ObjectiveThis paper aims to observe the syndrome improvement and negative antigen conversion rate of Qingxuan Daozhi formula in the treatment of influenza in children （heat accumulation in the lung and stomach syndrome）. MethodsThrough a multi-center randomized controlled methodology design，confirmed influenza cases were collected from October 2022 to April 2023 in the pediatrics department of eight hospitals，such as Dongfang Hospital of Beijing University of Chinese Medicine. A total of 180 children with influenza and heat accumulation in the lung and stomach syndrome conforming to the standard were recruited through the clinic. The sick children meeting the inclusion criteria were randomly divided into groups by a block-randomized method. The children in the experimental group were treated with Qingxuan Daozhi formula for five days，and those in the control group were treated with Oseltamivir Phosphate Granules for five days. The primary efficacy indicator was the negative conversion rate of influenza antigen detection. Secondary efficacy indicators were the Canadian acute respiratory illness and flu scale （CARIFS） and the incidence of complications，severe cases， and critical cases. Follow-up observation was conducted on the day of enrollment，48 hours after medication，72 hours after medication， and （6+1） d after medication. ResultsOne hundred and eighty participants were randomly assigned to the experimental group （90 cases） or the control group （90 cases）. All participants were followed up during the study. Comparison of influenza antigen detection results in the primary efficacy indicators showed that the average time of negative influenza antigen conversion in the experimental group was （5.29±1.25） d，and that in the control group was （5.40±1.68） d，without a statistically significant difference. After five days of intervention，52 cases in the experimental group and 51 cases in the control group converted to negative，without a statistically significant difference. CARIFS score results in the secondary efficacy indicators showed that during 72 hours after intervention，there were statistically significant differences between the experimental group and the control group in three dimensions， including headache，muscle soreness， and the need for extra care （P<0.05）. On the （6+1） days after the intervention，the differences in both the experimental group and the control group were statistically significant in 10 dimensions， including sore throat，bad sleep，uncomfortable feeling，poor spirit and fatigue，crying more than usual，the need for extra care，symptom，function，influence on parents，and total score （P<0.05）. The comparison results within the group in the dimensional scores of symptom， function， and influence on parents，as well as the CARIFS total score showed that with the delay of follow-up time，scores of both groups decreased significantly，with a statistically significant difference （P<0.01）. Inter-group comparison results showed that the mean score of the experimental group was higher than that of the control group at the time of enrollment. With the progress of intervention，the score of the experimental group was significantly decreased compared with that of the control group. At the end of follow-up，the mean score of the experimental group was lower than that of the control group，with no statistically significant difference. In terms of the incidence of complications，severe cases， and critical cases， there were no complications，severe cases， and critical cases in the two groups，without a statistically significant difference. ConclusionThe symptom improvement effect and negative antigen conversion rate of Qingxuan Daozhi formula in the treatment of influenza in children （heat accumulation in the lung and stomach syndrome） are not inferior to Oseltamivir Phosphate granules， and children's acceptance is better. It can be more widely used in clinical treatment of influenza in children （heat accumulation in the lung and stomach syndrome）.

Objective To evaluate the feasibility of imaging the rat cardiac conduction system (CCS) using transaortic antegrade perfusion of Alexa Fluor 633-labeled antibodies targeting hyperpolarization-activated cyclic nucleotide-gated cation channel 4 (HCN4) and connexin (Cx). The study also sought to optimize antibody dosage, perfusion duration, and assess the photostability of the dye. Methods Ex vivo rat heart model with transaortic antegrade perfusion was established using 33 male SPF-grade Sprague-Dawley (SD) rats. Primary and secondary antibody solutions were sequentially perfused in an antegrade manner. After perfusion for predetermined durations, the atrioventricular junction was observed, and the fluorescence intensity of the corresponding area was recorded. Five dose-gradient groups (n=3 rats/group), five perfusion time-gradient groups (n=3 rats/group), and ten continuous LED light exposure time-gradient groups (using 3 rats prepared with a fixed dose and time) were established to observe and record regional fluorescence intensity. Standard immunofluorescence staining was performed on both paraffin and frozen sections for comparative histological analysis. Results A region of aggregated red fluorescent signal was observed in the atrioventricular junction. Following semi-quantitative fluorescence intensity analysis of HCN4/Cx43 and validation through comparative histology, this structure was identified as the atrioventricular node (AVN) region. The AVN-to-background fluorescence intensity ratio showed no statistically significant differences among groups with increasing antibody dosage (P>0.05). The ratio increased with longer antibody perfusion times. Furthermore, no statistically significant differences in the ratio were observed among groups with extended light exposure (P>0.05). Conclusion Transaortic antegrade perfusion of fluorescently labeled antibodies can successfully image the AVN within the CCS of ex vivo rat hearts. Increasing the antibody dosage does not significantly improve the AVN imaging effect. Longer antibody perfusion time results in better imaging quality of the AVN. The fluorescent dye maintains sufficient visualization of the AVN even after prolonged (8 h) exposure to light.

Objective: To explore the potential category patterns of risk prevention and control behaviors of HIV infection among young students who have sex with men (MSM) and their impact on HIV infection and late detection, aiming to optimize intervention strategies. Methods: From September 2017 to December 2024, a total of 1 637 MSM young students in Tianjin were recruited through both online and offline channels. Latent class analysis was applied to classify 11 HIV risk prevention and control behaviors [condom use during the most recent anal sex in the past 6 months, consistent condom use, use of water based lubricants, abstinence from recreational drugs, regular on site professional testing, fixed sexual partners, partner testing, awareness of partner s HIV testing results, testing before sexual activity, nucleic acid testing, and use of pre exposure prophylaxis (PrEP) or post exposure prophylaxis (PEP)]. Multivariate Logistic regression analyzed associations between demographic characteristics/intervention services factors and latent classes. Differences in HIV infection and late detection across behavior patterns were compared. Results: HIV risk prevention and control behaviors among MSM students were classified into three latent classes:condom dependent group (38.42%), low prevention group (27.73%), and comprehensive prevention group (33.85%). Students who received condom promotion/testing services were more likely to belong to the comprehensive prevention group ( OR =5.58), while those who received peer education were less likely to the comprehensive prevention group ( OR =0.43) (both P <0.01). Among the MSM student population, the HIV infection rate was 4.83%, with 2.26% of cases detected late. The HIV infection rate (1.45%) and late detection proportion (0.82%) in the comprehensive prevention group were lower than those in the low prevention group (7.89% and 3.83%, respectively) ( χ 2=16.20, 7.31, both P <0.01). Conclusions HIV risk prevention and control behaviors among MSM young students exhibit significant heterogeneity. Comprehensive prevention strategies can effectively reduce HIV infection and late detection risks. It is necessary to optimize peer education content and improve the accessibility of diversified prevention measures such as PrEP/PEP to enhance HIV prevention and control.

Objective To investigate the correlation between serum remnant cholesterol(RC)levels and the occurrence of arteriosclerosis obliterans(ASO)of the lower extremity in patients with type 2 diabetes mellitus(T2DM).Methods 355 cases of T2DM patients hospitalized in the department of endocrinology of Tianjin Hospital affiliated with Tianjin University from January 2018 to December 2022 were selected and di-vided into the non-ASO group(180 cases)and the ASO group(175 cases)according to whether the patients were combined with ASO or not.General clinical and laboratory data of patients were collected and RC levels were calculated;Spearman rank correlation analysis was performed to evaluate the correlation between RC lev-els and metabolic indices,and multivariate logistic regression analysis was conducted to assess the association between serum RC levels and the risk of ASO in T2DM patients.Results Compared with the non-ASO group,the ASO group had older age,the course of diabetes was longer,the incidence rates of diabetic peripher-al neuropathy,diabetic nephropathy,coronary heart disease,hypertension,and cerebral infarction were higher,statin use was more frequent,the levels of systolic blood pressure(SBP),triglyceride(TG),creatinine(Cr),uric acid(UA),and RC were higher,and the level of high-density lipoprotein cholesterol(HDL-C)was lower,all differences were statistically significant(P＜0.05).Spearman rank correlation analysis showed that serum RC levels were positively correlated with TG,total cholesterol(TC),and UA(r=0.628,0.289,0.192,P＜0.001),and negatively correlated with HDL-C(r=-0.202,P＜0.001).Multivariate logistic regression anal-ysis revealed that age(OR=1.095,95％CI:1.066-1.124,P＜0.001),diabetic peripheral neuropathy(OR=1.877,95％CI:1.114-3.162,P=0.018),diabetic nephropathy(OR=2.149,95％CI:1.272-3.629,P=0.004),systolic blood pressure(OR=1.017,95％CI:1.004-1.031,P=0.012),and RC(OR=2.644,95％CI:1.569-4.453,P＜0.001)were independent influencing factors for ASO in T2DM patients.Conclusion Elevated serum RC levels are closely associated with ASO in T2DM patients.

Objective: To analyze the use of preexposure prophylaxis (PrEP) among male students who had sex with men (MSM) with different sexual behavior patterns using potential categories, so as to provide evidence for determining the use patterns of PrEP consistent with MSM. Methods: A questionnaire survey was conducted by proportional sampling method on MSM in 31 provincial administrative regions in mainland China from 20 October to 30 December 2021, a total of 1 040 students were selected for the study. Latent variable analyses were conducted on a total of seven sexual behavioral characteristics, including knowledge of sexual partner HIV infection, frequency of condom use, number of sexual partners, engaging in group sex, provision of commercial sex, use of sex aids, and history of sexually transmitted infections (STIs) in the past year. And demographic characteristics were analyzed by Logistic regression analysis. The rates of PrEP awareness, willingness to use and usage rate in different sexual behavior risk groups were investigated. Results: Student MSM could be divided into two potential category groups:a lowrisk behavior group (82.4%) and a highrisk behavior group (17.6%). The PrEP usage rate (15.8%) was higher in the highrisk behavior group, and the difference was statistically significant compared to the lowrisk behavior group (7.2%) (χ2=13.43, P<0.05). Student MSM residing in the northeast, south, and northwest of China, in the pilot city, and with a sex role of "0.5" (possible acceptance and insertion of sexual behavior) were more likely to be in the highrisk behavior group (OR=3.13, 3.07, 3.87, 2.22, 1.66, P<0.05). Conclusion Student MSM in highrisk and lowrisk sexual differs in the behavior of PrEP, and targeted interventions should be implemented to promote the use of PrEP and reduce HIV infection in this population.

Objective: To investigate the current situation and related factors of antiretroviral therapy (ART) among HIV infected male students engaging in men who have sex with men (MSM), so as to provide the reference data for HIV prevention and treatment. Methods: In November 2021, 137 MSM students from 31 provincial administrative regions in China were recruited. An online survey was conducted to collect data on demographic characteristics, ART status, CD4 count, and HIV viral load before treatment. Logistic regression was used to analyze the factors related the effectiveness of ART in MSM. Results: Among the included research subjects, 14.6% had late detection of HIV,97.1% of participants were currently undergoing ART. Among those whose ART duration was less than 6 months, while 76.9% were undergoing ART. Logistic regression indicated that HIV infected students who received ART for more than 24 months ( OR =5.28, 95% CI =1.38-20.22) had a higher rate of successful HIV suppression. HIV infected students who reported physical sensory side effects ( OR =0.08, 95% CI =0.01-0.71) and cognitive side effects ( OR =0.28, 95% CI =0.09-0.90) were more likely to experience failure of ARI inhibition ( P <0.05). Conclusions There is still room for improvement in the efficacy of ART among MSM students. Strategies to improve treatment adherence must consider individual variances among HIV infected patients and the side effects of medications when designing treatment plans.

The cardiac conduction system (CCS) is a set of specialized myocardial pathways that spontaneously generate and conduct impulses transmitting throughout the heart, and causing the coordinated contractions of all parts of the heart. A comprehensive understanding of the anatomical characteristics of the CCS in the heart is the basis of studying cardiac electrophysiology and treating conduction-related diseases. It is also the key of avoiding damage to the CCS during open heart surgery. How to identify and locate the CCS has always been a hot topic in researches. Here, we review the histological imaging methods of the CCS and the specific molecular markers, as well as the exploration for localization and visualization of the CCS. We especially put emphasis on the clinical application prospects and the future development directions of non-destructive imaging technology and real-time localization methods of the CCS that have emerged in recent years.

Objective: To explore the pre-exposure prophylaxis (PrEP) awareness, willingness, uptake patterns, barriers and needs among Chinese student men who have sex with men (MSM), so as to provide relevant evidence for targeted interventions with PrEP. Methods: A proportional sampling method was used to conduct a cross sectional survey of MSM aged 16 years and older residing in 21 provinces, municipalities, and autonomous regions in mainland China between October 20 and December 20, 2021, to collect information on demographic and sexual behavioral characteristics, and 923 students of them were selected as the subjects of this study. The chi-square test and Fisher s test were used for univariate analysis, followed by multivariate Logistic regression to analyze the influencing factors of PrEP awareness and uptake. Results: According to the cascade analysis method, the awareness, willingness, uptake and adherence rates of PrEP among the student MSM were obtained as 88.95%, 67.36%, 13.20% and 45.21 %, respectively. HIV testing more than once in the last 3 months, and all of them were aware of the HIV test results of their sexual partners, and those with high frequency of condom use had a higher rate of awareness ( OR =2.32, 1.79, 1.69, P <0.05). Willingness rates were higher for those from the pilot city, using substances, and HIV testing more than once in the last 3 months ( OR =2.13, 1.65, 1.69, P <0.05). Higher rates of uptake were found among those from high risk and pilot areas, presence of commercial sex, substance use, and high literacy ( OR =5.60, 3.54,2.81, 1.92, 4.54, P <0.05). Adherence rates were higher among those who used one pill per day or both ( OR =12.77, 13.26, P <0.05). The barriers and needs faced by student MSM were primarily personal concerns about medication side effects, preventative effects, and confidence in sexual behavioral styles, and the high cost of medication and related service costs. Conclusions The student MSM population in China is characterized by high awareness, low willingness, low uptake, and low adherence to PrEP. Targeted interventions should be considered and tailored by the departments to facilitate PrEP promotion among student MSM.

Objective:To explore the impact of tislelizumab on renal function in bladder cancer patients with hydronephrosisMethods:A retrospective analysis of 34 bladder cancer patients with hydronephrosis treated at the Second Hospital of Tianjin Medical University from July 2020 to September 2023. Among them, 27 were male, and 7 were female, with an average age of (67.41±11.06)years and a body mass index (BMI) of (29.00±7.34) kg/m 2. 18 patients (52.9%) had hypertension, 5 (14.7%) had diabetes, and 5 (14.7%) had coronary heart disease. The baseline serum creatinine (SCr) was 81.15(69.18, 108.90)μmol/L, and the estimated glomerular filtration rate (eGFR) was 73.86(62.17, 91.12)ml/(min·1.73m 2). Of these, 26 patients (76.5%) had eGFR ≥60 ml/(min·1.73m 2)(G60+ group), and 8 patients (23.5%) had eGFR <60 ml/(min·1.73m 2)(G60- group). 10 patients (29.4%) had non-muscle invasive bladder cancer (NMIBC), and 24(70.6%) had muscle-invasive bladder cancer (MIBC). Eleven patients received surgical interventions within 1 month before baseline data collection that might affect hydronephrosis. All 34 patients received tislelizumab (200 mg, intravenous infusion every 3 weeks) combined with albumin-paclitaxel (200 mg, intravenous infusion every 3 weeks). Serum creatinine values were recorded before cycles 1, 2, and 3, and 21 days after cycle 3 (Cr1, Cr2, Cr3, CrE), and corresponding eGFR values (eGFR1, eGFR2, eGFR3, eGFRE) were calculated. A reduction in eGFR >25% from baseline at any of these points was defined as a decline in renal function (DRF), and an increase in eGFR >25% was defined as improvement in renal function (IRF). Differences in renal function changes and IRF, DRF incidence rates were compared between baseline subgroups Results:After 3 cycles of tislelizumab treatment, there was no significant change in eGFR []eGFR1 vs. eGFRE, 73.86 (62.16, 91.12)ml/(min·1.73m 2) vs. 83.82 (60.32, 90.62) ml/(min·1.73m 2), P=0.197]. Subgroup analysis showed that patients with diabetes had a significant increase in CrE compared to Cr1 (88.90 μmol/L vs. 69.40 μmol/L, P=0.043) and a significant decrease in eGFRE compared to eGFR1 [76.47 ml/(min·1.73m 2) vs. 87.73 ml/(min·1.73m 2), P=0.043]. No significant differences were observed in the other subgroups for SCr and eGFR within or between groups. DRF occurred in 4 patients (11.8%), with 1 diagnosed with acute renal injury, but not immune-related. IRF occurred in 8 patients (22.9%). In the subgroup analysis, the IRF incidence was significantly higher in the G60-group compared to the G60+ group (50.0% vs. 15.4%, P=0.044). No other factors were found to be associated with DRF or IRF. Conclusions:Tislelizumab treatment is safe for renal function in bladder cancer patients with hydronephrosis. Most patients with baseline poor renal function or underlying conditions like hypertension, diabetes, or coronary heart disease showed stable renal function during treatment.

Objective:To explore the impact of tislelizumab on renal function in bladder cancer patients with hydronephrosisMethods:A retrospective analysis of 34 bladder cancer patients with hydronephrosis treated at the Second Hospital of Tianjin Medical University from July 2020 to September 2023. Among them, 27 were male, and 7 were female, with an average age of (67.41±11.06)years and a body mass index (BMI) of (29.00±7.34) kg/m 2. 18 patients (52.9%) had hypertension, 5 (14.7%) had diabetes, and 5 (14.7%) had coronary heart disease. The baseline serum creatinine (SCr) was 81.15(69.18, 108.90)μmol/L, and the estimated glomerular filtration rate (eGFR) was 73.86(62.17, 91.12)ml/(min·1.73m 2). Of these, 26 patients (76.5%) had eGFR ≥60 ml/(min·1.73m 2)(G60+ group), and 8 patients (23.5%) had eGFR <60 ml/(min·1.73m 2)(G60- group). 10 patients (29.4%) had non-muscle invasive bladder cancer (NMIBC), and 24(70.6%) had muscle-invasive bladder cancer (MIBC). Eleven patients received surgical interventions within 1 month before baseline data collection that might affect hydronephrosis. All 34 patients received tislelizumab (200 mg, intravenous infusion every 3 weeks) combined with albumin-paclitaxel (200 mg, intravenous infusion every 3 weeks). Serum creatinine values were recorded before cycles 1, 2, and 3, and 21 days after cycle 3 (Cr1, Cr2, Cr3, CrE), and corresponding eGFR values (eGFR1, eGFR2, eGFR3, eGFRE) were calculated. A reduction in eGFR >25% from baseline at any of these points was defined as a decline in renal function (DRF), and an increase in eGFR >25% was defined as improvement in renal function (IRF). Differences in renal function changes and IRF, DRF incidence rates were compared between baseline subgroups Results:After 3 cycles of tislelizumab treatment, there was no significant change in eGFR []eGFR1 vs. eGFRE, 73.86 (62.16, 91.12)ml/(min·1.73m 2) vs. 83.82 (60.32, 90.62) ml/(min·1.73m 2), P=0.197]. Subgroup analysis showed that patients with diabetes had a significant increase in CrE compared to Cr1 (88.90 μmol/L vs. 69.40 μmol/L, P=0.043) and a significant decrease in eGFRE compared to eGFR1 [76.47 ml/(min·1.73m 2) vs. 87.73 ml/(min·1.73m 2), P=0.043]. No significant differences were observed in the other subgroups for SCr and eGFR within or between groups. DRF occurred in 4 patients (11.8%), with 1 diagnosed with acute renal injury, but not immune-related. IRF occurred in 8 patients (22.9%). In the subgroup analysis, the IRF incidence was significantly higher in the G60-group compared to the G60+ group (50.0% vs. 15.4%, P=0.044). No other factors were found to be associated with DRF or IRF. Conclusions:Tislelizumab treatment is safe for renal function in bladder cancer patients with hydronephrosis. Most patients with baseline poor renal function or underlying conditions like hypertension, diabetes, or coronary heart disease showed stable renal function during treatment.