Objective To investigate the prevalence of primary drug resistance among HIV-1 patients in Hubei Province from 2020 to 2022, and to provide corresponding basis and data support for HIV antiviral therapy (ART) in Hubei Province. Methods During 2020-2022, plasma samples of HIV-1 infected patients before ART were collected., Patients’ demographic data and baseline laboratory test data were also collected. HIV-1 pol region was amplified by in-house method for sub-type typing and drug-resistant mutation site analysis. Results The pol gene sequence was successfully amplified in 242 of 285 cases, with a success rate of 84.9%. CRF07_BC was the predominant HIV-1 sub-type, accounting for 47.11% (114/242), followed by CRF01_AE, accounting for 25.21% (61/242), sub-type B, accounting for 14.16% (35/242), and CRF55_01B, accounting for 4.13% (10/242). The primary resistance rate was 6.20% (15/242). The mutation site of nucleoside reverse transcriptase inhibitors (NRTIs) was mainly M184V, and the mutation sites of non-nucleoside reverse transcriptase inhibitors (NNRTIs) were mainly E138A/G/EG and V179E. These different mutation sites led to different degrees of drug resistance to 12 drugs. The incidence of drug resistance mutation of CRF55_01B sub-type was significantly higher than that of other sub-types. Conclusion The primary drug resistance rate of HIV-1 infected patients is at a slightly high level in Hubei Province, and close monitoring of primary drug resistance and mutation sites should be strengthened before ART, especially for CRF55_01B sub-type.

ObjectiveTaking Shengxuebao as the model traditional Chinese medicine（TCM）， this study aims to explore the methodologies and transfer patterns in the composition changes of TCM compound preparations from liquid to solid dosage forms. MethodBased on the previously established ultra-high performance liquid chromatography（UPLC） qualitative and quantitative methods for Shengxuebao， the fingerprint profiles of three preparations of Shengxuebao（homemade decoction， commercially available granules and mixtures） were established， and nineteen components were quantitatively analyzed. The similarities of fingerprint profiles among these three preparations were assessed using the Similarity Evaluation System for Chromatographic Fingerprint of TCM（2012 edition） and the total quantum statistical moment similarity method， respectively. The molecular connectivity index （MCI） and the average molar MCI of the chemical components in the three preparations were calculated. Seventy-two MCI values across 0-8 orders， including 8 subclasses， were calculated. The average molar MCI of 0-3 orders was used to study the "imprint template" structural characteristics and transfer patterns of the medicinal component groups. ResultThe similarities of the fingerprint profile of the decoction with those of the control， granules， and mixtures were 0.971， 0.888 and 0.799， respectively， indicating that the chemical composition of the granules and mixtures differed from that of the decoction， and that the 19 components were able to basically respond to the overall situation of the component group of Shengxuebao decoction. The total mass fractions of the detectable major components in Shengxuebao decoction， granules and mixtures was measured to be 5.498 6， 2.282 0， 1.416 6 mg·g^-1， respectively. The average molar MCI of 0-3 orders showed a gradual decrease across the three preparations， with the trend of decoction>granules>mixtures， indicating subtle changes in the overall structural characteristics of the chemical components in the samples of the three preparations. ConclusionAmong the three formulations of Shengxuebao， the traditional decoction contained the highest variety and quantity of components and carried the most substantial amount of component information， with a decreasing order observed in the granules and mixtures. This study further validates that traditional decoction is a reliable and fundamental dosage form， providing a reference for the modernization of TCM dosage forms and the quality consistency evaluation of compound preparations.

Objective To explore the application of nucleic acid test in the diagnosis of HIV western blotting (WB) indeterminate and negative samples. Methods A total of 2 518 HIV samples to be confirmed were collected from the Hubei HIV Confirmation Center Laboratory from 2014 to 2022. The results of follow-up antibody test and nucleic acid test of WB indeterminate and negative samples were analyzed, and the diagnostic rate, sensitivity, specificity and coincidence rate of the two detection strategies were compared. Results There were totally 133 indeterminate or negative samples by WB test. Of the 99 indeterminate samples , 76 (76.77%) had nucleic acid test results >5000 copies/mL. 40 cases were followed up, of which 33 cases (82.50%) turned positive and 7 (17.50%) were still uncertain. Of the 7 samples with 20~5000 copies /mL (7.07%), 2 cases were followed up and both turned positive during the follow-up. 1 case (1.01%) with nucleic acid <20 copies/mL turned positive during follow-up. Among the 34 WB negative samples, 15 cases (45.45%) were > 5 000 copies/mL, 9 of which were seroconversion. The diagnostic rates of ^“antibody confirmation^” and ^“nucleic acid test^” were 96.78% (2 437/2 518) and 99.60% (2 508/2 518), respectively. The sensitivities were 98.02% (2 430/2 479) and 99.88% (2476/2 479), and the specificities were 78.13% (25/32) and 100.00 % (32/32), respectively. The coincidence rates were 97.77% (2 455/2 511) and 99.88% (2 508/2 511), respectively. Conclusion Nucleic acid supplemental test strategy has high diagnostic rate, sensitivity, specificity and coincidence rate. WB indeterminate and negative samples can be diagnosed as early as possible through nucleic acid supplemental testing.

Objective:To explore the application value of 3.0T magnetic resonance imaging(MRI)combined with transvaginal ultrasound elastography technique in diagnosing uterine fibroids and adenomyosis.Methods:A retrospective analysis was performed on 56 patients with uterine fibroids and 41 patients with adenomyosis who admitted to Fengfeng General Hospital of North China Medical and Health Group from January 2021 to January 2022.MRI and transvaginal ultrasound elastography were respectively performed on all patients,and pathological diagnosis was taken as the"gold standard".The diagnostic results of MRI,transvaginal ultrasound elastography technique and their combination were compared,and the diagnostic situation of different examination methods were recorded.And then,the total coincidence rate was analyzed,and the sensitivity,specificity and accuracy were further calculated.Results:The totally diagnostic coincidence rate of MRI combined with transvaginal ultrasound elastography was 96.43% in detecting uterine fibroids,and that of MRI was 75.00%,and that of transvaginal ultrasonography was 80.36%.The differences of totally diagnostic coincidence rates among combined detection and single detection were significant(x2=10.500,7.049,P＜0.05).The totally diagnostic coincidence rate of MRI combined with transvaginal ultrasound elastography was 97.56% in detecting adenomyosis,which was significantly higher than that(78.05%)of MRI and that(78.05%)of transvaginal ultrasound elastography,and the differences were significant(x2=7.289,7.289,P＜0.05).The sensitivities of single MRI,single transvaginal ultrasound elastography and the combined detection of them were 71.74%,78.26% and 95.62% in detecting uterine fibroids,and the specificities of them were 90.00%,90.00% and 100.00%,and the accuracies of them were 75.00%,80.36% and 96.43%,respectively.The sensitivity and accuracy of the combined detection were significantly higher than those of single MRI detection(x2=5.029,10.500,P＜0.05),respectively.The accuracy of the combined detection was significantly higher than that of the single detection of vaginal ultrasonography(x2=7.049,P＜0.05).The sensitivities of single MRI,single transvaginal ultrasound elastography and the combined detection of them were 81.25%,78.73% and 96.88% in detecting adenomyosis,and the specificities of them were 66.67%,77.78% and 100.00%,and the accuracies of them were 78.05%,78.05% and 97.56%,respectively.The accuracy of the combined detection was significantly higher than that of single MRI detection(x2=7.289,P＜0.05),and the accuracy of the combined detection was significantly higher than that of single detection of vaginal ultrasonography(x2=7.289,P＜0.05).Conclusion:The diagnosis rate of MRI combined with transvaginal ultrasound elastography technique is higher for uterine fibroids and adenomyosis,which has better diagnostic value,and can provide reliable reference materials for clinicians in performing treatment.

ObjectiveTo investigate the effects of Buyang Huanwutang （BYWHT） on reducing inflammatory injury and improving neurological function after cerebral ischemia-reperfusion in rats via activating the adiponectin （APN） pathway. MethodMale SD rats were randomized into sham， model， BYHWT （16 g·kg^-1， twice a day）， and BYHWT + APN inhibitor （GW9662） groups. In the sham group， blood vessels were isolated. The rat model of middle cerebral artery occlusion （MCAO） was established. The rats in the BYHWT+GW9662 group was treated with subcutaneous injection of GW9662 at 4 m·kg^-1 30 min before MCAO surgery and BYHWT at 16 g·kg^-1 by gavage after MCAO surgery， once in the morning and once in the evening. The immunofluorescence （IF） assay was employed to observe the expression of adiponectin receptor 1 （AdipoR1） and the colocalization of AdipoR1 with neuronal nuclei （NeuN） and ionized calcium binding adaptor molecule 1 （Iba1） in the brain. Enzyme-linked immunosorbent assay （ELISA） was employed to detect the expression of APN in the serum and brain. The balance beam test was carried out to examine the balance ability， and the grasping test to assess the recovery of limb strength. The immunofluorescence assay was used to detect the expression of myeloperoxidase （MPO）. Western blot was employed to determine the expression of tumor necrosis factor-alpha （TNF-α）， interleukin （IL）-1β， IL-6， and IL-10 and in the brain. ResultCompared with the sham group， the modeling promoted the expression of AdipoR1 （P<0.01）， lowered the APN levels in the serum and brain （P<0.05， P<0.01）， increased the score in the balance beam test （P<0.01）， and decreased the grasping strength of forepaw （P<0.01）， which were accompanied with increased MPO， TNF-α， IL-1β， and IL-6 levels （P<0.01） and decreased IL-10 level （P<0.01）. Compared with the model group， BYHWT promoted the expression of AdipoR1 （P<0.01）， elevated APN levels in the serum and brain （P<0.05， P<0.01）， and increased the grasping strength of forepaw （P<0.01）， which were accompanied with lowered MPO， TNF-α， IL-1β， and IL-6 levels （P<0.01） and elevated IL-10 level （P<0.01）. All the above effects were partially blocked by GW9662. ConclusionBYHWT can reduce inflammatory injury and improve neurological function in the rat model of cerebral ischemia-reperfusion by activating the APN pathway.

Shenling Baizhusan is a traditional Chinese medicine compound prescription formulated on the basis of Si Junzitang （Ginseng Radix et Rhizoma， Atractylodis Macrocephalae Rhizoma， Poria， Glycyrrhizae Radix et Rhizoma）. It has excellent functions of replenishing Qi， invigorating spleen， draining dampness， and checking diarrhea， and is one of the classical prescriptions of ''reinforcing earth to generate metal''. This prescription is primarily used in clinical practice to treat malnutrition in children， chronic diarrhea， gastrointestinal dysfunction， and other disorders. In addition， it has a good effect on gastrointestinal adverse reactions associated with radiotherapy and chemotherapy. With the booming of molecular biology， researchers have revealed the role of Shenling Baizhusan in the treatment of diseases， especially the mechanism of regulating different signaling pathways. We retrieved 26 relevant papers （4 written in English and 22 in Chinese） published in recent 5 years from 6 databases including China National Knowledge Infrastructure （CNKI）， Wanfang Data， VIP， PubMed， Cochrance Library， and Excerpta Medica Database （Embase）. On the basis of these papers， we summarized the mechanisms of Shenling Baizhusan in disease treatment. In the animal model of inflammatory bowel disease， Shenling Baizhusan can protect gastrointestinal mucosa by regulating the activation of nuclear factor kappa-B （NF-κB）， mitogen-activated protein kinase （MAPK）， Janus kinase/signal transducer and activator of transcription （JAK/STAT）， and myosin light chain kinase-myosin light chain （MLCK-MLC） signaling pathways. In the animal model of non-alcoholic fatty liver disease， Shenling Baizhusan regulates the activation of phosphoinositide 3-kinase/protein kinase B/mammalian target of rapamycin （PI3K/Akt/mTOR） signaling pathway and Kelch-like ECH-associating protein 1/NF-E₂-related factor 2/advanced glycation end-products （KEAP1/NRF2/AREs） signaling pathway， thus alleviating the lipid metabolism disorder induced by high-fat diet and reducing liver lipid accumulation and inflammatory response. In the animal model of lung cancer with bone metastasis， Shenling Baizhusan regulates the activation of PI3K/Akt/mTOR signaling pathway， thus playing an analgesic role. By summarizing the mechanisms of Shenling Baizhusan in treatment of different disease models from signaling pathways， we aim to provide clues for the in-depth study of this prescription.

Objective Limiting antigen avidity enzyme immunoassay (LAg-Avidity EIA) was applied to calculate the HIV-1 incidence of new HIV infections among men who have sex with men(MSM), drug users(DUS), female sex workers(FSW) and male patients in sexually transmitted diseases clinics(STD) in 2017-2020 of Hubei. Methods HIV-1 antibody positive samples were collected from four key groups in the national HIV sentinel surveillance from 2017 to 2020, and tested by the LAg-Avidity EIA to estimate the annual new infection rate of each group. Results The prevalence of MSM was 2.90%, 4.48%, 3.63 and 2.78% from 2017-2020, respectively, which was the highest among the four groups. The rate of late diagnosis increased from 16.67% in 2017 to 28.81% in 2020.The incidence of MSM was 1.64%(0.85%-2.44%),1.41%(0.59%-2.23%),1.46% (0.71%-2.21%) and 0.96%(0.34%-1.57%), respectively, and the difference was not statistically significant (χ²=1.491, P=0.684). The prevalence of STD from 2017-2020 was 0.03%, 0.01%, 0.06% and 0.08%, respectively, with the incidence was 0.09% (-0.06%-0.25%), 0.10(-0.06%-0.26%), 0.26% (0.02%-0.50%) and 0.04%(-0.07%-0.15%). The prevalence and incidence among FSW remains very low, while the prevalence of DUS fluctuated slightly, but no new infections have been detected. Conclusion The incidence of new HIV infection among MSM in Hubei province from 2017-2020 is relatively high compared with other key groups, but the overall trend is declining, thus the intervention of MSM should be further strengthened and expand the coverage of testing in key populations.

Objective To analyze the positive results of HIV antibody screening in the laboratory of AIDS confirmation center of Hubei Provincial Center for Disease Control and Prevention from 2014 to 2020, and to provide a basis for improving detection strategies. Methods A total of 2 728 primary screening positive specimens received by the laboratory of Hubei confirmation center from 2014 to 2020 were retested with two reagents. Specimens with at least one reactive result were confirmed with western blot (WB). The samples with uncertain or negative WB results were further confirmed by nucleic acid quantitative detection. The test results were analyzed retrospectively. Results A total of 2 297 specimens with positive retest results were confirmed by WB, with a positive rate of 93.47%. The highest proportion of patients was from medical institutions. The positive rate detected by 4 diagnostic kits was apparently higher in S/CO＞10 cases than that in S/CO≤10, and the difference was statistically significant (P < 0.05). Of the 19 samples with inconsistent results in ELISA, 1 was confirmed as positive by WB, while 12 were negative both by WB and nucleic acid detection. Among 68 samples with uncertain WB results, 49 cases had nucleic acid quantitative results > 5 000cps / ml, and 12 cases were TND. 13 of the 30 WB negative samples had nucleic acid test results＞5 000CPs/mL . Conclusions The coverage of HIV screening laboratories in hospitals at all levels should be further increased to find more HIV infected persons. The anti-HIV ELISA S/CO ratio is correlated with the positive results confirmed by western blot. Therefore, ELISA S/CO ratio can be used to predict anti-HIV antibody positivity. For samples with uncertain or negative WB detection, supplemental nucleic acid test should be carried out timely for early diagnosis.

Objective:To understand the social support, social network, and sexual behavior characteristics of foreigners living in Guangzhou, analyze factors relating to aspects of online social interactions and sexual behaviors of foreigners in Guangzhou, and provide references for targeted HIV intervention services for foreigners.Methods:A cross-sectional survey (both online and offline), among those who met the inclusion criteria was conducted between November 2019 and January 2020. Data were collected on demographics, social support, online social interactions, sexual behaviors, and so on. Statistics were compiled to analyze the factors that may influence casual sexual behaviors.Results:A total of 434 participants were included in the study (241 offline and 193 online). The majority of the participants were male 68.4% (297/434), age (31.0±8.8) years old, African 79.0% (343/434), business people 46.5% (202/434), students 48.2% (209/434), who have business partners and family members in China were 59.4% (258/434) and 28.1% (122/434) separately. They also had the following features: less than 10 close friends 57.1% (248/434); spend 1-3 hours on social applications per day 43.3% (188/434), had casual sexual behaviors in the last 3 months 15.2% (55/363). Multiple logistic regression model analysis showed that compared with those who used social applications for less than 1 hour per day, participants who used social applications for more than 6 hours per day were more likely to have casual sexual behaviors in the last 3 months ( OR=3.63, 95% CI: 1.31-10.08). Conclusions:Participants who used social applications for a longer period every day were more likely to have casual sexual behaviors among foreigners in Guangzhou. Good use of social applications for health promotion and education of HIV can increase the health awareness of foreigners in China.

Objective:To develop a Risk Assessment Index System (RAIS) on HIV infection among young students based on Delphi method and to provide individual HIV infection risk assessment, targeted prevention and control measures.Methods:Delphi method was applied to determine the index system and weight of the assessment tool through three rounds of expert consultation and overall consideration of opinions and suggestions from 19 experts.Results:The positivity coefficients of three rounds of expert consultation were 100%. The authority coefficient of experts was between 0.887 and 0.945. The Kendall's W coefficients through first, second and third round specialist consultation was 0.379, 0.329 and 0.248, respectively (all P<0.001). The coefficients of variation in the third round were all less than 0.25, indicating that experts' opinion tend to be consistent and the results are highly reliable. The HIV infection risk assessment index system among young students consisted of 7 first grade indices and 54 second grade indices, of which weight was calculated. Conclusions:The RAIS on HIV infection for young students was initially established based on Delphi method, and could be used in the development of HIV infection risk assessment tools for personalized prevention and intervention among young students. However, the reliability, validity and effect of this assessment index system need to be further evaluated.