Objective:To analyze differences on characteristics of HIV/AIDS knowledge, beliefs and behavior among female college students who reported having sex in Zhejiang Province between 2018 and 2020, and provide reference for HIV/AIDS prevention and control among female college students.Methods:Cross-sectional surveys were conducted in October-November 2018 and November-December 2020 among female college students in 13 universities in 11 cities in Zhejiang Province, and female college students who self-reported having sexual intercourse in the past year were included as study subjects, with sample size estimates of 5 265 and 9 466 for the two surveys, respectively. The factors related to the change of relevant characteristics of the two survey subjects were analyzed. The χ2 test was used for univariate analysis and logistic regression model was used for multivariate analysis.Statistical analyses were performed with SPSS 23.0 software. Results:Of the 17 354 and 20 675 female college students surveyed in 2018 and 2020, respectively, the proportion who self-reported having had sex in the past year was 6.56% (1 139/17 354) and 4.19% (866/20 675). Multivariate logistic regression analysis showed that compared with female college students in 2018, the students who have sexual behaviour, receiving health education class by their university in the past year (a OR=1.57, 95% CI:1.29-1.91), receiving HIV testing promotion by the university in the past year (a OR=2.59,95% CI:2.13-3.14), receiving self-assessment of HIV risk by the university in the past year (a OR=2.97,95% CI:2.43-3.65), high self-efficacyfor condom use (a OR=2.00, 95% CI:1.66-2.41), receiving voluntary counseling and HIV testing (VCT) (a OR=1.81,95% CI: 1.41-2.87), perceived risk of HIV infection (a OR=2.44, 95% CI:1.32-4.54), using condoms whenever having casual sexual behaviour in the past year (a OR=3.35,95% CI:1.66-6.77) were significantly higher in 2020. Conclusions:Compared with female college students in 2018, the proportion of female college students who self-reported sexual activity decreased slightly in 2020, and the proportion of receiving HIV/AIDS lectures or health education classes, the proportion of self-rated at risk of HIV infection, the proportion of receiving VCT, the proportion of using condoms with very high confidence in self-efficacy and condom use had an increased.

Objective:To understand the prevalence of psychoactive substance use and related factors in men who have unprotected sex with men in Zhejiang Province.Methods:Men who have unprotected sex with men were recruited by snowball sampling through men who have sex with men (MSM) social organization in Zhejiang to conduct a cross-sectional investigation from January 2022 to December 2023. The sample size was estimated to be 1 169 individuals. The information about their socio-demographic information, sexual behaviors, psychoactive substance use, and HIV testing were collected through on-site questionnaire survey. Logistic regression analysis model was used to analyze related factors about psychoactive substance use in this population.Results:A total of 1 914 men who have unprotected sex with men were included in the study, the average age of the study subjects was (31.43±10.46) years, and most of them were aged ≤35 years (70.8%, 1 356/1 914). Those with education level of high school or below accounted for 50.1% (960/1 914) and those who were not married accounted for 63.5% (1 216/1 914). Psychoactive substance use in the past 3 months was reported in 19.7% (377/1 914) of the subjects. Multivariate logistic regression analysis showed that the factors associated with psychoactive substance use in the past 3 months included age 26-35 years (a OR=1.65, 95% CI: 1.24-2.19), ≥2 sexual partners in the past 3 months (a OR=2.33, 95% CI: 1.82-2.97), STD diagnosed in the past 3 months (a OR=2.62, 95% CI: 1.45-4.74), and awareness of the HIV infection status of sexual partners (a OR=2.83, 95% CI: 2.12-3.78). Conclusions:The prevalence of psychoactive substance use in men who have unprotected sex with men was high in Zhejiang. It is necessary to strengthen the intervention in this population.

Psoriasis is an incurable chronic inflammatory disease that requires new interventions. Here, we found that fibroblasts exacerbate psoriasis progression by promoting macrophage recruitment via CCL2 secretion by single-cell multi-omics analysis. The natural small molecule celastrol was screened to interfere with the secretion of CCL2 by fibroblasts and improve the psoriasis-like symptoms in both murine and cynomolgus monkey models. Mechanistically, celastrol directly bound to the low-density lipoprotein receptor-related protein 1 (LRP1) β-chain and abolished its binding to the transcription factor c-Jun in the nucleus, which in turn inhibited CCL2 production by skin fibroblasts, blocked fibroblast-macrophage crosstalk, and ameliorated psoriasis progression. Notably, fibroblast-specific LRP1 knockout mice exhibited a significant reduction in psoriasis like inflammation. Taken together, from clinical samples and combined with various mouse models, we revealed the pathogenesis of psoriasis from the perspective of fibroblast-macrophage crosstalk, and provided a foundation for LRP1 as a novel potential target for psoriasis treatment.

Objective:To analyze differences on characteristics of HIV/AIDS knowledge, beliefs and behavior among female college students who reported having sex in Zhejiang Province between 2018 and 2020, and provide reference for HIV/AIDS prevention and control among female college students.Methods:Cross-sectional surveys were conducted in October-November 2018 and November-December 2020 among female college students in 13 universities in 11 cities in Zhejiang Province, and female college students who self-reported having sexual intercourse in the past year were included as study subjects, with sample size estimates of 5 265 and 9 466 for the two surveys, respectively. The factors related to the change of relevant characteristics of the two survey subjects were analyzed. The χ2 test was used for univariate analysis and logistic regression model was used for multivariate analysis.Statistical analyses were performed with SPSS 23.0 software. Results:Of the 17 354 and 20 675 female college students surveyed in 2018 and 2020, respectively, the proportion who self-reported having had sex in the past year was 6.56% (1 139/17 354) and 4.19% (866/20 675). Multivariate logistic regression analysis showed that compared with female college students in 2018, the students who have sexual behaviour, receiving health education class by their university in the past year (a OR=1.57, 95% CI:1.29-1.91), receiving HIV testing promotion by the university in the past year (a OR=2.59,95% CI:2.13-3.14), receiving self-assessment of HIV risk by the university in the past year (a OR=2.97,95% CI:2.43-3.65), high self-efficacyfor condom use (a OR=2.00, 95% CI:1.66-2.41), receiving voluntary counseling and HIV testing (VCT) (a OR=1.81,95% CI: 1.41-2.87), perceived risk of HIV infection (a OR=2.44, 95% CI:1.32-4.54), using condoms whenever having casual sexual behaviour in the past year (a OR=3.35,95% CI:1.66-6.77) were significantly higher in 2020. Conclusions:Compared with female college students in 2018, the proportion of female college students who self-reported sexual activity decreased slightly in 2020, and the proportion of receiving HIV/AIDS lectures or health education classes, the proportion of self-rated at risk of HIV infection, the proportion of receiving VCT, the proportion of using condoms with very high confidence in self-efficacy and condom use had an increased.

Objective:To understand the prevalence of psychoactive substance use and related factors in men who have unprotected sex with men in Zhejiang Province.Methods:Men who have unprotected sex with men were recruited by snowball sampling through men who have sex with men (MSM) social organization in Zhejiang to conduct a cross-sectional investigation from January 2022 to December 2023. The sample size was estimated to be 1 169 individuals. The information about their socio-demographic information, sexual behaviors, psychoactive substance use, and HIV testing were collected through on-site questionnaire survey. Logistic regression analysis model was used to analyze related factors about psychoactive substance use in this population.Results:A total of 1 914 men who have unprotected sex with men were included in the study, the average age of the study subjects was (31.43±10.46) years, and most of them were aged ≤35 years (70.8%, 1 356/1 914). Those with education level of high school or below accounted for 50.1% (960/1 914) and those who were not married accounted for 63.5% (1 216/1 914). Psychoactive substance use in the past 3 months was reported in 19.7% (377/1 914) of the subjects. Multivariate logistic regression analysis showed that the factors associated with psychoactive substance use in the past 3 months included age 26-35 years (a OR=1.65, 95% CI: 1.24-2.19), ≥2 sexual partners in the past 3 months (a OR=2.33, 95% CI: 1.82-2.97), STD diagnosed in the past 3 months (a OR=2.62, 95% CI: 1.45-4.74), and awareness of the HIV infection status of sexual partners (a OR=2.83, 95% CI: 2.12-3.78). Conclusions:The prevalence of psychoactive substance use in men who have unprotected sex with men was high in Zhejiang. It is necessary to strengthen the intervention in this population.

Objective To investigate the value of prone-position MRI of lumbar spine for diagnosing pediatric occult tethered cord syndrome(OTCS).Methods A total of 67 children with suspected tethered cord syndrome(TCS)and confirmed OTCS by surgery were prospectively enrolled as OTCS group,while 73 healthy subjects were recruited as control group.Supine-and prone-position lumbar MR examinations were performed in both groups.The position of filum terminale on prone axial T2WI and the presence or absence of"sunset sign"(i.e.filum terminale located within the dorsal 1/2 of spinal canal on prone axial T2WI)were observed,spinal cord conus mobility was calculated.The efficacy of"sunset sign"for diagnosing OTCS in children was calculated through comparison between groups.Receiver operating characteristic curve was drawn,the area under the curve(AUC)was calculated to evaluate the diagnostic efficacy of spinal cord conus mobility.Results On prone-position axial T2WI,"sunset sign"was found in 58 cases(58/67,86.57％)but not in 9 cases(9/67,13.43％)in OTCS group,which was not even observed in control group.The sensitivity of"sunset sign"for diagnosing pediatric OTCS was 86.57％(58/67),with specificity of 100％(73/73),positive predictive value of 100％(58/58)and negative predictive value of 89.02％(73/82).The spinal cord conus mobility was(19.30±5.89)％in OTCS group and(31.71±6.58)％in control group,being statistically different between groups(t=-11.722,P＜0.001).The sensitivity,specificity and AUC of spinal cord conus mobility for diagnosing pediatric OTCS was 80.60％,90.41％and 0.920,respectively.Conclusion Prone-position MRI of lumbar spine could be used in diagnosing pediatric OTCS.

Objective To investigate the value of prone-position MRI of lumbar spine for diagnosing pediatric occult tethered cord syndrome(OTCS).Methods A total of 67 children with suspected tethered cord syndrome(TCS)and confirmed OTCS by surgery were prospectively enrolled as OTCS group,while 73 healthy subjects were recruited as control group.Supine-and prone-position lumbar MR examinations were performed in both groups.The position of filum terminale on prone axial T2WI and the presence or absence of"sunset sign"(i.e.filum terminale located within the dorsal 1/2 of spinal canal on prone axial T2WI)were observed,spinal cord conus mobility was calculated.The efficacy of"sunset sign"for diagnosing OTCS in children was calculated through comparison between groups.Receiver operating characteristic curve was drawn,the area under the curve(AUC)was calculated to evaluate the diagnostic efficacy of spinal cord conus mobility.Results On prone-position axial T2WI,"sunset sign"was found in 58 cases(58/67,86.57％)but not in 9 cases(9/67,13.43％)in OTCS group,which was not even observed in control group.The sensitivity of"sunset sign"for diagnosing pediatric OTCS was 86.57％(58/67),with specificity of 100％(73/73),positive predictive value of 100％(58/58)and negative predictive value of 89.02％(73/82).The spinal cord conus mobility was(19.30±5.89)％in OTCS group and(31.71±6.58)％in control group,being statistically different between groups(t=-11.722,P＜0.001).The sensitivity,specificity and AUC of spinal cord conus mobility for diagnosing pediatric OTCS was 80.60％,90.41％and 0.920,respectively.Conclusion Prone-position MRI of lumbar spine could be used in diagnosing pediatric OTCS.

Background::A phase II trial on recombinant human tenecteplase tissue-type plasminogen activator (rhTNK-tPA) has previously shown its preliminary efficacy in ST elevation myocardial infarction (STEMI) patients. This study was designed as a pivotal postmarketing trial to compare its efficacy and safety with rrecombinant human tissue-type plasminogen activator alteplase (rt-PA) in Chinese patients with STEMI.Methods::In this multicenter, randomized, open-label, non-inferiority trial, patients with acute STEMI were randomly assigned (1:1) to receive an intravenous bolus of 16 mg rhTNK-tPA or an intravenous bolus of 8 mg rt-PA followed by an infusion of 42 mg in 90 min. The primary endpoint was recanalization defined by thrombolysis in myocardial infarction (TIMI) flow grade 2 or 3. The secondary endpoint was clinically justified recanalization. Other endpoints included 30-day major adverse cardiovascular and cerebrovascular events (MACCEs) and safety endpoints.Results::From July 2016 to September 2019, 767 eligible patients were randomly assigned to receive rhTNK-tPA ( n = 384) or rt-PA ( n = 383). Among them, 369 patients had coronary angiography data on TIMI flow, and 711 patients had data on clinically justified recanalization. Both used a –15% difference as the non-inferiority efficacy margin. In comparison to rt-PA, both the proportion of patients with TIMI grade 2 or 3 flow (78.3% [148/189] vs. 81.7% [147/180]; differences: –3.4%; 95% confidence interval [CI]: –11.5%, 4.8%) and clinically justified recanalization (85.4% [305/357] vs. 85.9% [304/354]; difference: –0.5%; 95% CI: –5.6%, 4.7%) in the rhTNK-tPA group were non-inferior. The occurrence of 30-day MACCEs (10.2% [39/384] vs. 11.0% [42/383]; hazard ratio: 0.96; 95% CI: 0.61, 1.50) did not differ significantly between groups. No safety outcomes significantly differed between groups. Conclusion::rhTNK-tPA was non-inferior to rt-PA in the effect of improving recanalization of the infarct-related artery, a validated surrogate of clinical outcomes, among Chinese patients with acute STEMI.Trial registration::www.ClinicalTrials.gov (No. NCT02835534).

Objective:Childhood traumatic experiences greatly influenced the brain network activities of patients with depression,and there is an urgent need to explore the temporal dynamics for these changes.This study aims to investigate the abnormalities of resting-state electroencephalogram(EEG)microstates in eye-open state of depressed adolescents and to explore the correlations between their EEG microstates and the childhood traumatic experience. Methods:Using resting-state EEG microstate analysis,we explored the temporal dynamics of brain activity in patients with adolescent depression.This study selected 66 adolescents with depression as a patient group,and 27 healthy adolescents as a healthy control group.A modified k-means clustering algorithm was used to classify the 64-channel resting-state EEG data into different microstates.Independent sample t-tests were used to compare the microstate parameters between the 2 groups and further assciations between these parameters and childhood traumatic experience in patients were explored via using Spearman correlation. Results:In this study,significant differences were observed in the occurrence and transition probabilities of EEG microstates between the healthy control and the patient group.Notably,there was a statistically significant difference(P＜0.05)in the occurrence of microstate A across 2 groups,exhibiting a negative correlation with the emotional abuse component within the childhood trauma scores(Spearman's rho=-0.31,P=0.013).Furthermore,patient-specific,non-random transitions from microstate B to A(Spearman's rho=-0.30,P=0.015)and C to A(Spearman's rho=-0.31,P=0.013)were inversely associated with the scores of emotional abuse factors from childhood trauma in the patient group,showing statistically significant differences when comparing to the healthy controls(P＜0.05).Upon stratification into quartiles based on the emotional abuse factor scores,the occurrence of microstate A,as well as the transition rates from microstates B to A and C to A,retained statistical significance following adjustment for multiple comparisons(all P＜0.05). Conclusion:The abnormal temporal dynamics in brain networks of adolescents with depression are linked to childhood emotional abuse.Those who have suffered severe emotional abuse may show greater impairments in the brain's visual and central executive networks.EEG microstate analysis could be a potential tool for detecting adolescent depression with severe childhood trauma.

Objective:To understand the source and related factors among heterosexual casual partners among male college students for providing AIDS prevention strategies in this population.Methods:Stratified cluster sampling method was used to conduct a questionnaire survey among 31 674 college students in 13 colleges in Zhejiang Province, from October to November, 2018. A total of 2 665 male college students who reported having had heterosexual casual behavior and the source of their sexual partners were recruited. Data on demographic characteristics, knowledge of HIV/AIDS prevention, sexual behavior, and having received AIDS-related interventions were collected. The multivariable logistics regression model was used to analyze the related factors of the source of casual heterosexual behavior partners among male college students.Results:A total of 423 male college students having casual heterosexual sex were investigated, accounting for 15.9% (423/2 665) of the male college students who self-reported having sexual behaviors and informed their sexual partners. Among them, 39.4% (147/373), 37.5% (140/373), and 23.1% (86/373) of participants had 1, 2-4, and 5 or more heterosexual casual sexual partners, respectively. 40.1% (167/416) of participants used condoms consistently with casual partners. 143 (33.8%) participants with social individual's partners were an average age of (20.27±1.40) years old. Multivariate logistic regression analysis showed that: when compared with one person, common acquaintances, and no heterosexual casual partners in the previous year, the factors that related to the source of heterosexual casual partners of male college students appeared as follows: the number of heterosexual casual sexual partners ≥5 (a OR=3.00, 95% CI:1.53-5.89), seeking the casual sexual partners through entertainment venues (a OR=3.04,95% CI:1.64-5.64), male college students having sex with a regular partner in the last one year (a OR=0.41, 95% CI:0.25-0.68). Conclusions:Some of the male college students had heterosexual casual sexual behaviors, with the related factors as having five or more heterosexual casual sexual partners, seeking casual sex partners through entertainment venues, and low condom use. Self-protection awareness and ability should be emphasized to advocate safe sex to reduce the risk of AIDS transmission among college students.