Objective: To explore the factors affecting the prevalence of HIV-associated neurocognitive disorders (HAND) among HIV/AIDS patients, so as to provide insights into developing HAND prevention measures. Methods: HIV/AIDS patients aged 18 years and above in the Infection Department of Nanjing Second Hospital were selected.Demographic data, treatment regimen and blood biochemical indicators were collected. Depression was evaluated using Patient Health Questionnaire Depression Scale, frailty was evaluated using Chinese version of Tilburg Frailty Indicator, and HAND was evaluated by Montreal Cognitive Assessment Scale. Factors affecting HAND were analyzed using a multivariable logistic regression model. Results: Totally 440 questionnaires were allocated and 426 valid questionnaires were recovered, with an effective rate of 96.82%. The median age of patients investigated was 33.00 (interquartile range, 10.00) year. There were 407 males, accounting for 95.54%; 232 patients with bachelor degree or above, accounting for 54.46%; 171 patients with HAND, accounting for 40.14%. Multivariable logistic regression analysis showed that educational level (bachelor degree or above, OR=0.291, 95%CI: 0.157-0.541), depression (OR=2.499, 95%CI: 1.530-4.083), frailty (OR=2.121, 95%CI: 1.307-3.441) and treatment regimen including efavirenz (OR=2.223, 95%CI: 1.367-3.615) were the influencing factors for HAND among HIV/AIDS patients. Conclusion Educational level, depression, frailty and use of efavirenz may be associated with HAND risk.

Objective:To explore the effects of hyperbaric oxygen treatment on the serum chemokines and immune T cells in the patients with bronchial asthma, and to analyze the correlation between the treatment and the activity of cytochrome oxidase (COX).Methods:A total of 96 patients with bronchial asthma treated from January 2017 to December 2018 were selected as the research subjects, and were randomly divided into control group and observation group ( n=48). The control group was given the conventional treatment, while the observation group was additionally treated with the hyperbaric oxygen therapy. The changes of serum chemokines and the changes of Th1 and Th2 (subsets of CD 4+ T cells) in the two groups were compared before and after the treatment. The correlation between the hyperbaric oxygen therapy and the COX activity was also analyzed. Results:In the observation group, 38 cases were markedly improved, while only 27 cases in the control group were markedly improved. And the total effective rate of the observation group (95.83%) was significantly higher than that of the control group (85.42%) ( P<0.05). After the treatment, the partial pressure of oxygen (PaO 2), FEV1, FEV1/FVC of the patients in the observation group were significantly increased as compared with those in the control group with statistically significant differences ( P<0.05). The serum eotaxin and monocyte chemoattractant protein-1 (MCP-1) in both two groups after treatment were significantly decreased as compared with those before the treatment, and the serum chemokines of the observation group were sharply reduced compared with that of the control group ( P<0.05). After the treatment, the Th1 in the peripheral blood and the ratio of Th1/Th2 of patients in the two groups increased significantly, while the Th2 decreased significantly. Moreover, the distribution of immune T cell subgroups in the observation group was better than that in the control group. According to person correlation analysis, the levels of eotaxin, MCP-1, and Th2 were negatively correlated with COX activity ( r=-0.635, P=0.004; r=-0.673, P=0.002; r=-0.737, P<0.001), while the Th1 was positively correlated with COX activity ( r=0.684, P=0.001). Conclusion:Hyperbaric oxygen therapy can strengthen the immune function of the patients with bronchial asthma and improve the prognosis by enhancing COX activity and active aerobic metabolism, thus reducing the expression of serum chemokines.

Objective:To explore the effects of hyperbaric oxygen treatment on the serum chemokines and immune T cells in the patients with bronchial asthma, and to analyze the correlation between the treatment and the activity of cytochrome oxidase (COX).Methods:A total of 96 patients with bronchial asthma treated from January 2017 to December 2018 were selected as the research subjects, and were randomly divided into control group and observation group ( n=48). The control group was given the conventional treatment, while the observation group was additionally treated with the hyperbaric oxygen therapy. The changes of serum chemokines and the changes of Th1 and Th2 (subsets of CD 4+ T cells) in the two groups were compared before and after the treatment. The correlation between the hyperbaric oxygen therapy and the COX activity was also analyzed. Results:In the observation group, 38 cases were markedly improved, while only 27 cases in the control group were markedly improved. And the total effective rate of the observation group (95.83%) was significantly higher than that of the control group (85.42%) ( P<0.05). After the treatment, the partial pressure of oxygen (PaO 2), FEV1, FEV1/FVC of the patients in the observation group were significantly increased as compared with those in the control group with statistically significant differences ( P<0.05). The serum eotaxin and monocyte chemoattractant protein-1 (MCP-1) in both two groups after treatment were significantly decreased as compared with those before the treatment, and the serum chemokines of the observation group were sharply reduced compared with that of the control group ( P<0.05). After the treatment, the Th1 in the peripheral blood and the ratio of Th1/Th2 of patients in the two groups increased significantly, while the Th2 decreased significantly. Moreover, the distribution of immune T cell subgroups in the observation group was better than that in the control group. According to person correlation analysis, the levels of eotaxin, MCP-1, and Th2 were negatively correlated with COX activity ( r=-0.635, P=0.004; r=-0.673, P=0.002; r=-0.737, P<0.001), while the Th1 was positively correlated with COX activity ( r=0.684, P=0.001). Conclusion:Hyperbaric oxygen therapy can strengthen the immune function of the patients with bronchial asthma and improve the prognosis by enhancing COX activity and active aerobic metabolism, thus reducing the expression of serum chemokines.

Objective To study the distribution of the regions of ultrasound-guided erector spinae plane block (ESPB) at the level of T5 transverse process.Methods Thirty male patients,aged 18-64 yr,with body mass index of 18-24 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective thoracotomy,were enrolled in this study.ESPB was conducted with 0.5％ ropivacaine hydrochloride 0.4 ml/kg at the level of T5 transverse process under ultrasound guidance before induction of general anesthesia.Blocks in each thorax and back region (the left side of the body was divided into 18 different regions based on the anatomical "landmarks" on the body surface,No.1-18) were assessed by cold stimulation.Effective block in each region was recorded at 10,15,20,25,30,40 and 50 min after administration.The adverse reactions such as pneumothorax,puncture hematoma and local anesthetic intoxication were recorded.Results The blocking range was basically fixed at 30 min after a single ESPB injection at the level of T5 transverse process,and the regions covered from the sternal angle to the level of the rib arch.The regions of effective block were No.1-3 and 5-7 in ≥95％ patients,and the regions of effective block were No.1-15 and 17 in patients ≥90％ and ＜ 95％.No patients developed adverse reactions such as pneumothorax,puncture hematoma or local anesthetic intoxication.Conclusion The regions of effective ultrasound-guided ESPB at the level of T5 transverse process are mainly distributed in T2-T8 thoracodorsal skin areas.

Diabetes mellitus is a chronic disease, it is thus necessary for its patients to participate in its treatment and self-management. The emerging foreign and domestic methods for self-management of diabetes mellitus pa-tients were detected on different Websites and suggestions were proposed for its treatment and self-management in order to improve the quality of life in diabetes mellitus patients.

Objectives To investigate the ameliorative effect of cannabinoid 2 receptor(CB2R)agonist JWH-015 on the cog-nitive impairment of Alzheimer' s disease(AD)model mice and to assess the correlation with microglial phenotype transformation. Methods Twenty adult male C57BL/6J mice were randomly divided into four groups:C57BL/6J solvent group,JWH-015 control group,AD model group,and AD model treated with JWH-015 group. Amyloidβ1-42 oligomers of 4μg and the same volume of saline were intraventricularly administered to construct the AD mouse model and the solvent groups. CB2R agonist JWH-015 or the corre-sponding vehicle at a dose of 0.5 mg/(kg·d)was administered by intraperitoneal injection for 3 weeks. Non-spatial learning and memo-ry was measured using novel object recognition task. Furthermore,the mRNA expression levels of M1 microglia marker inducible ni-tric oxide synthase(iNOS)and M2 microglia marker chitinase-3 like protein(Ym1/2)in brain samples of cortex and hippocampus were evaluated using real-time quantitative PCR(qPCR). In the meantime,fifteen CB2R knockout(CB2RKO)mice and five CB2R wild-type(CB2RWT)littermates were assigned to identify the specificity of CB2R in the research. Based on the genotype and different treatment,the animals were divided into four groups:CB2RKO solvent group,CB2RKO AD model group,CB2RKO AD model treat-ed with JWH-015 group and CB2RWT solvent group. Results Compared with solvent group,there was a significant decrease in nov-el object recognition index in C57BL/6J AD model group(P<0.01). The mRNA expression levels of M1 phenotype microglia marker iNOS in cortex and hippocampus were significantly up-regulated(both P<0.05)and the mRNA expression levels of M2 phenotype mi-croglia marker Ym1/2 were significantly down-regulated(both P<0.01). Interestingly,administration of JWH-015 could reverse the impairment of novel object recognition index(P<0.05);compared with C57BL/6J AD model group,administration of JWH-015 also decreased the iNOS mRNA expression levels(both P<0.05)and increased the Ym1/2 mRNA expression levels(both P<0.05)in cortex and hippocampus;compared with CB2RKO solvent group,the novel object recognition index of CB2RKO AD model group was decreased(P<0.05);the mRNA expression levels of iNOS in cortex and hippocampus were significantly up-regulated(both P<0.05),the mRNA expression level of Ym1/2 in cortex was significantly down-regulated in cortex(P<0.05);compared with CB2RKO AD model group,administration of JWH-015 had no effect on novel object recognition index and the mRNA expression level of M1/M2 in cortex and hippocampus,respectively. Conclusion JWH-015 improves the cognitive impairment of Aβ-induced AD mice by the specific activation of CB2R,the mechanism of which is related to the direct regulation of CB2R on the M1/M2 microglial phenotype transformation and microglia-mediated neuroinflammation in brain.

By using the software CiteSpace Ⅱ,the paper makes a quantitative analysis and interpretation of research literatures on telemedicine in SCIE of Web of Science from three perspectives,namely the research hotspots,knowledge base and research fronts.The research hotspots of telemedicine mainly include tele-diagnosis,tele-monitoring and evaluation of the application effects of telemedicine.It sets forth key literatures representing the knowledge base one by one and reveals that most of them focus on clinical applications.The analysis of burst terms indicates that more attention has been paid to tele-monitoring and distance education of chronic diseases in recent years and mobile technology is one of the greatest driving forces for the development of telemedicine at the present stage.