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New Evidence of The Cochrane Library(Issue 4, 2004)

Quality evaluation of clinical guidelines and consensus for adult AIDS

Objective To evaluate the methodological and reporting quality of clinical guidelines and consensus for adult AIDS. Methods Databases including PubMed, EMbase, Web of Science, CBM, WanFang Data and CNKI were electronically searched and major guideline websites such as GIN, NICE, NGC and Yimaitong were also searched to collect guidelines and consensus for adult AIDS from inception to December 2021. Two researchers independently screened the literature and extracted data according to the inclusion and exclusion criteria. Four reviewers evaluated the methodological and reporting quality of the included guidelines and consensus by using AGREE Ⅱ and RIGHT, respectively. Results A total of 17 adult AIDS guidelines and consensus were included. The average scores of AGREE Ⅱ in various domains were 59.48% for scope and purpose, 37.17% for stakeholder involvement, 30.76% for rigor of development, 74.75% for clarity of presentation, 35.54% for applicability, and 50.49% for editorial independence. The items with the highest reporting rate among the RIGHT evaluation items were 1a, 1b and 1c (100.00%), followed by 3 and 4 (94.12%), 13a and 13b (88.24%), 7b and 11a (76.47%), and 5 (64.71%), and the remaining items were all reported below 60%. Results of subgroup analysis showed that the clarity of presentation, applicability and editorial independence of the guidelines for adult AIDS expressed in AGREE Ⅱ and the average score of RIGHT were higher than those of the consensuses for adult AIDS; the average scores of guidelines and consensuses based on evidence-based medicine in five domains of AGREE Ⅱ (scope and purpose, stakeholder involvement, rigor of development, clarity of presentation and applicability) and RIGHT were higher than those based on expert opinions or reviews. The foreign guidelines and consensus had higher average scores in the six domains of AGREE Ⅱ and the RIGHT score than the domestic guidelines. Conclusion The methodological quality and reporting quality of the published clinical guidelines and consensuses for adult AIDS is low; in particular, there is a certain gap between the national and international guidelines and consensuses. It is suggested that future guideline developers should refer to international standards, such as AGREE Ⅱ and RIGHT, formulate high-quality guidelines and promote their application to better regulate the diagnosis and treatment of adult AIDS.

Meta-analysis of Effect on HIV/AIDS Intervention in Floating Population

Objective　To evaluate the effect of a health education for preventing HIV/AIDS in floating population. Methods　A computerized literature search was carried out in PubMed, CBM (Chinese Biomedical Database), CNKI (Chinese National Knowledge Infrastructure), Wanfang (Chinese) and VIP (Chinese) databases to collect articles published between 1996 and 2006 concerning the effect of a HIV/AIDS education intervention in floating population. We also checked the reference lists of relevant articles. The study type was self-control intervention study. Meta-analyses were performed to assess 3 outcomes of the intervention, i.e. knowledge about HIV transmission, means of prevention and attitudes towards HIV/AIDS patients. Fixed and random effect models were employed to combine results after a heterogeneity test, with rate difference (RD) used as the indicator of intervention effect. Results　The analysis showed that the RD for knowing the sexual transmission route of HIV, the RD for knowing the effect of condoms for HIV prevention, and the RD for changing attitudes towards HIV/AIDS patients, i.e. treating them as ordinary people, were increased by 16% (0.10, 0.22), 22% (0.17, 0.28) and 19% (0.13, 0.25), respectively. Conclusion　Health education for preventing HIV/AIDS is effective in changing knowledge and attitudes in floating population.

Efficacy Analysis of Antiretroviral Therapy in 51 Cases with AIDS

目的:分析艾滋病患者抗病毒治療后的臨床療效,比較不同基線CD4+T淋巴細胞計數增長情況。方法:納入51例符合治療標準的初治患者,采用國家標準抗病毒治療一線方案和衛生部統一提供的免費藥物,通過對服藥后半月、1月、3月、6月、12月的時段進行臨床評估和實驗室檢查,并比較不同基線CD4+T淋巴細胞計數水平治療后的增長情況。結果:治療12月后,各方案組療效無差異,不同基線CD4+T淋巴細胞計數的增長有顯著差異。毒副反應為肝損傷、過敏性皮疹,消化道反應為主。結論:HAART可顯著的抑制體內HIV病毒的復制,重建機體的免疫功能,緩解患者病情,有利于存活期的延長。嚴重的毒副作用發生較少。

SMS intervention on improving antiretroviral treatment adherence in HIV patients: a meta-analysis

ObjectivesTo evaluate the effects of short message service (SMS) intervention for improving antiretroviral treatment adherence in HIV patients by meta-analysis.MethodsDatabases including PubMed, EMbase, CINAHL, Web of Science, ScienceDirect, The Cochrane Library, CNKI, WanFang Data, VIP and CBM were searched electronically from January 2000 to December 2018 to collect randomized controlled trials (RCTs) on the efficacy of SMS intervention on HIV patients. Two reviewers independently screened literature, extracted data, and assessed risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software.ResultsA total of 10 RCTs with 2 411 patients were included. The meta-analysis showed that SMS intervention could improve significantly treatment adherence of HIV patients (RR=1.11, 95%CI 1.03 to 1.20, P<0.01). The subgroup analysis showed that weekly texting had an effect on treatment adherence (RR=1.15, 95%CI 1.00 to 1.33, P<0.05); personal sending (RR=1.17, 95%CI 0.99 to 1.38, P=0.06) and daily sending (RR=1.02, 95%CI 0.83 to 1.26, P=0.84) of SMS had no statistical significance on treatment adherence; the intervention duration of 6 months (RR=1.11, 95%CI 1.00 to 1.23, P=0.05) could improve the treatment adherence, while the intervention duration of 12 months (RR=1.07, 95%CI 0.98 to 1.17, P=0.13) had no statistical difference on treatment adherence; there was no statistical difference in CD4+ cell count before and after treatment (WMD=4.18, 95%CI ?39.33 to 47.69, P=0.85).ConclusionsBy comparing SMS intervention with routine nursing, sending SMS weekly for 6 months to remind HIV patients to take medicine can improve treatment adherence. Due to the limitation of quantity and quality of the included studies, the above conclusions are required to be assessed by more high-quality studies.

發熱、活動后氣促，兩肺磨玻璃影（續）

艾滋病并發血小板極度低下一例

護理本科生對艾滋病相關知識及態度的調查分析

目的　了解護理本科生（護生）對艾滋病（AIDS）相關知識了解情況及對人類免疫缺陷病毒（HIV）感染者/AIDS患者的態度，為學校開展相關健康教育提供參考依據。 方法　2011年2月采用問卷調查法，對285名護生進行調查，收回問卷276份，有效問卷257份。 結果　護生對HIV/AIDS相關知識平均得分為（21.2 ± 3.8）分，對正確使用安全套知識平均得分為（3.7 ± 1.6）分，各年級掌握情況有差異（P＜0.001）。257名護生中，82.5%對因輸血或注射感染HIV者持同情態度，33.9%和32.3%的護生對因婚前或婚外性行為、性服務者而感染HIV者持歧視態度。 結論　學校應對護生進行系統正確的HIV/AIDS相關知識的教育，培養護生正確對待HIV感染者/AIDS患者的態度。

Effectiveness Evaluation of Intervention Modes among Street-based Female Sex Worksin Chongqing

Objective　To explore the methods of intervention for street-based female sex workers (FSWs) by assessing the intervention process, and evaluate the effectiveness. Methods　By cluster sampling procedure, many streetbased female sex workers in Yuzhong district were intervened systematically after informed consent. Before and after the intervention, questionnaire survey was conducted to understand their KAP towards AIDS and analyzed the results of the questionnaire and the effectiveness of intervention. Results　The recognition rate abut AIDS knowledge was improved markedly, from the previous 28% to the later 70.5%; condom use in last act increased the previous 59% to the later 75%, consistent use in recent month changed from 4% to 26%; Peer education was trained. Conclusion　systematical intervention among street-based female sex workers is critical for spread of AIDS.

艾滋病并發眼底病患者的護理

目的　總結艾滋病并發眼底病患者的護理要點。 方法　回顧分析2010年3月－2012年4月艾滋病并發眼底病7例患者（13只眼）的臨床資料和護理經驗。7例患者中3例放棄手術，4例實施7次手術治療。護理重點是護理人員的培訓和患者的心理護理、局部護理、全身癥狀護理和健康教育。 結果　艾滋病并發眼底病3例患者放棄手術，4例手術中接受玻璃體切割術者4例次，視網膜修復術2例次，硅油取出術1例次，硅油充填術3例；患者術后視網膜復位4例，術后視力：0.02者2例，數指5例。無1例不良事件和護理安全事件發生，出院隨訪康復和治療情況較好。 結論　艾滋病并發眼底病患者的護理重點是眼部和全身疾病的護理、患者的心理護理、隱私保護，以及醫護人員的職業防護。