男性雄激素性秃发患者雄激素受体基因和5α还原酶基因多态性研究

目的 探讨华东地区汉族男性雄激素性秃发与雄激素受体基因和5α还原酶基因多态性的关系.方法 研究对象为101例男性雄激素性秃发患者和104例健康对照,抽取外周血后分离纯化出基因组DNA,采用聚合酶链反应和限制性片段长度多态性方法研究雄激素受体基因1号外显子StuⅠ限制性片段长度多态性和Ⅰ型5α还原酶(SRD5A1)和Ⅱ型5α还原酶(SRD5A2)基因多态性,微卫星扫描分析1号外显子CAG和GGC重复序列的多态性.结果 雄激素受体基因1号外显子StuⅠ限制性片段长度多态性在汉族男性雄激素性秃发患者与健康对照之间差异无统计学意义(P>0.05),雄激素受体基因的CAG重复序列多态性分布在两组之间差异无统计学意义(P=0.130),GGC重复序列多态性分布在两组之间差异有统计学意义(P=0.004);短CAG/短GGC分别在病例与对照组中占25.53%和46.88%(P=0.002),长CAG/长GGC分别占42.55%和19.79%(P=0.001).未发现SRD5A1及SRD5A2等位基因和基因型出现的频率不同(P>0.05).结论 雄激素受体基因GGC重复序列以及CAG/GGC重复序列多态性与汉族男性雄激素性秃发有明显关系.而5α还原酶基因多态性与汉族男性雄激素性秃发无明显关系.     

白介素10基因启动子多态性与广西壮族系统性红斑狼疮的关系

目的 探讨广西壮族人白介素10(IL-10)基因启动子区单核苷酸多态性与广西壮族SLE的关系.方法 采用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)技术,检测90例SLE患者和110例正常对照者IL-10基因启动子-1082A/G、-819T/C和-592A/C位点基因型.结果 IL-10基因-819T/C和-592A/C多态性在SLE组和正常人群中的分布差异无统计学意义(P>0.05),而IL-10基因-1082A/G多态性在两组人群中的分布差异有统计学意义(P<0.05),基因型频率的相对风险分析发现,AG基因型携带者患SLE的风险是AA基因型的2.076倍(OR=2.076,95%CI:1.052～4.100);基因单倍型分析发现,GCC单倍型携带者显著增加了SLE的发病风险.结论 白介素10基因启动子-1082A/G多态性和它的单倍型与SLE具有相关性,其中-1082G等位基因可能是SLE的遗传易感基因.     

维生素D受体基因多态性与银屑病的关系

目的 探讨维生素D受体(VDR)基因多态性与银屑病的关系。方法 采用聚合酶链反应和限制性片段长度多态性(PCR-RFLP),对112例无血缘关系的银屑病患者和108例无血缘关系的健康人员的VDR基因型进行分析。结果 AA、Bb基因型在健康人中出现的频率仅7.4%及14.8%,而在银屑病人中出现的频率为19.6%及32.1%.进一步分析VDR基因型与银屑病患者性别、发病年龄、家族史等的关系,未发现显着相关。在统计等位基因A、a和B、b时,发现它们在两组人群中出现的频率差异均无显着性。结论 维生素D受体(VDR)基因型分布在银屑病患者与健康人中是显着不同的,纯合子AA基因型或杂合子Bb基因型的出现可能增加患银屑病的易患性。     

E选择素基因多态性与广西壮族系统性红斑狼疮的相关性研究

目的 探讨E选择素基因第2外显子G98T和第4外显子A561C多态性在广西壮族人群中的分布及其与系统性红斑狼疮(SLE)的相关性。方法 用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)技术检测82例系统性红斑狼疮患者和95例正常对照者E选择素基因型。结果 E选择素第2外显子基因型GG、GT、TT频率在SLE组和对照组分别为86.6%、12.2%、1.2%和90.5%、8.4%、1.1%;E选择素第4外显子基因型AA、AC、CC频率在SLE组和对照组分别为81.7%、15.9%、2.4%和92.6%、7.4%、0.0%。E选择素第4外显子基因型频率和等位基因频率在SLE组和对照组比较差异均有统计学意义(P<0.05)。基因型频率的相对风险分析发现,AC+CC基因型患SLE的风险是AA基因型2.81倍(OR=2.81,95%CI为1.087～7.290)。结论 E选择素A561C基因多态性与广西壮族人群SLE的发病有相关性,C等位基因可能是SLE的易感基因。     

汉族寻常型痤疮患者TNF-α-308 G/A基因多态性检测与分析

目的探讨前炎症介质TNF-α-308G/A基因多态性与汉族寻常型痤疮患者的关联性,为汉族寻常型疮痤发病遗传学研究奠定基础。方法通过PCR-RFLP技术研究了138例寻常型痤疮患者和120例正常对照TNF-α-308 G/A基因型的分布以及等位基因的频率。结果发现寻常型痤疮组基因型GG(62.40%),GA(30.40%),AA(7.20%)的频率分布与对照组(80.90%,18.30%,0.80%)比较,差异均有统计学意义(P<0.05);等位基因A(22.50%)频率分布,寻常型痤疮组与对照组比较,差异有统计学意义(P<0.05)。结论 TNF-α-308 A等位基因的存在,增大了寻常型痤疮的发生风险。     

新疆维吾尔族HCR基因多态性与寻常性银屑病的相关性研究

目的 检测新疆维吾尔族寻常性银屑病(PsV)患者外周血DNA中HCR基因第16外显子的1911位点多态性,探讨其与银屑病发病的相关性。方法 从128例患者及健康对照组132例的抗凝血中提取DNA,用PCR-限制性片段长度多态性法及PCR产物直接测序法鉴定基因类型,对结果进行统计学分析处理。结果 HCR基因第16外显子的1911位点核苷酸存在G、A二态性,可表现为GG纯合、AA纯合、GA杂合三种基因型。基因型和等位基因频率经卡方检验两组比较,差异无统计学意义(P>0.05)。其中Ⅰ型、Ⅱ型寻常性银屑病患者与对照组比较,差异无统计学意义(P>0.05),男女寻常性银屑病患者与对照组比较,差异无统计学意义(P>0.05)。结论 HCR基因第16外显子1911位点的多态性与新疆维吾尔族非家系寻常性银屑病在基因型和等位基因频率方面未发现相关性。     

血小板活化因子乙酰水解酶基因Val279Phe突变与银屑病的相关性研究

目的 探讨血小板活化因子乙酰水解酶(PAF-AH)在银屑病发病机制中的作用。方法 等位基因特异性聚合酶链反应技术分析银屑病患者及健康对照者PAF-AH基因Val279Phe位点的多态性,并对含有突变等位基因的多态性片段进行DNA测序分析。采用PAF-AH活性检测试剂盒测定血浆PAF-AH的活性。结果 所有研究对象中发现3例Val279Phe突变型杂合子,未发现突变型纯合子;银屑病组的突变等位基因频率与健康对照组差异无统计学意义(P>0.1);银屑病患者血浆PAF-AH活性低于健康献血者,两组比较差异有统计学意义(P<0.01)。结论 本研究结果提示PAF-AH基因的Val279Phe突变与银屑病无明显的相关关系,可能不是银屑病患者血浆PAF-AH活性降低的主要原因。     

湿疹及皮炎

20100482N-乙酰基转移酶2基因与染发皮炎的关系/徐宏俊(天津医大总医院皮肤科),刘原君,孙晨薇…∥中华皮肤科杂志.-2009,42(9).-642～643采用病例对照的方法,对天津地区染发皮炎组及健康对照组进行N-乙酰转移酶(NAT)2基因多态性分析,采用卡方检验比较两组间NAT2基因各等位基因频率及基因型频率分布的差异。结果,NAT2等位基因在染发皮炎组与对照组的分布比较,差异无统计学意义(χ2=3.0,P>0.05);NAT2基因型与染发皮炎易感性的关系显示NAT2快、慢乙酰化基因型在染发皮炎组中分布频率为92.9%,7.1%,在对照组中为87.5%,12.5%,两组比较,差异均无     

SLE与γ干扰素的基因型及血清水平的相关性

目的观察γ干扰素(IFN-γ)基因多态性各等位基因及基因型在系统性红斑狼疮(SLE)中的分布频率,初步分析其基因型及血清水平与SLE的相关性。方法采用序列特异性引物-聚合酶链反应(PCR-SSP)技术检测120例SLE患者和150名正常对照者IFN-γ的基因+874 A/T多态性,同时采用酶联免疫吸附试验(ELISA)检测血清IFN-γ水平。结果SLE组血清IFN-γ水平与对照组比较明显升高,且差异有显著性意义(P<0.05),IFN-γ基因+874 A/T多态性在两组人群中的分布差异有显著性意义(P<0.05),T等位基因携带者患SLE的风险是A等位基因的1.737倍(OR= 1.737,95%CI:1.193～2.529),携带T等位基因的SLE患者血清IFN-γ水平与不携带者比较明显升高,且差异有显著性意义(P<0.05)。结论IFN-γ基因+874 A/T多态性与SLE的发病具有相关性,T等位基因可能是SLE发病的遗传易感基因;携带T等位基因的个体可能通过促进IFN-γ的高度表达增加了SLE的发病风险。     

ACE基因插入/缺失多态性与银屑病关系的研究

目的探讨血管紧张素转换酶(ACE)基因插入/缺失多态性与中国人群银屑病之间的关系。方法应用聚合酶链反应(PCR)对泰安地区88例银屑病患者及95例正常对照者的ACE基因插入/缺失多态性进行检测和分析。结果银屑病患者与正常对照者的II,ID,DD基因型及等位基因分布频率均无显著性差异(P>0.05),进一步分析显示ACE插入/缺失基因多态性与银屑病患者的性别及有无明确的家族史均无关联。结论ACE基因插入/缺失多态性可能不是中国人群银屑病发病的遗传学危险因素。     

Clients of female sex workers in Lima, Peru: a bridge population for sexually transmitted disease/HIV transmission?

OBJECTIVES: The objectives of this study were to determine the prevalence of risk behaviors, gonorrhea, and chlamydia in clients of female sex workers, and to compare them with men selected from the general population. STUDY DESIGN: We conducted a cross-sectional study of men recruited from commercial sex venues in Lima, Peru from January to February 2002. Subjects answered a survey and provided a urine sample. RESULTS: Men reported that in the recently concluded commercial sex encounter, 95.8% used condoms, and 85.8% always used condoms with female sex workers. Only 16% reported always using condoms with their stable partners; 50.8% always used condoms with casual, noncommercial partners; and 59.6% always used condoms for homosexual anal sex. There were 8 (2%) cases of chlamydia and no cases of gonorrhea. CONCLUSIONS: Clients of female sex workers report high rates of condom use with sex workers and a low prevalence of chlamydia and gonorrhea. It is unlikely that they constitute a bridging population.     

Human immunodeficiency virus and other sexually transmitted infections among female sex workers in two major cities in Papua New Guinea

BACKGROUND: Treatable sexually transmitted infections are very common in developing countries and quite often are inadequately treated or remain untreated despite the fact that they enhance the transmission of human immunodeficiency virus (HIV). GOAL: To estimate the prevalence of HIV, syphilis, chlamydial infection, gonorrhea, and trichomoniasis among female sex workers in Port Moresby and Lae, Papua New Guinea, and to collect data on associated behaviors. STUDY DESIGN: Self-identified female sex workers recruited through our peer-mediated sexually transmitted disease (STD)/HIV risk-reduction community outreach program were invited to participate in the study. Participants underwent pretest counseling, were interviewed, and were asked to self-collect vaginal swab specimens for the detection of STDs and to provide 10 mL of blood for HIV and syphilis testing. RESULTS: A total of 407 female sex workers, 207 in Port Moresby and 200 in Lae, were enrolled in the study. The overall prevalence rates of HIV, syphilis, genital chlamydial infection, gonorrhea, and trichomoniasis among these women were estimated to be 10%, 32%, 31%, 36%, and 33%, respectively. The sex workers in Port Moresby had a significantly higher HIV infection rate (17%) than those in Lae (3%) and a significantly lower trichomoniasis rate (21%) than those in Lae (44%). Mixed infections were common, occurring in 45% of the cases. Despite a high rate of symptoms, the rate of treatment-seeking was low. Condom use among the sex workers was very inconsistent; 85% reported that they did not use condoms at all times when having sex with their clients. Common reasons cited were dislike by clients, unavailability, alcohol use, and familiarity with a client. CONCLUSIONS: STDs are very common among female sex workers in Port Moresby and Lae and very often present as multiple infections. Despite STD/HIV awareness campaigns, unsafe sex-particularly irregular use of condoms-continues among sex workers and their clients. Barriers to safer sexual behavior need to be addressed, as do improvements in provision of STD services.     

Prevalence of bisexual behaviors among men who have sex with men (MSM) in China and associations between condom use in MSM and heterosexual behaviors

OBJECTIVES: This study investigated the prevalence of bisexual behaviors and marital status among Chinese men who have sex with men (MSM) and the associations between MSM's condom use and their heterosexual behaviors. METHODOLOGY: Eight hundred ninety-six adult males in Yunnan Province, China, who reported to ever have engaged in MSM behaviors were interviewed. Data were acquired through the China-UK HIV/AIDS Prevention and Care Project from 2003 to 2006. RESULTS: Of all respondents, one-third had ever been married, 59% had ever engaged in bisexual behaviors, and 31% had done so in the past 6 months. High prevalence of inconsistent condom use was reported in heterosexual behaviors (71.9%), as well as with those who had engaged in MSM sexual behaviors in the past 6 months (30.8% with commercial sex workers and 54.7% with noncommercial sex partners) in the past 6 months. Those who did not use condoms with MSM partners were also more likely than others to not use condoms with their female sex partners (FSP). Those who had voluntary counseling and testing services were more likely than others to have used a condom in the last episode of sex with their FSP (multivariate odds ratio = 1.66). CONCLUSIONS: The clustering of unprotected sexual behaviors with male and FSP among bisexual MSM is revealed. The bridging effects of the risk for human immunodeficiency virus transmission from the MSM population to the female population are evident.     

HIV, syphilis infection, and sexual practices among transgenders, male sex workers, and other men who have sex with men in Jakarta, Indonesia

OBJECTIVES: To establish the prevalence of HIV, syphilis, and sexual risk behaviour among three groups of men who have sex with men in Jakarta, Indonesia, and to investigate sexual links between these men and broader heterosexual populations. METHODS: Anonymous, cross sectional surveys among community recruited transgender and male sex workers and self recognised men who have sex with men (MSM) were undertaken in mid-2002 in Jakarta, Indonesia. Places where transgender and male sex workers sell sex and where men go to meet non-commercial male sex partners were mapped. Probability samples were selected for the sex worker populations, while a mixed probability and convenience sample was drawn for self recognised MSM. Blood was drawn for HIV and syphilis serology and community interviewers administered a standardised questionnaire. RESULTS: HIV prevalence was 22% among transgender sex workers, 3.6% among male sex workers, and 2.5% among self recognised MSM, and syphilis prevalence was 19.3%, 2.0% and 1.1% respectively. 59.3% of transgender sex workers and 64.8% of male sex workers reported recent unprotected anal intercourse with clients, and 53.1% of other MSM reported unprotected anal sex with male partners. Some 54.4% of male sex workers and 18.3% of other MSM reported female partners in the preceding year. CONCLUSION: HIV has reached substantial levels among transgender sex workers, and is not negligible in other MSM groups. Risk behaviour is high in all subpopulations, and bisexual behaviour is common, meaning the threat of a wider epidemic is substantial. Prevention programmes targeting male-male sex are needed to reduce this threat.     

Sex worker health: San Francisco style

OBJECTIVES: To describe the characteristics of sex workers accessing care at a peer based clinic in San Francisco and to evaluate predictors of sexually transmitted infections (STI). METHODS: We conducted an observational study of sex workers at St James Infirmary. Individuals underwent an initial questionnaire, and we offered screening for STI at each clinic visit. We performed univariate, bivariate, and multivariable analyses to assess for predictors of STI in this population. RESULTS: We saw 783 sex workers identifying as female (53.6%), male (23.9%), male to female transgender (16.1%), and other (6.5%). 70% had never disclosed their sex work to a medical provider. Participants represented a wide range of ethnicities, educational backgrounds, and types of sex work. The most common substance used was tobacco (45.8%). Nearly 40% reported current illicit drug use. Over half reported domestic violence, and 36.0% reported sex work related violence. Those screened had gonorrhoea (12.4%), chlamydia (6.8%), syphilis (1.8%), or herpes simplex virus 2 (34.3%). Predictors of STI included African-American race (odds ratio (OR) 3.3), male gender (OR 1.9), and sex work related violence (OR 1.9). In contrast, participants who had only ever engaged in collective sex work were less likely to have an STI (OR 0.4). CONCLUSIONS: The majority of sex workers have never discussed their work with a medical provider. Domestic violence is extremely prevalent as is work related violence. Working with other sex workers appears to be protective of STIs. STI prevention interventions should target African-American and male sex workers. Addressing violence in the workplace and encouraging sex workers to work collectively may be effective prevention strategies.     

Migrant men: a priority for HIV control in Pakistan?

OBJECTIVES: To assess sexual risk behaviour and prevalence of treatable sexually transmitted infections (STI) in migrant male workers in Lahore, Pakistan. METHODS: Behavioural interviews were conducted on a representative sample of 590 migrant men aged 20-49 years. Biological samples were collected from a subsample of 190 and tested for chlamydia, gonorrhoea, and syphilis. RESULTS: Over half (55%) of single men were sexually experienced and 36% of married men reported premarital sex. The median ages at first intercourse and first marriage were 21 years and 28 years, respectively. In the total sample (including virgins), 13% reported any female non-marital partner in the past 12 months, 7% contact with a female sex worker, and 2% sex with a man. Only 10% reported using a condom during most recent contact with a sex worker. STI symptoms in the past 3 months were reported by 8% of men. Laboratory tests disclosed that STI prevalence was 3.2%. CONCLUSIONS: If and when HIV infection spreads among sex workers in Lahore, the reported behaviour of migrant men suggests that they may act as a conduit for further transmission to the general population. Condom promotion focused on the sex trade is likely to be the most effective way of reducing this risk.     

Syphilis among female sex workers in southwestern China: potential for HIV transmission

OBJECTIVE: The objective of this study was to investigate the prevalence and risk factors of syphilis infection among female sex workers in a southwestern Chinese city along a drug trafficking route. METHODS: From December 2004 to January 2005, 343 female sex workers (FSWs) were recruited through community outreach and peer referring. Confidential questionnaire interviews were administered to collect information on sexual and other sexually transmitted diseases/HIV risk behaviors. Cervical and blood samples were collected to test for syphilis and HIV antibodies and Neisseria gonorrhoeae infection; Condyloma acuminatum infection was diagnosed clinically. RESULTS: Of 343 FSWs, 15.7% were infected with syphilis. The prevalence of HIV, gonorrhea, and C. acuminatum was 0.6%, 2.0%, and 1.5%, respectively. The subtype of 2 HIV-1 infections was both CRF 07BC. Nearly 10% of FSWs reported using illicit drugs. Consistent use, inconsistent use, and never use of condoms with commercial sex clients in the last month were reported by 53.9%, 38.5%, and 7.6% FSWs, respectively. Longer duration of sex work (odds ratio [OR] = 1.98; 95% confidence interval [CI] = 1.08-3.62), working at low-end establishments (OR = 2.03; 95% CI = 1.10-3.76), and if primary sex partners had sex with other women in the past 6 months (OR = 2.06; 95% CI = 1.08-3.91) were independently associated with syphilis infection. CONCLUSIONS: High prevalence of syphilis and overlapped unprotected commercial sex and drug using behaviors among FSWs along a drug-trafficking route may suggest a potential for rapid spread of HIV from injection drug users to FSWs and then to the general population and underscore the urgency of preventive interventions to break the bridge of FSWs for HIV/sexually transmitted disease spread.     

Acceptability of the female condom among sex workers in Thailand: results from a prospective study.

BACKGROUND: The female condom may provide women with the first female-controlled barrier method that is effective against sexually transmitted diseases, including HIV infection. GOAL: This study evaluated the acceptability of the female condom among sex workers in Thailand. STUDY DESIGN: Data on use and acceptability of the female condom were collected using a structured questionnaire during an 8-week follow-up. RESULTS: Analyses included 148 women who were still in follow-up at week 8. Sex workers used, on average, 2.8 female condoms per week. The overall satisfaction rate with the female condom was 68%, although, among users, 31% had difficulties in device insertion, 37% had pain from the inner ring, and 22% reported itching sensations. The main reason for using the female condom in the future was its perceived safety, and the main reason for not using it would be the client's refusal. CONCLUSION: Two-thirds of the sex workers were satisfied with the female condom. Difficulties at insertion, discomfort during use, and clients' attitude were potential obstacles to the use of the female condom in the future.     

Factors associated with condom use for oral sex among female brothel-based sex workers in Singapore

BACKGROUND AND OBJECTIVE: The prevalence of oral sex increased from 27.1% in 1992 to 81.1% in 1997, with a concomitant increase in pharyngeal gonorrhea, among female sex workers in Singapore. The extent of condom use for oral sex among them is unknown. GOAL: To determine the prevalence of and factors associated with consistent condom use during oral sex. STUDY DESIGN: A cross-sectional study of 225 women randomly selected from the surveillance scheme register of female brothel-based sex workers with a history of oral sex documented in their medical records. RESULTS: Slightly more than half (56.9%) consistently used condoms for oral sex compared to 97% for vaginal sex. Condom use was significantly higher among middle than high class sex workers (adjusted rate ratio: 1.52, 95% CI: 1.01-2.29) and those with negotiation skills (adjusted rate ratio: 1.95, 95% CI: 1.32-2.07). CONCLUSION: Sex workers should be taught skills to negotiate condom use for oral sex.     

A comparative study of condom use and self-reported sexually transmitted infections between foreign Asian and local clients of sex workers in Singapore

OBJECTIVE: We conducted a survey to compare condom use and its associated factors between foreign Asian and local clients of female sex workers in Singapore. STUDY: A survey was conducted between 2001 and 2002 on a random sample of 810 clients (677 foreign Asian workers and 133 locals) recruited from the streets and outside the brothels in Singapore. RESULTS: Foreign clients were more likely than locals to be inconsistent condom users with sex workers. Clients from China reported the highest percentage of inconsistent condom use (29.2%) and sexually transmitted infections (16.7%) compared with 8.3% (P < 0.003) and 2.3% (P < 0.005), respectively, among locals. On multivariate analysis, inconsistent condom use among foreign clients increased significantly with the number of freelance sex workers. The reverse trend was found for local clients. CONCLUSION: There is a need to design separate condom-promotion programs for foreign Asian and local clients of sex workers in Singapore.