Objective:To understand the baseline viral load (VL) of newly reported HIV- infected patients before antiretroviral therapy and related factors in Tianjin.Methods:Data were obtained from the China Disease Control and Prevention Information System, and the study subjects were HIV-infected patients before the first antiretroviral therapy in Tianjin from 2019 to 2022, and the information about their socio-demographic characteristics, baseline CD4 +T lymphocyte (CD4) counts before antiretroviral therapy and baseline VL test results were collected, the baseline high VL was defined as ≥100 000 copies/ml. The effect of different factors on viral load were analyzed. Software SPSS 24.0 was used for statistical analysis. Results:A total of 1 296 newly reported HIV-infected patients were included in the study, in whom 15.89% (206/1 296) had high baseline VL, and multifactorial logistic regression analysis showed that those with history of STD (a OR=1.45, 95% CI:1.00-2.08) were more likely to have high baseline VL. Compared with those with baseline CD4 counts <200 cells/μl, those with baseline CD4 counts 200-350 cells/μl (a OR=0.40, 95% CI: 0.27-0.57), 351-500 cells/μl (a OR=0.32, 95% CI: 0.20-0.49), and >500 cells/μl (a OR=0.30, 95% CI: 0.18-0.49) were less likely to have high baseline VL. Conclusions:The proportion of HIV-infected patients with high baseline VL before antiretroviral therapy was low in Tianjin during 2019-2022. History of STD and baseline CD4 counts <200 cells/μl were associated with high baseline VL in HIV-infected patients, to which close attention needs to be paid in AIDS prevention and control.

Objective:The status quo and related factors of human papillomavirus (HPV) infection in multiple parts of men who have sex with men (MSM) in Tianjin were analyzed.Methods:Using the cross-sectional survey method, a total of 600 MSM were recruited in Tianjin from September to December 2023, including 200 (18-26 years old), 300 (27-45 years old), and 100 (≥46 years old) stratificaed by age group. Questionnaire survey was used to collect knowledge and behavioral information related to demography and STD prevention and treatment. Exfoliated cells from genital, perianal and oral cavity were collected for HPV typing detection. Logistic regression model was used to analyze the related factors of HPV infection.Results:The infection rate of HPV was 53.67% (322/600) in MSM, with high-risk type as 41.17% (247/600), low-risk type as 27.17% (163/600). The infection rate of HPV in both multiple and single types was 26.83% (161/600).The infection rates of genotypes covered by nine-valent HPV vaccine, quadrivalent HPV vaccine and bivalent HPV vaccine were 36.83% (221/600), 25.17% (151/600) and 9.50% (57/600), respectively.The infection rates of genital HPV, high-risk or low-risk types were 24.67% (148/600), 16.67% (100/600) and 11.00% (66/600), respectively. The infection rates of perianal HPV, high-risk or low-risk types were 42.00% (252/600), 30.17% (181/600) and 20.50% (123/600), respectively. The infection rates of oral HPV high-risk and low-risk types were 3.17% (19/600), 2.33% (14/600) and 1.17% (7/600), respectively. Divorce or widowhood (a OR=2.38, 95% CI: 1.26-4.50), history of homosexual anal intercourse in the past 6 months (a OR=2.28, 95% CI: 1.00-5.50), and use of dependent drugs (including new psychoactive substances) (a OR=1.62, 95% CI: 1.02-2.58) were risk factors for genital HPV infection. College degree/university degree or above (a OR=0.36, 95% CI: 0.16-0.81) was a protective factor for perianal HPV infection, and a history of drug dependence (a OR=1.85, 95% CI: 1.19-2.88) was a risk factor. Conclusions:MSM in Tianjin was a high-risk group for HPV infection, and the HPV infection in the perianal area was more severe than in the genital area and oral area.Marital status, education level, history of homosexual anal sex in the past 6 months, and history of drug dependence were related factors of HPV infection among MSM.

ObjectiveRoot rot is one of the most serious diseases in the cultivation and production of Atractylodes lancea. Trichoderma spp. are effective in the biocontrol of root rot without causing environmental pollution. This study aims to isolate and study a Trichoderma strain capable preventing and controlling root rot from the rhizosphere of A. lancea and to solve the problem of disease prevention and control in the planting and production of A. lancea. MethodTrichoderma T2204 was isolated by the dilution-coating method and identified by ITS sequencing. The inhibitory activities of T2204 and its volatiles against two pathogenic fungal strains were examined by dual-culture and co-culture experiments. The biocontrol potential of T2204 on root rot of A. lancea and the effect of T2204 on the accumulation of medicinal compounds in the rhizosphere of A. lancea were investigated by pot experiments and GC-MS， respectively. In addition， the optimal medium， photoperiod， temperature， pH， and carbon and nitrogen sources for the culture of T2204 were explored. ResultThe Trichoderma isolate T2204 was identified as T. citrinoviride and had direct inhibitory effects on two highly pathogenic strains causing root rot. In the dual-culture experiments with the two pathogenic strains， T2204 showcased the inhibition rates of 77.90% and 76.80%， respectively. In the co-culture experiments with the two pathogenic strains， the volatile organic compounds produced by T2204 showed the inhibition rates of 57.11% and 81.11%， respectively. The pot experiments showed that the survival rate of A. lancea seedlings infected by root rot reached 100% after inoculation with T2204 and was only 50% in the case without inoculation of T2204. After 150 days of cultivation， the dry weight and atractylodin content of the rhizome of A. lancea plants treated with T2204 increased by 32% （P<0.05） and 11%， respectively， compared with the untreated group. The optimal conditions for the growth of T2204 were PDA or PSA medium， photoperiod of 12 h dark/12 h light， 25-30 °C， pH 5-6， carbon sources of glucose， D-fructose， soluble starch， and maltose， and the nitrogen sources of ammonium sulfate and ammonium dihydrogen phosphate. The optimal conditions for the sporulation of T2204 were PSA or CMA medium， photoperiod of 12 h dark/12 h light， 20-30 °C， pH 8， carbon source of sucrose， and nitrogen source of sodium nitrate. ConclusionT2204 could improve the growth and root rot resistance of A. lancea and promote the accumulation of medicinal compounds. The findings laid a foundation for the industrialized production and application of T2204 in the production of A. lancea in the future.

Objective:To investigate the diagnostic features of pulmonary sclerosing pneumocytoma (PSP) in needle biopsy specimens so as to improve the preoperative diagnostic accuracy and to prevent misdiagnoses.Methods:A total of 79 needle biopsy cases confirmed as PSP in surgical resection specimens were collected in the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China from January 2015 to January 2023. A retrospective analysis was conducted to investigate the clinical, pathological, and immunohistochemical characteristics of PSP.Results:Among the 79 cases, there were 8 males and 71 females, with an age range of 14 to 67 years (median 47 years). Among the 79 needle biopsy cases of PSP, 5 cases were initially misdiagnosed as adenocarcinoma and 1 as carcinoid preoperatively, while the remaining 73 cases were correctly diagnosed. 84.8% (67/79) of the PSP presented with well-defined, homogeneous, solitary solid tumors on chest imaging. Morphologically, 26.6% (21/79) of the PSP mainly showed a single histological component, 67.1% (53/79) contained two histological components, and 6.3% (5/79) contained three histological components. There were no cases containing all four histological components simultaneously. The tumor was composed of cuboidal cells on the surface and round cells in the stroma and lacked significant cytological atypia and mitotic figures. Some cases exhibited variations in histology and cellular morphology, such as glandular spaces (58.2%, 46/79), sclerotic papillae (46.8%, 37/79), hypercellularity (16.5%, 13/79), and cytological atypia (24.1%, 19/79). Immunophenotyping indicated that both tumor cell types expressed TTF1, EMA and β-catenin, while surface cells expressed pan-cytokeratin and Napsin A, and stromal cells expressed vimentin. In some cases, ER and PR were also expressed.Conclusions:When diagnosing PSP in needle biopsy specimens, the key to avoiding misdiagnosis is recognizing the presence of dual-cell populations within the tumor. The useful clues include presence of cellular papillae, mild cellular atypia, morphological diversity, interstitial foam-like cell aggregates, and prominent background hemorrhage and sclerosis. The characteristic immunophenotype and middle-aged female predilection are also helpful for the diagnosis of PSP.

Objective:To explore the effect of hederagenin (HE) on the proliferation of bladder cancer cell T24 in vitro and in nude mice.Methods:Human bladder cancer cells T24 were divided into control group and experimental group. The experimental group was cultured with DMEM medium containing 25μg/mL hederogenin, and CCK8 was used to detect cell proliferation ability. Nude mice were divided into a control group and an experimental group and injected with T24 cells. The cells of the experimental group were injected with ivy sapogenin at 30 mg/kg every other day. The protein of T24 cells and tumor mass was extracted to detect the expression of p-JNK/JNK and p-p38/p38.Results:After the bladder cancer cells T24 were treated with hederagenin, the CCK8 results showed that the cell proliferation ability of the experimental group was significantly decreased ( P<0.05) . The expression levels of p-JNK in experimental group and control group were 0.21±0.06 and 0.89±0.15, respectively, and the expression levels of p-p38 were 0.38±0.09 and 1.44±0.26, respectively. The expressions of p-JNK and p-p38 were up-regulated (all P<0.05) . In vivo, it was found that after treatment with ivisaponin, the volume of tumor mass were 1192.07±250.92μm 3 in the subcutaneous tumor experimental group and 2280.50±600.1μm 3 in the control group, and the mass were 0.65±0.29g and 1.62±0.38g, respectively. The mass and volume of the experimental group were decreased (all P<0.05) . We extracted mass proteins, and western blotting results showed that the expression levels of p-JNK in the experimental group and control group were 0.38±0.08 and 1.03±0.19, respectively, and the expression levels of p-p38 were 0.71±0.12 and 1.36±0.25, respectively. The expressions of p-JNK and p-p38 were up-regulated (all P<0.05) . Conclusion:Hederagenin inhibits the proliferation of bladder cancer in vitro and in nude mice through the JNK/p38 MAPK signaling pathway.

Objective To understand the change of behavioral characteristics among drug users (DUS) in Tianjin and the prevalence rates of major sexually transmitted disease infections.A series of cross-sectional surveys were used.Methods Between April and June,2011 to 2015,a cross-sectional survey with face to face interview,was undertaken.Interview was conducted among DUS who entered the drug rehabilitation center and blood samples were drawn to test for HIV/syphilis/ HCV infections.Multivariate logistic regression analysis was used to analyze the relationship between the infection of major sexually transmitted diseases and drug abuse or sexual behavior.Results 2 000 DUS were included during the 5-year study,with the average age of the DUS as 34.5 ± 8.7.Female accounted for 17.9％ and club drug (new drugs) users accounted 45.4％ of the participants,with its proportion increasing over the years.Comparing to traditional drug users,club drug users showed more sexual activities with partners,but lower proportion of condom use.Prevalence rates of HIV/ Syphilis and HCV were 1.3％,11.0％,52.0％,respectively.The prevalence of syphilis among club drug users was significantly higher than those on traditional-drug use (x2=67.778,P＜0.001).Data from Binary logistic regression analysis showed that club drug use (adjusted OR=1.607,95％ CI:1.191-2.170) and females (adjusted OR=5.287,95％ CI:3.824-7.311) were associated with syphilis infection among DUS.Conclusion Drug abuse behavior changed among the drug abuse in Tianjin.Proportion of club drug use continued to increase so as the risk of infected sexually transmitted diseases.

Objective To evaluate the auxiliary diagnostic value of viral load test for samples with indeterminate HIV antibody detection results.Methods Thirty-two samples with indeterminate HIV antibody detection results collected from MSM were used for two viral load tests in Tianjin in 2015.Follow up was conducted for this population to confirm their HIV infection status.Results Virus loads were detected in the 2 viral load tests.In the follow-up survey,the results of HIV antibody test of all the samples were positive.The results of viral load test were completely consistent with those of HIIV antibody confirmation test.Conclusion The viral load test was effective in the auxiliary diagnosis of HIV infection in window phase,which can be used for the samples with indeterminate HIV antibody detection results.

Objective To understand the characteristics on the diversity of HIV subtypes and related transmission in Tianjin.Methods A total of 77 newly diagnosed ART-na(i)ve HIV infectors in 2015 were screened by CD4 +T cell counts ≥200 cells/μl.Viral RNAs were extracted from plasma samples.Reverse transcription PCR and nested PCR were used to analyze the amplification of pol and env gene fragments,sequencing,and related bioinformatics information.Results 46.03％ (29/63),30.16％ (19/63),11.11％ (7/63),4.76％ (3/63) and 7.94％ (5/63) of the individuals were infected under HIV subtypes CRF01_AE,CRF07_BC,B,CRF55_01B and URFs,with sexual transmission as the major mode of infection.CRF01_AE and CRF07_BC strains were predominant in both MSM and HST populations.The patterns of subtype distribution did not show statistical differences other than subtype B and CRF55_01B strain among HSTs.The proportion of CRFs increased significantly to 88.89％.8 new second-generation recombinant forms were identified the first time,including 3 CRF55_01B,2 AE/BC,1 AE/B and 1AE/B/C among MSMs and 1 AE/BC among HSTs.5.3％ of the NNRTI L100I HIV infectors transmitted the drug-resistant-mutation strain.3 linkages related to HIV transmission were confirmed through phylogenetic analysis with Bootstrap ≥98％ of pol and ≥80％of env.Conclusion The increasing complexity of HIV had been noticed in Tianjin,including the prevalence and transmission of second-generation recombinant and drug-resistant strains through different routes of transmission and in different regions.

Objective To analyze the vascular architecture characteristics of the complex direct cavernous arteriovenous fistula (cd-CAVF) and to discuss its treatment and the curative effect of interventional embolization. Methods The hospitalization records, imaging features and operation records of 12 patients with cd-CAVF were retrospectively analyzed. Results In the 12 patients with cd-CAVF, the lesion’s blood supply arteries included internal carotid artery (ICA,n=8), primary trigeminal artery (PTA,n=1), middle cerebral artery (MMA,n=2) and basilar artery (BA,n=1). Different degrees of “arterial steal” phenomenon could be observed in all patients. The drainage routes included the superior ophthalmic vein and the inferior petrosal sinus (n=10), and cortical vein (n=2). Interventional embolization was carried out via ICA (n=4), through both ICA and BA (n=5), through MMA (n=2), or through BA (n=1). For the embolization of the lesion the balloons were used in 8 patients, steel coils were adopted in 2 patients, and balloons together with coils were employed in 2 patients. All the patients were followed up for 3-6 months. After the treatment the clinical symptoms and signs disappeared, and the lesions were completely cured in all patients with no complications. During the follow-up period of (60.2 ±26.8) months no recurrence of CAVF was observed. Conclusion The blood supply of cd-CAVF comes directly from the rupture of the blood vessels surrounding the cavernous sinus wall, the “arterial steal” phenomenon is prone to occur, and the drainage via the superior ophthalmic vein and the inferior petrosal sinus is more often seen. Transarterial balloon embolization is very effective for the treatment of cd-CAVF, and the use of coils together with multi-artery approaches is an effective supplementary method.