Objective: To examine the mediating effect of resilience on AIDS-related stress and patient-reported outcome among elderly cases with HIV/AIDS, so as to provide the basis for promoting mental health and improving health outcomes of this population. Methods: From June to July 2024, elderly cases with HIV/AIDS receiving treatment in the infectious diseases department of a tertiary-level hospital in Sichuan Province and undergoing follow-up management at 12 community health service centers in Wuhou District, Chengdu City, Sichuan Province, were selected as study participants using convenience sampling method. Data on demographic information, duration since confirmed diagnosis and the most recent CD4+T lymphocyte count were collected through questionnaire surveys. The Chinese versions of the HIV/AIDS Stress Scale, the Chinese versions of the 10-item Connor-Davidson Resilience Scale, and the Patient-Reported Outcome Scale for Elderly HIV/AIDS Patients were used to assess AIDS-related stress, resilience, and patient-reported outcome, respectively. Structural equation modeling was performed using Mplus 8.3 software to analyze the mediating effect of resilience on AIDS-related stress and patient-reported outcome. The Bootstrap method was employed to test the significance of the mediating effect. Results: A total of 424 elderly HIV/AIDS cases were included, with a mean age of (62.04±8.73) years. Among them, 315 (74.29%) were males and 109 (25.71%) were females. The median scores were 23.00 (interquartile range, 11.00) points for AIDS-related stress, 30.00 (interquartile range, 7.00) points for resilience, and 363.45 (interquartile range, 53.03) points for the total score of patient-reported outcome. Resultsof the mediation effect analysis revealed that AIDS-related stress had a direct negative effect on patient-reported outcome (β=-0.608, 95%CI: -0.742 to -0.465). It also exerted an indirect negative effect on patient-reported outcome through the mediating role of resilience (β=-0.258, 95%CI: -0.364 to -0.158), with the mediating effect accounting for 29.79% of the total effect. Conclusion AIDS-related stress among elderly cases with HIV/AIDS can directly or indirectly negatively affect patient-reported outcome through resilience.

Objective To put forward suggestions for improving the scheme of general practice for functional communities from the perspective of supply and demand,guide the efficient use of the resources of general practice by the communities,and incorporate the general practice of communities into hierarchical diagnosis and treatment management. Methods In July 2021,stratified random sampling was employed to conduct the questionnaire surveys of the young and middle-aged (demand side) and the general practitioners (supply side),respectively.SPSS 20.0 was used for data analysis. Results The two sides had the same cognition about the main reasons for not signing a contract with a family doctor,which were the lack of knowledge about general practitioners and the lack of face-to-face communication opportunities.They had the same response about the form of services,with high acceptance of medical services via WeChat,outpatient consultation,and the internet.There were differences in service content between the two sides.The top three demands of the young and middle-aged were appointment registration and referral in superior hospitals,medication guidance,and massage,acupuncture,and moxibustion.The top service self-rated by general practitioners was personalized guidance and report interpretation of physical examination,and the bottom was massage,acupuncture,and moxibustion. Conclusions The general practice varies between the demand and supply sides.General practitioners should be encouraged to enter and learn functional communities and provide personalized services,thus improving the general medical service in functional communities.
General Practice ; Surveys and Questionnaires

Objective To evaluate the safety and efficacy of endoscopic submucosal tunnel dissection (ESTD) for esophageal submucosal tumors (SMTs). Methods A meta-analysis was performed on 18 related studies of ESTD on the treatment of esophageal SMTs retrieving from Chinese and English databases. Complete resection rate and en bloc resection rate were extracted for efficacy, and the complication rate, recurrence rate and death were used to evaluate safety. Results Complete resection rate was reported in all studies, and the pooled complete resection rate was 97. 5%(95%CI: 95. 4%-98. 6%). There were 9 studies that reported en bloc resection rate, and the pooled en bloc resection rate was 95. 9%(95%CI:90. 1%-98. 3%). Subcutaneous emphysema, mediastinal emphysema, pneumothorax, pneumoper-itoneum and perforation were reported in all 18 studies. The pooled prevalence of air leakage symptoms was 11. 3%(95%CI: 7. 0%-17. 6%) for subcutaneous emphysema and pneumomediastinum, 3. 6%( 95%CI:2. 1%-6. 2%) for pneumothorax and 3. 2%( 95%CI: 1. 9%-5. 4%) for pneumoperitoneum. Additionally, the pooled prevalence of perforation was 4. 9%(95%CI: 3. 1%-7. 8%).Intraoperative bleeding was reported in 2 studies, and the pooled incidence of bleeding was 3. 7%(95%CI: 2. 1%-6. 4%). During the follow-up of the 18 studies, no death was reported, and only 2 cases of recurrence were reported in one study. Conclusion ESTD is safe and effective for esophageal SMTs.

Objective:To evaluate the protective effect of Diclipterachinensis polysaccharide P2B on liver cell line L-02 injury in-duced by carbon tetrachloride ( CCl4 ) . Methods:The human liver L-02 cells were cultured, and the injury model was built by CCl4 . The L-02 cells were divided into the normal control group, the CCl4-damaged group, and the P2B sample groups (0. 125, 0. 250 and 0. 500 mg· ml-1 ). The contents of alanine aminotransferase ( ALT), aspartate aminotransferase ( AST), superoxide dismutase (SOD) and malondialdehyde (MDA) were determined by MTT assay. Results:Compared with the CCl4-damaged group, P2B could improve the activity of L-02 cells, and the activity of AST and ALT in the supernatant was significantly reduced, and the content of SOD in the cells was increased and that of MDA was decreased. Conclusion:P2B can significantly prevent L-02 cells from the damage induced by CCl4 in a dose-dependent manner, and the mechanism may be related with the anti-oxidative activity of P2B.

Objective To investigate the expression of macrophage migration inhibition factor (MIF) and cell cycle regulating factor Cyclin D1 in hepatocellular carcinoma tissue and the interaction between MIF and Cyclin D1 in hepatocellular carcinoma cell cycle controlling. Methods Using quantitative real-time PCR and Western blotting to detect mRNA and protein expression of MIF and Cyelin DI in HCC tissues and tumor adjacent tissues. Specific small interfering RNA(siRNA) targeting MIF gene was transfccted at doses of 50 nmol/L and 100 nmoL/L into HCC cell lines of PLC and HepG2 with lipofeetamine 2000 methods to knockdown the expression of M1F gene and to investigare the the interaction between M1F and Cyclin D1. Results MIF and Cyclin D1 protein and mRNA were overexpressed in HCC tumor tissues. The relative expression of MIF,Cyclin D1 protein and mRNA were 0.825±0.13,0.843± 0.104 and 7.31±1.85 folds、4.27±1.05 folds, compared with the tumor adjacent tissues (FMIF= 15.5, P<0.01;FCyclin D1=87.5,P <0.01). In MIF siRNA treated PLC and HepG2 cells, MIF mRNA down regulation 71.2%±7.2%, 87.4%±2.9% ,74.3%±8.9% and 88.4%±4.6% respectively (FPLC = 315.5 ,P < 0.01 ; FHepG2= 201.2 P < 0.01). While MIF protein expression were significandy reduced to 0.33±0.03,0.11±0.02, 0.81±0.08 and 0.36±0.02 in a dose-dependent manner (FPLC= 43.9, P <0.01 ;FHepG2 = 133.4 P <0.01). Cyclin D1 mRNA was significantly down-regnlated in MIF siRNA treated PLC and HepG2 cell lines when compared with control group(P <0.01). In 50 nmol/L and 100 nmol/L groups, Cyclin DI mRNA levels were respectively decreased by 68.2%±3% and 78.1%±1.4% in PLC cell, 65.8%±4.7% and 77.3%±2.6% in HepG2 cell (FPLC= 1569, P < 0.01 ; FHepG2= 480.4, P <0.01). Compared with control groups, Cyclin D1 protein levels significantly reduced to 0.28±0.06、0.15±0.03 and 0.44 ±0.04、0.13±0.02 in the PLC and HepG2 after M IF siRNA treatment(FPLC= 35.5, P < 0.01 ; FHepG2 = 114.7, P < 0.01). Conclusions MIF and Cyclin D1 mRNA and protein were overexpressed in HCC tumor tissues and participated in tumor cell cycle regulation. MIF may up-regnlate the expression of Cyclin DI via ERK signalling and precipitate in carcinogenesis of hepatocellular carcinoma.