Objective To evaluate the efficacy and safety of polyethylene glycol electrolyte powder(PEG)combined with linaclotide(Lin)for bowel preparation in elderly constipated patients before colonoscopy.Methods In this prospective,randomized controlled trial,90 elderly patients with constipation undergoing colonoscopy were recruited at our hospital from June 2022 to December 2023.Participants were randomly assigned to three groups(n=30 each):PEG-3L alone,PEG-3L+Lin,and PEG-2L+Lin.Primary outcome was Boston Bowel Preparation Scale(BBPS)score and secondary outcomes included adverse event rates,colonoscopy completion rate,withdrawal time,and polyp detection rate.Statistical analysis was performed using independent t-tests and chi-square tests.Results The PEG-3L+Lin group achieved significantly higher BBPS scores than both PEG-3L alone and PEG-2L+Lin groups did(both P<0.001).The PEG-2L+Lin group also outperformed the PEG-3L alone group in cleansing efficacy(90.0%vs.76.7%,P=0.008).The PEG-2L+Lin group demonstrated the best tolerability and lowest adverse event rate,the PEG-3L group had the longest withdrawal time(P<0.05),but the three groups showed no significant difference in polyp detection rates.Conclusion PEG combined with linaclotide significantly improves bowel cleansing in elderly constipated patients.PEG-2L+Lin regimen provides optimal balance between efficacy,safety,and tolerability,making it a preferable choice for this population.

Objective To evaluate the efficacy and safety of polyethylene glycol electrolyte powder(PEG)combined with linaclotide(Lin)for bowel preparation in elderly constipated patients before colonoscopy.Methods In this prospective,randomized controlled trial,90 elderly patients with constipation undergoing colonoscopy were recruited at our hospital from June 2022 to December 2023.Participants were randomly assigned to three groups(n=30 each):PEG-3L alone,PEG-3L+Lin,and PEG-2L+Lin.Primary outcome was Boston Bowel Preparation Scale(BBPS)score and secondary outcomes included adverse event rates,colonoscopy completion rate,withdrawal time,and polyp detection rate.Statistical analysis was performed using independent t-tests and chi-square tests.Results The PEG-3L+Lin group achieved significantly higher BBPS scores than both PEG-3L alone and PEG-2L+Lin groups did(both P<0.001).The PEG-2L+Lin group also outperformed the PEG-3L alone group in cleansing efficacy(90.0%vs.76.7%,P=0.008).The PEG-2L+Lin group demonstrated the best tolerability and lowest adverse event rate,the PEG-3L group had the longest withdrawal time(P<0.05),but the three groups showed no significant difference in polyp detection rates.Conclusion PEG combined with linaclotide significantly improves bowel cleansing in elderly constipated patients.PEG-2L+Lin regimen provides optimal balance between efficacy,safety,and tolerability,making it a preferable choice for this population.

Objective To construct and identify a patient-derived organoid model,and to investigate the sensitivity of chemotherapy drugs using this model.Methods Pancreatic cancer cells were obtained from the surgical specimens of two female patients with a confirmed diagnosis of pancreatic cancer after tumor tissue digestion,and then the cells were inoculated into a culture dish using matrigel for three-dimensional culture.Paraffin sections were prepared for HE staining and immunohistochemical staining and were compared with the parent tumor tissue to determine whether the histopathological features of the tumor in vivo were preserved.The pancreatic cancer organoids were treated with seven chemotherapy drugs at different concentrations;Cell Titer-Glo?3D reagent was used to measure cell viability,and the results of drug sensitivity were analyzed.Results Two patient-derived pancreatic cancer organoids were successfully constructed,and HE staining and immunohistochemical staining showed that the pancreatic cancer organoids had consistent histopathological features with the tumors of the corresponding patient.Both pancreatic cancer organoids were more sensitive to gemcitabine monotherapy and the combination of oxaliplatin+SN38+fluorouracil,and patient 1 was more sensitive than patient 2.There were individual differences in the response to drugs between the organoids from different patients.Conclusion The pancreatic cancer organoid model successfully constructed in this study can reflect the histological classification of parent pancreatic tumors and can be used for in vitro chemotherapy drug sensitivity test,which is expected to provide a reference for clinical medication.

Objective:To analyze the status of first viral load (VL) suppression for newly diagnosed HIV/AIDS on antiretroviral therapy (ART) from 2014 to 2016 in Shandong province, to provide theoretical evidence for improvement of ART effectiveness.Methods:Based on a retrospective cohort study, logistic regression model was used to identify influencing factors about VL suppression.Results:There were 4 833 newly diagnosed HIV/AIDS cases who received ART from 2014 to 2016 in Shandong province, and 3 449 cases achieved VL suppression at the first VL testing. The rate of first VL suppression was 71.36%. The possibilities of first VL suppression among patients on ART with education at junior high school, junior college and above were higher than those with education at primary school and below, with OR values at 1.75 and 2.00, separately. The possibilities of first VL suppression for patients treated at medical institutions was higher than those by CDC, with OR value 1.29. The possibilities of first VL suppression among patients whose CD4 count level at 201-350, 351-500 and ≥501 cells/μl were higher than that of the patients whose CD4 count level at ≤200 cells/μl, with OR values at 2.36, 2.11 and 2.66, respectively. The possibilities of first VL suppression among patients who missed doses was lower than those who did not miss doses, with OR value at 0.55. All the Pvalues for the above comparisons was <0.05. Conclusions:The suppression of viral load for HIV/AIDS on ART was influenced by culture level, CD4 count level at the entry of ART, treatment institutions and adherence to the therapy. Earlier diagnosis, treatment services provided by medical institutions and improvement of drug adherence can enhance ART effectiveness.

Objective: To analyze the epidemiological characteristics of HIV/AIDS infected students in Shandong Province, to provide a basis for the prevention and control of AIDS transmission in the student population. Methods: All 863 HIV/AIDS students cases during 2010-2019 were collected in Shandong Province. Epidemiological characteristics was described and the trends in the 10 years since 2010 was analyzed. Results: These 863 HIV/AIDS students were mainly transmitted through homosexual sex (763 cases, 88.41%), and the samples were mainly from voluntary consultation testing (433 cases, 50.17%). From 2010 to 2019, the proportion of student cases in the total number of cases showed an increasing trend ( χ 2 trend =30.21, P <0.01). Among them, the proportion of homosexual transmission cases increased year by year ( χ 2 trend =6.35, P =0.01), the proportion of cases aged 18-22 years increased year by year ( χ 2 trend =6.10, P =0.01), the proportion of cases with college degree or above increased year by year ( χ 2 trend =4.26, P =0.04). At present, voluntary consultation testing were the main source.There was no significant difference between the years of sample sources ( χ 2 trend =2.97, P =0.09). Conclusion The report number of students in Shandong Province are on the rise in recent years, especially those infected by same sex transmission, mainly with high education background, which calls for targeted strategies and intervention measures.

Objective:To analyze the timeliness and influencing factors of antiretroviral treatment (ART) among HIV/AIDS patients from 2017 to 2019 in Shandong province.Methods:Data were collected from the Chinese HIV/AIDS Comprehensive Response Information Management System, HIV/AIDS cases enrolled in antiretroviral therapy, from January 1, 2017 to December 31, 2019, ≥15 years of age and from the mainland of China were the subjects of the study. The general demographic characteristics (gender, age, ethnicity, education level, marital status, etc), infection routes, sample sources, date of diagnosis, baseline CD4+ T cell level, and clinical stage and other information were collected from the database. Univariate analysis was conducted for the timeliness of ART of the subjects by Chi square test, and the influencing factors associated with timeliness of ART were analyzed by binary non-conditional Logistic regression.Results:Among the 7 425 cases of HIV/AIDS, 6 813(91.8%) were male, 5 236(70.5%) had homosexual transmission, the age at the ART initiation was(36.05±12.51)years. The proportion of timeliness of ART within 30 d increased from 55.9% (1145/2050) in 2017 to 65.3% (1821/2789) in 2019. The possibility of timeliness of ART among HIV/AIDS who were married or cohabiting, education of high school and above were higher, with OR values at 1.136, 1.299. The possibility of timeliness of ART among HIV/AIDS cases whose domicile place is outside Shandong province were lower, with OR values at 0.664. The possibility of timeliness of ART in group of HIV/AIDS aging≥55, 45~54 and 35~44 years old were higher than that in 15~24 years old, with OR values at 1.530, 1.505 and 1.394. The possibility of timeliness of ART among the heterosexuals were lower than that of homosexuals, with OR values at 0.803. The possibility of timeliness of ART is lower for cases in places of detention centers than cases from volunteer testing and counseling, with OR values at 0.204. The possibility of timeliness of ART among HIV/AIDS cases whose CD4+ T lymphocyte at >500 cells/μL were lower than that of the cases whose CD4+ T lymphocyte at≤500 cells/μl, with OR values at 0.545. Patients without symptoms at baseline were less likely to receive prompt treatment than those with clinical symptoms, with OR values at 0.727. Patients with baseline clinical staging of stage Ⅳ, period of HIV/AIDS treatment with timeliness was longer than the cases with baseline clinical stages ofⅠ, Ⅱ, Ⅲ, with OR values at 1.307. Conclusions:The proportion of timeliness of ART increased from 2017 to 2019. Marital status, educational level, age, sample source, infection routes, baseline clinical stage, and CD4+ T lymphocyte levels were associated with the timeliness of ART.

Objective:To analyze the status of follow-up and its correlation with highly active antiretroviral therapy (HAART) for newly diagnosed HIV/AIDS patients from 2014 to 2016 in Shandong province, then to provide theoretical evidence for the improvement of follow-up and HAART.Methods:Based on retrospective cohort study, logistic regression model was used to identify influencing factors of follow-up for HIV/AIDS, and chi-square test was used to do correlation analysis.Results:There were 6253 newly diagnosed HIV/AIDS cases from 2014 to 2016 in Shandong province, and 6011 cases accepted follow-up service. The cumulative follow-up rate was 96.13%, and timely follow-up rate was 94.51%. Higher prevalence of follow-up was found among those aged 15-24 years at diagnosis, diagnosed by VCT, with education level of college and above, lived in east of Shandong province and infected with homosexual sex behaviors. HIV/AIDS cases who received follow-up service within 1 year of diagnosis were more likely to receive HAART ( OR=5.28, 95% CI: 3.51-7.95) and meet the level of viral load (VL) suppression ( OR=4.30, 95% CI: 2.89-6.40) than those who received follow-up service later. Conclusions:The status of follow-up of HIV/AIDS in Shandong province was influenced by age at diagnosis, sample resource, cultural level, address and transmission route. Timely follow-up can improve the proportion and effect of HIV/AIDS treatment.

Objective:To understand the use of drug and its related factors among men who have sex with men, and to provide reference for the development of reasonable intervention measures.Methods:MSM was recruited from Jinan and Qingdao by means of on-site and internet recruiting from March to June in 2016. Anonymous questionnaires were conducted and HIV and syphilis serological tests were performed. The questionnaire included the general situation, sexual behavior, HIV related services and so on. Multi-factor unconditioned logistic regression model was used to explore related factors about rush poppers use.Results:The rush poppers use rate of 901 MSM was 30.1%（271/901）, the age was (29.3±8.1) years, the HIV infection rate was 4.6% (41/901) and the syphilis infection rate was 8.7% (78/901). Multivariate analysis showed that compared with those who were>25 years old, the OR (95% CI) of those who were ≤ 25 years old was 1.571 (1.110-2.224); compared with the number of anal sexual behavior was<2 times in the last week, the OR (95% CI) of those whose number of anal sexual behavior was ≥2 times was 2.991 (1.100-8.132); compared with those who had not received peer education services in the last year, the OR (95% CI) of those who received peer education services was 13.651 (7.239-25.742). Conclusion:Rush poppers are very popular in the MSM crowd, and those who aged less than 25 years old, who had anal sex more than twice in the past week, and who had received peer education services were more likely to use rush poppers. We should carry out targeted interventions according to the characteristics.

Objective:To understand the use of drug and its related factors among men who have sex with men, and to provide reference for the development of reasonable intervention measures.Methods:MSM was recruited from Jinan and Qingdao by means of on-site and internet recruiting from March to June in 2016. Anonymous questionnaires were conducted and HIV and syphilis serological tests were performed. The questionnaire included the general situation, sexual behavior, HIV related services and so on. Multi-factor unconditioned logistic regression model was used to explore related factors about rush poppers use.Results:The rush poppers use rate of 901 MSM was 30.1%（271/901）, the age was (29.3±8.1) years, the HIV infection rate was 4.6% (41/901) and the syphilis infection rate was 8.7% (78/901). Multivariate analysis showed that compared with those who were>25 years old, the OR (95% CI) of those who were ≤ 25 years old was 1.571 (1.110-2.224); compared with the number of anal sexual behavior was<2 times in the last week, the OR (95% CI) of those whose number of anal sexual behavior was ≥2 times was 2.991 (1.100-8.132); compared with those who had not received peer education services in the last year, the OR (95% CI) of those who received peer education services was 13.651 (7.239-25.742). Conclusion:Rush poppers are very popular in the MSM crowd, and those who aged less than 25 years old, who had anal sex more than twice in the past week, and who had received peer education services were more likely to use rush poppers. We should carry out targeted interventions according to the characteristics.

Objective:To explore the impact of achievement of the "90-90-90" goals on reductions in HIV incidence in Shandong province.Methods:An algebraic method was developed to link new HIV infections and the "90-90-90" goals in Shandong province. The risk estimation equation was used to analyze the effect of achievement of the "90-90-90" goals on reductions of HIV incidence, and explore the impact of application of antiviral therapy based prevention and control strategy on reduction of new HIV infections.Results:If "90-90-90" goals were achieved in 2020 in Shandong compared with annual new HIV infections in 2010, the percentage of reduction would be 17.27%, 35.99% and 67.55% respectively when transmission rate decreased by 26.00%, 53.00% and 96.00% respectively. Compared with 2017, when the transmission rate decreased by 53.00%, the annual new HIV infections would has a decrease of 10.10% if the rates of diagnosis and ART reached 90.00%; the annual new HIV infections would has a decrease of 20.80% if the rates of diagnosis and viral suppression reached 90.00%; the annual new HIV infections would has a decrease of 12.29% if the rates of ART and viral suppression reached 90.00%.Conclusions:HIV incidence would decrease with the achievement of "90-90-90" goals in Shandong. Compared with the improvement of ART, the improvement in diagnosis of HIV infection and viral suppression would result in more rapid decrease of new HIV infections. Besides expanding ART coverage, more attention should be paid to the strengthening of the diagnosis of HIV infection and viral suppression in Shandong.