Objective? To investigate the changes of body temperature and the effect of nursing intervention in patients with low body mass index (BMI＜18.5 kg/m2) during thoracic surgery. Methods? Sixty patients with low BMI who underwent thoracic surgery in the Operating Department of the 4th Hospital of Hebei Medical University from June 2016 to December 2018 were randomly divided into observation group and control group, with 30 cases in each group. In addition, 30 patients with normal BMI (18.5-23.0 kg/m2) who underwent thoracic surgery in the same period were selected as the normal group. The observation group adopted comprehensive thermal insulation measures during the operation, and the control group and the normal group adopted routine insulation measures. The patient's body temperature of three groups was compared at each time point: entering operation room, disinfection, body cavity exploration , cutting specimens, closing the chest, suture skin and exiting operation time. the occurrence of adverse reactions during surgery, the blood coagulation index and lactic acid in the peripheral blood before and at the end of surgery, and the peripheral blood inflammatory factor levels were also compared. Results? There were no significant differences in body temperature between the three groups (P＞ 0.05). During the operation, the body temperature of the three groups decreased, and the recovery from the chest was restored. There were significant differences in body temperature between the three groups (P＜ 0.05) at the time point: closing the chest, suture skin and exiting operation room. The incidence of adverse reactions in the observation group was lower than that in the control group and the normal group, and the difference was statistically significant (P＜ 0.05). There was no significant difference in the incidence of adverse reactions between the control group and the normal group (P＞ 0.05). The coagulation and stress indexes of the observation group and the control group were significantly different from those of the normal group (P＜ 0.05). There was no significant difference in the coagulation,lactic acid and stress indexes between the observation group and the control group (P＞ 0.05). The coagulation, lactic acid and stress indexes of the three groups were significantly different before and after surgery (P＜ 0.05). There was a statistically significant difference in interleukin-6(IL-6) levels before and after surgery (F=134.241, P＜ 0.001); there was an interaction between the intervention and the time, and the difference was statistically significant (Finteraction =12.202, P＜0.001). There were significant differences between the three groups in the interleukin-10(IL-10) level group (between group F=7.792, P ＜ 0.001); the difference of IL-10 levels before and after surgery was statistically significant (Ftime=112.121, P＜ 0.001); There was an interaction between the intervention and the time, and the difference was not statistically significant (Finteraction=2.990,P=0.055). Conclusions? Compared with patients with normal BMI thoracic surgery, patients with low BMI have abnormal blood coagulation and stress indicators before surgery, and are more likely to have intraoperative blood pressure drop and adverse reactions. Comprehensive intraoperative warming measures can effectively prevent hypothermia in patients with low BMI.

ObjectiveTo determine the trend and influencing factors of HIV subtypes in newly reported HIV/AIDS cases in Dehong Dai and Jingpo Autonomous Prefecture （Dehong Prefecture） from 2017 to 2019. MethodsRNA extraction was conducted among newly reported HIV/AIDS cases in Dehong Prefecture from 2017 to 2019 whose plasma volume was more than 200 μL. The gag， env and pol genes were amplified by using RT-PCR and then sequenced to determine the subtypes. ResultsA total of 3 287 HIV-infected cases were newly reported in Dehong from 2017 to 2019. The HIV gag， env and pol genotypes were determined in 1 813 cases. The major subtypes were subtype C （28.4%，515/1 813）， recombination form BC （22.0%，398/1 813） and CRF_01AE （18.1%，329/1 813）. Furthermore， the proportion of subtype B， subtype C and CRF01_AE decreased over years， whereas 01/BC， CRF07_BC and CRF08_BC increased over years in both Chinese and Burmese patients （χ²=75.212，P<0.001）. There were significant differences in gender， age， marital status， ethnicity， educational level and transmission route among Chinese and Burmese HIV-infected cases with diverse HIV genotypes （all P<0.05）. ConclusionHIV subtypes in Dehong change over time， which demonstrates that the proportion of BC recombinant subtypes and unique recombinant subtypes increased significantly.

ObjectiveThis study aimed to investigate the HIV genotypic subtypes and molecular transmission clusters among men who have sex with men （MSM） with newly reported HIV infections in Dehong Dai and Jingpo Autonomous Prefecture （Dehong Prefecture）， Yunnan Province， China， between 2010 and 2019. The study aimed to identify potential high-risk transmitters and provide reference data for screening， management， and intervention of infection sources. MethodsPlasma samples from newly reported HIV-positive MSM individuals in Dehong Prefecture between 2010 and 2019 were collected. The viral pol gene fragments were amplified， sequenced， and genotyped. Genetic distances （GD） between pairwise sequences were analyzed and calculated. MEGA 7.0 and Gephi were used for phylogenetic and molecular transmission network analysis. ResultsA total of 159 newly reported HIV infections among MSM were included in the study， with successful genotyping of 100 cases. Nine HIV-1 subtypes were identified， with the most prevalent being CRF01_AE subtype （52%）， followed by CRF07_BC subtype （31%）， CRF55_01B subtype （10%）， and others （7%）. Cluster analysis revealed a total network access rate of 67%， forming three transmission clusters. CRF01_AE subtype formed two transmission clusters with 38 and 3 infected individuals， while CRF07_BC subtypes formed one transmission cluster with 26 infected individuals. The transmission network within the CRF01_AE clusters exhibited a more complex relationship. Significant differences in educational level were observed between the two main transmission clusters. ConclusionThe predominant HIV subtypes among newly reported MSM cases in Dehong Prefecture between 2010 and 2019 were CRF01_AE and CRF07_BC. Significant cultural differences are observed between the main transmission clusters. Continued monitoring of genotypic subtypes and targeted interventions within transmission clusters are warranted.