Objective: To investigate the status of condom use and its influencing factors among men who have sex with men (MSM), so as to provide a basis for improving condom utilization rates and AIDS prevention and control in this population. Methods: From May to October 2024, a snowball sampling method was employed to recruit MSM in Songjiang District, Shanghai Municipality. Self-administered questionnaires were used to collect data on demographic characteristics, AIDS-related knowledge, sexual behaviors, pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), and condom use in the past six months. Multivariable logistic regression model was used to analyze the influencing factors for consistent condom use. Results: A total of 921 MSM were surveyed, with a median age of 29.00 (interquartile range, 9.00) years. Among them, 697 (75.68%) were aware of AIDS-related knowledge, 826 (89.69%) expressed willingness to use PrEP, and 835 (90.66%) were willing to use PEP. Additionally, 787 (85.45%) MSM reported their age at first homosexual intercourse as ≥18 years, while 519 (56.35%) reported consistent condom use in the past six months. Multivariable logistic regression analysis revealed that MSM who were aware of AIDS-related knowledge (OR=0.582, 95% CI: 0.423-0.801), willing to use PrEP (OR =0.611, 95% CI: 0.385-0.969), and whose age at first homosexual intercourse was <18 years (OR=0.480, 95% CI: 0.330-0.700) were less likely to consistent use condoms. Conclusion The proportion of consistent condom use among the MSM remains relatively low, which is primarily associated with AIDS-related knowledge, willingness to use PrEP, and the age at first homosexual intercourse.

Neoadjuvant therapy has become the standard treatment for locally advanced resectable esophageal cancer, significantly improving long-term survival compared to surgery alone. Neoadjuvant therapy has evolved to include various strategies, such as concurrent chemoradiotherapy, chemotherapy, immunotherapy, or targeted combination therapy. This enriches clinical treatment options and provides a more personalized and scientific treatment approach for patients. This article aims to comprehensively summarize current academic research hot topics, review the rationale and evaluation measures of neoadjuvant therapy, discuss challenges in restaging methods after neoadjuvant therapy, and identify the advantages and disadvantages of various neoadjuvant therapeutic strategies.

Intelligence encompasses various abilities, including logical reasoning, comprehension, self-awareness, learning, planning, creativity, and problem-solving. Extensive research and practical experience suggest that there are sex differences in intellectual development, with females typically maturing earlier than males. However, the key genes and molecular network mechanisms underlying these sex differences in intellectual development remain unclear. To date, Genome-Wide Association Studies (GWAS) have identified 507 genes that are significantly associated with intelligence. This study first analyzed RNA sequencing data from different stages of brain development (from BrainSpan), revealing that during the late embryonic stage, the average expression levels of intelligence-related genes are higher in males than in females, while the opposite is observed during puberty. This study further constructed interaction networks of intelligence-related genes with sex-differential expression in the brain, including the prenatal male network (HELP-M: intelligence genes with higher expression levels in prenatal males) and the pubertal female network (HELP-F: intelligence genes with higher expression levels in pubertal females). The findings indicate that the key genes in both networks are Ep300 and Ctnnb1. Specifically, Ep300 regulates the transcription of 53 genes in both HELP-M and HELP-F, while Ctnnb1 regulates the transcription of 45 genes. Ctnnb1 plays a more prominent role in HELP-M, while Ep300 is more crucial in HELP-F. Finally, this study conducted sequencing validation on rats at different developmental stages, and the results indicated that in the prefrontal cortex of female rats during adolescence, the expression levels of the intelligence genes in HELP-F, as well as key genes Ep300 and Ctnnb1, were higher than those in male rats. These genes were also involved in neurodevelopment-related biological processes. The findings reveal a sex-differentiated intelligence gene network and its key genes, which exhibit varying expression levels during the neurodevelopmental process.
Female ; Intelligence/physiology* ; Male ; Sex Characteristics ; Animals ; Brain/growth & development* ; E1A-Associated p300 Protein/physiology* ; beta Catenin/physiology* ; Transcriptome ; Rats ; Gene Expression Profiling ; Genome-Wide Association Study

ObjectiveFunctional near-infrared spectroscopy (fNIRS), a novel non-invasive technique for monitoring cerebral activity, can be integrated with upper limb rehabilitation robots to facilitate the real-time assessment of neurological rehabilitation outcomes. The rehabilitation robot is designed with 3 training modes: passive, active, and resistance. Among these, the resistance mode has been demonstrated to yield superior rehabilitative outcomes for patients with a certain level of muscle strength. The control modes in the resistance mode can be categorized into dynamic and static control. However, the effects of different control modes in the resistance mode on the motor function of patients with upper limb hemiplegia in stroke remain unclear. Furthermore, the effects of force, an important parameter of different control modes, on the activation of brain regions have rarely been reported. This study investigates the effects of dynamic and static resistance modes under varying resistance levels on cerebral functional alterations during motor rehabilitation in post-stroke patients. MethodsA cohort of 20 stroke patients with upper limb dysfunction was enrolled in the study, completing preparatory adaptive training followed by 3 intensity-level tasks across 2 motor paradigms. The bilateral prefrontal cortices (PFC), bilateral primary motor cortices (M1), bilateral primary somatosensory cortices (S1), and bilateral premotor and supplementary motor cortices (PM) were examined in both the resting and motor training states. The lateralization index (LI), phase locking value (PLV), network metrics were employed to examine cortical activation patterns and topological properties of brain connectivity. ResultsThe data indicated that both dynamic and static modes resulted in significantly greater activation of the contralateral M1 area and the ipsilateral PM area when compared to the resting state. The static patterns demonstrated a more pronounced activation in the contralateral M1 in comparison to the dynamic patterns. The results of brain network analysis revealed significant differences between the dynamic and resting states in the contralateral PFC area and contralateral M1 area (F=4.709, P=0.038), as well as in the contralateral PM area and ipsilateral M1 area (F=4.218, P=0.049). Moreover, the findings indicated a positive correlation between the activation of the M1 region and the increase in force in the dynamic mode, which was reversed in the static mode. ConclusionBoth dynamic and static resistance training modes have been demonstrated to activate the corresponding brain functional regions. Dynamic resistance modes elicit greater oxygen changes and connectivity to the region of interest (ROI) than static resistance modes. Furthermore, the effects of increasing force differ between the two modes. In patients who have suffered a stroke, dynamic modes may have a more pronounced effect on the activation of exercise-related functional brain regions.

ObjectiveTo investigate the trend and influencing factors of newly reported human immunodeficiency virus (HIV) positivity rate among men who had sex with men (MSM) in Shanghai from 2021 to 2024, and to provide evidence for formulating scientific prevention and control measures of AIDS. MethodsMultiple rounds of cross-sectional questionnaire surveys were conducted among MSM by Shanghai Qing’ai Health Promotion Center. Pearson and Cochran-Armitage trend χ² tests were used to analyze the differences and changes in population characteristics and newly reported HIV positivity rates. A logistic regression model was applied for multivariate analyses of factors associated with newly reported HIV positivity. ResultsA total of 1 653 MSM who had not been previously diagnosed with HIV infection were surveyed. The newly reported HIV positivity rates in 2021, 2023, and 2024 were 7.87%, 3.91%, and 3.06%, respectively, showing a decreasing trend (χ²_trend=13.460, P_trend<0.001). Multivariate analyses revealed that MSM aged 18‒<25 years, residing locally for <1 year, identifying as bisexual, lacking HIV knowledge, and having ≥10 same-sex partners in the past 6 months exhibited higher newly reported HIV positivity rates. Conversely, MSM knowledgeable about HIV prevention, residing locally for 1‒5 years, and engaging in oral sex with male partners in the past 6 months demonstrated lower HIV positivity rates. Annual analyses revealed that MSM with HIV knowledge had lower newly reported HIV positivity rates in 2023 and 2024 (aOR=0.300, 95%CI: 0.811‒0.111; aOR=0.202, 95%CI: 0.085‒0.483). ConclusionThe newly reported HIV positivity rate among MSM in Shanghai from 2021 to 2024 showed a decline. Future interventions should focus on young and mobile MSM, strengthen HIV knowledge education through platforms such as the internet, promote safe sexual behaviors and regular testing, and further expand the coverage of pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) to control HIV transmission within this population.

Aim To investigate the effect of thioredox-in-interacting protein(TXNIP)on non-alcoholic fatty liver disease(NAFLD).Methods Littermate male wild(WT)mice and TXNIP gene whole-body knock-out(KO)mice were randomly divided into two groups:(1)normal diet(ND)group,and(2)The high-fat group,which was fed a high-fat diet(HFD)containing 60％fat for 12 weeks.Serum lipid-related indexes,liver injury indicators and hepatic fat content were detected using commercial kits.The protein lev-els of TXNIP,SLC25A1,SLC13A5,ACLY,CPT1a and PPARα were detected by Western blot.The gene ex-pressions of SLC25A1,SLC13A5 and ACLY were de-tected by RT-PCR.Results High fat diet increased TXNIP protein expression in the liver tissue.Compared with WT-HFD mice,the biochemical indexes in the se-rum and the liver of KO-HFD mice were improved.There was no significant difference in mRNA and pro-tein levels of SLC25A1 between the four groups of mice.For SLC13A5 and ACLY,the mRNA and protein levels of WT-HFD mice were up-regulated compared with WT mice,and these alterations were significantly restored in KO-HFD mice.Besides,compared with WT mice,the protein expressions of the fatty acid oxidation-related protein PPARα and CPT1a proteins in WT-HFD mice decreased,while the protein expressions of PPARα and CPT1 a in KO-HFD mice were significantly enhanced.Conclusion TXNIP gene knockout can improve hepatic steatosis and delay the progression of NAFLD by inhibiting the carbon flux of fatty acid syn-thesis and promoting fatty acid oxidation.

Objective:To investigate the surgical techniques and clinical efficacy of arthroscopic-assisted posterior malleolus reduction for the management of ankle fracture-dislocation.Methods:A retrospective analysis was performed on the clinical data of 27 patients who underwent arthroscopy-assisted posterior malleolar reduction via the posterior approach for the surgical management of ankle fracture-dislocation at the Third Affiliated Hospital of Nanjing Medical University (Changzhou No.2 People's Hospital) between January 2022 and June 2023. The cohort comprised 17 males and 10 females, with a mean age of 43.67±9.56 years (range, 25-63 years). Based on the Bartonícek and Rammelt classification, there were 15 type II cases, 9 type III cases, and 3 type IV cases. The operation time, posterior ankle arthroscopy duration, and postoperative complications, such as neurovascular injury, wound infection, or skin necrosis, were recorded. X-ray and 3D CT imaging were utilized to assess joint surface reduction quality, tibiofibular matching and fracture healing status. The ankle plantarflexion, dorsiflexion and hallux flexion contractures were recorded at the last follow-up. Functional outcomes were measured using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and the Olerud-Molander ankle score (OMAS), while pain was evaluated using the visual analogue scale (VAS).Results:All 27 patients were followed up postoperatively, with a mean follow-up duration of 14.30±1.38 months (range, 12-18 months). Postoperatively, one patient experienced wound exudation, while another developed intermuscular venous thrombosis in the calf. No cases of neurovascular injury, wound infection, skin necrosis, or hallux flexion contracture occurred, and no reduction loss was observed. The mean operation time was 96.11±11.55 min (range, 80-120 min), and the posterior ankle arthroscopy duration was 35.74±5.67 min (range, 30-45 min). Postoperative X-ray evaluations demonstrated no loss of fracture reduction, and all fractures achieved bony union. The mean fracture healing time was 3.78±0.75 months (range, 3-5 months). Postoperative CT evaluations showed no joint surface malalignment, and distal tibiofibular matching was satisfactory. At the final follow-up, mean ankle plantarflexion was 46.74°±4.73° (range, 33°-50°), and dorsiflexion was 20.96°±3.29° (range, 14°-26°). There was no hallux flexion contracture occurred. The mean AOFAS ankle-hindfoot score was 92.11±7.19 (range, 74-100), with 20 excellent, 5 good, and 2 fair, yielding an excellent-good rate of 93%. The mean OMAS score was 94.44±7.25 (range, 75-100), comprising 20 excellent and 7 good results, yielding an excellent-good rate of 100%. The mean VAS score was 0.70±0.95 (range, 0-3).Conclusion:Arthroscopy-assisted posterior malleolar reduction in ankle fracture-dislocation surgery provides optimal soft tissue protection and ensures precise fracture reduction and fixation.

Objective:To analyze the spatiotemporal correlation between the surveillance data of influenza in students reported by medical institutions and school absenteeism due to illness, and evaluate the application of Bayesian Structural Time Series model (BSTS) in the prediction of school influenza epidemic.Methods:A total of 13 schools in Dapeng new district of Shenzhen were selected. The incidence data of influenza in schools in Shenzhen from January 1, 2015 to December 31, 2019 were collected from China Disease Control and Prevention Information System and the illness related school absentence data during this period were collected from Shenzhen Student Health Surveillance System, and the spatiotemporal correlation between the data from two systems was analyzed and compared. BSTS was used to make long-term predictions of the monthly incidence of influenza in students in 2019 and short-term predictions of the weekly incidence of influenza in week 1-8 and week 45-52 of 2019 by using the data from two systems.Results:There was a temporal correlation between the data from China Disease Control and Prevention Information System and the data from Shenzhen Student Health Surveillance System ( r=0.93, P<0.001), and the lag of the former one was 1 day ( r=0.73, P<0.001). Influenza outbreaks were randomly distributed in different schools in Shenzhen, and there was no spatial correlation. The root mean square error ( RMSE) and mean absolute error ( MAE) were 0.35 and 0.28, respectively, in the long-term prediction, and the RMSE was 0.33 and 0.34, and the MAE was 0.26 and 0.28, respectively, in the short-term predictions of week 1-8 and week 45-52 of 2019, respectively, showing good prediction accuracy and fitting effect. Conclusion:By analyzing the data from China Disease Control and Prevention Information System and Shenzhen Student Health Surveillance System with BSTS, the dynamics of the school influenza epidemic can be accurately predicted, and effective technical support can be provided for the early warning and prevention and control of influenza epidemic.

Sanqi is first recorded in the Compendium of Materia Medica(Ben Cao Gang Mu) in the Ming Dynasty. During the Ming and Qing Dynasties, Sanqi, as a precious Dao-di herb, was successively spread and introduced for cultivation. This study verified the germplasm resources, production areas, and spread of Sanqi in the Ming and Qing Dynasties by systematically reviewing the historical materials, such as materia medica works and local chronicles, and the modern distribution of production areas. In the Ming and Qing Dynasties, the original plants of Sanqi included Panax notoginseng, P. japonicus, P. bipinnatifidus, P. zingiberensis, P. stipuleanatus, and Gynura japonica. Among them, the production area of P. notoginseng has changed. From 1578 to 1593, the main production areas of P. notoginseng were Nandan county, Hechi city in Guangxi Zhuang autonomous region and Guangnan county and Funing county, Wenshan prefecture in Yunnan province. From 1683 to 1755, the production areas of P. notoginseng additionally included Yizhou district, Tian'e county, and Huanjiang county in Hechi city, and Tianyang district and Tiandong county in Baise city, Xincheng county and Gongcheng county in Guangxi Zhuang autonomous region. From 1765 to 1892, the production areas additionally included Youjiang district, Debao county, Napo county, and Jingxi city in Baise city, and Tiandeng county in Guangxi Zhuang autonomous region, and Wenshan city, Malipo county, Yanshan county, Xichou county, and Maguan county in Wenshan prefecture, and Baoshan city, Dali prefecture, Lincang city, Honghe prefecture, Mangshi city, and Lushui city in Yunnan province. During the Wanli period of the Ming Dynasty, Sanqi was introduced to Zhejiang province. During the Qianlong period of the Qing Dynasty, it was introduced to Fujian province. During the Daoguang period of the Qing Dynasty, it was introduced to Hunan province. By comprehensively reviewing the materia medica works, local chronicles, and novel historical materials, this study restores the development history of the Sanqi industry in the Ming and Qing Dynasties. Historical data show that the introduction of Dao-di herbs should consider the biological characteristics of medicinal plants and avoid blind introduction.
China ; Drugs, Chinese Herbal/history* ; History, 17th Century ; History, 16th Century ; Plants, Medicinal/chemistry* ; Medicine, Chinese Traditional/history* ; History, 18th Century

Bajitian is a commonly used Chinese medicinal material with a long history of medicinal use, and there is controversy over the authentication of its origins. This article combined historical herbal works with local chronicle records to authenticate the origins of Bajitian used in different regions, analyzed the local chronicle records, and illustrated the evolution of the origins of Bajitian in different regions. The results indicate that Illustrated Classic of Materia Medica first included Guizhou Bajitian and Chuzhou Bajitian. By integrating images and texts and local medicinal practices of Bajitian in the Guizhou and Chouzhou regions in ancient and modern times, it was inferred that the original plant of Guizhou Bajitian was likely to be Damnacanthus officinarum or D. giganteus, while the origin of Chuzhou Bajitian remained unclear. The medicinal history of Sichuan Bajitian was first recorded in the Supplementary Records of Famous Physicians during the Northern and Southern Dynasties. Based on the inference from herbal documents and local chronicle records, it was inferred that the original plant of Sichuan Bajitian may be Schisandra propinqua subsp. sinensis and so on. Guangdong Bajitian is an emerging variety in modern times, and it could date back to the Xingning County Annals in the 20th year during the Kangxi period of the Qing Dynasty(1681). The original plant of Guangdong Bajitian is Morinda officinalis, and Guangdong province became the true producing area of Bajitian in the late Qing Dynasty. This article clarified the origins of Bajitian in different regions by sorting out historical herbal documents and local chronicle records, providing a basis for the authentication of Bajitian in the field of herbology.
China ; Drugs, Chinese Herbal/history* ; History, Ancient ; Medicine, Chinese Traditional/history* ; Plants, Medicinal/chemistry* ; History, Medieval ; History, 20th Century ; History, 19th Century ; History, 18th Century ; History, 17th Century ; History, 16th Century