ObjectiveTo investigate the effect of Qingrun prescription（QRP）-containing serum on improving insulin resistance in HepG2 cells and its potential mechanisms. MethodsAn insulin resistance model was established in HepG2 cells with 1×10^-6 mol·L^-1 insulin. Branched-chain α-keto acid dehydrogenase （BCKDH） gene silencing was achieved using siRNA， and the cells were divided into 8 groups： normal group， model group （1×10^-6 mol·L^-1 insulin）， metformin group （1 mmol·L^-1 metformin）， high-， medium-， and low-dose QRP groups （20%， 10%， and 5% QRP-containing serum， respectively）， QRP + siRNA-silenced BCKDH （si-BCKDH） group （10% QRP-containing serum + si-BCKDH）， and QRP + si-NC group （10% QRP-containing serum + si-NC）. Glucose levels in the supernatant were measured with a glucose assay kit， while glycogen content was assessed using a glycogen assay kit. Levels of branched-chain amino acids （BCAAs） and branched-chain keto acids （BCKAs） were determined using ultra-high performance liquid chromatography-tandem mass spectrometry （UHPLC-MS/MS）. mRNA transcription and protein expression levels of BCKDH， dishevelled， Egl-10， and pleckstrin （DEP） domain-containing mammalian target of rapamycin （mTOR）-interacting protein （DEPTOR）， mTOR， and ribosomal protein S6 kinase 1 （S6K1） were detected using real-time quantitative polymerase chain reaction （Real-time PCR） and Western blot. ResultsCompared to the normal group， the model group exhibited significantly decreased glucose consumption and glycogen content， increased levels of BCAAs and BCKAs， downregulated expression of BCKDH and DEPTOR， and upregulated mTOR and S6K1 expression （P<0.01）. In comparison to the model group， QRP treatment at all doses significantly enhanced glucose consumption and glycogen content while reducing BCAAs and BCKAs levels （P<0.01）. The high- and medium-dose QRP groups demonstrated significant upregulation of BCKDH mRNA transcription and protein expression， as well as DEPTOR mRNA transcription. Moreover， the DEPTOR protein expression level was significantly increased in high-， medium-， and low-dose QRP groups， while mTOR and S6K1 mRNA and protein expression levels were markedly downregulated （P<0.05， P<0.01）. Compared to the QRP + si-NC group， the QRP + si-BCKDH group exhibited increased BCAAs and BCKAs levels， significantly decreased BCKDH mRNA transcription and protein expression， downregulated DEPTOR mRNA and protein expression， and upregulated mTOR and S6K1 mRNA and protein expression （P<0.05， P<0.01）. ConclusionQRP may improve insulin resistance by reprogramming BCAAs metabolism. This effect involves upregulating BCKDH， reducing BCAAs and BCKAs levels， and suppressing the mTOR pathway activation.

Objective:To analyze the transition patterns of anal sex and unprotected anal intercourse (UAI), estimate the transition intensity and probability, and identify factors influencing the transition patterns in men who have sex with men (MSM) in Shandong Province.Methods:In August 2019, MSM aged ≥18 years old were recruited as subjects from 11 cities in Shandong Province. The baseline survey were completed in December 2019, and followup surveys were conducted once every 3 mouths from June 2020 to March 2021. Time-continuous, state-discrete multi-state reversible Markov model was constructed based on the status of MSM's sexual behaviors with different types of sexual partners [anal sex occurred or not (S1=No, S2=Yes) and UAI occurred or not (S1=No,S2=Yes)] to analyze the transition patterns and the influencing factors.Results:A total of 735 MSM were included. The transition intensity of starting anal sex with stable and casual partners was 1.935 times and 0.595 times higher than that of discontinuing this behavior, respectively. While the transition intensity to start UAI with stable and casual partners was 0.430 times and 0.169 times higher than that of discontinuing it, respectively. During the follow-up, the transition probabilities of anal sex and UAI with both stable and casual partners increased first and then stabilized. For stable partners, the transition probability of starting anal sex was higher than that of discontinuing it at the same period, for casual partners, it was just the reverse. For both stable and casual partners, the transition probabilities of discontinuing UAI were higher than starting it at the same time. The results of multivariate analysis showed that participants who received intervention materials ( HR=1.47), had an associate degree ( HR=1.77) or a bachelor's degree and above ( HR=1.47) were at higher risk of starting anal sex with stable partners. Those who received intervention materials ( HR=1.39) were at higher risk of discontinuing anal sex with stable partners, while participants identified themselves as non-male gender ( HR=0.49) were at lower risk of discontinuing anal sex with stable partners. Participants received intervention materials ( HR=1.75) were at higher risk of starting UAI with stable partners. Those who lived apart, divorced, or widowed ( HR=3.22) were at higher risk of starting UAI with casual partners, whereas had a bachelor's degree and above ( HR=0.58) were at lower risk of starting UAI with casual partners. Participants identified themselves as non-male gender ( HR=0.45) at lower risk of discounting UAI with casual partners. Conclusions:The transition patterns of homosexual behavior in MSM are different. Marital status, gender identity, educational level and other factors are the influencing factors of sexual behavior status transitions. Future researches should develop targeted interventions for different types of sexual partners and characteristics of MSM.

Objective:To understand the related factors of new-type drugs use and high-risk behaviors in online-dating men who have sex with men (MSM) in Shandong Province, and provide evidence for the development of targeted HIV prevention and intervention strategies.Methods:A cross-sectional study was conducted from April to July 2023 in eight sentinel surveillance sites across cities in Shandong, recruiting MSM participants. Each city enrolled a sample of 400 individuals. Face-to-face questionnaire surveys were conducted to collect data on socio-demographic characteristics, drug use and sexual behaviors, risk perception, and online-dating practices of the MSM, and χ2 test was used to compare the differences between online-dating MSM who used new-type drugs and those who didn't use. Logistic regression model was used to analyze the related factors of group sex behavior and the lack of HIV detection before sexual behavior in the online-dating MSM. Statistical analysis was performed by using software SPSS 29.0. Results:A total of 3 235 MSM were surveyed, in whom 2 787 (86.15%) used online-dating platforms to find partners in the past six months. The majority were those who were aged 25-34 years (39.18%, 1 092/2 787), unmarried/divorced/widowed (71.51%, 1 993/2 787), had an education level of college or above (69.36%, 1 933/2 787), and primarily identified as homosexual gays (77.97%, 2 173/2 787), 37.78% (1 053/2 787) believed that they were at low risk for HIV infection and 10.88% (303/2 786) believed that using new-type drugs was less harmful and 57.59% (1 605/2 787) reported new-type drugs use. Multivariate logistic regression analysis indicated that MSM who used new-type drugs had higher risk for group sex in the past six months (a OR=1.31, 95% CI: 1.06-1.63) and sexual activity without pre-HIV testing (a OR=1.57, 95% CI:1.14-2.15) compared with those who didn't use new-type drugs.MSM who believed that the risk of using new-type drugs was general, higher and very high had higher risks for group sex in the past six months (a OR=1.54, 95% CI: 1.09-2.18) and sexual activity withou pre-HIV testing (a OR=2.02, 95% CI:1.34-3.05) compared with those who believed using new-type drugs was less harmful. Conclusions:The use of new-type drugs was relatively common in the online-dating MSM in Shandong, with widespread high-risk behaviors and poor awareness of risks to health. A gap between knowledge awareness and behavior exists. It is necessary to strengthen the health education and promotion of HIV informed dating practices in MSM.

Objective:To analyze the transition patterns of anal sex and unprotected anal intercourse (UAI), estimate the transition intensity and probability, and identify factors influencing the transition patterns in men who have sex with men (MSM) in Shandong Province.Methods:In August 2019, MSM aged ≥18 years old were recruited as subjects from 11 cities in Shandong Province. The baseline survey were completed in December 2019, and followup surveys were conducted once every 3 mouths from June 2020 to March 2021. Time-continuous, state-discrete multi-state reversible Markov model was constructed based on the status of MSM's sexual behaviors with different types of sexual partners [anal sex occurred or not (S1=No, S2=Yes) and UAI occurred or not (S1=No,S2=Yes)] to analyze the transition patterns and the influencing factors.Results:A total of 735 MSM were included. The transition intensity of starting anal sex with stable and casual partners was 1.935 times and 0.595 times higher than that of discontinuing this behavior, respectively. While the transition intensity to start UAI with stable and casual partners was 0.430 times and 0.169 times higher than that of discontinuing it, respectively. During the follow-up, the transition probabilities of anal sex and UAI with both stable and casual partners increased first and then stabilized. For stable partners, the transition probability of starting anal sex was higher than that of discontinuing it at the same period, for casual partners, it was just the reverse. For both stable and casual partners, the transition probabilities of discontinuing UAI were higher than starting it at the same time. The results of multivariate analysis showed that participants who received intervention materials ( HR=1.47), had an associate degree ( HR=1.77) or a bachelor's degree and above ( HR=1.47) were at higher risk of starting anal sex with stable partners. Those who received intervention materials ( HR=1.39) were at higher risk of discontinuing anal sex with stable partners, while participants identified themselves as non-male gender ( HR=0.49) were at lower risk of discontinuing anal sex with stable partners. Participants received intervention materials ( HR=1.75) were at higher risk of starting UAI with stable partners. Those who lived apart, divorced, or widowed ( HR=3.22) were at higher risk of starting UAI with casual partners, whereas had a bachelor's degree and above ( HR=0.58) were at lower risk of starting UAI with casual partners. Participants identified themselves as non-male gender ( HR=0.45) at lower risk of discounting UAI with casual partners. Conclusions:The transition patterns of homosexual behavior in MSM are different. Marital status, gender identity, educational level and other factors are the influencing factors of sexual behavior status transitions. Future researches should develop targeted interventions for different types of sexual partners and characteristics of MSM.

Objective:To understand the related factors of new-type drugs use and high-risk behaviors in online-dating men who have sex with men (MSM) in Shandong Province, and provide evidence for the development of targeted HIV prevention and intervention strategies.Methods:A cross-sectional study was conducted from April to July 2023 in eight sentinel surveillance sites across cities in Shandong, recruiting MSM participants. Each city enrolled a sample of 400 individuals. Face-to-face questionnaire surveys were conducted to collect data on socio-demographic characteristics, drug use and sexual behaviors, risk perception, and online-dating practices of the MSM, and χ2 test was used to compare the differences between online-dating MSM who used new-type drugs and those who didn't use. Logistic regression model was used to analyze the related factors of group sex behavior and the lack of HIV detection before sexual behavior in the online-dating MSM. Statistical analysis was performed by using software SPSS 29.0. Results:A total of 3 235 MSM were surveyed, in whom 2 787 (86.15%) used online-dating platforms to find partners in the past six months. The majority were those who were aged 25-34 years (39.18%, 1 092/2 787), unmarried/divorced/widowed (71.51%, 1 993/2 787), had an education level of college or above (69.36%, 1 933/2 787), and primarily identified as homosexual gays (77.97%, 2 173/2 787), 37.78% (1 053/2 787) believed that they were at low risk for HIV infection and 10.88% (303/2 786) believed that using new-type drugs was less harmful and 57.59% (1 605/2 787) reported new-type drugs use. Multivariate logistic regression analysis indicated that MSM who used new-type drugs had higher risk for group sex in the past six months (a OR=1.31, 95% CI: 1.06-1.63) and sexual activity without pre-HIV testing (a OR=1.57, 95% CI:1.14-2.15) compared with those who didn't use new-type drugs.MSM who believed that the risk of using new-type drugs was general, higher and very high had higher risks for group sex in the past six months (a OR=1.54, 95% CI: 1.09-2.18) and sexual activity withou pre-HIV testing (a OR=2.02, 95% CI:1.34-3.05) compared with those who believed using new-type drugs was less harmful. Conclusions:The use of new-type drugs was relatively common in the online-dating MSM in Shandong, with widespread high-risk behaviors and poor awareness of risks to health. A gap between knowledge awareness and behavior exists. It is necessary to strengthen the health education and promotion of HIV informed dating practices in MSM.

Objective:To understand the use of post-exposure prophylaxis (PEP) and analyze related factors among men who have sex with men (MSM) in Qingdao, and provide a reference for the AIDS prevention and control in this population.Methods:A cross-sectional survey conducted from April 2022 to February 2023. Relying on MSM social groups in Qingdao, a snowball sampling method was applied to recruit research subjects who met the inclusion criteria of age ≥18 years old, having had homosexual anal or oral sex in the past six months, and HIV-negative or infection status unknown. The sample size was estimated at 566. Data on demographic characteristics, sexual behavior characteristics, PEP use, and others of the research subjects was collected through on-site questionnaires. The logistic regression model was used to analyze the factors associated with using PEP.Results:A total of 811 participants were recruited, mainly aged 25-34 (53.6%, 435/811), unmarried (74.7%, 606/811), with an average monthly income of ≥5 000 yuan (52.2%, 423/811), and having lived in Qingdao for ≥10 years (75.6%, 613/811). The proportion of those who knew the HIV status of their sexual partners in the last six months was 67.1% (544/811), and those with HIV-positive partners were 3.6% (29/811). In the last six months, the proportion of participants who had group sex (86.4%, 701/811), unprotected anal sex (98.2%, 796/811), and use of club drugs (80.3%, 651/811) was high. Moreover, 28.4% (230/811) had used PEP. The multivariate logistic regression analysis showed that the factors related to the use of PEP included divorced or widowed (a OR=5.46,95% CI:1.96-15.17), average monthly income ≥5 000 yuan (a OR=2.04,95% CI:1.44-2.89), same-sex sexual orientation (a OR=0.40,95% CI:0.22-0.71), having HIV-positive sexual partners in the last six months (a OR=2.54,95% CI:1.13-5.71) and having been tested for HIV ≥3 times in the last six months (a OR=1.46,95% CI:1.04-2.06). Conclusions:The prevalence of risk behaviors among MSM in Qingdao was high, and the use of PEP was low. In the future, it is essential to increase HIV/AIDS prevention education among MSM, promote MSM to know the HIV status of their sexual partners, and reduce the prevalence of risk behaviors among this population. Additionally, explore medical insurance reimbursement plans for PEP to reduce utilization costs and promote the use of PEP by MSM after HIV exposure occurs as soon as possible.

Objective:To analyze the awareness status and influencing factors of hepatitis C among patients presented to hospitals in Shandong province, to provide reference for the prevention and control of viral hepatitis C.Methods:A total of 22, 139 questionnaires were collected from local residents aged 15-65 who visited general hospitals in 16 cities in Shandong province from May to December 2021. The survey was conducted in the form of face-to-face questionnaires, including general demographic information and questions and answers on hepatitis C prevention, treatment. and related behavioral characteristics. There are a total of 8 questions on the prevention and treatment of hepatitis C, and if 6 questions are correct, it is judged as knowing.Results:The overall awareness rate of hepatitis C-related knowledge among those who visited hospitals in Shandong province was 57.75%. The awareness rate of hepatitis C knowledge among respondents aged less than or equal to 20, 21-40, and 41-59 was higher than that of the age group over 60 years old. The OR values were 1.49, 2.30 and 1.88, respectively; the awareness rate of respondents with education level of high school or junior college and above was higher than that of people with education level of junior high school and below, the OR values were 1.14 and 1.21, respectively; The awareness rate of physical examination population and invasive diagnosis and treatment population was higher than that of family planning clinic visits, with OR values of 1.20 and 1.28, respectively. The awareness rate of respondents with a history of visiting a doctor in an informal medical service was lower than that of the population without such behavior. Conclusions:The awareness rate of hepatitis C knowledge among hospital patients in Shandong province needs to be further improved. Carrying out different forms of publicity and education for different groups of people is an effective means and method to reduce the hepatitis C infection rate.

Objective:To investigate the current status and influencing factors of stroke patients.Methods:Using stratified sampling method, 458 stroke patients was investigated for the health behavior from October to December, 2015. Based on PROCEDE-PROCEED model, logistic regression analysis was conducted with the health behavior level of the subjects as the dependent variable, and the characteristic factors in the chi-square test as the independent variables to analyze the factors which influence the health behavior level of stroke patients from predisposing factors, enabling factors and reinforcing factors.Results:The health behavior score of stroke patients was (14.5±3.9), which was at medium level. The score of each dimension was nutrition (0.80±0.25), disease management (0.60±0.26), interpersonal relationship (0.57±0.33), and medication compliance (0.49±0.41). The multiple logistic regression analysis showed that the predisposition factors including age ( OR=2.03, 95% CI=1.08-3.80) and history of hypertension( OR=2.35, 95%=1.16-4.76), the enabling factors including the allocation of social resources ( OR=1.73, 95% CI=0.89-3.36), and the reinforcing factors including family support ( OR=2.03, 95% CI=0.99-4.17) were important factors which affect the health behavior of stroke patients. Conclusion:The health behavior level of stroke patients need to be improved. The relevant community resource allocation system continuously, and focus on the impact of family environment and particularly the elderly and patients with a history of hypertension should be attentioned when improving the health behavior of patients.

Objective:To explore the experience of intimate partner-related violence (IPV) and its correlation with high-risk sexual behaviors among MSM.Methods:MSM were recruited in Ji'nan, Qingdao, and Jining of Shandong province from April to July 2019. Information on socio-demographic characteristics, AIDS prevention and control knowledge, IPV experience in the last year and high-risk sexual behaviors in the previous six months was collected by face-to-face questionnaire. EpiData 3.1 and SPSS 24.0 software were used for data cleansing and statistical analysis.Results:The average age of the 1 122 MSM was (29.80±8.78) years, with 68.1% (764/1 122) unmarried. 9.8% (110/1 122) had IPV experiences in the past year. MSM who came from Jining and Qingdao, living in the local area for more than two years, met their sexual partners in bar/bathroom/park, having no basic knowledge about AIDS, being drug users, and diagnosed with STD in the previous year, had a higher proportion of IPV experiences in the last year ( P<0.05). 49.0% (550/1 122) and 20.9% (234/1 122) had unprotected anal intercourse and group sex behavior during the past six months, respectively. The results of multivariate logistic regression showed that MSM who experienced IPV were likely to have unprotected anal intercourse and group sex behavior during the past six months (a OR = 1.82, 95% CI: 1.14-2.91;a OR = 3.30, 95% CI: 2.10-5.20) than those did not experience IPV. Conclusions:IPV exists in the MSM population, and the IPV experience is positively associated with high-risk sexual behaviors. Targeted intervention to reduce the risk of high-risk sexual behaviors should be taken among MSM who experienced IPV.

Objective:To understand the relationship between new-type drug use and high risk behavior in men who have sex with men (MSM) in Shandong province.Methods:Cross-sectional surveys was conducted to collect the information about demographics, sexual and drug use behaviors of MSM and HIV-related services in MSM in three sentinel surveillance sites in Shandong from April to July in 2019. Blood samples were taken from the MSM for serological tests of HIV antibody and syphilis antibody.Results:A total of 1 203 MSM were included in this study. The average age of the MSM was 30.2±8.9 years. Among these MSM, 67.7 % (815) were unmarried; 66.9 % (805) had education level of college or above; 62.2 % (721/1 160) had unprotected sex behaviors and 16.3 % (189/1 160) had group sex behavior in the past six months and 54.2 % (652/1 203) ever used new-type drugs. HIV infection and syphilis prevalence rates were 3.1 % (37/1 203) and 4.7 % (56/1 203), respectively. Multivariable logistic analysis indicated that MSM who had unprotected anal sex in the past six months were more likely to be from Qingdao (a OR=1.59, 95 %CI:1.13-2.23), with education level of high school or below (a OR=1.61, 95 %CI: 1.20-2.16), with male sex partners from bars/dance halls or other venues (a OR=1.69, 95 %CI: 1.06-2.69), with HIV knowledge awareness score <6 (a OR=1.55, 95 %CI: 1.01-2.37), with ≥2 sex partner in the past week (a OR=1.48, 95 %CI: 1.12-1.95), to have group sex behaviors in the past six months (a OR=2.43, 95 %CI:1.61-3.67) and to use new-type drugs (a OR=1.46, 95 %CI: 1.11-1.91). MSM who had group sex were more likely to have following features: being from Qingdao (a OR=2.21, 95 %CI: 1.45-3.38), non-Shandong residents (a OR=2.13, 95 %CI: 1.28-3.55), HIV knowledge awareness score ≥6 (a OR=3.11, 95 %CI: 1.55-6.25), ever having unprotected anal sex behaviors (a OR=2.60, 95 %CI: 1.71-3.96) and ever having male commercial sex (a OR=3.38, 95 %CI: 1.92-5.95) in the past six months, ever using new-type drugs (a OR=2.71, 95 %CI: 1.82-4.04), and never having HIV testing in the past year (a OR=2.66, 95 %CI: 1.59-4.43). Conclusion:New-type drug use is common in MSM in Shandong. The use of new-type drugs promotes unprotected sex and group sex in MSM. Surveillance and intervention measures targeting this population should be strengthened.