Objective To compare and analyze the main manifestations of HIV/ AIDS impact on marriage and family structure.Methods The relevant data of 931 HIV households and 995 non-HIV households were collected in five provinces with high HIV prevalence in China,using the method of questionnaire survey.The differences between people living with HIV/ AIDS(PLWHA)and non-HIV individuals in marriage and family structure were analyzed and compared.Results The percentage of PLWHA who were unmarried,divorced,widowed and remarried was higher than that of individuals in non-HIV households;the average size of the non-HIV households was 4.4 persons,while the size of HIV households was 4.0 persons;of the surveyed HIV households 41.1 % were stem families,while in the case of non-HIV households this percentage was lower,only 33.4 %.The rate of school enrollment among children in HIV households was lower than that in non-HIV households,while the rate of labor participation among the elderly in HIV households was higher than that in non-HIV households.Conclusion The results indicate that HIV/AIDS destroys the normal marriage among PLWHA,leading to an increased number of stem families and changes in family structure;the impact on the elderly and children in the HIV households is severe.All this means that HIV/AIDS weakens or even destroys the family function.

Objective:To investigate the status of clinical nurses′ professional identity and disaster cognition during the post-disaster reconstruction, and to analyze the correlation between the two.Methods:With the convenient sampling method, the 346 nursing staff of the First Affiliated Hospital of Zhengzhou University participated in the disaster reconstruction for the survey, using the general questionnaire, the nurse professional identity scale, the disaster cognition questionnaire for investigation. Pearson correlation was used to analyze the correlation between disaster cognition and professional identity.Results:The disaster cognition during the post-disaster needed to be improved, the choice rate of knowing disaster nursing well was 6.36%-70.23%. Gender had significant statistical significance on the scores of thinking the importance of disaster care training and willingness to join in disaster care continuing education ( t=-2.54 and -2.32, both P<0.05). Position had significant statistical significance on the score of willing to join in the enthusiasm of emergency rescue( F=6.62, P<0.05). Whether have ever participated in disaster training had significant statistical significance on the scores of focusing on the frequency of disasters and understanding the degree of disaster care ( t=5.57, 7.88, both P<0.05). Nurse professional identity level was high during the post-disaster reconstruction, the total score was (121.73 ± 19.75). Whether have ever participated in disaster training had significant statistical significance on the score of professional identity ( t=4.57, P<0.05). And the total score and each dimension score of disaster recognition were positively correlated with the total score and each dimension score of professional identity in nurses ( r values were 0.44-0.53, all P<0.05). Conclusions:The disaster cognition level is still lacking, the professional identity level is high. The disaster cognition affects professional identity levels to a certain extent, so nursing managers should improve the disaster recognition of nursing staff by making targeted strategy, which can not only improve the professional identity levels, but also reserve power for emergency disaster and post-disaster reconstruction reserves.

Objective:To explore the real experience of decompensated cirrhosis patients and their spouses returning to family dual disease management and to provide a reference for the targeted intervention strategies.Methods:Totally 13 decompensated cirrhosis patients and their spouses admitted in Infectious Disease Department, the First Affiliated Hospital of Zhengzhou University from February 2022 to April 2022 were recruited for semi-structured interviews. Colaizzi 7-step analysis was used to summarize and extract the themes.Results:The final analysis yielded a total of 8 generic categories belonging to 3 categories based on the dyadic illness management theory. These were negative disease perception including disease cognitive bias, lack of complication awareness, negative family management including low self-worth, conflict management, poor management compliance, economic pressure, passive attitude, dyadic health needs to be improved including negative emotional dominance, self-perceived discrimination, communication disorders, intimacy decrease.Conclusions:Decompensated cirrhosis patients and their spouses have negative and resistant psychology in disease perception, management compliance, management attitude, behavior, and so on, clinical medical staff should be aimed at decompensated cirrhosis patients and their spouses on the health education to strengthen disease, guiding role transformation, gives targeted positive psychological intervention, to provide multi-dimensional social support, to improve the negative mood, reduce stigma and improve binary health.

Objective To compare the difference of simple-rapid identification method and automatic biochemical identification method in the identification of Escherichia coli .Methods The strains of Escherichia coli isolated from clinical samples were identi-fied by the simple-rapid method and automatic biochemical method .The consistency of result and the time of two methods were compared .Results Among 492 suspected strains ,248 strains were identified as Escherichia coli by simple-rapid method ,and other 244 strains were not .Meanwhile ,231 strains of these 248 Escherichia coli strains and 7 strains of 244 non Escherichia coli strains were identified as Escherichia coli by automatic biochemical method .The positive and negative predictive value of simple-rapid method were 93 .1% (231/248) and 97 .1% (237/244) .2 .5-7 .0 h [average(4 .12 ± 1 .08) h] were used to identify Escherichia coli by automatic biochemical method while0 .5-2 .0 h[average(1 .08 ± 0 .45) h] were used by simple-rapid method ,the difference was statistically significant(t= -40 .252 ,P<0 .001) .Conclusion The result of simple-rapid method is close to that of automatic bio-chemical identification method on Escherichia coli ,and simple-rapid method used less time .

Agrimonia pilosa is one of the traditional Chinese herbal medicines for 2000 years history. Due to its various pharmacological effects, it is widely used in the clinical treatment of tumors and other diseases. Presently malignancy has become an important factor threatening human health that the anti-tumor effect of Agrimonia pilosa has attracted great attention. The author reviewed its anti-tumor effect mechanism by articles arrangement of experimental study, clinical study and experience introduction. A series of study revealed 3 mechanisms: blocking cell cycle, inducing apoptosis and strengthening the cellular immunity. As a kind of traditional Chinese herbal medicine which has anti-tumor effect, the Agrimonia pilosa should be reasonably applied according to the related research and previous experience.

In recent years,the tumor microenvironment(TME)has garnered significant attention from scientists.It is a com-plex system composed of tumor cells,cancer-associated fibroblasts(CAFs),immune cells,blood vessels,extracellular matrix,sur-rounding supportive tissues and their metabolic environment.Two fundamental characteristics of this system are immune escape and metabolic changes(the shift from aerobic to anaerobic metabolism of glucose,leading to lactate production).Although lactate has tra-ditionally been considered a metabolic"waste"product in the TME,it is now widely recognized that the increase in lactate and the acidification of the tumor microenvironment play key roles in tumor development and progression,including immune escape,tissue in-vasion/tumor metastasis,angiogenesis and tumor drug resistance.Therefore,studying the regulatory mechanisms of lactate metabo-lism,immune suppression,angiogenesis,and tumor drug resistance in the TME can provide a theoretical basis and practical evidence for new therapeutic strategies targeting the TME.

Objective To explore method of establishing and evaluating an asthma rat model with phlegm and blood stasis syndrome.Methods 60 SD male rats were randomly divided into 5 groups,a normal group,asthma group,combination of disease and syndrome(combination)group,DM group,and KCLW group,with 12 rats in each group.Asthma models were established using ovalbumin(OVA).A syndrome model of phlegm and blood stasis was established using a high-fat diet combined with the ice water bath method.We evaluated the asthma model through animal behavior observation,pathological section observation,inflammation index detection,and airway reactivity measurements.The phlegm and blood stasis syndrome model was evaluated via measurements of rat body mass,blood glucose,blood lipids,coagulation function,and hemorheological indexes and by observing symptoms and syndrome determination by Kechuan Liuwei mixture.Results(1)After OVA induction,the rats in the asthma model group and combination group showed symptoms such as shortness of breath,open mouth breathing,abdominal movement,restlessness,and irritability.HE staining showed the disordered arrangement of the bronchial mucosa in lung tissue,local detachment,thickening of the basement membrane and the bronchial tube wall,narrowing of the lumen,extensive infiltration of inflammatory cells,and congestion of capillaries.Compared with the normal group,the asthma model group and combination group(P＜0.05)had increased serum IL-4,IL-6,and TGF-β1.Penh values were increased after stimulation with various concentrations of Mch(P＜0.05).(2)Rats in the combination group showed symptoms such as chills,curling up with minimal movement,purple and dark claws,purple and black bruises on the tail,loose stools,and unclean perianal area.Compared with the rats in the asthma model group,rats in the combination group had increased body mass(P＜0.05)and blood glucose,triglyceride,and total cholesterol levels(P＜0.05),a shortened thrombin time(P＜0.05),increased fibrinogen content(P＜0.05),and significantly increased whole-blood viscosity at low,medium,and high shear rates(P＜0.05).The indexes were significantly improved after Kechuan Liuwei mixture administration.Conclusions The asthma rat model with phlegm and blood stasis syndrome can be established through OVA induction and high-fat diet combined with ice water bath.The model can be evaluated through behavioral observation,index measurements,and syndrome determination via formulas.

The American Association for the Study of Liver Diseases (AASLD) updated and published the Practice Guidance for the Diagnosis and Management of Nonalcoholic Fatty Liver Disease (NAFLD) in July 2017, which provides recommendations for the accurate diagnosis, treatment, and effective prevention of NAFLD. Related metabolic diseases should be considered during the initial evaluation of patients suspected of NAFLD. Noninvasive diagnostic techniques including transient elastography, magnetic resonance elastography, and serum biochemical models should be used to evaluate the development and progression of liver fibrosis in patients with NAFLD. Clinical liver pathology report should clearly differentiate between nonalcoholic fatty liver (NAFL), NAFL with inflammation, and nonalcoholic steatohepatitis (NASH) and identify the presence or absence of liver fibrosis and its degree. Early medication for NAFLD can only be used in patients with pathologically confirmed NASH and liver fibrosis, and it is not recommended to use pioglitazone and vitamin E as the first-line drugs for patients with NASH which has not been proven by biopsy or non-diabetic NASH patients. Foregut bariatric surgery can be considered for obese patients with NAFLD/NASH who meet related indications. It is emphasized that the risk factors for cardiovascular disease should be eliminated for NAFLD patients. Statins can be used for the treatment of dyslipidemia in patients with NAFLD/NASH, but they cannot be used in patients with decompensated liver cirrhosis. Routine screening or hepatocellular carcinoma surveillance is not recommended for NASH patients without liver cirrhosis. Cardiovascular disease should be taken seriously during liver transplantation evaluation. There is still no adequate clinical evidence for the treatment of NAFLD in children and adolescents, and intensive lifestyle intervention is recommended as the first-line therapy for such patients.

Objective:To investigate the clinical application value of left ventricular myocardial strain obtained by cardiac MR (CMR) in recent major adverse cardiovascular events (MACE) in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI).Methods:From January 2020 to December 2020, a total of 163 patients successfully underwent primary PCI and underwent CMR examination within one week after surgery at Affiliated Hospital of Xuzhou Medical University. The scan sequences included rapid balance-fast field echo and late-gadolinium enhancement. CVI42 post-processing software was used to analyze and measure the left ventricular myocardial strain indices, including left ventricular global longitudinal strain (GLS), left ventricular global circumferential strain (GCS), and left ventricular global radial strain (GRS). According to the results of the 1-year follow-up after surgery, the patients were divided into the MACE group ( n=28) and the non-MACE group ( n=135). For continuous variables with a normal distribution, the t test of two independent samples was used for comparisons between groups. For continuous variables with an abnormal distribution, the variables were compared and analyzed by the rank sum test. For categorical variables, the χ 2 tests were used for between-group comparisons. Cox regression was used to analyze the prognostic value of myocardial strain on the development of MACE in patients with STEMI. The receiver operating characteristic (ROC) curve was used to analyze the diagnostic efficacy of myocardial strain parameters, and the optimal cut-off value was evaluated by calculating the Youden index. Results:The GLS, GCS, and GRS of the MACE group were (-10.4±3.3)%, [-11.9 (-14.5, -9.3)]%, and (18.3±6.3)%, respectively, and those of the non-MACE group were (-13.7±3.4)%, [-14.6 (-16.4, -11.7)]%, and (22.3±6.1)%, respectively. The difference between the two groups was statistically significant ( t/ Z=-4.71, -3.04, 3.21, P<0.05). Multivariate Cox regression analysis showed that GLS was an independent predictor of MACE (HR=1.546, 95%CI 1.180-2.027, P=0.002). The ROC curve analysis showed that GLS had the largest area under the curve (AUC) (AUC=0.754, 95%CI 0.658-0.851, P<0.001), with a cut-off value of -12.45%. Its diagnostic sensitivity was 71.4%, and the specificity was 67.4%. The value was better than that of the traditional predictor of STEMI prognosis, namely, left ventricular ejection fraction (AUC=0.680, 95%CI 0.567-0.793, P=0.003). Conclusion:GLS of CMR is an independent predictor of MACE in STEMI patients undergoing primary PCI.

Objective:To investigate the factors influencing the occurrence of esophageal stenosis after endoscopic radiofrequency ablation (RFA) for total or near total circumferential early esophageal cancer and precancerous lesions.Methods:Between November 2018 and April 2022, 37 patients who underwent RFA for early esophageal squamous cell carcinoma or intraepithelial neoplasia at Zhongda Hospital, Southeast University were included in a case-control study, and were divided into two groups based on the occurrence of postoperative esophageal stricture: the group with postoperative esophageal stenosis (case group, n=15) and the group without postoperative esophageal stenosis (control group, n=22). The differences in general information, endoscopic findings, and surgical procedures between the two groups were analyzed. Results:There was no significant difference in gender ( P=0.708), age ( t=1.106, P=0.413), smoking or drinking ( P=0.329), preoperative pathology ( P=0.194), circumferential situation ( P=1.000), Paris type ( P=0.379), lesion length ( t=-0.825, P=0.927), ablation length ( t=-0.134, P=0.723), ablation times ( P=0.306), or interval between each ablation ( P=0.500) between the two groups; however, there was significant difference in invasion depth between the two groups ( P=0.021). Conclusion:For total or near total circumferential early esophageal cancer and precancerous lesions, the depth of lesion infiltration may affect the occurrence of esophageal stenosis after RFA. The likelihood of esophageal stenosis may rise with increased infiltration depth, suggesting a need for further research to validate these findings.