Objective To explore the value of high frequency ultrasonography for the early diagnosis of hyperuricemia in patients with joint disease.Methods Ninety-eight patients with hyperuricemia and 100 healthy persons,according to with or without history of acute gout attack,were divided into symptomatic group,asymptomatic group and control group,whose first metatarsophalangeal joint,ankle and knee were examined by high frequency ultrasonography.Chi-square test was used for statistical analysis.Results ① The joint lesions detection rate in the symptomatic group,asymptomatic group and the control group was 57％ (13/23),16％ (12/75),0 (0/100) respectively.There was statistical significant difference between the symptomatic group and the asymptomatic group (x2=9.69,P＜0.05).② The symptomatic group had 29 joint involvement (29/138),including 25 at the first metatarsophalangeal joint,3 at the ankle and one at the knee joint.The asymptomatic group had 14 joints involved (14/450),which were all located at the first metatarsophalangeal joint.③ The sonographic appearance of the two groups of arthropathy were synovial thickening,effusion,crystal deposition andbone erosion.The symptoms group presented as tophi,and increased synovial blood flow.Conclusion Patients with asymptomatic hyperuricemia may have joint diseases.The joint disease detection rate of the symptomatic group is higher than that of the asymptomatic group.High frequency ultrasonography can be used a conventional imaging method for the screening of patients with hyperuricemia joint disease.The focus of the screening of asymptomatic patients is the first metatarsophalangeal joint.The focus of the screening of symptomatic patients is the first metatarsophalangeal joint and the joints that were attacked in the past history.

Objective Based on the Hood Policy Tool perspective on China's DIP policy text mining,word frequen-cy analysis and clustering analysis of the policy content,to explore the actual policy in each pilot region,to further analyze the reasons,to provide a scientific and reference for the subsequent policy adjustment and implementation.Methods Policies were included in this study from platforms such as local healthcare protection bureaus,local health-care commissions,local people's government portals,and NVivo,from which policy documents with a high degree of relevance to DIP were selected.NVivo 20.0 software was used for text coding,word frequency analysis,and analysis based on Hood's policy tool dimensions and regional distribution dimensions to further explore DIP policy specifics.Results A total of 27 policies were included,covering all pilot provinces,with a total of 1,707 policy codes.Authoritative,fiscal,informational,and organizational policy instruments accounted for 54.9％,20.3％,16.9％,and 7.9％,respectively.The percentage of coded reference points in the East,Central,West,and Northeast regions were 23.0％,20.2％,44.5％,and 8.7％,respectively.Conclusion The use of DIP policy tools in the pilot regions focused on authoritative tools and less on organization tools.Among the authoritative policy tools,the sub-tools of mechanism building were mostly used,while the sub-tools of standards and norms were less used.The focus of the policy tools varies among the pilot regions,and the use of policy tools should be tailored to the local context.

Objective:To analysis the policy tools and targets of the policies of free training for order-oriented medical students in rural areas of China, for reference for further improving the free medical student training policy.Methods:The research team searched the official websites of the State Council, National Health Commission, Ministry of Education, and other ministries, as well as the Peking University Treasure Database, for national level policy documents related to free training of order-oriented medical students released from June 2010 to May 2023. Policy tool-policy target analysis framework was used to quantitative analysis the policy documents.Results:A total of 16 policy documents were included and 213 policy provisions were extracted. From the perspective of policy tools, the proportion of policy provisions using imperative policy tools was the highest, accounting for 63.38% (135 articles), followed by advisory policy tools(18.78%, 40 articles)and reward based policy tools(13.61%, 29 articles), while functional expansion tools(2.82%, 6 articles) and authoritative restructuring tools(1.41%, 3 articles) accounted for a relatively low proportion. The institutional education stage is the main policy target, with provisions accounting for 76.06% (162 articles), followed by the continuing education stage and the post graduation education stage, accounting for 17.84% (38 articles) and 7.51% (16 articles), respectively. It was uneven distribution of various policy tools and their sub tools within the same policy target.Conclusions:The distribution of policy tools for the free training policy of rural order oriented medical students in China needed to be further balanced. The policy targets were mainly concentrated in the education stage of universities.

Objective: To explore the influence of two voluntary counseling and testing(VCT) services on young students acquired immune deficiency syndrome(AIDS) related knowledge and behaviour, so as to provide a new idea for further improvement and promotion of VCT services. Methods: From April 2017 to December 2018, the sample size,selected from 12 patrol and fixed monitoring sites in colleges in Guangzhou, was calculated by non inferiority trial, and the students who received services at the same period were 1∶1 matched. A total of 113 students received conventional VCT and 186 recerived peer VCT services. The Chi square test was used to analyse the difference of AIDS related knowledge and behavior before and after intervention, and a survey was conducted on satisfaction. Results: After young students received conventional VCT services, the overall awareness rate of AIDS basic knowledge increased from 80.53% to 93.75%, and the frequency of condom use every time during heterosexual sexual activity in the past year increased by 29.17 percentage points ( χ 2=4.49,4.10, P <0.05). After young students received peer VCT services, the awareness rate of the Four Frees and One Care Policy increased from 34.95% to 58.26%, the rates of homosexual anal sex and more than or equal to 2 sexual partners in the past half a year decreased by 14.84 and 29.43 percentage points, respectively( χ 2=15.69, 4.82, 10.97, P <0.05). Conclusion After young students receive two modes of VCT services respectively, the AIDS related knowledge and behavior have been improved, and the influence of the two VCT services has different advantages. The combination of conventional VCT and peer education might be a more effective way of AIDS intervention.

Nosiheptide is a typical thiopeptide antibiotic displaying potent activity toward various drug-resistant strains of Gram-positive pathogens.Although nosiheptide lacks in vivo activity, and good water-solubility with a series of uncontrollable analogues, which may limit its clinical application, glycosylated analogues may overcome problem of low activity and may improve its druggability.In search of novel glycosylated nosiheptide producers, we applied a genome mining strategy that identified Actinoalloteichus sp.AHMU CJ021 that contains all genes required.However, despite the presence of a predicted glycosyltransferase, glycosylated derivatives of nosiheptide were not detected, after following one strain many compounds (OSMAC) strategy and heterologous expression of a regulatory protein NocP.Nevertheless, nosiheptide produced by this strain was remarkably pure, and further experiments were conducted to improve its production by optimization of the culture medium.Under optimal conditions, 58.73 mg/L nosiheptide was produced, representing an almost 6-fold improvement compared to the original fermentation medium.Therefore, we consider Actinoalloteichus sp.AHMU CJ021 a suitable potential candidate for industrial production of nosiheptide, which provides the basis for solving the problem of nosiheptide structural analogues.

Objective:To develop a Risk Assessment Index System (RAIS) on HIV infection among young students based on Delphi method and to provide individual HIV infection risk assessment, targeted prevention and control measures.Methods:Delphi method was applied to determine the index system and weight of the assessment tool through three rounds of expert consultation and overall consideration of opinions and suggestions from 19 experts.Results:The positivity coefficients of three rounds of expert consultation were 100%. The authority coefficient of experts was between 0.887 and 0.945. The Kendall's W coefficients through first, second and third round specialist consultation was 0.379, 0.329 and 0.248, respectively (all P<0.001). The coefficients of variation in the third round were all less than 0.25, indicating that experts' opinion tend to be consistent and the results are highly reliable. The HIV infection risk assessment index system among young students consisted of 7 first grade indices and 54 second grade indices, of which weight was calculated. Conclusions:The RAIS on HIV infection for young students was initially established based on Delphi method, and could be used in the development of HIV infection risk assessment tools for personalized prevention and intervention among young students. However, the reliability, validity and effect of this assessment index system need to be further evaluated.

Objective:To explore the difference of sexual health characteristics and demands in students in different groups, and provide the basis for targeted sexual health eduction for AIDS prevention in young students.Methods:A survey was conducted based on the requirement of health education about sexual health and AIDS prevention in young students by the education department of Guangdong province. A two-step cluster analysis was performed on the survey data obtained by convenient sampling, the variables and number of clusters included were determined by combination of analysis results and professional knowledge. The demographic characteristics, the content and form of sexual health education needed were compared among different groups.Results:Survey data of 3 884 students were collected, and six variables were used for classification: cognition or occurrence masturbation, sexual behavior, frequency of sexual information acquisition, number of acceptable sex partners and AIDS knowledge awareness rate. By these variables, the students were classified into three levels of risk groups: high risk group (46.6%), medium risk group (39.9%) and low risk group (13.5%). As for demographic characteristics, high risk group, with a median age of 19 years, had the highest proportions of boys (65.9%), students with non-heterosexuality orientation (15.2%), urban residents (58.2%), only children (30.8%) and undergraduates (54.7%). Medium risk group, with a median age of 19 years, had the highest proportions of girls (82.7%) and vocational college students (34.0%). Low risk group, with a median age of 18 years, had the highest proportions of rural residents (52.4%), non-only child (80.6%), senior high school students (41.3%), non-boarding students (17.5%) and students without internship and part-time job experience (43.2%). In terms of health education demands, high risk group had a higher demand of information about self-identity, sexual safety, sexual decision making, contraception, abortion, and sexually transmitted disease or AIDS prevention. Medium risk group paid more attention to value on love and marriage, sexual assault. Low risk group showed a higher demand of adolescent physiology knowledge. Compared with low risk group, high risk group had a higher demand of peer education, Internet/multimedia, anonymous counseling and other forms of sexual health education. The differences were significant.Conclusion:The characteristics, sexual knowledge awareness, attitude and behavior, and health education demands of young students in different groups are different, so health education materials and methods should be developed according to the characteristics of different groups to enhance the acceptance and enthusiasm of students and improve the quality of sexual health education.

Objective:To analyze the influencing factors for HIV testing services utilization in students with self-assessed high risk of HIV infection.Methods:The research framework of the influencing factors for HIV testing services utilization in students was developed based on Andersen's health services utilization behavioral model and related literature. A cross-sectional survey was performed in students with self-assessed high risk of HIV infection by an online HIV infection risk assessment tool from March to April 2019. Multiple logistic regressions were applied with hierarchical model.Results:A total of 526 students were included in the study (age: 19.30±1.19 years old), in whom 96.2% agreed that HIV testing should be received after high-risk behavior. 56.7% (298/526) had sexual behavior and the HIV testing rate was 11.0% (58/526). The HIV testing rates in students who had and had no sex behavior were 13.42%(40/298) and 7.89% (18/228), respectively. According to the results from multivariate logistic regression analysis, non-heterosexual (compared with heterosexual, OR=7.88, 95% CI: 3.98-15.61) and higher score of AIDS knowledge awareness (compared with lower score, OR=2.05, 95% CI: 1.07-3.93) in propensity factor module, and having risk sexual behavior (compared with having no risk sexual behavior, OR=2.66, 95% CI: 1.41-5.03) and having diagnosis of STD infection in hospital (compared with having no such diagnosis, OR=6.35, 95% CI: 2.21-18.27) in demand factor module, and receiving health education about AIDS prevention in the past year (compared with receiving no such health education, OR=0.29, 95% CI: 0.11-0.76) and receiving health education about AIDS testing service in the past year (compared with receiving no such health education, OR=3.67, 95% CI: 1.71-7.90) in ability factor module were the influencing factors for utilization of HIV testing services. Conclusions:The acceptance of HIV testing in students needs to be improved urgently. Propensity factors, such as their AIDS knowledge awareness and sexual orientation, and demand factors, such as having risk sexual behavior and STD infection, have obvious impacts on the utilization of HIV testing services. However, health education about AIDS prevention and HIV testing service can play a more important role in facilitating the utilization of HIV testing in students. In the future, we should further strengthen the publicity of voluntary HIV counseling and testing service in students with particular attention to girls and those with risk sexual behaviors.

Objective:To evaluate the effect of "self-categorization" on decision of health preference and the influence of self-categorized deviation in knowledge, attitude and practice (KAP) on the willingness of seeking help for sexual health among young students.Methods:From March to April 2019, young students who used a WeChat applet for sexual health and HIV infection risk assessment, which is called "Detective Bear" were recruited and investigated. According to the consistency between the self-categorization of KAP for sexual health and the systematic categorization from their honest answers, the participants were allocated into three groups: consistent, low or high status, according to their judgment on sexual information acquisition, sexual attitude, and the actual number of sexual experiences. Logistic regression was used to analyze the differences in the willingness to seek help for sexual health problems between the three groups.Results:2 009 students with an average age of (19.2±1.1) were included. 54.7% (1 099/2 009) were female, and 98.4% (1 976/2 009) were college, undergraduate or postgraduate students. 49.0% (984/2 009) were in the consistent group, 10.9% (219/2 009) had a lower self-categorization, 40.1% (806/2 009) had a higher self-categorization. Compared with the consistent group, students with lower self-categorization of KAP for sexual health were less likely to assess HIV voluntary counseling and testing (a OR=0.65, 95% CI: 0.43-0.99). However, students with higher self-categorization seemed to dislike seeking help for sexually transmitted diseases (a OR=0.76, 95% CI: 0.59-0.98). Conclusions:Deviation in self-categorization of KAP for sexual health will reduce the young students' willingness to seek help for related problems. Especially those with lower self-categorization, lack of risk consciousness, and refuse to assess counseling and testing may increase the HIV/AIDS epidemic among this population. It is necessary to strengthen the capacity of self-assessment for young students while promoting sex education.

Objective:To summarize the design and analysis of testing results of a WeChat applet, which is called "Detective Bear", for sexual health and HIV infection risk assessment in young students, and evaluate its feasibility and effectiveness.Methods:Based on self-categorization theory, by using cluster analysis and Delphi expert consulting method, the framework of WeChat applet, risk assessment index system and preventive intervention content were determined. Young students were recruited by student associations for the application test, the results of the repeated tests and the satisfaction survey were collected and analyzed.Results:The study included 393 participants who repeated the test twice and 750 participants who volunteered to participate in the satisfaction questionnaire survey. The applet contains five modules: self-role judgment, self-test, risk assessment, assessment report generation and background management. The risk assessment module contains 6 first-level indicators and 55 second-level indicators. Assessment report generation module includes role diagnosis type, radar chart of HIV sexual health KAP and intervention prescription. In 393 students who repeated the test, the awareness of AIDS to be a serious sexually transmitted disease, the epidemic trend in young students in China, with active seeking HIV testing services and caring the infected improved. The satisfaction survey showed that 75.7% of students (568/750) accepted the applet, 86.5% (649/750) agreed the evaluation report, 83.1%(623/750) thought that there were some problems, but it was easy to use, 93.3% (700/750) said they can learn something from the applet and 84.1% (631/750) satisfied with the page design. Some students thought the questionnaire was too long and somewhat difficult to complete ( P<0.05), and some reported that more can be learned ( P<0.05). Conclusions:The applet integrates AIDS prevention related knowledge and practice into a challenging, interesting, interactive game and provide individualized, concrete risk assessment and self-intervention for young students, which can effectively help students to improve the awareness of AIDS related knowledge and get links for access to condoms, testing and other intervention services. However, its large-scale application and long-term effect need to be further tested.