To analyze the transmission characteristics of newly reported HIV-infected students aged ≥18 years in Nanjing City from 2016 to 2022 and provide evidence for AIDS publicity and intervention among young students. The pol region sequences of newly reported HIV-infected students and non-student HIV-infected individuals in Nanjing City from 2016 to 2022 were collected, and the BLAST tool was used to search the published global non-Nanjing reported HIV infection sequences in the LANL HIV database. The basic molecular transmission network and regional molecular transmission network were constructed using the HIV-TRACE in a pairwise genetic distance threshold of 1.0%. 332 sequences of infected students aged≥18 years in Nanjing City, 1 904 sequences of non-student-infected individuals in Nanjing City and 1 698 non-Nanjing-infected individuals were obtained. Among the 332 infected students, the main route of infection was homosexual (96.39%), and the subtypes were CRF01_AE (37.95%), CRF07_BC (37.65%) and CRF105_0107 (10.24%). There were 890 sequences in the regional molecular transmission network, of which 21.80% were infected students in Nanjing City, 39.89% were non-student-infected individuals in Nanjing City, and 38.31% were non-Nanjing-infected individuals. In the CRF105_0107 transmission cluster, non-student-infected individuals from Nanjing accounted for 66.95% (81/121), while in the CRF07_BC transmission cluster, non-Nanjing-infected individuals accounted for 56.66% (200/353). There were 1 644 edges connected to infected students within the regional molecular transmission network, with local transmission accounting for 64.72% and regional transmission accounting for 35.28%. Regional transmission was mainly in Guangdong Province (19.83%) and other cities in Jiangsu Province (4.50%). The HIV-1 subtypes of newly reported HIV-infected students aged≥18 years in Nanjing City are mainly CRF01_AE, CRF07_BC and CRF105_0107, with local transmission as the main transmission characteristics. There is transmission between students and non-students.

Objectives:The purpose of this study was to observe the effect of closed-suction irrigation in patients with brucellosis spondylitis(BS)after one-stage posterior debridement and bone graft fusion with inter-nal fixation.Methods:30 patients with BS after one-stage posterior debridement and bone graft fusion with internal fixation,admitted between August 2022 and December 2023,were randomly divided into control group(15 cases)and observation group(15 cases).In the control group,there were 10 males and 5 females,with an age of 44.1±7.8 years;In the observation group,there were 11 males and 4 females,with an age of 42.1±6.6 years.The control group received conventional treatment after operation,and the observation group received gentamicin closed-suction irrigation treatment on the basis of the control group.From the first day after surgery,gentamicin 80mg+normal saline 3000mL was used to continuously inrigate the wound for 2 weeks.The erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),visual analogue scale(VAS),and Os-westry disability index(ODI)were observed before operaion,and on the 1st day after operation,at 1 week,2 weeks,3 months,6 months,and 1 year after operation.The imaging data of the two groups before operation and at 1 year after operation were compared,including lumbar lordosis(LL)and disc height(DH).At 1 year after operation,the fusion rate was evaluated according to Suk classification.The postoperative complications were recorded.Results:On the first day after operation,the levels of ESR and CRP in both groups were significantly higher than those before operation(P＜0.05).At 1 week after operation,the CRP level of patients in the two groups was significantly lower than that before operation(P＜0.05).At 2 weeks after operation,the ESR of the patients in the observation group was lower than that before operation(P＜0.05),while the ESR in the control group was lower than that before operation at 3 months after operation(P＜0.05).With the passage of time,the VAS score and ODI of the two groups were significantly lower than those before operation(P＜0.05).The ESR,CRP,VAS and ODI in the observation group were significantly lower than those in the control group at 1 week,2 weeks and 3 months after operation(P＜0.05).At 6 months after operation,the ESR and CRP levels of patients in both groups returned to normal.One year after operation,both LL and DH in the two groups of patients increased compared with those before operation(P＜0.05).The overall fusion rate was 100％in the control group and 93.33％in the experimental group(P＞0.05).No postoperative complications occurred during the study in either group.Conclusions:Closed-suction irrigation after one-stage posterior debridement and bone-graft fusion with internal fixation for the patients with BS can help to reduce the inflammatory markers,relieve back pain and improve lumbar function.

Objectives:The purpose of this study was to observe the effect of closed-suction irrigation in patients with brucellosis spondylitis(BS)after one-stage posterior debridement and bone graft fusion with inter-nal fixation.Methods:30 patients with BS after one-stage posterior debridement and bone graft fusion with internal fixation,admitted between August 2022 and December 2023,were randomly divided into control group(15 cases)and observation group(15 cases).In the control group,there were 10 males and 5 females,with an age of 44.1±7.8 years;In the observation group,there were 11 males and 4 females,with an age of 42.1±6.6 years.The control group received conventional treatment after operation,and the observation group received gentamicin closed-suction irrigation treatment on the basis of the control group.From the first day after surgery,gentamicin 80mg+normal saline 3000mL was used to continuously inrigate the wound for 2 weeks.The erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),visual analogue scale(VAS),and Os-westry disability index(ODI)were observed before operaion,and on the 1st day after operation,at 1 week,2 weeks,3 months,6 months,and 1 year after operation.The imaging data of the two groups before operation and at 1 year after operation were compared,including lumbar lordosis(LL)and disc height(DH).At 1 year after operation,the fusion rate was evaluated according to Suk classification.The postoperative complications were recorded.Results:On the first day after operation,the levels of ESR and CRP in both groups were significantly higher than those before operation(P＜0.05).At 1 week after operation,the CRP level of patients in the two groups was significantly lower than that before operation(P＜0.05).At 2 weeks after operation,the ESR of the patients in the observation group was lower than that before operation(P＜0.05),while the ESR in the control group was lower than that before operation at 3 months after operation(P＜0.05).With the passage of time,the VAS score and ODI of the two groups were significantly lower than those before operation(P＜0.05).The ESR,CRP,VAS and ODI in the observation group were significantly lower than those in the control group at 1 week,2 weeks and 3 months after operation(P＜0.05).At 6 months after operation,the ESR and CRP levels of patients in both groups returned to normal.One year after operation,both LL and DH in the two groups of patients increased compared with those before operation(P＜0.05).The overall fusion rate was 100％in the control group and 93.33％in the experimental group(P＞0.05).No postoperative complications occurred during the study in either group.Conclusions:Closed-suction irrigation after one-stage posterior debridement and bone-graft fusion with internal fixation for the patients with BS can help to reduce the inflammatory markers,relieve back pain and improve lumbar function.

To analyze the transmission characteristics of newly reported HIV-infected students aged ≥18 years in Nanjing City from 2016 to 2022 and provide evidence for AIDS publicity and intervention among young students. The pol region sequences of newly reported HIV-infected students and non-student HIV-infected individuals in Nanjing City from 2016 to 2022 were collected, and the BLAST tool was used to search the published global non-Nanjing reported HIV infection sequences in the LANL HIV database. The basic molecular transmission network and regional molecular transmission network were constructed using the HIV-TRACE in a pairwise genetic distance threshold of 1.0%. 332 sequences of infected students aged≥18 years in Nanjing City, 1 904 sequences of non-student-infected individuals in Nanjing City and 1 698 non-Nanjing-infected individuals were obtained. Among the 332 infected students, the main route of infection was homosexual (96.39%), and the subtypes were CRF01_AE (37.95%), CRF07_BC (37.65%) and CRF105_0107 (10.24%). There were 890 sequences in the regional molecular transmission network, of which 21.80% were infected students in Nanjing City, 39.89% were non-student-infected individuals in Nanjing City, and 38.31% were non-Nanjing-infected individuals. In the CRF105_0107 transmission cluster, non-student-infected individuals from Nanjing accounted for 66.95% (81/121), while in the CRF07_BC transmission cluster, non-Nanjing-infected individuals accounted for 56.66% (200/353). There were 1 644 edges connected to infected students within the regional molecular transmission network, with local transmission accounting for 64.72% and regional transmission accounting for 35.28%. Regional transmission was mainly in Guangdong Province (19.83%) and other cities in Jiangsu Province (4.50%). The HIV-1 subtypes of newly reported HIV-infected students aged≥18 years in Nanjing City are mainly CRF01_AE, CRF07_BC and CRF105_0107, with local transmission as the main transmission characteristics. There is transmission between students and non-students.

[Objective]To investigate the depression status and its influencing factors in HIV/AIDS patients receiving antiviral therapy.[Methods]From July 2022 to September 2022,successive sampling method was used to recruit HIV/AIDS patients receiving antiviral therapy from antiviral treatment institutions in Nanjing,and they were instructed to fill out anonymous questionnaires.The questionnaire collected the basic information of patients,and depression,HIV stigma score and social support level were investigated by Patient Health Questionnaire-9(PHQ-9),Berger HIV stigma scale(BHSS)and Multidimensional Scale of Perceived Social Support(MSPSS).Multivariate Logistic regression was used to an-alyze the influencing factors of depression.[Results]A total of 1879 valid questionnaires were collected in this study,and the detection rate of depression was 50.1%.The results of multivariate logistic analysis showed that compared with patients with middle school or below,the risk of depression was lower for those with postgraduate or above[OR=0.534,95%CI(0.341,0.835),P=0.006].Compared with antiviral therapy duration<1 year,antiviral therapy duration for 1 to 5 years[OR=0.729,95%CI(0.536,0.991)],>5 to 10 years[OR=0.516,95%CI(0.379,0.702)],>10 years[OR=0.603,95%CI(0.375,0.969)]was associated with a lower risk of depression.High level of social support was a protective factor for depression in HIV/AIDS patients compared with middle and low level of social support[OR=0.430,95%CI(0.349,0.530),P<0.001].There was a higher risk of depression with side effects than without side effects[OR=2.260,95%CI(1.833,2.786),P<0.001].The higher the score on the HIV stigma scale,the higher the possibility of depression was.[Conclusion]The detection rate of depression of patients receiving antiviral therapy in Nanjing is high.After starting antivi-ral therapy,we should strengthen the monitoring of side effects and psychological status of patients,carry out psychologi-cal intervention,alleviate psychological problems,and improve the quality of life of patients receiving antiviral therapy.

Objective To observe the value of CT radiomics nomogram for predicting Ki-67 expression of thymus epithelial tumors.Methods Totally 163 patients with thymus epithelial tumor,including 114 patients in training set and 49 patients in validation set were retrospectively enrolled.The patients were further divided into low expression(＜50％)and high expression(≥50％)subgroups according to Ki-67 index.Multivariate logistic regression analysis was performed to screen independent predicting factors of Ki-67 expression in thymus epithelial tumors,and clinical-CT model was constructed.The optimal radiomics features were extracted and screened based on chest plain and venous phase enhanced CT images,respectively.Then radiomics modelplain and radiomics modelenhanced were constructed,and Radscoreplain and Radscoreenhanced were calculated,respectively.The nomogram model was constructed based on clinical-CT model,Radscoreplain and Radscoreenhanced.Receiver operating characteristic curves were drawn,and the area under the curves(AUC)were calculated to evaluate the efficacy of each model for predicting Ki-67 expression of thymus epithelial tumors.Results Patient's gender and enhanced CT value of lesion were both independent predicting factors of Ki-67 expression in thymus epithelial tumors(both P＜0.05).The AUC of clinical-CT model,radiomics modelplain,radiomics modelenhanced and nomogram model for predicting Ki-67 expression was 0.736,0.814,0.836 and 0.857 in training set,which was 0.746,0.746,0.750 and 0.799 in validation set,respectively.Conclusion CT radiomics nomogram could be used to predict Ki-6 7 expression of thymus epithelial tumors.

ObjectiveTo investigate the efficacy and safety of endoscopic retrograde cholangiopancreatography （ERCP） during pregnancy and puerperium through a comparative analysis. MethodsA retrospective analysis was performed for the clinical data of 22 patients in pregnancy and 39 patients in puerperium who received ERCP in Digestive Endoscopy Center of The First Affiliated Hospital of Nanchang University from January 2007 to August 2022. The two groups of patients were compared in terms of baseline data， diagnosis during ERCP， interventions， laboratory results before and after ERCP， post-ERCP complications， and delivery and fetal outcomes. The independent-samples t test was used for comparison of continuous data between two groups， and the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups. ResultsThere were no significant differences between the patients in pregnancy and those in puerperium in all baseline data （all P>0.05） except the rate of CT examination （22.73% vs 58.97%， χ²=7.44， P=0.006）. During the ERCP procedure， compared with the patients in puerperium， the patients in pregnancy had a significantly lower proportion of the patients who underwent biliary stone extraction or endoscopic papillary balloon dilation （χ²=4.007 and 4.315， both P<0.05） and a significantly higher proportion of the patients who did not receive X-ray fluoroscopy （χ²=12.103， P=0.001）. After ERCP， both groups had significant improvements in white blood cell count， total bilirubin， direct bilirubin， alanine aminotransferase， and aspartate aminotransferase （all P<0.05）. The overall incidence rate of post-ERCP complications was 7.04% （5/71） for all patients， with post-ERCP biliary infection as the most common complication （3/71，4.23%）， and there was no significant difference in the incidence rate of post-ERCP complications between the two groups （P>0.05）. As for delivery and fetal outcomes， compared with the patients in puerperium， the patients in pregnancy had a significantly higher proportion of patients with early termination of pregnancy （50.00% vs 0，χ²=20.528， P<0.001） and a significantly lower proportion of patients with cesarean section （36.36% vs 76.92%， χ²=4.756， P=0.029）. There were no significant differences in the incidence rates of adverse events such as abnormal fetal development and stillbirth between the two groups （P>0.05）. ConclusionWith strict control of ERCP indications and timing， ERCP is effective and relatively safe in both pregnancy and puerperium and has a comparable incidence rate of post-ERCP complications to that in the general population， with relatively good delivery and fetal outcomes.

Objective: To understand the AIDS knowledge of male college students who have sex experience and the influencing factors of high-risk sexual behaviors, so as to provide a basis for AIDS prevention and control on campus. Methods: A total of 5 718 male college students who have sex from 18 colleges and universities in Nanjing were investigated by stratified random cluster sampling method from April to June in 2019. Their AIDS knowledge and high-risk sexual behaviors were investigated and risk factors were analyzed. Results: Male college students had poor AIDS related knowledge and the incidence of high-risk sexual behaviors was 61.5%. Logistic regression analysis showed that the proportion of male college students with sexual orientation of bisexuality(OR=1.61), uncertainty (OR=2.41) and heterosexuality (OR=1.47) who had high-risk sexual behaviors were higher than those of homosexuals. The age of first sexual intercourse ≤14 years old(OR=2.71), 15 to 17 years old(OR=1.87), and 18 to 20 years old (OR=1.35) had a higher proportion of high-risk sexual intercourse than the age of first sexual intercourse of older than 20 years old. In the past year, the proportion of commercial sex(OR=1.80), drug use(OR=4.28), sexually transmitted disease (OR=3.34) diagnosed in the most recent year who had high-risk sexual behaviors were higher. In the pust year, the proportion of stable relationship and cohabitation(OR=0.25), those who had received AIDS prevention propaganda in the most recent year(OR=0.81), and those who knew about AIDS (OR=0.65) were less likely to engage in high-risk sexual behaviors. Conclusion The knowledge rate of HIV/AIDS was low and the incidence of high-risk sexual behavior was high among male college students. Therefore, colleges are encouraged to, actively carry out AIDS prevention and control work, improve the awareness of both HIV/AIDS knowledge and safe sex basics.

Objective:To investigate HIV-1 genotypes and drug resistance among newly diagnosed young students in Nanjing in order to provide reference for the prevention and control of AIDS in this group.Methods:This study enrolled 200 newly diagnosed young students with HIV-1 infection in Nanjing from September 2015 to July 2019. Demographic information and blood samples were collected. Through RNA extraction and PCR amplification, 191 pol fragments were successfully obtained and subjected to genotyping and drug resistance analysis. Results:CRF01_AE (41.4%) and CRF07_BC (30.9%) were the predominant genotypes, followed by unique recombinant forms (URFs) (15.7%), CRF55_01B (5.2%), CRF68_01B (3.1%), CRF67_01B (2.6%), and subtype B (1.0 %). The incidence of drug-resistant mutations was 16.8%, and the rate of transmitted drug resistance (TDR) was 4.2%. The rates of TDR in CRF01_AE, CRF07_BC, CRF55_01B, URFs and other genotypes were 2.5%, 1.7%, 10.0%, 10.0% and 7.7%, respectively ( P>0.05). Conclusions:The rapid emergence of recombinant HIV-1 strains in the young students should be taken seriously. The prevalence of TDR was close to the alert level, thus needing to be monitored continuously.

Objective To analyze CT imaging findings and pathological features of the thymic cyst.Methods The CT findings of 20 cases with thymic cyst confirmed by pathology were analyzed retrospectively.The analysis included the location,shape ,size ,density ,contour, unilocular or multilocular,with or without walls,enhancement and lesion periphery.The pathology results were compared to CT findings.Results All lesions were located in the anterior mediastinum,in which the location of left side in 12 cases,right side in 6 cases,median mediastinum in 2 cases.All lesions had clear border and unilocular,including round shape in 4 cases,oval shape in 8 cases,and irregular shape in 8 cases with triangular shape in 1 case,the size range was 2-6 cm.4 cases had obvious cyst wall.The CT value of the cyst had range of 4-53 HU,with 10 cases less than 10 HU and 10 cases greater than 10 HU.There was no enhancement within the cysts of 20 cases and the cyst wall had enhancement in 4 cases.All cases of pathological findings were confirmed as thymus cyst.Gross sample showed gray red or isabeling.The lesion was cystic in 18 cases,soft stereocyst in 2 cases,bright yellow liquid within the capsule in 10 cases,butter fat in 5 cases,chylomicrons in 3 cases,unilocular in 19 cases and multilocular in 1 case (butter fat).Microscope showed the fibrous capsule wall in all cases,lined with squamous epithelium,ciliated columnar epithelium,monolayer columnar epithelium,in which could be seen normal thymus tissue.The thickness of the wall was no more than 0.5 cm,and multilocular wall smooth,no obvious inflammatory response in the surrounding.Conclusion CT image findings can clearly show the thymic cyst site,shape,size,density and boundaries,unilocular or multilocular,with or without walls.The CT image can reflect pathological features of the thymic cyst,and can provide accurate and reliable information for the clinic.