Objective: To investigate the prevalence of hypertension, diabetes and hyperlipidemia among HIV/AIDS patients aged 50 years and above receiving antiretroviral therapy (ART) in Wuxi City, Jiangsu Province, so as to provide insights into the prevention and intervention of chronic diseases for these populations. Methods: The HIV/AIDS patients aged 50 years and above receiving ART were recruited at designated HIV/AIDS medical institutions in Wuxi City using the convenient sampling method from March to June 2024. Demographic information, treatment status and self-reported prevalence of hypertension, diabetes and hyperlipidemia were collected through questionnaire surveys. Factors affecting the prevalence of chronic diseases were analyzed using a multivariable logistic regression model. Results: A total of 830 HIV/AIDS patients receiving ART were surveyed, including 656 males (79.04%) and 375 patients aged 50 to <60 years (45.18%). Among them, 366 patients reported having at least one type of chronic disease, including hypertension, diabetes and hyperlipidemia, with a self-reported prevalence rate of 44.10%. Specifically, 280, 114 and 61 patients reported having hypertension, diabetes and hyperlipidemia, with the self-reported prevalence rates of 33.73%, 13.73% and 7.35%, respectively. Multivariable logistic regression analysis showed that male patients (OR=1.725, 95%CI: 1.187-2.507), those with monthly income less than 3 000 yuan (OR=1.521, 95%CI: 1.122-2.063), those with body mass index of 24 kg/m2 and above (OR=1.577, 95%CI: 1.168-2.130), those who initiated ART at ages of 50 years and above (50 to <60 years, OR=1.535, 95%CI: 1.052-2.238; ≥60 years, OR=3.322, 95%CI: 2.191-5.038), those with ART duration of 10 years and above (OR=2.069, 95%CI: 1.419-3.017), and those who received non-first-line regimens (OR=1.776, 95%CI: 1.304-2.418) had higher risks of developing at least one type of chronic disease, including hypertension, diabetes and hyperlipidemia. Conclusions The self-reported prevalence of at least one type of chronic disease, including hypertension, diabetes and hyperlipidemia among HIV/AIDS patients aged 50 years and above receiving ART in Wuxi City was 44.10%. Gender, monthly income, body mass index and ART status are the main influencing factors for the risk of chronic diseases.

Objective:To understand the uptake of post-exposure prophylaxis (PEP) and related factors among male sex workers (MSW) and provide references for the promotion of PEP.Methods:A cross-sectional study was conducted using convenience sampling to recruit MSW participants with the help of a community-based organization in October 2023, in Wuxi City, Jiangsu Province. The sample size was estimated at 340 people. A self-administered questionnaire was used to collect their social demographic characteristics, sexual behaviors, knowledge, beliefs, and uptake of PEP. A logistic regression model was used to analyze factors associated with the uptake of PEP in MSW. The SPSS 26.0 software was used for statistical analysis.Results:A total of 357 participants were recruited, mainly aged 18-20 (55.7%,199/357), unmarried (94.4%,337/357), and having an education background of junior high school or below (50.1%,179/357). Among 357 participants, 64.4% (230/357) knew about PEP, 51.0% (182/357) believed in the efficacy of PEP, and 13.4% (48/357) had experience of using PEP. Among 68 respondents having high-risk sexual behaviors in the past 3 months, 17.6% (12/68) have had uptake of PEP. Multivariable logistic regression analysis showed that group sex with men in the past 3 months (a OR=7.51, 95% CI: 1.37-41.09), HIV testing in the past 3 months (a OR=2.89, 95% CI: 1.16-7.16), the experience of using pre-exposure prophylaxis (a OR=30.18,95% CI: 12.60-72.24) and believing in the efficacy of PEP (a OR=2.94, 95% CI: 1.04-8.29) were the associated factors with the uptake of PEP in MSW. Conclusions:Although the overall uptake rate of PEP in MSW was high, the proportion of using PEP was still low among participants having high-risk sexual behaviors in the past 3 months. Therefore, it is necessary to strengthen HIV risk awareness education considering their characteristics and promote timely uptake of PEP to interrupt HIV transmission.

Anthropometric indexes play a crucial role in identifying obesity. However, as an internationally commonly used indicator of obesity diagnosis, BMI has limitations in distinguishing lean body mass from fat mass. The weight-adjusted waist index (WWI), a novel anthropometric index, assesses adiposity through standardized waist circumference for weight, which presents an excellent capacity to predict the morbidity and mortality risks of various diseases. However, research on WWI is still in the exploratory stage, and there is a lack of unified standards for using this indicator to determine obesity. In addition, its potential application in children and adolescents also urgently needs to be explored. Therefore, this article comprehensively summarizes and compares the distinctive characteristics between WWI and other obesity-related anthropometric indexes. Bibliometric methods are used to analyze the hotspots and trends of WWI-related research, and we focus on discussing the value of WWI in predicting adverse health outcomes, including cardiovascular disease, diabetes, liver and kidney diseases. We aim to promote the application of WWI in a broader field and fully demonstrate its important public health significance and broad application prospects.

Objective:To investigate the association between quantified CT (QCT)-measured body composition and metabolic syndrome (MS) components in obese populations before bariatric surgery.Methods:A cross-sectional study. A retrospective analysis was conducted on a cohort of 97 obese patients scheduled for weight-loss surgery at the First Affiliated Hospital of Wannan Medical College from January 2021 to March 2023. The patients′ body mass index (BMI), biochemical parameters and body composition measurements obtained by QCT were recorded. The patients were stratified into groups based on gender, obesity severity and the number of MS components. Differences in body composition among the groups were compared. Additionally, the correlations between each body composition parameter and metabolic indicators were analyzed. The diagnostic efficacy of each body composition parameter for identifying obese individuals with different MS components was assessed using receiver operating characteristic (ROC) curve analysis.Results:There were 75 females (77.3%). Male obese patients had higher total abdominal fat area [(693.23±148.90) vs (574.99±114.89) cm 2, t=-3.958, P<0.001], visceral fat area [(289.65±57.67) vs (195.60±57.37) cm 2, t=-6.753, P<0.001], fat content of pancreatic head [27.45%(21.65%, 45.48%) vs 21.60%(17.6%, 26.9%), Z=-2.675, P=0.007], and skeletal muscle index [73.36(68.74, 81.26) vs 61.52(55.74, 66.41) cm 2/m 2, Z=-5.246, P<0.001]. With the increase of obesity, abdominal fat mainly increases in subcutaneous fat. With the increase of MS components (MS2 group, MS3 group, MS4 group, MS5 group), the abdominal fat area, abdominal fat/subcutaneous fat, liver fat content, pancreatic head fat content, and skeletal muscle index of patients all increased accordingly. In diagnosing the presence of two components of MS, area under the curve of visceral fat area was the largest (AUC=0.706, 95% CI=0.577-0.834). For diagnosing the presence of three, four and five components of MS, area under curve of liver fat content were all the largest (MS3=0.712, 95% CI=0.605-0.818; MS4=0.652, 95% CI=0.537-0.766; MS5=0.706, 95% CI=0.576-0.836). Conclusion:There are differences in QCT body composition among obese patients with different MS components, and there is a correlation between each body composition and MS component. Among them, intra-abdominal fat area and liver fat content are of great value in evaluating obese patients with different MS components.

Objective: To investigate the effects and underlying mechanisms of the macrophage migration inhibitory factor(MIF) inhibitor(S,R)-3-(4-hydroxyphenyl)-4,5-dihydro-5-isoxazoleacetic acid methyl ester(ISO-1) on sepsis-induced acute kidney injury(AKI). Methods: Human renal tubular epithelial HK-2 cells were divided into Con group(without any treatment), ISO-1 group(10 μg/ml ISO-1 treatment for 24 h) and LPS group(10 μg/ml LPS treatment for 24 h), LPS+ISO-1 group(10 μg/ml LPS treatment for 24 h followed by 10 μg/ml ISO-1 treatment for 24 h). ELISA was used to measure the levels of tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β), and interleukin-6(IL-6) in the cell supernatants. Reactive oxygen species(ROS) levels were assessed using the 6-carboxyl-2 ′,7′-dichlorodihydrofluorescein diacetate fluorescent indicator(DCFH-DA) method. Apoptosis levels were detected by TUNEL staining, and Western blot was employed to analyze the expression of proteins of Kelch like ECH associated protein 1(Keap1), NFE2 like bZIP transcription factor 2(Nrf2), heme oxygenase-1(HO-1), as well as apoptosis-related proteins Bcl-2, Bax, and cleaved Caspase-3(c-Caspase-3). A sepsis mouse model was established using the cecal ligation and puncture(CLP) method, and the mice were divided into four groups: sham-operated(Sham), ISO-1 control(ISO-1), CLP, and ISO-1 treatment(CLP+ISO-1). After the experiment, mouse kidney tissues were collected for HE staining to observe pathological changes. Blood urea nitrogen(BUN), serum creatinine(Scr), myeloperoxidase(MPO) levels in kidney tissues, glutathione(GSH) and superoxide dismutase(SOD) activities were measured. Western blot was also used to detect the expression of MIF and proteins in the Nrf2/Keap1 signaling pathway and apoptosis-related proteins in kidney tissues. Results: Compared to the Con group, the LPS and LPS+ISO-1 groups showed significantly increased levels of TNF-α, IL-1β, IL-6, TUNEL-positive rates, ROS levels, and protein expressions of Keap1, Bax, and c-Caspase-3 in HK-2 cells(P<0.05), while the expressions of Nrf2, HO-1, and Bcl-2 significantly decreased(P<0.05). The ISO-1 group showed no significant changes(P>0.05). Compared to the LPS group, the LPS+ISO-1 group exhibited significantly decreased levels of TNF-α, IL-1β, IL-6, TUNEL-positive rates, ROS levels, and protein expressions of Keap1, Bax, and c-Caspase-3, while the expressions of Nrf2, HO-1, and Bcl-2 significantly increased(P<0.05). In the mouse experiments, compared to the Sham group, the CLP and CLP+ISO-1 groups showed severe kidney tissue damage, increased levels of serum BUN, Scr, and kidney MIF, Keap1, Bax, and c-Caspase-3 protein expressions(P<0.05), while GSH, SOD activities, and protein expressions of Nrf2, HO-1, and Bcl-2 significantly decreased(P<0.05). The ISO-1 group showed no significant changes(P>0.05). Compared to the CLP group, the CLP+ISO-1 group showed significant improvements in the aforementioned indicators(P<0.05). Conclusion The specific MIF inhibitor ISO-1 can ameliorate sepsis-induced AKI by inhibiting oxidative stress, inflammatory response, and apoptosis bothin vitroandin vivo. The mechanism may be through Nrf2/Keap1 signaling pathway.

Objective To observe the effect of knee isometric training on mild to moderate lower limb muscle spasticity in stroke patients.Methods A total of 130 stroke hemiplegia patients were prospectively included in this study.They were admitted to Xiangcheng People's Hospital of Suzhou City between August 2021 and December 2023 and numbered according to the order of collection.The patients were then randomly assigned to either the control group or the isokinetic group using a random number table.Each group consisted of 65 cases.Both groups underwent conventional rehabilitation training(5 days a week,40 minutes per day),with the isokinetic group receiving additional isokinetic muscle training(5 days a week,20 minutes per day)on top of the conventional rehabilitation training.The treatment period lasted for 6 weeks.The surface electromyographic signals of the rectus femoris muscle on the affected side were analyzed for their root-mean-square(RMS),integral electromyographic(iEMG)values,the modified Ashworth scale(MAS)scores,knee flexors and extensors peak torque and its ratio,the Fugl-Meyer assessment scale-lower extremity(FMA-LE)scores,and the 10 m walk test were used before and after the treatments to compare the surface electromyography of rectus femoris,the degree of muscle spasticity and exercise capacity of the lower extremities of the two groups.Results Prior to treatment,there were no statistically significant differences between the two groups in terms of the RMS of the rectus femoris muscle,iEMG values,MAS scores,peak torque of the flexor and extensor muscles and their ratio,FMA-LE score,and step speed(all P＞0.05).RMS of the rectus femoris muscle,iEMG values,MAS scores,peak torque of the knee flexors and extensors and their ratios,FMA-LE scores,and step speed improved in control group after treatment compared to before treatment([12.3±2.2]μV vs.[15.5± 2.9]μV,[24.8±2.3]μV·s vs.[29.2±3.1]μV·s,[1.34±0.15]points vs.[1.56± 0.25]points,[20.8±3.4]N·m vs.[12.3±2.5]N·m,[34.5±2.3]N·m vs.[26.3±3.6]N·m,0.60±0.16 vs.0.47±0.14,[26.1±2.9]points vs.[21.3±2.4]points,[0.61±0.14]m/s vs.[0.46±0.15]m/s;all P＜0.05).Rectus femoris muscle RMS,iEMG values,MAS scores,peak torque of the flexor and extensor muscles and their ratio,FMA-LE scores and step speed after treatment in the isokinetic group were(10.9±1.8)μV,(22.4±2.1)μV·s,(1.25±0.18)points,(28.7±3.0)N·m,(41.5±2.8)N·m,0.69±0.18,(29.0±2.3)points,(0.69±0.18)m/s,compared with pretreatment(respectively[15.4±2.2]μV,[29.6±3.0]μV·s,[1.58±0.34]points,[12.6± 2.3]N·m,[26.1±3.1]N·m,0.48±0.17,[21.5±2.1]points,[0.48±0.17]m/s)and control group after treatment,the differences were statistically significant(all P＜0.05).Before treatment,the differences in rectus femoris muscle RMS and iEMG values between patients with mild spasticity and patients with moderate spasticity in the isokinetic group and the corresponding patients with mild spasticity and moderate spasticity within the control group were not statistically significant(all P＞0.05).After treatment,the rectus femoris muscle RMS and iEMG values in patients with mild spasticity within the isokinetic group([10.2±1.0]μV and[20.2±2.0]μV·s,respectively)were statistically different from those before treatment([14.1±2.3]μV and[28.1±3.2]μV·s,respectively)and those after treatment in patients with mild spasticity within the control group([11.4±1.7]μV and[23.6±2.5]μV·s respectively;all P＜0.05);the rectus femoris muscle RMS and iEMG values in patients with moderate spasticity within the isokinetic group improved compared with the pre-treatment period([11.8±1.5]μV vs.[16.9±2.6)μV,and[24.9±2.2]μV·s vs.[31.3±3.8]μV·s,respectively;both P＜0.05),and with the control group after treatment(RMS and iEMG values of[13.2±2.5]μV and[26.1± 2.7]μV·s,respectively),the difference in RMS was statistically significant(P＜0.01),and the difference in iEMG values was not statistically significant(P＞0.05).Conclusion Isokinetic muscle training has a positive effect on improving mild-to-moderate muscle spasticity of the lower limb knee extension,and the effect is more significant the lighter the degree of spasticity.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

The review summarizes the kidney protective mechanism of sodium-glucose-coupled transporter 2 inhibitors and their efficacy and safety for diabetic recipients of kidney transplantation.It is intended to improve patient outcomes.

ObjectiveTo determine the epidemiological characteristics and distributions of measles in Baoshan District， Shanghai. MethodsThis study used the measles surveillance information and reporting system to collect reported cases of measles in Baoshan District in 2005‒2021 and then conducted descriptive epidemiological methods to determine the temporality using the concentration method. ResultsIn 2005‒2021， a total of 525 measles cases were reported in Baoshan District with an average annual reported incidence rate of 1.75/10⁵， showing an overall fluctuating downward trend and obvious seasonality. The cases concentrated in 30‒39 years of age （31.24%）， 20‒29 years （28.57%）， and under 5 years （16.57%）. Majority of them were workers （18.10%）， preschool children （16.19%）， and unemployed persons （12.76%）. The incidence was significantly higher in the central region than in the other two regions for workers， preschool children， and unemployed persons （χ²=54.515， P<0.001）. Spatially， the incidence was significantly higher in the north-central sub-districts than in the south （χ²=88.103， P<0.001）. Moreover， 33.14% of measles cases did not receive measles-containing vaccine （MCV）， while 53.90% of the cases remained unknown. Additionally， uptake rate of MCV in non-local residents was significantly lower than in local residents （χ²=14.422， P<0.001）. ConclusionThe measles incidence remains remarkably low in Baoshan District of Shanghai. Young and middle-aged populations in the north-central region are susceptible to measles. It is recommended to further strengthen measles surveillance， maintain high coverage of MCV among school-age children combined with catch-up immunization for at-risk populations， and improve health education.

Background Air pollution is a major public health concern. Air Quality Health Index (AQHI) is a very important air quality risk communication tool. However, AQHI is usually constructed by single-pollutant model, which has obvious disadvantages. Objective To construct an AQHI based on the joint effects of multiple air pollutants (J-AQHI), and to provide a scientific tool for health risk warning and risk communication of air pollution. Methods Data on non-accidental deaths in Yunnan, Guangdong, Hunan, Zhejiang, and Jilin provinces from January 1, 2013 to December 31, 2018 were obtained from the corresponding provincial disease surveillance points systems (DSPS), including date of death, age, gender, and cause of death. Daily meteorological (temperature and relative humidity) and air pollution data (SO₂, NO₂, CO, PM_2.5, PM₁₀, and maximum 8 h O₃ concentrations) at the same period were respectively derived from China Meteorological Data Sharing Service System and National Urban Air Quality Real-time Publishing Platform. Lasso regression was first applied to select air pollutants, then a time-stratified case-crossover design was applied. Each case was matched to 3 or 4 control days which were selected on the same days of the week in the same calendar month. Then a distributed lag nonlinear model (DLNM) was used to estimate the exposure-response relationship between selected air pollutants and mortality, which was used to construct the AQHI. Finally, AQHI was classified into four levels according to the air pollutant guidance limit values from World Health Organization Global Air Quality Guidelines (AQG 2021), and the excess risks (ERs) were calculated to compare the AQHI based on single-pollutant model and the J-AQHI based on multi-pollutant model. Results PM_2.5, NO₂, SO₂, and O₃ were selected by Lasso regression to establish DLNM model. The ERs for an interquartile range (IQR) increase and 95% confidence intervals (CI) for PM_2.5, NO₂, SO₂ and O₃ were 0.71% (0.34%–1.09%), 2.46% (1.78%–3.15%), 1.25% (0.9%–1.6%), and 0.27% (−0.11%–0.65%) respectively. The distribution of J-AQHI was right-skewed, and it was divided into four levels, with ranges of 0-1 for low risk, 2-3 for moderate risk, 4-5 for high health risk, and ≥6 for severe risk, and the corresponding proportions were 11.25%, 64.61%, 19.33%, and 4.81%, respectively. The ER (95%CI) of mortality risk increased by 3.61% (2.93–4.29) for each IQR increase of the multi-pollutant based J-AQHI , while it was 3.39% (2.68–4.11) for the single-pollutant based AQHI . Conclusion The J-AQHI generated by multi-pollutant model demonstrates the actual exposure health risk of air pollution in the population and provides new ideas for further improvement of AQHI calculation methods.