Objective: To investigate the current status and related factors of human papillomavirus (HPV) vaccination intention among male college students in Shanghai, so as to provide references for promoting HPV vaccination among males. Methods: From January to February 2025, a stratified random cluster sampling method was used to select 548 male college students in 10 universities from Shanghai for a self questionnaire survey. The survey included socio demographic characteristics, vaccine hesitancy, vaccine beliefs (complacency, confidence, convenience), HPV knowledge level, health status, social support, and information acquisition channels. Latent class analysis (LCA) was used to identify latent classes of vaccine beliefs, and multinomial Logistic regression was used to analyze the related factors of vaccination intentions. Results: The acceptance, hesitancy, and refusal rates of HPV vaccine among college students in Shanghai were 39.4% ( n =216), 35.2% ( n =193), and 25.4% ( n =139), respectively. LCA identified four vaccine belief groups: low complacency high confidence (21.4%), high complacency high confidence (36.1%), low complacency low confidence (18.8%), and high complacency low confidence (23.7%). Multinomial Logistic regression showed that vaccine belief category was an important factor affecting vaccination intentions among college students in Shanghai. Compared with the low complacency high confidence group, high complacency low confidence group had the highest risk of vaccine refusal ( OR =24.80， P <0.05). Medical majors ( OR =0.13), participation in basic medical insurance ( OR =0.37), and recommendations from relatives, friends ( OR =0.39) or healthcare professionals ( OR =0.33) reduced the risk of vaccine refusal among male college students in Shanghai (all P <0.05). The Internet (70.6%) was the main source of HPV related information for male college students, and recommendations from healthcare professionals were associated with more positive vaccination intentions. Conclusions HPV vaccine hesitancy and refusal are common among male college students in Shanghai, with significant heterogeneity in vaccine belief structures. Targeted health education based on belief categories should be conducted to improve the vaccination intentions of male college students.

Objective: To explore the treatment plan for severe papillary defects in the aesthetic zone caused by severe periodontitis, providing a reference for clinical practice. Methods : A patient with severe periodontitis leading to severe papillary defects in the upper anterior teeth from 12 to 23 was treated using interdental tunnel technique combined with personalized connective tissue grafting for periodontal plastic surgery, and stable soft tissue augmentation was achieved. Resin restoration was conducted to modify the crown shape of the aesthetic zone teeth, reconstruct white aesthetics, guide the shaping of the gingival papillae, reduce “black triangles,” and enhance the patient’s confidence in smiling. Results : The patient’s periodontal condition and the regeneration of soft tissues in the aesthetic zone were good, and the smile aesthetics were restored. After a 3-year follow-up, the gingival morphology, color, and texture were good, and the effect was stable. The literature review indicates that for papillary defects in the aesthetic zone, analysis should be conducted based on the following aspects: whether a defect is present in periodontal hard and soft tissues, crown shape, and the distance from the most apical part of the crown contact area to the top of the alveolar crest. Based on the analysis of aesthetic defects and surgical indications, a personalized treatment plan should be designed. Conclusion For patients with obvious papillary defects in the aesthetic zone due to the reduction of periodontal support tissues caused by severe periodontitis, factors such as periodontal hard and soft tissue defects, crown shape, and the distance from the most apical part of the crown contact area to the top of the alveolar crest should be fully considered, and a personalized treatment plan should be formulated after multidisciplinary joint consultation.

There is currently a huge worldwide demand for donor kidneys for organ transplantation. Consequently, numerous marginal donor kidneys, such as kidneys with microthrombi, are used to save patients' lives. While some studies have shown an association between the presence of microthrombi in donor kidneys and an increased risk for delayed graft function (DGF) (McCall et al., 2003; Gao et al., 2019), other studies have demonstrated that microthrombi negatively impact the rate of DGF (Batra et al., 2016; Hansen et al., 2018), but not graft survival rate (McCall et al., 2003; Batra et al., 2016; Gao et al., 2019). In contrast, Hansen et al. (2018) concluded that fibrin thrombi were not only associated with reduced graft function six months post-transplantation but also with increased graft loss within the first year of transplantation. On the other hand, Batra et al. (2016) found no significant differences in the DGF rate or one-year graft function between recipients in diffuse and focal microthrombi groups. To date, however, the overall influence of donor kidney microthrombi and the degree of influence on prognosis remain controversial, necessitating further research.
Humans ; Thrombotic Microangiopathies ; Transplantation, Homologous ; Tissue Donors ; Kidney ; Allografts

BK polyomavirus-associated nephropathy (BKPyVAN) is a common cause of allograft failure. However, differentiation between BKPyVAN and type I T cell-mediated rejection (TCMR) is challenging when simian virus 40 (SV40) staining is negative, because of the similarities in histopathology. This study investigated whether donor-derived cell-free DNA (ddcfDNA) can be used to differentiate BKPyVAN. Target region capture sequencing was applied to detect the ddcfDNAs of 12 recipients with stable graft function, 22 with type I TCMR, 21 with proven BKPyVAN, and 5 with possible PyVAN. We found that urinary ddcfDNA levels were upregulated in recipients with graft injury, whereas plasma ddcfDNA levels were comparable for all groups. The median urinary concentrations and fractions of ddcfDNA in proven BKPyVAN recipients were significantly higher than those in type I TCMR recipients (10.4 vs. 6.1 ng/mL,

Objective: To analyze the pathological features and their influence on the clinical outcome of non-nasopharyngeal EBV-associated carcinomas. Methods: One hundred and twenty cases of non-nasopharyngeal EBV-associated carcinoma confirmed by in situ hybridization were identified at Zhejiang Cancer Hospital from January 1, 2006 to May 1, 2018, and the clinicopathological data were collected and analyzed using Kaplan-Meier survival analysis, Cox univariate and multivariate analysis. Results: One hundred and twenty cases were involved in the study; the male to female ratio was 1∶1; patients′ age range was 24 to 89 years (median 50 years). The primary sites were large parotid glands (62 cases), lung(26 cases), stomach(15 cases), and others (oral, oropharynx, larynx, cervix, liver; totally 17cases). Non-nasopharyngeal EBV-associated cancer could be divided into two histological types according to the amount of interstitial lymphocytes: type Ⅰ was "lymphoepithelial-like carcinoma" and rich in stromal lymphocytes; type Ⅱ lacked lymphocytic infiltration. Ninety-eight primary tumor samples could be classified morphologically: 43 cases were as type Ⅰ and 55 cases as typeⅡ; the distribution of type Ⅰ was 57.4% (27/47) in large parotid glands, 20.8% (5/24) in lung, 4/13 in stomach, and 7/14 in other sites. Complete treatment and survival data were obtained for 114 patients. According to the TNM staging criteria of WHO, 52 patients were at early stages (Ⅰ-Ⅱ) and 62 were at advanced stages (Ⅲ-Ⅳ); 102 patients underwent surgery. Seventy-four patients received adjuvant chemotherapy before or after surgery, and 52 patients received local radiotherapy. Kaplan-Meier survival analysis showed that patients with type Ⅱ EBV-associated carcinoma had a worse prognosis than patients with type Ⅰtumors (P=0.010 2). In addition, vascular invasion(P=0.021 8),neural recidivism(P=0.000 1),advanced stage(P=0.017 1),lymph node metastasis (P=0.005 0) and chemotherapy (P=0.013 2) were poor prognostic factors; female patients had better survival than male (P=0.028 4). Cox multivariate regression analysis found that lymph node metastasis (95%CI: 1.489-13.830, P=0.007 6) and neural recidivism (95%CI: 1.228-6.544, P=0.014 7) were independent adverse prognostic factors. Cox multivariate regression analysis after stratification by site revealed that radiotherapy was a preferable prognostic factor for EBV-associated carcinoma of the large salivary glands (95%CI: 0.003-0.569, P=0.016 8). Conclusion EBV associated carcinoma can be divided into two types, for which type Ⅰ was with abundant interstitial lymphocytes and type Ⅱ was lack of interstitial lymphocytes. TypeⅡ EBV-associated carcinoma has a worse prognosis than type Ⅰ. Radiation therapy can prolong the survival time of patients with primary EBV-associated carcinoma of large salivary glands.

Objective To observe the effect of exteme dose of heat-clearing drugs on temperature in the postoperative fever patients.Methods A total of 70 patients with postoperative fever who met the inclusion criteria were randomly divided into the control group (35 patients) and observation group (35 patients). The observation group was treated with exteme dose of heat-clearing drugs, and the control group was treated with the common dose formula. Both groups were treated for 3 day, and followed up for 3 day. The changing of the temperature before and after treatment, the onset time and time of relieving fever were analyzed.Results Compared with the baseline before the treatment, the 1st day, 2nd after treatment, the highest temperature in observation group at thte 3rd day(37.5 ± 0.5℃vs. 37.6 ± 0.5℃, 38.1 ± 0.5℃,38.3 ± 0.5℃,F=20.883) was significantly lower; the highest body temperature in the control group at the 3rd day (37.5 ± 0.6℃vs. 37.5 ± 0.5℃, 38.1 ± 0.6℃, 38.4 ± 0.4℃,F=25.088) was significantly lower (P<0.01). At the 3 day in the follow up period, compared with the baseline before the treatment, the 1st day, 2nd after treatment, the highest body temperature in observation group (36.9 ± 0.5℃vs. 37.1 ± 0.2℃, 37.3 ± 0.5℃,F=7.778) were significantly lower (P<0.01).Conclusions The high of heat-clearing drugs treatment for the postoperative fever can effectively lower the temperature, and there is no obvious difference of the onset time and the time of relieving fever between two groups.

Objective To investigate the levels of hypersensitive C-reactive protein(hs-CRP)and serum lipid in patients with acute cerebral infarction.Methods A total of 300 patients with acute cerebral infarction and 300 healthy subjects (normal controls)were included in this study.The levels of hypersensitive C -reactive protein and serum lipid were measured and analyzed via statistics soft.Results The levels of hs-CRP,total cholesterol, triglyceride,low density lipoprotein and high density lipoprotein in the research group were (25.9 ±5.2)mmol/L, (7.5 ±2.3)mmol/L,(2.8 ±0.21)mmol/L,(0.8 ±0.1)mmol/L and (3.3 ±0.2)mmol/L respectively;The levels of hs-CRP,total cholesterol,triglyceride,low density lipoprotein and high density lipoprotein in the control group were (6.3 ±1.2)mmol/L,(4.2 ±0.2)mmol/L,(1.5 ±0.2)mmol/L,(2.2 ±1.5)mmol/L and(2.5 ±0.5)mmol/Lrespectively.There was a significant statistically difference between the two groups(t =5.9,5.1,4.8,4.6 and 4.5,all P <0.05).Multivariate Logistic regression analysis showed that total cholesterol,triglyceride,low density lipoprotein and high density lipoprotein hs-CRP were independent risk factors for the acute cerebral infarction (beta respectively 0.53,0.68,0.69,1.20,0.69;S.E were 0.23,0.16,0.28,0.24,0.25,OR values were 5.6,4.8,6.2,7.8,9.2;95%CI were 0.69 -36.8,0.57 -35.7,0.58 -38.5,0.68 -44.2,0.21 -48.2,all P <0.01).Conclusion The abnormal metabolism of serum lipid and C -reactive protein were independent risk factors in patients with acute cere-bral infarction,which should be positively treated about this.

Objective To examine the reliability and validity of the Connor-Davidson Resilience Scale (CD-RISC) in nurses in China.Methods Item analysis and confirmatory factor analysis of CD-RISC was conducted.A total of 1 084 nurses were randomly divided into 2 groups using random number table.One group was used to revise CD-RISC and the other to evaluate its reliability and validity.Results Confirmatory factor analysis of the original RSA showed thatx2/df,RMSEA,GFI,AGFI,CFI were 6.714,0.103,0.804,0.764,and 0.718,respectively.The number of item was reduced to 21 based on exploratory factor analysis results,including three factors which explained 54.034％ of the total variance.Factor loading ranged from 0.490 to 0.755.Coefficient of internal consistency ranged from 0.688 to 0.930 and the 4 week test-retest reliabilities ranged from 0.825 to 0.917.The factor scores were closely correlated with the total scores with correlation coefficient ranging from 0.683 to 0.943.The factors were closely correlated with each other with correlation coefficient ranging from 0.564 to 0765.The confirmatory factor analysis of the revised CD-RISC showed that x2/df,RMSEA,GFI,AGF,CFI were 3.304,0.065,0.902,0.878,and 0.913 respectively.The total scores and all factors were negatively correlated with depression and anxiety and somatization.Conclusions The revised CD-RISC has good psychometric properties and can be used to measure the resilience of nurses.

Objective To develop a high performance liquid chromatographic method (HPLC) for the analysis of of cholesterol in erythrocyte membranes.Methods The study included 167 consecutive chest pain patients who underwent coronary artery angiography in the Department of Cardiology,Nanjing General Hospital of Nanjing Command between September 2012 and February 2013.According to the clinical symptoms and t angiographic results,patients were divided into three groups:acute coronary syndrome (ACS) group (n =46),stable angina pectoris (SAP) group (n =76) and the control group (n =45).After the erythrocyte sample was hypotonically lysed and washed,saponification was carried out in a polassium hydroxide solution at 70 ℃.After extraction by Hexane/isopropanol mixture,the sample was separated on a Lichrospher column and detected by ultraviolet absorbance at 208 nm.A mobile phase composed of acetonitrile-isopropyl alcohol was found to be the most suitable for this separation.Concentrations of cholesterol in erythrocyte membranes were tested.Analysis of variance with covariates (ANOVA) was used to evaluate differences in CEM levels among groups.The relationship between continuous variables was evaluated by Spearman's correlation coefficient.Results Under the chromatographic conditions described,retention time of the cholesterol was approximately 6.1 min.Good separation and detectability of cholesterol in erythrocyte membranes were obtained.The method proved to be linear in the injection range of cholesterol from 0.05 g to 2.00 g.Cholesterol content in erythrocyte membranes were (87.0 μg/mg,75.4-98.9 μg/mg),(92.9 μg/mg,83.8-109.0 μg/mg) and (173.9 μg/mg,140.0-188.8 μ g/mg) in the control,SAP and ACS groups,respectively.Cholesterol content in erythrocyte membranes was significantly higher in ACS group than that in SAP and control groups (P ＜ 0.01).Conclusion We have successfully developed a method for the determination of cholesterol in erythrocyte membranes with good sensitivity,specificity and repeatability.

Objective To observe the clinical effects of radiotherapy and/or chemotherapy in the treatment of nasal and Waldeyer ring natural killer (NK)/T cell lymphoma and to analyze the prognostic factors.Methods Between January 20,2000 and December 21,2010,109 patients with nasal NK/T cell lymphoma and 21 patients with Waldeyer ring NK/T cell lymphoma were admitted to our hospital; the diagnosis was confirmed by immunohistochemistry.According to the Ann Arbor staging system,116 patients were classified as stage Ⅰ E,and 14 as stage Ⅱ E.Thirty patients received radiotherapy alone;2 patients received chemotherapy alone; 98 patients received radiochemotherapy.Results The follow-up rate was 100％.Seventy-eight patients were followed up for at least 5 years.The complete remission (CR) rate was 89.2％ in all patients.The CR rates of stage Ⅰ E patients and stage Ⅱ E patients were 88.8％ and 92.9％,respectively (x2 =0.02,P =0.837).The CR rates of patients receiving radiotherapy alone and patients receiving radiochemotherapy were 86％ and 96％,respectively (x2 =1.44,P =0.230).The five-year overall survival (OS) rate and disease-free survival (DFS) rate of all patients were 58.0％ and 57.2％,respectively.The five-year OS rates of stage Ⅰ E patients and stage Ⅱ E patients were 60.6％ and 36.3％,respectively (x2 =0.25,P =0.615) ;the five-year DFS rates of stage Ⅰ E patients and stage Ⅱ E patients were 59.7％ and 36.3％,respectively (x2 =0.21,P =0.648).The five-year OS rates of patients receiving radiotherapy alone and patients receiving radiochemotherapy were 70.0％ and 48.4％,respectively (x2 =0.01,P =0.933) ; the five-year DFS rates of patients receiving radiotherapy alone and patients receiving radiochemotherapy were 65.6％ and 48.4％,respectively (x2 =0.09,P =0.764).The grade 3-4 toxicity rates of radiotherapy alone and radiochemotherapy were 6.7％ and 54.1％,respectively (x2 =41.38,P=0.002).The radiation dose to the primary lesion and Eastern Cooperative Oncology Group (ECOG) score were correlated with OS (x2 =3.1 8,P =0.005 ; x2 =2.97,P =0.008).Conclusions The clinical effect of radiochemotherapy is similar to that of radiotherapy alone in the patients with stage ⅠE and ⅡE nasal and Waldeyer ring NK/T cell lymphoma,but radiochemotherapy has higher toxicity than radiotherapy alone.The radiation dose to the primary lesion and ECOG score are the influential factors for OS.