The overuse of injection exists more than 20 years since economic reform in China.It is a persistent problem and seems becoming a new challenge in the new health reform period.This study was designed to assess the eff...The overuse of injection exists more than 20 years since economic reform in China.It is a persistent problem and seems becoming a new challenge in the new health reform period.This study was designed to assess the effect of national essential medicines policy(NEMP) on injection use at primary health facilities in China by investigating their prescription information.Questionnaires were designed and disseminated to collect empirical data on injection use at 120 primary health facilities in 6 provinces from January to September in 2010 and 2011.The injection use was measured as the indicator as the percentage of prescriptions with one or more injections.The results showed that the percentage of prescriptions with one or more injections was decreased from 38.91% to 36.82%(2 =11.158,P=0.001) in the all survey areas during the NEMP reform.The difference in level of the injection use in 2011 was significant among the eastern,central and western regions(2 =223.584,P=0.000);level of the injection use in western region was the lowest(27.73%),while that in the central region was the highest(43.10%).The level of the injection use in 2011 among different provinces was also of great difference(26.00%-58.25%,range:32.25%).The level of the injection use in 2011 was still much higher than the standard suggested by WHO for developing countries(13.4%-24.1%).It was concluded that NEMP has improved injection use in China,but the injection abuse situation remains serious,indicating that one of the priorities to the next stage of NEMP is to promote the rational use of drugs,especially the injection use.展开更多
After nearly three decades of being virtually drug free, use of heroin and other illicit drugs has re-emerged in China as a major public health problem. One result is that drug abuse, particularly heroin injection, ha...After nearly three decades of being virtually drug free, use of heroin and other illicit drugs has re-emerged in China as a major public health problem. One result is that drug abuse, particularly heroin injection, has come to play a predomi- nant role in fueling China’s AIDS epidemic. The first outbreak of HIV among China’s IDUs was reported in the border area of Yunnan province between China and Myanmar where drug trafficking is heavy. Since then drug-related HIV has spread to all 31 provinces, autonomous regions and municipalities. This paper provides an overview to HIV/AIDS transmission through injection drug use in China. It begins with a brief history of the illicit drug trade in China, followed by a discussion of the emergence of drug related AIDS, and a profile of drug users and their sexual partners who have contracted the virus or who are vulnerable to infection. It ends by summarizing three national strategies being used by China to address both drug use and AIDS as major health threats.展开更多
BACKGROUND: Inadvertent intra-arterial injection of illicit substances is a known complication of injection drug use and can lead to severe complications, including infection, ischemia and compartment syndrome. Identi...BACKGROUND: Inadvertent intra-arterial injection of illicit substances is a known complication of injection drug use and can lead to severe complications, including infection, ischemia and compartment syndrome. Identifying complications of intra-arterial injection can be difficult, as clinical manifestations overlap with other more common conditions such as cellulitis and soft tissue infection, and a history of injection drug use is frequently not disclosed.METHODS: A 37-year-old male patient presented with 24 hours of right hand pain, erythema and swelling. Despite classic "track marks", he denied a history of injection drug use, and vascular insults were not initially considered. After failing to respond to three days of aggressive treatment for suspected deep-space infection, an arteriogram demonstrated findings consistent with digital ischemia of embolic etiology.RESULTS: As a result of the delay in diagnosis, the lesion was not amenable to reperfusion and the patient required amputation of the distal digit.CONCLUSION: Practitioners should be alert to the possibility of intra-arterial injection and resulting complications when evaluating unusual extremity infections or unexplained ischemic symptoms, even in the absence of a definite history of injection drug use.展开更多
Objective The mode of human immunodeficiency virus(HIV) transmission via injection drug use(IDU)still exists, and the recent shift in IDU-related transmission of HIV infection is largely unknown. The purpose of this s...Objective The mode of human immunodeficiency virus(HIV) transmission via injection drug use(IDU)still exists, and the recent shift in IDU-related transmission of HIV infection is largely unknown. The purpose of this study was to analyze the spatiotemporal sources and dynamics of HIV-1 transmission through IDU in Guangxi.Methods We performed a molecular epidemiological investigation of infections across Guangxi from2009 to 2019. Phylogenetic and Bayesian time-geographic analyses of HIV-1 sequences were performed to confirm the characteristics of transmission between IDUs in combination with epidemiological data.Results Among the 535 subjects, CRF08_BC(57.4%), CRF01_AE(28.4%), and CRF07_BC(10.7%) were the top 3 HIV strains;72.6% of infections were linked to other provinces in the transmission network;93.6% of sequence-transmitted strains were locally endemic, with the rest coming from other provinces,predominantly Guangdong and Yunnan;92.1% of the HIV transmission among people who inject drugs tended to be transmitted between HIV-positive IDUs.Conclusion HIV recombinants were high diversity, and circulating local strains were the transmission sources among IDUs in Guangxi. However, there were still cases of IDUs linked to other provinces.Coverage of traditional prevention strategies should be expanded, and inter-provincial collaboration between Guangxi, Yunnan, and Guangdong provinces should be strengthened.展开更多
Hepatitis A virus(HAV)is one of the most common infectious etiologies of acute hepatitis worldwide.The virus is known to be transmitted fecal-orally,resulting in symptoms ranging from asymptomatic infection to fulmina...Hepatitis A virus(HAV)is one of the most common infectious etiologies of acute hepatitis worldwide.The virus is known to be transmitted fecal-orally,resulting in symptoms ranging from asymptomatic infection to fulminant hepatitis.HAV can also be transmitted through oral-anal sex.Residents from regions of low endemicity for HAV infection often remain susceptible in their adulthood.Therefore,clustered HAV infections or outbreaks of acute hepatitis A among men who have sex with men and injecting drug users have been reported in countries of low endemicity for HAV infection.The duration of HAV viremia and stool shedding of HAV may be longer in human immunodeficiency virus(HIV)-positive individuals compared to HIV-negative individuals with acute hepatitis A.Current guidelines recommend HAV vaccination for individuals with increased risks of exposure to HAV(such as from injecting drug use,oral-anal sex,travel to or residence in endemic areas,frequent clotting factor or blood transfusions)or with increased risks of fulminant disease(such as those with chronic hepatitis).The seroconversion rates following the recommended standard adult dosing schedule(2doses of HAVRIX 1440 U or VAQTA 50 U administered6-12 mo apart)are lower among HIV-positive individuals compared to HIV-negative individuals.While the response rates may be augmented by adding a booster dose at week 4 sandwiched between the first dose and the 6-mo dose,the need of booster vaccination remain less clear among HIV-positive individuals who have lost anti-HAV antibodies.展开更多
Discovered in 1989, the hepatitis C virus (HCV) continues to cause signifi cant morbidity and mortality world-wide despite a huge research commitment to defining and understanding the virus and the disease it causes. ...Discovered in 1989, the hepatitis C virus (HCV) continues to cause signifi cant morbidity and mortality world-wide despite a huge research commitment to defining and understanding the virus and the disease it causes. This paper discusses a number of areas where progress in the management of the HCV have not kept pace with the scientifi c understanding of the HCV. It is suggested that in the fi elds of HCV prevention and providing access to treatment, practice falls short of what could be achieved. The role of alcohol in the pathogenesis of HCV liver injury is discussed. Discrimination against those with HCV infection and particularly those in prison settings fails to match good clinical practice. The complicated processes of sharing information between specialty groups is also discussed in an attempt to optimise knowledge dissemination in this field.展开更多
A method to generate the optical quadruple frequency millimeter-wave with high power efficiency is pro- posed and demonstrated based on the combination of the injection 2nd-order rational harmonic mode- locked fiber r...A method to generate the optical quadruple frequency millimeter-wave with high power efficiency is pro- posed and demonstrated based on the combination of the injection 2nd-order rational harmonic mode- locked fiber ring laser technique and the fiber grating notch filter. In this approach, the fiber Bragg grating notch filter is inserted into the laser cavity to prevent the undesired optical carrier, so that the pump power can be converted to 2nd-order harmonic wave more efficiently. In our experiment, the power efficiency of optical quadruple frequency millimeter-wave （40 GHz） generation is ten folds of that of our previous method based only on the rational harmonic mode-locked technique.展开更多
The authors reported 8 cases of solitaty eosinophilic granuloma of the skull proved by percutaneous aspiration biopsy and treated with local prednisolone injection under fluoroscopic guidance and palpation with excell...The authors reported 8 cases of solitaty eosinophilic granuloma of the skull proved by percutaneous aspiration biopsy and treated with local prednisolone injection under fluoroscopic guidance and palpation with excellent results.展开更多
基金supported by the National Natural Science Foundation of China (No. 71173082)
文摘The overuse of injection exists more than 20 years since economic reform in China.It is a persistent problem and seems becoming a new challenge in the new health reform period.This study was designed to assess the effect of national essential medicines policy(NEMP) on injection use at primary health facilities in China by investigating their prescription information.Questionnaires were designed and disseminated to collect empirical data on injection use at 120 primary health facilities in 6 provinces from January to September in 2010 and 2011.The injection use was measured as the indicator as the percentage of prescriptions with one or more injections.The results showed that the percentage of prescriptions with one or more injections was decreased from 38.91% to 36.82%(2 =11.158,P=0.001) in the all survey areas during the NEMP reform.The difference in level of the injection use in 2011 was significant among the eastern,central and western regions(2 =223.584,P=0.000);level of the injection use in western region was the lowest(27.73%),while that in the central region was the highest(43.10%).The level of the injection use in 2011 among different provinces was also of great difference(26.00%-58.25%,range:32.25%).The level of the injection use in 2011 was still much higher than the standard suggested by WHO for developing countries(13.4%-24.1%).It was concluded that NEMP has improved injection use in China,but the injection abuse situation remains serious,indicating that one of the priorities to the next stage of NEMP is to promote the rational use of drugs,especially the injection use.
文摘After nearly three decades of being virtually drug free, use of heroin and other illicit drugs has re-emerged in China as a major public health problem. One result is that drug abuse, particularly heroin injection, has come to play a predomi- nant role in fueling China’s AIDS epidemic. The first outbreak of HIV among China’s IDUs was reported in the border area of Yunnan province between China and Myanmar where drug trafficking is heavy. Since then drug-related HIV has spread to all 31 provinces, autonomous regions and municipalities. This paper provides an overview to HIV/AIDS transmission through injection drug use in China. It begins with a brief history of the illicit drug trade in China, followed by a discussion of the emergence of drug related AIDS, and a profile of drug users and their sexual partners who have contracted the virus or who are vulnerable to infection. It ends by summarizing three national strategies being used by China to address both drug use and AIDS as major health threats.
文摘BACKGROUND: Inadvertent intra-arterial injection of illicit substances is a known complication of injection drug use and can lead to severe complications, including infection, ischemia and compartment syndrome. Identifying complications of intra-arterial injection can be difficult, as clinical manifestations overlap with other more common conditions such as cellulitis and soft tissue infection, and a history of injection drug use is frequently not disclosed.METHODS: A 37-year-old male patient presented with 24 hours of right hand pain, erythema and swelling. Despite classic "track marks", he denied a history of injection drug use, and vascular insults were not initially considered. After failing to respond to three days of aggressive treatment for suspected deep-space infection, an arteriogram demonstrated findings consistent with digital ischemia of embolic etiology.RESULTS: As a result of the delay in diagnosis, the lesion was not amenable to reperfusion and the patient required amputation of the distal digit.CONCLUSION: Practitioners should be alert to the possibility of intra-arterial injection and resulting complications when evaluating unusual extremity infections or unexplained ischemic symptoms, even in the absence of a definite history of injection drug use.
基金National Natural Science Foundation of China [grant no. 82060610]National Natural Science Foundation of China [grant no. 82103899]+2 种基金Guangxi Scientific and Technological Key Project[Gui Ke AB19245038]Guangxi Scientific and Technological Key Project [Guike 2022AC23005, 2022AC20031,2022JJA141110]Science and Technology Project of Nanning [20223051]。
文摘Objective The mode of human immunodeficiency virus(HIV) transmission via injection drug use(IDU)still exists, and the recent shift in IDU-related transmission of HIV infection is largely unknown. The purpose of this study was to analyze the spatiotemporal sources and dynamics of HIV-1 transmission through IDU in Guangxi.Methods We performed a molecular epidemiological investigation of infections across Guangxi from2009 to 2019. Phylogenetic and Bayesian time-geographic analyses of HIV-1 sequences were performed to confirm the characteristics of transmission between IDUs in combination with epidemiological data.Results Among the 535 subjects, CRF08_BC(57.4%), CRF01_AE(28.4%), and CRF07_BC(10.7%) were the top 3 HIV strains;72.6% of infections were linked to other provinces in the transmission network;93.6% of sequence-transmitted strains were locally endemic, with the rest coming from other provinces,predominantly Guangdong and Yunnan;92.1% of the HIV transmission among people who inject drugs tended to be transmitted between HIV-positive IDUs.Conclusion HIV recombinants were high diversity, and circulating local strains were the transmission sources among IDUs in Guangxi. However, there were still cases of IDUs linked to other provinces.Coverage of traditional prevention strategies should be expanded, and inter-provincial collaboration between Guangxi, Yunnan, and Guangdong provinces should be strengthened.
文摘Hepatitis A virus(HAV)is one of the most common infectious etiologies of acute hepatitis worldwide.The virus is known to be transmitted fecal-orally,resulting in symptoms ranging from asymptomatic infection to fulminant hepatitis.HAV can also be transmitted through oral-anal sex.Residents from regions of low endemicity for HAV infection often remain susceptible in their adulthood.Therefore,clustered HAV infections or outbreaks of acute hepatitis A among men who have sex with men and injecting drug users have been reported in countries of low endemicity for HAV infection.The duration of HAV viremia and stool shedding of HAV may be longer in human immunodeficiency virus(HIV)-positive individuals compared to HIV-negative individuals with acute hepatitis A.Current guidelines recommend HAV vaccination for individuals with increased risks of exposure to HAV(such as from injecting drug use,oral-anal sex,travel to or residence in endemic areas,frequent clotting factor or blood transfusions)or with increased risks of fulminant disease(such as those with chronic hepatitis).The seroconversion rates following the recommended standard adult dosing schedule(2doses of HAVRIX 1440 U or VAQTA 50 U administered6-12 mo apart)are lower among HIV-positive individuals compared to HIV-negative individuals.While the response rates may be augmented by adding a booster dose at week 4 sandwiched between the first dose and the 6-mo dose,the need of booster vaccination remain less clear among HIV-positive individuals who have lost anti-HAV antibodies.
文摘Discovered in 1989, the hepatitis C virus (HCV) continues to cause signifi cant morbidity and mortality world-wide despite a huge research commitment to defining and understanding the virus and the disease it causes. This paper discusses a number of areas where progress in the management of the HCV have not kept pace with the scientifi c understanding of the HCV. It is suggested that in the fi elds of HCV prevention and providing access to treatment, practice falls short of what could be achieved. The role of alcohol in the pathogenesis of HCV liver injury is discussed. Discrimination against those with HCV infection and particularly those in prison settings fails to match good clinical practice. The complicated processes of sharing information between specialty groups is also discussed in an attempt to optimise knowledge dissemination in this field.
基金supported by the National "973" Program of China under Grant No. 2006CB302806
文摘A method to generate the optical quadruple frequency millimeter-wave with high power efficiency is pro- posed and demonstrated based on the combination of the injection 2nd-order rational harmonic mode- locked fiber ring laser technique and the fiber grating notch filter. In this approach, the fiber Bragg grating notch filter is inserted into the laser cavity to prevent the undesired optical carrier, so that the pump power can be converted to 2nd-order harmonic wave more efficiently. In our experiment, the power efficiency of optical quadruple frequency millimeter-wave （40 GHz） generation is ten folds of that of our previous method based only on the rational harmonic mode-locked technique.
文摘The authors reported 8 cases of solitaty eosinophilic granuloma of the skull proved by percutaneous aspiration biopsy and treated with local prednisolone injection under fluoroscopic guidance and palpation with excellent results.
