Objective To investigate the effects and mechanism of Yanghe Decoction containing serum on the migration and invasion of BT-549 cells intervened by conditioned medium of cancer-associated adipocytes(CAAcm)based on the JAK2/STAT3 signaling pathway.Methods 3T3-L1 mouse embryonic fibroblasts were induced to differentiate into mature adipocytes using adipogenic induction medium.Yanghe Decoction containing serum was prepared from SD rats.BT-549 cells were co-cultured with mature adipocytes to obtain CAAcm.Transwell assay was used to detect the migration and invasion ability of BT-549 cells before and after intervention with CAAcm.BT-549 cells after CAAcm intervention were divided into blank serum group,positive drug group and Yanghe Decoction low-,medium-and high-dosage groups,and cultured with 10%corresponding serum.Cell proliferation was assessed using the CCK-8 assay,scratch assay was performed to evaluate the lateral migration of BT-549 cells,Transwell assay was conducted to evaluate the vertical migration and invasion ability of BT-549 cells,Western blot was performed to detect the expressions of proteins including JAK2,STAT3,VEGF and HIF-1α.Results CAAcm intervention had a promoting effect on the migration and invasion of BT-549 cells.Compared with the blank serum group,the growth inhibition rate of BT-549 cells significantly increased in Yanghe Decoction low-,medium-and high-dosage groups(P<0.05,P<0.01),the scratch healing rate was significantly decreased(P<0.05,P<0.01),the number of migrating cells and invading cells significantly reduced(P<0.01),and the expressions of JAK2,STAT3,VEGF and HIF-1α proteins significantly decreased(P<0.05,P<0.01).Conclusion Yanghe Decoction containing serum can inhibit the proliferation,migration and invasion of BT-549 cells intervened by CAAcm,and the mechanism may be related to the inhibition of JAK2,STAT3,VEGF and HIF-1α protein expressions.

Objective To investigate the effects and mechanism of Yanghe Decoction containing serum on the migration and invasion of BT-549 cells intervened by conditioned medium of cancer-associated adipocytes(CAAcm)based on the JAK2/STAT3 signaling pathway.Methods 3T3-L1 mouse embryonic fibroblasts were induced to differentiate into mature adipocytes using adipogenic induction medium.Yanghe Decoction containing serum was prepared from SD rats.BT-549 cells were co-cultured with mature adipocytes to obtain CAAcm.Transwell assay was used to detect the migration and invasion ability of BT-549 cells before and after intervention with CAAcm.BT-549 cells after CAAcm intervention were divided into blank serum group,positive drug group and Yanghe Decoction low-,medium-and high-dosage groups,and cultured with 10%corresponding serum.Cell proliferation was assessed using the CCK-8 assay,scratch assay was performed to evaluate the lateral migration of BT-549 cells,Transwell assay was conducted to evaluate the vertical migration and invasion ability of BT-549 cells,Western blot was performed to detect the expressions of proteins including JAK2,STAT3,VEGF and HIF-1α.Results CAAcm intervention had a promoting effect on the migration and invasion of BT-549 cells.Compared with the blank serum group,the growth inhibition rate of BT-549 cells significantly increased in Yanghe Decoction low-,medium-and high-dosage groups(P<0.05,P<0.01),the scratch healing rate was significantly decreased(P<0.05,P<0.01),the number of migrating cells and invading cells significantly reduced(P<0.01),and the expressions of JAK2,STAT3,VEGF and HIF-1α proteins significantly decreased(P<0.05,P<0.01).Conclusion Yanghe Decoction containing serum can inhibit the proliferation,migration and invasion of BT-549 cells intervened by CAAcm,and the mechanism may be related to the inhibition of JAK2,STAT3,VEGF and HIF-1α protein expressions.

To explore the effect of doctor-patient relationship perception on work performance among medical staff in public hospitals and its mechanism. The convenient sampling method was used to select 380 medical staff working in four public tertiary hospitals in Sichuan Province, Zhejiang Province, and Fujian Province from August 2022 to October 2022 as the research objects, and the General Information Questionnaire, Doctor-Patient Relationship Scale, General Self-Efficacy Scale, Perceived Organizational Support Scale, Work Performance Questionnaire were used. This paper showed that the doctor-patient relationship perception of medical staff was negatively correlated with self-efficacy (r=-0.392, P<0.01) and work performance (r=-0.286, P<0.01), self-efficacy was positively correlated with perceived organizational support (r=0.538, P<0.01) and work performance (r=0.507, P<0.01), perceived organizational support was positively correlated with work performance (r=0.510, P<0.01). Self-efficacy played a partial mediating role between doctor-patient relationship perception and work performance, and its effect value was -0.241, accounting for 64.78% of the total effect. Perceived organizational support weakened the negative predictive effect of doctor-patient relationship perception on self-efficacy, which moderates the first half path of the mediating model that doctor-patient relationship perception affects work performance through self-efficacy. It indicated that the doctor-patient relationship perceived by medical staff in public hospitals is poor. Measures should be taken from the aspects of policy support, hospital and society levels to alleviate the doctor-patient relationship, play the mediating role of self-efficacy and the moderating role of organizational support, minimize the negative impact of doctor-patient relationship on the work performance among medical staff, and improve the work performance of medical staff, so as to improve the overall quality of medical services.

Objective To analyze the survival rate of HIV /AIDS patients receiving highly active antiretroviral therapy(HAART)since the implementation of the national Four Free and One Carepolicy against HIV in Hangzhou.Methods Clinical data of 2370 AIDS patients were collected from National AIDS Comprehensive Treatment Information System Treatment Library from 2004 to 2014.The data, including basic information,viral load,CD4 +T lymphocyte counts,starting time of treatment,WHO clinical stage,infection pathways and follow-up were respectively analyzed.Kaplan-Meier and Cox proportional hazards models were used to analyze the survival rate and the factors affecting survival.Results The total follow-up time was 3968.14 person years and 57 patients died in 2370 patients with a mortality rate of 1 .44 /100 person years (57 /3968.14).Kaplan-Meier method showed that the cumulative survival rates of the first,third and fifth year were 98.08%,96.20% and 95.24%,respectively.The overall mortality rate fell from 6.06 /100 person years in 2006 to 1 .44 /100 person years in 2014.The mortality rate of AIDS-related disease declined from 1 .10 /100 person years in 2009 to 0.90 /100 person years in 2014.Multivariate Cox regression analysis showed that the risk of death for patients with CD4 +T 200-349 cells/μL was 0.466 times(95%CI 0.246-0.882)as that for patients with CD4 +T cells <200 /μL.The risk of death was 3.408 times(95%CI 1 .365-8.506)in patients aged≥ 50 years,3.788 times(95%CI 1 .645-8.718)in patients aged 40 to <50 years,and 2.593 times(95%CI 1 .139-5.905)in patients aged 30 to 40 years as that in patients aged <30 years.The mortality risk for patients with baseline WHO stage Ⅲ and Ⅳ was 1 .960 times as patients with WHO stage Ⅰ and Ⅱ (95% CI 1 .117-3.439 ).Conclusions Patients with increased age,low CD4 +T counts and baseline WHO stage Ⅲ or Ⅳ are main risk factors affecting survival rate of HIV /AIDS patients,early antiviral therapy is the key for improving the survival rate of patients.

OBJECTIVETo understand the syphilis infection and its high risk factors among men who have sex with men (MSM) recruited from different channels.

METHODSSupported by the China-Gates Foundation HIV program from July to December 2011, we cooperated with community based organizations to conduct syphilis testing intervention among MSM from 14 cities (Beijing, Shanghai, Tianjin, Chongqing, Harbin, Shenyang, Qingdao, Xi'an, Nanjing, Wuhan, Hangzhou, Changsha, Kunming, and Guangzhou) and one province (Hainan province). Participants were recruited from different channels by the staff of local CBOs, Demographic (e.g. age, marital status, and education) and behavioral (e.g. condom use and sexual partners) data were collected using anonymous questionnaires. Blood samples were also collected to test for syphilis. A total of 34 100 MSM participated in the survey. Participants were excluded from data analysis (1 399, 4.1%) if they did not receive syphilis tests or they completed less than 80.00% of the key questions in the survey. Chi-square tests were used to understand the socio-demographic and behavioral differences between each group. Results of syphilis tests were also compared. Logistic regression models were used to test the statistical significance of these differences.

RESULTSA total of 32 701 MSM were enrolled and received syphilis testing. The average age of participates was 30.96 ± 9.57. And among them, 2 284 cases (7.0%) were recruited from gay bathhouses, 4 774 (14.6%) from gay bars, 6 266 (19.2%) from the internet, 1 997 (6.1%) from the parks/toilets and 17 380 (53.1%) from other channels. MSM recruited from the bathhouses had the highest syphilis infection rate than other 4 groups: gaybars (4.5%, 216/4 774), internet (6.7%, 422/6 266), parks/toilets (8.3%, 166/1 997), other channels (6.4%, 1 103/17 380) (χ² = 164.58, P < 0.001). The multivariate logistic regression analysis showed that being > 20 years of age (P < 0.001), having more than 2 homosexual partners in recent 3 months (8.0% (1 408/17 714), OR (95% CI) = 1.44 (1.04-1.98)), having no sex with females in past 3 months (6.8% (1 446/21 276), OR (95% CI) = 1.25 (1.07-1.46)), and not using condom at last anal sex (8.0% (769/9 668), OR (95% CI) = 1.13 (1.03-1.25)) were associated with a higher probability of being infected with syphilis. Whereas MSM married (7.2% (456/6 305), OR (95% CI) = 0.84 (0.73-0.98)), having a college or a higher education (5.3% (829/15 684), OR (95% CI) = 0.60 (0.53-0.67)), being local residents (6.5% (1 843/28 185), OR (95% CI) = 0.73 (0.61-0.87)) and living in the local province of project cities (6.6% (170/2 593), OR (95% CI) = 0.67 (0.53-0.85)) were protective factors.

CONCLUSIONMSM who were recruited from gay bathhouses have a higher rate of syphilis infection than those in channels relatively. They are older, with low education levels and high-risk sexual behaviors. Tailored interventions are required in the future, especially for MSM from gay bathhouses.

Adult ; China ; Condoms ; Demography ; Homosexuality, Male ; Humans ; Logistic Models ; Male ; Risk Factors ; Safe Sex ; Sexual Behavior ; Sexual Partners ; Surveys and Questionnaires ; Syphilis ; Universities

Objective To understand the syphilis infection and its high risk factors among men who have sex with men(MSM) recruited from different channels. Methods Supported by the China-Gates Foundation HIV program from July to December 2011, we cooperated with community based organizations to conduct syphilis testing intervention among MSM from 14 cities(Beijing, Shanghai, Tianjin, Chongqing, Harbin, Shenyang, Qingdao, Xi'an, Nanjing, Wuhan, Hangzhou,Changsha, Kunming, and Guangzhou) and one province(Hainan province).Participants were recruited from different channels by the staff of local CBOs, Demographic(e.g. age, marital status, and education) and behavioral(e.g. condom use and sexual partners) data were collected using anonymous questionnaires. Blood samples were also collected to test for syphilis. A total of 34 100 MSM participated in the survey. Participants were excluded from data analysis(1 399, 4.1%) if they did not receive syphilis tests or they completed less than 80.00%of the key questions in the survey. Chi-square tests were used to understand the socio-demographic and behavioral differences between each group. Results of syphilis tests were also compared. Logistic regression models were used to test the statistical significance of these differences.Results A total of 32 701 MSM were enrolled and received syphilis testing. The average age of participates was 30.96±9.57. And among them, 2 284 cases(7.0%)were recruited from gay bathhouses, 4 774(14.6%)from gay bars, 6 266(19.2%)from the internet,1 997(6.1%) from the parks/toilets and 17 380(53.1%)from other channels.MSM recruited from the bathhouses had the highest syphilis infection rate than other 4 groups:gaybars(4.5%,216/4 774),internet(6.7%,422/6 266), parks/toilets(8.3%,166/1 997),other channels(6.4%,1 103/17 380)(χ2=164.58,P<0.001).The multivariate logistic regression analysis showed that being>20 years of age(P<0.001),having more than 2 homosexual partners in recent 3 months(8.0%(1 408/17 714),OR(95%CI)=1.44(1.04-1.98)), having no sex with females in past 3 months(6.8%(1 446/21 276),OR(95%CI)=1.25(1.07-1.46)), and not using condom at last anal sex (8.0%(769/9 668),OR(95%CI)=1.13(1.03-1.25)) were associated with a higher probability of being infected with syphilis. Whereas MSM married(7.2%(456/6 305),OR(95%CI)=0.84(0.73-0.98)), having a college or a higher education (5.3%(829/15 684),OR(95%CI)=0.60(0.53-0.67)),being local residents (6.5%(1 843/28 185),OR(95%CI)=0.73(0.61-0.87)) and living in the local province of project cities(6.6%(170/2 593),OR (95%CI)=0.67(0.53-0.85)) were protective factors.Conclusion MSM who were recruited from gay bathhouses have a higher rate of syphilis infection than those in channels relatively. They are older, with low education levels and high-risk sexual behaviors. Tailored interventions are required in the future, especially for MSM from gay bathhouses.

Objective To understand the syphilis infection and its high risk factors among men who have sex with men(MSM) recruited from different channels. Methods Supported by the China-Gates Foundation HIV program from July to December 2011, we cooperated with community based organizations to conduct syphilis testing intervention among MSM from 14 cities(Beijing, Shanghai, Tianjin, Chongqing, Harbin, Shenyang, Qingdao, Xi'an, Nanjing, Wuhan, Hangzhou,Changsha, Kunming, and Guangzhou) and one province(Hainan province).Participants were recruited from different channels by the staff of local CBOs, Demographic(e.g. age, marital status, and education) and behavioral(e.g. condom use and sexual partners) data were collected using anonymous questionnaires. Blood samples were also collected to test for syphilis. A total of 34 100 MSM participated in the survey. Participants were excluded from data analysis(1 399, 4.1%) if they did not receive syphilis tests or they completed less than 80.00%of the key questions in the survey. Chi-square tests were used to understand the socio-demographic and behavioral differences between each group. Results of syphilis tests were also compared. Logistic regression models were used to test the statistical significance of these differences.Results A total of 32 701 MSM were enrolled and received syphilis testing. The average age of participates was 30.96±9.57. And among them, 2 284 cases(7.0%)were recruited from gay bathhouses, 4 774(14.6%)from gay bars, 6 266(19.2%)from the internet,1 997(6.1%) from the parks/toilets and 17 380(53.1%)from other channels.MSM recruited from the bathhouses had the highest syphilis infection rate than other 4 groups:gaybars(4.5%,216/4 774),internet(6.7%,422/6 266), parks/toilets(8.3%,166/1 997),other channels(6.4%,1 103/17 380)(χ2=164.58,P<0.001).The multivariate logistic regression analysis showed that being>20 years of age(P<0.001),having more than 2 homosexual partners in recent 3 months(8.0%(1 408/17 714),OR(95%CI)=1.44(1.04-1.98)), having no sex with females in past 3 months(6.8%(1 446/21 276),OR(95%CI)=1.25(1.07-1.46)), and not using condom at last anal sex (8.0%(769/9 668),OR(95%CI)=1.13(1.03-1.25)) were associated with a higher probability of being infected with syphilis. Whereas MSM married(7.2%(456/6 305),OR(95%CI)=0.84(0.73-0.98)), having a college or a higher education (5.3%(829/15 684),OR(95%CI)=0.60(0.53-0.67)),being local residents (6.5%(1 843/28 185),OR(95%CI)=0.73(0.61-0.87)) and living in the local province of project cities(6.6%(170/2 593),OR (95%CI)=0.67(0.53-0.85)) were protective factors.Conclusion MSM who were recruited from gay bathhouses have a higher rate of syphilis infection than those in channels relatively. They are older, with low education levels and high-risk sexual behaviors. Tailored interventions are required in the future, especially for MSM from gay bathhouses.

Objective To observe the regulation of Toll-like receptor 4 (TLR4) signal and the release of inflammation factors after angiotensin Ⅱ (Ang Ⅱ) stimulation in rat mesangial cells under high glucose condition,revealing the innate immune-related mechanism of injury by Ang Ⅱ on mesangial cells under high glucose.Methods After synchronization,cells incubated with Ang Ⅱ (10-7 mmo/L) and/or high glucose (25 mmol/L) were used as the stimulation group,cells without stimulation were as normal control (5.6 mmol/L glucose).To determine the role of TLR4 and the adaptor myeloid differentiation factor 88 (MyD88),equal number of HBZY-1 cells were added with 10-5 mmol/L irbesartan and/or TLR4 blocker (10 mg/L) for 1 h and then incubated with Ang Ⅱ (10-7 mmo/L) and/or high glucose (25 mmol/L) for 12 h or 24 h respectively.Real-time PCR was used to analyze TLR4 mRNA and MyD88 mRNA expression after 12 h.Immunofluorescence was used to observe TLR4 protein expression after 24 h; Western blotting was used to observe TLR4,MyD88 and nuclear factor κB (NF-κB) protein; ELISA was used to detect the concentration of MCP-1,IL-6 in cell supernatant respectively.Results Compared with normal control group,TLR4 mRNA and MyD88 mRNA were highly expressed in high glucose or Ang Ⅱ-induced HBZY-1 cells (P ＜ 0.01),TLR4,MyD88 and NF-κB protein as well as MCP-1,IL-6 were also up-regulated significantly (P ＜ 0.01).Compared with high glucose or Ang Ⅱ group,MyD88 and NF-κB protein as well as MCP-1,IL-6 were further up-regulated markedly in Ang Ⅱ and high glucose costimulated group (P ＜ 0.01).In HBZY-1 cells that were preincubated with irbesartan and/or TLR4 blocker,TLR4 and MyD88 protein expression were obviously inhibited,IL-6 and MCP-1 production were also decreased remarkably compared with high glucose and/or Ang Ⅱ group (P ＜ 0.01).Conclusions High glucose and Ang Ⅱ stimulate the release of proinflammatory factors in rat glomerular mesangial cells via TLR4-MyD88 pathway.This process is inhibited by irbesartan or TLR4 blocker via modulation of the signal.Ang Ⅱ has the positive-regulation potential on the release of inflammation factors via TLR4 signal in rat mesangial cells under high glucose condition.