Objective: To investigate the status of regular HIV testing and post exposure prophylaxis (PEP) behaviors among men who have sex with men (MSM) in Lishui City, Zhejiang Province, so as to provide the reference for developing targeted intervention strategies. Methods: A total of 389 MSM were selected from Lishui City by convenient sampling method from April to August 2022, and demographic information, sexual behaviors, HIV testing and PEP behaviors were collected through questionnaire surveys. MSM were clustered using two step clustering analysis, and regular HIV testing and PEP behaviors among different groups of MSM were compared. Factors affecting regular HIV testing and PEP behaviors were evaluated using a multivariable logistic regression model. Results: The MSM surveyed had a median age of 31.00 (interquartile range, 16.00) years. There were 146 MSM undergoing regular HIV testing, accounting for 37.53%, and 47 MSM receiving PEP, accounting for 12.08%. MSM were divided into two groups. There were 28.05% of MSM with regular HIV testing in group 1, which was lower than the 44.44% in group 2; and 22.56% receiving PEP, which was higher than the 4.44% in group 2 (both P<0.05). Multivariable logistic regression analysis identified age (OR=1.030, 95%CI: 1.011-1.050), sexual roles (both receptive and insertive, OR=2.999, 95%CI: 1.732-5.194) and homosexual behaviors in the past 6 months (use condoms every time, OR=4.567, 95%CI: 2.593-8.044) as factors affecting regular HIV testing among MSM; age (OR=0.970, 95%CI: 0.942-0.999), sexual orientation (OR=0.292, 95%CI: 0.139-0.612) and homosexual behaviors in the past 6 months (not use condoms, OR=0.135, 95%CI: 0.040-0.460; use condoms every time, OR=0.076, 95%CI: 0.018-0.326) as factors affecting PEP behaviors among MSM. Conclusion MSM with different characteristics of sexual behaviors have different preferences for HIV regular testing and PEP, with homosexual behaviors in the past 6 months, sexual roles and sexual orientation being the main influencing factors.

ObjectiveTo explore the effectiveness and safety of vibration-kneading abdominal tuina as an adjunct treatment for insomnia of phlegm-heat harassing the interior syndrome with "stomach disharmony" symptom. MethodsSeventy-six insomnia patients of phlegm-heat harassing the interior syndrome with "stomach disharmony" symptom were recruited， and randomly divided into the treatment group and the control group with 38 cases in each group. The control group received eszopiclone 2mg once a night and sleep hygiene guidance， while the treatment group received vibration-kneading abdominal tuina additionally， 5 times a week， 30 min each time. Both groups were treated for 4 weeks. The Pittsburgh Sleep Quality Index （PSQI） （including sleep quality， time to fall asleep， sleep duration， sleep efficiency， sleep disorders， daytime functioning scores， and total scores） and traditional Chinese medicine （TCM） symptom scores of "stomach disharmony" was assessed before and after 4-week treatment and at follow-up （12 weeks after treatment）. Adverse events were also observed and recorded during the study. Pearson correlation analysis was used to assess the correlation between the pre-treatment PQSI total score and TCM symptom score of "stomach disharmony". ResultsThe PSQI scores of sleep quality， time to fall asleep， sleep duration， sleep efficiency， sleep disorders， daytime dysfunction scores， and total scores reduced in both groups decreased after treatment and at follow-up （P＜0.05 or P＜0.01）， as well as the TCM symptom score of "stomach disharmony" （P＜0.01）. After treatment， the PSQI scores of sleep quality， sleep duration， and TCM symptom score of "stomach disharmony" of the treatment group were lower than those of the control group （P＜0.05 or P＜0.01）. At follow-up， the PSQI scores of sleep quality， sleep duration， sleep efficiency， daytime dysfunction score， total score， and TCM symptom score of "stomach disharmony" of the treatment group were lower than those of the control group （P＜0.05 or P＜0.01）. No adverse reactions occurred in any participants during the study. There was a positive correlation between the patients' pre-treatment PQSI total scores and TCM symptom score of "stomach disharmony" （r=0.88， P＜0.01）. ConclusionVibration-kneading abdominal tuina as an adjunct treatment could significantly improve the symptoms of stomach and epigastric symptoms in insomnia patients of phlegm-heat harassing the interior syndrome with "stomach disharmony" symptom， and improve the quality of sleep， with good immediate and long-term therapeutic effects， and sound safety.

This study was performed to investigate the inhibitory effects of Xuebijing injection(XBJ)on lipopolysaccharide(LPS)-induced inflammatory signals on EA.hy926 vascular endothelial cells and the underlying mechanism,and to provide a theoretical basis for the treatment of sepsis with XBJ.WST-1 assay was used to detect the effects of XBJ on the cell viability;Western blot analysis was performed to detect the protein expression levels of IκBα,p-p65,p-ERK,p-JNK,p-p38,p-AMAD17 in cell lysates and the content of sTLR4 fragment in the concentrated culture supernatants.ADAM17 sheddase activity in cells was detected by using a commercial available kit.Data showed that all of the TLR4-mediated inflammatory signals were significantly inhibited by the treatment of XBJ(P＜0.01).ADAM17 phosphorylation and shedding activity were induced by XBJ treatment,simultaneously the sTLR4 contents in the culture media were increased.XBJ-induced shedding of TLR4 was suppressed by the preteatment of 10 μmol/L TAPI-1(an ADAM17 inhibitor).Taken together,XBJ can induce the shedding of TLR4 from cell membrane by up-regulating ADAM17 shedding activity,thereby inhibiting the activation of TLR4-mediated intracellular inflammatory signals in EA.hy926 cells.

Objective:To evaluate the role of autophagy in hydrogen-rich solution-induced reduction of remifentanil-induced hyperalgesia in rats.Methods:Thirty-two clean-grade healthy male Sprague-Dawley rats, aged 2-3 months, weighing 240-260 g, were divided into 4 groups ( n=8 each) by a random number table method: incisional pain group (group I), remifentanil+ incisional pain group (group RI), hydrogen-rich solution+ remifentanil+ incisional pain group (group HRI), and hydrogen-rich solution + autophagy inhibitor+ remifentanil+ incisional pain group (MHRI group). The tail vein was catheterized, the equal volume of normal saline was intravenously infused for 60 min while the incisional pain model was developed in group I, and remifentanil was intravenously infused at a rate of 1 μg·kg -1·min -1 for 60 min while the incisional pain model was developed in RI, HRI and MHRI groups, hydrogen-rich solution 10 ml/kg was intraperitoneally injected at 10 min before preparing the model in group HRI, and 3-MA 15 mg/kg was intraperitoneally injected at 1 h before preparing the model in MHRI group, and the other treatments were similar to those previously described in group HRI. The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were determined at 24 h before and 2, 6, 24 and 48 h after the end of infusion. The rats were sacrificed under anesthesia after the behavioral testing, and the lumbar enlargement segment of the spinal cord was removed for determination of the expression of microtubule-associated protein 1 light chain 3Ⅱ (LC3Ⅱ), Beclin-1 and P62 by Western blot. Results:Compared with the baseline at T 0, the MWT was significantly decreased and TWL was shortened at T 1-4 in the four groups ( P<0.05). Compared with group I, the MWT was significantly decreased and TWL was shortened at T 1-4, the expression of LC3 II and Beclin-1 was up-regulated, and the expression of P62 was down-regulated in group RI and group HRI ( P<0.05). Compared with group RI, the MWT was significantly increased and TWL was prolonged at T 1-4 in group HRI and group MHRI, the expression of LC3 II and Beclin-1 was significantly up-regulated, and the expression of P62 was down-regulated in group HRI, and the expression of LC3 II and Beclin-1 was significantly down-regulated, and the expression of P62 was up-regulated in group MHRI ( P<0.05). Compared with group HRI, the MWT was significantly decreased and TWL was shortened at T 1-4, the expression of LC3 II and Beclin-1 was down-regulated, and the expression of P62 was up-regulated in group MHRI ( P<0.05). Conclusions:The mechanism by which hydrogen-rich solution alleviates hyperalgesia may be related to enhancing the level of autophagy in the spinal cord of rats with incisional pain induced by remifentanil.

Objective To evaluate the effects of simulation training based on the concept of experiential education on im-proving first aid skills of medical staff in nursing homes.Methods The assessment data of 120 medical staff participating in first aid simulation training in our nursing home from January 2020 to June 2023 were retrospectively analyzed.Using a self-controlled design,the changes in skills operation,reaction time,team cooperation,etc.were statistically analyzed.Results All indicators were significantly improved after training.The skill operation score increased by 12.4 points(P＜0.05),the average reaction time decreased by 5.2 seconds(P＜0.05),and the team cooperation score increased by 13.8 points(P＜0.05)compared with before training.Conclusion Simulation training based on the experiential education model can effectively improve the first aid skills and cooperation ability of medical staff,which is an important means to continuously improve the emergency response capac-ity in nursing homes.

Objective:To explore the teaching effect and novel ideas of online teaching applied in skill operation course.Methods:One hundred and fifty-one students studying in Sichuan University taking the First Aid in the Life: Basic Knowledge and Skills as an elective course in the autumn semester of 2019 and spring semester of 2020 were included as the research subjects in this study. Among them, 77 students in the spring semester of 2020 were selected as the experimental group and 74 students in the autumn semester of 2019 were selected as the control group. The students in the experimental group studied the first aid course by online platform, and the others in the control group studied through traditional teaching mode. The teaching effect of the two groups was compared and the teaching satisfaction of the two groups weas analyzed. SPSS 23.0 was used for Chi-square test and t-test. Results:There was no significant difference between the control group and the experimental group in the assessment scores of cardiopulmonary resuscitation, hemostatic bandaging, and fracture fixation [(8.65±0.81 vs 8.69±0.90, P=0.750); (8.10±0.50 vs 8.12±0.61, P=0.880); (8.21±0.89 vs 8.16±0.78, P=0.710)]. Among the students participating in the questionnaire survey in the experimental group, 59 (95.16%) students thought that this course was helpful in dealing with first aid in daily life, and 38 (61.29%) students did not want to change the traditional teaching method to online teaching. Conclusion:The application of online teaching in first-aid skill operation course is feasible and can achieve the similar teaching effect, which provides a novel idea for exploring the online teaching of first aid skills.

Objective　To understand the infection status and typing of Wolbachia in Culex pipiens pallens population in coastal areas of Shandong Province, and to provide new research directions and theoretical basis for the prevention and control of mosquito-borne diseases. Methods　From June 2022 to August 2023, mosquito samples were collected from 8 sites in four coastal cities of Yantai, Qingdao, Rizhao, and Dongying in Shandong Province by light lure method. The collected samples were identified as Culex pipiens pallens by combining morphological and molecular methods. Then, using the PCR detection method established by the Wolbachia surface protein (wsp) gene sequence, the Wolbachia infection rate of Culex pipiens pallens collected in the field from 8 sites along the coast of Shandong Province was detected. In addition, the representative strain of Wolbachia was downloaded from the GenBank database, and the obtained gene sequences were subjected to phylogenetic analysis using Mega5.2 software for typing. Results　Wolbachia infection was found in all four coastal areas of Shandong Province, with an average infection rate of 80.8% (261/323). Among them, Yanti had the highest infection rate of 100% (46/46), while Wulian County, Rizhao City had the lowest infection rate of 60.6% (20/33). A total of 12 wsp haplotypes were identified, with 92.5% infection rates for Hap1, 70.0% for Hap2, and lower rates for Hap3 to Hap12. From the perspective of haplotype sources, Hap1 was detected in all 8 sampling sites, while other haplotypes were only detected in some geographical populations of sampling sites. Among them, Dongying District, Dongying City had the highest haplotype diversity, with six haplotypes detected. Phylogenetic tree analysis concluded that the Wolbachia strains found in all eight sampling points belonged to group B. Conclusions　Infection of Wolbachia group B is common in Culex pipiens pallens in coastal areas of Shandong Province. Still, there are certain differences in the haplotypes of Wolbachia infections in different regions. This provides a valuable theoretical basis for targeted prevention and control of specific mosquito-borne diseases in the region．

Objective:To explore the feasibility and clinical effects of using superficial temporal artery lobulated perforator flaps in repairing skin and soft tissue defects after tumor resection in the temporal region.Methods:A retrospective observational study method was used. From March 2017 to October 2022, ten patients with temporal skin tumors were admitted to the Affiliated Hospital of Zunyi Medical University, including six women and four men, with age ranging from 42 to 87 years. Among them, three patients had squamous cell carcinoma and seven patients had basal cell carcinoma, with disease duration ranging from 6 months to 5 years. All temporal tumors underwent expanded resection, leaving wound areas of 5.4 cm×4.2 cm to 7.0 cm×4.0 cm after tumor resection. Superficial temporal artery frontal branch flaps with areas of 5.5 cm×1.2 cm to 7.0 cm×1.5 cm, superficial temporal artery descending branch flaps with areas of 4.2 cm×3.5 cm to 5.0 cm×4.0 cm, and superficial temporal artery parietal branch flaps with areas of 4.2 cm×1.0 cm to 5.0 cm×1.0 cm were designed to repair the wounds and reconstruct the hairline. The donor areas of the flaps were closed and sutured directly. The survival of the flaps was observed on 3 to 5 days after surgery, and the healing of wounds on the donor and recipient sites was observed when the stitches were removed on 5 to 7 days after surgery. During follow-up after surgery, the appearance of the temporal area, scar hyperplasia, hairline reconstruction, and tumor recurrence were observed in the temporal region on the affected side.Results:All the flaps survived well on 3 to 5 days after surgery, and all the donor and recipient site wounds healed well on 5 to 7 days after surgery. During follow-up of 3 to 6 months after surgery, the surgical incisions were concealed; the flaps were not swollen, with a consistent color to the surrounding skin; there were no obvious hypertrophic scars; the reconstructed hairline on the affected side was not significantly different from that of the healthy side; there was no tumor recurrence in the local area.Conclusions:For large areas of skin and soft tissue defects in the temporal region, the use of superficial temporal artery lobulated perforator flaps can repair the wounds in different regions and suture the donor sites in the primary stage simultaneously. The surgical operation is simple, and the facial appearance conforms to the aesthetic requirement after surgery with no tumor recurrence in the local area but a good repair effect. This method is particularly suitable for repairing large areas of skin and soft tissue defects in the temporal region in elderly patients.

According to the characteristics of short time and large amount of samples for out of hospital emergency nucleic acid detection, this study introduces an out of hospital emergency nucleic acid detection cloud platform system, which realizes the functions of rapid identification of the detected person and one-to-one correspondence with the samples, and real-time upload of the detection results to Zhejiang Government service network for quick viewing and statistics, so as to complete the task of national nucleic acid screening efficiently and accurately that we must provide information support.
COVID-19 ; Cloud Computing ; Humans ; Nucleic Acids ; SARS-CoV-2

Objective:To evaluate the relationship between autophagy and oxidative stress during remifentanil-induced hyperalgesia in the rats with incisional pain.Methods:Thirty-two clean-grade healthy male Sprague-Dawley rats, weighing 230-250 g, aged 2-3 months, were divided into 4 groups ( n=8 each) using a random number table method: incisional pain group (I group), remifentanil + incisional pain group (RI group), autophagy inhibitor 3-methyladenine + remifentanil + incisional pain group (MRI group) and autophagy agonist rapamycin group + remifentanil + incisional pain group (RRI group). The model of incision pain was developed and the equal volume of normal saline was intravenously infused simultaneously for 60 min.In RI, MRI and RRI groups, the model of incision pain was developed and remifentanil 1 μg·kg -1·min -1 was simultaneously infused for 60 min.In MRI group, 3-methyladenine 15 mg/kg was intraperitoneally injected at 12 h before developing the model, and rapamycin 10 mg/kg was intraperitoneally injected at 12 h before developing the model in RRI group.Thermal paw withdrawal latency (TWL) and mechanical paw withdrawal threshold (MWT) were measured at 24 h before infusion of remifentanil or normal saline (T 0) and at 2, 6, 24 and 48 h after the end of infusion (T 1-4). The rats were sacrificed after the end of behavioral testing, and the lumbar enlargement segments of the spinal cord were harvested for determination of the expression of autophagy microtubule-associated protein 1 light chain 3Ⅱ (LC3Ⅱ), Beclin-1 and P62 (by Western blot), activity of superoxide dismutase (SOD) (by xanthine oxidase method) and content of malondialdehyde (MDA) (by thiobarbital method). Results:Compared with the baseline at T 0, PWT was significantly decreased and TWL was shortened at T 1-4 in the four groups ( P<0.05). Compared with I group, MWT was significantly decreased and TWL was shortened at T 1-4, the expression of LC3 Ⅱand Beclin-1 was up-regulated, the expression of P62 was down-regulated, SOD activity was decreased, and MDA content was increased in RI group ( P<0.05). Compared with RI group, MWT was significantly decreased and TWL was shortened at T 1-4, the expression of LC3 Ⅱand Beclin-1 was down-regulated, the expression of P62 was up-regulated, SOD activity was decreased, and MDA content was increased in MRI group ( P<0.05), and MWT was significantly increased and TWL was prolonged at T 1-4, the expression of LC3 Ⅱand Beclin-1 was up-regulated, the expression of P62 was down-regulated, SOD activity was increased, and MDA content was decreased in RRI group ( P<0.05). Conclusions:Autophagy is involved in the process of remifentanil-induced incisional hyperalgesia through regulating the level of oxidative stress in rats.