Objective: To investigate the characteristics of newly reported HIV/AIDS cases aged 15 years and older in Shangcheng District, Hangzhou City from 2006 to 2022, so as to provide the basis for improving AIDS prevention and control strategies. Methods: Data of newly reported HIV/AIDS cases aged 15 years and older in Shangcheng District from 2006 to 2022 were collected through HIV/AIDS Comprehensive Control System of Chinese Disease Prevention and Control Information System. Population distribution and transmission routes were analyzed, and changing trends in case number were analyzed using average annual percent change (AAPC) and annual percent change (APC). Results: A total of 4 409 HIV/AIDS cases aged 15 years and older were newly reported in Shangcheng District from 2006 to 2022, including 3 932 males (89.18%). There were 3 447 cases (78.18%) under 50 years old and 962 cases (21.82%) being 50 years and older. Sexual contact was a predominant transmission route, with 4 326 cases accounting for 98.12%, including 2 626 cases (59.56%) with homosexual contact and 1 700 cases (38.56%) with heterosexual contact. The number of HIV/AIDS cases showed an overall upward trend from 2006 to 2022 (AAPC=13.038%, P<0.05), with an upward trend from 2006 to 2015 (APC=42.578%, P<0.05) and a downward trend from 2015 to 2022 (APC=-19.713%, P<0.05). The increase in the number of cases aged 50 years and older group was faster than that of cases aged under 50 years (AAPC=22.641% vs. 11.162%, both P<0.05). The increase in the number of cases with homosexual contact transmission was faster than that of cases with heterosexual contact transmission (AAPC=20.417% vs. 7.455%, both P<0.05). Conclusions The number of newly reported HIV/AIDS cases aged 15 years and older in Shangcheng District performed an overall upward trend from 2006 to 2022. The cases aged 50 years and older and transmitted through homosexual contact increased rapidly, which should be taken seriously.

BACKGROUNDTo investigate the diagnostic value of chest CT scan combined with telomerase activity and p16 gene methylation from exfoliated cells of sputum in 55 cases of solitary pulmonary nodules (SPN; ≤30 mm)suspected early peripheral lung cancer.

METHODSThe sputum specimens from 34 cases of cancer nodules and 21 cases of benign lesion were detected for telomerase activity by TRAP-PCR-ELISA and p16 gene methylation by PCR-based methylation analysis.

RESULTSThe qualitative diagnostic accuracy of CT scan was 61.8%(34/55) for SPN provided by pathology. Cytology analysis of sputum was positive in 13 cases (38.2%). Telomerase activity was positive in 29 cases: sensitivity was 79.4%, specificity was 90.5%, accuracy was 83.6%; p16 gene methylation was found in 11 cases: sensitivity was 32.4%, specificity was 100.0%, and accuracy was 58.2%. The sensitivity was increased to 86.1% by combination of telomerase activity and p16 gene methylation. Compared with nodules without malignant CT signs, expression of telomerase activity and p16 methylation of SPN with malignant CT signs (lobulation or spiculate protuberance or spicule sign) had a significant difference (P < 0.01).

CONCLUSIONSThe results suggest that chest CT scan combined with telomerase activity and p16 gene methylation detection in sputum for patients with peripheral lung cancer may enhance the diagnostic value of radiology and conventional cytology.

Objective To explore the surgical treatment of spindle aneurysms in V4 segment of vertebral artery. Methods The clinical data, surgical methods and prognosis of 6 patients with V4 spindle aneurysms of vertebral artery admitted from 2011 to November 2018 in Sanbo Brain Hospital were retrospectively analyzed,Results There were 4 males and 2 females aged from 45 to 65 years. Aneurysm rupture and bleeding occurred in 3 cases. Far lateral approach was used in all patients. One case was clipped with window aneurysms, 2 cases were treated with occipital artery (OA)- posterior inferior cerebellar artery (PICA) bypass, and 3 cases were treated with vertebral artery occlusion. Postoperative patients were generally in good condition. Postoperative CT arteriography confirmed that the bypass vessels were unobstructed in 2 cases. All vertebral aneurysms were treated satisfactorily and PICA arteries were preserved. Tracheotomy was performed in 5 patients (1 case was incised before operation). Three patients were removed 3 months after operation. The Glasgow Prognosis Score (GOS) was 4 points. Long-term tracheotomy was performed in 1 case, and GOS score was 3 points. Two patients died 4 months and 3 years after operation. Conclusions Craniotomy is an important method for the treatment of spindle aneurysm of V4 segment of vertebral artery. Different surgical methods should be selected according to the size of the aneurysm, the relationship between the location of the aneurysm and PICA, and the compensation of the vertebral artery.

Chronic myeloid leukemia (CML) is a malignant tumor formed by clonal proliferation of bone marrow hematopoietic stem cells. With the improvement of disease awareness and the introduction of new drugs, more than 90% of CML patients can achieve long-term survival. However, a few patients still show drug resistance. This article reviews the mechanism of drug resistance in CML patients treated with tyrosine kinase inhibitor (TKI) and the characteristics of ABL kinase region mutation.

Objective:To analyze the incidence and prognosis of epilepsy in frontotemporal lobe glioma.Methods:The clinical data of 208 patients with frontotemporal lobe gliomas in Sanbo Brain Hospital Capital Medical University from 2019 to 2021 were analyzed retrospectively. According to the 2016 World Health Organization (WHO) classification of tumors of the central nervous system, the incidence of epilepsy, Modified Rankin Scale (MRS) score, and Engel Outcome Scale of patients with different grades of tumors were calculated.Results:Among all the patients with frontotemporal lobe gliomas, there was more males than females, and it was more common in the 40 -59 age group. The incidence of epilepsy associated with WHO grade Ⅰand Ⅱ glioma was 100.0% (33/33) and 60.9% (14/23), respectively, while that of WHO grade Ⅳ glioma was 19.0%(19/100). The average follow-up time was (22 ± 9) months. During the follow-up period, the incidence of WHO grade Ⅰ, Ⅱ and Ⅲ glioma-related epilepsy decreased significantly. There was no significant difference in the incidence of glioma-related epilepsy between the total and subtotal resection groups ( P>0.05). There was no statistical correlation between the side of tumor occurrence and the occurrence of epilepsy ( P>0.05), also between the gene phenotype and the occurrence of epilepsy ( P>0.05). There was no significant difference in the Engel Outcome Scale among different grades of gliomas ( P>0.05). The prognosis of patients with Engel Outcome Scale Class 1 was significantly better than that of other grades. Conclusions:The incidence of glioma-related epilepsy is negatively correlated with tumor grade. Age and sex are risk factors for glioma-related epilepsy. The incidence of postoperative epilepsy in patients with low grade glioma is significantly lower than that in patients with high grade glioma, and the prognosis is better. However, there is no significant difference in the Engel Outcome Scale among different grades of gliomas.

Objective:To explore the etiology and treatment of craniopharyngioma with aneurysm.Methods:Seven cases of craniopharyngioma with aneurysm from March 2014 to October 2019 treated in Sanbo Brain Hospital, Capital Medical University were retrospectively analyzed. Among the 7 patients, there were 5 males and 2 females. There were 4 cases of recurrent craniopharyngiomas, 1 case of primary tumor and 2 cases of non-recurrence tumor. Three patients with blood blister-like aneurysms were treated with microsurgical suture after craniopharyngioma resection. Among the three cases with internal carotid artery fusiform aneurysm, 1 case underwent craniopharyngioma resection after internal maxillary artery-radial artery-middle cerebral artery bypass and isolation of the aneurysm; 1 case only underwent internal maxillary artery-radial artery-middle cerebral artery bypass and isolation of the aneurysm for non-recurrence tumor; 1 case underwent craniopharyngioma resection and dynamic observation of aneurysm. One case with a cystic aneurysm of the middle cerebral artery was clipped and the craniopharyngioma did not relapse.Results:All patients had no serious postoperative complications. During the follow-up period, there was no recurrence of craniopharyngioma, no recurrence of treated aneurysms, and the stability of aneurysms was observed.Conclusions:Inflammatory stimulation of craniopharyngioma cystic fluid and operation itself are the important reasons for the occurrence of aneurysms after craniopharyngioma surgery. Choosing appropriate surgical methods can complete the removal of craniopharyngioma and the treatment of aneurysms at one time.

Objective:To investigate the method and effect of microneurosurgery in the treatment of recurrent craniopharyngioma.Methods:The clinical data of 41 recurrent craniopharyngioma patients treated by microneurosurgery in Capital Medical University Sanbo Brain Hospitalfrom January 2018 to January 2022 were retrospectively analyzed.Results:Among the 41 patients, 38 cases were treated with the frontal basal interhemispheric approach and 3 cases with the translongitudinal fissure combined with the transSylvian fissure approach. Gross total resection was performed in 34 cases (82.9%) and subtotal resection in 7 cases (17.1%). One patient (2.4%) died of pulmonary embolism during perioperative period. All patients had transient electrolyte disorder after operation, and recovered within 3 months after treatment. All patients had endocrine dysfunction. After 3 months of hormone replacement therapy, 11 patients were cured. Visual acuity decreased in 3 cases after operation, and 2 cases improved after treatment.Conclusions:Surgical treatment of recurrent craniopharyngioma is very difficult, which is a great challenge for doctors and patients. However, through the individualized evaluation of the patients and the meticulous technique of the doctors during the operation, a satisfactory effect can be achieved post the operation of recurrent craniopharyngioma.

Objective:To investigate the clinical characteristics and prognosis of acute myeloid leukemia (AML) patients with positive TLS-ERG fusion gene.Methods:The clinical data of 9 AML patients with positive TLS-ERG fusion gene in the First Hospital of Jilin University from June 2013 to August 2020 were retrospectively analyzed, and the relevant literature was reviewed.Results:Among 9 patients with positive TLS-ERG fusion gene, there were 5 males and 4 females, with a median age of 16 years old (6-40 years old). Five patients received chemotherapy alone, 3 patients received allogeneic hematopoietic stem cell transplantation (allo-HSCT), and 1 patient did not receive systematic treatment. Among 8 patients with systematic treatment, 1 patient had complete remission after the first induction chemotherapy and 5 patients had complete remission after induction therapy. The median overall survival time of 5 patients with chemotherapy alone was 1.5 months (1-11 months), of which 3 patients did not respond to the first course of treatment and died of infection, and 2 patients died after relapse. The median overall survival time of 3 patients with allo-HSCT was 16 months (13-17 months), of which 2 patients died after relapse and 1 patient had sustained molecular complete remission by the end of follow-up.Conclusions:AML with positive TLS-ERG fusion gene has low incidence rate and poor induction efficacy. Hematopoietic stem cell transplantation may partially improve the survival prognosis of patients, but it cannot overcome the adverse effect of positive TLS-ERG fusion gene on prognosis.

Objective:To explore the application effect of four-track teaching mode (LBL: lecture-based learning; CBL: case-based learning; PBL: problem-based learning) in pediatric teaching of integrated traditional Chinese and Western Medicine.Methods:175 integrated traditional Chinese and Western medical students in seven-year program were divided into experimental group and control group. The experimental group was taught by four-track teaching mode, while students in the control group. Were applied with traditional teaching method ("LBL+CBL").Results:Students in the experimental group highly rated the four-track teaching mode and were better than those in the control group in the following aspects: satisfaction with teaching methods, interest in learning, the ability of creative thinking, the thinking ability of clinical diagnosis and treatment, and memorization ( P<0.05). And students' mid-term, final and comprehensive scores in the experimental group were significantly higher than those in the control group ( P<0.05). Conclusion:Compared with traditional teaching methods, the four-track teaching mode can improve the quality of pediatric teaching of integrated traditional Chinese and Western medical students, which should be further integrated and perfected in the teaching practice.

Objective By summarizing the literature on the treatment of bronchial asthma with"Tonifying the spleen to help the lung"as the guiding ideology and"tonifying spleen drugs"published in recent 25 years,analyzing the domestic research situation,to understanding the research status of the mechanism of"Tonifying the spleen to help the lung"in the treatment of asthma,so as to provide ideas for the research of traditional Chinese medicine in the treatment of asthma.Methods Taking"Tonifying the spleen to help the lung","tonifying the spleen","strengthening the spleen","transporting the spleen","benefiting the spleen","Shenling Baizhu Powder","Yigong Powder","Ginseng Schisandra Decoction","Maimendong Decoction","Liujunzi Decoction"and"asthma"as the keywords,searching the literature in the Chinese Journal Full-text Database(CNKI),extracting the data recorded in the literature,including prescriptions,drug composition,test indexes and experimental results,and summarize and analyze the data.Results A total of 54 literatures were included in this literature study.The prescriptions of"Tonifying the spleen to help the lung"method in the treatment of asthma are complex.The classic prescriptions often involved include Liujunzi Decoction,Yupingfeng Powder,Yigong Powder,Buzhong yiqi decoction,Shenling baizhu powder,Maimendong decoction,Ginseng Schisandra decoction and Erchen decoction.The commonly used drugs include Atractylodes macrocephala,Astragalus membranaceus,Poria cocos,licorice,tangerine peel,etc.Experimental research mainly involves inflammatory cells,immunoglobulins,cytokines,signaling pathway,T cell subsets,cell receptors,intestinal flora and other aspects,and the specific detection indicators are complex and diverse.Conclusion The method of"Tonifying the spleen to help the lung"is effective in the treatment of bronchial asthma.Many studies show that its effect has a clear scientific basis,but its mechanism is complex and diverse and is gradually becoming clear.