ObjectiveTo analyze the epidemiological characteristics of the newly reported HIV-infected cases aged ≥50 years in Tiantai County from 2006 to 2020, and to provide a scientific basis for the formulation of intervention measures and control strategies for the elderly. MethodsData of the newly reported HIV-infected individuals aged ≥50 years in Tiantai County from 2006 to 2020 were analyzed. A trend χ² test was used to analyze the changing trends of the composition ratio over the years. ResultsA total of 201 HIV-infected cases aged ≥50 years were newly reported from 2006 to 2020, accounting for 52.62% of the total reported cases, and the proportion of HIV- infected patients aged ≥50 years in the total number of reported cases increased from 12.50% in 2011 to 80.00% in 2020, showing a yearly increasing trend (χ²_trend=36.898, P<0.001). The mean age of the elderly at diagnosis of HIV infection was (64.8±9.1) years old, and the average age of infection was (58.1±9.3) years old. Patients who were male (79.10%), married with a spouse (58.21%), with an educational level of primary school and below (68.16%), with a local registered residence (75.12%) and peasants (88.06%) were associated with increased risk of HIV infection. Heterosexual transmission (89.55%) was the major route of HIV transmission among the HIV-infected cases aged ≥50 years and 75.12% of them were detected while visited medical and healthcare facilities. Among heterosexual transmission, males were more likely to be infected through non-marital heterosexual contact(χ²=229.381, P<0.001), while females were more likely to be infected through contact with their positive spouse or fixed sexual partner(χ²=216.699, P<0.001). The AIDS epidemic had affected 15 townships (streets) in the county. Pingqiao Town and Chicheng Street were seriously affected, with the confirmed cases accounted for 45.27% of the total number of the cases in the county. ConclusionThe number of the newly reported HIV-infected cases aged ≥50 years in Tiantai County showed a rapid growth trend from 2006 to 2020. Males with low educational level predominated in the total number of the cases. Commercial heterosexual behavior is the main route of infection. Lack of timely detection and management on positive clandestine prostitutes, resulting in the existence of gathering trend in the key towns. Crackdown on clandestine prostitution should be strengthened, and interventions on high-risk sexual behaviors should be carried out, in order to promote the acquisition of HIV/AIDS prevention knowledge and behavioral change for the elderly, furthermore, to control the spread and epidemic of HIV/AIDS.

Objective To investigate the therapeutic effectiveness of ozone combined with low-temperature plasma coagulation therapy on patients with cervical spondylotic radiculopathy and its influence on inflammatory responses.Methods Ozone in combination with low-temperature plasma radio-frequency coagulation was applied to 75 patients with cervical spondylotic radiculopathy in Pain Medicine Department of Capital Medical University Affiliated Beijing Anzhen Hospital from May 2022 to May 2023.Pain scores were assessed using Visual Analog Scale(VAS)and Neck Disability Index(NDI)before and two weeks after treatment.Enzyme-linked immunosor-bent assay(ELISA)was used to analyze the level of tumor necrosis factor-alpha(TNF-α),interleukin-6(IL-6)and interferon-gamma(IFN-γ)before and two weeks after treatment.Results After treatment with ozone plus low-temperature plasma radiofrequency,VAS and NDI scores showed a significant decrease[VAS:5.36(4,7)vs.1.32(1,2),P＜0.000 1;NDI:32.72(24,70)vs.7.62(3.55,8.9),P＜0.000 1].Two weeks after surgical intervention,there was an effective reduction in the level of IL-6,TNF-αand IFN-γ alleviating the inflammatory re-sponse[IL-6:4.33(2.51,5.04)vs.3.49(2.08,4.43),P＜0.05;TNF-α:1.95(1.41,2.21)vs.1.61(1.02,2.03),P＜0.05;IFN-γ:1.84(1.18,2.47)vs.1.55(0.76,2.09),P＜0.05].Conclusions This Ozone combined with low-temperature plasma radiofrequency ablation is an effective technology for treatment of cer-vical spondylotic radiculopathy.

Objective:To exploring the application effect of doctors-nurses-patients theory of goal attainment combined with StMarys cluster intervention mode in patients with tracheotomy after stroke.Methods:Using convenient sampling method, a total of 130 stroke patients with tracheostomy who were admitted to Shangqiu First People's Hospital from August 2020 to February 2022 were selected as the research objects. The patients were divided into the control group and the observation group using the random number table method, with 65 cases in each group. The control group received routine nursing care, while the observation group applied doctors-nurses-patients theory of goal attainment combined with StMarys cluster nursing intervention mode on the basis of the control group. After intervention, scores of Self Rating Anxiety Scale (SAS) and Self Rating Depression Scale (SDS) and patient nursing satisfaction were compared between the two groups.Results:After intervention, the SAS and SDS scores of the observation group were lower than those of the control group, and the nursing satisfaction was higher than that of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The doctors-nurses-patients theory of goal attainment combined with StMarys cluster intervention mode can help improve the psychological state of patients and increase nursing satisfaction.

Objective: To investigate the prevalence of soil-borne nematode infections among rural residents in Tiantai County, Zhejiang Province, so as to provide insights into improving the control strategy. Methods: According to the Zhejiang Provincial Surveillance Programme on Soil-borne Nematodiasis and Clonorchiasis, 5 administrative villages were randomly selected in Tiantai County according to geographical locations on April, 2021, and all permanent residents at ages of 3 years and older were sampled from each village using a cluster sampling method. Subjects' gender, age, occupation, education level and deworming were collected. Subjects' stool samples were collected, and soil-borne nematode eggs were detected using the modified Kato-Katz technique, and larval culture was performed using a filter-paper culture method among hookworm egg positives for identification of hookworm species. In addition, the intensity of infection was evaluated using hookworm eggs per gram stool sample. Results: A total of 1 013 residents participated in the survey, including 495 men (48.86%) and 518 women (51.14%), and there were 502 participants at ages of 51 to 70 years (49.56%), 874 farmers (86.28%) and 436 subjects with an education level of primary school (43.04%). However, no subjects received deworming. The prevalence of hookworm infections was 3.85% among the study subjects, and only Necator americanus was identified. There were 31 cases with mild infections (79.49%), 5 cases with moderate infections (12.82%) and 3 cases with severe infections (7.69%), and all infections occurred in farmers. The prevalence of hookworm infections was 3.84% among men and 3.86% among women. No hookworm infection was detected among residents at ages of <41 years, and the prevalence of hookworm infections appeared a tendency towards a rise with age among residents at ages of 51 years and older (χ2trend=24.091, P<0.001), while the prevalence of hookworm infections appeared a tendency towards a decline with educational levels among residents (χ2trend=19.534, P<0.001). The greatest prevalence of hookworm infections was found in Qianyang Village (10.95%). Conclusions Hookworm disease is the predominant type of soil-borne nematodiasis in Tiantai County, and the middle-aged and elderly farmers with a low education level are high-risk populations for soil-borne nematodiasis control.

Objective:To investigate whether it is by regulating interleukin 1β ( IL-1β) gene expression that androgen receptor (AR) in macrophages affects hyperphosphate-induced vascular smooth muscle cell calcification. Methods:The chromatin immunoprecipitation (ChIP) experiment was used to determine whether AR was bound to the androgen receptor element (ARE) sequence of IL-1β promoter in THP-1 cells. Whether the AR regulated IL-1β gene expression was detected by luciferase assay experiments. AR of THP-1 cells was silenced and transfected by lentivirus with vector or shRNA. Flow cytometry was used to select positive transfected cells THP-1ARsc (control) and THP-1ARsi (AR silencing) with fluorescent markers. Western blotting was used to detect AR protein levels of THP-1ARsc (control) and THP-1ARsi cells (AR silencing in monocytes). Macrophages MФARsc (control) or MФARsi (AR silencing) were induced by 50 ng/ml phorbol ester. Enzyme-linked immunosorbent assay was used to detect IL-1β expression levels of MФARsc or MФARsi conditioned medium. The human aortic smooth muscle cells (HASMC) were cultured in MФARsc or MФARsi conditioned medium with phosphate (2.5 mmol/L final concentration of sodium dihydrogen phosphate), and Alizarin red S staining was used to analyze HASMC calcification degree. Western blotting was used to detect the expression levels of RUNX2 (osteoblast marker) and SM22α (HASMC marker), and neutralization assay was performed to test IL-1β-mediating effect of macrophages AR on HASMC calcification. Results:AR was bound to ARE sequence of IL-1β promoter and regulated IL-1β gene expression. The expression level of IL-1β protein in conditioned medium of MФARsi cells decreased significantly compared to MФARsc cells ( P<0.001). Compared with MФARsc conditioned medium group, HASMC calcium deposition in MФARsi conditioned medium group decreased significantly, RUNX2 protein decreased and SM22α protein increased (all P<0.05). The degree of HASMC calcification in the MФARsi conditioned medium+IgG antibody group decreased than that in the MФARsc conditioned medium+IgG antibody group significantly, and the degree of HASMC calcification in the MФARsc conditioned medium+IL-1β antibody group decreased significantly than that in the MФARsc conditioned medium+IgG antibody group; while the degree of HASMC calcification in the MФARsi conditioned medium+IgG antibody group and MФARsi conditioned medium+IL-1β antibody group decreased than that in the MФARsc conditioned medium+IL-1β antibody group (all P<0.05). Conclusions:Macrophage AR regulates IL-1β expression by binding to ARE sequence within IL-1β promoter, and IL-1β mediates the effect of macrophage AR on hyperphosphate-induced HASMC calcification.

Objective:To evaluate the efficacy and safety of warfarin in the treatment of atrial fibrillation (AF) in patients with maintenance hemodialysis (MHD).Methods:Studies on evaluating efficacy and safety of warfarin in maintenance hemodialysis patients with AF were searched in CNKI, Wanfang Database of Chinese Academic Journals, PubMed, Embase and Cochrane databases from January 2001 to October 2021. The data were extracted independently by two reviewers. Meta-analysis was performed with RevMan 5.2.Results:Twelve relevant studies were included, involving 30 488 patients, 7 276 in the warfarin group and 23 212 in the control group. Meta-analysis showed that warfarin had no significant efficacy for treatment of AF in patients with maintenance hemodialysis, and there was no difference in the incidence of stroke( RR=1.10, 95%CI:0.82-1.48, P=0.52)between two groups; subgroup analysis showed that there was no significant effect on ischemic stroke or hemorrhagic stroke( RR=1.06,95% CI:0.80-1.42, P=0.67; RR=1.55,95% CI:0.93-2.58, P=0.09). There was no significant difference in mortality between the two groups( RR=1.09,95% CI:0.86-1.39, P=0.48). Meanwhile, the risk of bleeding in warfarin group was higher than that in control group( RR=1.32,95% CI:1.11-1.58, P=0.002). Conclusions:Warfarin has no significant effect on the incidence of stroke and mortality, while it increases the risk of bleeding in AF patients with maintenance hemodialysis So it is not recommended to use warfarin treatment for AF in patients with maintenance hemodialysis.

Objective:To understand the current situation of nurses in 52 hospitals in China on mastery of knowledge about skin injury in the elderly based on the background of mixed-mode homogenization training.Methods:Using the convenient sampling method, a total of 1 067 nurses from 52 hospitals in China were selected as the research objects in January 2021. A self-designed questionnaire on knowledge of skin injury in the elderly was used to investigate the nurses through the questionnaire star and univariate analysis was used to analyze the influencing factors. A total of 1 067 questionnaires were distributed and 1 067 valid questionnaires were recovered, and the effective recovery rate was 100%.Results:The knowledge scores of pressure injury, incontinence-associated dermatitis, skin tear and xerosis cutis among 1067 nurses were (95.66±7.37) , (95.65±9.15) , (91.37±15.45) and (87.67±15.91) , respectively. The results of univariate analysis showed that hospital grade was the influencing factor of nurses' knowledge score of pressure injury, skin tear and incontinence-associated dermatitis ( P<0.05) , educational background was the influencing factor of nurses' knowledge score of skin tear ( P<0.05) , professional title was the influencing factor of nurses' knowledge scores of pressure injury, incontinence-associated dermatitis and xerosis cutis ( P<0.05) . Conclusions:Hospitals at all levels need to strengthen the theoretical and practical knowledge training for nurses on skin xerosis and skin tear in the elderly, especially for nurses with primary titles and lower education in grassroots hospitals.

Objective:To evaluate the safety and efficacy of endoscopic resection in the treatment of patients with primary non-ampullary duodenal early cancer.Methods:A total of 20 cases with primary non-ampullary duodenal early cancer receiving endoscopic resection were collected from Jan 2015 to Dec 2019 at the Department of Endoscopy, the First Affiliated Hospital of Shandong First Medical University.Results:The size of lesions ranged from 0.3-2.5 cm (0.9±0.5)cm.The size of removed membrane samples ranged from 1.5-3.5 cm (2.5±0.7)cm. The edges were all negatiue pathologically. Duodenal perforation occurred in 2 cases, and all were successfully clipped by endoscopy. The follow-up time was from 4-42 months (20.4±11.4)m and no recurrence was found.Conclusion:Endoscopic resection is a safe and effective method for primary non-ampullary duodenal early cancer.

The development of information technology in the medical industry is accelerating the construction of 3-level rehabilitation networks centering on community-based rehabilitation, which is based on the Internet and in combination with the Internet of things(IOT). A municipal rehabilitation hospital cooperated with the health centers of sub-district communities in the city to build a remote rehabilitation network based on IOT technology, for rehabilitation training of community stroke patients. The two sides worked out a cooperation scheme on project management, designed and built a remote community rehabilitation management model. Under the remote monitoring and equipment data IOT, the medical team of the municipal rehabilitation hospital could formulate the therapeutic plan according to the immediately obtained relevant functional evaluation data, and the medical team of the community health service center was responsible for the implementation of the plan. Fifty-three patients in the experimental group received the training of remote lower limb intelligent feedback system based on IOT together with routine rehabilitation training. After 8 weeks of treatment, the functional evaluation data of the two groups were improved in varying degrees( P< 0.05), but the improvement of the experimental group was significantly better than that of the control group( P < 0.05). Remote rehabilitation under the construction path of remote rehabilitation network based on IOT technology could significantly promote the improvement of post-functional rehabilitation of community stroke patients. This study can provide reference for the construction of three-level remote rehabilitation networks based on IOT and the implementation of home-based remote rehabilitation therapy in the future.

Objective:To Clone the silencer sequences of human stimulator of interferon genes (STING) and evaluate its activity in HEK293T and HeLa, and to preliminarily investigate the transcriptional regulatory mechanisms, screening and verifying the possible binding elements for the silencer sequences of STING.Methods:The human STING-5-1a(-124~+ 267, transcription start site, TSS: 0) and STING-5-2a(-124~+ 168) regions were amplified by PCR, subcloned into pGL3-Basic plasmid, and the luciferase activity was detected in HEK293T and HeLa; the human STING silencer region STING-5-1b(+ 169~+ 267) was subcloned into the pGL3-Control plasmid (pGL3-C-5-1b-positive/negative) and STING-5-1b is divided into two complementary elements, subcloned into pGL3-Control vector, named pGL3-C-STING 5-1b-α(+ 169~+ 209) and pGL3-C-STING-5-1b-β(+ 210~+ 267), detecting the relative luciferase activity of the above plasmid in HEK293T and HeLa. Using bioinformatics methods to predict the transcription factor binding site of human STING silencer, make site-directed mutagenesis at the predicted binding site, and detect luciferase activity. Knockdown of THAP1 and TEAD1 by a siRNA strategy and detect the expression level of STING by western blot analysis. Chromosome immunoprecipitation assay further verified the binding of transcription factor to hSTING silencer.Results:It was verified that plasmids mentioned above were constructed correctly by nucleotide sequencing. The relative luciferase increased after truncating the STING-5-1b(+ 169~+ 267) fragment. The relative luciferase activity of pGL3-C-5-1b-positive recombinant plasmid decreased ( P<0.05), compared with pGL3-Control plasmid. Among them, STING-5-1b-β(+ 210~+ 267) fragment play a major inhibitory role. Using bioinformatics software to predict that the transcription factors PR domain zinc finger protein 4 (PRDM4), Thanatos-associated protein 1 (THAP1), TEA Domain Transcription Factor 1 (TEAD1), Nuclear receptor subfamily 4 group A member 1 (NR4A1), Krueppel-like factor 4 (KLF4) and Forkhead box protein O3(FOXO3) may bind to the human STING silencer region (+ 210~+ 267). After transfecting the mutant recombinant plasmid of the transcription factors into HEK293T and HeLa, the relative luciferase activity of THAP1-Mut and TEAD1-Mut were significantly increased, suggesting that STING silencers may contain binding sites of THAP1 and TEAD1. Knockdown of THAP1 and TEAD1 by a siRNA strategy significantly enhanced the transcription activity. Chromosome immunoprecipitation assay showed that the transcription factors TEAD1 and THAP1 combined with hSTING silencer region in the cells. Conclusions:The hSTING silencer luciferase reporter plasmid was successfully constructed. By the activity comparison, it is speculated that the core silencer region of human STING is located in the + 210~+ 267 element, which may contain several potential transcription factor binding sequences.The potential binding sites for transcription factors that may be contained in the DNA, and use Western blot and chromosome immunoprecipitation assays to further confirm the combination of transcription factors TEAD1 and THAP1 with hSTING silencer, laying the foundation for subsequent research.