OBJECTIVE To systematically evaluate the efficacy and safety of different induction regimens for AIDS complicated with cryptococcal meningitis.METHODS PubMed,Embase,Cochranre library,Web of science,CNKI,Wanfang,Weipu and other databases were systematically searched to collect randomized controlled trials related to the induction treatments of AIDS complicated with cryptococcal meningitis.The search was limited to Oct.2024.The Cochrane risk of bias evaluation system was used to evaluate the quality of the literature,and Stata 15.1 and Revman 5.3 software were used for network meta-analysis.RESULTS A total of 17 randomized controlled trials involving 3,281 patients were included.The result of network meta-analysis showed that the treatment regi-men with the lowest early mortality was the short-course of amphotericin B+fluconazole+flucytosine;the regi-men with the lowest late mortality was a single high-dose amphotericin B liposome;the regimen with the highest 14-day fungal clearance rate was amphotericin B+flucytosine;the regimen with the lowest incidence of grade 3+4 anemia was a single high-dose amphotericin B liposome;the regimen with the lowest incidence of grade 3+4 re-nal injury was amphotericin B liposome;the regimen with the lowest incidence of grade 3-4 hypokalemia was flu-conazole+flucytosine.CONCLUSION According to the comprehensive analysis of various indices,there is good efficacy and safety for the inclusion of short-course amphotericin B regimen and single high-dose amphotericin B li-posome as induction period therapy for AIDS complicated with cryptococcal meningitis.

Objective:To investigate the clinical effect of physical intervention combined with medical nutritional weight loss(PI+MNWL)in the treatment of short penis in obese children.Methods:One hundred and twenty obese children with a short pe-nis were included and equally divided into three groups:PI+MNWL,MNWL,and self-guided diet,who underwent PI+MNWL,MN-WL intervention under the supervision of professional nutritionists in the hospital,or self-guided diet intervention at home,respective-ly,all for 30 days.We measured the penile parameters,including stretched penile length(SPL),flaccid penile length(FPL)and pe-nile diameter(PD),of the children before and after treatment,and compared them among the three groups.Results:After inter-vention,the body weight of the children was significantly decreased in all the three groups(27.1-94.1[53.59±11.88]kg vs 23.0-85.1[49.01±11.61]kg,P＜0.05).The weight of children in 3 groups decreased to different degrees,and the difference was statistically significant(P＜0.05).MNWL was found remarkably more effective than self-guided weight loss in reducing the body weight of the children(P＜0.05).Based on weight loss achieved through medical nutrition combined with physical intervention,the FPL in the PI+MNWL group increased from(1.93±0.76)cm before treatment to(3.41±1.41)cm after one course of compre-hensive treatment,with a statistically significant difference(P＜0.05).Similarly,SPL increased from(3.75±0.76)cm before treatment to(4.98±0.64)cm,and PD increased from(1.32±0.21)cm before treatment to(1.61±0.66)cm,both showing statistically significant differences(P＜0.05).In the MNWL group,FPL increased from(2.01±0.81)cm to(2.77±0.84)cm after one course of treatment,with a statistically significant difference(P＜0.05).Additionally,SPL increased from(4.03±0.84)cm before treatment to(4.40±0.76)cm,also demonstrating statistical significance(P＜0.05),while PD increased from(1.37±0.21)cm before treatment to(1.42±0.22)cm,with statistical significance(P＜0.05).FPL and SPL increased sig-nificantly in the PI+MNWL group compared to the MNWL group(P＜0.05,P＜0.01).However,there was no significant differ-ence in PD between the two groups following the intervention(P＞0.05).Conclusion:MNWL is more effective than self-guided diet in controlling the body weight of children,while the combination approach of PI+MNWL is even superior to the management of short penis in obese children,with the advantages of improving the appearance and increasing the exposed length of the penis.

OBJECTIVE To systematically evaluate the efficacy and safety of different induction regimens for AIDS complicated with cryptococcal meningitis.METHODS PubMed,Embase,Cochranre library,Web of science,CNKI,Wanfang,Weipu and other databases were systematically searched to collect randomized controlled trials related to the induction treatments of AIDS complicated with cryptococcal meningitis.The search was limited to Oct.2024.The Cochrane risk of bias evaluation system was used to evaluate the quality of the literature,and Stata 15.1 and Revman 5.3 software were used for network meta-analysis.RESULTS A total of 17 randomized controlled trials involving 3,281 patients were included.The result of network meta-analysis showed that the treatment regi-men with the lowest early mortality was the short-course of amphotericin B+fluconazole+flucytosine;the regi-men with the lowest late mortality was a single high-dose amphotericin B liposome;the regimen with the highest 14-day fungal clearance rate was amphotericin B+flucytosine;the regimen with the lowest incidence of grade 3+4 anemia was a single high-dose amphotericin B liposome;the regimen with the lowest incidence of grade 3+4 re-nal injury was amphotericin B liposome;the regimen with the lowest incidence of grade 3-4 hypokalemia was flu-conazole+flucytosine.CONCLUSION According to the comprehensive analysis of various indices,there is good efficacy and safety for the inclusion of short-course amphotericin B regimen and single high-dose amphotericin B li-posome as induction period therapy for AIDS complicated with cryptococcal meningitis.

PURPOSE: To judge the injury mode and injury severity of the real human body through the measured values of anthropomorphic test devices (ATD) injury indices, the mapping relationship of lumbar injury between ATD and human body model (HBM) was explored. METHODS: Through the ATD model and HBM simulation, the mapping relationship of lumbar injury between the 2 subjects was explored. The sled environment consisted of a semi-rigid seat with an adjustable seatback angle and a 3-point seat belt system with a seatback-mounted D-ring. Three seatback recline states of 25°, 45°, and 65° were designed, and the seat pan angle was maintained at 15°. A 23 g, 47 km/h pulse was used. The validity of the finite element model of the sled was verified by the comparison of ATD simulation and test results. ATD model was the test device for human occupant restraint for autonomous vehicles (THOR-AV) dummy model and HBM was the total human model for safety (THUMS) v6.1. The posture of the 2 models was adjusted to adapt to the 3 seat states. The lumbar response of THOR-AV and the mechanical and biomechanical data on L1 - L5 vertebrae of THUMS were output, and the response relationship between THOR-AV and THUMS was descriptive statistically analyzed. RESULTS: Both THOR-AV and THUMS were submarined in the 65° seatback angle case. With the change of seatback angle, the lumbar spine axial compression force (F_z) of THOR-AV and THUMS changed in the similar trend. The maximum F_z ratio of THOR-AV to THUMS at 25° and 45° seatback angle cases were 1.6 and 1.7. The flexion moment (M_y) and the time when the maximum M_y occurred in the 2 subjects were very different. In particular, the form of moment experienced by the L1 - L5 vertebrae of THUMS also changed. The changing trend of M_y measured by THOR-AV over time can reflect the changing trend of maximum stress of L1 and L2 of THUMS. CONCLUSION The F_z of ATD and HBM presents a certain proportional relationship, and there is a mapping relationship between the 2 subjects on F_z. The mapping function can be further clarified by applying more pulses and adopting more seatback angles. It is difficult to map M_y directly because they are very different in ATD and HBM. The M_y of ATD and stress of HBM lumbar showed a similar change trend over time, and there may be a hidden mapping relationship.
Humans ; Lumbar Vertebrae/injuries* ; Finite Element Analysis ; Biomechanical Phenomena ; Manikins ; Spinal Injuries/physiopathology*

This study primarily aimed to investigate the prevalence of human papillomavirus (HPV) and other common pathogens of sexually transmitted infections (STIs) in spermatozoa of infertile men and their effects on semen parameters. These pathogens included Ureaplasma urealyticum, Ureaplasma parvum, Chlamydia trachomatis, Mycoplasma genitalium , herpes simplex virus 2, Neisseria gonorrhoeae, Enterococcus faecalis, Streptococcus agalactiae, Pseudomonas aeruginosa , and Staphylococcus aureus . A total of 1951 men of infertile couples were recruited between 23 March 2023, and 17 May 2023, at the Department of Reproductive Medicine of The First People's Hospital of Yunnan Province (Kunming, China). Multiplex polymerase chain reaction and capillary electrophoresis were used for HPV genotyping. Polymerase chain reaction and electrophoresis were also used to detect the presence of other STIs. The overall prevalence of HPV infection was 12.4%. The top five prevalent HPV subtypes were types 56, 52, 43, 16, and 53 among those tested positive for HPV. Other common infections with high prevalence rates were Ureaplasma urealyticum (28.3%), Ureaplasma parvum (20.4%), and Enterococcus faecalis (9.5%). The prevalence rates of HPV coinfection with Ureaplasma urealyticum, Ureaplasma parvum, Chlamydia trachomatis, Mycoplasma genitalium , herpes simplex virus 2, Neisseria gonorrhoeae, Enterococcus faecalis, Streptococcus agalactiae , and Staphylococcus aureus were 24.8%, 25.4%, 10.6%, 6.4%, 2.4%, 7.9%, 5.9%, 0.9%, and 1.3%, respectively. The semen volume and total sperm count were greatly decreased by HPV infection alone. Coinfection with HPV and Ureaplasma urealyticum significantly reduced sperm motility and viability. Our study shows that coinfection with STIs is highly prevalent in the semen of infertile men and that coinfection with pathogens can seriously affect semen parameters, emphasizing the necessity of semen screening for STIs.
Humans ; Male ; Infertility, Male/epidemiology* ; Coinfection/microbiology* ; Papillomavirus Infections/virology* ; Adult ; Sexually Transmitted Diseases/complications* ; China/epidemiology* ; Staphylococcus aureus/isolation & purification* ; Chlamydia trachomatis/isolation & purification* ; Prevalence ; Mycoplasma genitalium/isolation & purification* ; Ureaplasma urealyticum/isolation & purification* ; Neisseria gonorrhoeae/isolation & purification* ; Enterococcus faecalis/isolation & purification* ; Streptococcus agalactiae/isolation & purification* ; Herpesvirus 2, Human/genetics* ; Pseudomonas aeruginosa/isolation & purification* ; Semen/virology* ; Sperm Motility ; Spermatozoa/microbiology* ; Human Papillomavirus Viruses

Recurrent spontaneous abortion(RSA)mainly refers to two or more consecutive abortions of the same spouse before 28 weeks of pregnancy.These pathogenic factors are complex and diverse.Vitamin D levels are considered to play an important role in the reproductive process.Low levels of vitamin D have been correlated with the onset of RSA.The intervention and therapeutic effects of vitamin D levels on RSA have attracted widespread attention from scholars.However,it's still unclear that how vitamin D levels affect the pathogenesis of recurrent miscarriage.This article reviewed the recent studies on the correlation between vitamin D levels and recurrent miscarriage.

OBJECTIVE: To investigate the therapeutic effect of the short-penis treatment apparatus and wide-band infrared therapy apparatus on penile dysplasia (PDP) in children and establish objective parameters for assessing the severity of PDP. METHODS: This study included 252 children received in the Department of pediatric urology of the First Affiliated Hospital of Xinjiang Medical University from January to December 2023, 102 with PDP (the PDP group) and the other 150 with normal penile development (the control group), those of the former group treated with the short-penis therapeutic apparatus and wide-band infrared therapy apparatus. Before and after 30 days of treatment, we measured the flaccid penile length (FPL), stretched penile length (SPL) and penile diameters (PD) of the children, and defined the penile dysplasia index as the FPL/SPL and FPL/PD ratios. RESULTS: The penile parameters exhibited statistically significant differences between the PDP and control groups, (FPL:［1.97±0.72］cm vs ［3.25±0.51］ cm, P<0.01; SPL:［3.80±0.81］cm vs ［5.21±0.79］cm,P<0.01).The FPL remarkably increased in the PDP group after treatment(［1.97±0.72］cm vs ［2.90±1.20］ cm, P<0.01). Both FPL and SPL were notably shorter in the PDP cases than in the controls, with the cutoff values of 0.57 and 2.09, sensitivities of 80.7% and 95.3%, and specificities of 69.6% and 82.4% for FPL/SPL and FPL/PD, respectively. CONCLUSION The short-penis therapeutic apparatus and wide-band infrared therapy apparatus can promote the growth and development of the penis in children. The ratio of FPL/PD can serve as an objective indicator to effectively describe the severity of penile developmental abnormalities.
Humans ; Male ; Penis/abnormalities* ; Child ; Penile Diseases/therapy* ; Child, Preschool ; Infant

OBJECTIVE: To investigate whether Buyang Huanwu Decoction (BYHWD) had a good curative effect on the neuroprotection of red nucleus neurons after spinal cord injury (SCI) and the possible molecular mechanism. METHODS: Ninety male Sprague-Dawley rats were divided into 5 groups (n=18 per group) according to a random number table, including the control, model, low- (12.78 g/kg, BL group), medium- (25.65 g/kg, BM group), and high-dose BYHWD groups (51.30 g/kg, BH group). A rubrospinal tract transection model in rats was established, and different doses of BYHWD were intragastrically administrated for 4 weeks. The forelimb locomotor function was recorded using the spontaneous vertical exploration test. Cyclic adenosine monophosphate (cAMP) level in red nucleus was detected through an enzyme-linked immunosorbent assay. The morphology and number of red nucleus neurons were observed using Nissl's staining and axonal retrograde tracing by Fluoro-Gold (FG). The expression of cAMP-dependent protein kinase A (PKA), nuclear factor kappa-B (NF-κB) p65, and brain-derived neurotrophic factor (BDNF) in red nucleus were detected using immunohistochemistry and quantitative real-time polymerase chain reaction. RESULTS: Compared with the control group, the utilization rate of bilateral forelimbs, unilateral right forelimbs, proportion of FG-labeled positive neurons, cAMP level, protein expressions of PKA and BDNF, and BDNF mRNA expression were significantly decreased in the model group (P<0.01), while NF-κB p65 was increased in the model group (P<0.01). Compared with the model group, the utilization rate of bilateral forelimbs and unilateral right forelimbs were significantly higher in the BL, BM and BH groups (P<0.01), the proportion of FG-labeled positive neurons, cAMP level, protein expressions of PKA and BDNF and BDNF mRNA expression in all BYHWD groups were increased (P<0.05 or P<0.01), while NF-κB p65 were decreased in all BYHWD groups (P<0.05 or P<0.01). CONCLUSIONS BYHWD possesses a sound neuroprotective effect on red nucleus neurons after SCI, and the efficacy was dose-related. The mechanism may be related to regulating the cAMP/PKA/NF-κ B p65 signaling pathway, finally promoting expression of BDNF.
Animals ; Spinal Cord Injuries/pathology* ; Drugs, Chinese Herbal/therapeutic use* ; Rats, Sprague-Dawley ; Male ; Cyclic AMP/metabolism* ; Transcription Factor RelA/metabolism* ; Cyclic AMP-Dependent Protein Kinases/metabolism* ; Signal Transduction/drug effects* ; Brain-Derived Neurotrophic Factor/genetics* ; Red Nucleus/metabolism* ; Recovery of Function/drug effects* ; Neurons/metabolism* ; Rats

Background: The genetic basis for hyperglycaemia in pregnancy remain unclear. This study aimed to uncover the genetic determinants of gestational diabetes mellitus (GDM) and investigate their applications. Methods: We performed a meta-analysis of genome-wide association studies (GWAS) for GDM in Chinese women (464 cases and 1,217 controls), followed by de novo replications in an independent Chinese cohort (564 cases and 572 controls) and in silico replication in European (12,332 cases and 131,109 controls) and multi-ethnic populations (5,485 cases and 347,856 controls). A polygenic risk score (PRS) was derived based on the identified variants. Results: Using the genome-wide scan and candidate gene approaches, we identified four susceptibility loci for GDM. These included three previously reported loci for GDM and type 2 diabetes mellitus (T2DM) at MTNR1B (rs7945617, odds ratio [OR], 1.64; 95% confidence interval [CI],1.38 to 1.96]), CDKAL1 (rs7754840, OR, 1.33; 95% CI, 1.13 to 1.58), and INS-IGF2-KCNQ1 (rs2237897, OR, 1.48; 95% CI, 1.23 to 1.79), as well as a novel genome-wide significant locus near TBR1-SLC4A10 (rs117781972, OR, 2.05; 95% CI, 1.61 to 2.62; Pmeta=7.6×10-9), which has not been previously reported in GWAS for T2DM or glycaemic traits. Moreover, we found that women with a high PRS (top quintile) had over threefold (95% CI, 2.30 to 4.09; Pmeta=3.1×10-14) and 71% (95% CI, 1.08 to 2.71; P=0.0220) higher risk for GDM and abnormal glucose tolerance post-pregnancy, respectively, compared to other individuals. Conclusion Our results indicate that the genetic architecture of glucose metabolism exhibits both similarities and differences between the pregnant and non-pregnant states. Integrating genetic information can facilitate identification of pregnant women at a higher risk of developing GDM or later diabetes.

Background: The genetic basis for hyperglycaemia in pregnancy remain unclear. This study aimed to uncover the genetic determinants of gestational diabetes mellitus (GDM) and investigate their applications. Methods: We performed a meta-analysis of genome-wide association studies (GWAS) for GDM in Chinese women (464 cases and 1,217 controls), followed by de novo replications in an independent Chinese cohort (564 cases and 572 controls) and in silico replication in European (12,332 cases and 131,109 controls) and multi-ethnic populations (5,485 cases and 347,856 controls). A polygenic risk score (PRS) was derived based on the identified variants. Results: Using the genome-wide scan and candidate gene approaches, we identified four susceptibility loci for GDM. These included three previously reported loci for GDM and type 2 diabetes mellitus (T2DM) at MTNR1B (rs7945617, odds ratio [OR], 1.64; 95% confidence interval [CI],1.38 to 1.96]), CDKAL1 (rs7754840, OR, 1.33; 95% CI, 1.13 to 1.58), and INS-IGF2-KCNQ1 (rs2237897, OR, 1.48; 95% CI, 1.23 to 1.79), as well as a novel genome-wide significant locus near TBR1-SLC4A10 (rs117781972, OR, 2.05; 95% CI, 1.61 to 2.62; Pmeta=7.6×10-9), which has not been previously reported in GWAS for T2DM or glycaemic traits. Moreover, we found that women with a high PRS (top quintile) had over threefold (95% CI, 2.30 to 4.09; Pmeta=3.1×10-14) and 71% (95% CI, 1.08 to 2.71; P=0.0220) higher risk for GDM and abnormal glucose tolerance post-pregnancy, respectively, compared to other individuals. Conclusion Our results indicate that the genetic architecture of glucose metabolism exhibits both similarities and differences between the pregnant and non-pregnant states. Integrating genetic information can facilitate identification of pregnant women at a higher risk of developing GDM or later diabetes.