Cardiac arrest (CA) is a critical condition in the field of cardiovascular medicine. Despite successful resuscitation, patients continue to have a high mortality rate, largely due to post CA syndrome (PCAS). However, the injury and pathophysiological mechanisms underlying PCAS remain unclear. Experimental animal models are valuable tools for exploring the etiology, pathogenesis, and potential interventions for CA and PCAS. Current CA animal models include electrical induction of ventricular fibrillation (VF), myocardial infarction, high potassium, asphyxia, and hemorrhagic shock. Although these models do not fully replicate the complexity of clinical CA, the mechanistic insights they provide remain highly relevant, including post-CA brain injury (PCABI), post-CA myocardial dysfunction (PAMD), systemic ischaemia/reperfusion injury (IRI), and the persistent precipitating pathology. Summarizing the methods of establishing CA models, the challenges encountered in the modeling process, and the mechanisms of PCAS can provide a foundation for developing standardized CA modeling protocols.
Animals ; Disease Models, Animal ; Post-Cardiac Arrest Syndrome/physiopathology* ; Heart Arrest/physiopathology* ; Humans ; Ventricular Fibrillation/complications*

Azvudine and nirmatrelvir/ritonavir (Paxlovid) are recommended for COVID-19 treatment in China, but their safety and efficacy in the elderly population are not fully known. In this multicenter, retrospective, cohort study, we identified 5131 elderly hospitalized COVID-19 patients from 32,864 COVID-19 patients admitted to nine hospitals in Henan Province, China, from December 5, 2022, to January 31, 2023. The primary outcome was all-cause death, and the secondary outcome was composite disease progression. Propensity score matching (PSM) was performed to control for confounding factors, including demographics, vaccination status, comorbidities, and laboratory tests. After 2:1 PSM, 1786 elderly patients receiving azvudine and 893 elderly patients receiving Paxlovid were included. Kaplan-Meier and Cox regression analyses revealed that compared with Paxlovid group, azvudine could significantly reduce the risk of all-cause death (log-rank P = 0.002; HR: 0.71, 95% CI: 0.573-0.883, P = 0.002), but there was no difference in composite disease progression (log-rank P = 0.52; HR: 1.05, 95% CI: 0.877-1.260, P = 0.588). Four sensitivity analyses verified the robustness of above results. Subgroup analysis suggested that a greater benefit of azvudine over Paxlovid was observed in elderly patients with primary malignant tumors (P for interaction = 0.005, HR: 0.32, 95% CI: 0.18-0.57) compared to patients without primary malignant tumors. Safety analysis revealed that azvudine treatment had a lower incidence of adverse events and higher lymphocyte levels than Paxlovid treatment. In conclusion, azvudine treatment is not inferior to Paxlovid treatment in terms of all-cause death, composite disease progression and adverse events in elderly hospitalized COVID-19 patients.

Adult ; Humans ; Heart Arrest/therapy* ; Cardiopulmonary Resuscitation ; Emergency Service, Hospital ; Out-of-Hospital Cardiac Arrest/therapy* ; Treatment Outcome

Objective:To understand the incidence of HIV infection, high risk behaviors and pre-exposure prophylaxis/post-exposure prophylaxis (PrEP/PEP) utilization in men who have sex with men (MSM) in Beijing.Methods:Sample size was estimated to be 1 227 persons and 207 person year respectively in the survey and the cohort by using Epi Info 7.0 software. Using convenient sampling method, MSM were recruited by using Wechat app. Questionnaire was completed online to collect the information about demographic characteristics, high risk behavior, and utilization of PrEP/PEP of the MSM. MSM collected dry blood spot (DBS) samples by themselves, and mailed the DBS samples to laboratory for HIV nucleic acid testing. Open cohort was established and those with HIV negative nucleic acid testing results were followed up. Non-conditional binary logistic regression method was used to identify the associated factors for high risk anal sex in the last month and having multiple homosexual partners in the last month.Results:A total of 1 147 MSM were recruited, and follow up for 236 person years was conducted in 956 MSM with negative HIV nucleic acid testing results. The detection rate of new HIV infection was 1.3 per 100 person-years (3/236). During the last month, the proportions of consistent condom use in anal sex and oral sex were 50.7% (238/469) and 4.9% (23/469). In the MSM, 5.9% (43/723) had sex with HIV positive partners in the last month. 9.8% (103/1 049) used PrEP, and 8.7% (91/1 049) used PEP. The proportion of consistent condom use in PrEP and PEP were 34.3% (24/70) and 72.2% (39/54) respectively. Logistic regression analysis revealed that compared with those who used no PrEP/PEP, those who used PrEP/PEP were more likely to have unprotected anal sex in the last month (a OR=3.16, 95% CI:1.45-7.18), and more likely to have multiple homosexual partners in the last month (a OR=2.64, 95% CI:1.19-6.30), and compared with those who used no Rush Popper or drugs in the last month, those who used Rush Popper or drugs in the last month were more likely to have unprotected anal sex in the last month (a OR=2.34, 95% CI:1.67-3.30), and more likely to have multiple homosexual partners (a OR=2.42,95% CI:1.76-3.33). Conclusions:It is necessary to strengthen the health education to promote condom use and introduce the harm of drug use in MSM. In PrEP and PEP services, it is still necessary to suggest consistent condom use for MSM.

Cystatin, a cysteine protease inhibitor found in many parasites, plays important roles in immune evasion. This study analyzed the molecular characteristics of a cystatin from Fasciola hepatica (FhCystatin) and expressed recombinant FhCystatin (rFhcystatin) to investigate the immune modulatory effects on lipopolysaccharide-induced proliferation, migration, cytokine secretion, nitric oxide (NO) production, and apoptosis in mouse macrophages. The FhCystatin gene encoded 116 amino acids and contained a conserved cystatin-like domain. rFhCystatin significantly inhibited the activity of cathepsin B. rFhCystatin bound to the surface of mouse RAW264.7 cells, significantly inhibited cell proliferation and promoted apoptosis. Moreover, rFhCystatin inhibited the expression of cellular nitric oxide, interleukin-6, and tumor necrosis factor-α, and promoted the expression of transforming growth factor-β and interleukin-10. These results showed that FhCystatin played an important role in regulating the activity of mouse macrophages. Our findings provide new insights into mechanisms underlying the immune evasion and contribute to the exploration of potential targets for the development of new drug to control F. hepatica infection.

[摘 要] 目的：探究微小RNA-504（miRNA-504）在胃癌（GC）组织中的表达水平及其对GC细胞生物学行为的调控机制。方法：收集2020年6月至2020年12月期间三亚中心医院外科收治的48例胃癌患者的肿瘤组织及癌旁组织标本，qPCR检测组织中miR-504、肿瘤蛋白53诱导型核蛋白1（tumor protein 53-induced nuclear protein 1，TP53INP1）mRNA的水平，WB法检测TP53INP1水平。体外培养人胃癌细胞BGC-823，分为对照组（正常培养的BGC-823细胞）、miR-504 mimic组、mimic-NC组、miR-504 inhibitor组、inhibitor-NC组、miR-504 inhibitor+si-NC组、miR-504 inhibitor+si-TP53INP1组，qPCR检测细胞中miR-504和TP53INP1 mRNA的表达，MTT法、流式细胞术、划痕实验和Transwell侵袭实验分别检测各组细胞的增殖、凋亡、迁移和侵袭能力，WB法检测各组细胞中增殖、迁移和侵袭相关蛋白（Cyclin D1、E-cadherin、MMP-2、MMP-9）以及TP53INP1的表达。双荧光素酶报告基因实验进一步验证miR-504与TP53INP1 mRNA的靶向关系。结果：与癌旁组织相比，胃癌组织中miR-504的表达显著升高（P<0.05），而TP53INP1 mRNA和蛋白表达水平显著降低（P<0.05或P<0.01），miR-504和TP53INP mRNA两者的表达呈负相关（P<0.01）。与对照组相比，miR-504 mimic组BGC-823细胞中miR-504的表达显著升高（P<0.05）、TP53INP1 mRNA和蛋白的表达显著降低（均P<0.05），且细胞增殖率、划痕愈合率、侵袭入Transwell小室下层的细胞数量，Cyclin D1、MMP-2、MMP-9蛋白表达均显著增加，细胞凋亡率和E-cadherin蛋白表达均显著降低（均P<0.05）。转染miR-504 inhibitor能显著下调BGC-823中miR-504的表达、上调TP53INP1 mRNA和蛋白的表达，抑制细胞的增殖、迁移与侵袭能力而促进细胞凋亡（均P<0.05）；而下调TP53INP1的表达可明显减弱miR-504下调对BGC-823细胞增殖、迁移与侵袭的抑制作用（P<0.01）。miR-504高表达能明显抑制野生型TP53INP1质粒的荧光素酶活性（P<0.05）。结论：miR-504在胃癌组织中呈高表达，下调miR-504可抑制胃癌BGC-823细胞的恶性生物学行为而促进其凋亡，其作用机制可能与靶向调控TP53INP1的表达有关。

Non-occupational post-exposure prophylaxis (nPEP), a biological means to block the transmission of HIV, is recommended by European countries, USA and WHO to use in HIV high-risk groups, but its utilization rate is still very low. The information-motivation-behavioral skills model (IMB) can accurately explain the prevalence and change of health behaviors. Based on this model, this paper summarizes the progress in research of the influencing factors for nPEP use to provide a basis for further research to promote the use of nPEP.

Objective:To analyze the influencing factors of HIV-testing awareness of Myanmar people in Dehong, and provide references for early discovery of HIV infection among Myanmar people.Methods:A cross-sectional study was conducted among 400 Myanmar people in Dehong through convenient sampling method in a form of face-to-face questionnaire interview. HIV-testing awareness and influencing factors were described and analyzed with χ2 and logistic regression method . Results:A total of 393 participants were included in the study, in whom 241 (61.3%) were males, 256(65.1%) were Myanmar people, 233(59.3%) received 1-7 years of education in Myanmar, 348 do not speak Chinese (88.5%), 226(57.5%) were married, 378(96.2%) were non-solitary, 257(65.4%) were workers, the main purpose of etering into China in 273(69.5%) was working in China, 273(69.5%) had stayed in China for more than 2 years, 573(95.4%) had a clear plan on whether to stay in China for a long time in the future. In these Myanmar people, the rate of AIDS-related knowledge awareness was 75.6%; 165(42.0%) had sexual behavior in the last 6 months. 221(56.2%) knew that they had been tested for HIV. Ninety (22.9%) were more likely to actively seek HIV-testing after they had unprotected behaviors such as homosexual sex, injecting drug use, and sex without using condom. Multivariate logistic regression analysis showed that the influencing factors of HIV-testing awareness included being women (compared with men, OR=2.155, 95% CI: 1.088-4.270), educational level of 8-10 years or more than 10 years (compared with education level 1-4 years, OR=5.207, 95% CI: 2.094-12.950; OR=19.780, 95% CI: 5.800-67.457), having sexual behavior in the last 6 months (compared with those who had not, OR=2.534, 95% CI: 1.343-4.779), having received AIDS-related education in the last 6 months (compared with those who had not, OR=2.462, 95% CI: 1.303-4.654), AIDS-related knowledge awareness (compared with those who had no awareness, OR=8.126, 95% CI: 2.936-22.491). Conclusions:Myanmar people have low awareness of HIV-testing in Dehong. Those who were women and high literacy levels, having received AIDS-related knowledge education in the past 6 months, and having AIDS-related knowledge have an active HIV-testing awareness, after they have high-risk behaviors. AIDS-related knowledge should be publicized to promote early discovery of high-risk behaviors.

Objectives:To understand the prevalence of HIV nucleic acid using internet-based dry blood spots HIV testing strategy in men who had sex with men (MSM) and to probe the factors associated with HIV infection.Methods:Using convenient sampling method, 1 375 MSM were recruited and their dry blood spots samples were collected before being mailed to the laboratories for HIV nucleic acid testing. Results were showed to these MSM on a specific website by inputting their codes to it. Non-conditional binary logistic regression method was used to identify the associated factors on HIV infection.Results:The overall proportions of HIV nucleic acid positives appeared as 9.7 % (131/1 349) and HIV antibody positives as 8.3 % (112/1 349). Fresh infections accounted for 14.5 % (19/131) among the newly-identified HIV nucleic acid positives, and the interval was ranging from 6 to 120 days, between the laboratory testings and the closest date that experiencing high risk behavior. Risk factors that related to HIV infection would include: 30 to 39 years of age (comparing to those under the age of 30, OR=1.88, 95 %CI: 1.07-3.29), ≥8 000 Yuan of monthly income (comparing to those without income, OR=0.42, 95 %CI: 0.19-0.96), inconsistent condom use during anal sexual contacts in the last six months (compared with those who had not anal sex or used condoms consistently in anal sex in the past six months, OR=2.22, 95 %CI: 1.45-3.40), ever use of Rush Poppers (compared with those who never used Rush Poppers, OR=2.33, 95 %CI: 1.49-3.64), addictive drug abuse (compared with those who never abused addictive drugs, OR=5.43, 95 %CI: 2.32-12.69), and not having regular sexual partners (compared with having regular sexual partners, OR=1.74, 95 %CI: 1.13-2.68) etc.. Conclusions:Dry blood spots HIV nucleic acid testing could help to identify the fresh HIV infections at an early stage, so as to prevent further transmission in the MSM population, among which fresh HIV infections accounted for a fairly large proportion. It is necessary to set up programs in reducing the abuse of drugs or Rush Poppers, and to promote condom use and advocate on stable sexual partnership etc., among the MSM population.

Objective: To investigate the clinical features and prognostic factors of extrahepatic biliary neuroendocrine neoplasms(EB-NENs). Methods: The clinical data and survival of 21 patients with EB-NENs admitted from May 2014 to May 2018 were analyzed retrospectively. Results: These 21 EB-NENs patients accounted for 1.6% (21/1313) of all biliary tract neoplasms treated during the study period. Seven (33.3%) cases had lymph node metastasis. Five (23.8%) suffered from distant metastasis. The follow up time was (4~46.5) months with median survival time of (23.23 ±4.17) months. Univariate analysis showed that the risk factors for survival were tumor TNM stage (χ²=9.066, P=0.003), lymph node metastasis(χ²=6.399, P=0.011) and distant metastasis (χ²=9.808, P=0.002). By multivariate analysis, independent risk factors were tumor TNM stage(P=0.008, RR=3.003, 95% CI: 1.332~6.774), lymph node metastasis(P=0.023, RR=5.382, 95% CI: 1.261~22.971) and distant metastasis or not(P=0.007, RR=7.423, 95% CI: 1.730~31.851). Conclusion EB-NENs was a rare malignant tumor with poor prognosis. Tumor TNM stage, lymph node metastasis and distant metastasis were independent prognostic factors for EB-NENs patients.