Objective: To investigate the status of drug resistance before anti-retroviral therapy among newly dignosed HIV/AIDS patients aged ≥50 years in Yangzhou City, Jiangsu Province, so as to provide the evidence for improving the anti-retroviral therapy effect of AIDS. Methods: HIV/AIDS patients aged ≥50 years who were newly dignosed in Yangzhou City from 2021 to 2024 and did not receive anti-retroviral therapy were selected. Basic information were collected through the Chinese Disease Prevention and Control Information System. Blood samples were collected to determine CD4+T lymphocyte (CD4 cell) counts and HIV-1 viral load. Following nucleic acid extraction, the pol gene region was amplified using reverse transcription and nested PCR, and subsequently subjected to Sanger sequencing. The resulting sequences were uploaded to the Stanford University HIV Drug Resistance Database to analyze drug resistance to non-nucleoside reverse transcriptase inhibitors (NNRTIs), protease inhibitors (PIs), and nucleoside reverse transcriptase inhibitors (NRTIs). Results: Totally 404 blood samples from HIV/AIDS patients were collected, with successful sequencing of the pol gene region in 341 cases. Among them, 253 (74.19%) were males and 88 (25.81%) were females, with a mean age of (62.48±7.60) years. A total of 152 cases (44.57%) had CD4 cell counts below 200 cells/μL, and 296 cases (86.80%) had HIV-1 viral loads exceeding 5 000 copies/mL. A total of 87 cases exhibited drug resistance-associated mutations, corresponding to a mutation rate of 25.51%. The predominant mutation site was V179, with a mutation rate of 17.01%. A total of 29 cases exhibited resistance to at least one drug, resulting in a resistance rate of 8.50%. The resistance rates to NNRTIs, PIs, and NRTIs were 5.57%, 2.93%, and 1.17%, respectively. The HIV/AIDS patients exhibited varying degrees of resistance to 13 anti-retroviral drugs, with low- or intermediate-level drug resistance being predominant. High-level drug resistance cases were observed against NNRTIs such as nevirapine and efavirenz. Conclusions The drug resistance rate before anti-retroviral therapy among newly dignosed HIV/AIDS patients aged ≥50 years in Yangzhou City was at a moderate level. The predominant resistance mutation was observed at V179 site, with NNRTIs resistance being most prevalent, primarily demonstrating low- or intermediate-level drug resistance.

Objective:To systematically integrate qualitative research on the real experience and management of cancer pain in adult cancer patients, so as to provide reference for improving the management of cancer pain in adult cancer patients and reducing their cancer pain.Methods:Qualitative research literature on the real experience and management of cancer pain in cancer patients was systematically searched in Cochrane Library, PubMed, Web of Science, CINAHL, Embase, ProQuest, Scopus, China Biomedical Database, China National Knowledge Infrastructure, Wanfang Data, and VIP. The search period was from database establishment to August 2023. The literature was evaluated using the quality evaluation criteria for qualitative research of the Joanna Briggs Institute Evidence-Based Health Care Center. The aggregation Meta-synthesis method was used to integrate and summarize research results.Results:A total of 16 articles were included, and 78 results were extracted to form 11 categories, which were summarized into four integrated results of the cognitive status of adult cancer patients towards cancer pain, the impact of cancer pain on patients, self-management strategies for cancer pain, and medical experiences related to cancer pain.Conclusions:Adult cancer patients face obstacles in alleviating cancer pain, such as lack of awareness of cancer pain, negative impacts, inadequate self-management strategies, and poor medical experience. Patients need to improve their self-management strategies, and the country and medical institutions should provide comprehensive support to enable patients and clinical medical and nursing staff to manage cancer pain.

OBJECTIVE To explore the improvement effect and mechanism of vitexin on asthmatic model mice based on Notch signaling pathway. METHODS Asthma model of mice was established by intraperitoneal injection of ovalbumin and aluminum hydroxide suspension and nebulization stimulation of ovalbumin， and randomly divided into model group， vitexin group （40 mg/kg）， Notch activator group （1 mg/kg Jagged1）， vitexin+Notch activator group （40 mg/kg vitexin+1 mg/kg Jagged1）， with 12 mice in each group. Another 12 mice were selected as the control group. Each group received intragastric/intraperitoneal injection of relevant medicine or normal saline， once a day， for consecutive 14 days. After the last medication， minute ventilation at rest （VE） and peak expiratory flow （PEF） were detected in mice； the pathological morphology of lung tissue and fibrosis degeneration were observed and determined. The proportion of T helper cell 17 （Th17） and T regulatory cell （Treg） in peripheral blood were detected， and the Th17/Treg ratio was calculated. The levels of serum inflammatory factors interleukin （IL）-18， IL-6， IL-17 and IL-10 were determined， and the expressions of Notch1， Delta-like ligand 4 （DLL4）， hairy and enhancer of split 1 （Hes1） in lung tissue were detected. RESULTS Compared with the control group， serious pathological injury and inflammatory cell infiltration occurred in the lung tissue of mice in the model group， while VE， PEF， the proportion of Treg cells in peripheral blood and serum level of IL-10 were significantly reduced （P＜0.05）； collagen volume fraction （CVF） in lung tissue， Th17 cells proportion and Th17/Treg ratio in peripheral blood， serum levels of IL-18， IL-6 and IL-17， and the protein expressions of Notch1， DLL4 and Hes1 in lung tissue were significantly increased （P＜0.05）. Compared with the model group， the pathological injury of lung tissue in vitexin group was significantly improved compared with model group， and the changing trend of the above indexes was reversed （P＜0.05）； Notch activator Jagged1 could significantly reverse the pharmacological effects of vitexin on asthmatic mice （P＜0.05）. CONCLUSIONS Vitexin can improve lung function， Th17/Treg immune imbalance and inflammatory response， and alleviate pathological injury and fibrosis of lung tissue in asthmatic mice by inhibiting the Notch signaling pathway.

ObjectiveTo explore the underlying mechanism of modified Zhenwutang in delaying renal interstitial fibrosis in chronic renal failure （CRF） by observing the effects of modified Zhenwutang on the expression of angiotensin Ⅱ （Ang Ⅱ）， angiotensin Ⅱ type 1 receptor （AT1R）， nicotinamide adenine dinucleotide phosphate （NADPH） oxidase 4 （NOX4）， transforming growth factor-β₁ （TGF-β₁）， type I collagen （COL1A1）， and type Ⅲ collagen （COL3A1） in the serum and renal tissues of adenine-induced CRF rats. MethodFifty male SPF-grade SD rats were randomly divided into a normal group （n=10） and an experimental group （n=40） using a random number table. After one week of adaptive feeding， the experimental CRF model was established in rats by administering adenine at 150 mg·kg^-1·d^-1 orally. Three rats from each group were randomly selected to evaluate the model induction. After successful modeling， rats in the experimental group were randomly divided into a model group， low-， medium， and high-dose modified Zhenwutang groups， and a benazepril hydrochloride group， with six rats in each group. The rats were orally administered the corresponding drugs once daily for four weeks. At the end of the first week， 13^th week， and 17^th week of the experiment， 24 hour urinary protein quantification （24 h-UTP） was measured. At the end of the 17th week， the rats were euthanized， and blood samples were collected from the abdominal aorta for the measurement of total protein （TP）， albumin （ALB）， creatinine （Cr）， and blood urea nitrogen （BUN） in the serum. Enzyme-linked immunosorbent assay （ELISA） was used to measure the expression levels of serum Ang Ⅱ. Hematoxylin-eosin （HE） staining and Masson's trichrome staining were performed to observe the pathological changes in renal tissues. Immunohistochemistry （IHC） was performed to observe the expression of AT1R， NOX4， TGF-β₁， COL1A1， and COL3A1. Real-time fluorescence-based quantitative polymerase chain reaction （Real-time PCR） was used to observe the mRNA expression levels of AT1R， NOX4， and TGF-β₁. Western blot was conducted to measure the protein expression levels of AT1R， NOX4， and TGF-β₁. Result① Compared with the normal group， the model group showed a significant increase in 24 h-UTP （P<0.01）. The levels of Cr and BUN in the model group were significantly higher （P<0.01）， while the levels of TP and ALB were significantly lower （P<0.01）. The serum Ang Ⅱ level in the model group was significantly elevated （P<0.01）. The model group exhibited widening of the renal glomerular mesangial space， necrotic glomeruli， increased interstitial width with extensive inflammatory cell infiltration， brownish precipitates blocking the renal tubular lumens， irregular renal tubules， and significant deposition of collagen fibers in the renal interstitium. Additionally， the collagen fibers around the renal vessels， outside the parietal layer of the renal sacs， glomerular basement membrane， and tubular basement membrane increased significantly. The expression of AT1R and NOX4 in the glomeruli and renal tubules of the model group was significantly enhanced， and TGF-β₁ expression also significantly increased in the renal tubules. The expression of COL1A1 and COL3A1 in the renal interstitium significantly increased. The mRNA expression of AT1R and TGF-β₁ in the model group significantly increased （P<0.01）， while NOX4 mRNA expression significantly decreased （P<0.01）. The protein expression of AT1R， NOX4， and TGF-β₁ was significantly enhanced （P<0.01）. ② Compared with the model group， modified Zhenwutang significantly reduced 24h-UTP （P<0.01）， decreased levels of Cr and BUN （P<0.01）， increased levels of TP and ALB （P<0.01）， reduced serum Ang Ⅱ level （P<0.01）， alleviated renal pathological damage， reduced expression of AT1R， NOX4， TGF-β₁， COL1A1， and COL3A1 in the glomeruli， renal tubules， and renal interstitium， reduced mRNA expression of AT1R and TGF-β₁ （P<0.01）， increased NOX4 mRNA expression （P<0.01）， and weakened protein expression of AT1R， NOX4， and TGF-β₁ （P<0.01）. The modified Zhenwutang groups showed a significant dose-effect trend. ConclusionModified Zhenwutang may delay renal interstitial fibrosis in CRF rats by reducing the expression of Ang Ⅱ， AT1R， NOX4， and TGF-β₁ in the serum and renal tissues， thereby alleviating renal pathological damage， reducing proteinuria， protecting renal function， and delaying the progression of CRF. The modified Zhenwutang group exhibited a dose-effect trend.

Objective To examine the expression pattern of miR-135a-5p and miR-135b-5p in seminal plasma as well as the clinical value of their variation in the male patients with infertility.Methods The clinical samples of 5 kinds,including serum,morning urine,pleural effusion,cerebrospinal fluid and seminal plasma,were collected from 30 patients respectively in the Department of Clini-cal Laboratory,Jiangsu Province Hospital of Chinese Medicine from January 2019 to December 2021.In addition,the frozen seminal plasma samples from the patients with non-obstructive azoospermia,asthenozoospermia of 54 cases for each illness statuses,and 54 healthy controls with fertile ability from 2010 to 2019 in Jiangsu Province Hospital of Chinese Medicine and Jinling Hospital were also selected.Fluorescent quantitative RT-qPCR analyses were applied to measure the expression levels of miR-135a-5p and miR-135b-5p in seminal plasma.Receiver operating characteristic curve(ROC)was used to construct the area under the curve(AUCROC)to evalu-ate the ability for discriminating infertility males from healthy controls.Correlation analyses were performed to explore the correlations between the levels of miR-135a-5p and miR-135b-5p in seminal plasma and other semen parameters.Results The concentrations of miR-135a-5p and miR-135b-5p in the samples from five different kinds of body fluid showed significantly difference(H=64.88,P＜0.01 and H=64.7,P＜0.01,respectively).The highest levels were found in serum and seminal plasma,and the lowest levels were in u-rine.The concentrations of miR-135a-5p and miR-135b-5p in seminal plasma were also showed marked difference among the azoosper-mia group,asthenozoospermia group and healthy fertile control group(H=32.14,P＜0.01 and H=21.37,P＜0.01,respectively).Compared to the fertile control group,the levels of miR-135a-5p and miR-135b-5p in seminal plasma were significantly downregulated in azoospermia patients(U=687,P＜0.01 and U=843,P＜0.01,respectively).The contents of the two miRNAs showed no statistical-ly difference between asthenozoospermia patients and healthy fertile controls,but showed markedly difference between the two patients groups(U=635,P＜0.01 and U=779,P＜0.01,respectively).Receiver operating characteristic curve(ROC)analyses results re-vealed that levels of miR-135a-5p and miR-135b-5p in seminal plasma could successfully discriminate the azoospermia patients from fertile controls and asthenozoospermia patients with the AUCROC of 0.764(95％CI:0.675 to 0.854),0.711(95％CI:0.612 to 0.810)and 0.782(95％CI:0.695 to 0.869),and 0.733(95％CI:0.637 to 0.829),respectively.Correlation analyses demonstrated that the concentrations of miR-135a-5p and miR-135b-5p in seminal plasma were significantly associated with sperm concentration,total sperm motility,and percentages of progressive sperm and non-progressive sperm(all with the P-value＜0.01).Conclusion miR-135a-5p and miR-135b-5p are the highly expressed miRNA in seminal plasma,and significantly decreased in azoospermia patients.Both of them may play pivot roles in male infertility.

Objective:To measure the proximal enamel thickness (PET) at the mesial and distal contact areas of the permanent teeth and to provide a reference for interproximal enamel reduction (IPR).Methods:From May 2016 to February 2018, 182 isolated permanent teeth were collected and screened from patients who underwent extraction at Department of Oral and Maxillofacial Surgery, Capital Medical University School of Stomatology. These teeth were extracted for orthodontic purpose or due to severe periodontitis. The patients having teeth extracted were all Beijing residents, Han nationality, and aged (39.5±10.6) years. Ninety percent of the teeth came from patients under 50 years old. These teeth were classified according to different tooth type. The mesial and distal contact areas of these teeth were marked with fluid resin. The isolated teeth were scanned using micro-CT and the enamel thickness was measured and analyzed. The parameters measured included mesial PET (PETm), distal PET (PETd), the distance from mesial contact area to occlusal plane (CAm-OP), the distance from distal contact area to occlusal plane (CAd-OP), the distance from mesial contact area to the cementoenamel junction (CAm-CEJ), the distance from distal contact area to cementoenamel junction (CAd-CEJ) and tooth width (TWmd).Results:The PET gradually increased from the anterior tooth area [(0.63±0.16) mm] to the molar area [(1.46±0.25) mm]. The sum of the PET from the second molar to the contralateral second molar in the maxillary dentition was 31.60 mm, and that of the PET from the second molar to the contralateral second molar in the mandibular dentition was 29.68 mm. The contact areas were located on the occlusal third of the proximal walls of anterior teeth and the middle third of the proximal walls of posterior teeth. The PET were positively correlated with the tooth width between the mesial and distal contact areas ( P<0.05). Conclusions:The PET was thinner in the incisor area and thicker in the molar area. IPR should be carried out close to the occlusal side of the proximal walls in anterior teeth and the cementoenamel junction side of the proximal walls in posterior teeth.

Objective:To observe the dynamic changes in specific IgG antibodies induced by recombinant hepatitis E vaccine using different immunization strategies in BALB/c mice.Methods:BALB/c, C57BL/6, NIH and KM mice were immunized intraperitoneally with serially diluted hepatitis E vaccine to select a mouse strain appropriately responding to hepatitis E vaccine. Then the selected BALB/c mice were randomly divided into three experimental groups, one-dose immunization group (0 week), two-dose immunization group (0 and 4 weeks) and three-dose immunization group (0, 4 and 12 weeks), and three adjuvant control groups with the same immunization strategy as the corresponding experimental group. Blood samples were collected from the intraocular canthus at different time points and serum antibody levels were detected quantitatively.Results:The BALB/c and NIH mice had proper responses to hepatitis E vaccine administrated at different doses than the C57BL/6 and KM mice, and the antibody positive conversion rates also showed a certain dose-effect relationship. Thus, the BALB/c mice were used as the animal model. The level of specific IgG antibodies in BALB/c mice immunized with one dose of vaccine reached a peak of 44.35 U/ml around the 10th week after the immunization, and then maintained at (5.52-13.28) U/ml after a decrease. The antibody level in the two-dose immunization group increased rapidly after the second immunization and peaked at the 8th week. From the 10th week, it gradually decreased and maintained at (16.50-32.54) U/ml. The trend of antibody changes in the three-dose immunization group was similar to that of the two-dose immunization group during the first 12 weeks, but a significant increase was induced after the third immunization and the level maintained at (62.65-72.61) U/ml for a long time, which was about nine times higher than that of the one-dose immunization group and three times of the two-dose immunization group.Conclusions:This study showed that BALB/c mice were suitable models to study the dynamic changes in specific IgG antibodies elicited by hepatitis E vaccine using different immunization strategies, which provided reference for future research on its in vivo efficacy.

Objective To investigate the application effect of the teaching method of team-based learning (TBL) combined with case-based learning (CBL) in the teaching of military positive psychology. Methods A total of 100 medical undergraduates of the class 2017 in Army Medical University were selected and randomly divided into TBL+CBL teaching group and traditional teaching group , with 50 undergraduates in each group . The teaching effect of the two methods was evaluated by assessment of theoretical knowledge and case analysis, questionnaire survey, and psychological evaluation. SPSS 19.0 was used to perform the t-test. Results Compared with the traditional teaching group, the TBL+CBL teaching group had significantly higher scores of theoretical knowledge (54.87±4.98 vs. 48.65±3.51) and case analysis (36.84 ±2.73 vs. 32.37 ±2.34). As for the results of psychological evaluation, compared with the traditional teaching group , the TBL+CBL teaching group had a significantly lower score of Symptom Checklist-90 (143.31±43.62 vs. 149.89±46.96) and significantly higher scores of ERC (48.76±5.37 vs.43.58 ±5.79) and GWB (107.87 ±15.56 vs. 102.32 ±12.13). In addition, the satisfaction rate of the TBL and CBL teaching method reached 95.83％ (46/50) in the TBL+CBL group. Conclusion The teaching method of TBL combined with CBL can achieve good teaching results in the teaching of military positive psychology and improve students' abilities of knowledge application and psychological adjustment. Therefore, it has good feasibility and applicability.

Objective To investigate the relationships between mindfulness,anxiety and depression in surface warship soldiers and the mediating role of attentional control.Methods Chinese versions of State-Trait Anxiety Inventory ( STAI ) , Center for Epidemiologic Studies Depression Scale ( CES-D ) , Attentional Control Scale ( ACS) and the Five Facet Mindfulness Questionnaire ( FFMQ) were used to survey 475 sur-face warship soldiers. Single factor analysis of variance,correlation analysis and path analysis were conducted by SPSS 20.0 and Amos18.0. Results ①The scores of the state anxiety,trait anxiety and depression in the soldiers and noncommissioned officers were significantly higher than that of commissioned officers (P<0.05) . As for the state anxiety,trait anxiety,depression and attentional focusing,there were statistically significant differences among different educational levels (P<0.05) . Specifically,the lower educational level,the higher anxiety and depression,the lower control focusing. ② There were significant positive correlations among at-tentional focusing (27.12±4.43),attentional shifting (29.43±3.78) and mindfulness (120.27±11.16,r=0.49-0.51,P<0.01). State anxiety (38.65±10.07) was negatively correlated with attentional focusing,atten-tional shifting and mindfulness (r=-0.32--0.54, P<0.01). Similar results were observed for trait anxiety (41.28±8.79) and depression (9.97±10.13). ③Attentional focusing partially mediated the relationships be-tween state anxiety,trait anxiety,depression and mindfulness. Conclusion Anxiety and depression of sol-diers have obvious relationships with kinds of soldiers' rank and education level. Mindfulness and attentional control are vital protective factors for marine army's mental health. This study indicates that mindfulness may improve individuals' attentional focusing and attentional shifting,and ameliorate negative moods such as anx-iety and depression.

Objective To evaluate the effect of hydrogen on mitochondrial dynamics during endotoxin-induced damage to human umbilical vein endothelial cells (HUVECs).Methods HUVECs cultured in vitro were seeded in the culture plate and divided into 4 groups using a random number table:control group (group C),hydrogen-saturated culture medium group (H group),endotoxin group (group E) and endotoxin + hydrogen-saturated culture medium group (group E+H).The cells were cultured in the plain culture medium in C and E groups.The cells were cultured in the hydrogen-saturated culture medium containing lipopolysaccharide (LPS) with the final concentration of 10 μg/ml in H and E+H groups.At 2,8 and 24 h of culture or incubation with LPS,the cell viability was detected by methyl thiazolyl tetrazolium assay,the intracellular ATP content was measured using the phosphomolybdic acid colorimetric method,and the expression of dynamin-related protein 1 (DRP1) was detected by using Western blot.The expression of DRP1 was detected by immunofluorescence at 8 h of incubation with LPS.Results Compared with group C,the cell viability and ATP content were significantly decreased,and the expression of DRP1 was up-regulated at each incubation time point in E and E +H groups (P＜0.05),and no significant change was found in the parameters mentioned above in group H (P＞0.05).Compared with group E,the cell viability and ATP content were significantly increased,and the expression of DRP1 was down-regulated at each incubation time point in group E+H (P＜0.05).Conclusion The mechanism by which hydrogen reduces endotoxin-induced damage to HUVECs is related to down-regulation of DRP1 expression and inhibition of excessive mitochondrial fission.