Objective:To understand the consultation for post-exposure prophylaxis(PEP) services and their related factors among college students who were at high risk for HIV infection in Hangzhou,and to provide a reference basis for formulating an intervention model for college students at high risk of HIV infection.Methods:A cross-sectional survey was conducted between November 2022, and March 2023, in 5 different types of schools in Hangzhou. The subjects should meet the inclusion criteria of age between 18 years and 24 years old self-reported having ever had sex in the past. The sample size was estimated at 864. An online survey was conducted among college students by questionnaire star of an online survey platform to collect their demographic information, sexual behavior characteristics, HIV test status, and consultation for PEP services. The HIV infection risk among participants was evaluated according to their sexual behavior. The consultation for PEP services and the related factors of college students who were at high risk for HIV infection were analyzed.Results:A total of 20 973 college students were surveyed, and 2 291 who have ever had sex were recruited in the study. The proportion assessed as being at high risk for HIV infection was 43.47% (996/2 291), and the proportion of consultation for PEP services was 9.24% (92/996). Multivariate logistic regression analysis showed that among college students who were at high risk for HIV infection, the positive related factors of consultation for PEP services included knowing about PEP services (a OR=17.49, 95% CI: 7.98-38.36) ,having HIV tests (a OR=3.92, 95% CI: 2.08-7.42) and access to condoms on campus (a OR=3.38, 95% CI: 2.02-5.65), and the negative related factor was homosexual orientation (a OR=0.24, 95% CI: 0.06-0.91). Conclusions:Among college students who were at high risk for HIV infection, the proportion of consultation for PEP services was at a lower level. It is necessary to strengthen further the health education of PEP services knowledge among college students, improve the PEP services system, and promote the utilization of PEP services to reduce new HIV infections among college students.

Objective:To understand the consultation for post-exposure prophylaxis(PEP) services and their related factors among college students who were at high risk for HIV infection in Hangzhou,and to provide a reference basis for formulating an intervention model for college students at high risk of HIV infection.Methods:A cross-sectional survey was conducted between November 2022, and March 2023, in 5 different types of schools in Hangzhou. The subjects should meet the inclusion criteria of age between 18 years and 24 years old self-reported having ever had sex in the past. The sample size was estimated at 864. An online survey was conducted among college students by questionnaire star of an online survey platform to collect their demographic information, sexual behavior characteristics, HIV test status, and consultation for PEP services. The HIV infection risk among participants was evaluated according to their sexual behavior. The consultation for PEP services and the related factors of college students who were at high risk for HIV infection were analyzed.Results:A total of 20 973 college students were surveyed, and 2 291 who have ever had sex were recruited in the study. The proportion assessed as being at high risk for HIV infection was 43.47% (996/2 291), and the proportion of consultation for PEP services was 9.24% (92/996). Multivariate logistic regression analysis showed that among college students who were at high risk for HIV infection, the positive related factors of consultation for PEP services included knowing about PEP services (a OR=17.49, 95% CI: 7.98-38.36) ,having HIV tests (a OR=3.92, 95% CI: 2.08-7.42) and access to condoms on campus (a OR=3.38, 95% CI: 2.02-5.65), and the negative related factor was homosexual orientation (a OR=0.24, 95% CI: 0.06-0.91). Conclusions:Among college students who were at high risk for HIV infection, the proportion of consultation for PEP services was at a lower level. It is necessary to strengthen further the health education of PEP services knowledge among college students, improve the PEP services system, and promote the utilization of PEP services to reduce new HIV infections among college students.

Objective:To study the clinical characteristics of patients with difficulty in decannulation after a tracheotomy in a neurological intensive care unit.Methods:A total of 122 patients undergoing tracheotomy were divided into a decannulation success group ( n=73) and a difficult decannulation group ( n=49). The Full Outline of Unresponsiveness (FOUR) and the revised version of the Coma Recovery Scale (CRS-R) were used to assess the consciousness of those in both groups. Their swallowing ability, airway anatomy, secretion retention and aspiration were documented using the Functional Oral Intake Scale (FOIS), fiberoptic endoscopic examination, Marianjoy′s 5-point secretion severity scale and the penetration-aspiration scale (PAS). Univariate analysis and multiva-riate logistic regression analysis were conducted to isolate risk factors. Results:The univariate analysis showed that age, status of consciousness, swallowing ability, secretion retention, aspiration and opening of the glottis may be indicators of difficult decannulation after a tracheotomy among those with severe neurological diseases. The logistic regression analysis found that too much retention of pharyngeal secretions and insufficient opening of the glottis should also be treated as risk factors for difficult decannulation with such patients.Conclusions:Too much retention of pharyngeal secretions and poor opening of the glottis are independent risk factors for difficult decannulation after a tracheotomy. Endoscopic examination can play an important role in the prediction and treatment of difficult decannulation.

Physiological parameters monitoring is essential to direct medical staff to evaluate, diagnose and treat critical patients quantitatively. ECG, blood pressure, SpO2, respiratory rate and body temperature are the basic vital signs of patients in the ICU. The measuring methods are relatively mature at present, and the trend is to be wireless and more accurate and comfortable. Hemodynamics, oxygen metabolism and microcirculation should be taken seriously during the treatment of acute critical patients. The related monitoring technology has made significant progress in recent years, the trend is to reduce the trauma and improve the accuracy and usability. With the development of machine vision and data fusion technology, the identification of patient behavior and deterioration has become hot topics. This review is focused on current parameters monitoring technologies, aims to provide reference for future related research.
Humans ; Intensive Care Units ; Monitoring, Physiologic ; Oxygen Saturation ; Technology ; Vital Signs

Objective: To study the effect of growth differentiation factor (GDF) 11-silenced bone marrow stromal cells (BMSCs) on bone regeneration in early steroid-induced osteonecrosis of the femoral head in rats. Methods: After GDF11 expression in BMSCs was inhibited by siRNA, the knockdown efficiency and transfection cytotoxicity were detected. The further experiments both in vitro (n=3) and in vivo (n=8) were divided into 4 groups respectively: blank control group (without any intervention), model group (glucocorticoid treatment), experimental group (siRNA transfection and glucocorticoid treatment) and negative control group (negative control transfection and glucocorticoid treatment). The BMSCs were induced into osteogenic differentiation. Alkaline phosphatase (ALP) staining and alizarin red staining were applied to evaluate the osteogenic differentiation ability of the cells while reverse transcription polymerase chain reaction (qRT-PCR) was employed to detect the relative expression levels of osteogenic markers. The osteogenesis in the necrotic femoral head was evaluated by microCT, H&E staining, immunohistochemistry staining and biomechanical test. Results: No transfection cytotoxicity was found (P>0.05). The ALP staining and alizarin red staining showed that the osteogenic differentiation of BMSCs in the experimental group was better than that in the model group. At the level of mRNA, the relative expression of ALP, runt-related transcription factor (Runx) 2, osteocalcin (OCN) and type Ⅰ collagen (α1) (COL1A1) in the blank control group (1.00±0.09, 1.02±0.23, 1.03±0.30 and 1.02±0.25, respectively) were significantly higher than those in the model group (0.46±0.11, 0.50±0.11, 0.35±0.01 and 0.57±0.02, respectively) but significantly lower than those in the experimental group (1.97±0.30, 0.94±0.19, 1.50±0.18 and 1.28±0.37) (all P<0.05). MicroCT images and quantitative analysis showed that the bone mass in the experimental group was significantly increased compared with the model group (P<0.05). Histological examination showed better bone regeneration and higher expression of Runx2 and COL1 in the necrotic femoral head in the experimental group than in the model group. Improved biomechanical properties were shown in the experimental group compared with the model group (P<0.05). Conclusions Silence of GDF11 expression may alleviate the inhibitory effect of glucocorticoid on osteogenic differentiation of BMSCs. Early transplantation of GDF11-silenced BMSCs may promote osteogenesis in the necrotic femoral head in rats.

OBJECTIVE： To screen the best proportion of Astragalus membranaceus injection combined with Erigeron breviscapus injection against cerebral ischemia-reperfusion injury in rats. METHODS： Male SD rats were randomly divided into sham operation group， model group and administration group [different A. membranaceus injection-E. breviscapus injection proportion groups， being A（0 ∶ 10）， B（2 ∶ 8）， C（4 ∶ 6）， D（6 ∶ 4）， E（8 ∶ 2）， F（10 ∶ 0）groups， set by baseline geometric proportion increasing and decreasing design]， with 8 rats in each group. Except for sham operation group， reperfusion injury model of middle cerebral artery occlusion were induced by modified suture method in rats. The each administration group was given relevant medicine intraperitoneally once immediately after inducing model， and then given again after 24 hours （medication interval between the two injections of 30 min）. Constant volume of normal saline was given to rats in sham operation group and model group. Forty-eight hours after reperfusion， Longa scoring method was used to evaluate neurological impairment of rats， and neurological impairment score was recorded. Serum content of MDA and activity of SOD were measured by colorimetry assay. TTC assay was used to detect cerebral infraction， and cerebral infarction rate was calculated. Kim’s formula was used to calculate the synergistic index （q） of rats in administration groups. RESULTS： Compared with sham operation group， neurological impairment score and serum content of MDA were increased significantly in model group， while activity of SOD was decreased significantly （P＜0.01）. The area of cerebral infarction increased significantly， and the rate of cerebral infarction increased significantly （P＜0.01）. Compared with model group， neurological impairment scores and serum contents of MDA were decreased significantly in group A， B， C， D and E； neurological impairment score of group C was significantly lower than those of group A and F； serum contents of MDA in group B， C， D and E were significantly lower than that of group F （P＜0.05 or P＜0.01）. Activities of SOD in group A， B， C， D and E were increased significantly， and group C was significantly higher than group F （P＜0.05 or P＜0.01）. The cerebral infarction area of rats in each administration group was reduced to varying degrees. The cerebral infarction rates of rats in group B， C， D and E were significantly reduced， and group C and D were significantly lower than group F， while group C was significantly lower than group A （P＜0.05 or P＜0.01）. The q values of group B， C， D and E were 0.90， 1.30， 1.00， 0.70 （neurological impairment score） and 0.79， 1.27， 0.98， 0.82 （cerebral infarction rate）. CONCLUSIONS： Different ratios of A. membranaceus injection and E. breviscapus injection have certain protective effects on cerebral ischemia-reperfusion injury model rats， can relieve their neurological deficits， alleviate their oxidative stress and reduce their cerebral infarction areas. The effect of the combination of the two drugs is better than that of single use， and the optimum ratio is 4 ∶ 6.

OBJECTIVETo compare the difference in the efficacy on cervical spondylotic radiculopathy (CSR) between acupuncture at the acupoints on the axillary nerve distribution and the regular selection of acupoints. Methods Eighty patients of cervical spondylotic radiculopathy were randomized into an observation group and a control group, 40 ca.ses in each one. In the observation group, Jianjing (GB 21), Jianzhen (SI 9), Jianliao (TE 14) , Jianyu (LI 15) , Quyuan (SI 13), Tianzong (SI 11) and the trigger points in the scalpular region were selected along the axillary nerve distribution. The Hegu needling was adopted at the trigger points and stimulated with electric apparatus, continuous wave, 1Hz. In the control group, Dazhui (GV 14), Tianzhu (BL 10), Houxi (SI 3), cervical Jiaji (EX-B 2) were selected and stimulated with the regular acupuncture. Electric stimulation was added at cervical Jiaii (EX-B 2), with continuous wave, 1Hz. The needles were retained for 30 min in the two groups, once every two days and 10 treatments made one session. The efficacy was assessed in one session of treatment. The 20-point scale of CSR developed by Japanese scholar, Tanaka Yasuhisa, and the visual analogue scale (VAS) were adopted to score the clinical symptoms and pain degree before and after treatment in the patients and assess the efficacy of the two groups.

RESULTSThe symptom scores and VAS scores after treatment were improved apparently as compared with those before treatment in the two groups (P<0. 05, P<0. 01), and the results in the observation group were better than those in the control group (both P<0. 05). The total effective rate in the observation group was 85. 0% (34/40), better than 71. 8% (28/39) in the control group (P<0. 05).

CONCLUSIONThe acupuncture at the acupoints on the axillary nerve distribution achieves the definite efficacy on CSR, better I than the regular acupuncture at cervical Jiaji (EX-B 2).

Acupuncture Therapy ; Adult ; Aged ; Axilla ; innervation ; Female ; Humans ; Male ; Middle Aged ; Pain Measurement ; Radiculopathy ; therapy ; Shoulder Pain ; therapy ; Spondylosis ; therapy ; Treatment Outcome

Objective To compare the value of assessment with DWI and contrast-enhanced MRI (CE-MRI) in activity of sacroiliitis of patients with ankylosing spondylitis(AS).Methods Ninety-six patients conforming to modified New York criteria were prospectively collectedas the AS group, and twenty-one healthy volunteers were enrolled into the control group. According to the Bath AS disease activity index (BASDAI), erythrocyte sedimentation rate and C-reaction protein, AS patients were divided into the active AS group (n=60) and the chronic AS group (n=36) . All subjects were performed with conventional MRI, DWI and CE-MRI of bilateral sacroiliac joints. The MRI manifestations were reviewed and the ADC values and signal intensity enhancement rate (ΔSI) were measured.ANOVA was performed for the comparison ofΔSI and ADC values among active AS group, chronic AS group and control group with BASDAI and lab test results as the gold standards. ROC was analyzed with ΔSI and ADC values for activity of AS and paired
samples t test was obtained to comparethe areas under the ROC ofΔSI and ADC values.Results Among 96 cases of AS patients, MRI of sacroiliac jointsshowed that 62 cases had subchondral bone edema (57 cases of active group, 5 cases of chronic group), that 11 cases had bone surface erosion(4 cases of active group, 7 cases of chronic group), that 15 cases had bone sclerosis(6 cases of active group, 9 cases of chronic group) and that 58 cases had fat deposition on the sacroiliac joints (27 cases of active group, 31 cases of chronic group). The ΔSI values of the active group, the chronic group and control group were respectively (2.51 ± 1.69)%,(1.19 ± 0.67)%and(0.75 ± 0.21)%, and the ADCvalues were(1.33 ± 0.33)× 10-3,(1.00 ± 0.43)× 10-3 and(0.38±0.13)×10-3mm2/s. There were significant differences forΔSI and ADC values among three groups (F=18.375, 16.366. P<0.01), and statistical significance ofΔSI and ADC values were found between every two groups of three(P< 0.05).The area under the ROC between ΔSI and ADC to determine activity of AS patients were respectively 0.814 and 0.730, which had nostatistical significance(t=1.632, P=0.103). The sensitivity and specificity to determine activity of AS patients byΔSI=1.44%were 81.67%and 80.00%.The sensitivity and specificity to determine activity of AS patients by ADC=1.15 × 10-3/mm2 were 76.67% and 71.43%.Conclusion DWI and CE-MRI performed equally in detecting activity of AS patients.

OBJECTIVEThe aim of this study was to clarify whether the fusion of bone marrow mesenchymal stem cells (MSCs) with tumor cells can promote tumor angiogensis.

METHODSHuman glioma stem/progenitor cells (GSPCs) (SU3 cells) were transfected with red fluorescent protein (RFP) gene. Bone marrow mesenchymal stem cells (MSCs) were harvested from nude mice with whole-body green fluorescent protein (GFP) gene expression. Then the two kinds of cells were co-cultured in vitro. At the same time SU3-RFP was transplanted into the brain of GFP-expressing nude mice to establish xenograft tumors. The co-cultured cells, GFP/RFP double positive (yellow) cells and blood vessels obtained from the xenograft tumors were observed under fluorescent microscope and laser scanning confocal microscope.

RESULTSAfter five passages in vitro, MSCs maintained the proliferative activity and highly expressed CD105. CD105 was also expressed in the femurs of GFP-expressing nude mice, tumor cells, blood vessels of SU3 xenograft tumors, and clinical malignant gliomas. When MSCs were co-cultured with SU3-RFP, the ratio of yellow cells co-expressing RFP and GFP was significantly increased after extended time and continuous passages. According to the flow cytometry, yellow cells co-expressing RFP and GFP were 83.7% of the cultured cells. In tissue slices of the xenograft tumors, bundles of yellow vessel-like structure and cross-sectioned yellow vascular wall structures including vascular wall stroma cells were observed with RFP and GFP expression, and were identified as de novo formed vessels derived from fusion of MSCs with SU3-RFP cells.

CONCLUSIONCell fusion occurs between tumor cells and host MSCs and it promotes tumor angiogenesis.

Animals ; Bone Marrow Cells ; physiology ; Cell Communication ; Cell Fusion ; Cells, Cultured ; Glioma ; Green Fluorescent Proteins ; Humans ; Luminescent Proteins ; Mesenchymal Stromal Cells ; Mice ; Mice, Nude ; Microscopy, Fluorescence ; Neoplasms ; Neovascularization, Pathologic ; Stem Cells ; Transfection ; Transplantation, Heterologous

Objective The aim of this study was to clarify whether the fusion of bone marrow mesenchymal stem cells ( MSCs) with tumor cells can promote tumor angiogensis.Methods Human glioma stem/progenitor cells (GSPCs) (SU3 cells) were transfected with red fluorescent protein (RFP) gene.Bone marrow mesenchymal stem cells ( MSCs) were harvested from nude mice with whole-body green fluorescent protein (GFP) gene expression.Then the two kinds of cells were co-cultured in vitro.At the same time SU3-RFP was transplanted into the brain of GFP-expressing nude mice to establish xenograft tumors.The co-cultured cells, GFP/RFP double positive ( yellow ) cells and blood vessels obtained from the xenograft tumors were observed under fluorescent microscope and laser scanning confocal microscope.Results After five passages in vitro, MSCs maintained the proliferative activity and highly expressed CD105.CD105 was also expressed in the femurs of GFP-expressing nude mice, tumor cells, blood vessels of SU3 xenograft tumors, and clinical malignant gliomas.When MSCs were co -cultured with SU3-RFP, the ratio of yellow cells co-expressing RFP and GFP was significantly increased after extended time and continuous passages. According to the flow cytometry, yellow cells co-expressing RFP and GFP were 83.7%of the cultured cells. In tissue slices of the xenograft tumors, bundles of yellow vessel-like structure and cross-sectioned yellow vascular wall structures including vascular wall stroma cells were observed with RFP and GFP expression, and were identified as de novo formed vessels derived from fusion of MSCs with SU3-RFP cells.Conclu sion Cell fusion occurs between tumor cells and host MSCs and it promotes tumor angiogenesis.