Objective:To understand the prevalence of psychoactive substance use and related factors in men who have unprotected sex with men in Zhejiang Province.Methods:Men who have unprotected sex with men were recruited by snowball sampling through men who have sex with men (MSM) social organization in Zhejiang to conduct a cross-sectional investigation from January 2022 to December 2023. The sample size was estimated to be 1 169 individuals. The information about their socio-demographic information, sexual behaviors, psychoactive substance use, and HIV testing were collected through on-site questionnaire survey. Logistic regression analysis model was used to analyze related factors about psychoactive substance use in this population.Results:A total of 1 914 men who have unprotected sex with men were included in the study, the average age of the study subjects was (31.43±10.46) years, and most of them were aged ≤35 years (70.8%, 1 356/1 914). Those with education level of high school or below accounted for 50.1% (960/1 914) and those who were not married accounted for 63.5% (1 216/1 914). Psychoactive substance use in the past 3 months was reported in 19.7% (377/1 914) of the subjects. Multivariate logistic regression analysis showed that the factors associated with psychoactive substance use in the past 3 months included age 26-35 years (a OR=1.65, 95% CI: 1.24-2.19), ≥2 sexual partners in the past 3 months (a OR=2.33, 95% CI: 1.82-2.97), STD diagnosed in the past 3 months (a OR=2.62, 95% CI: 1.45-4.74), and awareness of the HIV infection status of sexual partners (a OR=2.83, 95% CI: 2.12-3.78). Conclusions:The prevalence of psychoactive substance use in men who have unprotected sex with men was high in Zhejiang. It is necessary to strengthen the intervention in this population.

Objective:To understand the prevalence of psychoactive substance use and related factors in men who have unprotected sex with men in Zhejiang Province.Methods:Men who have unprotected sex with men were recruited by snowball sampling through men who have sex with men (MSM) social organization in Zhejiang to conduct a cross-sectional investigation from January 2022 to December 2023. The sample size was estimated to be 1 169 individuals. The information about their socio-demographic information, sexual behaviors, psychoactive substance use, and HIV testing were collected through on-site questionnaire survey. Logistic regression analysis model was used to analyze related factors about psychoactive substance use in this population.Results:A total of 1 914 men who have unprotected sex with men were included in the study, the average age of the study subjects was (31.43±10.46) years, and most of them were aged ≤35 years (70.8%, 1 356/1 914). Those with education level of high school or below accounted for 50.1% (960/1 914) and those who were not married accounted for 63.5% (1 216/1 914). Psychoactive substance use in the past 3 months was reported in 19.7% (377/1 914) of the subjects. Multivariate logistic regression analysis showed that the factors associated with psychoactive substance use in the past 3 months included age 26-35 years (a OR=1.65, 95% CI: 1.24-2.19), ≥2 sexual partners in the past 3 months (a OR=2.33, 95% CI: 1.82-2.97), STD diagnosed in the past 3 months (a OR=2.62, 95% CI: 1.45-4.74), and awareness of the HIV infection status of sexual partners (a OR=2.83, 95% CI: 2.12-3.78). Conclusions:The prevalence of psychoactive substance use in men who have unprotected sex with men was high in Zhejiang. It is necessary to strengthen the intervention in this population.

OBJECTIVE: To investigate the clinical efficacy of femoral neck system(FNS) and three cannulated compression screws(CCS) in the treatment of unstable femoral neck fractures in young adults. METHODS: The clinical data of 52 young and middle-aged patients with unstable femoral neck fractures admitted from August 2018 to August 2021 were reviewed and analyzed. All patients were divided into two groups according to the internal fixation method, 25 cases were treated with FNS fixation, 27 cases were treated with closed reduction and 3 CCS inverted triangular distribution. The operation time, incision length, intraoperative bleeding, hospitalization expenses and fracture reduction quality of two groups were recorded and compared;The patients were followed up regularly after operation. The fracture healing time, complete weight-bearing time and postoperative complications(nonunion, femoral neck shortening, femoral head necrosis) of two groups were compared. The Harris score was used to evaluate hip function 6 months after surgery. RESULTS: The operation was successfully completed in both groups. The patients in FNS group had more bleeding, longer incision length and higher hospitalization cost than CCS group(P<0.01). There ware no significant difference in operation time and Garden index between two groups(P>0.05). Patients in both groups were followed up for 6 to 32 months.The fracture healing time in FNS group was less than that in CCS group, the time of complete weight bearing after surgery was earlier than that in CCS group, and the hip Harris score was higher than that in CCS group (P<0.01). There were no internal fixation fracture complications in two groups during follow-up. In the FNS group, there were 4 cases of avascular necrosis of the femoral head and 2 cases of femoral neck shortening, of which 3 cases underwent total hip replacement due to avascular necrosis of the femoral head. In the CCS group, there were 2 cases of nonunion, 9 cases of avascular necrosis of the femoral head, and 11 cases of femoral neck shortening, among which 5 cases underwent total hip replacement due to nonunion and avascular necrosis of the femoral head. CONCLUSION With simple operation, rotational stability and angular stability, FNS enables patients to start functional exercise as early as possible and reduces the incidence of postoperative complications of unstable femoral neck fracture. It is a new choice for the treatment of unstable femoral neck fracture in young adults.

Most drugs need to interact with cell membrane to reach the biological target, so that membrane affinity assay is an important early screening step in drug discovery. However, at present, the traditional oil-water distribution method is still used, a new, simple and accurate method for membrane affinity assay is urgently needed. In this study, according to the colorimetric principle, a new assay model based on polydiacetylene vesicles was optimized through a series of experiments including different concentrations of vesicle solution, temperature, or pH reaction environment. On this basis, tetracaine hydrochloride, 2-methylimidazole and histamine were used as model drugs to measure the membrane affinity constants and verify the between-batch precision of the optimized assay model (relative standard deviation less than 5%). In addition, polydiacetylene vesicles were stable for up to 180 days, demonstrating the potential application of the assay model. This strategy is simple, stable, reliable, with high reproducibility, low cost and easy to promote, which provided a new tool and a new direction for the high-throughput assay of membrane affinity.

Femoral neck fracture (FNF) in the elderly patients is currently a major health challenge worldwide, with excessive consumption of medical resources, high incidence of complications as well as suboptimal outcome and prognosis. Hip joint arthroplasty (HJA) has been the mainstream treatment for FNF in the elderly, but the conventional surgical approaches and techniques are still confronted with a series of bottlenecks such as dislocation, limp and limb length discrepancy. In recent years, direct anterior approach (DAA) for HJA (DAA-HJA) has been a major new choice in the field of joint replacement, which achieves improved clinical effectiveness of HJA in the treatment of elderly FNF, due to the fact that DAA approach involves the neuromuscular interface and accords with the idea of soft tissue retention and enhanced recovery after surgery. However, there is still a lack of unified understanding of standard technique and procedure of DAA-HJA in the treatment of elderly FNF. Therefore, relevant experts from the Hip Joint Group of Chinese Orthopedics Association of Chinese Medical Association, Youth Arthrology Group of Orthopedic Committee of PLA, Orthopedic Committee of Chongqing Medical Association, Branch of Orthopedic Surgeons of Chongqing Medical Doctor Association and Sport Medicine Committee of Chongqing Medical Association were organized to formulate the " Chinese expert consensus on the technical standard of direct anterior hip arthroplasty for elderly femoral neck fracture ( version 2023)" based on evidence-based medicine. This consensus mainly proposed 13 recommendations covering indications, surgical plans, prosthesis selections, surgical techniques and processes, and postoperative management of DAA-HJA in elderly patients with FNF, aiming to promote standardized, systematic and patient-specific diagnosis and treatment to improve the functional prognosis of the patients.

Sepsis is one of the main causes of death in critically ill patients. The intestinal tract is not only the organ easily involved in sepsis, but also the initial organ in the progression of sepsis, so the improvement of intestinal barrier function is the key of the treatment of sepsis. In recent years, it has been found that autophagy is involved in the pathological process of sepsis, maintaining mitochondrial function by clearing damaged organelles, inhibiting inflammation, oxidative stress and apoptosis, regulating immunity, maintaining intestinal homeostasis, and improving the condition and prognosis of sepsis. It is an effective target for the treatment of sepsis. As a new type of medical gas signal molecule, hydrogen sulfide (H 2S) can regulate autophagy by regulating multiple signal pathways, which has become a new target in the treatment of sepsis. This article reviews the signal pathway regulation mechanism of H 2S regulating autophagy in septic intestinal dysfunction.

Sepsis is an organ dysfunction that endangers a patient's life caused by an imbalanced infection response, and is a clinically critical illness. Despite a deep understanding of the pathogenesis of sepsis, there has been no significant improvement in sepsis mortality during clinical treatment at home and abroad. In recent years, the role of autophagy in the pathogenesis of sepsis has become a new research point in the field of medical research. Autophagy may protect the body by removing pathogenic microorganisms, neutralizing microbial toxins, and regulating cytokine release in sepsis. Studies have shown that autophagy plays a role in heart and lung organ dysfunction and inflammatory immune response in sepsis. Studies have also shown that hydrogen sulphide (H 2S) can activate autophagy through multiple signaling pathways, such as adenylate-activated protein kinase/mammalian target of rapamycin (AMPK/mTOR), phosphoinositide 3 kinase/Akt/mTOR (PI3K/Akt/mTOR), liver kinase B1/STE20 related adapter protein/mouse protein 25 (LKB1/STRAD/MO25) and microRNA-30c (miR-30c), etc. signaling pathways. This article reviewed the effects of H 2S on autophagy-related genes Beclin-1 and microtubule-associated protein light 3 chain (LC3) on intestinal function of sepsis in order to explore the H 2S-mediated autophagy gene expression in pus. The protective role of autophagy gene for intestinal dysfunction provides a new strategy for the treatment of sepsis in the future.

Melatonin is an indoleamine secreted by the pineal gland and plays a key role in a variety of physiological activities, including the regulation of circadian rhythm, immune response, oxidative process and apoptosis. In recent years, the anti-tumor properties of melatonin have attracted more and more attention. A large number of studies have found that melatonin plays a protective role in the early process of acute pancreatitis and can inhibit the production of pancreatic adenocarcinoma cells through apoptosis; moreover, it can regulate the synthesis and secretion of pancreatic endocrine hormones through autophagy and affect the development of pancreatic endocrine tumors. Therefore, melatonin may affect the development of pancreatic disease, but the mechanism of its action on pancreatic diseases has not been fully understood. This paper reviews the research progress of melatonin and pancreatic diseases in recent years, analyzes the role of melatonin in pancreatic diseases and the therapeutic effect of melatonin combined with chemotherapy drugs on pancreatic cancer.

Adolescent ; Empyema, Subdural ; etiology ; Female ; Humans ; Sinusitis ; complications ; Tomography, X-Ray Computed

In recent five years,brain imaging studies suggested that internet addicts' neural pathway have abnormalities in reward circuits,executive control system,and decision-making system when they are in resting state or induced state.For internet addicts,in the aspect of reward circuits,they showed decreased metabolism level when undergoing a resting-state fMRI scan,and enhanced reward sensitivity as well as decreased loss sensitivity when functioning.In the aspect of executive control system,the related brain areas were associated with reduced white matter integrity and disrupted functional comnectivity in resting-state.When the task was internet-related,internet addicts showed enhanced executive control function.However,when the task was not internet-related,they showed reduced executive control function.In the aspect of decision-making system,reduced cortical thickness in related brain areas was found when internet addicts are in resting-state,and they possess high impulsivity and high risk tendency when they are in induced state.These findings are consistent with the conclusions of substance addicts which are based on the research of brain imaging,therefore,we preliminary think the internet addiction is a new type of addictive mental disorder.