Objective To understand the risk and related influencing factors of death of patients with infection of human immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS)in Shaoyang City.Methods The survival status and death risk of HIV/AIDS patients in Shaoyang City from 1997 to 2024 were analyzed by Kap-lan-Meier survival analysis and Cox proportional hazards regression model of retrospective cohort study method.Results A total of 5 805 patients were included in analysis,1 941 died during the observation period,out of which 54.20％died from diseases irrelevant to AIDs,and the all-cause mortality was 9.01/100 person-year.The risk of death for males was 1.447 times of females.The comparison of death risk among patients with different ages of HIV infection diagnosis and educational levels showed statistically significant differences(all P＜0.05).The death risk of patients with baseline CD4+T lymphocyte count in the 0-199 group was 1.497 times higher than that in the ≥500 group(P＜0.001),and the mortality in this group was higher than those in other groups.Patients with lower last CD4+T lymphocyte counts had a higher risk of death(P＜0.001).The mortality of patients who did not receive antiviral treatment was 36.37/100 person-year,which was higher than 4.21/100 person-year of those who received treatment.The maximum ratio of death risk between the two was 6.578(P＜0.001).Compared with patients in the INSTI-containing regimen group,the death risks of patients in LPV/r-containing and NNRTI-containing regi-men groups were 4.902 and 2.769,respectively(both P＜0.001),and patients in the LPV/r-containing regimen group had a higher percentage of deaths due to cardiovascular and cerebrovascular diseases than those in the NNRTI regimen group(11.79％vs 7.26％;x2=3.872,P=0.049).Conclusion HIV/AIDS patients in Shaoyang City face a high risk of death.Male,advanced age,low educational level,without receiving antiviral treatment,and low baseline/last CD4+T lymphocyte count are all important factors that contribute to the increase of death risk.Re-ceiving INSTI-containing treatment regimen can significantly reduce mortality.Therefore,early detecting cases,timely optimizing antiviral treatment regimen,as well as strengthening patient management and compliance educa-tion have certain clinical reference value for reducing the risk of death in HIV/AIDS patients.

Objective:To analyze the short-term efficacy and safety of robot-assisted laparoscopic partial nephrectomy（RAPN）for non-metastatic pathological stage T 3a renal cell carcinoma. Methods:The clinical and pathological data of 45 patients with pathologically confirmed non-metastatic T 3a renal cell carcinoma who underwent RAPN at Sun Yat-sen University Cancer Center between January 2016 and December 2023 were retrospectively reviewed. There were 30 males and 15 females. The average age of the cohort was（54.3±10.7）years，and the average clinical tumor diameter was（4.9±1.8）cm. Of all the patients，35（77.8%）were asymptomatic，7（15.6%）presented with hematuria，and 3（6.7%）presented with lumbar pain. Preoperative imaging assessed 34 patients（75.6%）as having clinical stage T 3a，all suspected of involving the collecting system or perirenal fat invasion；the remaining 11 patients（24.4%）were assessed as having stage T 1-2 disease. The median R.E.N.A.L. nephrectomy score was 8.0（7.0，10.0）. A history of hypertension，diabetes，or chronic kidney disease was present in 18 patients（40.0%）. The primary endpoint was progression-free survival，and the secondary endpoints included postoperative complications and short-term renal function outcomes. Survival curve was estimated using the Kaplan-Meier method，and renal function comparisons were made using the paired t-test. Results:The RAPN was performed through a transabdominal approach in 32 patients（71.1%），with a median estimated blood loss of 150.0（50.0，300.0）ml. Seven（15.6%）patients required intraoperative blood transfusion. The median length of postoperative hospital stay was 4.0（4.0，6.0）days. Postoperative complications occurred in 6 patients（13.3%），including 5（11.1%）with mild complications and 1（2.2%）with a severe complication. Renal function returned to baseline in 24 of 39 evaluable patients（61.5%），while 3 patients（7.7%）developed surgery-related chronic kidney disease 3 to 12 months postoperatively，but none required dialysis. The median follow-up time was 31.8（22.7，50.9）months，12（26.7%）patients received programmed cell death protein 1 inhibitor adjuvant therapy postoperatively. During follow-up，3 patients experienced tumor recurrence，the 3-year progression-free survival rate of the entire cohort was 95.4%.Conclusions:For some carefully selected patients with T 3a renal cell carcinoma，RAPN performed by experienced surgeons is a feasible and safe option，providing excellent short-term oncological outcomes，complication control，and renal function recovery. The long-term efficacy remains to be seen.

Objective:To analyze the short-term efficacy and safety of robot-assisted laparoscopic partial nephrectomy（RAPN）for non-metastatic pathological stage T 3a renal cell carcinoma. Methods:The clinical and pathological data of 45 patients with pathologically confirmed non-metastatic T 3a renal cell carcinoma who underwent RAPN at Sun Yat-sen University Cancer Center between January 2016 and December 2023 were retrospectively reviewed. There were 30 males and 15 females. The average age of the cohort was（54.3±10.7）years，and the average clinical tumor diameter was（4.9±1.8）cm. Of all the patients，35（77.8%）were asymptomatic，7（15.6%）presented with hematuria，and 3（6.7%）presented with lumbar pain. Preoperative imaging assessed 34 patients（75.6%）as having clinical stage T 3a，all suspected of involving the collecting system or perirenal fat invasion；the remaining 11 patients（24.4%）were assessed as having stage T 1-2 disease. The median R.E.N.A.L. nephrectomy score was 8.0（7.0，10.0）. A history of hypertension，diabetes，or chronic kidney disease was present in 18 patients（40.0%）. The primary endpoint was progression-free survival，and the secondary endpoints included postoperative complications and short-term renal function outcomes. Survival curve was estimated using the Kaplan-Meier method，and renal function comparisons were made using the paired t-test. Results:The RAPN was performed through a transabdominal approach in 32 patients（71.1%），with a median estimated blood loss of 150.0（50.0，300.0）ml. Seven（15.6%）patients required intraoperative blood transfusion. The median length of postoperative hospital stay was 4.0（4.0，6.0）days. Postoperative complications occurred in 6 patients（13.3%），including 5（11.1%）with mild complications and 1（2.2%）with a severe complication. Renal function returned to baseline in 24 of 39 evaluable patients（61.5%），while 3 patients（7.7%）developed surgery-related chronic kidney disease 3 to 12 months postoperatively，but none required dialysis. The median follow-up time was 31.8（22.7，50.9）months，12（26.7%）patients received programmed cell death protein 1 inhibitor adjuvant therapy postoperatively. During follow-up，3 patients experienced tumor recurrence，the 3-year progression-free survival rate of the entire cohort was 95.4%.Conclusions:For some carefully selected patients with T 3a renal cell carcinoma，RAPN performed by experienced surgeons is a feasible and safe option，providing excellent short-term oncological outcomes，complication control，and renal function recovery. The long-term efficacy remains to be seen.

Objective To investigate the association between the variability of remnant cholesterol inflammatory index(RCII),a novel composite biomarker,and the risk of stroke,in order to provide a theoretical basis for stroke prevention.Methods A prospective cohort study was conducted on 38 659 Kailuan individuals who took annual physical examinations in 2006,2008,and 2010.These subjects were grouped based on the quartiles of RCII variability,which was represented by standard deviation(SD)and average real variability(ARV),and were followed up every 2 years,with the occurrence of stroke(including ischemic and hemorrhagic strokes),death,or the end of follow-up on December 31,2022 as the endpoints.Kaplan-Meier method was used to calculate the cumulative incidence rate of endpoint events across different groups,and log-rank test was used to compare the difference of cumulative incidence of endpoint events in each group.Multivariate Cox proportional hazards regression model was adopted to analyze the association between RCII variability and risk of stroke.Results Among the 38 659 participants,a total of 2 539 strokes occurred during a mean follow-up period of 11.22±2.26 years.After adjusting confounding factors,when the participants were grouped by the quartiles of RCII-SD,the hazard ratio(HR)for stroke was 1.034(95%CI:0.917～1.167,P=0.584),1.146(95%CI:1.018～1.290,P=0.025),and 1.209(95%CI:1.066～1.370,P=0.003),respectively in the Q2,Q3,and Q4 groups,when compared with the Q1 group(Ptrend<0.05).When they were grouped by the quartiles of RCII-ARV,the HR for stroke was 1.008(95%CI:0.894～1.136,P=0.901),1.109(95%CI:0.986～1.248,P=0.085),and 1.152(95%CI:1.018～1.303,P=0.025),respectively,in the Q2,Q3,and Q4 groups,when compared with the Q1 group.Furthermore,both sensitivity and stratified analyses yielded similar results.Conclusion RCII variability is significantly associated with stroke,and the risk of stroke is gradually increasing with increment of the variability.Countermeasures Relevant authorities can focus on reducing RCII variability as a central objective by establishing regular monitoring mechanism,strengthening lifestyle interventions,and standardizing dietary,exercise,and weight management in order to suppress the index fluctuations.The principle of stable lipid-lowering in medication and optimization of therapeutic regimens with stable efficacy should be emphasized to prevent the risk of additional vascular damage.

Background and Aims:Laparoscopic cholecystectomy(LC)is a common surgical method for the treatment of gallbladder diseases.However,some patients experience symptoms such as dyspepsia after surgery,which can affect their quality of life.Compound azinomide enteric-coated tablets,a novel drug,may improve dyspeptic symptoms after LC.This study was conducted to explore the clinical efficacy of compound azinomide enteric-coated tablets in treating post-LC dyspepsia symptoms through a multicenter clinical trial.Methods:A multicenter,superior efficacy,open-label,parallel-controlled design was used.Patients with postoperative dyspepsia were enrolled in 7 centers between January 2023 and May 2024.Patients were randomly assigned to either the observation or control groups using a random number table.The observation group received compound azinomide enteric-coated tablets,while the control group was treated with a combination of oryzae pancreatin tablets and ursodeoxycholic acid tablets.Both groups were treated for 4 weeks.The primary endpoints included gastrointestinal symptom scores and quality of life scores assessed before and at 14 and 28 d after treatment.Additionally,the incidence of adverse reactions and cost-effectiveness ratio(CER)were compared between the groups.Results:A total of 303 patients were included,with 150 in the observation group and 153 in the control group.Baseline characteristics were balanced between the groups before treatment(all P>0.05).After treatment,the observation group showed significantly higher effective rates at 14 d and 28 d than the control group(44.7%vs.29.4%;98.0%vs.73.9%,both P<0.05).The observation group also had significantly lower symptom scores and quality of life scores at both 14 and 28 d,with a significantly higher improvement rate in symptom scores compared to the control group(all P<0.05).Further analysis of the improvement rate and treatment efficacy for individual symptoms revealed that,except for the 14-d improvement in abdominal pain/discomfort,the observation group showed better improvement in all other symptoms at 14 d and in all symptoms at 28 d compared to the control group(all P<0.05).No adverse reactions were observed in either group.The CER for the observation group was 283.78 yuan/efficacy rate at 14 d and 128.57 yuan/efficacy rate at 28 d,while the control group's CER was 729.93 yuan/efficacy rate at 14 d and 290.22 yuan/efficacy rate at 28 d.Conclusion:Compound azinomide enteric-coated tablets demonstrated good clinical efficacy in treating dyspepsia symptoms after LC with excellent safety and high cost-effectiveness.Despite some limitations,the results provide a new treatment option for dyspepsia after LC.Larger-scale randomized controlled trials are needed to validate this study's conclusions further.

Background and Aims:Laparoscopic cholecystectomy(LC)is a common surgical method for the treatment of gallbladder diseases.However,some patients experience symptoms such as dyspepsia after surgery,which can affect their quality of life.Compound azinomide enteric-coated tablets,a novel drug,may improve dyspeptic symptoms after LC.This study was conducted to explore the clinical efficacy of compound azinomide enteric-coated tablets in treating post-LC dyspepsia symptoms through a multicenter clinical trial.Methods:A multicenter,superior efficacy,open-label,parallel-controlled design was used.Patients with postoperative dyspepsia were enrolled in 7 centers between January 2023 and May 2024.Patients were randomly assigned to either the observation or control groups using a random number table.The observation group received compound azinomide enteric-coated tablets,while the control group was treated with a combination of oryzae pancreatin tablets and ursodeoxycholic acid tablets.Both groups were treated for 4 weeks.The primary endpoints included gastrointestinal symptom scores and quality of life scores assessed before and at 14 and 28 d after treatment.Additionally,the incidence of adverse reactions and cost-effectiveness ratio(CER)were compared between the groups.Results:A total of 303 patients were included,with 150 in the observation group and 153 in the control group.Baseline characteristics were balanced between the groups before treatment(all P>0.05).After treatment,the observation group showed significantly higher effective rates at 14 d and 28 d than the control group(44.7%vs.29.4%;98.0%vs.73.9%,both P<0.05).The observation group also had significantly lower symptom scores and quality of life scores at both 14 and 28 d,with a significantly higher improvement rate in symptom scores compared to the control group(all P<0.05).Further analysis of the improvement rate and treatment efficacy for individual symptoms revealed that,except for the 14-d improvement in abdominal pain/discomfort,the observation group showed better improvement in all other symptoms at 14 d and in all symptoms at 28 d compared to the control group(all P<0.05).No adverse reactions were observed in either group.The CER for the observation group was 283.78 yuan/efficacy rate at 14 d and 128.57 yuan/efficacy rate at 28 d,while the control group's CER was 729.93 yuan/efficacy rate at 14 d and 290.22 yuan/efficacy rate at 28 d.Conclusion:Compound azinomide enteric-coated tablets demonstrated good clinical efficacy in treating dyspepsia symptoms after LC with excellent safety and high cost-effectiveness.Despite some limitations,the results provide a new treatment option for dyspepsia after LC.Larger-scale randomized controlled trials are needed to validate this study's conclusions further.

Objective To understand the risk and related influencing factors of death of patients with infection of human immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS)in Shaoyang City.Methods The survival status and death risk of HIV/AIDS patients in Shaoyang City from 1997 to 2024 were analyzed by Kap-lan-Meier survival analysis and Cox proportional hazards regression model of retrospective cohort study method.Results A total of 5 805 patients were included in analysis,1 941 died during the observation period,out of which 54.20％died from diseases irrelevant to AIDs,and the all-cause mortality was 9.01/100 person-year.The risk of death for males was 1.447 times of females.The comparison of death risk among patients with different ages of HIV infection diagnosis and educational levels showed statistically significant differences(all P＜0.05).The death risk of patients with baseline CD4+T lymphocyte count in the 0-199 group was 1.497 times higher than that in the ≥500 group(P＜0.001),and the mortality in this group was higher than those in other groups.Patients with lower last CD4+T lymphocyte counts had a higher risk of death(P＜0.001).The mortality of patients who did not receive antiviral treatment was 36.37/100 person-year,which was higher than 4.21/100 person-year of those who received treatment.The maximum ratio of death risk between the two was 6.578(P＜0.001).Compared with patients in the INSTI-containing regimen group,the death risks of patients in LPV/r-containing and NNRTI-containing regi-men groups were 4.902 and 2.769,respectively(both P＜0.001),and patients in the LPV/r-containing regimen group had a higher percentage of deaths due to cardiovascular and cerebrovascular diseases than those in the NNRTI regimen group(11.79％vs 7.26％;x2=3.872,P=0.049).Conclusion HIV/AIDS patients in Shaoyang City face a high risk of death.Male,advanced age,low educational level,without receiving antiviral treatment,and low baseline/last CD4+T lymphocyte count are all important factors that contribute to the increase of death risk.Re-ceiving INSTI-containing treatment regimen can significantly reduce mortality.Therefore,early detecting cases,timely optimizing antiviral treatment regimen,as well as strengthening patient management and compliance educa-tion have certain clinical reference value for reducing the risk of death in HIV/AIDS patients.

Objective:To provide a basis for dealing with passengers′ health safety events by understanding the disease spectrum of passengers′ health safety events.Methods:Passengers who experienced health safety events in the cabin of an airline from 2021 to 2022 were select as the research objects, and the types and characteristics of diseases were analyzed.Results:A total of 1 226 health safety events among air passengers from 2021 to 2022, including 563 cases for man and 663 cases for woman, with a gender ratio of 0.85∶1, and the average age of all cases was (45.03±19.91) years old. The top 5 diseases were damage (30.67%), cardiovascular system disease (23.25%), digestive system disease (11.42%), respiratory disease (11.17%) and nervous system disease (10.03%). The luggage falling and burn caused injuries took high incidence in damage. Cardiovascular diseases mainly included angina pectoris and myocardial infarction. Digestive system diseases included symptoms such as abdominal discomfort, abdominal pain, diarrhea and vomiting caused by diet. Respiratory diseases mainly included asthma, bronchiectasis, lung tumor, and acute upper respiratory tract infections. Epilepsy ranked the first in nervous system diseases.Conclusions:Damage, cardiovascular system, digestive system, respiratory system, and nervous system diseases rank the top diseases in the disease spectrum of air passengers′ health safety events. Those provide the reference to passenger's safety management for making the countermeasure and emergency plan. The risk notification and reminder, as well as the publicity of traveling safety should be strengthened.

Objective:To provide references for personnel management in centralized quarantine medical observation units by investigating the psychological health status of the entry quarantine crews during the COVID-19 epidemic.Methods:A total of 8 241 Chinese quarantined crews who stayed in centralized segregation hotels from February of 2021 to December of 2022 were selected, and a self-made electronic questionnaire was used to investigate the psychological health status of the entry quarantine crews. Generalized Anxiety Disorder-7 (GAD-7), Insomnia Severity Index (ISI) and Patient Health Questionnaire-9 (PHQ-9) were used to assess their psychological health status. The entry quarantine crews were divided into 4 groups by age (20-29 years, 30-39 years, 40-49 years, 50-59 years) and 4 groups by post (pilots, cabin crews, security guards, maintenance men). The results were analyzed by using the SPSS 26.0 software.Results:① All 8 241 questionnaires were valid, and 9.9% (817/8 241) of the quarantine crews had mild or higher anxiety, 8.9% (736/8 241) had mild or higher insomnia, and 15.2% (1 251/8 241) had mild or higher depression. ② The proportion of male crews experiencing anxiety was higher than that of females ( χ2=13.04, P<0.001). The proportion of pilots with anxiety was higher than that of cabin crews, security guards, and maintenance men ( χ2=58.69, 39.54, 15.23, all P<0.001). The proportion of pilots with depression was higher than that of cabin crews and security guards ( χ2=21.07, 27.02, both P<0.001). ③Males had higher proportion of moderate/severe anxiety, insomnia, and depression than females ( χ2=8.30, 14.11, 10.07, P=0.004,<0.001,=0.002). The proportions of moderate/severe anxiety and moderate/severe depression in 40-49 years group were higher than those in 20-29 years group ( χ2=15.13, 22.29, both P<0.001). The proportion of moderate/severe depression in 40-49 years group was higher than that in 30-39 years group ( χ2=8.80, P=0.003). The proportions of pilots with moderate/severe anxiety and moderate/severe depression symptoms were higher than those of cabin crews ( χ2=17.30, 27.85, both P<0.001)and security guards ( χ2=10.39, 18.74, P≤0.001). The proportion of pilots with moderate/severe insomnia was higher than that of cabin crews ( χ2=14.19, P<0.001). ④ There was a positive correlation among the degree of anxiety, insomnia, and depression. Post was the risk factor for anxiety and depression among the entry quarantine crews. The risks of anxiety symptoms in cabin crews ( OR=0.508, P<0.001), security guards ( OR=0.382, P<0.001), and maintenance men ( OR=0.372, P<0.001) were lower than that in pilots, and the risks of depression symptoms in cabin crews ( OR=0.629, P<0.001) and security guards( OR=0.528, P<0.001) were lower than that in pilots. Conclusions:Attention should be paid to the psychological health status of the entry quarantine crews, and psychological assessment and intervention measures should be taken to reduce the risk of quarantined pilots experiencing moderate/severe anxiety, insomnia, and depression.