ObjectiveTo assess the cost-effectiveness of human immunodeficiency virus (HIV) prevention and control strategies across different high-risk populations, investment levels, and allocation proportions in an area, thereby providing a reference for optimizing resource allocation in acquired immunodeficiency syndrome (AIDS) prevention and control. MethodsDemographic, epidemiological, and clinical progression data of the target population in an area from 2018 to 2024 were collected, along with the input costs and intervention coverage of HIV-related projects. The Optima HIV model was utilized to perform fitting and prediction, whereby the allocation of resources to optimized target populations and program interventions was modeled under varying future investment scenarios to predict the impacts on the reduction of new HIV infections and HIV-related deaths. ResultsUnder the scenario of maintaining the current level of intervention input for HIV key populations, new HIV infections and related deaths in the region were predicted to be controlled at a low level by 2030. In terms of intervention input for HIV key populations, it is suggested that appropriately increasing the intervention input for key HIV populations will further reduce new HIV infections and HIV-related deaths in the region. However, when the total input increases to 1.75 times the baseline level, the marginal effect of input will be saturated. Regarding structural adjustments in investment and considering both the current total investment scenario and 1.75 times the total investment scenario, it is predicted that further reductions in regional HIV new infections and HIV-related deaths can be achieved, provided that the intervention input for key populations (including men who have sex with men, MSM) is increased, while concurrently intensifying the proportion of intervention measures such as condom promotion to form optimized intervention portfolios. ConclusionIn the field of HIV/ AIDS prevention and control, sustained commitment to intervention investment, with a strategic focus on interventions for key populations and intensified implementation of critical intervention measures, will effectively improve the epidemiological impacts of HIV/AIDS prevention and control efforts.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

As China accelerates its efforts in deep space exploration and long-duration space missions, including the operationalization of the Tiangong Space Station and the development of manned lunar missions, safeguarding astronauts’ physiological and cognitive functions under extreme space conditions becomes a pressing scientific imperative. Among the multifactorial stressors of spaceflight, microgravity emerges as a particularly potent disruptor of neurobehavioral homeostasis. Dopamine (DA) plays a central role in regulating behavior under space microgravity by influencing reward processing, motivation, executive function and sensorimotor integration. Changes in gravity disrupt dopaminergic signaling at multiple levels, leading to impairments in motor coordination, cognitive flexibility, and emotional stability. Microgravity exposure induces a cascade of neurobiological changes that challenge dopaminergic stability at multiple levels: from the transcriptional regulation of DA synthesis enzymes and the excitability of DA neurons, to receptor distribution dynamics and the efficiency of downstream signaling pathways. These changes involve downregulation of tyrosine hydroxylase in the substantia nigra, reduced phosphorylation of DA receptors, and alterations in vesicular monoamine transporter expression, all of which compromise synaptic DA availability. Experimental findings from space analog studies and simulated microgravity models suggest that gravitational unloading alters striatal and mesocorticolimbic DA circuitry, resulting in diminished motor coordination, impaired vestibular compensation, and decreased cognitive flexibility. These alterations not only compromise astronauts’ operational performance but also elevate the risk of mood disturbances and motivational deficits during prolonged missions. The review systematically synthesizes current findings across multiple domains: molecular neurobiology, behavioral neuroscience, and gravitational physiology. It highlights that maintaining DA homeostasis is pivotal in preserving neuroplasticity, particularly within brain regions critical to adaptation, such as the basal ganglia, prefrontal cortex, and cerebellum. The paper also discusses the dual-edged nature of DA plasticity: while adaptive remodeling of synapses and receptor sensitivity can serve as compensatory mechanisms under stress, chronic dopaminergic imbalance may lead to maladaptive outcomes, such as cognitive rigidity and motor dysregulation. Furthermore, we propose a conceptual framework that integrates homeostatic neuroregulation with the demands of space environmental adaptation. By drawing from interdisciplinary research, the review underscores the potential of multiple intervention strategies including pharmacological treatment, nutritional support, neural stimulation techniques, and most importantly, structured physical exercise. Recent rodent studies demonstrate that treadmill exercise upregulates DA transporter expression in the dorsal striatum, enhances tyrosine hydroxylase activity, and increases DA release during cognitive tasks, indicating both protective and restorative effects on dopaminergic networks. Thus, exercise is highlighted as a key approach because of its sustained effects on DA production, receptor function, and brain plasticity, making it a strong candidate for developing effective measures to support astronauts in maintaining cognitive and emotional stability during space missions. In conclusion, the paper not only underscores the centrality of DA homeostasis in space neuroscience but also reflects the authors’ broader academic viewpoint: understanding the neurochemical substrates of behavior under microgravity is fundamental to both space health and terrestrial neuroscience. By bridging basic neurobiology with applied space medicine, this work contributes to the emerging field of gravitational neurobiology and provides a foundation for future research into individualized performance optimization in extreme environments.

Postoperative infection of internal fixation of closed fractures the lower limbs in adults represents a devastating complication, characterized by diagnostic challenges, prolonged treatment duration and high disability rates. Current management of these infections faces multiple challenges, such as difficulties in early accurate diagnosis, and various controversies about the treatment plan, leading to poor overall diagnosis and treatment results. To address these issues, based on evidence-based medicine and principles with emphasis on scientific rigor, clinical applicability and innovation, the Trauma Branch of the Chinese Medical Association, Orthopedic Branch of the Chinese Medical Doctor Association, Orthopedics Branch of the Chinese Medical Association, and Trauma Orthopedics and Polytrauma Group of the Resuscitation and Emergency Committee of the Chinese Medical Doctor Association have collaboratively organized a panel of relevant experts to develop the Guideline for diagnosis and treatment of infection after internal fixation of closed lower limb fractures in adults ( version 2025). The guideline proposed 10 recommendations, aiming to provide a foundation for standardized diagnosis and treatment of postoperative infection in adults with closed lower limb fractures.

Objective To explore the clinical characteristics and CT features of malignant ovarian germ cell tumor(MOGCT)in children.Methods The CT image features and clinical characteristics of 27 cases of MOGCT confirmed by postoperative pathology were retrospectively analyzed.Results There were 6 cases of dysgerminoma(DG)(22.2%).The CT features were solid soft tissue masses with mild to moderate enhancement,"separate-like"enhancement within the mass,and thickened blood vessels around it.There were 8 cases of immature teratoma(IT)(29.7%).The CT features were mixed-density masses with soft tissue,fat,and calcifi-cation inside,and the solid part was significantly enhanced.There were 7 cases of yolk sac tumor(YST)(25.9%).The CT features were significantly enhanced,tortuous small blood vessels inside the mass,presenting a"bright spot sign".There were 3 cases of non-gestational choriocarcinoma(11.1%).The CT features were a low-density mass with large central necrosis,obvious enhance-ment after contrast,and thickened ovarian arteries and veins around it.There were 3 cases of mixed germ cell tumor(MGCT)(11.1%).The CT features were related to the tumor components.Conclusion MOGCT in children have their own CT characteristics.Combi-ning with the clinical manifestations of the children and serum tumor markers,qualitative diagnosis of the lesions can be made,which provides reliable help for the formulation of clinical diagnosis and treatment plans.

Objective To explore the CT features of pediatric pleuropulmonary blastoma(PPB)and its clinical application value.Methods The CT features of 9 patients with PPB confirmed by postoperative pathology were analyzed retrospectively and compared with the postoperative pathological types.Results There was 1 case with type Ⅰ PPB,whose CT manifestations were multilocular septated cystic space-occupying lesions,with mild enhancement of the cyst wall and septum after enhancement,and was misdiagnosed as type Ⅳ congenital pulmonary airway malformation(CPAM)before surgery.There were 2 cases with type Ⅱ PPB,whose CT manifestations were well-defined cystic and solid space-occupying lesions,closely related to the pleura,with uneven mild to moderate progressive enhancement of the solid components,and multiple thickened and tortuous blood vessels were visible in both lesions.The preoperative imaging diagnosis and pathological type prediction of type Ⅱ PPB,lesions were completely consistent with the post-operative pathological diagnosis and type,with a diagnostic accuracy of 100％.There were 6 cases with type Ⅲ PPB,whose CT man-ifestations were solid soft tissue density space-occupying lesions,with uneven enhancement of the solid part after enhancement,and multiple thickened and tortuous blood vessels within the masses.Before surgery,2 cases(33.3％)with type Ⅲ PPB were misdiag-nosed as Askin tumors of the chest wall,and the diagnostic accuracy was 66.7％.Conclusion PPB is a rare tumor in the chest of children,with high malignancy.Type Ⅰ PPB is difficult to be differentiated from benign cystic lesions of the chest before surgery.For suspected type Ⅰ PPB pulmonary cystic lesions,the postoperative pathological sampling should be extensive to search for whether there are primitive mesenchymal cells for a clear diagnosis.The CT features of type Ⅱ and Ⅲ PPB are cystic-solid and solid masses in the chest,with clear boundaries,pseudocapsules,and nodular enhancement.Generally,the consistency rate between preoperative imaging diagnosis and pathological type prediction and postoperative pathological diagnosis and type is relatively high.Combining the CT characteristics of PPB is helpful to improve the accuracy of preoperative diagnosis and pathological type prediction,and can assist clinicians in selecting reasonable treatment plans.

Objective To explore the CT features of pediatric pleuropulmonary blastoma(PPB)and its clinical application value.Methods The CT features of 9 patients with PPB confirmed by postoperative pathology were analyzed retrospectively and compared with the postoperative pathological types.Results There was 1 case with type Ⅰ PPB,whose CT manifestations were multilocular septated cystic space-occupying lesions,with mild enhancement of the cyst wall and septum after enhancement,and was misdiagnosed as type Ⅳ congenital pulmonary airway malformation(CPAM)before surgery.There were 2 cases with type Ⅱ PPB,whose CT manifestations were well-defined cystic and solid space-occupying lesions,closely related to the pleura,with uneven mild to moderate progressive enhancement of the solid components,and multiple thickened and tortuous blood vessels were visible in both lesions.The preoperative imaging diagnosis and pathological type prediction of type Ⅱ PPB,lesions were completely consistent with the post-operative pathological diagnosis and type,with a diagnostic accuracy of 100％.There were 6 cases with type Ⅲ PPB,whose CT man-ifestations were solid soft tissue density space-occupying lesions,with uneven enhancement of the solid part after enhancement,and multiple thickened and tortuous blood vessels within the masses.Before surgery,2 cases(33.3％)with type Ⅲ PPB were misdiag-nosed as Askin tumors of the chest wall,and the diagnostic accuracy was 66.7％.Conclusion PPB is a rare tumor in the chest of children,with high malignancy.Type Ⅰ PPB is difficult to be differentiated from benign cystic lesions of the chest before surgery.For suspected type Ⅰ PPB pulmonary cystic lesions,the postoperative pathological sampling should be extensive to search for whether there are primitive mesenchymal cells for a clear diagnosis.The CT features of type Ⅱ and Ⅲ PPB are cystic-solid and solid masses in the chest,with clear boundaries,pseudocapsules,and nodular enhancement.Generally,the consistency rate between preoperative imaging diagnosis and pathological type prediction and postoperative pathological diagnosis and type is relatively high.Combining the CT characteristics of PPB is helpful to improve the accuracy of preoperative diagnosis and pathological type prediction,and can assist clinicians in selecting reasonable treatment plans.

Objective To explore the clinical characteristics and CT features of malignant ovarian germ cell tumor(MOGCT)in children.Methods The CT image features and clinical characteristics of 27 cases of MOGCT confirmed by postoperative pathology were retrospectively analyzed.Results There were 6 cases of dysgerminoma(DG)(22.2%).The CT features were solid soft tissue masses with mild to moderate enhancement,"separate-like"enhancement within the mass,and thickened blood vessels around it.There were 8 cases of immature teratoma(IT)(29.7%).The CT features were mixed-density masses with soft tissue,fat,and calcifi-cation inside,and the solid part was significantly enhanced.There were 7 cases of yolk sac tumor(YST)(25.9%).The CT features were significantly enhanced,tortuous small blood vessels inside the mass,presenting a"bright spot sign".There were 3 cases of non-gestational choriocarcinoma(11.1%).The CT features were a low-density mass with large central necrosis,obvious enhance-ment after contrast,and thickened ovarian arteries and veins around it.There were 3 cases of mixed germ cell tumor(MGCT)(11.1%).The CT features were related to the tumor components.Conclusion MOGCT in children have their own CT characteristics.Combi-ning with the clinical manifestations of the children and serum tumor markers,qualitative diagnosis of the lesions can be made,which provides reliable help for the formulation of clinical diagnosis and treatment plans.

Postoperative infection of internal fixation of closed fractures the lower limbs in adults represents a devastating complication, characterized by diagnostic challenges, prolonged treatment duration and high disability rates. Current management of these infections faces multiple challenges, such as difficulties in early accurate diagnosis, and various controversies about the treatment plan, leading to poor overall diagnosis and treatment results. To address these issues, based on evidence-based medicine and principles with emphasis on scientific rigor, clinical applicability and innovation, the Trauma Branch of the Chinese Medical Association, Orthopedic Branch of the Chinese Medical Doctor Association, Orthopedics Branch of the Chinese Medical Association, and Trauma Orthopedics and Polytrauma Group of the Resuscitation and Emergency Committee of the Chinese Medical Doctor Association have collaboratively organized a panel of relevant experts to develop the Guideline for diagnosis and treatment of infection after internal fixation of closed lower limb fractures in adults ( version 2025). The guideline proposed 10 recommendations, aiming to provide a foundation for standardized diagnosis and treatment of postoperative infection in adults with closed lower limb fractures.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.