Objective: To explore the potential category patterns of risk prevention and control behaviors of HIV infection among young students who have sex with men (MSM) and their impact on HIV infection and late detection, aiming to optimize intervention strategies. Methods: From September 2017 to December 2024, a total of 1 637 MSM young students in Tianjin were recruited through both online and offline channels. Latent class analysis was applied to classify 11 HIV risk prevention and control behaviors [condom use during the most recent anal sex in the past 6 months, consistent condom use, use of water based lubricants, abstinence from recreational drugs, regular on site professional testing, fixed sexual partners, partner testing, awareness of partner s HIV testing results, testing before sexual activity, nucleic acid testing, and use of pre exposure prophylaxis (PrEP) or post exposure prophylaxis (PEP)]. Multivariate Logistic regression analyzed associations between demographic characteristics/intervention services factors and latent classes. Differences in HIV infection and late detection across behavior patterns were compared. Results: HIV risk prevention and control behaviors among MSM students were classified into three latent classes:condom dependent group (38.42%), low prevention group (27.73%), and comprehensive prevention group (33.85%). Students who received condom promotion/testing services were more likely to belong to the comprehensive prevention group ( OR =5.58), while those who received peer education were less likely to the comprehensive prevention group ( OR =0.43) (both P <0.01). Among the MSM student population, the HIV infection rate was 4.83%, with 2.26% of cases detected late. The HIV infection rate (1.45%) and late detection proportion (0.82%) in the comprehensive prevention group were lower than those in the low prevention group (7.89% and 3.83%, respectively) ( χ 2=16.20, 7.31, both P <0.01). Conclusions HIV risk prevention and control behaviors among MSM young students exhibit significant heterogeneity. Comprehensive prevention strategies can effectively reduce HIV infection and late detection risks. It is necessary to optimize peer education content and improve the accessibility of diversified prevention measures such as PrEP/PEP to enhance HIV prevention and control.

Purpose To explore the pathological features of angioimmunoblastic T-cell lymphoma(AITL)with bone marrow involvement and to improve awareness of bone marrow infiltration in AITL.Methods The tissue morphology of 32 cases of AITL with bone marrow involvement was retrospectively analyzed.Im-munohistochemistry using the EnVision method and ten-color flow cytometry were conducted to detect AITL-related immune markers.T cell clonality was analyzed through T cell receptor(TCR)gene rearrangement.Results The predominant pat-terns of tumor cell infiltration were nodular(20/32,62.5％)and interstitial or small clusters(10/32,31.3％).The nodules showed a mixture of cellular components.In some cases,the fo-ci contained a mixture of cells with characteristic"granuloma-toid"changes.The tumor cells were mainly small to medium-sized lymphocytes with inconspicuous atypia.Some cases showed plasma cell proliferation.19 cases were subject to immunohisto-chemical staining,which revealed a low count of CD4-positive T cells,with an average of 8.4％.The positive rates of T follic-ular helper cells(TFH)markers were as follows:CD10(7/14,50.0％),BCL6(6/19,31.6％),PD-1(13/19,68.4％),and CXCL13(13/19,68.4％).In most cases,tumor cells showed co-expression of PD-1 and CXCL13,but the number of positive cells was less than 1％.Flow cytometry analysis was performed in 24 cases,among which 22 cases all consistently expressed cytoplasmic CD3(cCD3),CD5,CD4,and CD2,with varying degrees of CD10 expression.In some cases,there was a lack of expression of surface CD3(sCD3)(12/22,54.5％),while there was a lack of expression of CD7(8/22,36.4％).and no abnormal T cells were found in 2 cases.TCR gene rearrangement analysis was performed in 7 cases,with 3 cases showing TCR clonality.Conclusion AITL with bone marrow involvement exhibits a lower proportion of tumor cells and less atypia,making it prone to misdiagnosis.The presence of lymphocytic foci with mixed cellular components in the bone marrow can indicate bone marrow involvement in AITL.Flow cy-tometry detection of abnormal T cells(double positive for CD4 and CD10)strongly suggests bone marrow infiltration in AITL.A comprehensive diagnosis of bone marrow involvement in AITL re-quires consideration of bone marrow biopsy,flow cytometry,and TCR gene rearrangement analysis.

Objective:To explore and construct the nursing quality standards of spine surgery, provide a scientific basis for improving the nursing quality of spine surgery.Methods:Taking the "structure-process-outcome" three-dimensional quality model as the theoretical framework, through evidenced-based literature search and semi-structured interview, the items pool was formed, and finally the nursing quality standards were determined by two rounds of Delphi method of expert inquiry from May to July 2023.Results:The positive coefficients of the two rounds of inquiries to experts were 0.90 and 1.00, respectively. The authority coefficients were 0.946 and 0.951, respectively. The Kendall coefficients of the first, second and third level standards in the first round were 0.161, 0.095 and 0.108, respectively, and the Kendall coefficients of the first, second and third level standards in the second round were 0.162, 0.088 and 0.100, respectively, the differences were statistically significant (all P<0.05). The final nursing quality standards were finally constructed, including 3 first-level standards (structural quality, process quality and outcome quality), 20 second-level standards and 60 third-level standards.Conclusions:The nursing quality standards of spine surgery based on the three-dimensional quality model of "structure-process-outcome" have high reliability and science, which can provide target incentives for clinical nurses, provide a basis for the quality of specialized spine nursing, and promote the development of nursing specialization and the construction of nursing discipline.

Objective: To explore the effects of high-altitude hypoxia on thyroid hormone(TH) synthesis by quasi-targeted metabolomics technology. Methods: Twenty SPF male SD rats were randomly divided into Control group and Hypoxia group. An acute hypoxia injury model was established in SD rats by simulating hypoxia stress in a hypobaric oxygen chamber at an altitude of 6 km for 48 hours. The body weight, arterial oxygen partial pressure(PaO2) and blood oxygen saturation(SaO2) were detected. KEGG enrichment analysis was performed after the metabolites in the blood of two groups were detected by quasi-targeted metabolomics technology. The expression levels of sodium iodide symporter(NIS), thyroid peroxidase(TPO) and thyroglobulin(TG) were detected by RT-PCR and Western blot in TH synthesis pathway. The content of serum thyroxine(T4) and the expression levels of glutathione peroxidase(GSH-Px), superoxide dismutase(SOD) and malondialdehyde(MDA) were detected by ELISA. The expression levels of toll-like receptors-4(TLR-4), interleukin-6(IL-6), nuclear factor-κB/p65(NF-κB/p65) and tumor necrosis factor-α(TNF-α) were detected by RT-PCR, Western blot and ELISA. The expression levels of Pro apoptotic protein Bcl-2 associated X protein(Bax) and inhibitor of apoptosis protein B-cell lymphoma/leukemia-2(Bcl-2) were detected by RT-PCR and Western blot in rats thyroid tissue. Results: Compared with the Control group, the body weight, PaO2and SaO2of rats in the Hypoxia group significantly decreased(P<0.01). The differential metabolites in arterial serum of hypoxia group rats were significantly enriched in the TH synthesis pathway, and the content of the pathway end product T4decreased significantly(P<0.01). In addition, the mRNA and protein expression levels of NIS, TPO, TG in rats thyroid tissue significantly decreased(P<0.05). The ELISA validation results showed that the changes of T4content were completely consistent with the above results. Compared with the Control group, the enzyme activities of SOD and GSH-Px in the serum of rats in the hypoxia group decreased, while the content of MDA increased(P<0.01); the mRNA, protein expression levels and contents of TLR-4, IL-6, NF-κ B/p65, TNF-α significantly increased(P<0.05), while the mRNA and protein expression levels of Bax in thyroid tissue significantly increased, Bcl-2 significantly decreased(P<0.05). Conclusion Hypoxia stress at high altitude leads to apoptosis of thyroid follicular epithelial cells by promoting oxidative stress and inflammatory response, which effects thyroid function and ultimately reduces thyroid hormone synthesis.

Objective:To observe the expression level of bone morphogenetic protein 9 (bone morphogenetic protein 9,BMP9) in patients with sepsis-associated acute respiratory distress syndrome (acute respiratory distress syndrome,ARDS), and to explore the role of BMP9 in early recognition and prognosis prediction of sepsis-associated ARDS.Methods:From May 2022 to May 2023, total of 56 patients with sepsis-associated ARDS in Shanxi Bethune Hospital were selected as the ARDS group, 49 patients with cardiogenic pulmonary edema as the case control group, and 46 adults who underwent physical examination in the physical examination center of our hospital as the healthy control group.The patients in the ARDS group were followed up for 28 days and divided into survival group ( n = 26) and death group ( n = 30). The expression level of serum BMP9 and its correlation with clinical indicators in each group were analyzed and compared. The risk factors of sepsis-associated ARDS were analyzed by Logistic regression, and the diagnostic efficacy and prognostic value of related indicators were analyzed. Results:The serum level of BMP9 in sepsis-associated ARDS group [1401.14 (856.59,1982.86) ]pg/mL was significantly higher than that in case control group (438.26±128.52) pg/mL and healthy control group (398.96±96.55)pg/mL, the differences were statistically significant ( P<0.01). In addition, BMP9 expression significantly correlated with procalcitonin, lymphocyte count and SOFA score ( P < 0.05, P < 0.01, respectively). Multivariate Logistic regression analysis showed that BMP9 was a high risk factor for the development of sepsis-associated ARDS ( P<0.01). The area under the ROC curve (area under the ROC curve,AUC) of BMP9 to predict the occurrence of sepsis-associated ARDS was 0.930. The specificity was 100.0% and the sensitivity was 80.4%, which was significantly higher than the specificity (89.8%) and sensitivity (67.9%) of the oxygenation index. Follow-up and comparison of BMP9 levels in patients with different prognosis of sepsis-associated ARDS showed that the expression level of BMP9 in the death group was higher than that in the survival group, and the difference was statistically significant ( P < 0.05). The ROC curve of BMP9 in predicting the prognosis of patients with sepsis-associated ARDS. The area under the ROC curve was 0.699, the sensitivity was 43.3%, and the specificity was 100.0%. Conclusions:The expression of BMP9 in sepsis-associated ARDS patients significantly increased, and its high expression was significantly correlated with inflammatory markers such as procalcitonin, lymphocyte count and SOFA score. BMP9 is an independent risk factor in patients with sepsis-associated ARDS, and it is promising as a new biomarker for early identification of sepsis-associated ARDS. However, it do not show a good predictive effect on the prognosis of the disease.

The articles related to Cariology and Endodontology published in Chinese Journal of Stomatology from August 1953 to July 2023 were summarized. Total 1 247 articles accounting for 12.5% of the journal′s publications were involved, which reflected the progress of Cariology and Endodontology in China. The publications of five pioneers and nine chairmen of Chinese Stomatological Association Society of Cariology and Endodontology were also recorded. Whether in clinical diagnosis and treatment or cutting-edge scientific research of Cariology and Endodontology, China is catching up with or has exceeded the international professions. Over the past 70 years, China has made outstanding achievements in dental caries and endodontics. Regards to occlusal diseases, dental developmental diseases, pulp biology, pulp and periradicular diseases, and operative dentistry, a significant progress also has been made. While the articles published in the Chinese Journal of Stomatology represent only a portion of the approaches within Cariology and Endodontology, they nonetheless provide valuable insights into the development of these fields in China.

Botulinum toxin A (BTX-A) is a powerful neurotoxin produced by Clostridium botulinum, which can relieve muscle spasm or limit gland secretion by inhibiting the release of acetylcholine at the neuromuscular/glandular junction. In addition, BTX-A can also play a role in the sensory feedback loop, which can ease pain. Currently, dentists are paying more attention to the cosmetic applications of BTX-A in the oral and maxillofacial region, while their understanding of BTX-A′s non-cosmetic applications is still insufficient. Although the specific molecular mechanism of BTX-A in oral diseases has not been fully clarified, with the development of evidence-based medicine, more and more clinical evidence has began to support the effectiveness of BTX-A in the therapeutic applications of oral diseases. This article will briefly review the main molecular mechanisms of BTX-A, the latest clinical research progress of BTX-A at home and abroad in the treatment of oral diseases, clinical contraindications and adverse reactions of BTX-A, providing a new idea for the treatment of oral diseases.

Objective:To investigate the association of exposure to PM 2.5 and its constituents during pregnancy and fetal growth and to further identify critical windows of exposure for fetal growth. Methods:We included 4 089 mother-child pairs from the Jiangsu Birth Cohort Study between January 2016 and October 2019. Data of general characteristics, clinical information, daily average PM 2.5 exposure, and its constituents during pregnancy were collected. Fetal growth parameters, including head circumference (HC), abdominal circumference (AC), and femur length (FL), were measured by ultrasound after 20 weeks of gestation, and then estimated fetal weight (EFW) was calculated. Generalized linear mixed models were adopted to examine the associations of prenatal exposure to PM 2.5 and its constituents with fetal growth. Distributed lag nonlinear models were used to identify critical exposure windows for each outcome. Results:A 10 μg/m 3 increase in PM 2.5 exposure during pregnancy was associated with a decrease of 0.025 ( β=-0.025, 95% CI: -0.048- -0.001) in HC Z-score, 0.026 ( β=-0.026, 95% CI: -0.049- -0.003) in AC Z-score, and 0.028 ( β=-0.028, 95% CI:-0.052--0.004) in EFW Z-score, along with an increased risk of 8.5% ( RR=1.085, 95% CI: 1.010-1.165) and 13.5% ( RR=1.135, 95% CI: 1.016-1.268) for undergrowth of HC and EFW, respectively. Regarding PM 2.5 constituents, prenatal exposure to black carbon, organic matter, nitrate, sulfate (SO 42-) and ammonium consistently correlated with decreased HC Z-score. SO 42- exposure was also associated with decreased FL Z-scores. In addition, we found that gestational weeks 2-5 were critical windows for HC, weeks 4-13 and 19-40 for AC, weeks 4-13 and 23-37 for FL, and weeks 4-12 and 20-40 for EFW. Conclusions:Our findings demonstrated that exposure to PM 2.5 and its constituents during pregnancy could adversely affect fetal growth and the critical windows for different fetal growth parameters are not completely consistent.

Population based health data collection and analysis are important in epidemiological research. In recent years, with the rapid development of big data, Internet and cloud computing, artificial intelligence has gradually attracted attention of epidemiological researchers. More and more researchers are trying to use artificial intelligence algorithms for genome sequencing and medical image data mining, and for disease diagnosis, risk prediction and others. In recent years, machine learning, a branch of artificial intelligence, has been widely used in epidemiological research. This paper summarizes the key fields and progress in the application of machine learning in epidemiology, reviews the development history of machine learning, analyzes the classic cases and current challenges in its application in epidemiological research, and introduces the current application scenarios and future development trends of machine learning and artificial intelligence algorithms for the better exploration of the epidemiological research value of massive medical health data in China.

Objective:To report the results of national surveillance on the distribution and antimicrobial resistance profile of clinical Gram-negative bacteria isolates from bloodstream infections in China in 2022.Methods:The clinical isolates of Gram-negative bacteria from blood cultures in member hospitals of national bloodstream infection Bacterial Resistant Investigation Collaborative System（BRICS）were collected during January 2022 to December 2022. Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by Clinical and Laboratory Standards Institute（CLSI）. WHONET 5.6 and SPSS 25.0 software were used to analyze the data.Results:During the study period，9 035 strains of Gram-negative bacteria were collected from 51 hospitals，of which 7 895（87.4%）were Enterobacteriaceae and 1 140（12.6%）were non-fermenting bacteria. The top 5 bacterial species were Escherichia coli（ n=4 510，49.9%）， Klebsiella pneumoniae（ n=2 340，25.9%）， Pseudomonas aeruginosa（ n=534，5.9%）， Acinetobacter baumannii complex（ n=405，4.5%）and Enterobacter cloacae（ n=327，3.6%）. The ESBLs-producing rates in Escherichia coli， Klebsiella pneumoniae and Proteus spp. were 47.1%（2 095/4 452），21.0%（427/2 033）and 41.1%（58/141），respectively. The prevalence of carbapenem-resistant Escherichia coli（CREC）and carbapenem-resistant Klebsiella pneumoniae（CRKP）were 1.3%（58/4 510）and 13.1%（307/2 340）；62.1%（36/58）and 9.8%（30/307）of CREC and CRKP were resistant to ceftazidime/avibactam combination，respectively. The prevalence of carbapenem-resistant Acinetobacter baumannii（CRAB）complex was 59.5%（241/405），while less than 5% of Acinetobacter baumannii complex was resistant to tigecycline and polymyxin B. The prevalence of carbapenem-resistant Pseudomonas aeruginosa（CRPA）was 18.4%（98/534）. There were differences in the composition ratio of Gram-negative bacteria in bloodstream infections and the prevalence of main Gram-negative bacteria resistance among different regions，with statistically significant differences in the prevalence of CRKP and CRPA（ χ2=20.489 and 20.252， P<0.001）. The prevalence of CREC，CRKP，CRPA，CRAB，ESBLs-producing Escherichia coli and Klebsiella pneumoniae were higher in provinicial hospitals than those in municipal hospitals（ χ2=11.953，81.183，10.404，5.915，12.415 and 6.459， P<0.01 or <0.05），while the prevalence of CRPA was higher in economically developed regions（per capita GDP ≥ 92 059 Yuan）than that in economically less-developed regions（per capita GDP <92 059 Yuan）（ χ2=6.240， P=0.012）. Conclusions:The proportion of Gram-negative bacteria in bloodstream infections shows an increasing trend，and Escherichia coli is ranked in the top，while the trend of CRKP decreases continuously with time. Decreasing trends are noted in ESBLs-producing Escherichia coli and Klebsiella pneumoniae. Low prevalence of carbapenem resistance in Escherichia coli and high prevalence in CRAB complex have been observed. The composition ratio and antibacterial spectrum of bloodstream infections in different regions of China are slightly different，and the proportion of main drug resistant bacteria in provincial hospitals is higher than those in municipal hospitals.