Objective To prepare insulin thiolated hyaluronic acid nanoparticles (Ins-HA-Cys-NPs)and study its physicochemical properties. Methods The Ins-HA-Cys-NPs was prepared by ultrasonic emulsifying method,and the properties of nanoparticles including morphology,mean diameter,Zeta potential,entrapment efficiency and drug loading efficiency were studied,as well as the cryoprotectant selection.Results The prepared nanoparticles was round in appearance and the mean diameter was(178.5 ±0.8)nm,the polydispersity index was (0.214 ±0.013)and the Zeta potential was -(38.47 ±0.46 )mV,while the entrapment efficiency was (48.85 ±0.66 )%,drug loading efficiency was (4.79 ±0.13 )%;10%mannitol as cryoprotectant provided uniform and well dispersed suspension of nanoparticles with blue opalescence after redispersion.Conclusion The thiolated hyaluronic acid nanoparticles may be used as the carrier for oral drug delivery system of insulin,and it provides a basis for studies on rats in vivo.

Objective: To investigate the awareness, sexual behavior characteristics and infection status of AIDS among male floating population in Anhui Province, so as to provide insights into formulating prevention and control measures for male floating population. Methods: Male floating population of three occupations including construction workers, enterprise workers, and business operators in Wuhu, Tongling, Hefei, and Fuyang cities were selected using stratified cluster random method from April to August 2021. Demographic information, knowledge of AIDS and high-risk behaviors were collected through questionnaires surveys. The results of HIV, syphilis and hepatitis C virus (HCV) antibody testing were collected through laboratory tests. Awareness rate of AIDS knowledge, sexual behavior characteristics, and positive rates of HIV, syphilis, and HCV among male floating population of different occupations were analyzed. Results: A total of 1 616 people were enrolled, including 1 016 construction workers (62.87%), 253 enterprise workers (15.66%) and 347 business operators (21.47%), and had a mean age of (40.63±12.32) years. The overall awareness rate of AIDS knowledge among male floating population was 89.54%, the awareness rates of business operators, construction workers, and enterprise workers were 98.33%, 88.29% and 82.61%, respectively, and the difference was statistically significant (P<0.05). The proportions of consistent condom use during sexual intercourse with a spouse or cohabitant, during commercial sexual encounters, and with casual partners in the past year were 7.15% (91/1 273), 64.00% (16/25) and 50.00% (8/16), respectively. The proportions of construction workers, enterprise workers, and business operators who used condoms every time they had sexual behavior with their spouses/cohabitants in the past year were 4.54%, 11.63%, and 15.60%, respectively, with statistically significant differences (P<0.05). One case of HIV, one case of syphilis, and three cases of HCV antibody were detected. Conclusion The overall awareness rate of AIDS knowledge among the male floating population in Anhui Province is relatively high, but unsafe sex behaviors exist, which may lead to the risk of HIV infection.

BACKGROUND:Buprenorphine transdermal patches have the characteristics of stable blood concentration, long duration of analgesia, respiratory depression and less side effects, which have been widely used in the treatment of moderate to severe chronic pain. OBJECTIVE:To observe the clinical outcome of preoperative analgesia by buprenorphine transdermal patches for pain management after posterior lumbar surgery. METHODS: Eighty patients scheduled for posterior lumbar decompression and interbody fusion under general anesthesia were enroled, 45 males and 35 females, aged 42-71 years, who were randomly divided into two groups, 40 cases in each group: experimental group and control group. In the experimental group, buprenorphine transdermal patches were given 2 days prior to the internal fixation, and intravenous injection of parecoxib was given for postoperative pain management. In the control group, placebo patches were given prior to the internal fixation, and self-control vein analgesia pump and intravenous injection of parecoxib were given for postoperative pain management. Visual analog scale scores were recorded at 6, 12, 24, 48 hours after surgery as wel as doses of tramadol hydrochloride and pethidine hydrochloride used postoperatively and side effects. The patient's satisfaction, drainage and blood count, erythrocyte sedimentation rate, C-reactive protein level at 48 hours postoperatively were detected and recorded in the two groups. RESULTS AND CONCLUSION:There was no significant difference between these two groups in visual analog scale scores, dosage of tramadol hydrochloride and pethidine hydrochloride used postoperatively, postoperative drainage amount, leukocyte count, erythrocyte sedimentation rate and C-reactive protein level (P > 0.05). Postoperative incidence of nausea, vomiting and delirium was lower in the experimental group than the control group (P < 0.05), but the patient's satisfaction in the experimental group was better than that in the control group (P< 0.05). These findings indicate that buprenorphine transdermal patches have better preemptive analgesia for posterior lumbar surgery, with less adverse effects and better patient's satisfaction.

OBJECTIVE:To develop a method for simultaneous determination of irinotecan(CPT-11)and its active metabo-lite 7-ethyl-10-hydroxycamptothecin(SN-38)in human plasma.METHODS:After precipitated by acetonitrile and acidified with hy-drochloric acid,using camptothecin as internal standard,the plasma sample was determined by HPLC-FLD. The determination was performed on Waters Luna C18column with mobile phase consisted of 0.05 mol/L sodium dihydrogen phosphate-acetonitrile(70:30, V/V,adjusted pH to 4.0 by phosphoric acid)at flow rate of 1 mL/min. The excitation wavelength was set at 380 nm;the emis-sion wavelengths of CPT-11 and SN-38 were set at 480 nm and 535 nm,respectively. The column temperature was 25 ℃ and the sample size was 20 μL. RESULTS:The linear ranges were 200-1 000 ng/mL for CPT-11(r=0.999 4,n=5)and 5-45 ng/mL for SN-38(r=0.999 2,n=5). RSDs of inter-day and intra-day were 1.68%-5.57%. The relative recoveries of CPT-11 and SN-38 were 90.12%-106.93%(RSD<8%,n=5)and 92.07%-102.56%(RSD<6%,n=5);the extraction recoveries of CPT-11 and SN-38 were 72.23%-86.56%(RSD<6%,n=5)and 71.98%-83.44%(RSD<7%,n=5),respectively. The plasma concentra-tions of CPT-11 and SN-38 in 5 patients with colon cancer were 431.13-617.19,13.97-31.89 ng/mL(1 h after intravenous drip-ping)and 398.14-584.43,11.61-29.94 ng/mL(2 h after intravenous dripping). CONCLUSIONS:The method is simple,rapid, sensitive,reproducible and suitable for the determination of plasma concentration and pharmacokinetic study of CPT-11 and its metabolite SN-38.

Objective: To explore the clinical effect of minimally invasive treatment of C type pilon fracture with single main plate combined with multiple planar screws for supporting fixation. Methods: From January 2013 to March 2017, data of 22 patients treated by minimally invasive treatment with single main plate combined with multiple planar screws for supporting fixa-tion were retrospectively analyzed. There were 17 males and 5 females, aged from 23 to 69 years (average, 51.2 years). All cases were closed fractures involving fibula including weight hitting (5 cases), traffic accident (7 cases) and fall injury (10 cases). There were 3 cases of 43-C1 type, 11 cases of 43-C2 type and 8 cases of 43-C3 type according to AO/OTA classification. According to the Rüedi-Allgöwer classification, there were 5 cases of type Ⅱ and 17 cases of type Ⅲ. Complications were recorded postopera-tively and the articular surface reduction was evaluated using the Burwell-Charnley score. At the last follow-up, Tornetta’s pilon fracture clinical treatment outcome criteria was used to evaluate ankle joint function. Results: All the patients were followed up for 13 to 25 months (average, 17.3 months). There were 20 cases of anatomical reduction, 1 case of fair reduction and 1 case of poor reduction according to the Burwell-Charnley score. All the 22 patients were healed with healing time of 3 to 6 months (aver-age, 4.8 months). The efficacy was evaluated according to the evaluation criteria of the clinical treatment results of pilon fracture by Tornetta: excellent in 8 cases, good in 10 cases, fair in 3 cases, and poor in 1 case. The excellent and good rate was 81.8% (18/22) . All patients had no complications such as wound edge blistering, skin necrosis and infection. Among them, 1 case of internal fixa-tion rejection occurred, and the incision was well healed after removal of the internal fixation after 3 months. Conclusion Mini-mally invasive treatment of C type pilon fracture with single main plate combined with multiple planar screws for supporting fixa-tion not only provides a better anatomical reduction of the articular surface, but also effectively reduces or even avoids incision complications. The long-term clinical results are satisfactory.

Objective To study the clinical characteristic of acquired immune deficiency syndrome (AIDS) patients younger than 15 years old and to explore the influence of human immunodeficiency virus (HIV) infection on them. Methods The clinical information, including demographic profile, clinical stages of the disease, laboratory test results and developmental status were gathered from 275 antiretroviral therapy naive patients. Results Seventy eight point nine percent patients were infected by vertical transmission. Sixteen percent were infected by receiving blood products. The average age was (7.6±3. 7) years, with 5 cases younger than 1 year old, 104 cases ranging from 1 - 5 years and 166 cases elder than 6 years. Seventy point one percent patients were classified as stage 3 or 4 according to World Health Organization definitions. The average CD4 count was ( 137 ± 159 )/μL, ( 304 ± 317 ) /μL and ( 1 246 ± 776 )/μL respectively in children elder than 6 years, ranging from 1 to 5 years and younger than 1 year. One hundred and eighty one cases suffered from anemia on different severity grading. The most common HIV related symdromes included persistent fever, skin damage, persistent diarrhea, oral candidiasis and recurrent upper respiratory tract infection. Among these infected children, 49. 6% showed height lower than x - 2s and 19. 9% showed weight lower than x - 2s. Conclusions Most survival pediatric AIDS patients are elder than 6 years. HIV infection can significantly affect the children's immune system function,growth and development.

OBJECTIVETo investigate the prevalence and related factors of abnormal pelvic floor muscle strength and provide theoretical evidence for the prevention and treatment of pelvic floor dysfunction.

METHODSA total of 1008 migrant women in hospitals of Guangzhou and Foshan were screened for pelvic floor strength at 42 days postpartum from Oct, 2013 to July, 2014. EMG biofeedback equipment was employed to assess the strength of type I and II muscle fiber and a questionnaire was designed to record its related factors.

RESULTSThe incidence of abnormal type I and II muscle fiber strength was 49.21% and 49.60%, respectively. No statistical significance was observed in the abnormal rates among women with different ages or occupations. Compared with women who chose vaginal delivery, women with cesarean section had significantly reduced abnormal rates. A negative correlation was found between parity and type I and II muscle fiber strength.

CONCLUSIONThe delivery mode and parity are factors affecting pelvic floor muscle strength among migrant women in the Pearl River Delta, suggesting the necessity of health education and promotion of family planning policy.

Cesarean Section ; Delivery, Obstetric ; Female ; Humans ; Muscle Fibers, Skeletal ; physiology ; Muscle Strength ; Parity ; Pelvic Floor ; physiology ; Postpartum Period ; Pregnancy ; Transients and Migrants

Objective: To understand the awareness and service utilization of HIV preexposure prophylaxis (PrEP) and postexposure prophylaxis (PEP) among the young students aged 15-24 in Hefei, so as to provide reference for the prevention and treatment of AIDS among young students in the future. Methods: From May to June 2022, a stratified random cluster sampling method was used to select two different types of universities(undergraduate and vocational colleges) in Hefei, and a crosssectional survey was conducted among the 916 young students at the selected schools. The Chisquare test was used for statistical analysis. Results: Among the surveyed young students, 88.4% had heterosexual orientation, and 12.4% had sexual behavior including 8.8% of homosexual sexual behavior and 91.2% of heterosexual sexual behavior. The rate of condom use was 70.0% in the last homosexual intercourse, and the rate of condom use was 83.7% in the last heterosexual intercourse. About 41.9% of young students heard of PrEP, and the proportions of young students who knew about PrEP, consulted PrEP and used PrEP were 43.0%, 15.9% and 9.4% respectively. About 38.3% of young students had heard of PEP, and the proportions of young students who knew about PEP, consulted PEP and used PEP were 18.2%, 15.4% and 6.0%. Conclusions The awareness rate and utilization rate of PrEP and PEP among young students in Hefei are relatively low. PrEP and PEP publicity should be combined with education of HIV knowledge, and enhance the awareness rate of the young students, in order to reduce the risk of AIDS infection among young students with highrisk behaviors.

Objective: To evaluate the efficacy of articular compression molding techniques in the surgery for acetabular posterior wall fracture. Methods: A retrospective study was conducted of the 28 patients (28 hips) with fracture of acetabular posterior wall plus comminuted compression of articular surface who had been treated using the articular compression molding techniques at Department of Orthopedics, The Hospital of 81 Group Army of PLA from January 2014 to January 2018. They were 25 males and 3 females, aged from 26 to 63 years (average, 49.3 years). The time from injury to surgery ranged from 4 to 12 days (average, 7.8 days). According to the Letournel-Judet classification, all were single element (simple) posterior wall fractures combined with posterior dislocation of the femoral head and articular compression of different degrees; transient sciatic nerve injury was complicated in 12 cases. The posterior hip dislocations were timely and successful reset at emergency treatment. The compression fractures of the posterior wall and hip joint were treated by open reduction and internal fixation via the acetabular posterior (K-L) approach. The articular compression was treated by 4 stabilization techniques: absorbable screwing and blocking technique in 10 cases, indwelling screwing in 12 cases, indwelling Kirschner wiring in 2 cases and die push and squeeze tamping in 4 cases. The operation time, intraoperative bleeding and complications were recorded. The therapeutic efficacy was evaluated by the modified Merle d’Aubigne & Postel scoring criteria at the final follow-up. Results: The operation time lasted from 76 to 118 minutes (average, 94.2 minutes); the intraoperative bleeding ranged from 100 to 320 mL (average,220.8 mL). No incision liquefaction, infection or other complications occurred. The 28 patients were followed up for 10 to 36 months (average, 17.6 months). According to the Matta scoring criteria, 24 cases achieved anatomical reduction but 4 dissatisfactory reduction. By the modified Merle d’Aubigne & Postel scoring criteria at the final follow-up, the efficacy was evaluated as excellent in 26 cases and as good in 2. Heterotopic ossification was observed in 3 cases and microscopic free dense shadow in the joint cavity (about 2 mm in the round ligament) in 3 cases. There were no cases of obvious traumatic arthritis or osteoarthritis, femoral head necrosis, walking pain, lameness or hip abduction weakness. The 12 patients complicated with preoperative transient sciatic nerve injury recovered within 3 months after surgery. Conclusion The articular compression molding techniques can effectively treat severely comminuted articular compression in the acetabular posterior wall fracture and improve reduction of articular surface and hip joint matching, leading to stability and good joint function.

Objective To observe the changes of serum clara cell protein?16 ( CC?16 ) and monocyte chemotaxis protein?1 (MCP?1) level in patients with acute respiratory distress syndrome (ARDS) and to explore their relationship with the disease severity and prognosis of ARDS??Methods One hundred and fourteen patients with ARDS who were admitted to Changzhi People′s hospital from January 2017 to March 2018 were selected as the subjects??They were divided into mild group ( n＝37),moderate group (n＝41) and severe group ( n＝36) according to the severity of ARDS??Sixty healthy persons in out?patient examination were selected as control group??The survival situation of patients in 4 weeks were recorded,the patients were divided into survival group ( n＝65) and death group ( n＝49) according to their survival situation??The age,gender,body mass index (BMI),smoking history,acute physiology and acute physiology and chronic health evaluation II ( APACHE II) score,sequential organ failure assessment ( SOFA) score, serum CC?16 and MCP?1 level were analyzed in each group??The relationship between serum CC?16,MCP?1 level and disease and prognosis of patients with ARDS were analyzed??Results With the increase of disease severity,APACHE II score, SOFA score and serum CC?16, MCP?1 level in patients with ARDS were significantly increased??The differences were statistically significant ( F＝1 216??886,1 339??247,290??879, 417??262; all P＝0??000)??The APACHE II score,SOFA score and serum CC?16,MCP?1 levels in the death group were (22??13± 2??47) scores,( 15??09 ± 1??97) scores,( 23??85 ± 4??27) μg／L, ( 36??64 ± 5??21) ng／L respectively,which were significantly higher than those in the survival group (18??25±2??35) scores,(13??23 ±2??03) scores,(17??34±4??13) μg／L,(27??93±4??88) ng／L,the differences were statistically significant (t＝8??538,4??905,8??211,9??146;all P＝0??000)??Pearson correlation analysis showed that there was a positive correlation between serum CC?16 level and MCP?1 level in patients with ARDS ( r＝0??589, P ＝0??000)??Meanwhile,the CC?16,MCP?1 were positive correlation with APACHE II score,SOFA score and mortality (CC?16:r＝0??504,0??549,0??472;P＝0??000,0??000,0??012;MCP?1:r＝0??493,0??528,0??435;P＝0??006, 0??000,0??025)??APACHE II score ( OR＝3??083,95%CI:0??025－1??364,P＜0??05),CC?16 ( OR＝5??403, 95%CI:0??011－6??561, P＜0??05) and MCP?1 ( OR＝2??892, 95%CI: 0??034－1??619, P＜0??05) were all closely related to ARDS death??CC?16 independent detection, MCP?1 independent detection and the two combined detection predicted the under?curve area, sensitivity and specificity of ARDS patients with in 4 weeks were 0??830, 82??35% and 72??16%; 0??719, 79??25% and 72??19%; 0??866, 85??06% and 80??72%respectively??Conclusion CC?16,MCP?1 are abnormally high expression in serum of patients with ARDS, and its levels are closely related to the severity and prognosis of patients with ARDS??CC?16 combined with MCP?1 detection has high diagnostic value for patients with ARDS,which can be used as an effective index to judge the disease and prognosis of patients with ARDS??