ObjectiveThe significance of adverse childhood experiences (ACEs) among men who have sex with men (MSM) should not be overlooked. This study aims to assess the reliability and validity of the Chinese version of the Adverse Childhood Experiences-International Questionnaire (ACE-IQ) among the MSM population in China to evaluate its applicability in this group. MethodsA cross-sectional survey was conducted in three Chinese cities(Shanghai, Shenyang and Kunming) using snowball sampling, with a total of 1 130 MSM participants included. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to assess the structural validity of the scale. Internal consistency reliability was evaluated using Cronbach’s α coefficient, and split-half reliability was assessed with the Spearman-Brown coefficient. ResultsAccording to the EFA results, after removing item ACE10 (“parental death”), the 23-item ACE-IQ demonstrated a six-factor structure, including victimization or witnessing emotional/physical abuse, sexual abuse, physical neglect, family dysfunction, emotional neglect, and peer violence. CFA results indicated a good model fit for the six-factor model, supporting the EFA findings. The scale demonstrated good reliability, with a Cronbach's α coefficient of 0.852 and a Spearman-Brown coefficient of 0.899, indicating high internal consistency and split-half reliability within the studied population. ConclusionThe Chinese version of the ACE-IQ demonstrates satisfactory reliability and validity among MSM population, supporting its suitability for assessing ACEs in this group. The findings provide an empirical basis for subsequent mental health interventions.

Objective:To investigate and explore the expressional condition and therapeutic role of PD-1 and CD161 in the peripheral blood of patients treated with PEG-IFN-α for chronic hepatitis B (CHB), and their correlation with the degree of decrease in hepatitis B surface antigen (HBsAg).Methods:A retrospective cohort study was conducted. CHB patients who visited the Second Affiliated Hospital of Xi'an Jiaotong University from July 2022 to December 2023 and healthy controls during the same period were included. Peripheral blood samples were collected from the IFN treatment group (31 cases), the non-IFN treatment group (30 cases), and the healthy control group (30 cases). Flow cytometry was used to detect the CD8, + PD-1, + CD161 + T lymphocytes and their subpopulations among the three groups. The proportions of cellular subpopulations were compared to analyze intergroup differences using Kruskal-Wallis and Mann-Whitney U tests. The patients in the IFN treatment group were divided into two subgroups, high-and low-level, according to the median levels of PD-1 + lymphocytes, CD8 +PD-1 +T cells, and CD161 + lymphocytes. The magnitude of HBsAg decline was compared between the two groups. Results:The proportions of PD-1 + lymphocytes and CD8 +PD-1 +T cells in the IFN treatment group were significantly higher than those in the healthy control group and the non-IFN treatment group ( P<0.001). Moreover, the proportions of PD-1 + lymphocytes [IFN treatment group 48 weeks: 24.3 (23.7, 28.0)%, non-IFN treatment group: 12.7 (10.0, 18.5)%, P<0.01] and CD8 +PD-1 +T cells [IFN treatment group 48 weeks: 29.29 (26.73, 32.98)%, non-IFN treatment group: 17.69 (9.62, 20.68)%, P<0.05] were higher in the IFN treatment group than those in the non-IFN treatment group at 48 weeks. The proportion of CD8 +CD161 +T cells was significantly lower in patients treated with IFN than in the non-IFN treatment group ( P<0.05) at 24 and 48 weeks, with no statistically significant difference with the healthy control group ( P>0.05). In the IFN treatment group, patients with high levels of PD-1 + and CD8 + PD1 lymphocytes had a significantly lower HBsAg decline compared to low-level patients, whereas no significant correlation was found between CD161 levels and HBsAg decline [PD-1 + lymphocytes: 0.15 (0.02, 0.18) log 10 IU/mL vs. 0.32 (0.13, 0.42) log 10 IU/mL, P<0.01; CD8 +PD-1 +T cells: 0.16 (0.03, 0.17) log 10 IU/mL vs. 0.34 (0.13, 0.44) log 10 IU/mL, P<0.05]. Conclusion:The proportions of CD8 +PD-1 +T cells and CD8 +CD161 +T cells were significantly regulated by PEG-IFN-α therapy in the peripheral blood of patients with CHB, revealing the important role of T cell immune activation status during antiviral treatment. The gradual decline of HBsAg is closely related to the high expression of PD-1, suggesting that PD-1 may be negatively regulated during the process of T cell exhaustion and immunological evasion.

With the progression of liver cirrhosis， patients often develop sarcopenia and lipid metabolism disorders， and the complex interaction between p sarcopenia and lipid metabolism disorders not only promotes the progression of liver cirrhosis， but also affects the prognosis and quality of life of patients. As an effective intervention for alleviating complications associated with liver cirrhosis， transjugular intrahepatic portosystemic shunt （TIPS） can improve sarcopenia to a certain degree by improving hepatic hemodynamics and reducing portal venous pressure. In addition， there might be varying degrees of changes in blood lipid levels after TIPS， which may be closely associated with the recovery of liver metabolic function and the alterations in hemodynamics. This article introduces the association between liver cirrhosis， sarcopenia， and lipid metabolism disorders， elaborates on the effect of TIPS on sarcopenia and abnormal lipid metabolism， and discusses related mechanism and clinical significance， in order to provide a theoretical basis for clinical treatment.

Objective To observe the changes in the serum level of tumor necrosis factor-α(TNF-α)during pegylated interferon-alpha(PEG-IFN-α)treatment in inactive HBsAg carriers(IHCs),to investigate the association between the dynamic changes of TNF-α and HBsAg clearance,and to assess the value of TNF-α as a potential biomarker for predicting the therapeutic efficacy of PEG-IFN-α.Methods A prospective study was conducted among 455 IHCs who attended our hospital from January 2018 to March 2023,and they were divided into treatment group and IHC control group.The 210 IHCs in the treatment group voluntarily received PEG-IFNα-2b treatment for 48 weeks,followed by follow-up for 24 weeks,and the 245 IHCs in the IHC control group were followed up for 72 weeks without treatment.The serum level of TNF-α was measured at baseline(week 0)and at weeks 12,24,48,and 72,and at week 72,the treatment group was further divided into HBsAg clearance group and non-clearance group.The serum level of TNF-α at different time points was compared between groups.The logistic regression analysis was used to assess the value of TNF-α in predicting HBsAg clearance.The t-test was used for comparison of normally distributed continuous data between two groups,and a one-way analysis of variance used for comparison between multiple groups;the repeated measures analysis of variance was used for comparison of normally distributed repeated measurement data within each group and between groups;the chi-square test or the Fisher's exact test was used for comparison of categorical data between groups.Univariate and multivariate logistic regression analyses were used to investigate the predictive factors for HBsAg clearance,and the receiver operating characteristic(ROC)curve was used to determine the cut-off value of TNF-α in predicting HBsAg clearance.Results At week 72,compared with the IHC control group,the treatment group had significantly higher HBsAg clearance rate(46.2%vs 1.2%,χ2=133.333,P<0.001)and seroconversion rate(34.8%vs 0.8%,χ2=94.650,P<0.001).The HBsAg clearance group and the non-clearance group had a significant increase in the serum level of TNF-α during treatment,which gradually returned to the baseline level after drug withdrawal(F=351.733 and 76.434,both P<0.001).Comparisons between groups showed that the HBsAg clearance group had the highest serum level of TNF-α at weeks 12,24,and 48,followed by the non-clearance group and the IHC control group(all P<0.001).The multivariate logistic regression analysis showed that baseline HBsAg level(odds ratio[OR]=0.329,95%confidence interval[CI]:0.189-0.571,P<0.001),baseline HBV DNA<20 IU/mL(OR=1.414,95%CI:1.057-1.787,P=0.045),ALT≥2×upper limit of normal at week 12(OR=1.127,95%CI:1.028-1.722,P=0.043),TNF-α level at week 12(OR=1.336,95%CI:1.018-1.754,P=0.037),and TNF-α level at week 24(OR=1.879,95%CI:1.477-2.391,P<0.001)were independent predictive factors for HBsAg clearance.The ROC analysis showed that TNF-α level at week 12 had an area under the ROC curve(AUC)of 0.846(95%CI:0.814-0.889)in predicting HBsAg clearance at week 72,with a sensitivity of 76.3%and a specificity of 81.0%,while TNF-α level at week 24 had an AUC of 0.912(95%CI:0.758-0.972),with a sensitivity of 81.4%and a specificity of 96.2%.Conclusion PEG-IFN-α can increase the serum level of TNF-α in IHCs,and the serum level of TNF-α at weeks 12 and 24 can effectively predict HBsAg clearance induced by PEG-IFN-α.

The incidence of generalized anxiety disorder(GAD)has recently been increasing year by year,in a complex social environment.The diagnosis of GAD currently often relies on DSM-5 and ICD-10 criteria,which include subjectivity and limitations.Understanding the intrinsic activity of brain network functions and structural connectivity is an important goal of contemporary neuroscience research.Electroencephalographic microstates are capable of observing broad frequency components and capturing dynamic changes in brain activity,thus providing a novel perspective on the accuracy of GAD diagnosis.This review considers the electroencephalographic microstate features and explores the abnormalities in the functional brain network in patients with GAD,with the aim of providing a clear diagnosis,optimizing the therapeutic efficacy,and improving the quality of medical care for patients with GAD.

Objective To observe the changes in the serum level of tumor necrosis factor-α(TNF-α)during pegylated interferon-alpha(PEG-IFN-α)treatment in inactive HBsAg carriers(IHCs),to investigate the association between the dynamic changes of TNF-α and HBsAg clearance,and to assess the value of TNF-α as a potential biomarker for predicting the therapeutic efficacy of PEG-IFN-α.Methods A prospective study was conducted among 455 IHCs who attended our hospital from January 2018 to March 2023,and they were divided into treatment group and IHC control group.The 210 IHCs in the treatment group voluntarily received PEG-IFNα-2b treatment for 48 weeks,followed by follow-up for 24 weeks,and the 245 IHCs in the IHC control group were followed up for 72 weeks without treatment.The serum level of TNF-α was measured at baseline(week 0)and at weeks 12,24,48,and 72,and at week 72,the treatment group was further divided into HBsAg clearance group and non-clearance group.The serum level of TNF-α at different time points was compared between groups.The logistic regression analysis was used to assess the value of TNF-α in predicting HBsAg clearance.The t-test was used for comparison of normally distributed continuous data between two groups,and a one-way analysis of variance used for comparison between multiple groups;the repeated measures analysis of variance was used for comparison of normally distributed repeated measurement data within each group and between groups;the chi-square test or the Fisher's exact test was used for comparison of categorical data between groups.Univariate and multivariate logistic regression analyses were used to investigate the predictive factors for HBsAg clearance,and the receiver operating characteristic(ROC)curve was used to determine the cut-off value of TNF-α in predicting HBsAg clearance.Results At week 72,compared with the IHC control group,the treatment group had significantly higher HBsAg clearance rate(46.2%vs 1.2%,χ2=133.333,P<0.001)and seroconversion rate(34.8%vs 0.8%,χ2=94.650,P<0.001).The HBsAg clearance group and the non-clearance group had a significant increase in the serum level of TNF-α during treatment,which gradually returned to the baseline level after drug withdrawal(F=351.733 and 76.434,both P<0.001).Comparisons between groups showed that the HBsAg clearance group had the highest serum level of TNF-α at weeks 12,24,and 48,followed by the non-clearance group and the IHC control group(all P<0.001).The multivariate logistic regression analysis showed that baseline HBsAg level(odds ratio[OR]=0.329,95%confidence interval[CI]:0.189-0.571,P<0.001),baseline HBV DNA<20 IU/mL(OR=1.414,95%CI:1.057-1.787,P=0.045),ALT≥2×upper limit of normal at week 12(OR=1.127,95%CI:1.028-1.722,P=0.043),TNF-α level at week 12(OR=1.336,95%CI:1.018-1.754,P=0.037),and TNF-α level at week 24(OR=1.879,95%CI:1.477-2.391,P<0.001)were independent predictive factors for HBsAg clearance.The ROC analysis showed that TNF-α level at week 12 had an area under the ROC curve(AUC)of 0.846(95%CI:0.814-0.889)in predicting HBsAg clearance at week 72,with a sensitivity of 76.3%and a specificity of 81.0%,while TNF-α level at week 24 had an AUC of 0.912(95%CI:0.758-0.972),with a sensitivity of 81.4%and a specificity of 96.2%.Conclusion PEG-IFN-α can increase the serum level of TNF-α in IHCs,and the serum level of TNF-α at weeks 12 and 24 can effectively predict HBsAg clearance induced by PEG-IFN-α.

The incidence of generalized anxiety disorder(GAD)has recently been increasing year by year,in a complex social environment.The diagnosis of GAD currently often relies on DSM-5 and ICD-10 criteria,which include subjectivity and limitations.Understanding the intrinsic activity of brain network functions and structural connectivity is an important goal of contemporary neuroscience research.Electroencephalographic microstates are capable of observing broad frequency components and capturing dynamic changes in brain activity,thus providing a novel perspective on the accuracy of GAD diagnosis.This review considers the electroencephalographic microstate features and explores the abnormalities in the functional brain network in patients with GAD,with the aim of providing a clear diagnosis,optimizing the therapeutic efficacy,and improving the quality of medical care for patients with GAD.

Objective:To investigate and explore the expressional condition and therapeutic role of PD-1 and CD161 in the peripheral blood of patients treated with PEG-IFN-α for chronic hepatitis B (CHB), and their correlation with the degree of decrease in hepatitis B surface antigen (HBsAg).Methods:A retrospective cohort study was conducted. CHB patients who visited the Second Affiliated Hospital of Xi'an Jiaotong University from July 2022 to December 2023 and healthy controls during the same period were included. Peripheral blood samples were collected from the IFN treatment group (31 cases), the non-IFN treatment group (30 cases), and the healthy control group (30 cases). Flow cytometry was used to detect the CD8, + PD-1, + CD161 + T lymphocytes and their subpopulations among the three groups. The proportions of cellular subpopulations were compared to analyze intergroup differences using Kruskal-Wallis and Mann-Whitney U tests. The patients in the IFN treatment group were divided into two subgroups, high-and low-level, according to the median levels of PD-1 + lymphocytes, CD8 +PD-1 +T cells, and CD161 + lymphocytes. The magnitude of HBsAg decline was compared between the two groups. Results:The proportions of PD-1 + lymphocytes and CD8 +PD-1 +T cells in the IFN treatment group were significantly higher than those in the healthy control group and the non-IFN treatment group ( P<0.001). Moreover, the proportions of PD-1 + lymphocytes [IFN treatment group 48 weeks: 24.3 (23.7, 28.0)%, non-IFN treatment group: 12.7 (10.0, 18.5)%, P<0.01] and CD8 +PD-1 +T cells [IFN treatment group 48 weeks: 29.29 (26.73, 32.98)%, non-IFN treatment group: 17.69 (9.62, 20.68)%, P<0.05] were higher in the IFN treatment group than those in the non-IFN treatment group at 48 weeks. The proportion of CD8 +CD161 +T cells was significantly lower in patients treated with IFN than in the non-IFN treatment group ( P<0.05) at 24 and 48 weeks, with no statistically significant difference with the healthy control group ( P>0.05). In the IFN treatment group, patients with high levels of PD-1 + and CD8 + PD1 lymphocytes had a significantly lower HBsAg decline compared to low-level patients, whereas no significant correlation was found between CD161 levels and HBsAg decline [PD-1 + lymphocytes: 0.15 (0.02, 0.18) log 10 IU/mL vs. 0.32 (0.13, 0.42) log 10 IU/mL, P<0.01; CD8 +PD-1 +T cells: 0.16 (0.03, 0.17) log 10 IU/mL vs. 0.34 (0.13, 0.44) log 10 IU/mL, P<0.05]. Conclusion:The proportions of CD8 +PD-1 +T cells and CD8 +CD161 +T cells were significantly regulated by PEG-IFN-α therapy in the peripheral blood of patients with CHB, revealing the important role of T cell immune activation status during antiviral treatment. The gradual decline of HBsAg is closely related to the high expression of PD-1, suggesting that PD-1 may be negatively regulated during the process of T cell exhaustion and immunological evasion.

Orchitis is a common male genitourinary disorder that significantly impacts patients' life quality.Current treatment strategies have certain limitations and side effects.Ongoing therapeutic strategies focus on the interactions and regulatory networks among pathways and factors involved in the progression of orchitis.The targeted pharmacological agents include inflammatory pathways (p38MAPK, NF-κB, PI3K/Akt), cytokines (TNF-α, IL-6), and the nitric oxide synthase (NOS) system.However, these studies are currently at the animal research stage, and further clinical investigations are necessary to validate their efficacy and safety before clinical use.This article reviews the preclinical animal studies on new treatment methods of orchitis from the aspects of autoimmunity and exogenous microorganism induction, including ketotifen furmarate, aspirin, L-NAME, activin A, cortisol, melatonin, methane, long non-coding RNA MEG3, Abaloparatide, recombinant type Ⅰ interferon, and so on.

Abstract： Objective　To investigate the epidemiological and molecular characteristics of carbapenem-resistant Klebsiella pneumoniae isolated from blood cultures of patients with bloodstream infections in Shanxi Bethune Hospital from January 2015 to January 2022. Methods　Klebsiella pneumoniae strains isolated from blood cultures of patients with bloodstream infections at Shanxi Bethune Hospital from January 2015 to January 2022 were collected for the study. Bacterial identification, drug sensitivity testing, and an improved carbapenem inactivation test were conducted to screen for carbapenem-resistant Klebsiella pneumoniae. Next-generation sequencing was performed on all strains, while whole genome sequencing was carried out on two strains that tested positive for the modified Hodge test indicating resistance to carbapenems. Results　A total of 431 strains of Klebsiella pneumoniae were isolated from blood cultures of patients with bloodstream infections at Shanxi Bethune Hospital between January 2015 to January 2022, among which 33 were carbapenem-resistant strains including 11 highly virulent ones and 2 of these exhibited positive for the modified Hodge test. All strains were resistant to both ertapenem and imipenem, with only one strain being intermediate-resistant to meropenem. Among the 33 resistant strains, KPC-2 was detected in 26 strains and NDM-1 in 4; three strains possessed dual carbapenemase types (KPC-2/NDM-9, KPC-2/OXA-1, NDM-1/OXA-1), while four did not show any detectable carbapenem-resistance genes. Evolutionary analysis following next-generation sequencing revealed that the main sequence types (ST) among these isolates were ST11, ST147, and ST412; and the predominant serotypes were KL64, KL47, and KL25. The plasmid conjugal transfer experiments were successful in 18 strains. The two high virulence strains identified in the modified Hodge test were found to carry virulence and resistance plasmids upon whole genome sequencing. Conclusions　The detection of carbapenem-resistant Klebsiella pneumoniae in patients with bloodstream infections has been increasing annually since 2015, with an outbreak occurring in 2021. The carbapenemase KPC-2 gene was the most prevalent, with the majority of strains being of the ST11/KL64 type. Strengthening screening and control measures for clinical drug-resistant strains is crucial for effective anti-infective treatment.