The establishment and maintenance of latent cellular reservoirs of human immunodeficiency virus(HIV)within days after infection remains a major obstacle to achieving functional HIV cure.Epigenetics pertains to the regulation of gene ex-pression through means beyond mutations in DNA sequences.Research on epigenetic modifications in recent decades has facili-tated in-depth understanding of HIV pathogenesis and ongoing AIDS therapy strategies.This review briefly introduces princi-ples of epigenetics,and summarizes current epigenetic findings observed during HIV infection,particularly regarding the roles of epigenetic mechanisms including DNA methylation,histone modification,RNA modification,and non-coding RNAs in the processes of viral latency and formation of reservoirs.In addition,the implications and challenges of these epigenetic regulatory mechanisms in functional AIDS cure strategies are discussed.This review is aimed at encouraging more research groups to focus on epigenetic studies in HIV-infected populations,to develop more therapeutic drugs based on epigenetics,and to propose more rational and feasible functional AIDS cure strategies.

Objective:To study the expression of the Homeobox C6(HOXC6)gene in the homeobox family in PCa,its effect on the biological behavior of PCa cells and its action mechanism.Methods:Based on the studies of HOXC6 retrieved from the data-base of Gene Expression Profiling Interactive Analysis(GEPIA),we analyzed the expression of HOXC6 in PCa and the relationship of its expression level with the survival prognosis of the patients.We detected the expression of the HOXC6 protein in PCa tissues and cells by Western blot,stably interfered with the expression of the HOXC6 gene in human PCa DU145 and PC-3 cells and normal prosta-tic epithelial RWPE-1 cells using the siRNA plasmid,and determined the effects of HOXC6 on the proliferation,migration and inva-siveness of PCa cells by CCK8,plate cloning and scratch healing and Transwell invasion assays.Using the GEPIA database,we ana-lyzed the correlation of the Wnt tumor inhibitory factor-secreted frizzled-related protein 1(SFRP1)gene with HOXC6,and detected the expressions of HOXC6,SFRP1,Wnt and β-catenin in PC-3 cells after siRNA-HOXC6 transfection by Western blot.Results:The expression of HOXC6 was dramatically higher in the PCa than in the normal prostate tissue(P<0.01),and in the PCa cells than in the normal prostatic epithelial cells(P<0.01).Bioinformatics analysis indicated a lower survival rate of the PCa patients with a high than those with a low HOXC6 expression(P=0.011).The relative expression of the HOXC6 protein,absorbance value,number of clones formed and number of invaded cells were significantly lower in the siRNA group than in the negative controls(P<0.05).Ac-cording to the GEPIA database,highly expressed SFRP1 was associated with a good prognosis of PCa,and the protein expressions of Wnt and β-catenin were markedly increased while that of SFRP1 decreased in the PCa PC-3 cell line(P<0.05).The expressions of the Wnt and β-catenin proteins were decreased and that of SFRP1 increased significantly in the siRNA-HOXC6 transfection group com-pared with those in the siRNA negative control and PCa PC-3 groups(P<0.05).Conclusion:HOXC6 is highly expressed in PCa tissues and related to the proliferation,migration and invasiveness of PCa cells.HOXC6 promotes the growth of DU145 and PC-3 cells in PCa by inhibiting the SFRP1/Wnt/β-catenin signaling pathway,and may be a potential target for clinical treatment of PCa.

AIM To establish an HPLC method for the simultaneous content determination of spinosin,ferulic acid,rosmarinic acid,salvianolic acid B,schisandrin A,schizandrin B and schisandrol A in Anshen Capsules.METHODS The analysis was performed on a 30℃thermostatic Inertsustain C18 column(5 μm,4.6 mm×250 mm),with the mobile phase comprising of methanol-acetonitrile-0.1%phosphoric acid flowing at 1.0 mL/min in a gradient elution manner,and the detection wavelengths were set at 203,270 nm.Subsequently,principal component analysis and partial least squares discriminant analysis were made.RESULTS Seven constituents showed good linear relationships within their own ranges(r＞0.999 0),whose average recoveries were 96.12%-102.70%with the RSDs of 0.31%-1.83%.Ten batches of samples were divided into two categories according to manufacturers,and peaks 5(schisandrol A),4(salvianolic acid B)were quality difference markers.CONCLUSION This simple,sensitive,specific and reproducible method can be used for the quality control of Anshen Capsules.

Objective:To explore the efficacy and safety of Neuroform Atlas stent-assisted coil embolization in ruptured anterior communicating wide-necked aneurysms.Methods:Thirty-two patients with ruptured anterior communicating wide-necked aneurysms accepted Neuroform Atlas stent assisted coil embolization in Department of Neurosurgery, People's Hospital Affiliated to Shandong First Medical University from January 2022 to June 2023 were chosen. DSA was performed immediately after surgery, and aneurysm embolization was assessed using Raymond grading. Prognoses were assessed by modified Rankin Scale (mRS, mRS scores≤2 as good prognosis and mRS scores>2 as poor prognosis) at last follow-up. DSA was performed again 6 months after surgery to assess the aneurysm healingResults:Neuroform Atlas stents were successfully implanted in all 32 patients; Postoperative DSA showed that aneurysm embolization reached Raymond grading I in all 32 patients(100%). No such complications as in-stent thrombosis, cerebral vasospasm, or poor opening of the stent were noted excepted for one with intraoperative aneurysm rupture hemorrhage. At the last follow-up, 31 patients had good prognosis and 1 had poor prognosis; in 22 patients underwent DSA re-examination, Raymond grading I was noted in 20 patients (90.91%) and grading II in 2 (9.09%).Conclusion:Neuroform Atlas stent-assisted coil embolization for ruptured anterior communicating wide-necked aneurysms seems safe and effective.

Objective To compare the dosimetric effects of volume modulated arc therapy(VMAT)and intensity modulated radiation therapy(I M RT)on the anal sphincter(AS)and its sub-structures in neoadjuvant radiotherapy for rectal cancer to facilitate the selection of radiotherapy techniques.Methods Fifty rectal cancer patients receiving neoadjuvant radiotherapy were selected,and 2 types of radiotherapy plans,including coplanar double full-arc VMAT and coplanar seven-field homo-geneous IMRT,were designed based on the CT images of the patients,respectively.Under the premise of ensuring that the irradiated doses to the target area and the major organs at risk reached the standard and met the clinical requirements,AS and its substructures were added as the organs at risk for dosimetric evaluation.The absolute dose parameters and relative dose parameters of AS and its substructures were counted by dose-volume histograms.Statistical analysis was performed using IBM SPSS 22.0 software.Results The VMAT plan had the relative dose parameters V20,V30,and V40 of AS and its substructures lower those of the IMRT plan,the differences were statistically significant(P＜0.05),while the differences in V5 and V 10 were not statistically significant(P＞0.05).The VMAT plan had the absolute dose parameterDmeanlower while the D2％slightly higher than those of the IMRT plan,the differences were statistically significant(P＜0.05).The difference in D98％between the two plans was not statistically significant(P＞0.05).Conclusion During rectal cancer radiotherapy VMAT generally behaves better than IMRT in protecting AS and its sub-structures and decreasing injuries of AS and its sub-structures dosimetrically.[Chinese Medical Equipment Journal,2024,45(8):63-67]

Objective To design a small-size dual-microphone front-end system to solve the problems of the portable field medical equipment in speech interaction due to noises in field conditions.Methods The system realized small-size dual-microphone beamforming based on the least squares criterion and then implemented front-end speech enhancement,which was composed of dual microphones(SMD micro electro mechanical system microphone),a signal preprocessing module,an embedded processor(STM32F405 series processor),an analog to digital converter(ADC),an digital to analog converter(DAC)and a power supply module.The signal preprocessing module,ADC and DAC were built into the general-purpose audio encoder WM8978,and a LM1117 voltage regulator chip was adopted as the power supply module.Keil μ Vision4 development software was used for software compiling and testing.Directivity experiment and speech enhancement experiment were carried out to verify the performance of the system.Results Directivity experiment showed that the system gained high directivity consistency at each frequency point in the frequency range of 0.5 to 2.0 kHz;speech enhancement experiment indicated that the system effectively improved the sound quality and recognition rate of speech under the conditions of three types of non-smooth noises,namely,gunshot,alarm of the monitor and collision of the medical utensils.Connclusion The system developed can realize speech enhancement to facilitate speech interaction of the portable field medical equipment.[Chinese Medical Equipment Journal,2024,45(11):39-43]

Objective To explore the clinical characteristics of children with acute T-lymphoblastic leukemia(T-ALL)and analyze their relationship with prognosis.Methods A retrospective analysis was conducted on the clinical data and follow-up results of 50 children with T-ALL who were treated using the CCCG-ALL-2015 protocol at the Department of Hematology and Oncology,Children's Hospital of Nanjing Medical University from November 2015 to December 2019.Kaplan-Meier survival analysis and Cox regression analysis were employed to identify factors affecting prognosis.Results Among the 50 T-ALL patients,there were 7 cases of relapse.There was no statistically significant difference in the baseline clinical data between the relapse group and the non-relapse group(P>0.05).However,the positive rate of minimal residual disease(MRD)(≥0.01%)on day 46 after induction remission therapy in the relapse group was significantly higher than that in the non-relapse group(P=0.037).The 5-year overall survival rate for the 50 patients was(87±5)%,and the 5-year event-free survival rate was(86±5)%.Multivariate Cox regression analysis indicated that the MRD level on day 46 after induction remission therapy was an independent prognostic factor(HR=0.104,95%CI:0.015-0.740,P=0.024).Conclusions MRD is of significant importance for the prognosis of T-ALL children.Personalized treatment should be provided based on MRD levels to prevent relapse and improve prognosis in these patients.

Objective To analyze the epidemiological and clinical characteristics of patients with monkeypox.Methods Data of 17 patients with monkeypox hospitalized in a hospital in Nanning City from July to October 2023 were collected retrospectively.The epidemiological history,clinical manifestations,laboratory examinations,treat-ment and prognosis were analyzed and summarized.Results All 17 patients were male,with a median age of 28 years old.Fifteen(88.2％)patients were men who had sex with men(MSM)within 21 days prior to onset.Major clinical manifestations were rash and fever.Rashes distributed mainly in the anus,perineum and genitals(82.4％),followed by the trunk and limbs(52.9％),head and face(35.3％),while soles and palms were rare.Some patients had swollen inguinal lymph nodes.All patients were discharged from hospital after improvement,with an average hospital stay of 7 days.Conclusion The monkeypox epidemic in Nanning area of Guangxi occurs mainly in MSM population,with fever and rashes as the major symptoms.All patients have mild disease and good prognosis.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

The incidence of osteoporotic thoracolumbar vertebral fracture (OTLVF) in the elderly is gradually increasing. The kyphotic deformity caused by various factors has become an important characteristic of OTLVF and has received increasing attention. Its clinical manifestations include pain, delayed nerve damage, sagittal imbalance, etc. Currently, the definition and diagnosis of OTLVF with kyphotic deformity in the elderly are still unclear. Although there are many treatment options, they are controversial. Existing guidelines or consensuses pay little attention to this type of fracture with kyphotic deformity. To this end, the Lumbar Education Working Group of the Spine Branch of the Chinese Medicine Education Association and Editorial Committee of Chinese Journal of Trauma organized the experts in the relevant fields to jointly develop Clinical guidelines for the diagnosis and treatment of osteoporotic thoracolumbar vertebral fractures with kyphotic deformity in the elderly ( version 2024), based on evidence-based medical advancements and the principles of scientificity, practicality, and advanced nature, which provided 18 recommendations to standardize the clinical diagnosis and treatment.