This paper summarizes Professor SHI Zaixiang's clinical experience in treating high fever caused by sepsis using Chaihu Guizhi Ganjiang Decoction （柴胡桂枝干姜汤）. He holds that the key pathogenesis of sepsis involves constrained heat in the shaoyang and internal accumulation of water and fluids. The clinical manifestations such as high fever， chills， and alternating sensations of cold and heat are attributed to pathogenic heat constrained in the shaoyang. Meanwhile， soft tissue edema and serous cavity effusions are due to shaoyang dysfunction and internal water retention. In clinical practice， treating sepsis-related high fever requires addressing both the shaoyang-constrained heat and the associated edema and effusions. The therapeutic approach focuses on harmonizing the shaoyang and resolving internal fluids， using Chaihu Guizhi Ganjiang Decoction as the base formula with flexible modifications. Professor SHI emphasizes that this formula shows a rapid antipyretic effect， particularly in cases where multiple anti-infective treatments have failed.

Objective: To explore the potential category patterns of risk prevention and control behaviors of HIV infection among young students who have sex with men (MSM) and their impact on HIV infection and late detection, aiming to optimize intervention strategies. Methods: From September 2017 to December 2024, a total of 1 637 MSM young students in Tianjin were recruited through both online and offline channels. Latent class analysis was applied to classify 11 HIV risk prevention and control behaviors [condom use during the most recent anal sex in the past 6 months, consistent condom use, use of water based lubricants, abstinence from recreational drugs, regular on site professional testing, fixed sexual partners, partner testing, awareness of partner s HIV testing results, testing before sexual activity, nucleic acid testing, and use of pre exposure prophylaxis (PrEP) or post exposure prophylaxis (PEP)]. Multivariate Logistic regression analyzed associations between demographic characteristics/intervention services factors and latent classes. Differences in HIV infection and late detection across behavior patterns were compared. Results: HIV risk prevention and control behaviors among MSM students were classified into three latent classes:condom dependent group (38.42%), low prevention group (27.73%), and comprehensive prevention group (33.85%). Students who received condom promotion/testing services were more likely to belong to the comprehensive prevention group ( OR =5.58), while those who received peer education were less likely to the comprehensive prevention group ( OR =0.43) (both P <0.01). Among the MSM student population, the HIV infection rate was 4.83%, with 2.26% of cases detected late. The HIV infection rate (1.45%) and late detection proportion (0.82%) in the comprehensive prevention group were lower than those in the low prevention group (7.89% and 3.83%, respectively) ( χ 2=16.20, 7.31, both P <0.01). Conclusions HIV risk prevention and control behaviors among MSM young students exhibit significant heterogeneity. Comprehensive prevention strategies can effectively reduce HIV infection and late detection risks. It is necessary to optimize peer education content and improve the accessibility of diversified prevention measures such as PrEP/PEP to enhance HIV prevention and control.

As phagocytic innate immune cells,macrophages interact with various tissue types and play an important role in immune defense,inflam-matory response and tissue remodeling.Macro-phages participate in the occurrence and develop-ment of disease by polarizing into classically acti-vated M1 type and substitutively activated M2 type,or more complex phenotypes,when the tis-sue microenvironment changes.This paper focused on the application of macrophage polarization in cardiovascular diseases,and introduces macro-phage origin and activation to propose the relation-ship between macrophage polarization and cardio-vascular diseases.Then,the strategies for targeted macrophage therapy were proposed to provide an important theoretical basis for improving the in-flammatory state of cardiovascular diseases.

As phagocytic innate immune cells,macrophages interact with various tissue types and play an important role in immune defense,inflam-matory response and tissue remodeling.Macro-phages participate in the occurrence and develop-ment of disease by polarizing into classically acti-vated M1 type and substitutively activated M2 type,or more complex phenotypes,when the tis-sue microenvironment changes.This paper focused on the application of macrophage polarization in cardiovascular diseases,and introduces macro-phage origin and activation to propose the relation-ship between macrophage polarization and cardio-vascular diseases.Then,the strategies for targeted macrophage therapy were proposed to provide an important theoretical basis for improving the in-flammatory state of cardiovascular diseases.

Objective: To explore the pre-exposure prophylaxis (PrEP) awareness, willingness, uptake patterns, barriers and needs among Chinese student men who have sex with men (MSM), so as to provide relevant evidence for targeted interventions with PrEP. Methods: A proportional sampling method was used to conduct a cross sectional survey of MSM aged 16 years and older residing in 21 provinces, municipalities, and autonomous regions in mainland China between October 20 and December 20, 2021, to collect information on demographic and sexual behavioral characteristics, and 923 students of them were selected as the subjects of this study. The chi-square test and Fisher s test were used for univariate analysis, followed by multivariate Logistic regression to analyze the influencing factors of PrEP awareness and uptake. Results: According to the cascade analysis method, the awareness, willingness, uptake and adherence rates of PrEP among the student MSM were obtained as 88.95%, 67.36%, 13.20% and 45.21 %, respectively. HIV testing more than once in the last 3 months, and all of them were aware of the HIV test results of their sexual partners, and those with high frequency of condom use had a higher rate of awareness ( OR =2.32, 1.79, 1.69, P <0.05). Willingness rates were higher for those from the pilot city, using substances, and HIV testing more than once in the last 3 months ( OR =2.13, 1.65, 1.69, P <0.05). Higher rates of uptake were found among those from high risk and pilot areas, presence of commercial sex, substance use, and high literacy ( OR =5.60, 3.54,2.81, 1.92, 4.54, P <0.05). Adherence rates were higher among those who used one pill per day or both ( OR =12.77, 13.26, P <0.05). The barriers and needs faced by student MSM were primarily personal concerns about medication side effects, preventative effects, and confidence in sexual behavioral styles, and the high cost of medication and related service costs. Conclusions The student MSM population in China is characterized by high awareness, low willingness, low uptake, and low adherence to PrEP. Targeted interventions should be considered and tailored by the departments to facilitate PrEP promotion among student MSM.

Objective: To investigate the current situation and related factors of antiretroviral therapy (ART) among HIV infected male students engaging in men who have sex with men (MSM), so as to provide the reference data for HIV prevention and treatment. Methods: In November 2021, 137 MSM students from 31 provincial administrative regions in China were recruited. An online survey was conducted to collect data on demographic characteristics, ART status, CD4 count, and HIV viral load before treatment. Logistic regression was used to analyze the factors related the effectiveness of ART in MSM. Results: Among the included research subjects, 14.6% had late detection of HIV,97.1% of participants were currently undergoing ART. Among those whose ART duration was less than 6 months, while 76.9% were undergoing ART. Logistic regression indicated that HIV infected students who received ART for more than 24 months ( OR =5.28, 95% CI =1.38-20.22) had a higher rate of successful HIV suppression. HIV infected students who reported physical sensory side effects ( OR =0.08, 95% CI =0.01-0.71) and cognitive side effects ( OR =0.28, 95% CI =0.09-0.90) were more likely to experience failure of ARI inhibition ( P <0.05). Conclusions There is still room for improvement in the efficacy of ART among MSM students. Strategies to improve treatment adherence must consider individual variances among HIV infected patients and the side effects of medications when designing treatment plans.

Objective: To analyze the use of preexposure prophylaxis (PrEP) among male students who had sex with men (MSM) with different sexual behavior patterns using potential categories, so as to provide evidence for determining the use patterns of PrEP consistent with MSM. Methods: A questionnaire survey was conducted by proportional sampling method on MSM in 31 provincial administrative regions in mainland China from 20 October to 30 December 2021, a total of 1 040 students were selected for the study. Latent variable analyses were conducted on a total of seven sexual behavioral characteristics, including knowledge of sexual partner HIV infection, frequency of condom use, number of sexual partners, engaging in group sex, provision of commercial sex, use of sex aids, and history of sexually transmitted infections (STIs) in the past year. And demographic characteristics were analyzed by Logistic regression analysis. The rates of PrEP awareness, willingness to use and usage rate in different sexual behavior risk groups were investigated. Results: Student MSM could be divided into two potential category groups:a lowrisk behavior group (82.4%) and a highrisk behavior group (17.6%). The PrEP usage rate (15.8%) was higher in the highrisk behavior group, and the difference was statistically significant compared to the lowrisk behavior group (7.2%) (χ2=13.43, P<0.05). Student MSM residing in the northeast, south, and northwest of China, in the pilot city, and with a sex role of "0.5" (possible acceptance and insertion of sexual behavior) were more likely to be in the highrisk behavior group (OR=3.13, 3.07, 3.87, 2.22, 1.66, P<0.05). Conclusion Student MSM in highrisk and lowrisk sexual differs in the behavior of PrEP, and targeted interventions should be implemented to promote the use of PrEP and reduce HIV infection in this population.

BACKGROUND: Although previous studies have shown that meteorological factors such as temperature are related to the incidence of bacillary dysentery (BD), researches about the non-linear and interaction effect among meteorological variables remain limited. The objective of this study was to analyze the effects of temperature and other meteorological variables on BD in Beijing-Tianjin-Hebei region, which is a high-risk area for BD distribution. METHODS: Our study was based on the daily-scale data of BD cases and meteorological variables from 2014 to 2019, using generalized additive model (GAM) to explore the relationship between meteorological variables and BD cases and distributed lag non-linear model (DLNM) to analyze the lag and cumulative effects. The interaction effects and stratified analysis were developed by the GAM. RESULTS: A total of 147,001 cases were reported from 2014 to 2019. The relationship between temperature and BD was approximately liner above 0 °C, but the turning point of total temperature effect was 10 °C. Results of DLNM indicated that the effect of high temperature was significant on lag 5d and lag 6d, and the lag effect showed that each 5 °C rise caused a 3% [Relative risk (RR) = 1.03, 95% Confidence interval (CI): 1.02-1.05] increase in BD cases. The cumulative BD cases delayed by 7 days increased by 31% for each 5 °C rise in temperature above 10 °C (RR = 1.31, 95% CI: 1.30-1.33). The interaction effects and stratified analysis manifested that the incidence of BD was highest in hot and humid climates. CONCLUSIONS This study suggests that temperature can significantly affect the incidence of BD, and its effect can be enhanced by humidity and precipitation, which means that the hot and humid environment positively increases the incidence of BD.
Beijing/epidemiology* ; China/epidemiology* ; Dysentery, Bacillary/epidemiology* ; Humans ; Humidity ; Temperature

Objective: To analyze associated factors of HIV infection among college students who are young men and have sex with men (YMSM) in Tianjin, providing reference for HIV prevention and control among YMSM college students. Methods: During Aug. 1st, 2018 to Dec. 31st, 2018, SHENLAN recruited college students who were YMSM aged 18-24 years from gay baths, gay bars, QQ, WeChat and gay dating app BLUED. HIV infection status and associated factors (general demographic characteristics, unsafe sexual behaviors, addictive substance using, basic knowledge of HIV) was collected and analyzed. Results: A total of 470 college students, including 21 HIV infected (4.47%), were enrolled in this study. Univariate Logistic regression analyses indicated that age, age at first sex behavior, HIV related knowledge, tobacco use, recreational drug usage, syphilis infection was associated with HIV infection among YMSM students (P<0.05). Multivariate analysis found age of first sex (OR=21.20，95%CI=3.09-145.43), recreational drug use (OR=5.07，95%CI=1.77-14.48), lack of HIV related knowledge (OR=3.38，95%CI=1.33-8.63)were associated with HIV infection (P<0.05). Conclusion College students who are YMSM in Tianjin have a high rate of HIV infection, who deserves further attention. Targeted campus HIV/AIDS prevention program should be developed combined with specific characteristics of this population.

Objective:A large single-center, premature acute myocardial infarction (AMI) age (≤45 years) cohort was established to investigate the clinical features and the factors affecting major adverse cardiac events (MACE).Methods:This is a prospective and observational study. 603 patients with a clear diagnosis of AMI admitted to the Tianjin Chest Hospital from March 2015 to December 2017 were continuously selected. All patients were aged ≤45 years old, and a single-center large-sample premature AMI cohort was established. The patient's clinical basic conditions, laboratory indicators, imaging data, coronary angiography and treatment were collected. All patients were followed up for 1 year. MACE events such as cardiac death, recurrent AMI, revascularization, severe heart failure requiring hospitalization and stroke were recorded. Kaplan Meier method was used to draw the survival curve. Cox regression analysis was used to analyze the influence of risk factors, clinical characteristics and intervention methods on the long-term prognosis of MACE events.Results:A total of 603 AMI patients were included, 575 males (95.36%), 28 females (4.64%), and median age 41 (37, 44) years old. There were 422 patients (69.98%) with acute ST segment elevation myocardial infarction (STEMI), 206 patients (48.82%) with anterior myocardial infarction, and 181 patients (30.02%) with non ST segment elevation myocardial infarction (NSTEMI). Smoking was the most common risk factor for premature AMI (77.45%), followed by hyperlipidemia (48.42%) and hypertension (48.09%); smoking was the most common risk factor for male patients (80.35%), and hyperlipidemia was the most common risk factor for female patients (35.71%). 302 (50.08%) patients with premature AMI were treated with symptom onset to first medical contact (SO-to-FMC) ≤12 h; 563 patients (93.37%) had coronary angiography; coronary angiography showed that no significant stenosis, single-vessel disease, double-vessel disease, three-vessel disease, and patients with left main disease were 15(2.66%), 212(37.66%), 153(25.37%), 167(29.66%), 16(2.84%) cases; 318(56.48%) patients with vascular occlusion; The proportion of male combined with left main lesions was lower than that of female group (2.41% vs 12.50%, P=0.026); A total of 45 patients (7.46%) were recorded MACE. The 1-year MACE incidence was lower in the male group than in the female group (6.96% vs 17.86%, P=0.032). Multivariate COX regression analysis: there were 5 indicators that entered the regression model and were statistically significant: female ( HR:4.184; 95% CI:1.583-11.064; P=0.004), SO-to-FMC≤12 h ( HR:0.447; 95% CI:0.224-0.889; P=0.022), left ventricular ejection fraction (LVEF)≤40% ( HR:3.727; 95% CI:1.876-7.405; P<0.001), low-density lipoprotein (LDL) ( HR:1.315; 95% CI:1.041-1.662; P=0.022), homocysteine (Hcy) ( HR:1.011; 95% CI:1.002-1.019; P=0.011) were independent predictor of MACE occurrence in patients with early-onset AMI within 1 year. Conclusions:Smoking is the most common risk factor for young men with AMI. The most common risk factors for young women's AMI is hyperlipidemia, and the proportion of patients with left main artery disease is higher than that of men, but the proportion of patients receiving emergency intervention is lower than that of men, and the long-term prognosis of young women is poor. Early detection and control of these risk factors is a key measure to prevent the onset of AMI.