Objective: To analyze the infection characteristics of newly reported HIV/AIDS cases in Hangzhou City, so as to provide the reference for effective AIDS intervention. Methods: Newly reported HIV/AIDS cases in Hangzhou City in 2022 were recruited. Demographic information, HIV testing status, infection routes and sexual behaviors were collected using questionnaire surveys. Blood samples were collected before antiviral treatment, and HIV-1 pol gene sequences were detected to construct molecular transmission networks. The characteristics of HIV/AIDS cases, including infection routes, time, and location were analyzed. Factors affecting infection time and location among HIV/AIDS cases were analyzed using a multivariable logistic regression model. Results: A total of 1 007 HIV/AIDS cases were reported in Hangzhou City in 2022, with 907 cases (90.07%) completing questionnaire surveys. Among them, 833 were males (91.84%), and 532 had out-of-province household registrations (58.65%). Ninety-one molecular transmission networks were established, and 276 cases were involved, with homosexual contact as the main infection route (199 cases, 72.10%). There were 311 recently infected cases (35.34%) and 569 previously infected cases (64.66%) among 880 cases whose infection time could be determined. There were 531 locally infected. cases (70.24%) and 225 imported cases (29.76%) among 756 cases whose infection location could be determined. Multivariable logistic regression analysis showed that the HIV/AIDS cases who were identified through voluntary counseling and testing (OR=1.826, 95%CI: 1.055-3.175) and sought sexual partners through homosexual dating apps (OR=2.461, 95%CI: 1.193-5.234) were more likely to be recently infected; the cases who lived in Hangzhou City for more than one year (>1 to 5 years, OR=2.853, 95%CI: 1.552-5.358; >5 years, OR=3.534, 95%CI: 1.382-9.804), sought sexual partners through entertainment venues (OR=3.449, 95%CI: 1.390-8.935), online/social apps (OR=2.416, 95%CI: 1.084-5.488) and homosexual dating apps (OR=3.734, 95%CI: 1.677-8.493) were more likely to be locally infected; student cases were more likely to be infected outside Hangzhou City (OR=0.115, 95%CI: 0.019-0.525). Conclusions The newly reported HIV/AIDS cases in Hangzhou City in 2022 were primarily infected through homosexual contact, previously and locally. Seeking sexual partners through homosexual dating apps is an important influencing factor for recent and local infections, highlighting the need for strengthening traceback investigations of related cases.

ObjectiveTo investigate the potential mechanism of Shenqi Yiliu Formula （参芪抑瘤方） in treating precancerous lesions of gastric cancer （PLGC） by the Wnt/β-catenin signaling pathway. MethodsThe CCK-8 assay was used to determine the optimal intervention time for Shenqi Yiliu Formula drug-containing serum and the concentration of the Wnt/β-catenin pathway inhibitor XAV939 depends on the survival rate of AGS gastric cancer cell line. AGS cells were divided into the gastric cancer cell group （15% blank serum）， inhibitor group （selected concentration of XAV939）， high-dose Shenqi Yiliu Formula group （12% Shenqi Yiliu Formula drug-containing serum + 3% blank serum）， medium-dose Shenqi Yiliu Formula group （6% Shenqi Yiliu Formula drug-containing serum + 9% blank serum）， and low-dose Shenqi Yiliu Formula group （3% Shenqi Yiliu Formula drug-containing serum + 12% blank serum）. Each group was tested in triplicate. After culturing for 24 and 48 hours， cell migration and invasion were assessed by scratch assays； after a selected intervention period （48 hours）， cell cycle distribution was analyzed using flow cytometry， Ki67 protein levels were detected by immunofluorescence， the protein levels of Wnt， β-catenin， GSK-3β， and intranuclear T-cell specific factor（TCF） were measured by the protein immunoblotting assay， and the mRNA expressions of these above factors were determined by quantitative real-time PCR. ResultsThe optimal intervention time for Shenqi Yiliu Formula drug-containing serum was determined to be 48 hours， and the effective concentration of XAV939 was 20 μmol/L. Compared with the gastric cancer cell group， Shenqi Yiliu Formula at all doses reduced the cell migration rate at 24 and 48 hours （P＜0.05）， except for the low-dose group at 24 hours. Compared to the low-dose group at corresponding time points， high- and medium-dose Shenqi Yiliu Formula groups showed significantly reduced migration rates， particularly the high-dose group at 48 hours （P＜0.05）. Compared with the gastric cancer cell group， the high-dose Shenqi Yiliu Formula and inhibitor groups exhibited reduced protein and mRNA levels of Wnt， β-catenin， and TCF， along with reduced Ki67 protein levels and a decreased proportion of cells in the S and G2 phases of the cell cycle， but GSK-3β protein levels， GSK-3β mRNA expression， and the proportion of cells in the G1 phase increased （P＜0.05）. Compared to the inhibitor group， the high-dose Shenqi Yiliu Formula group showed a decreased proportion of G1-phase cells and an increased proportion of G2-phase cells （P＜0.05）， although differences in Wnt and β-catenin protein levels and mRNA expressions were not statistically significant （P＞0.05）. ConclusionShenqi Yiliu Formula drug-containing serum inhibits the migration and invasion of gastric cancer AGS cells and block the cell cycle at G1 phase， and its underlying mechanism may be related to the regulation of the Wnt/β-catenin signaling pathway.

YE Tianshi possessed a comprehensive theoretical system and extensive therapeutic experience in the treatment of warm disease caused by latent pathogenic qi,all of which was recorded in his medical records.YE Tianshi elucidated the characteristics of the pathogenesis of the three types of warm disease caused by latent pathogenic qi,namely spring warmth,summer heat,and winter warmth,and explained the pathogenesis of latent pathogenic qi from the perspective of vital qi and pathogen,and pointed out that the weakness of vital qi and the pathogenic qi led to the concealment of pathogenic qi,and that the struggle between vital qi and pathogen led to the onset of latent pathogenic qi.In the treatment,YE Tianshi emphasized the importance of clearly identifying the level of qi and blood in the internal organs where the latent pathogenic qi is located,and focused on the syndrome differentiation of weifen,qifen,yingfen,and xuefen,and combined with the syndrome differentiation of zang-fu viscera,the principle and method of treatment and medication law of warm disease caused by latent pathogenic qi were formulated.Although warm disease caused by latent pathogenic qi is a heat syndrome,YE Tianshi also attached importance to the deficiency and excess of yang qi,pointed out that latent pathogenic qi had the possibility of transforming into cold syndrome,and discussed the rules of medication for cold latent pathogenic qi in the spleen,kidney,and eight extraordinary meridians.YE Tianshi's treatment of warm disease caused by latent pathogenic qi not only emphasizes the nourishment of yin,but also emphasizes clearing qi and blood,and the circulation of qi in order to clear and penetrate the evil qi;he also pays attention to the sanjiao transmission of the latent pathogenic evil.The study of the law of YE Tianshi's differentiation and treatment of warm disease caused by latent pathogenic qi may provide ideas for the clinical treatment of COVID-19,as well as diseases in various disciplines.

Emphasizing symptom efficacy is an important manifestation of the personalized diagnosis and treatment of traditional Chinese medicine （TCM）. However， in current clinical practice of TCM， there are challenges such as diverse symptom expressions， difficulty in standardization， inconsistent evaluation standards for symptom efficacy， lack of universal quantitative methods， and complexity in collecting complete and accurate symptom information. These issues hinder the full and effective utilization of symptom information. Addressing the current research status and existing problems of symptom terminology standardization， quantification and grading of symptom efficacy， and collection of symptom information， this paper proposes methodological strategies for effectively recording and utilizing TCM symptom efficacy information in the era of big data. These strategies include collecting TCM symptom information based on patient reporting， standardizing the evaluation of TCM symptom efficacy from measurement scales and evaluation dimensions， integrating TCM symptom efficacy evaluation into clinical diagnosis and treatment processes， and utilizing artificial intelligence technology to acquire and process TCM symptom efficacy information. TCM symptom efficacy evaluation strategies based on patient perspectives and artificial intelligence technology will help fully explore the value of data elements， promote the objective demonstration of the specific efficacy of TCM， and facilitate the discovery of effective patterns.

Objective:To analyze the survival status and death factors of confirmed HIV-infected patients in Hangzhou to provide a basis for the formulation of AIDS prevention and treatment strategies.Methods:A retrospective cohort study was conducted. The data were from the HIV/AIDS Comprehensive Response Information Management System of the Chinese Disease Control and Prevention Information System.Epidemiological characteristics of HIV-infected patients were comparied in Hangzhou City from 2004 to 2023 by using chi-square Test. The survival rate of HIV-infected patients in Hangzhou was calculated by the life table method, the survival curves of different subgroups were described by the Kaplan-Meier method, and the Cox proportional hazard regression model was used to analyze the influencing factors of death risk. The SPSS 26.0 software was used for statistical analysis.Results:Among the 9 457 subjects, the total follow-up time was 58 004.18 person-years, 494 patients died, fatality rate of all-cause cases was 0.85 per 100 person-years.The average survival time was 18.59 (95% CI:18.40-18.78) years. Malignant neoplasms and pneumocystis pneumonia were the first (14.37%,71/494) and second (10.73%, 53/494) causes of death, respectively. Death within 6 months after diagnosis accounted for 42.51% (210/494), and suicide accounted for 4.25% (21/494). Multivariate Cox regression analysis showed that compared with those who received antiviral treatment (ART) within 3 months of diagnosis, those who received ART outside 3 months and those who did not receive ART had a 1.65 (95% CI:1.25-2.19) and 20.68 (95% CI:15.80-27.06) times risk of death, respectively. The HIV-infected patients with high CD4 +T lymphocytes (CD4) counts for the first time had a lower risk of death. The risk of death of patients with baseline CD4 counts of 200-349 cells/μl, 350-499 cells/μl, and ≥500 cells/μl was 0.38 (95% CI:0.29-0.49), 0.26 (95% CI:0.19-0.36), 0.21 (95% CI:0.14-0.31) times higher than that of baseline CD4 counts <200 cells/μl, respectively. Conclusions:The overall survival of the HIV-infected patients was good in Hangzhou from 2004 to 2023. Early detection of HIV infection and timely mobilization to participate in ART was the key to improving the survival rate of patients. At the same time, given the suicide problem of HIV-infected patients, suicide surveillance and depression and anxiety screening of HIV-infected patients should be further strengthened, and targeted psychological intervention policies should be implemented.

Asian ginseng mostly appeared in herbal medical books in the late Qing Dynasty and the early Republic of China.In modern literature,it is believed that this drug is alias of vigorously cultivated ginseng,Talinum paniculatum(Jacq.)Gaertn.,Pananis Japonici Rhizoma,Arctii Fructus and other drugs,and the origin is confused.This article made a textual research on the name,origin,producing areas,processing,property and taste,and efficacy.It is concluded that the Asian ginseng was earlier included in the Ben Cao Gang Mu Shi Yi in the Qing Dynasty,and was named Asian ginseng because it was produced in Japan.The original plant is Panax ginseng C.A.Meyer,which is a kind of Araliaceae plant.It takes Yunzhou,Huijin and Xinzhou of Japan as the true land,and is also cultivated in Northeast China.Asian ginseng medicinal materials are made by processing techniques such as net whiskers,boiling,cooling,and exposure to dryness.They are warm in property,sweet and slightly bitter in taste.They are good at tonifying qi and generating fluid,and can treat all deficiency syndromes of fluid and qi.In the Qing Dynasty,they were often used as Ginseng Radix et Rhizoma.The identification of false was also attached for distinguishing.

Objective : To investigate the quality of life among people living with HIV/AIDS in Hangzhou City and analyze the influencing factors, so as to provide insights into the control of AIDS. Methods : From 1 January 2014 to 30 June 2018, the demographic characteristics, medical expenditures and disease status were collected from HIV/AIDS patients living in Hangzhou City, and the quality of life was assessed using the simplified Chinese version of Medical Outcomes Study-HIV Health Survey ( MOS-HIV ). Factors affecting the quality of life were identified among HIV/AIDS patients using multivariable linear regression analysis. Results : A total of 2 808 HIV/AIDS patients were surveyed, including 1 684 cases with HIV infections and 1 124 cases with AIDS. The participants included 2 510 men ( 89.39% ) and 298 women ( 10.61% ), and were predominantly at ages of 25 to 39 years ( 1 531 cases, 54.52% ). The physical and mental health scores were 53.87±6.96 and 46.03±9.09, respectively. Multivariable linear regression analysis identified age, average monthly income, self-paid medical expenses during the past year, and the latest CD4+T cell count as factors affecting physical and mental health ( P<0.05 ). Conclusions The quality of life is low among people living with HIV/AIDS in Hangzhou City, and is associated with age, income, medical expenditures and CD4+T cell count.

Cell pyroptosis is a programmed death of inflammatory cells. Many members of the gasdermin family （the effector protein family that forms pores） participate in the pathological process of a variety of diseases， such as cancer， myocardial ischemia， renal injury， and osteoarthritis， mainly by activating cysteine aspartate-specific protease （Caspase） for polymerization and shear. Cell pyroptosis has bidirectional regulation. Induction of pyroptosis can promote cell clearance under pathological conditions （such as cancer and tumor cells）， but long-term induction of pyroptosis can lead to abnormal lipid and related vitamin metabolism in vivo. Regulating the balance between cell pyroptosis and proliferation is an important target for traditional Chinese medicine （TCM） treatment of diseases. The Yin-Yang theory runs through the whole process of TCM diagnosis and treatment， which is used to explain the physiological and pathological changes of human body and guide the theory， diagnosis and treatment of diseases and health care. The balance between cell proliferation and pyroptosis is essentially the embodiment of Yin-Yang balance at the cellular level， and the theory of Yin-Yang spontaneous harmonization dominates the balance. TCM intervention on cell pyroptosis is mainly reflected in promoting and inhibiting cell pyroptosis， which has the same significance as Yin-Yang regulation. Based on this theory， this paper revealed the relationship between TCM inhibiting and promoting cell pyroptosis through the Yin-Yang theory， to provide theoretical support for the modernization of the Yin-Yang theory and new goals for the diagnosis and treatment of diseases.

Objective : To investigate the HIV-1 molecular transmission network among school students with newly confirmed HIV/AIDS in Hangzhou City from 2020 to 2021, so as to provide insights into AIDS control in school. Methods : School students with newly confirmed HIV/AIDS in Hangzhou City from 2020 to 2021 were sampled, and participants' demographics and epidemiological survey data were retrieved from the HIV/AIDS Control Information System of Chinese Disease Prevention and Control Information System. The HIV-1 pol gene was amplified in participants' blood samples using reverse transcription (RT) and nested PCR assays, and the HIV subtypes were characterized through multiple sequence alignments. The gene sequences were aligned among newly confirmed HIV/AIDS patients in Hangzhou City during the same study period. The genetic distance was estimated using the software MEGA 11, and the molecular transmission network was created using the software Cytoscape 3.9.1 to analyze the characteristics of clustered cases in the network. Results: A total of 99 school students were newly confirmed with HIV/AIDS in Hangzhou City from 2020 to 2021, including 98 men (98.98%), and 94 men who had sex with men (94.94%). The HIV-1 pol gene sequence was successfully amplified from 87 cases, and four HIV-1 subtypes were characterized, including CRF07_BC (49 cases, 56.32%), CRF01_AE (27 cases, 31.03%), CRF55_01B (6 cases, 6.90%) and CRF67_01B (5 cases, 5.75%). There were 30 molecular clusters in 50 MSM, with 2 to 16 cases in each cluster, and 27 molecular clusters associated with non-student cases, and clustered cases were all MSM. Infection route, location of schools and current address of non-student cases were identified as factors affecting case clustering, and the residence of schools was an important area of activity among clustered HIV/AIDS cases. Conclusions CRF07_BC and CRF01_AE were predominant HIV-1 subtypes among school students with newly confirmed HIV/AIDS in Hangzhou City from 2020 to 2021, and the transmission of HIV/AIDS strongly correlated with non-student cases, with men-men sexual behaviors as the predominant transmission route. The interventions for of MSM is recommended to be reinforced to block the transmission of HIV/AIDS from community to schools.

BACKGROUND: Intracerebral hemorrhage (ICH) is one of the most severe complications during veno-venous extracorporeal membrane oxygenation (VV-ECMO). This study aimed to determine the risk factors for ICH and mortality in such patients. METHODS: We analyzed the clinical data of 77 patients who received VV-ECMO due to severe respiratory failure from July 2013 to May 2019 at China-Japan Friendship Hospital. Demographical data, laboratory indices, imaging characteristics, and other clinical information were collected. Multivariable logistic regression analyses were performed to identify risk factors for ICH and mortality. RESULTS: Of 77 patients, 11 (14.3%) suffered from ICH, and 36 (46.8%) survived. The survival rate was significantly lower (18.2% [2/11] vs. 51.5% [34/66], P = 0.040) in patients with ICH than in those without ICH. Multivariable analysis revealed that factors independently associated with ICH were diabetes mellitus (adjusted odds ratio [aOR]: 12.848, 95% confidence interval [CI]: 1.129-146.188, P = 0.040) and minimum fibrinogen during ECMO (aOR: 2.557, 95% CI: 1.244-5.252, P = 0.011). Multivariable analysis showed that factors independently associated with mortality were acute hepatic failure during ECMO (aOR: 9.205, 95% CI: 1.375-61.604, P = 0.022), CO2 retention before ECMO (aOR: 7.602, 95% CI: 1.514-38.188, P = 0.014), and minimum platelet concentration during ECMO (aOR: 0.130, 95% CI: 0.029-0.577, P = 0.007). CONCLUSIONS Diabetes mellitus and minimum fibrinogen concentration during ECMO are risk factors for ICH in patients with severe respiratory failure managed using VV-ECMO. This indicated that anticoagulants use and nervous system monitoring should be performed more carefully in patients with diabetes when treated with VV-ECMO due to severe respiratory failure.
Adult ; Anticoagulants ; Extracorporeal Membrane Oxygenation ; Humans ; Intracranial Hemorrhages ; Respiratory Insufficiency/therapy* ; Retrospective Studies ; Risk Factors