1.Analyses of T lymphocyte subset levels and viral loads in human immunodeficiency virus antibody-confirmed positive cases in Suzhou from 2021 to 2024
Runfang TIAN ; Qiang SHEN ; Xuerong YA ; Yue DAI ; Qian GAO
Shanghai Journal of Preventive Medicine 2026;38(3):210-215
ObjectiveTo investigate the T lymphocyte subset levels and viral loads in newly human immunodeficiency virus (HIV) antibody-confirmed positive cases in Suzhou (2021‒2024), and to analyze potential influencing factors by integrating their demographic characteristics, immune status, and viral replication patterns, thereby providing evidence for HIV/acquired immune deficiency syndrome (AIDS) prevention and control. MethodsPeripheral whole blood samples were collected from newly confirmed HIV-positive cases in Suzhou from 2021 to 2024. T lymphocyte subset analysis and viral load testing were performed, and influencing factors were identified in combination with demographic characteristics. Logistic regression models were employed to identify factors associated with CD4+T lymphocyte counts ≤350 cells·μL-1, and Spearman’s rank correlation test was used to analyze the correlation between logarithmic value of viral load and CD4+/CD8+ ratio. ResultsAmong the 3 022 confirmed HIV-positive samples, the median CD4+T lymphocyte count was 298.00 cells·μL-1, with 882 cases (29.19%) showing CD4+ T lymphocyte counts <200 cells·μL-1. The median CD8+T lymphocyte count was 1 011.00 cells·μL-1. The median CD4+/CD8+ ratio was 0.28, with 32.46% of cases exhibiting CD4+/CD8+ ratios <0.20, and there were statistically significant differences in CD4+/CD8+ ratio among different genders, age groups, marital status, and sample sources (all P<0.05). Multivariate logistic regression analyses indicated that individuals aged ≥20 years, those who were divorced or widowed, and cases identified through medical institutions had a significantly higher proportion of CD4+T lymphocyte counts ≤350 cells·µL⁻¹ compared to those aged <20 years, unmarried individuals, and cases sourced from voluntary counseling and testing (VCT) clinics, respectively. The mean logarithmic value of viral load was (4.29±1.15) copies·mL-1. The logarithmic value of viral load demonstrated a significantly negative correlation with both CD4+/CD8+ ratio (r=-0.43, P<0.001) and CD4+T lymphocyte count (r=-0.37, P<0.001). ConclusionA substantial proportion of newly diagnosed HIV/AIDS cases in Suzhou are late presenters with high viral load levels. Targeted interventions should prioritize high-risk populations through enhanced active surveillance and the implementation of combined T lymphocyte subsets analysis and viral load testing, which can enable earlier case-finding and timely antiretroviral therapy initiation.
2.Neuroelectromagnetic Activities Across Temporal Scales
Zhuo-Qun SHEN ; Xiao-Fei XU ; Yan-Qing WANG ; Jing-Xin LI ; Lan TIAN ; Wei GUO ; Jing-Jing XU
Progress in Biochemistry and Biophysics 2026;53(6):1541-1560
Although global brain science research has progressed rapidly in recent decades, several fundamental questions in neuroscience remain unresolved. In particular, the physical mechanism underlying neural signal transmission remains controversial, and the carriers responsible for neural information storage and retrieval have not yet been fully clarified. These unresolved issues motivate us to re-examine the processes of neural information generation, transmission, integration, storage, and retrieval from multiple perspectives. A key observation is that neural electromagnetic activities are closely associated with time. Their duration, temporal structure, and dynamic evolution play crucial roles in neural information processing. In this work, we analyze neural electromagnetic activities from the perspective of temporal scales (referred to here as the “time course”). By reviewing and integrating findings from previous studies, we examine the characteristic time requirements and dynamic features of neural processes occurring at different stages of information processing. These stages include neural signal generation, signal transmission along axons, synaptic integration, synaptic plasticity, and memory formation and retrieval. Based on this temporal analysis, we outline a framework describing neural electromagnetic activities across a wide range of time scales, spanning from microseconds to minutes, hours, or even longer periods associated with long-term memory, which suggests that neural information processing involves multiple physical processes operating at different time levels. Rapid electromagnetic events may occur on microsecond scales, whereas electrophysiological phenomena such as action potentials typically last on the order of milliseconds. Longer time scales are associated with synaptic plasticity and memory-related processes. From this perspective, we propose that the physical carrier of neural information may be transient electromagnetic pulses with durations on the microsecond scale. In this framework, action potentials can be interpreted as the macroscopic electrophysiological manifestation of underlying electromagnetic processes triggered by ionic currents across neuronal membranes. Rather than being the fundamental neural signal itself, the action potential may represent a measurable membrane-level response associated with the successful activation of these electromagnetic events. Moreover, we discuss a possible mechanism for long-term memory storage. Considering the apparent temporal contradiction between the millisecond-scale excitation of neurons and the long-term persistence of memories, we believe that long-term memory information may be stored within neural network topologies formed by electrical synapse coupling. Such structures, referred to as electrically coupled memory networks (ECMNs), may enable neurons within the same network to respond rapidly and synchronously to stimuli, thereby facilitating efficient memory retrieval. Overall, this study emphasizes the importance of considering the temporal organization of neural electromagnetic activities when interpreting neural signaling mechanisms. It may provide new insights into the physical nature of neural information carriers and the mechanisms of memory storage and retrieval. Furthermore, highlighting the potential role of electromagnetic interactions in neural activity may contribute to the development of new theoretical frameworks and experimental approaches in neuroscience. Such perspectives may also offer valuable references for future research on neural coding, brain function mechanisms, and neuromodulation technologies.
3.5G remote robot-assisted thoracoscopic lobectomy/segmentectomy for ten patients
Fan SHEN ; Jia HUANG ; Yu TIAN ; Hanbo PAN ; Jiantao LI ; Long JIANG ; Hong GUO ; Bentong YU ; Qingquan LUO
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(06):908-912
Objective To explore the safety and feasibility of 5G remote robot-assisted thoracoscopic anatomic lobectomy and segmentectomy. Methods A retrospective analysis was conducted on patients who underwent 5G remote robot-assisted thoracoscopic anatomic lobectomy or segmentectomy between July and September 2024. The surgeries were performed collaboratively by Shanghai Chest Hospital, Affiliated Hospital of Yangzhou University, and The First Affiliated Hospital of Nanchang University. Perioperative outcomes were recorded and analyzed. Results Ten patients were included, comprising 4 anatomic lobectomies and 6 segmentectomies. The median age was 61.0 (56.0, 72.0) years. The median intraoperative bi-directional network latency was 52.5 (39.0, 54.0) ms. There were no instances of network interruption, robot-related adverse events, or conversions to open thoracotomy. The median postoperative chest tube drainage volume was 500.0 (375.0, 600.0) mL, and the median hospital stay was 5.5 (4.0, 6.0) days. No complications of Clavien-Dindo grade Ⅱor higher occurred. All patients were recurrence-free and alive during the 6-month postoperative follow-up period. Conclusion 5G remote robot-assisted thoracoscopic surgery demonstrates high safety and operational stability. This technology shows promising potential for clinical application and is worthy of further development and utilization.
4.Pathogen detection and genetic characteristic analyses of hand-foot-and-mouth disease in Dehong Prefecture of Yunnan Province in 2023
Zhuoya GAO ; Jiangli ZHU ; Dingfu LUO ; Bingjun TIAN ; Kang YANG ; Zengjiao DUAN ; Runbo ZHANG ; Yinghao CHEN ; Zhuo SHEN
Shanghai Journal of Preventive Medicine 2026;38(6):446-452
ObjectiveTo genotype the specimens from hand-foot-and-mouth disease (HFMD) cases in Dehong Prefecture, Yunnan Province in 2023 by gene sequencing, and to analyze the genetic characteristics of Coxsackievirus A4 (CVA4), CVA6, CVA10, CVA16 and enterovirus A71 (EV-A71), so as to clarify the serotypes of enteroviruses causing endemic HFMD and the genotype composition of CVA4, CVA6, CVA10, CVA16 and EV-A71 prevalent in HFMD, and to provide baseline genotype data for monitoring the dynamic changes of the five virus genotypes. MethodsStool specimens from HFMD cases in Dehong Prefecture in 2023 that tested positive for EV-A71, CVA16 and other enteroviruses by real-time quantitative reverse transcription polymerase chain reaction (RT-qPCR) were first subjected to gene sequencing and typing of the VP4/VP2 junction region to determine the viral types. Subsequently, the complete VP1 gene of each virus was amplified in two segments using group-specific VP1 gene primers corresponding to enterovirus groups (i.e., enterovirus group A, B, and C) and sequenced (group A virus: primers 486/488 and 487/489, group B virus: primers 490/492 and 491/493, group C virus: primers 494/496 and 495/497). The representative reference sequences of VP1 genes for CVA4, CVA6, CVA10, CVA16 and EV-A71 were downloaded from the literature, and the VP1 gene phylogenetic tree was constructed using MEGA 6.0 software for genetic characterization. ResultsA total of 256 stool specimens were collected from HFMD cases in Dehong Prefecture in 2023, of which 94 tested positive for nucleic acid by RT-qPCR, yielding a positive rate of 36.72%. Of the 94 positive specimens, 83 were identified as group A viruses, and were classified into 5 serotypes (17 strains of CVA4, 3 of CVA6, 6 of CVA10, 49 of CVA16, and 8 of EV-A71). Nine strains were group B viruses, comprising 2 serotypes: 2 strains of echovirus type 3 (E3) and 7 strains of Coxsackievirus B type 5 (CVB5). The remaining 2 strains were group C viruses, both identified as poliovirus type 3 (PV3). Genetic analyses of the VP1 region showed that all 17 CVA4 strains were identified as subgenotype C2, all 3 CVA6 strains as subgenotype D3a, all 6 CVA10 strains as genotype C. Among the 49 CVA16 strains, 46 were identified as subgenotype B1a and 3 as subgenotype B1b, and all 8 EV-A71 strains were identified as subgenotype C4a. ConclusionIn 2023, group A viruses dominated the pathogenic spectrum of HFMD in Dehong Prefecture. Among them, CVA16 had the highest positivity rate. Genetic characteristic analyses showed that CVA4, CVA6, CVA10 and EV-A71 were each composed of a single genotype (subgenotype), while CVA16 was composed of two subgenotypes (B1a and B1b), with B1a being the predominant one. It is recommended that molecular epidemiological surveillance of HFMD pathogens, particularly group A viruses, be continuously strengthened in Dehong Prefecture.
5.Changes in health status and management strategies for workers in a chemical enterprise under low-level multiple occupational exposure
Xueting WANG ; Jiming ZHANG ; Yulai TIAN ; Zhiping DUAN ; Wenjie LI ; Chaoye SHEN ; Dasheng LU ; Zhijun ZHOU
Journal of Environmental and Occupational Medicine 2026;43(6):693-701
Background Long-term occupational health surveillance facilitates the identification of chronic health risks arising from occupational hazard exposures. However, under low-level exposure conditions in chemical enterprises, traditional workplace-centered risk assessment models are insufficient to fully explain the observed health effects among workers, highlighting the need for individual-focused health management strategies that focus on the worker. Objective To characterize long-term health trends among workers in a chemical enterprise and examine the limitations of workplace hazard monitoring and health surveillance under low-level multiple exposure scenarios, thereby providing a scientific basis for more comprehensive worker health protection measures. Methods We analyzed 972 occupational health examination records collected over a 15-year period (2010–2024) from a chemical enterprise, integrating these with enterprise hazard monitoring reports and workshop air monitoring of volatile organic compounds (VOCs). The annual counts and prevalences of abnormalities in liver function tests, metabolic syndrome-related indicators, and liver imaging were summarized. Temporal trends were evaluated using the Cochran-Armitage trend test. Time-related changes in abnormal health indicators among active workers were evaluated by generalized linear mixed-effects models (GLMMs), adjusting for age and sex. Individual longitudinal profiles were described for nine workers with continuous 15-year records. In addition, paired comparisons of health outcomes were conducted for 81 workers with both pre-employment and periodic examinations. Results Workplace hazard monitoring indicated that airborne concentrations of major occupational contaminants including VOCs, acids and bases, dust, and physical factors were below national occupational exposure limits. However, 62 VOC species—including chlorobenzene, chloromethane, and cyclohexane—were detected in workshop air, suggesting complex mixed organic solvent exposure. From 2010 to 2015, occupational health examination records were primarily based on physicians’ qualitative assessment, yielding generally low abnormality detection rates. During 2016–2024, data collection was complete, and the prevalences of abnormalities in liver function, metabolic syndrome-related indicators, and liver imaging among active workers remained relatively high. Trend analysis indicated that only the abnormality rates of total bilirubin (TBIL) and hypertension showed statistically significant temporal trends; other indicators exhibited no significant linear changes despite high prevalences. After adjusting for age and sex, the GLMMs showed that the abnormality rates of aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), TBIL, and hypertension decreased over time, whereas those of total cholesterol, triglycerides, and fatty liver increased. In a subgroup of 9 workers with continuous 15-year follow-up data, the cumulative number of abnormal health indicators increased in several individuals after 2016. Among the 81 workers with both pre-employment and periodic records, abnormalities in total cholesterol, triglycerides, body mass index, and fatty liver were significantly more prevalent after employment over time, whereas changes in liver function enzymes were not statistically significant. Conclusion With increasing age, workers exhibit a gradual deterioration in liver function and metabolic-related health indicators, reaching abnormality rates comparable to those reported in the general population. These findings suggest that both workplace-related and non-occupational factors jointly contribute to the observed health changes. Consequently, occupational health management should shift towards an "individual-centered" approach. Enhancing workers' health literacy, strengthening workplace health promotion, and extending occupational health services beyond the workplace are essential to comprehensively protect workers' health.
6.Effect of anterior seat inclination on sit-to-stand ability in patients with stroke and related brain network
Xiaohua SHEN ; Fangyuan CHEN ; Jifeng RONG ; Biaoqin RAO ; Lingxuan KONG ; Wei TIAN ; Zhiqun CHEN ; Li LI
Chinese Journal of Rehabilitation Theory and Practice 2026;32(9):1061-1067
ObjectiveTo observe the clinical effect of anterior seat inclination on sit-to-stand (STS) ability and balance function in patients with stroke, as well as brain functional connectivity based on functional near-infrared spectroscopy (fNIRS). MethodsFrom January, 2024 to December, 2025, 43 patients with stroke were randomly divided into control group (n = 21) and experimental group (n = 22). The control group received conventional rehabilitation combined with STS training on a flat seat, while the experimental group received conventional rehabilitation plus STS training with a 20° anterior seat inclination, for two weeks. Five-times sit-to-stand test (FTSST) and Berg Balance Scale (BBS) were assessed before and after training. fNIRS was used to detect changes in cerebral blood oxygenation in the prefrontal cortex (PFC), primary motor cortex (M1), primary somatosensory cortex (S1) and premotor cortex (PMC), and to analyze functional connectivity strength. ResultsAfter training, FTSST time shortened in both groups (t > 3.469, P < 0.01), and was shorter in the experimental group than in the control group (t = -2.065, P < 0.05); BBS scores increased in both groups (|Z| > 4.019, P < 0.01), and was higher in the experimental group than in the control group (Z = -2.250, P < 0.05). fNIRS showed that after training, the functional connectivity strength between the left M1 and the right PFC increased, as well as between the left M1 and the right S1 in the experimental group (t > 3.311, P < 0.05). ConclusionSTS training with anterior seat inclination can enhance functional connectivity in relevant brain regions, which may contribute to improvements of STS ability and balance function in patients with stroke.
7.Differentiation and Treatment of Systemic Sclerosis-Associated Interstitial Lung Disease Based on the Theory of "Combined Bi (痹) Syndrome of the Body and Zang (脏) Organs"
Xieli MA ; Quan JIANG ; Xun GONG ; Congmin XIA ; Chuanhui YAO ; Tian CHANG ; Zixia LIU ; Yuchen YANG ; Zhengyao SHEN
Journal of Traditional Chinese Medicine 2026;67(21):2286-2291
Based on the theory of "combined bi (痹) syndrome of the body and zang (脏)organs", this paper elucidates the pathogenic transmission and treatment principles of systemic sclerosis-associated interstitial lung disease (SSc-ILD). For the pattern in which the disease transmits from the body to the zang organs, the underlying pathogenesis is blood deficiency and liver constraint with cold congealing in the collaterals. The treatment principle is to nourish the blood and warm the channels, diffuse the lung and defend against pathogenic factors, so as to interrupt the inward transmission of the disease. For the pattern in which the disease transmits from the zang organs to the body, the pathogenesis may involve lung deficiency with insecurity of the exterior, liver fire attacking the lung and scorching the collaterals, or latent pathogens of phlegm and blood stasis permeating outward. The treatment principle is to tonify the lung and secure the exterior, clear the liver and purge the lung, and resolve blood stasis and unblock the collaterals, so that when the zang organs are restored, the body can be nourished. For the pattern in which the body and zang organs are simultaneously affected, the pathogenesis lies in violent toxin pathogens spreading throughout the three jiao (焦) and damaging both the body and zang organs. The treatment principle is to cool the blood and resolve toxins, resolve blood stasis and unblock the collaterals, thereby eliminating pathogenic factors from both the interior and exterior. Emphasis is placed on simultaneous treatment of the body and zang organs and dynamic syndrome differentiation and treatment, providing a new approach to understanding the pathogenesis of SSc-ILD in traditional Chinese medicine and to its stratified treatment.
8.Influence of mindful attention awareness on sleep quality in soldiers:Mediating effect of occupational stress
Lei SHI ; Shen XIN ; Qin SUN ; Danni LI ; Pengyan SONG ; Ye TIAN ; Yuan WANG
Journal of Navy Medicine 2025;46(5):435-439
Objective To investigate the relationship of mindful attention awareness with sleep quality and occupational stress of soldiers.Methods A questionnaire survey was conducted on 1 100 soldiers by using the mindful attention awareness scale(MAAS),occupational stress scale(OSS),and Pittsburgh sleep quality index(PSQI).Results The PSQI of the soldiers was negatively correlated with mindful attention awareness(r=-0.446,P<0.01),and positively correlated with occupational stress(r=0.569,P<0.01).Mindful attention awareness and occupational stress were effective predictors for sleep quality,accounting for 34.7%of variance.And the mediating effect of occupational stress between mindful attention awareness and sleep quality accounted for 58.86%.Conclusion The mindful attention awareness in soldiers can not only directly affect the sleep quality,but also indirectly affect the sleep quality through their occupational stress.
9.PIK3CA Somatic Mutations Are Associated With Lymph Node Metastasis in Endometrial Cancer
Qingyu SHEN ; Chenfan TIAN ; Xiaoxiao LUO ; Fan YANG ; Peng JIANG ; Yunfeng ZHENG
Journal of Sichuan University (Medical Sciences) 2025;56(2):434-441
Objective To investigate the expression levels and mutation status of phosphatidylinositol-4,5-bisphosphate3-kinase catalytic subunit alpha(PIK3CA)in endometrial cancer(EC)and evaluate its association with lymph node metastasis in EC.Methods We retrosepctively collected and analyzed EC genetic mutation testing data submitted to the Molecular Detection Center,The First Affiliated Hospital of Chongqing Medical University between July 2020 and June 2022.The mutation rate of PIK3CA gene was calculated based on the sequencing results of EC patients,and the correlation between PIK3CA mutations and clinical pathological parameters,as well as protein expression consistency,was analyzed accordingly.Results A total of 97 EC patients were enrolled in this study,and PIK3CA mutations were identified in approximately 48.5%(47 out of 97 cases).The rate of lymph node metastasis in patients with PIK3CA mutations was higher than that in patients with wild-type PIK3CA(21.3%vs.6.0%,P=0.027).Findings from univariate and multivariate logistic analyses indicated that histological subtype Ⅱ(odds ratio[OR]=5.51;95%CI,1.08-28.06;P=0.040),positive result for lymphovascular space invasion(LVSI)(OR=7.96;95%CI,1.37-46.44;P=0.021),and PIK3CA mutation(OR=8.58;95%CI,1.51-48.84;P=0.015)were independent risk factors for lymph node metastasis in EC.In addition,the receiver-operating characteristic(ROC)curves demonstrated that the combined use of clinicopathological parameters and PIK3CA mutations could more accurately predict lymph node metastasis in EC,with an area under the curve of 0.824(95%CI,0.678-0.970).It is noteworthy that there was a high consistency between PIK3CA mutations and its protein expression,and EC patients with positive expression of PIK3CA protein had a higher rate of lymph node metastasis(53.8%vs.9.1%,P=0.078).Conclusion PIK3CA somatic mutations are strongly correlated with lymph node metastasis in EC.
10.Value of the new WHO pathological classification of pituitary tumors in diagnosis and treatment of clinically non-functioning pituitary adenomas
Tian SUN ; Xue-Dong ZHANG ; Er-Han ZHENG ; Hao SHEN ; Tao ZHOU ; Xiang-Hui MENG ; Qing-Hua GUO
Medical Journal of Chinese People's Liberation Army 2025;50(4):387-392
Non-functioning pituitary adenomas(NFPAs)are relatively common.Apart from hyperprolactinemia caused by pituitary compression,they typically lack overt hormonal hypersecretion and usually present with clinical symptoms due to mass effects.Previously considered a uniform entity,NFPAs are actually a highly heterogeneous group of tumors,including aggressive subtypes like silent corticotroph adenomas(SCA)and null cell adenomas.The 2022 WHO new classification of pituitary tumors employs transcription factors[e.g.,pituitary-specific transcription factor 1(PIT-1),T-box transcription factor 19(TBX19,also known as TPIT),steroidogenic factor 1(SF-1)]for detailed categorization,allowing precise subclassification of NFPAs into multiple subtypes derived from distinct cell lineages,including silent gonadotroph adenomas,SCA,and plurihormonal PIT-1-positive adenomas.This helps identify highly invasive subtypes with high recurrence risk,guiding clinical diagnosis and treatment,prognostic assessment,and individualized management.The new classification also provides a theoretical basis for targeted therapies of NFPAs(e.g.,somatostatin analogs and temozolomide).This review comprehensively discusses the latest pathological classification of NFPAs and its clinical implications,aiming to enhance understanding of this disease and offer valuable insights for precise diagnosis,treatment,and prognostic assessment.

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