ObjectiveTo investigate the prevalence rate of chronic non-communicable diseases （NCDs） and the association with quality of life in middle-aged and elderly patients with HIV/AIDS. MethodsThis cross-sectional study surveyed 432 patients with HIV/AIDS （aged≥45 years） in the Infectious Disease Center in Guangzhou Eighth People’s Hospital of Guangzhou Medical University， and 366 participants were included in the analysis after quality control. A questionnaire and the EuroQol 5-Dimensional 3-level version （EQ-5D-3L） were used to investigate NCDs and quality of life and Tobit regression model was used to estimate the association between chronic diseases and quality of life. ResultsAmong the 366 participants， 29（7.9%） had cardiovascular disease， 45（12.3%） had hypertension， 122（33.3%） had hyperglycemia， 151（41.3%）had hyperlipidemia，7（1.9%） had cancer， 17 （4.6%） had chronic kidney disease， 38 （10.4%） had chronic liver disease， 21（5.7%） had musculoskeletal disorders， and 253（69.1%） suffered from at least one type of chronic diseases. The median （lower and upper quartiles） of EQ-5D utility index was 1.000（0.964~1.000）. Multivariate Tobit regression results of the total population showed that cancer ［b_a=-0.08，95%CI （-0.15，-0.01），P=0.036］， chronic kidney disease ［b_a=-0.07， 95%CI （-0.12，-0.02），P=0.006］， musculoskeletal disease ［b_a=-0.09， 95%CI （-0.13， -0.05），P<0.001］， and ≥3 types of chronic diseases［b_a=-0.05， 95%CI（-0.08，-0.01），P=0.013］ were negatively correlated with EQ-5D utility index. The stratified analysis results of different CD4+T cell levels showed that hypertension ［b_a=-0.07， 95%CI （-0.12， -0.02）， P=0.007］， chronic kidney disease ［b_a=-0.10，95%CI （-0.18，-0.03）， P=0.006］， musculoskeletal disease ［b_a=-0.15， 95%CI （-0.22，-0.07）， P<0.001］ and ≥3 types of chronic diseases ［b_a=-0.09， 95%CI （-0.09， -0.01）， P<0.001］ were negatively correlated with EQ-5D utility index in the group with CD4≤500 （cells/μL）， whereas cancer［b_a=-0.11， 95%CI （-0.20，-0.01）， P=0.031］ was negatively correlated with EQ-5D utility index in the group with CD4＞500（cells/μL）. ConclusionsThe prevalence rate of chronic non-communicable diseases in middle-aged and elderly patients with HIV/AIDS is relatively high. The classification of NCDs such as cancer or chronic kidney disease or other chronic diseases and the numbers of NCDs categories are negatively correlated with quality of life. However，this association varies among patients with HIV/AIDS of different CD4+T cell levels. It is suggested that we should try to prevent and identify NCDs at an early stage， strengthen linkages and integration of health services for AIDS and chronic NCDs， and jointly manage and control AIDS with chronic diseases to improve the quality of life among people living with HIV/AIDS.

Objective Based on the epidemic situation of hepatitis B and liver cancer patients in Nantong from 2019 to 2022, to analyze the trend of hepatitis B virus DNA (HBV-DNA) changes and provide theoretical basis for the prevention and treatment of hepatitis B and liver cancer. Methods The data of patients with hepatitis B and liver cancer in Nantong Cancer Hospital were collected, and the general data, the time of infection with hepatitis B and the results of quantitative HBV-DNA test were statistically analyzed. Results A total of 487 patients with hepatitis B and liver cancer were collected, including 395 males and 92 females. Among them, patients aged 51-60 were the most common, accounting for 28.34%, followed by those aged 41-50 and 61-70, accounting for 23.00% and 21.56% respectively. In addition to 84 patients with unknown infection time, most of the patients with hepatitis B infection time distributed in 11 to 20 years, followed by 21 to 30 years and 1 to 10 years. Except for 126 patients with unknown levels of HBV DNA, the positive rate of HBV DNA in 361 patients was 64.82%. Between 2019 and 2022, except for patients with unknown levels of HBV-DNA, the proportion of patients with HBV-DNA<500 copies/mL showed an upward trend, while the proportion of patients with HBV-DNA (103-106) copies/mL showed a downward trend. Conclusion Sex and the time of infection with hepatitis B are high risk factors for hepatitis B liver cancer. Most patients with liver cancer are positive for HBV-DNA, which needs to be tested regularly to guide antiviral treatment.

Objective:To evaluate the item properties and applicability of the eHealth Literacy Scale in Web 3.0 context (eHLS-Web 3.0) among diabetic patients by applying classical test theory (CTT) and item response theory (IRT) to provide a new effective tool for assessing the level of eHealth literacy among diabetic patients.Methods:A cross-sectional study design was adopted and 230 diabetic patients from the inpatient endocrinology department of the Affiliated Yantai Yuhuangding Hospital of Qingdao University were selected by convenience sampling from November 2022 to May 2023 and were surveyed by using the self-general information questionnaire and eHLS-Web 3.0. The correlation coefficient method, Cronbach α coefficient, Guttman split-half reliability coefficient, and structural validity in CCT were used, and discriminant validity, convergent validity, and Samejima Graded Response model in IRT were used to evaluate the scale items. Results:The CTT results showed that Cronbach α coefficient for the eHLS-Web 3.0 was 0.973, the Guttman split-half reliability coefficient was 0.894, and the correlation coefficient between the items and the total score of the scale ranged from 0.708 to 0.845 (all P<0.01). Exploratory factor analysis extracted three common factors with a cumulative variance contribution rate of 76.75%, and the confirmatory factor analysis model had a good fit. The reliability of each dimension combination was >0.60, and the average variance extracted was >0.50. The square root of the average variance extracted from each dimension (0.817, 0.875, 0.845) was greater than the correlation coefficient between this dimension and other dimensions (0.742, 0.763, 0.715). The IRT results showed that the discrimination parameter of all the items ranged from 2.174 to 4.054, the difficulty coefficients increased with the increase of the level (- 2.471 - 2.187), and the average information content of all the items ranged from 1.217 to 2.609. Conclusions:The eHLS-Web 3.0 has good characteristics among diabetic patients as tested by CTT and IRT, and can be used as an effective tool to assess the eHealth literacy level of diabetic patients in China.

Congenital cataract is an important cause of irreversible visual impairment in children. Although surgery and rehabilitation can significantly improve the clinical symptoms of children, increasing studies have shown that children with congenital cataract still have many problems associated with poor quality of life, such as poor ability, psychological and social function impairment, etc., which have a nonnegligible impact on their growth. In this review, the current status of assessment methods and research on quality of life in children with congenital cataract was summarized, with a view to providing a reference for targeted intervention.

[摘 要] 目的：探讨食管恶性黑色素瘤（MEM）患者的临床特征，分析以PD-1单抗为基础的免疫治疗疗效及预后的影响因素。方法：收集2011年5月至2022年6月在北京大学肿瘤医院黑色素瘤暨肉瘤内科收治的手术不可切除或者转移性MEM患者的临床资料，包括基本信息、病理资料、实验室指标、治疗方案和生存情况等。采用实体瘤疗效评价标准1.1进行疗效评估，用Kaplan-Meier曲线进行生存分析，用单因素和多因素COX回归进行预后分析。结果：共收集到有完整资料的MEM患者79例，中位年龄59.0岁。大部分患者发病时伴有进食哽噎和吞咽困难等症状，以食管下段发病最为常见，NRAS和KIT基因突变的比例较高，乳酸脱氢酶（LDH）水平升高占21.5%；其中，17例患者接受化疗为主的治疗方案，62例患者接受PD-1单抗为主的免疫治疗方案，客观有效率分别为5.9%和28.8%，疾病控制率分别为35.3%和72.9%，总生存期（OS）分别为7个月[95%CI（0，16.7）个月]和13.2个月[95%CI（9.5，16.9）个月]（P<0.05）。多因素分析显示，就诊时LDH水平、ECOG评分、是否有临床症状、是否接受PD-1单抗治疗与OS显著相关（P<0.05）。结论：MEM患者对PD-1单抗为主的免疫治疗应答较好，LDH升高、ECOG评分≥2分、就诊时有临床症状可能是预后的不良因素。

Objective:To investigate the difference of lymphocyte subsets between elderly patients with rheumatoid arthritis and non-elderly patients and its clinical significance.Methods:A total of 124 patients with rheumatoid arthritis in Affiliated Hospital of Nantong University from January, 2017 to December, 2019 were enrolled.The patients were divided into elderly group(≥60 years old, 34 cases)and non-elderly group(<60 years old, 90 cases). Rheumatoid arthritis activity(DAS-28)scoring was performed for each patient.Peripheral blood mononuclear cells(PBMCs)were extracted by Ficoll density centrifugation.Lymphocytes were labeled and detected by 18-color flowcytometry with more than 30 fluorescent antibodies.Results:DAS-28 scoring showed that the disease activity score of the elderly group(4.56±1.89)was higher than that of the non-elderly group(3.37±1.49)( t=3.633, P<0.001). Flow cytometry showed that MAIL%T(mucus-associated lymphoid tissue T cell subset)( Z=-2.798, P=0.005), Tn%CD8 T cells(initial CD8 T cells)( Z=-2.179, P=0.029), VD2% T(Vδ2+ T, γδT cell subtype)( Z=-2.806, P=0.005), PD1-CD28-%Th( Z=-2.050, P=0.040)and IGM+ D-%B( Z=-2.376, P=0.017)were lower in the elderly group than in the non-elderly group.While, CD45+ CD27+ %CD8 T cells( Z=-3.069, P=0.002), abT%T cell(αβT cells)( Z=-2.103, P=0.035), CD27-CD28+ %T cells( Z=-2.341, P=0.019), ASC%PBMC( Z=-2.341, P=0.019)and ASC%CD19+ ( Z=-2.000, P=0.046)subgroup expression were higher in the elderly group than in the non-elderly group. Conclusions:The disease activity of elderly patients with rheumatoid arthritis is significantly higher than that of younger patients.The expressions of abT%T and CD4% abT in effector T cells of elderly patients with rheumatoid arthritis are higher than those of younger patients, while the expression of VD2% T is lower.The expression level of CD45RA+ CD27+ %CD8 T with cytotoxic effect is higher; However, the expression level of Tn%CD8 T in naive cells is lower.

Aim To prepare prostate cancer exosomes containing melittin and observe their uptake by prostate cancer cells. Methods Cells treated with starvation for different time were screened for exosome extraction. Exosomes from PC-3 cells were extracted by ultracentrifugation, and the extracted particles were examined by transmission electron microscopy, nanoparticle tracking analyzer(NTA), and Western blot. Melittin exosome system was prepared by repeated freeze-thaw method, incubation at room temperature as well as electroporation, and the size of encapsulation efficiency was measured by centrifugation. A high-performance liquid chromatography(HPLC)method was applied to assay the content of melittin exosomes(exo-mel). Fluorescence inverted microscopy was employed to evaluate the uptake of melittin exosomes by PC-3 cells, DU145 cells as well as LNCaP cells. Results The results of starvation treatment showed that 24 h starvation treatment was the optimal time point. TEM results showed that the exosomes were round or oval in shape with a distinct membranous structure, and the diameter was around 100 nm. The reagent protein concentration for NTA analysis of exosomes was 0.222 g·L-1. The results of Western blot for the marker proteins of exosomes showed that Alix and CD63 were positively expressed, which indicated that the exosomes could be obtained by starvation culture of PC-3 cells and ultracentrifugation. The results of entrapment efficiency showed that the entrapment efficiency of electroporation method was 17.51% ± 2.39%, that of repeated freeze-thaw method was 11.46% ± 1.02%, and that of room temperature incubation method was 3.93% ± 2.44%. The encapsulation efficiency of electroporation was the highest with significant difference(P<0.05). The uptake assay showed that PC-3 cells could efficiently take up exo-mel in a time-dependent manner, and DU145 cells and LNCaP cells also could take up exo-mel over time. Conclusions Exosomes can be accessed by starvation treatment and high-speed centrifugation, and the prostate cancer melittin exosome system prepared by electroporation method could be taken up by prostate cancer cells.

Objective:To explore the effects of tensile force on vascular lumen formation in three-dimensional printed tissue.Methods:The experimental research method was used. Human umbilical vein endothelial cells (HUVECs) were extracted from discarded umbilical cord tissue of 3 healthy women (aged 22 to 35 years) who gave birth in the Department of Gynaecology and Obstetrics of Suzhou Ruihua Orthopaedic Hospital from September 2020 to May 2021. Human skin fibroblasts (HSFs) were extracted from discarded normal skin tissue of 10 male patients (aged 20 to 45 years) who underwent wound repair in the Department of Hand Surgery of Suzhou Ruihua Orthopaedic Hospital from September 2020 to September 2022. After identification of the two kinds of cells, the 4 th to 6 th passage of cells were taken for the follow-up experiments. HUVECs and HSFs were used as seed cells, and polycaprolactone, gelatin, hyaluronic acid, and fibrin were used as scaffold materials, and the three-dimensional printed vascularized tissue was created by three-dimensional bioprinting technology. The printed tissue with polycaprolactone scaffold of 6 and 10 mm spacing, and without polycaprolactone scaffold were set as 6 mm spacing polycaprolactone group, 10 mm spacing polycaprolactone group, and non-polycaprolactone group, respectively. After 4 days of culture, the printed tissue in 10 mm spacing polycaprolactone group was selected to detect the cell survival by cell viability detection kit, and the cell survival rate was calculated. After 14 days of culture, the printed tissue in three groups were taken, and the shape change of tissue was observed by naked eyes; immunofluorescence staining was performed to observe the arrangement of filamentous actin, and lumen diameter, total length, and number of branches of vessel in the tissue. The tissue with micro-spring structure in the above-mentioned three groups was designed, printed, and cultured for 9 days, and the tensile force applied in the printed tissue was measured according to the force-displacement curve. The number of samples was all 3 in the above experiments. Data were statistically analyzed with one-way analysis of variance and Tukey test. Results:After 4 days of culture, the cell survival rate in printed tissue in 10 mm spacing polycaprolactone group was (91.3±2.2)%. After 14 days of culture, the shape change of printed tissue in non-polycaprolactone group was not obvious, while the shape changes of printed tissue in 6 mm spacing polycaprolactone group and 10 mm spacing polycaprolactone group were obvious. After 14 days of culture, the arrangement of filamentous actin in the printed tissue in non-polycaprolactone group had no specific direction, while the arrangement of filamentous actin in the printed tissue in 6 mm spacing polycaprolactone group and 10 mm spacing polycaprolactone group had a specific direction. After 14 days of culture, The vascular lumen diameters of the printed tissue in 6 mm spacing polycaprolactone group and 10 mm spacing polycaprolactone group were (6.0±1.3) and (10.8±1.3) μm, respectively, which were significantly larger than 0 μm in non-polycaprolactone group ( P<0.05), and the vascular lumen diameter of printed tissue in 10 mm spacing polycaprolactone group was significantly larger than that in 6 mm spacing polycaprolactone group ( P<0.05); the total length and number of branches of blood vessel in the printed tissue in 6 mm spacing polycaprolactone group and 10 mm spacing polycaprolactone group were significantly shorter or less than those in non-polycaprolactone group ( P<0.05), and the total length and number of branches of blood vessel in the printed tissue in 10 mm spacing polycaprolactone group were significantly shorter or less than those in 6 mm spacing polycaprolactone group. After 9 days of culture, the tensile forces applied in the printed tissue in 6 mm spacing polycaprolactone group and 10 mm spacing polycaprolactone group were (2 340±59) and (4 284±538) μN, respectively, which were significantly higher than 0 μN in non-polycaprolactone group ( P<0.05), and the tensile force applied in the printed tissue in 10 mm spacing polycaprolactone group was significantly higher than that in 6 mm spacing polycaprolactone group ( P<0.05). Conclusions:The three-dimensional printed scaffold structure can exert different tensile force in the printed tissue, and the vascular lumen diameter of the printed tissue can be regulated by adjusting the tensile force.

OBJECTIVE: To observe the effect of thumb-tack needles based on "Biaoben acupoint compatibility" on sequela symptoms, mental state and pulmonary ventilation function in patients with coronavirus disease 2019 (COVID-19) during recovery period. METHODS: Fifty cases of COVID-19 during recovery period were randomly divided into an observation group and a control group, 25 cases in each group. The patients in the observation group were treated with thumb-tack needles at Guanyuan (CV 4), Zusanli (ST 36) and Taiyuan (LU 9). The patients in the control group were treated with sham thumb-tack needles at identical acupoints as the observation group. The treatment in the two groups was given once a day, 7-day treatment was taken as a course of treatment, and totally two courses of treatment were given. The TCM symptom score, Hamilton anxiety scale (HAMA) score, Hamilton depression scale (HAMD) score, pulmonary function (forced vital capacity [FVC], forced expiratory volume in the first second [FEV1], peak expiratory flow [PEF]), the severity of pulmonary ventilation dysfunction and pulmonary imaging changes in the two groups were compared before and after treatment. RESULTS: Compared before treatment, the total scores and each item scores of TCM symptom scale, HAMA scores and HAMD scores in the two groups were reduced after treatment (P<0.05). Except for the symptom scores of dry throat and dry stool, the total score and each item score of TCM symptom scale, HAMA score and HAMD score in the observation group were lower than those in the control group (P<0.05). Compared before treatment, FVC, FEV1 and PEF in the two groups were increased after treatment (P<0.05), and those in the observation group were higher than the control group (P<0.05). The severity of pulmonary ventilation dysfunction in the two groups was reduced after treatment (P<0.05), and the severity in the observation group was better than that in the control group (P<0.05). After treatment, the lung shadow area in the two groups was decreased (P<0.05), and that in the observation group was smaller than the control group (P<0.05). The improvement of imaging change in the observation group was better than that in the control group (P<0.05). CONCLUSION The thumb-tack needles based on "Biaoben acupoint compatibility" could significantly reduce the sequela symptoms, anxiety and depression in patients with COVID-19 during recovery stage, and improve the pulmonary ventilation function.
Acupuncture Points ; Anxiety/etiology* ; COVID-19/therapy* ; Depression/etiology* ; Humans ; Needles ; Respiratory Function Tests ; Thumb