Stem cell transplantation has great potential in the treatment of ischemic stroke, and bone marrow mesenchymal stem cells (BMSCs) are the most widely studied. Studies have shown that BMSCs mainly perform their functions in a paracrine manner, and the exosomes released by BMSCs show biological activities similar to BMSCs. As a cell-free therapy, BMSCs exosomes have made a lot of progress in the field of ischemic stroke. This article reviews the research progress of BMSCs-derived exosomes in the treatment of ischemic stroke.

Objective:To understand death's mortality and risk factors among HIV-positive injecting drug users (IDU) aged 15 or above in China and provide further reference to future prevention and treatment policies.Method:Retrospective cohort study was conducted to calculate the mortality rate of HIV-positive IDU based on HIV/AIDS Comprehensive Response Information Management System. Cox proportion hazards regression model was performed to assess the risk factors for deaths. The Excel 2019 and SPSS 22.0 software was used for data cleaning and statistical analysis.Results:Between 2001 and 2020, 119 209 HIV-positive IDU were reported with 59 094 deaths. The all-cause mortality rate was 6.96 per 100 person-years (py), and the AIDS-related mortality rate was 1.91 per 100 py, with a decreasing trend over the years. Multivariate Cox regression indicated for all-cause death risks of HIV-positive IDU, compared with those baseline T + lymphocyte cells (CD4) counts above 500 cells/μl, the HR (95% CI) of those CD4 counts untested, between 0-199, 200-349, 350-500 cells/μl was 2.85 (2.78-2.93), 2.47 (2.40-2.54), 1.58 (1.53-1.62) and 1.24 (1.21-1.28) respectively. The HR (95% CI) of antiretroviral treatment (ART) na?ve was 7.13 (6.99-7.27) compared with those under ART. The HR (95% CI) of methadone maintenance treatment (MMT) na?ve was 1.07 (1.04-1.10) compared to those receiving MMT. As for AIDS-related death risks, compared with baseline T+ lymphocyte cell CD4 counts >500 cells/μl, the HR (95% CI) of those CD4 counts untested, between 0-199, 200-349, 350-500 cells/μl was 3.26 (3.08-3.46), 5.54 (5.24-5.85), 2.35 (2.21-2.50) and 1.41 (1.32-1.50). HR (95% CI) of ART na?ve was 5.96(5.74-6.18) compared to those under ART. Conclusions:Further efforts should be made timely on diagnosis, treatment, and harm reduction programs such as MMT for improvement compliance to reduce mortality risks of HIV-positive IDU.

Objective:To understand the epidemiological characteristics of HIV-infected farmers aged ≥60 years in China and provide evidence for the development of AIDS prevention and control policies for elderly farmers.Methods:Data of newly HIV-infected farmers aged ≥60 years reported between 2018 and 2022 were obtained from China Information System for Disease Control and Prevention. The differences in epidemiological characteristics of HIV infection between farmers and other populations were compared using χ2 test. Based on 6 representative indicators, 31 provinces were divided into three sub-epidemic areas of A, B, and C by using sample system clustering method in SPSS 24.0 software. Results:From 2018 to 2022, a total of 113 311 HIV infection cases in farmers aged ≥60 years were reported, accounting for 71.8% of the reported cases in this age group nationwide (113 311/157 792). In the 113 311 HIV infection cases, 86 517 (76.4%) were men, 80 176 (70.8%) were diagnosed by medical institutions, 80 667 (71.2%) were distributed in the western region and 92 191 (81.4%) had education level of primary school or below [higher than the proportion in other populations (49.8%, 22 165/44 481)]. In 113 311 HIV infection cases, 96.7%(109 562/113 311) were infected through heterosexual transmission, in whom 50.4% (55 184/109 562) had commercial heterosexual behavior, 9.1%(9 958/109 562) had fixed sexual partners, 40.5%(44 420/109 562) had other heterosexual behaviors. The clustering analysis indicated that in region A (Guangxi, Chongqing, Guizhou, Sichuan, Yunnan and Xinjiang), the proportions of people living with HIV (30.2/10 000), HIV-infected farmers aged ≥60 years in rural population (22.8/10 000), counties reported HIV-infected elderly farmers (93.4%), the population had HIV test (44.2%), were all higher than those in region B and C. Compared with region B and C, The net income of farmers (10 000 yuan) was lower in region A, and the proportion of commercial heterosexual behavior in male farmers in region A (41.0%) was slightly lower than that in region B (46.1%), but higher than that in region C (15.2%).Conclusions:HIV infections in farmers aged ≥60 years were mainly caused by heterosexual behaviors, such as commercial heterosexual sex, in China from 2018 to 2022. The low awareness of self-protection against AIDS and high-risk sexual behaviors are closely associated with HIV infection in elderly farmers. Attention should be paid to the behavior intervention and health education about AIDS prevention in elderly farmers and the prevention and intervention in rural female sex workers and HIV positive spouses should be strengthened.

Objective:To understand the epidemiological characteristics and changing trends of HIV-infected patients aged ≥60 years reported in recent years in China and provide reference for the development of HIV prevention and control strategies for the elderly.Methods:The data of newly reported HIV-infected patients aged ≥60 years between 2015 and 2022 were obtained from China Information System for Disease Control and Prevention. The differences in epidemiological characteristics of HIV infections among groups were compared by using t test and Kruskal-Wallis H nonparametric test in software SPSS 24.0. Software Joinpoint 4.9.0 was used to calculate annual percent change (APC) and trend analysis was conducted by using Joinpoint regression model. Software Excel 2019 was used for graph drawing. Results:The number of reported HIV-infected patients aged ≥60 years in China increased from 17 451 in 2015 to 27 004 in 2022, with newly diagnosed rate rising from 9.0/100 000 to 10.2/100 000. The newly diagnosed rate in men was higher than that in women. Trend analysis demonstrated that the newly diagnosed rate in both elderly men and women peaked in 2019 (APC for men=13.5%, P=0.003; APC for women=15.0%, P=0.002), and showed a downward trend after 2019 (APC for men=-12.4%, P=0.006; APC for women=-13.0%, P=0.007). Among the elderly infected men, those infected by heterosexual and homosexual transmission accounted for 93.5% (160 747/171 924) and 5.1% (8 781/171 924), respectively. Among the elderly infected women, those infected by heterosexual transmission accounted for 98.4% (48 899/49 697). The infected elder people diagnosed by medical institutions accounted for 71.5% (158 394/221 621), whose baseline CD4 +T lymphocytes level was lower than that in those diagnosed by other ways ( H=1 079.82, P<0.001). Conclusions:The poor risk awareness and high-risk sexual behavior made the elderly at higher risk for HIV infection. More efforts should be made to improve active surveillance, timely detection and origin-tracing for infected elderly for the accurate and effective prevention and control of HIV infection.

Objective:To analyze the basic characteristics and change trend of mortality in HIV-infected patients aged ≥60 years in China from 2013 to 2021.Methods:The data of HIV-infected patients aged ≥60 years at diagnosis were collected from China Information System for Disease Control and Prevention to calculate the mortality density. The trajectory model was fitted using the Proc traj process in software SAS 9.4 to explore trajectory of AIDS-related mortality density and non-AIDS-related mortality density under different combinations of region, gender and age.Results:Between 2013 and 2021, a total of 244 770 HIV-infected patients were reported with 40 079 AIDS-related deaths and 50 245 non-AIDS-related deaths. The AIDS-related mortality density was 6.32 per 100 person-years, and the non-AIDS-related mortality density was 7.92 per 100 person-years, both of which showed decreasing trends over the years, and the mortality density in men was higher than that in women. Two developmental trajectories could be categorized for different trends of AIDS-related mortality density: the lower mortality density group accounted for 80.95% and showed a slow decreasing trend; the higher mortality density group accounted for 19.05% and showed a three-curve developmental trend. There were three developmental trajectories of non-AIDS-related mortality density trends: the lower mortality density group accounted for 59.52% and the medium mortality density group accounted for 28.57%, with a flat overall trend in these two groups; the higher mortality density group accounted for 11.91% with a three-curve trend.Conclusions:The mortality in HIV-infected patients aged ≥60 years in China is still high. Further attention should be paid to the early detection, diagnosis and treatment of HIV infection to effectively reduce the density of AIDS-related deaths. At the same time, attention should be paid to non-AIDS-related deaths in the elderly, and comprehensive interventions should be taken. It is necessary to conduct targeted HIV/AIDS prevention and control based on actual situation in different areas and populations

In February 2022, the world′s first gallbladder reporting and data system (GB-RADS) for the assessment of gallbladder wall thickening on ultrasonography was published in the form of an international expert consensus. The GB-RADS system classifies gallbladder wall thickening into six levels (GB-RADS 0?5), with gradually increasing risk of malignancy. It is mainly based on the following features: symmetry and extent (focal versus circumferential) of involvement, layered appearance, intramural features (including intramural cysts and echogenic foci), and interface with the liver. The proposed system is important for the standardized diagnosis and treatment of gallbladder diseases. The authors interpret the consensus, introduce the evaluation points and classification standards, and suggest the future applications and research directions.

ObjectiveTo develop a bilateral rehabilitation robot motion assistance strategy based on admittance control, so that rehabilitation physicians can assist patients in rehabilitation training through remote teaching. MethodsA bilateral remote rehabilitation platform with upper limb terminal traction was constructed. Based on the velocity admittance control, the interactive movement between the master robot and the rehabilitation physician was realized, and the position information transmission of the master-slave robot was realized through the communication framework built. The slave robot received the position coordinates of the main robot, and drove the patient to carry out rehabilitation exercises under the attitude admittance controller. ResultsThe robot could drive the patient to accurately track the trajectory of the doctor's teaching in real time, and improve the safety and compliance of the training and human-computer interaction. ConclusionBy introducing two admittance controllers, the trajectory of the physician's end can be accurately tracked when driving the patient's movement from the robotic arm, which effectively avoids the discomfort of the patient's arm in process of rehabilitation.

Due to the lack of effective early diagnosis and treatment, gallbladder cancer(GBC) remains a malignant tumor with extremely high malignancy and poor prognosis. Therefore, high quality studies are required to break through the bottleneck in GBC diagnosis and treatment. This article reviewed the domestic and foreign GBC research published in 2021, presenting a comprehensive summary of the important advances in the field of clinical diagnosis and treatment. Latest epidemiological data and risk factors, emerging diagnostic methods of peripheral blood laboratory tests and imaging, new pathologic classification system, hot topics and controversies of surgical treatment as well as the dynamics of systemic treatment of GBC are reviewed in the article. The present findings may contribute to a more efficient means of diagnosis and treatment for GBC and hold the promise of improved outcomes for patients with GBC.

Due to the lack of effective early diagnosis and treatment, gallbladder cancer(GBC) remains a malignant tumor with extremely high malignancy and poor prognosis. Therefore, high quality studies are required to break through the bottleneck in GBC diagnosis and treatment. This article reviewed the domestic and foreign GBC research published in 2021, presenting a comprehensive summary of the important advances in the field of clinical diagnosis and treatment. Latest epidemiological data and risk factors, emerging diagnostic methods of peripheral blood laboratory tests and imaging, new pathologic classification system, hot topics and controversies of surgical treatment as well as the dynamics of systemic treatment of GBC are reviewed in the article. The present findings may contribute to a more efficient means of diagnosis and treatment for GBC and hold the promise of improved outcomes for patients with GBC.

Objective     To explore the correlation between the quantitative and qualitative features of CT images and the invasiveness of pulmonary ground-glass nodules, providing reference value for preoperative planning of patients with ground-glass nodules. Methods    The patients with ground-glass nodules who underwent surgical treatment and were diagnosed with pulmonary adenocarcinoma from September 2020 to July 2022 at the Third Affiliated Hospital of Kunming Medical University were collected. Based on the pathological diagnosis results, they were divided into two groups: a non-invasive adenocarcinoma group with in situ and minimally invasive adenocarcinoma, and an invasive adenocarcinoma group. Imaging features were collected, and a univariate logistic regression analysis was conducted on the clinical and imaging data of the patients. Variables with statistical difference were selected for multivariate logistic regression analysis to establish a predictive model of invasive adenocarcinoma based on independent risk factors. Finally, the sensitivity and specificity were calculated based on the Youden index. Results     A total of 555 patients were collected. The were 310 patients in the non-invasive adenocarcinoma group, including 235 females and 75 males, with a meadian age of 49 (43, 58) years, and 245 patients in the invasive adenocarcinoma group, including 163 females and 82 males, with a meadian age of 53 (46, 61) years. The binary logistic regression analysis showed that the maximum diameter (OR=4.707, 95%CI 2.060 to 10.758), consolidation/tumor ratio (CTR, OR=1.027, 95%CI 1.011 to 1.043), maximum CT value (OR=1.025, 95%CI 1.004 to 1.047), mean CT value (OR=1.035, 95%CI 1.008 to 1.063), spiculation sign (OR=2.055, 95%CI 1.148 to 3.679), and vascular convergence sign (OR=2.508, 95%CI 1.345 to 4.676) were independent risk factors for the occurrence of invasive adenocarcinoma (P<0.05). Based on the independent predictive factors, a predictive model of invasive adenocarcinoma was constructed. The formula for the model prediction was: Logit(P)=–1.293+1.549×maximum diameter of lesion+0.026×CTR+0.025×maximum CT value+0.034×mean CT value+0.72×spiculation sign+0.919×vascular convergence sign. The area under the receiver operating characteristic curve of the model was 0.910 (95%CI 0.885 to 0.934), indicating that the model had good discrimination ability. The calibration curve showed that the predictive model had good calibration, and the decision analysis curve showed that the model had good clinical utility. Conclusion     The predictive model combining quantitative and qualitative features of CT has a good predictive ability for the invasiveness of ground-glass nodules. Its predictive performance is higher than any single indicator.