Background and objective: Early and accurate diagnosis is one of the critical requirements for successful management of all diseases. Yet, delayed diagnosis and misdiagnosis remain as vital problems, consequently impo...Background and objective: Early and accurate diagnosis is one of the critical requirements for successful management of all diseases. Yet, delayed diagnosis and misdiagnosis remain as vital problems, consequently impose adverse effects on patient treatment. Sexually transmitted disease (STD) is one of the most common infectious diseases, and more than one million of STD cases are acquired every day globally. Misdiagnosis of STD inevitably exists, therefore should not be overlooked. Being a medical diagnostic laboratory providing various STDs diagnosing service in Hong Kong, we aimed to determine the misdiagnosis rate of STDs and investigate the possible underlying cause. Methods: Specimens were collected for STD diagnosis from multiple clinics during 1 June 2021 to 20 October 2021 from different clinics and hospitals were included in the study. DNA extraction was performed using magnetic bead based method;then the extracted DNA was tested using the DiagCor GenoFlow<sup>TM</sup> STD Array kit to detect the existence of any targeted pathogens. Results: 1459 specimens were collected and included during the designated time period, with 643 specimens found to be positive with at least one targeted STD pathogen. 494 of these were found to be aligned with test ordered by physicians, and the remaining 149 positive cases had at least one pathogen detected but not requested to be tested by the physicians resulting in misdiagnosis. The overall misdiagnosis rate was determined to be 23.2% (149/643), with high frequency of misdiagnosis occurred to tests ordered for one to three pathogens detection. Also, Ureaplasma urealyticum and/or Ureaplasma parvum (UU/UP) was the commonest pathogen detected in this study. Conclusion: The findings suggested incorrect test selection made by physicians was one of the major reasons of STDs misdiagnosis in outpatient settings. To reduce diagnostic errors in STD diagnosis, physicians are encouraged to select and request test that allow detection of multiple pathogens, as co-infection of multiple pathogens in STD patients is commonly observed. The correct selection of test would not only benefit the patient, but also the public health.展开更多
Gyirong basin and its adjacent area are located at a special position in the Himalayan orogen, where the south Tibetan detachment system (STDS) and N-S trending rift converged. The north Himalayan orogen here can be d...Gyirong basin and its adjacent area are located at a special position in the Himalayan orogen, where the south Tibetan detachment system (STDS) and N-S trending rift converged. The north Himalayan orogen here can be divided into five petrologic-tectonic units successively from south to north: 1) the Greater Himalayan crystalline complex (GHC); 2) the STDS shear zone; 3) the Tethyan Himalayan sedimentary sequence (THS); 4) the late Cenozoic sedimentary basins, such as Gyirong and Oma basins; and 5) the Malashan gneiss dome. Structural studies show that this area experienced four stages of deformation: 1) the earlier south-directed thrusting, preserved both in the GHC and THS; 2) top-down-to-north slip along the STDS, normal faults related to this slip formed the early controlling structures of the Cenozoic basins,and the tilted pattern of the blocks between the basins indicated a north-directed slip; 3) east-west extension, the resultant N-S trending normal fault formed the eastern boundary of the basins; and 4) late gravitational collapse. Zircon SHRIMP U-Pb dating on the syn-deformational (leuco-) granite along the STDS indicates that the major activity of the STDS occurred at ca. 26 Ma, but its onset may have begun as early as ca. 36 Ma.展开更多
The Xainza-Dinggye Normal Fault System (XDNFS) is a large-scale nearly-north-south trending exten-sional structure across central and southern Tibet. Its middle segment developed in Tethys Himalaya with features of ea...The Xainza-Dinggye Normal Fault System (XDNFS) is a large-scale nearly-north-south trending exten-sional structure across central and southern Tibet. Its middle segment developed in Tethys Himalaya with features of earlier magmatic core complex and later normal faults dipping moderately to northwest-west. The magmatic core complex is made up by mylonitic leucogrante with a low-angle detachment fault on the top of it and overlain by lower-grade meta-sedimentary rocks. The structural pattern of the southern segment of XDNFS take the shape of a detachment fault dipping to southeast-east with the High-Himalayan rock series as the lower plate. The Southern Tibetan Detachment System (STDS) is expressed as a ductile shear zone composed of mylonitic leucogranite in the studied area of this note. STDS was cut by the later XDNFS, which presents that nearly-east-west striking STDS is not the controlling or adjusting structure of the nearly-north-south trending ex-tensional structures. The origin of展开更多
Background:Delayed or inappropriate treatment for sexually transmitted diseases(STDs)increases the risk of HIV acquisition and may cause other harmful outcomes.However,studies on STD treatment-seeking behaviour and co...Background:Delayed or inappropriate treatment for sexually transmitted diseases(STDs)increases the risk of HIV acquisition and may cause other harmful outcomes.However,studies on STD treatment-seeking behaviour and correlated factors in men who have sex with men(MSM)are scarce.This information is crucial for the promotion of STD treatment-seeking behaviour and reduction of HIV transmission among Chinese MSM.Methods:During 2012-2013,a multicentre cross-sectional study was conducted in 7 Chinese cities.Participants completed an interview-questionnaire and gave venous blood samples,which were then tested for antibodies to HIV,syphilis,and herpes simplex virus-2(HSV-2).MSM who tested positive for syphilis/HSV-2 or had obvious STD-related symptoms within the last 12 months were defined as suspected STD-infected MSM.Results:Of the 4496 eligible MSM who completed this survey,24.4%(1096/4496)were categorized as suspected STD-infected MSM.35.7%(391/1096)of these MSM with suspected STD infections sought STD treatment in clinics within the last 12 months.Among MSM who did not attend STD clinics for treatment,the prevalence of syphilis and HSV-2 was significantly higher;the HIV prevalence and incidence within this subpopulation reached as high as 14.5%and 12.2/100 person-years,respectively.Multivariate logistic regression analysis indicated that having 7-12 years of education(vs.≤6 years;aOR,2.5;95%CI,1.0-6.1),≥13 years of education(vs.≤6 years:aOR,2.8;95%CI,1.2-7.0),monthly income>500 USD(vs.≤500 USD:aOR,1.5;95%CI,1.1-2.1),obvious STD-related symptoms within last 12 months(aOR,5.3;95%CI,3.7-7.5),being HIV infected(aOR,1.7;95%CI,1.1-2.6),currently syphilis infected(aOR,0.6;95%CI,0.4-0.9)and HSV-2 infected(aOR,0.6;95%CI,0.5-0.9)were independent correlates with seeking STD treatment in clinics among Chinese MSM.Conclusions:The high prevalence of STD infection coupled with a low proportion of individuals who exhibit appropriate treatment-seeking behaviour create a high risk of a growing HIV epidemic among Chinese MSM.Models that prioritize better screening for and education about STDs should be urgently implemented,especially among low-income MSM.展开更多
文摘Background and objective: Early and accurate diagnosis is one of the critical requirements for successful management of all diseases. Yet, delayed diagnosis and misdiagnosis remain as vital problems, consequently impose adverse effects on patient treatment. Sexually transmitted disease (STD) is one of the most common infectious diseases, and more than one million of STD cases are acquired every day globally. Misdiagnosis of STD inevitably exists, therefore should not be overlooked. Being a medical diagnostic laboratory providing various STDs diagnosing service in Hong Kong, we aimed to determine the misdiagnosis rate of STDs and investigate the possible underlying cause. Methods: Specimens were collected for STD diagnosis from multiple clinics during 1 June 2021 to 20 October 2021 from different clinics and hospitals were included in the study. DNA extraction was performed using magnetic bead based method;then the extracted DNA was tested using the DiagCor GenoFlow<sup>TM</sup> STD Array kit to detect the existence of any targeted pathogens. Results: 1459 specimens were collected and included during the designated time period, with 643 specimens found to be positive with at least one targeted STD pathogen. 494 of these were found to be aligned with test ordered by physicians, and the remaining 149 positive cases had at least one pathogen detected but not requested to be tested by the physicians resulting in misdiagnosis. The overall misdiagnosis rate was determined to be 23.2% (149/643), with high frequency of misdiagnosis occurred to tests ordered for one to three pathogens detection. Also, Ureaplasma urealyticum and/or Ureaplasma parvum (UU/UP) was the commonest pathogen detected in this study. Conclusion: The findings suggested incorrect test selection made by physicians was one of the major reasons of STDs misdiagnosis in outpatient settings. To reduce diagnostic errors in STD diagnosis, physicians are encouraged to select and request test that allow detection of multiple pathogens, as co-infection of multiple pathogens in STD patients is commonly observed. The correct selection of test would not only benefit the patient, but also the public health.
基金Supported by National Natural Science Foundation of China (Grant Nos. 40821002, 40572115)
文摘Gyirong basin and its adjacent area are located at a special position in the Himalayan orogen, where the south Tibetan detachment system (STDS) and N-S trending rift converged. The north Himalayan orogen here can be divided into five petrologic-tectonic units successively from south to north: 1) the Greater Himalayan crystalline complex (GHC); 2) the STDS shear zone; 3) the Tethyan Himalayan sedimentary sequence (THS); 4) the late Cenozoic sedimentary basins, such as Gyirong and Oma basins; and 5) the Malashan gneiss dome. Structural studies show that this area experienced four stages of deformation: 1) the earlier south-directed thrusting, preserved both in the GHC and THS; 2) top-down-to-north slip along the STDS, normal faults related to this slip formed the early controlling structures of the Cenozoic basins,and the tilted pattern of the blocks between the basins indicated a north-directed slip; 3) east-west extension, the resultant N-S trending normal fault formed the eastern boundary of the basins; and 4) late gravitational collapse. Zircon SHRIMP U-Pb dating on the syn-deformational (leuco-) granite along the STDS indicates that the major activity of the STDS occurred at ca. 26 Ma, but its onset may have begun as early as ca. 36 Ma.
基金This work was supported by the Special Project lor Authors of the National Best Ph. D. Dissertations in College and University (Grant No. 200022)the National Natural Science Foundation of China (Grant Nos. 40172074 and 49802020) the National "973" Pr
文摘The Xainza-Dinggye Normal Fault System (XDNFS) is a large-scale nearly-north-south trending exten-sional structure across central and southern Tibet. Its middle segment developed in Tethys Himalaya with features of earlier magmatic core complex and later normal faults dipping moderately to northwest-west. The magmatic core complex is made up by mylonitic leucogrante with a low-angle detachment fault on the top of it and overlain by lower-grade meta-sedimentary rocks. The structural pattern of the southern segment of XDNFS take the shape of a detachment fault dipping to southeast-east with the High-Himalayan rock series as the lower plate. The Southern Tibetan Detachment System (STDS) is expressed as a ductile shear zone composed of mylonitic leucogranite in the studied area of this note. STDS was cut by the later XDNFS, which presents that nearly-east-west striking STDS is not the controlling or adjusting structure of the nearly-north-south trending ex-tensional structures. The origin of
基金The study was supported by the Mega-Projects of national science research for the 12th 5-Year Plan(2012ZX10001-006)China-Gates Foundation Cooperation Programme(grant no.2012)+1 种基金Liaoning educational department research project(grant no.LZ2014038)Research project of the first hospital of CMU(grant no.FSFH1512)。
文摘Background:Delayed or inappropriate treatment for sexually transmitted diseases(STDs)increases the risk of HIV acquisition and may cause other harmful outcomes.However,studies on STD treatment-seeking behaviour and correlated factors in men who have sex with men(MSM)are scarce.This information is crucial for the promotion of STD treatment-seeking behaviour and reduction of HIV transmission among Chinese MSM.Methods:During 2012-2013,a multicentre cross-sectional study was conducted in 7 Chinese cities.Participants completed an interview-questionnaire and gave venous blood samples,which were then tested for antibodies to HIV,syphilis,and herpes simplex virus-2(HSV-2).MSM who tested positive for syphilis/HSV-2 or had obvious STD-related symptoms within the last 12 months were defined as suspected STD-infected MSM.Results:Of the 4496 eligible MSM who completed this survey,24.4%(1096/4496)were categorized as suspected STD-infected MSM.35.7%(391/1096)of these MSM with suspected STD infections sought STD treatment in clinics within the last 12 months.Among MSM who did not attend STD clinics for treatment,the prevalence of syphilis and HSV-2 was significantly higher;the HIV prevalence and incidence within this subpopulation reached as high as 14.5%and 12.2/100 person-years,respectively.Multivariate logistic regression analysis indicated that having 7-12 years of education(vs.≤6 years;aOR,2.5;95%CI,1.0-6.1),≥13 years of education(vs.≤6 years:aOR,2.8;95%CI,1.2-7.0),monthly income>500 USD(vs.≤500 USD:aOR,1.5;95%CI,1.1-2.1),obvious STD-related symptoms within last 12 months(aOR,5.3;95%CI,3.7-7.5),being HIV infected(aOR,1.7;95%CI,1.1-2.6),currently syphilis infected(aOR,0.6;95%CI,0.4-0.9)and HSV-2 infected(aOR,0.6;95%CI,0.5-0.9)were independent correlates with seeking STD treatment in clinics among Chinese MSM.Conclusions:The high prevalence of STD infection coupled with a low proportion of individuals who exhibit appropriate treatment-seeking behaviour create a high risk of a growing HIV epidemic among Chinese MSM.Models that prioritize better screening for and education about STDs should be urgently implemented,especially among low-income MSM.
