Glucose metabolism continuous deteriorating in male patients with human immunodeficiency virus accepted antiretroviral therapy for 156 weeks

BACKGROUND The dynamic characteristics of glucose metabolism and its risk factors in patients living with human immunodeficiency virus(PLWH)who accepted primary treatment with the efavirenz(EFV)plus lamivudine(3TC)plus tenofovir(TDF)(EFV+3TC+TDF)regimen are unclear and warrant investigation.AIM To study the long-term dynamic characteristics of glucose metabolism and its contributing factors in male PLWH who accepted primary treatment with the EFV+3TC+TDF regimen for 156 wk.METHODS This study was designed using a follow-up design.Sixty-one male treatmentnaive PLWH,including 50 cases with normal glucose tolerance and 11 cases with prediabetes,were treated with the EFV+3TC+TDF regimen for 156 wk.The glucose metabolism dynamic characteristics,the main risk factors and the differences among the three CD4+count groups were analyzed.RESULTS In treatment-naive male PLWH,regardless of whether glucose metabolism disorder was present at baseline,who accepted treatment with the EFV+3TC+TDF regimen for 156 wk,a continuous increase in the fasting plasma glucose(FPG)level,the rate of impaired fasting glucose(IFG)and the glycosylated hemoglobin(HbA1c)level were found.These changes were not due to insulin resistance but rather to significantly reduced isletβcell function,according to the homeostasis model assessment ofβcell function(HOMA-β).Moreover,the lower the baseline CD4+T-cell count was,the higher the FPG level and the lower the HOMA-βvalue.Furthermore,the main risk factors for the FPG levels were the CD3+CD8+cell count and viral load(VL),and the factors contributing to the HOMA-βvalues were the alanine aminotransferase level,VL and CD3+CD8+cell count.CONCLUSION These findings provide guidance to clinicians who are monitoring FPG levels closely and are concerned about IFG and decreased isletβcell function during antiretroviral therapy with the EFV+3TC+TDF regimen for long-term application.

Investigation and Analysis on the Physical and Mental Health Status of Intern Nurses in a Hospital,Gansu Province

Objective:To analyze the investigation results of mental health Symptom Checklist-90(SCL-90)of nursing interns(hereinafter referred to as nursing students)in a hospital in Gansu Province,to comprehensively and objectively understand the mental health status of nursing students,in order to provide the basis of maintaining and improving the mental health level of nursing students.Methods:Totally 121 nursing interns were surveyed using SCL-90,and statistical analysis was performed using SPSS19.0.Results:The mental health status of nursing students in a hospital in Gansu Province is higher than that of normal adults in China.The scores of the six factors(somatization,obsessive-compulsive symptoms,depression,anxiety,horror,and psychosis)are higher(P<0.01).Compared with the group norm,the four factors of somatization,obsessive-compulsive symptoms,terror,and anxiety are higher(P<0.01),but they are better than the mental health status of college students in China(except for somatic symptoms)(P<0.01).Conclusion:The mental health status of nursing students is poor and needs attention.Interventions can be taken to alleviate psychological problems of nursing students,thoroughly improve their anxiety and depression,and thus improve their health.