The purpose of this study was to explore the factors associated with suicidal ideation and attempt among female sex workers (FSWs) in China. A cross-sectional survey was administered among 454 FSWs in a rural county of Guangxi, China. About 14% of FSWs had thought of suicide and 8% had attempted suicide in the past 6 months. Multiple logistic regression analyses indicated that those FSWs who were dissatisfied with life, abused alcohol, were deceived or forced into commercial sex, and had stable sexual partners were more likely to report suicidal ideation. Female sex workers who had multiple stable partners, experienced sexual coercion, and worried about an inability to make enough money were more likely to report a suicide attempt. These FSWs who entered commercial sex because of financial needs or who were influenced by the peers were less likely to report a suicide attempt. Our data suggested that the rates of suicidal ideation and attempts were high among FSWs in China, and there were multiple factors associated with their suicidality. Future health education and promotion efforts among FSWs need to take into consideration substance abuse, interpartner conflict, and psychological stress.

Context. There exists a research interest shift from separate symptoms to symptom clusters among people living with HIV (PLWH), which may provide a better understanding of symptom management in HIV/AIDS care. However, the symptom clusters among Chinese PLWH are still unknown.Objectives. The aim of our study was to identify symptom clusters and to examine demographic and health-related factors associated with these symptom clusters among PLWH prescribing antiretroviral therapy (ART) in China.Methods. From April to September 2017, we recruited 1116 participants through a convenience sampling in five HIV/ AIDS designated facilities in the eastern, middle, and southwest regions of China. The principal component analysis was used to identify the symptom clusters. Association network was adopted to describe the relationships among symptoms and clusters. A multiple linear model was used to investigate the associated factors for the severity of overall symptoms and the prevalence of each symptom clusters.Results. Five symptom clusters were identified, including cognitive dysfunction, mood disturbance, wasting syndrome, dizziness/headache, and skin-muscle-joint disorder. Cognitive dysfunction was the most central symptom cluster. Variables including primary caregiver during ART treatment, years of HIV diagnosis and ART use, having comorbidity, self-rated health, and quality of life were associated with the prevalence of these five symptom clusters. Conclusion.Our study suggests that there is a need to evaluate symptom clusters for the improvement of symptom management among PLWH. It is particularly important to include assessment and treatment of cognitive symptoms as an essential component of the HIV care.

ABSTRACT:Previous reports have demonstrated that sulfate metabolites may be excreted into bile by the multidrug resistance-associated protein 2 (Mrp2, Abcc2). Although recombinant human breast cancer resistance protein (BCRP, ABCG2) has affinity for sulfated xenobiotics and endobiotics, its relative importance in biliary excretion of sulfate metabolites in the intact liver is unknown. In the present studies, the potential contribution of Bcrp1 to the biliary excretion of acetaminophen sulfate (AS) was examined following acetaminophen administration (66 mol, bolus) to isolated perfused livers ; TR؊ and wild-type, respectively). In vitro assays indicated that impaired AS biliary excretion in the presence of GF120918 was due to inhibition of Bcrp1, and not P-glycoprotein. In conclusion, Mrp2 and, to a lesser extent, Bcrp1 mediate biliary excretion of AS in the intact liver.Hepatic sulfation of xenobiotics is a common phase II metabolic reaction that increases hydrophilicity of the molecule prior to biliary excretion or efflux across the hepatic basolateral membrane for subsequent renal clearance. Xenobiotic inactivation and/or detoxification may occur by direct sulfation of the parent compound (e.g., acetaminophen) or may follow phase I oxidation (e.g., phenobarbital). However, hepatic xenobiotic sulfation also can lead to activation of prodrugs [e.g., minoxidil (Buhl et al., 1990)] and hepatotoxins [e.g., covalent microsomal protein binding of phenacetin sulfate (Mulder et al., 1977); formation of DNA adducts with tamoxifen sulfate (Glatt et al., 1998); potent bile salt export pump inhibition by troglitazone sulfate leading to cholestasis (Funk et al., 2001)]. Considering that sulfated xenobiotics may exhibit pharmacologic or toxicologic activity, perturbations in transport mechanisms responsible for excretion of sulfate conjugates may have important therapeutic and toxic implications.Previous studies have demonstrated that the canalicular multispecific organic anion transporter, multidrug resistance-associated protein 2 (Mrp2, Abcc2), is responsible for the biliary excretion of glucuronide and glutathione conjugates of xenobiotics, but that it only partially mediates biliary excretion of sulfate metabolites. Transport of the sulfate metabolite of the dual inhibitor of 5-lipooxygenase and thromboxane A 2 synthase, E3040, was largely maintained in canalicular liver plasma membrane vesicles (ϳ75% of wild-type) and isolated perfused livers [(IPLs) comparable to wild-type] from Mrp2-deficient rats, whereas translocation of E3040 glucuronide across the canalicular membrane was negligible in the absence of Mrp2 (Takenaka et al., 1995). Cumulative biliary excretion of phenobarbital sulfate in IPLs from Mrp2-deficient rats was ϳ30% of that observed in livers from wild-type rats, whereas biliary excretion of the glucuronide conjugate was not observed in the absence of Mrp2 . Similarly, biliary excretion of phenolphthalein disulfate, but not glucuronide, was partially (ϳ15% of wild-type) maintained in rats lacking Mrp2 (Og...

Previously, we demonstrated acupuncture at acupoint HT7 (Shen-Men) attenuated ethanol withdrawal syndrome by normalizing the dopamine release in nucleus accumbens shell. In the present study, we investigated the effect of acupuncture on anxiety-like behavior in rats and its relevant mechanism by studying neuro-endocrine parameters during ethanol withdrawal. Rats were treated with 3 g kg−1day−1 of ethanol (20%, w/v) or saline by intraperitoneal injections for 28 days. The rats undergoing ethanol withdrawal exhibited anxiety-like behavior 72 h after the last dose of ethanol characterized by the decrease of time spent in the open arms of the elevated plus maze compared with the saline-treated rats (P < .05). Radioimmunoassay exhibited there were notably increased concentrations of plasma corticosterone in ethanol-withdrawn rats compared with saline-treated rats (P < .05). Additionally, high performance liquid chromatography analysis also showed the levels of norepinephrine and 3-methoxy-4-hydroxy-phenylglycol were markedly increased while the levels of dopamine and 3,4-dihydroxyphenylacetic acid were significantly decreased in the central nucleus of the amygdala of ethanol-withdrawn rats compared with saline-treated rats (P < .01). Acupuncture groups were treated with acupuncture at acupoint HT7 or PC6 (Nei-Guan). Acupuncture at HT7 but not PC6 greatly attenuated the anxiety-like behavior during ethanol withdrawal as evidenced by significant increases in the percentage of time spent in open arms (P < .05). In the meantime, acupuncture at HT7 also markedly inhibited the alterations of neuro-endocrine parameters induced by ethanol withdrawal (P < .05). These results suggest that acupuncture may attenuate anxiety-like behavior during ethanol withdrawal through regulation of neuro-endocrine system.

We performed this study to examine the association of sexual coercion with HIV-related risk behaviors and suicidal thoughts and attempts among female sex workers (FSWs) in Guangxi, China. Four hundred fifty-four FSWs in 57 entertainment establishments (including shampooing salons, massage parlors, and restaurants) were interviewed between March and May 2004. Fifteen percent of the women reported having been coerced into sex in the last 6 months. The prevalence of suicidal thoughts and suicide attempts in the last 6 months were 14.3% and 8.4%, respectively. Sexual coercion was significantly associated with both an increased rate of HIV-related risk behavior, and suicidal thoughts and attempts among FSWs. Therefore, along with the awareness and intervention programs, efforts should be taken to reduce the exposure of FSWs to sexual coercion and to improve the mental health of FSWs.