INSTIs were 7.7% (61/789), 19.3% (152/789), 2.7% (21/789), and 1.1% (9/789), respectively. Furthermore, multivariate Logistic regression modeling revealed that transmission route, CD4+ T-cell count, viral load, and the time interval between diagnosis and ART initiation were associated with an increased risk of pre-treatment drug resistance (P<0.05) . Conclusion The incidence of pre-treatment drug resistance and acquired drug resistance mutations among PLWH in Southwest China is relatively high, 18.7% and 27.8% respectively. Transmission route, CD4+ T-cell count, viral load, and the time interval between diagnosis and ART initiation are associated with an increased risk of pretreatment drug resistance. Therefore, to prevent the development of resistance, there is an urgent need for routine baseline genotypic resistance testing and adequate intervals for viral load monitoring.

BackgroundThe frequency of low-level viremia (LLV) may vary across China. This study aims to analyze the epidemiological characteristics and related factors of LLV among HIV/AIDS patients in Guizhou Province from 2016 to 2022, and further analyze the impact of LLV on virological failure (VF).Research design and methodsIn this retrospective cohort study, we analyzed people living with HIV/AIDS whose demographic data, CD4+ T lymphocyte count, and viral load. LLV was defined as at least one VL measurement between 50 and 999 copies/mL after ART. Viral suppression refers to the maintenance of a VL < 50 copies/mL after undergoing ART. VF was defined as a VL ≥ 1,000 copies/mL after ART. To examine and compare the incidence of LLV at different levels, this study divided LLV into three groups based on previous research definitions: low-level LLV (LLLV) ranging from 50 to 199 copies/mL, medium-level LLV (MLLV) ranging from 200 to 399 copies/mL, and high-level LLV (HLLV) ranging from 400 to 999 copies/mL. LLV occurrence frequency was divided into two groups: intermittent LLV (iLLV) was defined as one independent LLV with both the previous and the subsequent viral load below the lower limit of detection. Persistent LLV (pLLV) was defined as at least two consecutive episodes of LLV. We divided the people living with HIV/AIDS into two sub-cohorts based on whether they experienced LLV. Non-LLV was defined as never having experienced LLV. We compared the occurrence of LLV at different levels and frequencies, as well as the risk of virological failure (VF), using the Chi-square test. Non-conditional binary logistic regression analysis was used to identify factors influencing LLV.ResultsIn total, 28,613 cases of infection were analyzed, with 33.72% (9,649/28,613) exhibiting LLV. The LLV proportion rates were 20.69, 6.50, and 6.48% in the low-level LLV (LLLV) (50–199 copies/mL), medium-level LLV (MLLV) (200–399 copies/mL), and high-level LLV (HLLV) (400–999 copies/mL) groups, respectively. The intermittent LLV (iLLV) and persistent LLV (pLLV) groups had LLV rates of 28.65 and 5.07%, respectively. The VF rates were 6.18, 11.79, and 13.70% in the LLLV, MLLV, and HLLV groups, respectively (p < 0.001). The iLLV and pLLV groups had VF rates of 8.82 and 8.14%, respectively (p = 0.397). Multivariate logistic regression analysis revealed that the gender, ethnicity, age at antiretroviral therapy initiation, baseline CD4+ T lymphocyte count, and current treatment regimen were factors influencing the occurrence of LLV.ConclusionThe incidence of LLV among people living with HIV/AIDS treated with INSTI-sparing regimens in Guizhou Province is relatively high and is mainly influenced by factors such as age, CD4+ T lymphocyte count and treatment regimens. A comprehensive assessment of these factors is essential to implement targeted interventions that prevent LLV and enhance the effectiveness of antiretroviral therapy.

Objective The aim of the study is to investigate the clinical characteristics of AIDS-related progressive multifocal leukoencephalopathy.Methods We enrolled 15 patients in the Infection Department of Guiyang Public Health Treatment Center from May 2021 to May 2022.The patients were diagnosed as AIDS-related progressive multifocal leukoencephalopathy by metagenomic nextgeneration sequencing.Furthermore,PCR and flow cytometry were used to detect HIV RNA level and CD4 + T lymphocyte cell counts in peripheral blood,respectively.Meanwhile,metagenomic next-generation sequencing was used to detect JCV DNA in cerebrospinal fluid.Moreover,we also retrospectively analyzed the clinical symptom,magnetic resonance imaging findings,treatment,and clinical outcomes of15 individuals.Results Among the 15 AIDS-related PML patients,there were 12 males and 3 females.The age was （40.8±11.45） years.The median CD4 + T lymphocyte count was 59 （36.5,131.0）/μl,and the median CD4 + T/CD8 + T ratio was 0.14 （0.06,0.29）.The minimum HIV RNA is less than the lower limit of the monitoring value,and the maximum is 1.21×10~6 copies/ml.The number of JCV DNA sequences in cerebrospinal fluid ranged from 1 to 12 950,with a median of 94.The range of glasgow coma scale:9-15;The median time from diagnosis of HIV infection to diagnosis of PML was 30 （29.5,65.0） days.Overall median survival time was 195 （59.5,330.0） days.The median survival time of patients who died was 21 （19.0,46.0） days.The median survival time was 237.5 （39.75,309.75） days for patients using DTG-based and 189.0 （120.0,387.0） days for patients using other antiretroviral therapy regimens.The clinical manifestations were contralateral limb weakness and dyskinesia in 6 cases,ataxia in 3 cases,speech ambiguity in 3 cases,blurred vision in 2 cases,and memory loss in 1 case.Nuclear magnetic resonance manifestation:Abnormal signal shadow can be found anywhere.Among the 15 patients,1 patient was lost to follow-up,5 patients died,and the remaining 9 patients survived.Among surviving patients,4 patients had improved symptoms,4 patients progressed and worsened,and 1 patient did not improve.Conclusions Based on the clinical manifestations,routine cerebrospinal fluid test results and imaging findings,the application of metagenomic next-generation sequencing of cerebrospinal fluid is helpful for the diagnosis of PML.Furthermore,the effectively,early and regular antiviral therapy can improve the prognosis of patients.

艾滋病可导致人体免疫功能缺陷,易合并机会性感染及肿瘤,增加住院风险、延长住院时间,严重的有死亡风险,因此无论是在社会层面,还是在个人层面,都应加强对艾滋病的科普力度和重视程度,从根源上杜绝艾滋病的感染风险,强化艾滋病的预防措施.为了缓解艾滋病的感染危害及风险,应抓紧在社会层面建立起切实有效的艾滋病干预感控模式,例如政府部门积极宣传健康知识、社区派发艾滋病科普单、免费派发避孕套等.

目的:了解贵阳市人类免疫缺陷病毒(HIV)暴露后预防门诊就诊者艾滋病的知信行(KAP)现状,并探讨其影响因素,为艾滋病随访门诊开展相关健康教育工作提供基础数据.方法:选择 2019 年 6 月至 2020 年 6 月在贵阳市公共卫生救治中心艾滋病随访门诊寻求HIV暴露后预防的就诊者1000 例作为研究对象,对暴露后就诊者的人口学特征和艾滋病相关知识、信念(态度)、行为两部分内容以及获得相关艾滋病知识的途径进行调查.结果:1000 例研究对象对艾滋病知识的总体知晓率为 91.5％;不同年龄、文化程度、暴露途径及婚姻状况人群对艾滋病知识的知晓率对比差异有统计学意义(P＜0.05),不同性别、职业、月收入及民族人群对艾滋病知识的知晓率对比差异无统计学意义(P＞0.05).研究对象艾滋病知识的获取途径包括互联网、电视、宣传材料和医务人员、咨询服务等.1000例就诊者艾滋病相关积极态度总体持有率为 70.2％,艾滋病相关健康行为总体形成率为 67.1％;通过多因素logistic回归分析,结果显示就诊者年龄、文化程度是其知识、信念(态度)、行为的主要影响因素(P＜0.05).结论:需加大随访门诊HIV暴露后预防就诊者艾滋病健康教育宣教力度,促进高危人群持有积极的信念(态度),采取健康的生活方式,减少HIV的传播,从而对艾滋病进行有效防控.

目的 研究 53 例艾滋病伴马尔尼菲篮状菌(TM)感染患者的临床特点.方法 回顾性分析 53 例艾滋病合并TM感染患者的临床资料,总结其临床特点、治疗及转归情况.结果 艾滋病合并TM感染患者以男性居多,农村患者多于城镇,大部分患者均经抗病毒治疗.53 例患者均存在不同程度发热,咳嗽 47 例,消瘦 39 例,乏力 29 例,皮疹 20 例;实验室检查显示多数患者白细胞、粒细胞、淋巴细胞、嗜酸粒细胞、血小板减少,中性粒细胞百分比、降钙素原升高及贫血均较多.所有患者血培养均培养出TM.53 例患者中,孢子菌肺炎 24 例应用磺胺甲噁唑治疗,巨细胞病毒感染 10 例采用更昔洛韦抗病毒治疗,真菌感染 47 例使用伊曲康唑治疗.23 例患者好转出院,28 例患者自动出院,2 例死亡.结论 艾滋病合并TM感染主要表现为发热,还可伴有其他症状,也有血细胞减少及肝功能异常的情况,好发于CD4+淋巴细胞计数较低的患者,两性霉素B静脉滴注效果良好.

COVID-19 appears to put people living with HIV and AIDS (PLWHA) at a higher risk of catastrophic consequences and mortality. However, investigations on the hesitancy and vaccination behavior of PLWHA in China were lacking compared to the general population. From January 2022 to March 2022, we conducted a multi-center cross-sectional survey of PLWHA in China. Logistic regression models were used to examine factors associated to vaccine hesitancy and COVID-19 vaccine uptake. Among 1424 participants, 108 participants (7.6%) were hesitant to be vaccinated while 1258 (88.3%) had already received at least one dose of the COVID-19 vaccine. Higher COVID-19 vaccine hesitancy was associated with older age, a lower academic level, chronic disease, lower CD4+ T cell counts, severe anxiety and despair, and high perception of illness. Lower education level, lower CD4+ T cell counts, and significant anxiety and depression were all associated with a lower vaccination rate. When compared to vaccinated participants, those who were not hesitant but nevertheless unvaccinated had a higher presence of chronic disease and lower CD4+ T cell count. Tailored interventions (e.g. targeted education programs) based on these linked characteristics were required to alleviate concerns for PLWHA in promoting COVID-19 vaccination rates, particularly for PLWHA with lower education levels, lower CD4+ T cell counts, and severe anxiety and depression.

To assess the prevalence and exacerbating factors of intimate partner violence in people with human immunodeficiency virus (PWH) in China, we conducted a cross-sectional study, involving 2792 PWH in 4 provinces in China from 1 September 2020 to 1 June 2021. The categories of intimate partner violence (IPV) included physical violence, sexual violence, emotional abuse, and controlling behavior. The severity of a violent act was divided into mild, moderate, and severe. Among PWH, the prevalence of IPV was 15.4% (95% confidence interval, 14.1%-16.8%). The severity of physical violence was mainly moderate, and the severity of sexual violence, emotional abuse, and controlling behavior was mainly mild. The prevalence of IPV in men was higher than that in women. Results from the multivariable logistic regression showed that age, ethnic, registered residence, education, and duration of HIV antiretroviral therapy were factors related to IPV in PWH (P < .05).

Background The promotion of use of antiretroviral therapy (ART) prolongs the life expectancy of people living with HIV. But age-related diseases are increasingly common, and the risks of opportunistic infections, coinfections and poor health condition are also increased significantly in this group, resulting in high medical costs and heavy economic burden. However, there are few studies on the household economic burden of HIV/AIDS patients. Objective To investigate the household economic burden in HIV/AIDS patients and associated factors in four regions (Beijing, Henan, Guizhou and Anhui) of China. Methods From December 2020 to May 2021, by use of typical sampling, three medical institutions (one in Beijing, another in Guizhou and another in Anhui) , and a center for disease control and prevention (located in Henan) were selected, where HIV/AIDS patients who received health services in 2020 were chosen by convenient sampling. A questionnaire developed by our research team was used to collect information on the patients' sociodemographic and economic features, disease-related conditions, and treatment. Household economic burden was defined as ratio of out-of-pocket medical expenses to annual household income (OME/AHI) in 2020 exceeded 25%. Results A total of 1 446 patients were included. The patients were classified into two major groups by the OME/AHI ratio: ≤1% group (n=400, 27.7%) , and >1%-5% group (n=418, 28.9%) . Two hundred and thirty-seven cases (16.4%) had household economic burden. The prevalence of household economic burden differed significantly by region, sex, age, marital status, education level, occupation, urban or rural hukou, floating or permanent population, type of medical insurance, annual household income level, route of infection, CD4+ T cell count level, and type of medical treatment (P<0.001) . Stepwise multinomial Logistic regression analysis revealed the following: women had higher risk of household economic burden than men〔OR (95%CI) =1.729 (1.050, 2.853) 〕; Sixty-five-year-olds and above had higher risk of household economic burden than 18-24-year-olds〔OR (95%CI) =3.445 (1.188, 10.227) 〕; The divorced had higher risk of household economic burden than those unmarried〔OR (95%CI) =2.241 (1.073, 4.678) 〕; Public institution employees had lower risk of household economic burden than housekeepers, jobseekers, or those unemployed〔OR (95%CI) =0.287 (0.081, 0.898) 〕; Individuals with low〔OR (95%CI) =29.614 (12.348, 79.211) 〕 or low-to-middle annual household income〔OR (95%CI) =3.556 (1.471, 9.428) 〕 had higher risk of household economic burden compared with those with high annual household income; Heterosexual individuals had lower risk of household economic burden than homosexual individuals〔OR (95%CI) =0.356 (0.186, 0.670) 〕; ART non-recipients had lower risk of household economic burden than ART recipients〔OR (95%CI) =0.241 (0.055, 0.835) 〕; Individuals with CD4+ T cell count 201-350 cells/μl〔OR (95%CI) =2.347 (1.237, 4.515) 〕 or ≤200 cells/μl〔OR (95%CI) =2.365 (1.200, 4.702) 〕 had higher risk of household economic burden compared with those with CD4+ T cell count >500 cells/μl; Inpatient service recipients〔OR (95%CI) =12.492 (5.592, 27.818) 〕, and both outpatient and inpatient services recipients〔OR (95%CI) =23.69 (14.519, 39.933) 〕 had higher risk of household economic burden compared with outpatient service recipients. Conclusion HIV/AIDS patients had relatively low OME/AHI ratio generally, but some of them had household economic burden. Factors associated with household economic burden may include sociodemographic and economic factors such as sex, age, marital status, occupation, annual household income, and features related to HIV/AIDS and treatment such as route of infection, use of ART treatment, CD4+ T cell count level, and type of medical treatment. To tangibly reduce the household economic burden of in this group, more attention should be paid to women, the elderly, those with very poor condition or low annual household income. Besides, it is essential to continue to implement and improve relevant medical insurance policies.

隐球菌性脑膜炎是艾滋病患者最常见的机会性感染之一。早期诊断和积极治疗是改善艾滋病合并隐球菌性脑膜炎患者预后的关键，本文针对艾滋病合并隐球菌性脑膜炎的病原学、发病机制、流行病学、诊断、实验室检查、临床表现、影像学表现及治疗等方面的临床研究进行综述，以期为临床医生提供参考。

目的 分析SF-12量表评价我国接受ART的HIV/AIDS患者生存质量的信度和效度.方法 采用方便抽样选取北京、河南、贵州和安徽接受ART的HIV/AIDS患者,使用自行设计的调查表和SF-12量表收集患者一般情况和生存质量.使用Cronbach's α系数和Spearman-Brown系数评价量表的信度.利用探索性因子分析方法提取2个公因子作为生理健康总分和心理健康总分,将8个维度与生理健康总分和心理健康总分间的相关性分为高度、中度和低度相关,评价结构效度.通过分析患者CD4细胞数和生存质量得分的关系评价效标效度.通过比较条目与所属维度及其他维度的相关系数大小评价集合效度和区分效度.结果 SF-12量表的Cronbach's α系数为0.857,Spear-man-Brown系数为0.849.探索性因子分析结果显示,除情感职能和社会功能外,其余维度与生理健康总分和心理健康总分的相关性与SF-36一致.除生理健康总分外,患者CD4细胞数水平越高,8个维度得分和心理健康总分越高.量表12个条目与所属维度的相关系数均＞0.400,且均大于该条目与其他维度的相关系数.结论 SF-12量表用以评价我国接受ART的HIV/AIDS患者生存质量的信效度良好,可推广应用于测量我国HIV/AIDS患者的生存质量.

Objectives To estimate anaemia prevalence and the associated factors among hospitalised people living with HIV (PLHIV) receiving antiretroviral therapy (ART).Design A cross-sectional study.Setting PLHIV receiving ART and hospitalised in a specialised hospital for infectious disease in Guizhou Province, Southwest China, between 1 January 2018 and 31 March 2021.Participants A total of 6959 hospitalised PLHIV aged ≥18 years and receiving ART were included in this study.Primary and secondary outcome measures Anaemia was diagnosed as a haemoglobin concentration <120 g/L for non-pregnant females and <130 g/L for males. Mild, moderate and severe anaemia were diagnosed as below the gender‐specific lower limit of normal but ≥110 g/L, 80–110 g/L and <80 g/L, respectively.Results The prevalence of anaemia was 27.5%, and that of mild, moderate and severe anaemia was 9.2%, 12.2% and 6.1%, respectively. Results from multivariate logistic regression showed that females had increased odds of anaemia (adjusted OR (aOR)=1.60, 95% CI: 1.42 to 1.81) compared with males. Widowed or divorced inpatients (anaemia: aOR=1.26, 95% CI: 1.08 to 1.47; severe anaemia: aOR=1.52, 95% CI: 1.16 to 1.97) and thrombocytopenia inpatients (anaemia: aOR=4.25, 95% CI: 3.54 to 5.10; severe anaemia: aOR=4.16, 95% CI: 3.24 to 5.35) had increased odds of anaemia and severe anaemia compared with their counterparts. Hepatitis C was associated with increased odds of severe anaemia (aOR=1.80, 95% CI: 1.11 to 2.92).Conclusions Anaemia was prevalent among hospitalised PLHIV. Female sex, those widowed or divorced, and thrombocytopenia were associated with increased odds of anaemia, and those widowed or divorced, thrombocytopenia and hepatitis C were associated with increased odds of severe anaemia. Determination of anaemia predictors, early detection and timely management of anaemia are crucial to prevent anaemia progression.

目的 分析获得性免疫缺陷综合症(AIDS)合并隐球菌性脑膜炎(CM)患者预后影响因素.方法 137例AIDS合并CM患者根据随访结束时的生存状况分为生存组及死亡组,采用单因素方差分析两组患者的年龄、性别、影像学检查(胸部CT、头颅CT或MRI)、临床症状(头痛、发热、呕吐及意识障碍)、血常规、C反应蛋白、红细胞沉降率、降钙素原、血(1,3)-β-D葡聚糖、细菌内毒素、血液隐球菌抗原(CrAg)阳性率、CD4+T淋巴细胞、HIV病毒载量、脑脊液氯化物、脑脊液葡萄糖及脑脊液蛋白的差异,将有差异的因素(P<0.05)纳入COX比例风险回归模型,确定AIDS合并CM的独立预后影响因素;采用Kaplan-Meier法测定患者生存率,Log-rank检验各影响因素差异的显著性.结果 137例AIDS合并CM患者中,生存组111例、死亡组26例,单因素分析显示患者年龄、CD4+T淋巴细胞、HIV病毒载量、血(1,3)-β-D葡聚糖及血液CrAg阳性是AIDS合并CM患者预后影响因素(P<0.05);多因素COX回归分析显示患者年龄(HR=4.375,95％CI为1.855～10.319,P=0.001)、CD4+T淋巴细胞(HR=4.110,95％CI为2.351～12.553,P=0.013)、HIV病毒载量(HR=5.040,95％CI为1.119～22.699,P=0.035)及血液CrAg阳性(HR=8.135,95％CI为2.353～26.113,P=0.001)是AIDS合并CM独立预后影响因素;Log-rank检验及Kaplan-Meier生存曲线图显示患者年龄≥50岁、CD4+T淋巴细胞<50个/μL、HIV病毒载量≥1×107拷贝/L及血液CrAg阳性可导致AIDS合并CM患者生存率明显下降(P<0.05).结论 年龄、CD4+T淋巴细胞、HIV病毒载量、及血液CrAg阳性是影响AIDS合并CM独立预后影响因素.

目的:探讨血浆(1-3)-β-D葡聚糖对获得性免疫缺陷综合症(Acquired Immune Defi-ciency Syndrome,AIDS)合并隐球菌性脑膜炎(Cryptococcal meningitis,CM)患者预后评估的价值.方法:回顾性分析2015年1月1日至2020年12月31日贵阳市公共卫生救治中心收治的66例AIDS合并CM患者的临床病例资料,按照1年内生存状况分为生存组(56例)和死亡组(10例),收集两组患者性别、年龄、传播途径、临床症状(头痛、发热、呕吐及意识障碍),头颅影像学检查、入院时实验室检查(CD4+T淋巴细胞计数、血浆HIV-RNA病毒载量、外周血血红蛋白、外周白细胞计数、外周血中性粒细胞计数、C反应蛋白、血沉、PCT、脑脊液葡萄糖、脑脊液氯化物及脑脊液蛋白、脑脊液培养、脑脊液涂片、血液隐球菌培养、血浆(1-3)-β-D葡聚糖浓度)及抗真菌治疗后第一次血浆(1-3)-β-D葡聚糖浓度.多因素Logistic回归分析AIDS合并CM患者死亡危险因素.受试者工作特征曲线ROC分析血浆(1-3)-β-D葡聚糖浓度预测AIDS合并CM患者死亡的价值.结果:单因素分析显示PCT、CD4+T淋巴细胞、血浆(1-3)-β-D葡聚糖浓度是AIDS合并CM患者死亡危险因素(P均<0.05).多因素Logistic回归分析显示高浓度血浆(1-3)-β-D葡聚糖是AIDS合并CM患者独立死亡危险影响因素(P<0.05).ROC曲线分析显示,抗真菌治疗前血浆(1-3)-β-D葡聚糖为65.63pg/mL时患者死亡的曲线下面积最大(0.787,95％CI 0.665～0.910),其敏感度和特异度较高(分别为90.0％和62.5％,P<0.05).结论:血浆(1-3)-β-D葡聚糖对AIDS合并CM患者预后具有较高的评估价值,当血浆(1-3)-β-D葡聚糖>65.63pg/mL提示患者死亡风险高.

肝衰竭是多种因素引起的严重肝脏损害,导致其合成、解毒、排泄和生物转化等功能发生严重障碍或失代偿,出现以凝血功能障碍、黄疸、肝性脑病、腹水等为主要表现的一组临床症候群,药物是引起肝衰竭的常见原因,目前宿主免疫在肝衰竭发病中的作用已被广泛认可[1].

目的 研究降钙素原(PCT)、白细胞介素-6(IL-6)及超敏C-反应蛋白(hs-CRP)对肺结核合并肺部细菌感染的诊断价值.方法 选取2017年1月-2018年1月于贵阳市公共卫生救治中心就诊的60例肺结核合并肺部普通细菌感染患者作为研究组,选取同期60例肺结核无肺部普通细菌感染患者作为对照组,同时根据急性生理学和慢性健康评价(APACHEⅡ)评分将研究组患者分为重症患者和非重症患者.检测患者血清中PCT、hs-CRP、IL-6浓度,对比PCT、hs-CRP、IL-6检测的特异度和灵敏度,评估其对肺结核合并肺部普通细菌感染的诊断效果.结果 研究组的PCT、hs-CRP、IL-6分别为(1.78±0.97)ng/ml、(26.23±7.86)mg/L、(31.14±8.65)pg/ml高于对照组(P<0.05),重症患者PCT、hs-CRP、IL-6分别为(2.42±0.48)ng/ml、(34.65±8.34)mg/L、(33.55±7.69)pg/ml高于非重症患者(P<0.05).PCT检测的特异度为96.67％ 高于IL-6、hs-CRP(P<0.05),hs-CRP检测的敏感度为95.00％ 高于IL-6、PC T(P<0.05),三者联合检测时,检测的敏感度和特异度为95.00％ 和96.67％ 均升高(P<0.05).结论 PCT、hs-CRP、IL-6对于肺结核合并肺部普通细菌感染有较高的诊断价值,联合应用可提高检测的敏感度和特异度.

ObjectiveTo investigate the distribution of HCV genotypes in 383 patients with HIV/HCV coinfection in Guizhou, China and the effect of coinfection on HIV viral load, CD4+ T lymphocytes, and platelet count (PLT), and to provide a basis for individualized treatment of patients with HIV/HCV coinfection. MethodsRelated clinical data were collected from 383 patients with HIV/HCV coinfection who were treated in Guiyang Public Health Clinical Center from March 2015 to December 2019, and HCV genotype, HIV viral load, CD4+ T lymphocytes, and PLT were determined. A total of 1068 patients with HIV alone were enrolled as control. The Kruskal-Wallis H test was used for comparison between multiple groups, the Wilcoxon rank-sum test was used for comparison between two groups, and the Bonferroni method was used for further comparison between two groups; the chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups. ResultsAmong the 4664 patients with HIV infection, 383 (8.21%) had HCV coinfection, and the main HCV genotypes were genotype 6a (35.51%), genotype 3b (27.42%), and genotype 1b (21.41%), followed by genotypes 3a (1332%), 1a (1.31%), 2a (0.52%), 6n (0.26%), and 6xa (0.26%). The most common route of infection was intravenous drug addiction (72.59%), followed by sexual contact (24.80%). Compared with the patients with HIV infection alone, the patients with HIV/HCV coinfection had a significantly higher HIV RNA load and significantly lower CD4+ T lymphocytes and PLT (Z=6.716, 11.813, and 9.192, all P＜0.05). Among the patients with coinfection, the patients with HCV genotype 3b had the highest HIV RNA load and the lowest CD4+ T lymphocytes and PLT, while the patients with HCV genotype 1a had the lowest HIV RNA load and the highest CD4+ T lymphocytes (all P＜0.05). Among the patients with different clinical stages, the patients with compensated cirrhosis had the highest HIV RNA load, the patients with chronic hepatitis C had the lowest HIV RNA load, the patients with end-stage liver disease had the lowest count of CD4+ T lymphocytes, and the patients with chronic hepatitis C had the highest PLT (all P＜0.05). ConclusionThe distribution of HCV genotypes is diverse in the patients with HIV/HCV coinfection in Guizhou, and HCV strains with genotypes 6a, 3b, and 1b are the main epidemic strains. Intravenous drug addiction is the main route of infection. Coinfection may affect HIV replication and immune status, with a significantly marked effect on HCV genotype 3b and liver cirrhosis or end-stage liver disease.

<span id="ChDivSummary" name="ChDivSummary" class="abstract-text">目的调查贵州省农村结核病社会支持情况,并了解其影响因素。方法 2016年9月—2017年4月以随机抽样法调查贵州省农村2 500例结核病患者并发放社会支持评定量表（SSRS）,收回2 418份（96.72%）,并分析不同因子下社会支持情况及其各因子对社会支持影响。结果患者SSRS总分为（34.74±4.69）分,其中主观支持为（17.64±3.17）分,客观支持为（10.04±1.52）分,对支持利用度为（7.06±1.57）分;不同年龄、年收入、医疗报销比例、耐药SSRS评分比较差异无统计学意义（P&gt; 0.05）,不同性别、学历、婚姻、职业、痰涂片比较差异具有统计学意义（P &lt;0.05）;性别、学历、婚姻、职业、痰涂片是影响患者社会支持主要因素（P &lt;0.05）。结论贵州省农村结核病社会支持尚可,关注重点人群给予充分社会支持。</span>

目的 本文主要针对纤维支气管镜肺泡灌洗术治疗小儿感染致肺不张效果进行研究,希望能在促进患者治疗效果的前提下,为各医院研究小儿感染致肺不张治疗的实验提供更多的参考资料.方法 选取2017年1月～2018年12月本院收治的小儿感染致肺不张患者62例作为研究对象,对照组使用常规输液抗感染治疗,观察组在该基础上同时采用纤维支气管镜下行,支气管肺泡灌洗进行治疗,最终通过比较两组患者的治疗效果,并发症发生率,以及治疗满意度的各项指标来分析纤维支气管镜肺泡灌洗术的临床治疗效果.结果 本次研究收集到的所有数据均真实有效,差异有统计学意义(P<0.05),通过对收集到的所有数据进行分析之后,我们发现使用纤维支气管镜肺泡灌洗技术对患者进行具体的治疗操作,能够改善患者感染情况和肺不张情况,同时对于患者治疗满意度,以及最终治疗效果等各项指标中的数据也能进行优化.结论 使用两种不同的治疗方式对小儿感染致肺不张疾病进行治疗,可发现纤维支气管镜行肺泡灌洗术具有较高的临床价值,它能促进疾病的治疗,见效快,治愈率高,值得在医学临床推广.