The goal of gastrointestinal endoscopy anesthesia management is to effectively calm and re-lieve pain while minimizing related adverse reactions and ensuring patient safety.Hypoxemia is the most com-mon adverse event during painless gastrointestinalendoscopy,and severe hypoxemia can cause cardiac and brain accidents.Therefore,how to prevent and reduce the occurrence of hypoxemia isa hot topic in clinical re-search.This article reviews the methods of preventing and reducing hypoxemia in general painless gastrointes-tinal endoscopy,and provides a reference for the selection of appropriate sedation and ventilation strategies for general painless gastrointestinal endoscopy anesthesia.

Objective: To investigate the characteristics of HIV-1 molecular transmission network among HIV/AIDS patients in Zhoushan City, Zhejing Province. Methods: The newly reported HIV/AIDS cases in Zhoushan City from 2020 to 2022 were selected. Basic information was collected and whole blood samples were obtained at the initial follow-up. The pol gene sequences of HIV-1 were amplified by RT-PCR and nested-PCR. HIV-1 subtypes were identified by Neighbor-Joining phylogenetic trees. The HIV-1 molecular transmission network was built and analyzed using Cytoscape 3.6.1 software. Results: A total of 222 HIV/AIDS cases were reported in Zhoushan City from 2020 to 2022, 200 whole blood samples were collected, and 152 sequences were obtained successfully, including 122 males (80.26%), 75 cases aged 50 years and above (49.34%), 109 cases with a junior high school education or below (71.71%), and 63 cases with commercial heterosexual contact (41.45%). The main subtypes were CRF07_BC and CRF01_AE, accounting for 45.39% and 21.05%, respectively. When the threshold of genetic distance was set to 1%, 20 molecular clusters were formed in 69 cases, with a clustering rate of 45.39%. Using the molecular network constituted by reported HIV/AIDS cases in 2020 as the baseline network, there were 2 active molecular clusters with ≥5 new cases in 2022, each with 9 cases, characterized mainly by individuals aged 50 or above, with a junior high school education or below, and transmission through commercial heterosexual sex. Conclusions The predominant HIV-1 subtypes among HIV/AIDS cases in Zhoushan City are CRF07_BC and CRF01_AE. Transmission through commercial heterosexual contact among middle-aged and elderly people is a main mode of HIV transmission.

Cervical cancer is one of the most common gynecological malignant tumors,the five-year survival rate decreased significantly in the case of lymph node metastasis and distant metasta-sis,so the development of new anti-cervical cancer drugs is of great significance for the treatment of cervical cancer.Molecular docking technology is one of the most commonly used research methods in computer aided drug design,which is widely used in screening the effective components of drugs,finding the targets of drugs acting on tumors and exploring the mechanism of antineoplastic drugs.This paper reviews the molecular docking technology in the screening of anti-cervical cancer drugs,the determination of anti-tumor targets and the mechanism of anti-cervical cancer,in order to provide more sufficient theoretical basis for the screening of anti-cervical cancer drugs and new drug research and development.

ObjectiveTo understand the influencing factors of work-related injury medical expenses in Kunshan City. Methods The work-related injury data of Kunshan City from 2016 to 2021 were collected from the “Jiangsu Human Resources and Social Security Integration Handling Platform” of Kunshan Municipal Human Resources and Social Security Bureau, and the influencing factors of work-related injury medical expenses were analyzed using quantile regression. Results The median (interquartile range) of per capita work-related injury medical expenses in Kunshan City from 2016 to 2021 was 1 025.6(7 199.1) yuan. The result of 0.50 quantile regression analysis showed that the work-related injury medical expenses of male workers were higher than that of female workers (P<0.01), the work-related injury medical expenses of workers aged 46 and above were higher than those aged 16-<26 (P<0.01), the work-related injury medical expenses of veteran workers were lower than those of new workers (P<0.01), the work-related injury medical expenses of workers in the third, fourth, fifth, and sixth major risk industries were higher than that in the first major risk industry (all P<0.05), the work-related injury medical expenses on lower limb, head and neck, trunk, and multiple injured areas were lower than upper limb injuries (all P<0.01), the work-related injury medical expenses of workers with death, grades 5 to 6, grades 7 to 10, failure to reach grade, and ungraded injuries were lower than those of workers with grades 1 to 4 injuries (all P<0.01), the medical expenses for work-related injuries such as scalds, burns, and scorch were higher than cuts, abrasions, and stabs injuries (P<0.01). Conclusion The influencing factors of the workers' medical expenses for work-related injuries are age, gender, and injured body part. It is necessary to further strengthen the prevention of work-related injuries for males, new workers, workers in the third to sixth major risk industries, and those aged 46 and above. Meanwhile, it is needed to prevent workers from suffering scalds, burns, scorch injuries, upper limb injuries, and high disability grades injuries, to reduce the economic burden on workers and the society.

ObjectiveTo analyze the current situation and characteristics of work-related injuries in Kunshan City. Methods Data on work-related injuries in Kunshan City from January 2016 to December 2021 was collected from the integrated management platform of Jiangsu Human Resources and Social Security Bureau. The situations and characteristics of work-related injuries were analyzed. Results A total of 46 358 work-related injuries occurred in Kunshan City from 2016 to 2021, with the incidence of 0.57% to 0.67%. The incidence showed a decreasing trend year by year (P<0.05). The work-related injuries leading to level 10 disability in workers accounted for 44.45%. The incidence of work-related injuries was highest in the sixth major risk industry category, accounted for 0.79%. The incidence of work-related injuries was the highest in July and August, both accounted for 0.60‰. The incidence of work-related injuries was the highest in the traditional manufacturing area of all regions, accounted for 0.65%. The incidence of work-related injuries was higher in males than in females (0.56% vs 0.23%, P<0.01). The incidence of work-related injuries of workers aged ≥46 years was 0.74%, which was higher than those in the other three age groups <46 years old (all P<0.008). Workers with 11 to <16 and 16 to <21 years of social insurance had relatively higher incidence of work-related injuries, accounted for 0.84% and 1.00%, respectively (both P<0.003). The incidence of work-related injuries was lower in urban workers than in rural workers (0.43% vs 0.44%, P<0.01). Work-related wrist and hand injuries had the highest incidence among all body parts, accounted for 44.67%. Contusions, crush injuries, and compression injuries were the most common types of injuries, accounted for 56.18%. Conclusion The incidence of work-related injuries in Kunshan City is lower than the national average. The incidence of work-related injuries is related to the category of risk industry, region, gender, age, years of social insurance and household registration type. Hierarchical classification should be implemented to prevent work-related injuries.

Objective To construct a culture system of endometrial organoids for infertility induced by non-immune or immune factors,and to compare the immune cytokines between them.Methods The samples were collected from infertility patients undergoing hysteroscopy in Department of Reproductive Medicine Center of The First Affiliated Hospital of Naval Medical University(Second Military Medical University).Endometrial tissues were obtained from patients with infertility caused by non-immune factors(n=3)and patients with repeated implantation failure(RIF)(n=5).The tissues were embedded in matrix glue for 3D culture after washing,digestion,re-suspension and plate attachment.The growth of endometrial organoids of the 2 groups was observed under inverted microscope;the expression of estrogen receptor,keratin and E-cadherin,which were specific endometrial markers,was detected by immunofluorescence staining;and the cytokines of the 2 groups were determined by enzyme-linked immunosorbent assay(ELISA)and the differences of cytokines between the 2 groups were observed.Results During the process of in vitro culture of endometrial organoids,the volume of organoids and the number of cells gradually increased.After 7-10 d of culture,the volume of organoids reached a stable state,and the shape gradually became a perfect circle.At the same time,the number of organoids from the infertility patients caused by non-immune factors was more than that from the infertility patients caused by RIF.Immunofluorescence staining showed the expression of endometrial related marker proteins estrogen receptor,keratin and E-cadherin,indicating the successful construction of endometrial organoids.ELISA results showed that the levels of interferon(IFN)-γ,interleukin(IL)-10,tumor necrosis factor(TNF)-α,IL-4 and TNF-α/IL-4 ratio between the 2 groups were significantly different(P＜0.05 or P＜0.01).There were no significant differences in the levels of TGF-β1 or IL-17,the ratios of IL-17/TGF-β1,IFN-γ/IL-10 or TNF-α/IL-10(all P＞0.05).Conclusion Endometrial organoids with proliferative ability from patients with non-immune infertility and RIF have been successfully cultured in vitro,which provides a new model for the basic research of immune infertility.

Objective:To evaluate the clinical efficacy of microfat on neck wrinkles and its structure and viability.Methods:A retrospective analysis was conducted to review the clinical data of 23 patients with neck wrinkles corrected by microfat injection from June 2018 to June 2021 at the Body Contouring and Fat Grafting Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, aged (38.1±10.7) years old. A blunt cannula with multiple side holes of 0.8 mm was used to obtain fat particles under low negative pressure and to prepare the microfat by washing and soft centrifugation. A 26-gauge sharp needle was used to inject microfat with small amount and at multiple points into the intradermal and subdermal layer where the neck lines were linearly depressed. Regular follow-ups were carried out after the operation, and the efficacy of the operation was evaluated from routine neck examinations, third-party doctor′s grade scoring and patient′s scoring towards satisfaction. To clarify the structure and viability of microfat, scanning electron microscope was used to observe the structure of fat particles, Calcein-AM/propidium iodide (Calcein-AM/PI) staining to detect tissue viability and Musecell counting to count SVF cells.Results:All of the 23 patients successfully completed the operation without complications such as infection and fat liquefaction. After a follow-up of 3 to 30 months, the neck wrinkles were effectively improved. The postoperative grade scores of third-party doctor was significantly reduced ( P<0.05). And the satisfaction of patients was high, with 20 cases (87.0%) satisfied. Scanning electron microscopy showed that the fat granule cells were tightly arranged and the structure remained intact. Calcein-AM/PI staining showed that most cells in the granules survived. The number of viable SVF cells in fat particles was (9.34±2.68)×10 5/ml. Conclusions:Microfat is easy to obtain with high tissue activity, which is suitable for neck wrinkle filling. Good effects can be achieved with high patients′ satisfaction. It is worthy of clinical application.

Objective:To investigate the clinical effect and safety of mid-face lifting combined with compound fat transplantation in facial rejuvenation.Methods:From October 2016 to May 2020, 26 patients with mid-facial aging were enrolled, including 10 males and 16 females, with an average age of (47±6) years (38-65 years). The facial superficial musculoaponeurotic system was stripped, folded and suspended through the temporal hairline incision to lift the middle of the face. Liposuction was performed and compound fat was prepared, in which structural fat was injected into the area marked with loss of facial volume before operation, and extravascular matrix component gel was injected into the static wrinkle dermis. Six and 12 months after operation, the global aesthetic improvement scale of the observer and the global aesthetic improvement scale of the patient were scored, and the postoperative complications and patients＇ satisfaction were counted.Results:At the end of 6 months, improvements in mid face were reported in all patients by blinded reviewers. 12 months after operation, 53.8% (14 cases) of patients had significant improvement in facial aging, 30.8% (8 cases) had moderate improvement, and 15.4% (4 cases) had slight improvement; 25 patients (96%) were satisfied with the postoperative results. Postoperative hemorrhage occurred in one patient, scar hyperplasia occurred in one patient, and no obvious complications occurred in the other patients.Conclusions:The method of midface lifting combined with compound fat transplantation can improve the facial soft tissue and supplement the facial missing capacity, improve the static wrinkles of the face, and comprehensively solve the aging problem of midface. It has a definite clinical effect, fewer complications, and is safe and reliable. It has definite clinical effect with less complications.

Objective: To investigate the AIDS-related knowledge, attitudes and practice among university students in a pilot site of AIDS health education in Zhoushan City, so as to provide the reference for AIDS health education in universities. Methods: University students were recruited from Zhejiang Ocean University using a stratified cluster sampling method in 2018 and 2020, and the AIDS-related knowledge, attitudes and practice were collected using a questionnaire survey. Results: A total of 2 862 and 2 850 students were surveyed in 2018 and 2020, including 1 429 ( 49.93% ) and 1 414 ( 49.61% ) male students, respectively. The overall awareness of AIDS-related knowledge was 86.62% and 94.11% in 2018 and 2020, respectively. There were 544 ( 19.01% ) and 394 ( 13.82% ) students that were in favor of one-night stand, 308 ( 10.76% ) and 198 ( 6.95% ) students that were in favor of commercial sexual behaviors, and there were 59 ( 2.06% ) and 34 ( 1.19% ) students that had casual sexual behaviors within one year, and 20 ( 0.70% ) and 8 students ( 0.28% ) with commercial sexual behaviors within one year. There was a significant difference in the awareness of AIDS-related knowledge among students with different years at the university ( P<0.05 ). The lowest awareness of AIDS-related knowledge was seen in freshmen in 2018 ( 81.74% ), and the highest awareness was found in freshmen in 2020 (97.17% ). The proportions of being in favor of one-night stand ( 2018: 31.35% vs. 6.70%; 2020: 22.07% vs. 5.71%; P<0.05 ), being in favor of commercial sexual behaviors ( 2018: 19.91% vs. 2.23%; 2020: 12.09% vs. 1.88%; P<0.05), having casual sexual behaviors within one year (2018: 3.71% vs. 0.42%; 2020: 2.19% vs. 0.21%; P<0.05), and having commercial sexual behaviors within one year ( 2018: 1.33% vs. 0.07%; 2020: 0.50% vs. 0.07%; P<0.05 ) were significantly greater in male students than in female students. Conclusions The pilot AIDS health education is effective to increase the awareness of AIDS-related knowledge, possess the correct attitudes towards sexual behaviors and reduce high-risk sex behaviors among university students in Zhoushan City. Intensified AIDS health education is recommended among senior and male university students.

Objective:To assess the safety and efficacy of mammaplasty with autologous fat grafting(AFG).Methods:A retrospective analysis was conducted to review cases of mammaplasty with AFG from December 2010 to December 2020 in Department of Body Contouring and Fat Grafting Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences. Liposuction was performed using low negative pressure (-60 kPa) by liposuction machine. After lipoaspirate was washed with normal saline, cotton pad or low-speed centrifugation method was utilized to process fat. A blunt cannula with a diameter of 2.5 mm was used for multi-layer injection into the breast. The efficacy of surgery was evaluated from routine breast examinations, ultrasound examinations, third-party evaluations of pre- and post-operative photos, and patient’s scoring on breast appearance and the quality of life. The score interval is 0-100 points, and the higher the score, the better the effect. The Mann-Whitney U test was applied to compare the differences between groups, and the paired t-test was used to compare the difference of chest circumferences before and after surgery and the doctors’ scores. P<0.05 indicates statistically significant difference. Results:449 patients with 829 breasts were enrolled, aged (37.6±9.4) years old with a body mass index of (21.4±2.8) kg/m 2, including 372 patients with breast dysplasia, 42 patients underwent total mastectomy due to breast cancer, 8 patients with breast deformity after breast-conserving surgery, and 27 cases with breast implants for augmentation. Of the 449 cases, 37 cases used Brava before surgery, including 25 patients with breast dysplasia and 12 patients who underwent total mastectomy. All patients successfully completed the operation. Patients with breast dysplasia required (2.0±0.7) times of AFG for breast augmentation, with a unilateral injection volume of (244.4±58.1) ml per session. Patients who underwent total mastectomy required (2.9±1.1) times of AFG, with a unilateral injection volume of (223.2±62.4) ml per session. Patients with breast deformity after breast-conserving surgery required (1.5±0.5) times of AFG, with a unilateral injection volume of (204.0±29.5) ml per session. And for patients with breast implants for augmentation, it takes (2.2±0.8) times of AFG after removal of implants. The postoperative follow-up time was (14.0±6.8) months. Cystic nodules and benign calcifications with a diameter of 0.1-0.3 cm was found in 34 patients in ultrasound, 5 patients had palpable nodules and 3 patients had intramammary infections. No serious complications occurred. The breast circumference of 353 patients with bilateral breast dysplasia increased by (4.8±1.0) cm ( P<0.01) compared with that before operation. Breast circumference of the 27 patients who underwent implant removal and AFG for augmentation reduced by (1.2±1.7) cm ( P<0.01) after operation. The scores of third-party after operation in each group were significantly higher than those before operation ( P<0.05). The doctor’s score of patients with breast reconstruction after total mastectomy for breast cancer increased the most, which was 15.4±4.9 points ( P<0.01). In this group, the scores of patients who underwent radiotherapy increased by (19.3±2.3) points, which was higher than those without radiotherapy 13.4±5.5 points ( P<0.01). Patients with breast reconstruction after total mastectomy for breast cancer had the lowest breast satisfaction and quality of life scores, which were 84.6±2.9 and 84.7±3.2 points respectively, while those with breast deformity correction after breast conserving surgery had the highest scores, 88.8±4.0 and 90.6±3.7 points respectively. Conclusions:The application of AFG to mammaplasty is both safe and effective, with fewer complications, and high satisfaction rate.