Objective　To analyse the crude detection rate and trends of newly detected HIV/AIDS cases in medical institutions in China from 2017 to 2023, and to provide a reference for optimizing HIV testing strategies in medical institutions. Methods　Data on HIV testing and newly reported HIV/AIDS cases were analysed using data from the Comprehensive AIDS Prevention and Control Information System of the China Information System for Disease Control and Prevention for the period from 2017 to 2023. HIV testing in medical institutions includes patients tested preoperatively, those tested before transfusion, those tested in sexually transmitted disease (STD) clinics, prenatal care clinics, and other types of patients. Descriptive statistical analysis and χ2 test were performed using SAS 9.4 software. Joinpoint regression was performed using Joinpoint 4.9.0 software to analyse trends of the crude detection rates over time. Results　From 2017 to 2023, the person-times of HIV tests in medical institutions increased from 143 million to 255 million, with an increase of 78.07%. The number of newly detected HIV/AIDS cases increased from 74 000 to 88 000 and then declined to 69 000. The crude detection rate of new HIV/AIDS cases declined from 5.18/10 000 to 2.71/10 000, showed a declining trend, the mean annual percentage change was -9.99%(P<0.001). The crude detection rate of new HIV/AIDS cases in STD clinics was the highest among all types of clinic visits (12.79/10 000-24.47/10 000), and the crude detection rate of new cases among all types of clinic visits showed a decreasing trend(P<0.05). Among different medical institutions, general hospitals were the most important source of the number of tests and the number of newly detected HIV/AIDS cases, accounting for more than 62.93% and 62.68%, respectively. Specialised medical institutions had the highest crude detection rate of new cases, which was maintained at more than 5.13/10 000. The crude detection rate of new cases for all four types of medical institutions, except for primary medical institutions, showed a decreasing trend (P<0.05). Conclusions　The detection rate of new cases in medical institutions showed a decreasing trend in 2017-2023, and the efficiency of STD clinics testing and detection was higher among all types of attendees. General hospitals are the main source of new cases detection, and testing in specialised medical institutions is more efficient. Testing should be strengthened in key groups of patients and in key medical institutions.

Objective: To investigate the current status and influencing factors of overweight and obesity among adults in Jiaxing City, Zhejiang Province, so as to provide a basis for developing targeted weight management measures. Methods: In 2024, a multistage stratified random cluster sampling method was employed to recruit permanent residents aged ≥18 years from Jiaxing City for questionnaire surveys. Data on basic information, lifestyle behaviors, and history of chronic diseases were collected. Height and body weight were measured, and overweight and obesity were determined based on body mass index (BMI). The influencing factors of overweight and obesity among adults were analyzed by a multivariable logistic regression model. Results: Totally 10 509 questionnaires were allocated, and 9 802 valid questionnaires were recovered, with an effective recovery rate of 93.27%. Among the respondents, 4 808 (49.05%) were males and 4 994 (50.95%) were females, with a mean age of (51.27±17.26) years. A total of 4 884 overweight and obesity individuals were identified, with a detection rate of 49.83%. Multivariable logistic regression analysis showed that gender (male, OR=1.719, 95%CI: 1.578-1.873), age (≥60 years, OR=0.802, 95%CI: 0.652-0.986), educational level (bachelor and above, OR=0.640, 95%CI: 0.518-0.791), marital status (being married/cohabiting, OR=1.224, 95%CI: 1.009-1.486), adequate nut intake (OR=0.910, 95%CI: 0.832-0.995), hypertension (OR=2.462, 95%CI: 2.219-2.732), and dyslipidemia (OR=1.629, 95%CI: 1.444-1.837) were statistically associated with overweight and obesity among adults. Conclusion The detected rate of overweight and obesity among adults in Jiaxing City was relatively high, and was mainly associated with gender, age, education level, marital status, nut intake, hypertension, and dyslipidemia.

Objectives:To analyze the impact of the kyphotic apical vertebra(KAV)position on sagittal plane characteristics and quality of life in patients with degenerative kyphosis(DK).Methods:A retrospective analy-sis was conducted on the clinical and imaging data of 68 DK patients hospitalized and treated in the Depart-ment of Orthopedic Surgery,Nanjing Drum Tower Hospital from February 2010 to December 2022.There were 8 males and 60 females,aged 46-76 years old(60.6±6.5 years).The patients were divided into two groups based on the position of the KAV:Group 1(G1)included 38 patients with the KAV at or above L1,and Group 2(G2)included 30 patients with the KAV below L1.The thoracic kyphosis(TK),lumbar lordosis(LL),sagittal vertical axis(SVA),pelvic incidence(PI),pelvic tilt(PT),sacral slope(SS),T1-pelvic angle(TPA),and global kyphosis(GK)were measured on standing full-spine lateral X-rays before operation,and the value of PI-LL was calculated.Health related quality of life(HRQoL)was assessed using the Scoliosis Research So-ciety-22(SRS-22)questionnaire,Oswestry disability index(ODI),visual analog scale(VAS)score,and SF-36 questionnaire.Independent samples t-tests were used to compare sagittal plane parameters and HRQoL scores between the two groups.Pearson correlation analysis was employed to examine the relationship between sagit-tal plane parameters and HRQoL scores.Results:There was no significant difference in the age and sex ra-tios between the two groups(P＞0.05).The GK,LL,TK,SVA,PI,PT,SS,TPA,and PI-LL in G1 group were respectively 61.3°±20.0°,26.9°±18.9°,32.3°±19.0°,53.5±48.1mm,40.4°±13.4°,24.8°±12.6°,17.0°±11.7°,23.0°±13.5°,and 21.6°±15.6°,which in G2 group were 38.8°±16.0°,14.4°±13.7,10.8±9.8°,96.5±67.8mm,44.8°±16.2°,30.1°±10.8°,14.7°±11.5°,32.6°±14.5°,and 33.8°±18.3°.The GK,LL,and TK were significantly greater in G1 group than those in G2 group(P＜0.05),and SVA,TPA,and PI-LL were less in G1 group than those in G2 group(P＜0.05).The VAS score,ODI,SF-36 physical component score(PCS),SF-36 mental com-ponent score(MCS),SRS-22(function,pain,self-image,mental health,subtotal score)in G1 group were 4.2±1.6,(37.9±15.2)％,45.8±11.3,48.6±12.7,and(17.6±4.6,18.6±4.3,17.7±4.5,17.8±4.9,71.7±9.3),which were 5.8±1.7,(48.6±20.0)％,38.2±12.9,44.2±13.1,and(15.6±4.5,16.0±3.6,16.6±4.9,17.1±4.3,65.4±11.1)in G2 group.G1 group was lower in VAS score and ODI significantly(P＜0.05)and higher in SRS-22 subtotal score,SRS-22 pain domain score,and SF-36 PCS significantly(P＜0.05)than G2 group.Pearson correlation analysis showed that SVA was positively correlated with VAS and ODI in both groups(G1 group:r=0.437,P=0.006 and r=0.356,P=0.028;G2 group:r=0.405,P=0.027 and r=0.408,P=0.025),while negatively correlated with SF-36 PCS(G1 group:r=-0.365,P=0.024;G2 group:r=-0.410,P=0.024).TPA was positively correlated with VAS score in both groups(G1 group:r=0.343,P=0.035;G2 group:r=0.369,P=0.045).In G2 group,SVA neg-atively correlated with SRS-22 subtotal score(r=-0.391,P=0.033),and PI-LL was positively correlated with VAS score(r=0.390,P=0.033).Conclusions:The position of KAV affects the pelvic-spinal sagittal alignment obviously in DK patients,and the patients with KAV located below L1 level have significantly higher SVA,TPA,and PI-LL compared to the patients whose KAV located at or above L1 level,which is significantly associated with decreased quality of life.

AIM To rapidly screen xanthine oxidase(XOD)inhibitors from Smilax glabra Roxb.by enzyme-immobilized magnetic microspheres and LC-MS/MS,and to confirm the anti-uric acid constituents from S.glabra Roxb.METHODS The immobilized xanthine oxidase was prepared by covalent coupling with carboxyl magnetic beads as a carrier.The xanthine oxidase inhibitors in S.glabra were screened by the specific adsorption of immobilized enzyme.LC-MS/MS and standard substances were used for analysis and comparison,and the inhibitory activity and inhibition type of the screened and identified components were investigated.RESULTS The successful synthesis of immobilized xanthine oxidase was characterized by scanning electron microscopy and infrared spectroscopy.The enzyme loading was 70.50 μg/mg and the relative activity was 79.44%.Thirteen active compounds were screened from the extract of S.glabra,and eleven compounds were identified.The enzyme activity test showed that the inhibitory activites of engeletin and isoengeletin were the strongest,which was close to the positive control allopurinol.The IC50 value and inhibition type were 32.25 μg/mL,mixed inhibition,35.12 μg/mL,competitive inhibition.CONCLUSION The method is simple,rapid,accurate and suitable for directly screened active ingredients which can inhibit XOD from complex extract of traditional Chinese medicines.

Objective To develop a prediction tool for post-endoscopic retrograde cholangiopancreatography(ER-CP)early biliary tract infection(PEEBI)in patients with choledocholithiasis,and assist clinical decision-making be-fore ERCP and early personalized intervention after ERCP.Methods An observational bidirectional cohort study was adopted to select inpatients with choledocholithiasis who underwent ERCP in a hospital.Directed acyclic graph(DAGs)and the least absolute shrinkage and selection operator(LASSO)were used to predict PEEBI based on lo-gistic regression,and the models were compared and validated internally and externally.Results From January 1,2020 to September 30,2023,a total of 2 121 patients with choledocholithiasis underwent ERCP were enrolled,of whom 77(3.6％)developed PEEBI,mostly in the first 2 days after surgery(66.2％).The major influencing fac-tors for PEEBI were non-iatrogenic patient-related factors,namely diabetes mellitus(OR=2.43,95％CI:1.14-4.85),bile duct malignancy(OR=3.95,95％CI:1.74-8.31)and duodenal papillary diverticulum(OR=4.39,95％CI:1.86-9.52).Compared with the LASSO model,the DAGs model showed higher ability(3.0％)in com-prehensive discrimination(P=0.007),as well as good differentiation performance(D=0.133,P=0.894)and cal-ibration performance(x2=5.499,P=0.703)in external validation.Conclusion The DAGs model constructed in this study has good predictive performance.With the help of this tool,targeted early preventive measures in clinical practice can be taken to reduce the occurrence of PEEBI.

Objective To quantitatively analyze the impact of environmental hygiene on the occurrence of health-care-associated infections(HAI).Methods Monitoring data of HAI and environmental hygiene from a tertiary first-class hospital from January 2018 to December 2022 were collected,and the impact of environmental bacterial colony forming unit(CFU)on the occurrence of HAI was analyzed by a time-series generalized additive model.Results The single-contamination model showed a significant positive correlation between HAI and staff's hand bacterial CFU(β1=0.009,P=0.012).For an increase of 1 interquartile range(IQR)in the monthly mean CFU per dish(MCFU/Dish)of staffs'hand,the incidence of HAI increased by 13.28％(95％CI:2.82％-24.81％).Subgroup and lag effect analysis showed that when the monthly MCFU/Dish(after hand disinfection)of staffs'hand in-creased by one IQR,the excess risk(ER)of HAI for the month(lag0)was 16.26％(95％CI:15.45％-17.09％).In the multi-contamination model,the correlation between surface contamination and HAI was also statistically sig-nificant.Conclusion There is a significant correlation between hospital environmental hygiene and the occurrence of HAI.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

ObjectiveBased on the ultrastructure of enteric nervous system （ENS）-platelet-derived growth factor receptor α positive （PDGFRα⁺） cell - smooth muscle cell （SMC） network， the effect and mechanism of Shuwei Decoction （舒胃汤） for rats with functional dyspepsia （FD） of liver-depression and spleen-deficiency syndrome were explored. MethodsFifty SD rats were divided into blank group， model group， low-， medium- and high-dose Shuwei Decoction groups randomly， with 10 rats in each group. The blank group was not set up， and the other 4 groups were set up with the modified composite cause （chronic restraint stress + tail irritation + excessive fatigue + diet disorder） for 21 days， resulting in FD model rats with liver-depression and spleen-deficiency syndrome. After successful modelling， rats in the low-， medium- and high-dose groups were given 3.78， 7.56 and 15.12 g/（kg·d） of Shuwei Decoction by gavage， respectively， while rats in the blank group and the model group were given 10 ml/（kg·d） of saline by gavage； all of them were given gavage once a day for 14 days. Body mass increase were collected before and after gavage， and compared after the experiment； the elevated cross maze experiment was conducted to observe the percentage of staying time and the percentage of times entering the open arm of rats； the gastric emptying rate and small intestinal propulsion rate were measured by black semi-solid paste； HE staining was used to observe histopathology of the gastric antrum； the Western Blotting and RT-qPCR were used to detect the expression levels of PDGFRα， small conductance calcium activated potassium （SK3）， and purinergic G protein-coupled receptor P2Y1 （P2Y1 R）， and mRNA expression in gastric antrum； immunofluorescence double staining was used to detect the co-localization of PDGFRα with receptor tyrosine kinase （C-kit）， protein gene product 9.5 （PGP9.5）， Sk3， and smooth muscle cells （SMCs） in gastric sinusoidal tissues； and transmission electron microscopy was used to observe the ultrastructure of the ENS-PDGFRα⁺ cell-SMC network. ResultsHE staining results showed that the mucosal folds of gastric tissue were clear in all groups， no organic lesions such as bleeding， ulceration and swelling were observed， and the arrangement of gastric glands in the lamina propria of gastric sinusoidal tissues in model group and low-dose Shuwei Decoction group was disordered. The arrangement of gastric glands in lamina propria in medium- and high-dose Shuwei Decoction groups was more orderly， and the lesion degree was less than that in model group and low-dose Shuwei Decoction group. Compared with the blank group， the growth value of body mass， the percentage of open arm retention time， the percentage of times entering the open arm， the small intestine propulsion rate， and the gastric empty rate of rats in the model group significantly decreased after gavage； the expressions of PDGFRα， Sk3， P2Y1 protein and mRNA in gastric sinusoidal tissues decreased； the co-localization expression of PDGFRα with C-kit， Sk3， SMC and PGP9.5 significantly decreased （P＜0.05 or P＜0.01）； the ultrastructure of ENS-PDGFRα⁺ cell-SMC network was damaged without gap junction. Compared with model group and low-dose Shuwei Decoction group， the growth value of body mass， the percentage of open arm retention time， the percentage of times entering the open arm， the small intestine propulsion rate， and the gastric empting rate of rats in medium- and high-dose Shuwei Decoction groups increased after gavage； the expressions of PDGFRα， Sk3， P2Y1 protein and mRNA in gastric sinusoidal tissues increased； the co-localization expression of PDGFRα with C-kit， Sk3， SMC and PGP9.5 significantly increased （P＜0.05 or P＜0.01）； the ultrastructure of ENS-PDGFRα⁺ cell-SMC network was intact. Compared with medium-dose Shuwei Decoction group， the protein expressions of PDGFRα， Sk3 and P2Y1， the mRNA expressions of PDGFRα and Sk3， and the co-localization expressions of PDGFRα and C-kit， Sk3， SMC， and PGP9.5 in high-dose Shuwei Decoction group increased （P＜0.05 or P＜0.01）. ConclusionShuwei Decoction can improve the pathological lesion of the gastric antrum in the FD model rats with liver-depression and spleen-deficiency syndrome and increase the gastric emptying rate as well as the small intestinal propusion rate. The mechanism of Shuwei Decoction on FD rats with liver-depression and spleen-deficiency syndrome is related to the protection of the ultrastructural integrity of ENS-PDGFRα⁺ cell-SMC network.

Prostate cancer （PCa） is one of the most common malignant tumors in the male genitourinary system. The phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt） signaling pathway is a carcinogenic pathway responsible for the migration， proliferation， and drug resistance of various cancers. In recent years， as the research on the pathogenesis of PCa is deepening， the role of the PI3K/Akt signaling pathway in the development of PCa has attracted much attention. Traditional Chinese medicine， comprehensively regulating multiple components， targets， and pathways， has shown great potential in the treatment of PCa. This article reviews the research progress of traditional Chinese medicine targeting the PI3K/Akt signaling pathway in the treatment of PCa and discusses the expression of the PI3K/Akt signaling pathway in PCa， which involves inhibiting apoptosis of PCa cells， promoting the cell cycle， invasion， and migration of PCa cells， promoting tumor tissue angiogenesis， and mediating the androgen receptor. Additionally， it summarizes the single Chinese medicines that target and regulate this pathway， including Hedyotis diffusa， Taxus chinensis， Bovisc Alculus， and Atractylodis Macrocephalae Rhizoma. The active ingredients of these Chinese medicines mainly include flavonoids， alkaloids， terpenes， polyphenols， lignans， and other compounds. The Chinese medicine compound prescriptions targeting the PI3K/Akt pathway mainly include Wenshen Sanjie prescription， Jianspi Lishi Huayu prescription， Yishen Tonglongtang， Qilan prescription， Xihuangwan， and modified Shenqi Dihuangtang. This review is expected to provide a scientific basis for deeply understanding the pathogenesis of PCa and identifying potential therapeutic targets， as well as to provide new ideas for clinical research and drug development for PCa.

Objective: To evaluate the incidence, treatment, and survival outcomes of Swyer syndrome with gonadal non-dysgerminoma malignant germ cell tumor (MGCT-NDG). Methods: A retrospective study was performed on Swyer syndrome patients with MGCT-NDG between January 2011 and December 2022 in Peking Union Medical College Hospital to investigate their characteristics and outcomes. Results: A total of 15 patients (4.9%, 15/307) with Swyer syndrome were identified in 307 MGCT-NDG patients. The average age at diagnosis of MGCT-NDG and Swyer syndrome were (16.8±6.7) and (16.7±6.6) years, respectively. Six cases were preoperatively diagnosed as Swyer syndrome, of which 4 cases received bilateral gonadectomy with or without hysterectomy, while the other 2 cases underwent removal of gonadal tumor and unilateral gonadectomy with hysterectomy, respectively. Of the 9 patients postoperatively diagnosed as Swyer syndrome, unilateral gonadectomy, removal of gonadal tumor, and unilateral gonadectomy with hysterectomy were performed in 6 patients, 2 patients, and 1 patient, respectively. Mixed malignant germ cell tumor (MGCT;10 cases), yolk sac tumor (4 cases), and immature teratoma (1 case) were the pathological subtypes, in the descending order. There were International Federation of Gynecology and Obstetrics (FIGO) stage Ⅰ in 6 cases, stage Ⅱ in 3 cases, stage Ⅲ in 5 cases, and stage Ⅳ in 1 case, respectively. Eleven patients received reoperation for residual gonadectomy after a average delay of (7.9±6.2) months, including 8 MGCT-NDG patients and 1 gonadoblastoma patient, no tumor involved was seen in the remaining gonads in the other 2 cases. Ten patients experienced at least one recurrence, with a median event free survival of 9 months (5, 30 months), of which 2 patients received surgery only at the time of initial treatment. All patients with recurrence received surgery and combined with postoperative chemotherapy. After a median follow-up of 25 months (15, 42 months), 10 patients were disease-free, 3 patients died of the tumor, 1 died of side effects of leukemia chemotherapy, and 1 survived with disease. Conclusion: The incidence rate of Swyer syndrome in patients with MGCT-NDG is about 4.9%; timely diagnosis and bilateral gonadectomy should be emphasized to reduce the risk of reoperation and second carcinogenesis in this population.
Female ; Humans ; Retrospective Studies ; Gonadal Dysgenesis, 46,XY/surgery* ; Gonadoblastoma/surgery* ; Neoplasms, Germ Cell and Embryonal/surgery* ; Ovarian Neoplasms/pathology*