Objective To understand the risk and related influencing factors of death of patients with infection of human immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS)in Shaoyang City.Methods The survival status and death risk of HIV/AIDS patients in Shaoyang City from 1997 to 2024 were analyzed by Kap-lan-Meier survival analysis and Cox proportional hazards regression model of retrospective cohort study method.Results A total of 5 805 patients were included in analysis,1 941 died during the observation period,out of which 54.20％died from diseases irrelevant to AIDs,and the all-cause mortality was 9.01/100 person-year.The risk of death for males was 1.447 times of females.The comparison of death risk among patients with different ages of HIV infection diagnosis and educational levels showed statistically significant differences(all P＜0.05).The death risk of patients with baseline CD4+T lymphocyte count in the 0-199 group was 1.497 times higher than that in the ≥500 group(P＜0.001),and the mortality in this group was higher than those in other groups.Patients with lower last CD4+T lymphocyte counts had a higher risk of death(P＜0.001).The mortality of patients who did not receive antiviral treatment was 36.37/100 person-year,which was higher than 4.21/100 person-year of those who received treatment.The maximum ratio of death risk between the two was 6.578(P＜0.001).Compared with patients in the INSTI-containing regimen group,the death risks of patients in LPV/r-containing and NNRTI-containing regi-men groups were 4.902 and 2.769,respectively(both P＜0.001),and patients in the LPV/r-containing regimen group had a higher percentage of deaths due to cardiovascular and cerebrovascular diseases than those in the NNRTI regimen group(11.79％vs 7.26％;x2=3.872,P=0.049).Conclusion HIV/AIDS patients in Shaoyang City face a high risk of death.Male,advanced age,low educational level,without receiving antiviral treatment,and low baseline/last CD4+T lymphocyte count are all important factors that contribute to the increase of death risk.Re-ceiving INSTI-containing treatment regimen can significantly reduce mortality.Therefore,early detecting cases,timely optimizing antiviral treatment regimen,as well as strengthening patient management and compliance educa-tion have certain clinical reference value for reducing the risk of death in HIV/AIDS patients.

Objective To understand the risk and related influencing factors of death of patients with infection of human immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS)in Shaoyang City.Methods The survival status and death risk of HIV/AIDS patients in Shaoyang City from 1997 to 2024 were analyzed by Kap-lan-Meier survival analysis and Cox proportional hazards regression model of retrospective cohort study method.Results A total of 5 805 patients were included in analysis,1 941 died during the observation period,out of which 54.20％died from diseases irrelevant to AIDs,and the all-cause mortality was 9.01/100 person-year.The risk of death for males was 1.447 times of females.The comparison of death risk among patients with different ages of HIV infection diagnosis and educational levels showed statistically significant differences(all P＜0.05).The death risk of patients with baseline CD4+T lymphocyte count in the 0-199 group was 1.497 times higher than that in the ≥500 group(P＜0.001),and the mortality in this group was higher than those in other groups.Patients with lower last CD4+T lymphocyte counts had a higher risk of death(P＜0.001).The mortality of patients who did not receive antiviral treatment was 36.37/100 person-year,which was higher than 4.21/100 person-year of those who received treatment.The maximum ratio of death risk between the two was 6.578(P＜0.001).Compared with patients in the INSTI-containing regimen group,the death risks of patients in LPV/r-containing and NNRTI-containing regi-men groups were 4.902 and 2.769,respectively(both P＜0.001),and patients in the LPV/r-containing regimen group had a higher percentage of deaths due to cardiovascular and cerebrovascular diseases than those in the NNRTI regimen group(11.79％vs 7.26％;x2=3.872,P=0.049).Conclusion HIV/AIDS patients in Shaoyang City face a high risk of death.Male,advanced age,low educational level,without receiving antiviral treatment,and low baseline/last CD4+T lymphocyte count are all important factors that contribute to the increase of death risk.Re-ceiving INSTI-containing treatment regimen can significantly reduce mortality.Therefore,early detecting cases,timely optimizing antiviral treatment regimen,as well as strengthening patient management and compliance educa-tion have certain clinical reference value for reducing the risk of death in HIV/AIDS patients.

OBJECTIVE: To review the research progress of pathological changes of glenohumeral capsule in patients with recurrent shoulder anterior dislocation (RSAD). METHODS: The literature on shoulder capsules, both domestic and international, was reviewed. The anatomy, histology, and molecular biology characteristics of the glenohumeral capsule in RSAD patients were summarized. RESULTS: Anatomically, the glenohumeral capsule is composed of four distinct parts: the upper, lower, anterior, and posterior sections. The thickness of these sections is uneven, and the stability of the capsule is further enhanced by the presence of the glenohumeral and coracohumeral ligaments. Histologically, the capsule tissue undergoes adaptive changes following RSAD, which improve its ability to withstand stretching and deformation. In the realm of molecular biology, genes associated with the regulation of structure formation, function, and extracellular matrix homeostasis of the shoulder capsule's collagen fibers exhibit varying degrees of expression changes. Specifically, the up-regulation of transforming growth factor β ₁ (TGF-β ₁), TGF-β receptor 1, lysyl oxidase, and procollagen-lysine, 2-oxoglutarate 5-dioxygenase 1 facilitates the repair of the joint capsule, thereby contributing to the maintenance of shoulder joint stability. Conversely, the up-regulation of collagen type Ⅰ alpha 1 (COL1A1), COL3A1, and COL5A1 is linked to the recurrence of shoulder anterior dislocation, as these changes reflect the joint capsule's response to dislocation. Additionally, the expressions of tenascin C and fibronectin 1 may play a role in the pathological processes occurring during the early stages of RSAD. CONCLUSION Glenohumeral capsular laxity is both a consequence of RSAD and a significant factor contributing to its recurrence. While numerous studies have documented alterations in the shoulder capsule following RSAD, further research is necessary to confirm the specific pathological anatomy, histological, and molecular biological changes involved.
Humans ; Joint Capsule/metabolism* ; Shoulder Dislocation/metabolism* ; Recurrence ; Shoulder Joint/metabolism* ; Tenascin/metabolism* ; Transforming Growth Factor beta1/genetics* ; Collagen Type I/genetics* ; Extracellular Matrix/metabolism*

Objective To discuss the surgical technique and effectiveness of total knee arthroplasty (TKA) for the valgus knee in adult.Methods Retrospective analysis the clinical data from 2015 January to 2017 May of 38 patients with 40 knees treated in our hospital.Age 46-73(61 ±4.2) years old.The femur-tibia angle (FTA) was 7°-35 ° (11 ° ± 4.3 °),the average range of motion (ROM) was 115 ° ± 10°,the Hospital for Special Surgery (HSS) score was 21-65 (43 ± 8.6).All cases were corrected deformity and improved function by TKA.Results 38 patients were followed up 6 months to 3 years.All patients had no severe pain and dysfunction.The postoperative FTA was 1 °-7°(4 ± 3°),the average ROM was 115° ± 10°,the HSS score was 76 ± 14,showing significant difference compared with preoperative data (P ＜ 0.05).Conclusions The TKA is a conventional therapy for valgus deformed knee in adult.By appropriate approach,precise osteotomy,accurate soft tissue balance,satisfactory joint function and effectiveness can be achieved.

Currently ischemic preconditioning is one of the most efficacious ways to treat ischemia reperfusion via triggering endogenously protective system. However, pharmacologic preconditioning has been produced due to the difficulty of performing ischemia preconditioning. Pharmacologic preconditioning, including both receptors and non-receptors, is actively investigated for the treatment of ischemia reperfusion.