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1 Chin J Clinicians Electronic Edition September Vol. 6 No. 18 李子然李学松 1999 ~ HIV WHO HIV HIV WHO 50% Cochrane 2009 Cochrane HIV 24 38% ~ 66% 10 Mills % Weiss WHO UNAIDS HIV 48% 2010 HIV HIV HIV HIV 2007 WHO % WHO HIV % WHO UNAIDS HIV WHO % 15 ~ ~ ~ ~ HIV 2010 HIV 55 / / / / % 2000 % HIV STIs 80% CROI 20% 14 20% ~ 80% WHO HIV 60% WHO % CDC DOI /cma. j. issn pineneedle@ sina. com HIV 73% HIV 7 8

3400 2010 HIV 270 7-9 1 HIV 180 1 HIV 2007 WHO % 20 16 10 WHO HIV % 1. 6 1. 3 1. 8 2004. 11 2006. 12 2006. 12 2005. 4 2007. 6 2007.

2 Chin J Clinicians Electronic Edition September Vol. 6 No % % HIV 1 12 Maimonides Guide for the perplexed Jonathan Hutchinson HIV 19 Reynolds % 23% HIV 2 HIV HIV UTI 1 HIV HSV-2 HPV HIV 1 UTI Meta 12 7 Meta HIV Van Howe 21 Meta h 22 Meta HSV % 57% HPV Meta Chessare 23 1

1% 23% HIV 2 HIV HIV UTI 1 HIV HSV-2 HPV 2 19 2 2 HIV 1 UTI + + + Meta 12 7 Meta 14 + + + + 3 HIV + + + Van Howe 21

3 Chin J Clinicians Electronic Edition September Vol. 6 No. 18 WHO % 1. 8% ~ 38% % 0 ~ 24% WHO Krieger ~ % 99% 24 h 0 0 ~ 3% 2% ~ 8% 7-9 Weiss 27 Weiss % 0 ~ 16% HIV HIV WHO 0% 0 ~ 2% 6% 2% ~ 14% HIV 35 3 Auvert ~ ~ 24 Forceps guided % - Bailey % 15 97% - 30 ~ 89 d 38% 24% Bowa ~ Dorsal slit method % 0. 06% Kigozi ~ ~ 49 Sleeve method % Krieger ~ ~ 24 Forceps guided 90 d 1. 8% 0. 2% 3. 3% 0% 0. 7% Magoha 32% ~ % Forceps guided - 11% 2. 8% 61% 1 d Peltzer ~ % 0% 4 % % % ~ ~ ~ ~ ~

8% - Bailey 28 2004 469 63% 15 97% - 30 ~ 89 d 38% 24% Bowa 29 2004 ~ 2006 900 5 96 Dorsal slit method 8 3. 0% 0. 06% Kigozi 30 2003 ~ 2006 2746 15 ~ 49 Sleeve method 6 7.

4 Chin J Clinicians Electronic Edition September Vol. 6 No ~ % % 10 Siegfried N Muller M Deeks JJ et al. Male circumcision for prevention 2. 66% of heterosexual acquisition of HIV in men. Cochrane Database Syst Rev 2009 CD Mills E Cooper C Anema A et al. Male circumcision for the prevention of heterosexually acquired HIV infection a meta-analysis of ran- HIV domized trials involving men. HIV Med Weiss HA Quigley MA Hayes RJ. Male circumcision and risk of HIV infection in sub-saharan Africa a systematic review and meta-analysis. 13 WHO UNAIDS and JHPIEGO. Manual for male circumcision under local anaesthesia. Version 2. 5C. Switzerland WHO Press http www. who. int /hiv /pub /malecircumcision /local_anaesthesia /en /. WHO /UNAIDS 14 Totaro A Volpe A Racioppi M et al. Circumcision history religion HIV and law. Urologia Massry SG. History of circumcision a religious obligation or a medical necessity. J Nephrol Suppl 17 S HIV 17 Hargreave T. Male circumcision towards a World Health Organisation normative practice in resource limited settings. Asian J Androl Reynolds SJ Shepherd ME Risbud AR et al. Male circumcision and risk of HIV-1 and other sexually transmitted infections in India. Lancet Millett GA Ding H Lauby J et al. Circumcision status and HIV infection among Black and Latino men who have sex with men in 3 US cit- HIV ies. J Acquir Immune Defic Syndr Hill G. The case against circumcision. Journal of Men' s Health and Gender Van Howe RS. A cost-utility analysis of neonatal circumcision. Med Decis Making Mansfield CJ Hueston WJ Rudy M. Neonatal circumcision associated factors and length of hospital stay. J Fam Pract Chessare JB. Circumcision is the risk of urinary tract infection really the pivotal issue Clinical Pediatrics Doctors Opposing Circumcision. International Human Rights Law and the Circumcision of Children. http www. doctorsopposingcircumcision. org / pdf / US-HumanRightsReport. pdf. 1 WHO UNAIDS and UNICEF. Global HIV /AIDS response epidemic update and health sector progress towards universal access progress report Switzerland WHO Press whqlibdoc. who. int /publications /2011 / _eng. pdf. 2 WHO UNAIDS. Male circumcision global trends and determinants of prevalence safety and acceptability. Switzerland WHO Press http whqlibdoc. who. int /publications /2007 / _ eng. pdf. 3 Collier R. Circumcision indecision the ongoing saga of the world's most popular surgery. CMAJ http www. medscape. com /viewarticle / HIV 5 Centers for Disease Control and Prevention CDC. Trends in in-hospital newborn male circumcision--united States MMWR WHO /UNAIDS /UNICEF 2008 Morb Mortal Wkly Rep HIV 70 6 http www. medpagetoday. com /Pediatrics /Parenting / % % 7 Auvert B Taljaard D Lagarde E et al. Randomized controlled intervention trial of male circumcision for reduction of HIV infection risk 37 HIV the ANRS 1265 Trial. PLoS Med e Bailey RC Moses S Parker CB et al. Male circumcision for HIV prevention in young men in Kisumu Kenya a randomised controlled trial. Lancet ~ Gray RH Kigozi G Serwadda D et al. Male circumcision for HIV pre- vention in men in Rakai Uganda a randomised trial. Lancet 2007 AIDS Doctors Opposing Circumcision. Medical Ethics and the Circumcision of Children. http www. doctorsopposingcircumcision. org /pdf /US- MedicalEthicsReport. pdf. 26 http www. historyofcircumcision. net. 27 Weiss HA Larke N Halperin D et al. Complications of circumcision in male neonates infants and children a systematic review. BMC Urol Bailey RC Egesah O Rosenberg S. Male circumcision for HIV prevention a prospective study of complications in clinical and traditional settings in Bungoma Kenya. Bull World Health Organ

Male circumcision for the prevention of heterosexually acquired HIV infection a meta-analysis of ran- HIV domized trials involving 11 050 men. HIV Med 2008 9 332-335. 12 Weiss HA Quigley MA Hayes RJ.

5 Chin J Clinicians Electronic Edition September Vol. 6 No Bowa K Lukobo M. Male circumcision and HIV infection in Zambia. East and Central African Journal of Surgery Kigozi G Gray RH Wawer MJ et al. The safety of adult male circumcision in HIV-infected and uninfected men in Rakai Uganda. PLoS Med e Krieger JN Bailey RC Opeya JC et al. Adult male circumcision outcomes experience in a developing country setting. Urol Int Magoha GA. Circumcision in various Nigerian and Kenyan hospitals. East Afr Med J Peltzer K Kanta X. Medical circumcision and manhood initiation rituals in the Eastern Cape South Africa a post intervention evaluation. Cult Health Sex Krieger JN Bailey RC Opeya J et al. Adult male circumcision results of a standardized procedure in Kisumu District Kenya. BJU Int Kahn JG Marseille E Auvert B. Cost-effectiveness of male circumcision for HIV prevention in a South African setting. PLoS Med e WHO UNAIDS and unicef. Epidemiological Fact Sheet on HIV and AIDS Core data on epidemiology and response China. Switzerland WHO Press 李子然, 李学松. 关于包皮环切术的争议 [J /CD]. 中华临床医师杂志 : 电子版,2012,6( 18) :

PLoS Med 2008 5 e116. 31 Krieger JN Bailey RC Opeya JC et al. Adult male circumcision outcomes experience in a developing country setting. Urol Int 2007 78 235-240. 32 Magoha GA.

ment group was more effective than that of the control group OR = % CI = Conclusion The clinical efficacy of Chinese medic

ment group was more effective than that of the control group OR = % CI = Conclusion The clinical efficacy of Chinese medic 33 243 HAART Meta * 1 1 1 1 1 2 3 3 3 1. 530001 2. 538000 3. 530011 highly active anti-retroviral therapy HAART Pubmed HAART randomized controlled trials RCT Jadad RevMan5. 3 Meta 5 RCT 761 Meta HAART