Clinical Significance of Serum Uric Acid Combined with Cystatin C Detection in Patients with Different Levels of Hypertension with High Risk Degree and Above

Objective: To explore the clinical significance of serum uric acid combined with cystatin C detection in high risk degree of hypertension of different grades. Methods: The patients who were treated in the Department of Cardiovascular Medicine of our hospital from January to December 2022 were selected as the study subjects, and the high risk and extremely high risk groups of grade I, II and III hypertension were selected for comparative analysis to explore their clinical significance. Results: There was a statistically significant difference in the number of patients with extremely high risk of grade II hypertension between men and women (P 0.05), which showed that there was no specificity in the concentration detection of serum uric acid and cystatin C in different grades of hypertension;there was no significant difference in serum uric acid concentration between grade II and grade III of hypertension with high risk grade and cystatin C concentration between grade I and grade III of hypertension with high risk grade (P > 0.05), but there was significant difference in the concentration detection of serum uric acid and cystatin C between the other groups (P < 0.05), which indicates that the detection of serum uric acid and cystatin C has important clinical significance in the high risk degree of hypertension. Conclusion: In the comparison of the detection of blood uric acid and cystatin C in different levels of hypertension with extremely high risk, the difference of cystatin C in grade I and grade III was not statistically significant, and the rest were statistically significant;therefore, the detection of serum uric acid and cystatin C can provide reliable laboratory data for clinical diagnosis and treatment of the extremely high risk degree of different levels of hypertension.

Application Analysis of High Risk HPV Detection Combined with Cervical Cytology, Colposcopy and Pathology in Cervical Lesions of Women in Tiandeng County

Purpose: To understand the application of high-risk HPV detection combined with cervical cytology, colposcopy and pathology in cervical lesions of women in Tiandeng County. Method: Women in the outpatient and inpatient departments of our hospital from January 2021 to October 2022 were collected for high-risk HPV testing, TCT, colposcopy and pathological examination according to their personal wishes, to understand the application of relevant examinations in cervical lesions. Result: In 2021, the number of patients was 5801, among whom 1743 patients had received cervical cancer examination in the past, accounting for 30.05% of the total number of patients, and 5795 who had volunteered for TCT examination this time, accounting for 99.90% of the total;A total of 289 cases of atypical squamous cells with unclear significance (ASC-US) were detected, excluding 11 cases of high-grade squamous intraepithelial lesions (ASC-H), 122 cases of low-grade squamous intraepithelial lesions (LSIL), 16 cases of high-grade squamous intraepithelial lesions (HSIL), 2 cases of squamous cell carcinoma (SCC), and 4 cases of atypical adenocyte (AGC);Atypical cervical adenocytosis and cervical carcinoma in situ were not detected. The number of people who volunteered for high-risk HPV testing was 4237, and the number of positive cases was 740, accounting for 17.47% of the screening population;Among 740 HPV-positive patients, 488 high-risk HPV-positive patients were selected for TCT examination, and 87 patients were found to be TCT positive;From 401 high-risk HPV-positive and TCT negative patients, 287 patients with possible lesions were screened out for colposcopy;The results showed that 60 patients may have certain cervical lesions and need further pathological examination and the results showed that 28 patients had CTN1 and 18 patients had CIN2 - 3. In 2022, 8840 patients received medical treatment, among which 3188 patients had received cervical cancer examination in the past, accounting for 36.06% of the total number of patients, and 8314 patients voluntarily underwent TCT examination, accounting for 94.05% of the total number of patients. 434 cases of atypical squamous cells with ambiguous meaning (ASC-US) were detected, excluding 13 cases of high-grade squamous intraepithelial lesions (ASC-H), 217 cases of low-grade squamous intraepithelial lesions (LSIL), 35 cases of high-grade squamous intraepithelial lesions (HSIL), 1 case of squamous cell carcinoma, and 4 cases of atypical adenocarcinoma (AGC);Atypical cervical adenocytosis and cervical carcinoma in situ were not detected. The number of volunteers for high-risk HPV testing was 3871 cases, and the number of positive cases was 654 cases, accounting for 16.89% of the screening number. 527 high-risk HPV-positive patients were selected from 654 HPV-positive patients for TCT examination, and the number of TCT-positive patients was found to be 49. From 478 high-risk HPV-positive patients with TCT negative, 276 patients with possible lesions were screened out for colposcopy;The results showed that 66 patients may have certain cervical lesions and need further pathological examination;and then the results showed that 31 cases of CTN1 and 6 cases of CIN2 - 3. Conclusion: Gynecological high-risk HPV examination can provide better etiological sources for cervical cancer screening;Cervical cytology examination has high sensitivity;Colposcopy examination has high specificity;Pathological examination can be used as an effective supplement for cervical cytology examination and colposcopy;So high-risk HPV combined with cytology examination, colposcopy examination and pathological examination has high clinical application value;It is worth popularizing and applying.

Effects of High Risk Pregnancy Factors on Pelvic Floor Muscle Weakness and Changes of PG, ACTH and CRP

Objective: To investigate the effects of different delivery modes on perinatal pelvic floor muscle strength, PG, ACTH and CRP of high-risk pregnant women. Methods: 380 high-risk pregnant women who gave birth in our hospital from March 2021 to February 2022 were selected as subjects, including 100 vaginal natural delivery, 156 forceps assisted delivery and 124 cesarean section. Pelvic floor pressure, PG, ACTH, CRP, IL-6, TNF-α and IL-4, IL-10 levels were evaluated and compared. The perinatal occurrence of pelvic floor functional disease (PFD) in high-risk pregnant women in each group was analyzed and evaluated. Results: There were statistical differences in the amount of postpartum blood loss (P 0.0001, F = 99.01), postpartum blood loss 24 h (P = 0.0004, F = 19.54) and hospital stay (P 0.0001, F = 70.81) among the three groups of high-risk women in natural vaginal delivery, forceps delivery and cesarean section. In addition, there were 72, 134 and 70 cases of abnormal pelvic floor fatigue in natural vaginal delivery, forceps assisted delivery and cesarean section (P 0.0001, χ2 = 30.16). There were 36, 79 and 21 cases of muscle injury, respectively (P 0.0001, χ2 = 34.16). There were 49, 98 and 43 cases of dysmuscular contraction, respectively (P 0.0001, χ2 = 21.94). There were 65, 120 and 41 cases with vaginal dynamic pressure 80 cm H2O (P 0.0001, χ2 = 56.86), respectively. The.

A survey of high risk factors affecting retinopathy in full-term infants in China

AIM: To investigate the possible relationship between the influencing factors occurring before and during birth in full-term infants and the outcome of retinopathy. METHODS: Totally 816 full-term infants admitted in the neonate intensive unit of Boai Hospital of Zhongshan between 1 May, 2008 and 30 June, 2011 were included in the study. Fundus examination was performed and evaluated individually on them at the age of 48 hours after delivery, 2 weeks and 1 month. Some possible risk factors happening prenatally or during delivery such as pregnant related hypertension, placenta previa, placental abruption etc, as well as some neonatal risk factors such as neonatal asphyxia, hypoxic-ischemic encephalopathy (HIE), low birth weight etc, were recorded and evacuated. Then the effect of the risk factors of full-term infants on retinopathy was studied. RESULTS: The incidence of retinal hemorrhage of full-term infants with prenatal pregnant related hypertension (PRH) of the mother (43.6%) was significantly higher than that of full-term infants without (8.0%). (P<0.001). The incidence of retinal hemorrhage of full-term infants with neonatal asphyxia and /or hypoxic-ischemic encephalopathy (HIE)(29.3%) was significantly higher than that of those without (15.7%), but correlation was not found between the severity of retina hemorrhage and the degree of hypoxic disease. A pale color of optic disc was associated with a low birth weight of full-term infant. Full-term infants with birth weigh-less than 2500g had a significant higher incidence of retinopathy than those with birth weight equal or more than 2500g( P<0.001). CONCLUSION: The main influencing factors which lead to retinopathy of high risk full-term infants are prenatal factors such as PRH, and some neonatal risk factors such as asphyxia, hypoxic-ischemic encephalopathy, and low birth weight.

Contamination of Fungi and Mycotoxins in Foodstuffs in High Risk Area of Esophageal Cancer

Fungal and mycotoxin contamination has been found in fordstuffs from Cixian County, an area with a high incidence of esophageal carcinoma (Eca). To set a scientific foundation for the prevention of Eca at the etiological level, fungal and mycotoxin contaminations of local foodstuffs in Cixian County were analyzed using classical fungal culture methods and HPLC. From 1990 to 1994, 220 corn/wheat samples and 34 corn samples were studied. As a control, 26 corn samples collected from a relatively low incidence area of Eca in Zanhuang County were analyzed for mycotoxins in 1990. The results showed that fungal contamination in corn and wheat was severe and that several of the predominant contaminating fungi such as Furasium moniliforme, etc. were carcinogenic. HPLC results showed that the detection rate and mean content of the mycotoxin sterigmatocystin (ST) in the mountainous area (5/8; 9. 14 μg/kg) were significantly higher than those in the hilly (0; 0) and plain areas (1/18; 1. 29 μg/kg) as well as in low risk area control samples (3/26; 0. 76 μg/kg). Detection rates of deoxynivalenol (DON) in mountainous and hilly areas (5/8, 4/8 respectively) were slightly higher than that in plain area (8/18), while the mean content of DON in the plain area was significantly higher (90. 45-170. 22 vs 50. 56 and 46. 45 μg/kg).Among the different aflatoxins, AFB1 was detected in samples from the two villages in the plain area for the subsequent two years. The mean content of AFB1 was 0. 0183μg/kg, and the highest level was 0. 0497 μg/kg. No AFB1 was detected in the samples from mountainous and hilly areas. AFG1 was detected in more than half of all the samples, and its concentration ranged from 8. 77 to 46. 51 ng/kg. No AFG2 was found in the samples. Thus, the results suggest that at present, fungal and mycotoxin contamination of foodstuffs in Cixian County are quite common.

Risk Factors of Precancerous Gastric Lesions in A Population at High Risk of Gastric Cancer

Objective： In cancer prevention, the targeting of precancerous lesions has been recognized as the most promising method. However, little attention has been paid to the risk factors of precancerous gastric lesions, especially in rural China where there is high prevalence of precancerous gastric lesions. We therefore conducted a cross-sectional study in Liaoning province, China, to investigate the potential risk and protective factors of these precancerous gastric lesions. Methods： A total of 1,179 subjects with high risk of gastric cancer from Zhuanghe County were included in this study. Standard questionnaires were used in collecting epidemiological factors and the data were then analyzed by the unconditional logistic regression model. Results： Smoking and drinking were the risk factors for the precancerous gastric lesions among rural subjects, and the association of smoking or drinking and the precancerous gastric lesions increased in strength with the daily consumption and duration. As the factors such as age, gender, smoking, alcohol were controlled, a multivariable analysis revealed that there was a significant correlation between the deep-fry food intake and the gastric epithelial dysplasia with the odds ratio （OR） of 1.78 [95% confidence interval （CI）： 1.01-3.12]. Garlic eating was shown to confer protection against the development of gastric ulcer （OR=0.55, 95% CI： 0.33-0.92）. Conclusion： Smoking and drinking were the risk factors for the precancerous gastric lesions among rural subjects. Deep-fry food intake might be one of the risk factors for the precancerous gastric lesions and garlic eating was shown to confer protection against the development of gastric ulcer among rural Chinese population.

MUTAGENICITY AND CARCINOGENICITY OF FISH SAUCE FROM A COUNTY WITH THE HIGH RISK FOR GASTRIC CANCER IN CHINA

The mutagenicity and carcinogenicity of fish sauce (FS) sample from Changle County, a high gastric cancer mortality (113.20/105) area, were investigated with the biologic short-term tests and laboratory animal experiment. The results showed that the extract of FS was markedly direct mutagenic toward S. typhimurium TA100, induced high sister chromatid exchanges (SCE) and micronucleus (MN) in V79 cells after nitrosation with sodium nitrite. But the non-nitrosated FS did not. The nitrosated fish sauce (NFS) also induced SOS in E. coli PQ37 and alkylation of calfthymus DNA. The potency of NFS to induce unscheduled DNA synthesis (UDS) in human normal gastric mucosal cells was increased about fivefold compared with FS. When the NFS extract was given to newborn rats by gavage, dys-plasia and adenocaroinoma were induced in the glandular stomach in the 4th and 16th experimental week, respectively. N-nitrosamides were also found in NFS, which may account for the mutagenicity and carcinogenicity of NFS. It is indicated that FS, a traditional daily eaten seasoning, may contribute to the causes of the high gastric cancer mortality for the local residents.

Managing high risk glaucoma with the Ahmed valve implant:20 years of experience

AIM： To estimate the efficacy and safety of the Ahmed implant in patients with high risk for failure after glaucoma surgery.METHODS： In 342 eyes of 342 patients with refractory glaucoma, even with application of medical treatment, the Ahmed valve was introduced for intraocular pressure（IOP） control, in the period of the last 20y. The nature of glaucoma was neovascular in 162 eyes, pseudophakic or aphakic in 49 eyes, inflammatory in 29 eyes and non working previous antiglaucomatic surgical interventions in 102 eyes. RESULTS： Follow-up ranged from 18 to 120m o with a mean follow-up of 63.2m o. IOP before the operation decreased from 31.6±10.4 mmHg to 18.3±5.4 mm Hg（no systemic treatment） at the end of follow up period. When we compared the IOP values before the operation using ANOVA showed statistically significant difference（P〈0.001）. The success rate was 85.2% during the first semester, 76.8% at 12 mo and 50.3% at the end of follow up period（18 to 120 mo after implantation）. Success rate was 25.7% in neovascular glaucoma, 63.2% in aphakic glaucoma and 73.8% in non working previous antiglaucomatic surgical interventions. Complications due to the implant were： serous choroidal detachment in 14.8%, blockage of the tube in 2.8%, malposition of the tube in 4.9%, suprachoroidal hemorrhage in 2.1%, cataract progression in 39.6%（phakic eyes）, shallow anterior chamber in 9.2%, hyphaema in 28.9%, exposure of valve in 2.6%, exposure of tube in 9.3%, hypotony in 4.9% and conjunctival fibrosis in 41.5%.CONCLUSION： Despite the fact that Ahmed valve implant had suchlike results as other implants concerning the IOP control, complications rate due to hypotony or over filtration in the first days after the intervention are not that frequent as with other valve implants.

High Risk Factors of Pancreatic Carcinoma

Over the past decades, cancer has become one of the toughest challenges for health professionals. The epidemiologists are increasingly directing their research efforts on various malignant tumor worldwide. Of note, incidence of cancers is on the rise more quickly in developed countries. Indeed, great endeavors have to be made in the control of the life-threatening disease. As we know it, pancreatic cancer（PC） is a malignant disease with the worst prognosis. While little is known about the etiology of the PC and measures to prevent the condition, so far, a number of risk factors have been identified. Genetic factors, pre-malignant lesions, predisposing diseases and exogenous factors have been found to be linked to PC. Genetic susceptibility was observed in 10% of PC cases, including inherited PC syndromes and familial PC. However, in the remaining 90%, their PC might be caused by genetic factors in combination with environmental factors. Nonetheless, the exact mechanism of the two kinds of factors, endogenous and exogenous, working together to cause PC remains poorly understood. The fact that most pancreatic neoplasms are diagnosed at an incurable stage of the disease highlights the need to identify risk factors and to understand their contribution to carcinogenesis. This article reviews the high risk factors contributing to the development of PC, to provide information for clinicians and epidemiologists.

Adjustable muscle plication:a new surgical technique for strabismic patients with high risk for anterior segment ischemia

【正】INTRODUCTION Anterior ciliary arteries provide 70%of the vascular supply of the anterior segment.A significant interruption of the vascular flow of these arteries increases the risk for anterior ischemia.Although the frequency of this special condition is low after strabismus surgery(1:13 000)[1],its effects may involve substantial visual problems[2].We report the successful outcome of a new surgical approach for strabismus management in a case of high risk for anterior ischemia.Specifically,we show the correction of the horizontal ocular deviation by means of an adjustable muscle

A STUDY OF PRECANCEROUS GASTRIC LESIONS IN A HIGH RISK POPULATION

A study of precancerous gastric lesion was conducted in a randomly selected high risk population in Linqu, Shandong Province of China. 849 subjects aged from 30-64 were examined bioptically. There were 8 cases of gastric cancer, the prevalence rate was 0.9%. 169 subjects were diagnosed to be dysplasia, the prevalence rate of dysplasia was increased significantly with age. The regression equation was Y=0.47X-0.25. The prevalence of CAG was found in 36 per cent of the studied subjects and both dysplasia and CAG were more serious in the antrum than the. fundus. The results showed a natural history of precancerous gastric lesions in a high risk population in a high risk area.

Locally advanced and high risk prostate cancer:The best indication for initial radical prostatectomy?

High risk prostate cancer is a deadly disease that needs aggressive treatment.High risk prostate cancer is often treated with androgen deprivation therapy or combined radiohormonotherapy while there is a place for surgery in cases of operable and resectable locally advanced or high risk disease.This review summarises the results of the different treatment strategies for locally advanced and high risk prostate cancer.Radical prostatectomy monotherapy or in combination with radiotherapy and/or hormonal treatment are analysed.They show that radical prostatectomy is an effective treatment modality for these tumours.After surgery,the results of the pathology and the follow-up of serum PSA may indicate the need of additional adjuvant or salvage treatment strategies.

EFFECT OF ADDED DIETARY CALCIUM ON ESOPHAGEAL EPITHELIAL-CELL PROLIFERATION IN SUBJECTS AT HIGH RISK FOR ESOPHAGEAL CANCER: A DOUBLE-BLIND INTER-VENTION STUDY

A randomized double-blind intervention trial was carried determine whether oral calcium supplementation could lower the proliferation of epithelial cells of the esophagus. 41 subjects identified with precancerous lesions by histopathology were randomized to receive oral supplementation of their conventional diets with 0.6 g of calcium as calcium carbonate or placebo. Both at the entry to the study and at the end of the treatment, seven months later, the subjects were examined, with an emphasis on the frequency and distribution of proliferating epithelial cells of the esophagus. Patterns of cell proliferation was defined by dividing the esophageal epithelium into cell columns oriented perpendicularly to the basal cell layer and by comparing the numbers and fractions of tritiated thymidine-labeled epithelial cells in the various cell columns and cell compartments.Before dietary supplementation with calcium, the profile of proliferating epithelial cells in the esophageal compartments in calcium group is similar to that in the placebo group, which is comparable to that previously observed in subjects with high risk for esophageal cancer. Seven months after supplementation having been started, in calcium group, proliferation was significantly reduced and the profile of the esophageal columns approached to that previously observed in subjects at low risk for esophageal cancer, however, in the placebo group, the proliferation and profile maintain at the same level as that before supplementation. Our findings indicate that oral calcium supplementation induces a more quiescent equilibrium in epithelial-cell proliferation in the esophageal mucosa of the subjects at high-risk for esophageal cancer, similar to that observed in subjects at low risk.

Level of Acceptance of COVID-19 Vaccine and Its Determinants among High Risk Groups for Severe COVID-19 Infection Living in Mogadishu Somalia

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, which is widely referred to as “COVID-19”, has been infecting more than 5.5 million over 144 countries. A vaccine is considered to be the most awaiting intervention and hundreds of global R&D institutions engaged in unprecedented speed to develop the vaccine. The availability of COVID-19 vaccines may not translate into its uptake. Although governments will provide the vaccines, their uptake is voluntary. Objective: This study was carried out to evaluate the level of acceptance of COVID-19 vaccine and it’s determinants among high risk groups for severe COVID-19 infection living in Mogadishu Somalia. Methods: The study was cross-sectional, descriptive analysis conducted to obtain reliable information about the acceptance of COVID-19 vaccine and it is determinants among high-risk groups living in Mogadishu, Somalia. The calculated sample size was 404 using Cochran’s formula = Z2p(1 − p)/d2 and addition of 5% non-respondent rate. According to PESS population estimate in 2020, there are 17 districts. We grouped them into 2 strata and through simple random sampling one district was selected from each strata. After randomly selecting the two districts, three sub districts were randomly selected from each and then every second house (1, 3, 5) in the main roads will be selected. If target population were not found in the second selected house, the next house will be taken until sample size is obtained. Results: 59.4% of respondents were willing to accept and take vaccination while 40.6% of them were not accepting the vaccination. Being afraid of the side effect was the most common reason for not accepting the vaccine Conclusion: More than one third of respondents (40.6%) were not willing to accept the vaccination, knowledge towards COVID-19 was strongly associated with acceptance level of COVID-19 vaccine. Recommendation: Multi-sector organized awareness campaigns involving FMH as well as local authorities and civil society to enhance level of knowledge of community towards COVID-19.

Retrospective Analysis of Adjuvant Therapy in Intermediate and High Risk Endometrial Cancer Patients

Introduction: Endometrial cancer is the most common gynecologic malignancy in developed countries. The most significant prognostic factors are tumor stage, histological grade and type, depth of myometrial invasion, lympho-vascular space or nodal involvement. The optimal adjuvant therapy in high and intermediate risk endometrial cancer is still controversial. Aim of the work: Evaluating the impact of adjuvant chemotherapy in addition to radiotherapy on prognosis of high and intermediate risk endometrial cancer. Patients and methods: Forty six patients with high and intermediate risk endometrial cancer presenting to Kuwait Cancer Control Center (KCCC) underwent total abdominal hysterectomy, bilateral salpingo-ophorectomy, and 18 patients underwent lymphadenectomy (39.1%). All patients received adjuvant chemotherapy followed by adjuvant radiotherapy. According to GOG risk stratification, 28 patients (60.9%) were high risk, 6 (13%) high intermediate and 12 (26.1%) low intermediate. At the end of follow up period, 34.71% of patients relapsed, 21.71% locally and 13% systemic. Median PFS was 38.06 months(ms) (95% CI 36.94 - 39.18 ms). There was a statistically significant effect of lympho-vascular space invasion (LVSI), grade and near statistically significant effect of patients age on PFS (p = 0.01, 0.05, 0.06 respectively). Median OS for all patients was not reached;estimated survival at 3 years was 87.5%. There was no statistically significant effect of age, pathological subtype, grade, LVSI on survival (p = 0.35, 0.95, 0.53 and 0.09 respectively). On stratifying patients into high and intermediate risk based on GOG risk stratification, there was a statistically significant difference on PFS and near statistically significant difference on OS between those groups (p = 0.02 and 0.09 respectively). Conclusion: The most effective adjuvant treatment regimen for patients with intermediate and high risk endometrial cancer is still an area of controversy. Sequential chemotherapy and radiotherapy is both efficacious and well tolerated. Large-scale randomized controlled trials are necessary in the future.

Nursing Effects of Medical Treatment Combination on Patients at High Risk of Developing Pressure Ulcers at Rural Homes

Objective:To explore the nursing effects of medical treatment combination on patients at high risk of developing pressure ulcers at rural homes.Methods:From January 2018 to December 2018,86 patients at high risk of developing pressure ulcers at rural homes who were in Wenjiang Hospital were randomly divided into a control group and an observed group.The control group received the routine publicity and education and visiting,while the observed group adopted the cooperative nursing model of medical treatment combination.Then compare the healing status and nursing satisfaction of the two groups.Results:Of the 43 patients with pressure ulcers in the observed group,18 had been in the second stage of pressure ulcers and 16 had been healed;14 had been in the third stage of pressure ulcers and 8 had been healed;11 had been in the fourth stage of pressure ulcers and 5 had been healed.The nursing satisfaction of the patients in the observed group was 95.35%.Conclusion:Conducting medical treatment combination on patients at high risk of developing pressure ulcers at rural homes can effectively improve the patients’and their families’awareness of pressure ulcer nursing,standardize their nursing behaviour,help recover the patients themselves and promote the patients’satisfaction.

Partner profile of pregnant women who have obstetric prenatal high risk in a university hospital south of Brazil

This study aimed to relate the social and obstetric risk factors presented by pregnant women who underwent high risk prenatal in a southern Brazil hospital unit. This is a quantitative research. The data collection was conducted from January to September 2012, where 12 high-risk pregnancies and nine companions with diversified social and obstetric conditions were seen. The analysis was by simple statistics. Pregnant women social profile results indicated that predominant age group was 31 to 40 years old;all had some degree of education;84% Catholic;75% of pregnant women were accompanied by someone of their choice during high risk prenatal care;and 50% of the choices were for her spouse;half of these pregnant women have a professional occupation. Obstetrics findings demonstrated that the majority of women were not planning on the pregnancy, only 17% started prenatal care in the first trimester, 42% had already presented risk in previous pregnancy, 58% of women were classified as high risk due to fetal abnormalities. Given these findings, it is clear that high-risk pregnancy as a period involving several factors, including social and obstetric that, when connected, can compromise the process of gestating for both the mother and the fetus.

High risk populations and HIV-1 infection in China

China is currently experiencing one of the most rapidly expanding HIV epidemics in the world. Although the overall prevalence rate is still low, with a population of 1.3 billion, high-risk factors which have contributed to the HIV/AIDS epidemics worldwide continue to prevail in China, including a high rate of injecting drug use and needle sharing, commercial sex with low rates of condom use, and concurrent sex with both commercial sex workers and noncom- mercial casual or steady sex partners. In addition, there are increasing “double risk” populations overlapping drug users and sex workers, as well as increasing rates of STDs and HIV among high-risk populations. Sexual transmission, therefore, may serve as a bridge connecting high-risk populations with general populations. There is an urgent need to prevent the spread of HIV from these high-risk populations into the general population of China.