Swiss psychiatrist Carl Jung had a lifelong interest in the I Ching after discovering it in 1919. Jung\'s interest in the I Ching is arguably more practical than purely theoretical or intellectual, and references to I Ching divination appear frequently in his various publications, seminars, letters and clinical practice records. After a few observations on the history of the study of the I Ching in China, the author categorizes Jung\'s three uses of the I Ching as physical use (to preview future potentials of outer reality), psychological use (to reveal one\'s psychological state), and psychical approach (to engage with the divine through \"\"[\"shen\", spiritual agencies]). Finally, the author discusses the current Jungian engagement by demonstrating clinical cases in contemporary times. Some Jungian analysts practise I Ching divination to obtain insights into the physical and psychological state of therapeutic relationships and for personal development. This paper is a historical and critical engagement of the Jungian practice of I Ching divination.
Le psychiatre suisse Carl Jung s\'est intéressé tout au long de sa vie au Yi-King après l\'avoir découvert en 1919. L\'intérêt de Jung pour le Yi-King est sans doute plus pratique que purement théorique ou intellectuel, et des références à la divination avec le Yi-King apparaissent fréquemment dans ses diverses publications, séminaires, lettres et écrits en lien avec la pratique clinique. Après quelques observations sur l\'histoire de l\'étude du Yi-King en Chine, je classe les trois utilisations du Yi-King par Jung: l\'utilisation physique (pour avoir un aperçu des potentiels futurs de la réalité extérieure), l\'utilisation psychologique (pour révéler son propre état psychologique) et l\'approche psychique (pour s\'impliquer avec le divin à travers \'神\' [Shen, instances spirituelles]). Enfin, je traite de l\'engagement jungien actuel en apportant des cas cliniques de l\'époque contemporaine. Certains analystes jungiens pratiquent la divination avec le Yi-King pour obtenir des éclairages sur l\'état physique et psychologique des relations thérapeutiques et pour le développement personnel. Cet article est un engagement historique et critique de la pratique jungienne de la divination avec le Yi-King.
Der Schweizer Psychiater Carl Jung hatte ein lebenslanges Interesse am I Ging, nachdem er es 1919 entdeckt hatte. Jungs Interesse am I Ging ist möglicherweise mehr praktisch als rein theoretisch oder intellektuell. Verweise auf I Ging-Deutungen tauchen häufig in seinen verschiedenen Veröffentlichungen, Seminaren, Briefen und klinischen Aufzeichnungen auf. Nach einigen Betrachtungen zur Geschichte des Studiums des I Ging in China kategorisiert der Autor Jungs drei Verwendungen des I Ging als physische Verwendung (um zukünftige Potentiale der äußeren Realität zu erkunden), psychologische Verwendung (um einen psychologischen Zustand zu enthüllen) und einen psychischen Ansatz (um mit dem Göttlichen durch “神”[“shen”, spirituelle Instanzen] Verbindung herzustellen). Schließlich diskutiert der Autor die aktuelle jungianische Auseinandersetzung, indem er klinische Fälle aus heutiger Zeit heranzieht. Einige jungianische Analytiker praktizieren I Ging-Deutungen, um Einblicke in den physischen und psychologischen Zustand therapeutischer Beziehungen sowie zur persönlichen Entwicklung zu erhalten. Dieser Artikel ist eine historische und kritische Auseinandersetzung mit der jungianischen Praxis der I Ging-Deutung.
Lo psichiatra svizzero Carl Jung ha coltivato per tutta la sua vita un interesse per l\'I Ching, dopo averlo scoperto nel 1919. L\'interesse di Jung per l\'I Ching sembra essere stato più pratico che puramente teorico o intellettuale, ed i riferimenti alle sentenze dell\'I Ching sono frequenti nelle sue varie pubblicazioni, e nei seminari, nelle lettere e negli appunti clinici. Dopo alcune osservazioni sulla storia dello studio dell\'I Ching in Cina, l\'Autore identifica tre approcci con cui Jung ha utilizzato l\'I Ching, ovvero per la realtà fisica (per prevedere potenzialità nella realtà esterna), per l\'utilizzo psicologico (per far luce su uno stato psicologico di una persona), e l\'approccio psichico (per rapportarsi con il divino attraverso “神”[“shen”, la spiritualità]). Infine, l\'Autore discute l\'attuale l\'approccio junghiano con dimostrazioni di casi clinici dei nostri giorni. Alcuni analisti junghiani utilizzano l\'I Ching per ottenere insight riguardanti le condizioni fisiche e psicologiche delle relazioni terapeutiche, e per lo sviluppo personale. Questo articolo offre una prospettiva storica e critica sull\'utilizzo dell\'I Chung nella pratica junghiana.
Познакомившись с «Книгой перемен» в 1919 году, швейцарский психиатр Карл Юнг до конца жизни сохранял интерес к ней. Его интерес, вероятно, был скорее практическим, чем чисто теоретическим или интеллектуальным, и в публикациях, семинарах, письмах и клинических записях Юнга часто встречаются упоминания о гадании по «Книге перемен». После ряда замечаний об истории изучения «Книги перемен» в Китае я выделяю три способа ее использования Юнгом: физический (для предсказания о возможном будущем во внешней реальности), психологический (для выявления психологического состояния человека) и духовный (для взаимодействия с божественным через “神” [шэнь, духовные органы]). Наконец, я обсуждаю ее использование в современном юнгианском анализе и демонстрирую актуальные клинические случаи. Некоторые юнгианские аналитики прибегают к гаданию по «Книге перемен», чтобы получить представление о физическом и психологическом состоянии терапевтических отношений и для личного развития. Данная статья представляет собой историческое и критическое исследование юнгианской практики гадания по «Книги перемен».
El psiquiatra suizo Carl Jung se interesó durante toda su vida por el I Ching tras descubrirlo en 1919. Podría decirse que el interés de Jung por el I Ching es más práctico que puramente teórico o intelectual, y las referencias a la adivinación con el I Ching aparecen con frecuencia en sus diversas publicaciones, seminarios, cartas y registros de práctica clínica. Luego de algunas observaciones sobre la historia del estudio del I Ching en China, el autor categoriza los tres usos que Jung daba al I Ching en: uso físico (para prever potenciales futuros de la realidad exterior), uso psicológico (para revelar el propio estado psicológico) y abordaje psíquico (para relacionarse con lo divino a través del “神”[“shen”, agencias espirituales]). Por último, el autor analiza la utilización Junguiana actual mediante la demostración de casos clínicos en la época contemporánea. Algunos analistas Junguianos practican la adivinación I Ching para obtener información acerca del estado físico y psicológico de las relaciones terapéuticas y para su desarrollo personal. Este artículo es un compromiso histórico y crítico de la práctica Junguiana de la adivinación I Ching.
《易经》作为荣格学派的工具:历史与实践的视角 瑞士精神科医生卡尔-荣格在1919年得知《易经》之后, 对之保持着毕生的兴趣。荣格对《易经》的兴趣可以说更倾向于实践, 而非理论和知识。在荣格的众多发表物, 讲座, 信件和ิ床记录中, 经常出现使用《易经》占卜的引用。作者在观察了《易经》在中国的使用历史之后, 将荣格对《易经》的使用划分为三种类型:客观使用 (对外在现实的未来倾向性的预示), 心理使用 (展现个体心理状态), 灵性使用 (用以通过神 (灵性的媒介)连接灵性)。最后, 作者通过当代的临床个案, 讨论了当代荣格学派对《易经》的使用。一些荣格分析家用《易经》占卜, 以洞察治疗关系中的身心状态, 或是用以洞察个体发展。本文从历史与实践的视角讨论了荣格派实践中对《易经》占卜的使用。.

Nurses play an essential role in the People\'s Republic of China. In particular, they are essential to meet the challenges of an aging population. While there has been little change in their situation for many years, change is now underway. The National Health Commission of the People\'s Republic of China has announced the upcoming implementation of strategies essential to the development of the profession.

As analytical psychology in China develops, especially with the China Society for Analytical Psychology approved for membership in the International Association for Analytical Psychology (IAAP), many Chinese, who are already familiar with MBTI®-based personality testing in corporations, are interested in learning more about Jungian theory and practice with regard to psychological types. The author, a Chinese psychologist, emphasizes current problems standing in the way of this development, such as the common opinion that MBTI is equal to psychological types. He reports his recent research that highlights the present understanding of psychological types within China. Noting that Jung combined two attitudes with four functions to form eight function-attitudes of consciousness, the author explores the possible connection between Jung\'s eightfold system and the eight trigrams that organize the wisdom that the I Ching brings to emergent situations requiring exceptionally conscious decision-making. He compares I Ching translator Richard Wilhelm\'s naming and description of these eight Gua with Jungian analyst John Beebe\'s descriptions of the eight function-attitudes and finds striking parallels. This amplification sheds light on the archetypal nature of psychological consciousness as well upon the typology of it that Jung advanced.
Maintenant que la psychologie analytique se développe en Chine, particulièrement avec la Société Chinoise des Analystes Jungiens, reconnue par l’Association Internationale de Psychologie Analytique (AIPA), beaucoup de Chinois - étant déjà familiarisés avec l’évaluation de la personnalité dans les entreprises par le test MBTI - cherchent à en savoir plus sur les types psychologiques en théorie et en pratique. L’auteur, un psychologue chinois, évoque les problèmes actuels qui rendent ce développement difficile, par exemple l’opinion répandue que le MBTI est équivalent aux types psychologiques de Jung. L’auteur rend compte de ses recherches récentes en Chine sur la compréhension actuelle des types psychologiques. Soulignant que Jung a combiné deux attitudes avec quatre fonctions formant huit fonction-attitudes de la conscience, il explore le lien possible entre le système à huit parties de Jung et les huit trigrammes qui ordonnent la sagesse que le Yi King apporte à des situations naissantes et qui requièrent un processus de décision particulièrement conscient. Il compare la manière dont le traducteur du Yi King Richard Wilhelm nomme et décrit les huit Gua avec les descriptions par l’analyste Jungien John Beebe des huit fonction-attitudes et il trouve des parallèles frappants. Cette amplification éclaire la nature archétypale de la conscience psychologique et de sa typologie telle que Jung l’a conçue.
Mit der Entwicklung der Analytischen Psychologie in China, insbesondere durch die Anerkennung der China Society of Jungian Analysts als Mitglied der International Association for Analytical Psychology (IAAP), sind viele Chinesen, die bereits mit MBTI®-basierten Persönlichkeitstests in Unternehmen vertraut sind, daran interessiert, mehr über Jungianische Theorie und Praxis in Bezug auf psychologische Typen zu lernen. Der Autor, ein chinesischer Psychologe, hebt aktuelle Probleme hervor, die dieser Entwicklung im Wege stehen, wie die verbreitete Meinung, daß MBTI psychologischen Typen gleichgestellt ist. Er berichtet über seine jüngsten Forschungen, die das gegenwärtige Verständnis von psychologischen Typen in China beleuchten. Anmerkend, daß Jung zwei Einstellungen mit vier Funktionen kombinierte, um acht Funktions-Einstellungen des Bewußtseins zu bilden, untersucht der Autor die mögliche Verbindung zwischen Jungs achtfachem System und den acht Trigrammen, die die Weisheit organisieren, die das I Ging in entstehende Situationen bringt, die außergewöhnliches bewußtes Entscheiden erfordern. Er vergleicht die Benennung und Beschreibung dieser acht Gua durch den I Ging-Übersetzer Richard Wilhelm mit den Beschreibungen der acht Funktionseinstellungen durch den Jungianischen Analytiker John Beebe und findet auffallende Parallelen. Diese Amplifikation wirft ein Licht auf die archetypische Natur des psychologischen Bewußtseins sowie auf die von Jung entwickelte Typologie.
Con lo sviluppo della psicologia analitica in Cina, in particolare con la China Society of Jungian Analysts approvata per l\'ingresso nell\'International Association for Analytical Psychology (IAAP), molti cinesi, che hanno già familiarità con i test della personalità basati sul MBTI® nelle aziende, sono interessati a saperne di più sulla teoria e sulla pratica junghiana per quanto riguarda i tipi psicologici. L\'Autore, uno psicologo cinese, sottolinea i problemi attuali che ostacolano questo sviluppo, come l\'opinione comune che il MBTI sia uguale ai tipi psicologici. Egli riporta la sua recente ricerca che mette in evidenza l\'attuale comprensione dei tipi psicologici all\'interno della Cina. Osservando che Jung ha combinato due tipi con quattro funzioni per formare otto funzioni-tipi della coscienza, l’Autore esplora la possibile connessione tra l’ottuplice sistema di Jung e gli otto trigrammi che organizzano la saggezza che I Ching indica rispetto a situazioni emergenti che richiedono un processo decisionale particolarmente consapevole. L’Autore confronta la denominazione e la descrizione di questi otto Gua del traduttore di I Ching Richard Wilhelm, con le descrizioni delle otto funzioni-tipi dell’analista junghiano John Beebe e trova sorprendenti paralleli. Questa amplificazione getta luce sulla natura archetipica della coscienza psicologica e sulla tipologia sua come proposta da Jung.
По мере развития аналитической психологии в Китае, особенно после получения Китайским обществом юнгианских аналитиков статуса члена IAAP, многие китайцы, в частности те, кто уже знаком с опросником Майерс-Бриггс в корпорациях, заинтересовались теорией Юнга и практикой использования психологических типов. Автор, будучи китайским психологом, подчеркивает текущие проблемы, стоящие на пути этого развития, например, распространенное мнение, что опросник Майерс-Бриггс (MBTI) приравнивается к психологическим типам. Он приводит данные своего недавнего исследования, в котором выделено современное понимание психологических типов в Китае. Принимая во внимание, что Юнг сочетал две установки с четырьмя функциями, чтобы сформировать восемь функций-установок сознания, автор исследует возможную связь между восьмеричной системой Юнга и восьмью триграммами, образующими мудрость, которую И Цзин привносит в возникающие ситуации, требующие исключительно осознанного принятия решений. Он сравнивает название и описание этих восьми гуа переводчиком И Цзин Ричардом Вильгельмом с описанием восьми типов, предложенным юнгианским аналитиком Джоном Биби, и находит поразительные параллели. Такая амплификация проливает свет на архетипическую природу психологического сознания, а также на выдвинутую Юнгом типологию.
A medida que la psicología analítica se ha desarrollado en China, especialmente con la Sociedad China de Analistas Junguianos aprobada por la Asociación Internacional de Psicología Analítica (IAAP), muchas personas de China, quienes ya estaban familiarizadas con el test de personalidad MBTI® aplicado en corporaciones, se interesaron en aprender más sobre la teoría y práctica Junguiana con relación a los tipos psicológicos. El autor, psicólogo chino, enfatiza los problemas actuales que se interponen en este desarrollo, como la opinión común que sostiene que MBTI es lo mismo que los tipos psicológicos. El autor presenta su investigación reciente, la cual destaca la comprensión actual sobre tipos psicológicos en China. Observando que Jung combinó dos actitudes con cuatro funciones para formar ocho funciones-actitudes de la consciencia, el autor explora la posible conexión entre el sistema óctuple de Jung y los ocho trigramas que organizan la sabiduría que el I Ching brinda a las situaciones emergentes que requieren excepcionalmente una toma de decisión consciente. El autor compara las denominaciones y descripciones de los ocho Gua de Richard Wilhelm, traductor del I Ching, con las descripciones de las ocho funciones-actitudes descriptas por John Beebe, y encuentra notables paralelismos. Esta amplificación ilumina la naturaleza arquetipal de la consciencia psicológica, así como la de su tipología, que Jung desarrolló.
心理类型理论在中国的现状及文化背景探索 随着分析心理学在中国的发展, 特别是国际分析心理学会中国学会的成立, 许多已经熟悉企业中基于MBTI性格测试的中国人, 有兴趣学习更多关于心理学类型的荣格理论和实践。作者是一位中国心理学家, 他强调了目前阻碍这一发展的问题, 比如人们普遍认为MBTI等同于心理类型。他报告了他最近的研究, 尤其是目前在中国对心理类型的理解。注意到荣格将两种态度类型与四种功能类型组合形成意识的八种功能态度类型, 作者探讨了荣格的八种意识类型与易经八卦 (在紧急情况需要特别的意识决策, 八卦即此种智慧的呈现)之间的可能关联。他将《易经》翻译家威廉·维尔海姆对八卦的命名和描述与荣格分析家约翰·毕比对意识八种功能态度的描述进行了比较, 发现了惊人的相似之处。这种扩充揭示了心理意识的原型本质以及荣格提出的意识类型理论。.

BACKGROUND: Recent tendencies show a stabilization in Western countries of the incidence of anorexia nervosa but an increase in Asian countries where it used to be lower. The emergence of these diseases in non-Western countries suggests a culture change syndrome on an individual or societal scale. The great number of changes having occurred in China in the past decades would favor the occurrence of eating disorders. A variability of symptoms of eating disorders can be observed depending on the cultural background which also influences the treatment. There are few studies that exist within an Asian context, and they mostly focus on the care.
OBJECTIVE: In this study, we intend to explore the experience of Chinese female patients hospitalized for an eating disorder and the experience of their parents: their relationship with the symptoms, with their health and their understanding of the disease, in order to identify the impact of the Chinese cultural context upon the disorder.
METHODS: It is an observational, phenomenological and qualitative study. A purposive sampling was formed from a clinical population group of young teenagers and women, coming from various areas of China and hospitalized in the specialized Psychosomatic Department of Shanghai Mental Health Center, in August and December 2017. The degree of urbanization, the regions and ages categories were wide-ranging, allowing us to maximize the richness of the data assessing the disease and care representations. Two semi-structured interviews were realized with the participants, then with one or both parents. The interviews were realized with an evaluative interview guide by the same researcher together with a Chinese psychology student in order to clarify the translation and the interpretation of the cultural elements expressed by the participants. The analysis was based on the Interpretative Phenomenological Analysis. Two researchers read the interview transcripts several times, identified themes then connections between the themes to build a set of meta-themes depicting the narratives. Every meta-theme was linked with its corresponding themes which necessitated during the analysis constant back and forth between the analytical data and the source material.
RESULTS: Thirteen female patients and 11 parents took part in the study. The patients were between 12 and 31 years of age. They showed a wide range of eating disorders: restrictive anorexia, anorexia nervosa, or bulimia nervosa. Their Body Mass Index at the time of the interview ranged from 11 to 22. Three meta-themes emerged from the analysis: concerns about thinness and health are real catalysts for seeking care, the opposition between parental beliefs about factors of good health and eating symptoms in young girls, and changes in parenting and traditional educational methods induced by eating symptoms. These different themes highlight the fear of thinness and good health being powerful therapeutic levers in China, the intergenerational agreements and disagreements on the factors of good health with the parental experience of consideration around the eating disorder of their daughter, and an impact of traditional educational modalities on the family relational aspects that change with the disorder.
CONCLUSIONS: Exploring the experience of young Chinese girls or women suffering from eating disorders highlights the complex interactions between the cultural and clinical context of eating disorders. Weight loss is experienced with great difficulty by the young women of our study, who report somatic symptoms and worry about their thinness. Our results show the central position occupied by maintaining oneself in good health in China, for parents and teenagers alike. This allows a quick reliance on healthcare. The intergenerational differences in China are increased by the rapid changes occurring within Chinese society which can cause conflicts and particularly violent struggles. Its younger generations are becoming more and more globalized. These results provide further evidence that eating disorders are culture change syndromes. The therapeutic impact of our results is twofold. On the individual level, there are therapeutic cultural levers linked with Chinese culture, and they have to be sought in all cultures. The therapeutic education of Chinese patients must be centered on the somatic consequences of the disease in order to increase the adherence to the care. On the familial level, the therapeutic approaches centered on intergenerational conflicts must be developed.
CONCLUSIONS: The rapid sociocultural changes in China are causing important intergenerational differences, notably between traditional educational modalities and the need for independence of young people who require specific familial therapy. The cultural elements must be taken into account in order to understand eating disorders and to develop relevant therapeutic approaches.

Tuberculosis (TB) treatment success rates are high in China, but there are still a considerable number of cases who have unfavourable treatment outcomes (UTO). We aimed to determine the proportion of TB patients with UTO and to assess whether baseline characteristics that included glycaemic status [normal fasting blood glucose (FBG), transient hyperglycaemia and diabetes mellitus (DM)] and vitamin D status were associated with UTO.
Prospective cohort study conducted between November 2015 and July 2016 at six clinics within routine TB services in Jilin province, where persons with TB were consecutively recruited. Data analysis was performed using the chi-squared test and multivariate logistic regression.
Of the 306 recruited TB patients, 96 (31.4%) had smear-positive pulmonary TB, 187 (61.1%) had smear-negative pulmonary TB and 23 (7.5%) had extrapulmonary TB (EPTB). Of these, 95 (31.1%) had normal blood glucose, 83 (27.1%) had transient hyperglycaemia and 128 (41.8%) had DM. 227 (74.2%) patients had vitamin D deficiency/severe deficiency. There were 125 (40.8%) patients with UTO of whom the majority were lost to follow-up (57.6%) or not evaluated (28.8%). UTO was significantly associated with smear-negative pulmonary TB (P = 0.009), EPTB (P < 0.001) and DM (P = 0.007).
The proportion of TB patients with UTO increased with smear-negative pulmonary TB, EPTB and DM. TB programmes need to pay more attention to these issues and ensure intensive patient support to those at risk and early detection of DM.
Les taux de succès du traitement de la tuberculose (TB) sont élevés en Chine, mais il existe encore un nombre considérable de cas avec des résultats de traitement défavorables (RTD). Nous avons cherché à déterminer la proportion de patients TB avec un RTD et d\'évaluer si les caractéristiques de base comprenant le statut glycémique [glycémie normale à jeun (GJ), hyperglycémie transitoire et diabète sucré (DS)] et le statut en vitamine D étaient associés à un RTD. MÉTHODE: Etude de cohorte prospective réalisée entre novembre 2015 et juillet 2016 dans six cliniques des services anti-TB de routine de la province de Jilin, où des personnes atteintes de TB ont été recrutées consécutivement. L\'analyse des données a été réalisée à l\'aide du test du chi carré et de la régression logistique multivariée. RÉSULTATS: Sur 306 patients TB recrutés, 96 (31.4%) avaient une TB pulmonaire à frottis positif, 187 (61.1%) avaient une TB pulmonaire à frottis négatif et 23 (7.5%) avaient une TB extra pulmonaire (TBEP). Parmi ceux-ci, 95 (31.1%) avaient une glycémie normale, 83 (27.1%) avaient une hyperglycémie transitoire et 128 (41.8%) avaient un DS. 227 (74.2%) patients avaient une déficience/déficience sévère en vitamine D. Il y avait 125 (40.8%) patients avec un RTD dont la majorité (57.6%) ont été perdus de vue ou ont été non évalués (28.8%). Le RTD était significativement associé à la TB pulmonaire à frottis négatif (p = 0.009), la TBEP (P < 0.001) et le DS (P = 0.007).
La proportion de patients TB avec un RTD augmentait avec la TB pulmonaire à frottis négatif, la TBEP et le DS. Les programmes anti-TB devraient accorder plus d\'attention à ces problèmes et assurer un soutien intensif au patient pour les personnes à risque et une détection précoce du DS.

HIV-positive men who have sex with men (MSM) with CD4 cell counts> 350 cells/mm3 in China recently became eligible for free antiretroviral therapy (ART) due to updated national guidelines. This study aimed to investigate ART coverage and adherence among a large sample of HIV-positive MSM in China.
A cross-sectional survey was conducted in Chengdu and Hangzhou, China, from February to November 2016. Participants were 277 MSM who had received a confirmatory HIV diagnosis and had CD4 levels of> 350 cells/mm3 . Trained staff of collaborating non-governmental organizations contacted all HIV-positive MSM listed in their service records and invited them to join the study. The ART initiation, ART adherence and interactions between healthcare professionals and the patients were assessed.
ART coverage was 60.3%. Among those who were on ART (n = 167), no participants reported missing any doses in the last four days, but 25.7% reported non-compliance to either ART dosing schedule or dosage instructions. After adjusting for background variables and perceived eligibility for ART, two variables were significant factors of higher ART coverage: (i) receiving a recommendation from healthcare professionals for immediate ART initiation and (ii) perceiving having received an adequate explanation of potential harms of ART. Being prescribed> 3 pills per dose and not having a temporary resident permit were associated with non-compliance.
Significant efforts are needed to increase ART coverage among HIV-positive MSM with high CD4 counts in China. Although prevalence of missing doses was low, non-compliance to dosing schedule/instructions should not be neglected. Interactions between healthcare professionals and MSMs play an important role in facilitating ART initiation.
Les hommes VIH positifs ayant des rapports sexuels avec des hommes (HSH) avec un taux de cellules CD4 >350 cellules/mm3 en Chine sont récemment devenus éligibles à la thérapie antirétrovirale (ART) gratuite à la suite de la mise à jour des directives nationales. Cette étude visait à étudier la couverture et la compliance à l’ART dans un large échantillon de HSH VIH positifs en Chine. MÉTHODES: Etude transversale menée à Chengdu et Hangzhou, en Chine de février à novembre 2016. Les participants étaient 277 HSH qui avaient reçu un diagnostic de confirmation du VIH et avaient un taux de CD4 >350 cellules/mm3 . Le personnel formé d’organisations non gouvernementales collaboratrices a contacté tous les HSH positifs pour le VIH répertoriés dans les dossiers de leurs services et les ont invité à prendre part à l\'étude. L\'initiation de l’ART, la compliance à l’ART et les interactions entre les professionnels de santé et les patients ont été évaluées. RÉSULTATS: La couverture de l’ART était de 60,3%. Parmi ceux qui étaient sous ART (n = 167), aucun participant n\'a déclaré avoir manqué de prises au cours des quatre derniers jours, mais 25,7% ont déclaré un manque de compliance soit vis-à-vis du schéma posologique de l’ART ou aux instructions de dosage. Après ajustement pour les variables de base et l\'éligibilité perçue pour l’ART, deux variables étaient des facteurs significatifs d\'une couverture ART plus élevée: (1) le fait de recevoir une recommandation des professionnels de la santé pour l\'initiation immédiate de l’ART et (2) la perception d’avoir reçu une explication adéquate sur les méfaits potentiels de l’ART. Avoir été prescrit >3 comprimés par dose et ne pas detenir un permis de séjour temporaire était associé à la non-compliance.
Des efforts importants sont nécessaires pour augmenter la couverture de l’ART chez les HSH positifs pour le VIH ayant un taux élevé de CD4 en Chine. Bien que la prévalence des doses manquantes ait été faible, la non-compliance au calendrier/instructions posologiques ne doit pas être négligée. Les interactions entre les professionnels de la santé et les HSH jouent un rôle important dans la facilitation de l\'initiation de l’ART.

To investigate trends and socio-economic disparities in the catastrophic health expenditure (CHE) and health impoverishment in China after major reform of the health system and to examine the impacts of the chronic disease on CHE and impoverishment.
We obtained data from four rounds of the China Family Panel Studies 2010-2016, with a sample size of 14 960 households. We defined CHE as the point at which annual household health payments exceeded 40% of annual capacity to pay. Impoverishment is measured by the $1.90 per day poverty line. Multivariate logistic regression models were performed to identify impacts of the family member with chronic disease on CHE and impoverishment.
Between 2010 and 2016, the incidence of CHE in China decreased from 19.37% to 15.11% and from 7.39% to 5.14% for health impoverishment; however, the decrease in level of impoverishment was less in rural areas (from 6.16% down to 3.03%) than in urban areas (from 8.46% down to 7.81%). The gap between impoverishment rates across the income quartiles is growing. Multivariable analysis showed that households with two or more members suffering chronic diseases were significantly more likely to incur CHE (aOR: 2.46, 95% CI: 1.93-3.13) and impoverishment (aOR: 2.66, 95% CI: 1.87-3.78) than households with no members suffering chronic diseases, after adjusting for sociodemographic covariates.
Important advances have been made in achieving greater financial protection for Chinese citizens. Nevertheless, greater attention to the poor households with chronic disease members is needed. Policymakers in China should focus on optimising integrated rural-urban health insurance by expanding the current benefit packages and strengthening poverty alleviation efforts.
Investiguer les tendances et les disparités socioéconomiques dans les dépenses de santé catastrophiques (DSC) et l\'appauvrissement de la santé en Chine après une réforme majeure du système de santé et examiner les impacts de la maladie chronique sur les DSC et l\'appauvrissement. MÉTHODES: Nous avons obtenu des données provenant de quatre séries des Etudes du Panel de la Famille de Chine 2010-2016 sur un échantillon de 14.960 ménages. Nous avons défini la DSC comme le point à partir duquel les paiements annuels pour la santé des ménages dépassaient 40% de la capacité de paiement annuelle. L\'appauvrissement a été mesuré par le seuil de pauvreté de 1,90 $ par jour. Des modèles de régression logistique multivariée ont été effectués pour identifier les impacts du membre de la famille atteint d\'une maladie chronique sur la DSC et l\'appauvrissement. RÉSULTATS: Entre 2010 et 2016, l\'incidence des DSC en Chine est passée de 19,37% à 15,11% et de 7,39% à 5,14% pour l\'appauvrissement de la santé. Cependant, la baisse du niveau d\'appauvrissement a été moindre dans les zones rurales (de 8,46% à 7,81%) que dans les zones urbaines (de 6,16% à 3,03%). L\'écart entre les taux d\'appauvrissement dans les quartiles de revenu se creuse. L’analyse multivariée a montré que les ménages comptant deux membres ou plus souffrant de maladies chroniques étaient significativement plus susceptibles de subir une DSC (aOR: 2,46; IC95%: 1,93-3,13) et un appauvrissement (aOR: 2,66 ; IC95%: 1,87-3,78) que les ménages sans membres souffrant de maladies chroniques, après ajustement pour les covariables sociodémographiques.
D\'importants progrès ont été réalisés pour assurer une meilleure protection financière des citoyens chinois. Néanmoins, une plus grande attention aux ménages pauvres comptant des membres atteints de maladies chroniques reste nécessaire. Les décideurs de politiques en Chine devraient se concentrer sur l\'optimisation de l\'assurance maladie intégrée rurale-urbaine en élargissant les avantages sociaux actuels et en renforçant les efforts de lutte contre la pauvreté.

Blood component transfusion is increasingly promoted in sub-Saharan Africa (SSA), but is resource-intensive so whole blood is often used. We examined SSA recommendations about whole blood and packed red cell transfusions for pregnancy-related bleeding or anaemia, and paediatric anaemia, and evaluated the evidence underpinning these recommendations.
Relevant SSA guidelines were identified using five electronic databases, websites for SSA Ministries of Health, blood transfusion services and WHO. To facilitate comparisons, indications for transfusing packed red cells or whole blood within these guidelines and reasons given for these recommendations were recorded on a pre-designed matrix. The AGREE II tool was used to appraise guidelines that gave a reason for recommending either packed red cells or whole blood. We systematically searched MEDLINE, CINAHL, Global Health, Cochrane library and NHSBT Transfusion Evidence Library, using PRISMA guidelines, for clinical studies comparing whole blood with packed red cells or combined blood components in obstetric bleeding or anaemia, or paediatric anaemia. Characteristics and findings of included studies were extracted in a standardised format and narratively summarised.
32 English language guidelines from 15 SSA countries mentioned packed red cell or whole blood use for our conditions of interest. Only seven guidelines justified their recommendation for using packed red cells or whole blood. No recommendations or justifications had supporting citations to research evidence. 33 full-text papers, from 11 234 citations, were reviewed but only one study met our inclusion criteria. This was a single-centre study in post-partum haemorrhage.
Evidence comparing whole blood and packed red cell transfusion for common paediatric and maternal indications is virtually absent in SSA. Therefore, it is unclear whether policies promoting red cells over whole blood transfusion are clinically appropriate. Building a relevant evidence base will help develop effective policies promoting the most appropriate use of blood in African settings.

Intestinal tuberculosis (ITB) remains prevalent and a big health hazard in China. The aim of this study was to retrospectively analyse its clinico-pathological features.
Retrospective study of 85 consecutive ITB patients in two tertiary hospitals in East China. Relevant clinical, laboratory examination, radiological, endoscopic and histopathological features of ITB were recorded.
The mean age was 37.3 ± 16.0 years; 56 patients (65.9%) were male. 67.1% had ITB secondary to pulmonary tuberculosis. The overall median length of hospital stay was 28 days and was significantly longer in patients with intestinal complications (P = 0.003) and malnutrition (P = 0.042). Abdominal pain (88.2%) and weight loss (75.3%) were the commonest symptoms. The positive rate of the purified protein derivative (PPD) test was 88.2%; of the T-spot, 85.7%. Histopathology revealed caseating granuloma in 70.6% and caseating necrosis in 24.7% of patients. The most commonly affected sites were the ileocecal valve (56, 65.9%), terminal ileum (40, 47.1%) and caecum (33, 38.8%). Only 17 (20%) patients were initially diagnosed as ITB, the other 68 patients were misdiagnosed. Six patients with caecum tuberculosis were misdiagnosed as appendicitis, four of whom had improper surgical procedures followed by post-operative intestinal fistulas; two died due to MODS.
Diagnosis of ITB is often misdirected and delayed, which may lead to inappropriate treatment and high mortality. High diagnostic suspicion is necessary for patients with unexplained abdominal complaints. Diagnosis is not easy but could benefit coexisting pulmonary tuberculosis, T-spot, CT imaging, colonoscopy, pathological features, acid-fast bacilli and response to anti-tuberculosis therapy (ATT).

To evaluate price, availability and affordability of insulin products in Shaanxi Province, western China.
We used a simplified and adapted WHO/Health Action International method to obtain the availability and prices of insulin products and five oral anti-diabetic medicines as comparators in public general hospitals and private retail outlets. In addition, we investigated the price components of eight selected insulin products by tracing the supply chain.
All three kinds of insulin products, prandial, basal and premixed insulin, are 100% available in public hospitals, and have fairly high availability in the private sector (62.5-68.8%). The prices of most insulin products were higher than international reference prices in both sectors (ranging from 0.95 times to 2.33 times). All insulin products were unaffordable as they would cost 3.5-17.1 days\' wage of the lowest-paid government workers in Shaanxi. The manufacturer\'s markup (selling price), which comprised more than 60% of the final price of all insulin products surveyed, was the largest price component.
Although availability of insulin products was high in public general hospitals and private retail pharmacies, their high price made them unaffordable to diabetes patients, especially low-income patients. The government should increase insurance compensation for those who need these life-saving medicines or decrease the cost of insulin products through negotiation with suppliers.