Currently, human immunodeficiency virus (HIV) surveillance mainly relies on sentinel surveillance and the HIV/acquired immunodeficiency syndrome (AIDS) case reporting system to calculate the HIV infection rate, the number of newly reported HIV cases, and the HIV-related mortality rate, while theses measures are not able to directly estimate the HIV incidence. National-level research is conducted to investigate the characteristics of drug-resistant strains of HIV. HIV infection has the characteristics of a covert progression and a long-term latent phase, making it difficult to identify individuals in the acute infection stage. Conventional monitoring method struggles to determine the infection time of individuals, thereby introducing potential biases in the estimation of the incidence and impacting the comprehensive exploration of disease risk factors and the assessment of intervention measures. Recently, test for recent infection (TRI), as one of AIDS epidemic surveillance and intervention assessment measures, has become a vital way to estimate HIV incidence by testing the cross-sectional specimens. TRI can identify recent HIV infection and long-term HIV infection, consisting of serological and molecular method. Serological assays have been widely used because of their low cost, high accuracy of HIV infection incidence estimate and long development history, and their accuracy and simplicity have achieved significant progress in recent years. According to introduct the principle, accuracy and application of TRI, this paper reviews the latest progress, advantages, and limitations of TRI.

OBJECTIVE To investigate whether electroacupuncture(EA)ameliorates abnormal trigeminal neuralgia(TN)orofacial pain and anxiety-like behavior by altering synaptic plasticity in the hippocampus CA1.METHODS A mouse infraorbital nerve transection model(pT-ION)of neuropathic pain was established,and EA or sham EA was used to treat ipsilateral acu-puncture points(GV20-Baihui and ST7-Xia-guan).Golgi-Cox staining and transmission elec-tron microscopy(TEM)were administrated to observe the changes of synaptic plasticity in the hippocampus CA1.RESULTS Stable and per-sistent orofacial allodynia and anxiety-like behav-iors induced by pT-ION were related to changes in hippocampal synaptic plasticity.Golgi stain-ings showed a decrease in the density of dendritic spines,especially mushroom-type dendritic spines,in hippocampal CA1 neurons of pT-ION mice.TEM results showed that the density of synapses,membrane thickness of the postsynap-tic density,and length of the synaptic active zone were decreased,whereas the width of the synap-tic cleft was increased in pTION mice.EA attenu-ated pT-ION-induced orofacial allodynia and anx-iety-like behaviors and effectively reversed the abnormal changes in dendritic spines and syn-apse of the hippocampal CA1 region.CONCLU-SION EA modulates synaptic plasticity of hippo-campal CA1 neurons,and reduces abnormal oro-facial pain and anxiety-like behavior,providing evidence for a TN treatment strategy.

Objective:To explore the clinical symptoms, imaging and histopathological features of fibroadipose vascular anomaly (FAVA), and to propose the differential diagnostic criteria for FAVA and intramuscular venous malformation (IMVM).Methods:Clinical data of FAVA and IMVM patients admitted to the Department of Burn and Plastic Surgery, Jinling Hospital of Nanjing Medical University, General Hospital of Eastern Theater Command from January 2016 to December 2020 were retrospectively analyzed. The patients were divided into FAVA group and IMVM group, and the clinical symptoms, coagulation function and imaging results of the two groups were analyzed. The pathological characteristics of the surgically resected specimens were observed by HE staining, and the similarities and differences between FAVA and IMVM were summarized. Pearson chi-square test was used to investigate the occurrence of local intravascular coagulation (LIC) between the two groups, and P<0.05 was considered statistically significant. Results:Fourteen patients were included in FAVA group, including 4 males and 10 females. The age of treatment was (28.2 ± 13.2) years old and the age of onset was (20.5 ± 10.1) years old. A total of 39 patients were included in the IMVM group, including 16 males and 23 females. The age of treatment was (28.5 ± 14.1) years old and the age of onset was (18.8 ± 9.5) years old. The clinical symptoms of FAVA and IMVM patients were pain, swelling and paresthesia. MRI images of the FAVA group showed fat signal in muscle and varicose vascular shadow. The IMVM group showed large irregular vascular shadows in muscle without fat signal. Histopathological observation revealed fibroadipose hyperplasia accompanied by varicose veins in FAVA group. However, in IMVM group, the lesions showed a large number of malformed veins mixed with muscle, without fibroadipose hyperplasia. There were 2 cases of LIC in FAVA group and 21 cases of LIC in IMVM group, the difference was statistically significant ( χ2 =4.39, P=0.036). Conclusion:The clinical symptoms of FAVA and IMVM are similar. The differential diagnosis of FAVA and IMVM requires MRI and pathological examination. The main difference is that there is fibroadipose hyperplasia in FAVA lesion, while there is no fibroadipose hyperplasia in IMVM lesion.

Objective:To explore the clinical symptoms, imaging and histopathological features of fibroadipose vascular anomaly (FAVA), and to propose the differential diagnostic criteria for FAVA and intramuscular venous malformation (IMVM).Methods:Clinical data of FAVA and IMVM patients admitted to the Department of Burn and Plastic Surgery, Jinling Hospital of Nanjing Medical University, General Hospital of Eastern Theater Command from January 2016 to December 2020 were retrospectively analyzed. The patients were divided into FAVA group and IMVM group, and the clinical symptoms, coagulation function and imaging results of the two groups were analyzed. The pathological characteristics of the surgically resected specimens were observed by HE staining, and the similarities and differences between FAVA and IMVM were summarized. Pearson chi-square test was used to investigate the occurrence of local intravascular coagulation (LIC) between the two groups, and P<0.05 was considered statistically significant. Results:Fourteen patients were included in FAVA group, including 4 males and 10 females. The age of treatment was (28.2 ± 13.2) years old and the age of onset was (20.5 ± 10.1) years old. A total of 39 patients were included in the IMVM group, including 16 males and 23 females. The age of treatment was (28.5 ± 14.1) years old and the age of onset was (18.8 ± 9.5) years old. The clinical symptoms of FAVA and IMVM patients were pain, swelling and paresthesia. MRI images of the FAVA group showed fat signal in muscle and varicose vascular shadow. The IMVM group showed large irregular vascular shadows in muscle without fat signal. Histopathological observation revealed fibroadipose hyperplasia accompanied by varicose veins in FAVA group. However, in IMVM group, the lesions showed a large number of malformed veins mixed with muscle, without fibroadipose hyperplasia. There were 2 cases of LIC in FAVA group and 21 cases of LIC in IMVM group, the difference was statistically significant ( χ2 =4.39, P=0.036). Conclusion:The clinical symptoms of FAVA and IMVM are similar. The differential diagnosis of FAVA and IMVM requires MRI and pathological examination. The main difference is that there is fibroadipose hyperplasia in FAVA lesion, while there is no fibroadipose hyperplasia in IMVM lesion.

Objective:To propose a deep learning network model 2D-PE-GAN to automatically delineate the target area of nasopharyngeal carcinoma and improve the efficiency of target area delineation.Methods:The model adopted the architecture of generative adversarial networks which used a UNet similar structure as the generator, and 2D-PE-block was added after each layer of convolution operation of the generator to improve the accuracy of delineation. The experimental data included CT images from 130 cases of nasopharyngeal carcinoma. The images were preprocessed before model training. In addition, three models of UNet, GAN, and GAN with an attention mechanism were compared, and Dice similarity coefficient, Hausdorff distance, accuracy, Matthews correlation coefficient, Jaccard distance were employed to evaluate network performance.Results:Compared with UNet, GAN and GAN with the attention mechanism, the average Dice similarity coefficient of 2D-PE-GAN network segmentation of CTV was increased by 26%, 4% and 2%. The average Dice similarity coefficient of GTV segmentation was increased by 21%, 4%, 2%, respectively. Compared with the GAN network with the attention mechanism, the parameters and time of 2D-PE-GAN were reduced by 0.16% and 18%, respectively.Conclusions:Compared with the above three networks, 2D-PE-GAN network can increase the segmentation accuracy of nasopharyngeal carcinoma target area delineation. At the same time, compared with the attention mechanism with similar reasons, 2D-PE-GAN network can reduce the occupation of computing resources when the segmentation accuracy is not much different.

Objective:To compare the efficacy of conventional Western medicine alone and acupuncture combined with acupoint application in treating intestinal dysfunction secondary to mechanical ventilation in elderly patients with emergency sepsis.Methods:A retrospective analysis was performed on 111 elderly patients with mechanical ventilation for sepsis admitted to the emergency department of Dongzhimen Hospital of Beijing University of Chinese Medicine from January 2019 to June 2021. They were divided into two groups according to the time of admission: Western medicine treatment group alone (patients from January 2019 to December 2019, n=47) and acupuncture combined with acupoint application group (patients from January 2020 to June 2021, n=64). Acupuncture combined with acupoint application group was treated with acupuncture combined with acupoint application on the basis of conventional Western medicine. The intestinal dysfunction score, abdominal circumference and mortality after 4 weeks were compared between the two groups. Results:The abdominal circumference and intestinal dysfunction score in acupuncture combined with acupoint application group were significantly lower than those before treatment [(100.56±9.34)cm vs (106.25±9.74)cm; (0.92±0.72)point vs (2.31±0.69)point, all P< 0.05], while there was no significant difference in the above indexes before and after treatment in the Western medicine treatment group (all P>0.05). The abdominal circumference, intestinal dysfunction score and mortality after 4 weeks in the acupuncture combined with acupoint application group were significantly lower than those in the Western medicine treatment group [(100.56±9.34)cm vs (108.09±10.52)cm; (0.92±0.72)point vs (2.43±0.62)point; (29.7%, 19/64) vs (48.9%, 23/47), all P<0.05]. Conclusions:The curative effect of acupuncture combined with acupoint application in the treatment of intestinal dysfunction secondary to mechanical ventilation in elderly patients with sepsis in emergency is better than that of routine treatment of Western medicine alone. The gastrointestinal function and prognosis of patients have been significantly improved, which is worthy of clinical promotion.

We reported a case of neonatal Langerhans cell histiocytosis (LCH) with his clinical manifestations, examinations, diagnosis and treatment. This infant was hospitalized due to the rash and poor response. He was diagnosed as LCH after admission by imaging, skin biopsy and immunohistochemistry. The infant died because his parents refused all possible treatments. At the moment, no effective treatment is available for LCH patients, while the main managements are infection control and necessary supportive care. Pulmonary infections often contribute to the death of LCH patient and can aggravate the situation by stimulating histiocytic hyperplasia.

Objective To investigate the dynamic change of cardiac function in the patients of septic shock and analyze its influence to prognosis.Methods A total of 129 patients in department of emergency medicine,Beijing Chao-Yang Hospital,Capital Medical University,from January 2014 to January 2016 were enrolled in the investigation using mornitoring the hemodynamics including the contour pulse wave mean artery pressure (MAP),cardiac index (CI) and systemic vascular resistance indes (SVRI).Echocardiography was done 7 days laterenrollment of left ventricular eject fraction (LVEF),E and A peak of mitral blood flow velocity,mitral annulus moving speed (E') were detected changes.E/A and E/E'were calculated.According to the 28-day prognosis,all patients were devided into the survival and death group for detecting the risk factors of death.Results In all patients,hemodynamics detected changes showed the features of septic shock with high output and low vascular risistance.The values of CI in the survival group and death group were (4.30±0.71) L/(min.m2) and (4.52±0.91) L/(min· m2),repectively,and the values of SVRI were (1 477±297) dyn·s · cm-5m2 and (1 488±233) dyn·s · cm-5·m2,repectively.There were no significant differences in CI and SVRI were found between the two groups (both P＞0.05).When 7 days after admission in hospital,CI [(3.88±0.51) L/(min· m2)] was lower and SVRI [(2 044±266) dyn·s · cm-5·m2] was higher compared with those at admission in the survival group with significant differences,between the two intervals (all P＜0.05).In the death group,CI decreased to (2.52±0.87) L/(min · m2) and SVRI increased to (3 201±329) dyn·s · cm5·m2 after admission on the 7th day in hospital,significant differences between the two groups (all P＜0.01).There were significantly differenced with LVEF [(69.1±12.5)％ vs.(69.5±11.2)％] and E/E'(8.43±0.59) vs.(8.89±0.64) found between the two groups on the first day in hospital (all P＞0.05).Compared with survival group,LVEF significantly decreased (64.4％±16.3)％ vs.(54.4±17.6)％ and E/E'(8.73±0.67) vs.(9.97±0.55),all P＜0.01] was significantly decreased in the death group.APACHE Ⅱ (OR=1.667,95％CI:1.322-1.863,P=0.001),LVEF (OR=0.809,95％CI:0.612-0.912,P=0.001) and E/E'(OR=1.219,95％CI:1.030-1.501,P=0.006) were detected to be the risk factors by logistic analysis.Conclusions In septic shock patients,both the systolic,and the diastolic cardiac function were found to be significantly abnormal,resulting poor prognosis.

Objective To determine the protective effect of isosorbidemononitrate (IM) on myocardial injury after restoration of spontaneous circulation (ROSC)in swine models of cardiac arrest induced by ventricular fibrillation.Methods The experiment was carried out in Animal Lab of Beijing Chao-Yang Hospital,Capital Medical University.Ventricular fibrillation was induced and untreated for 8 min in twenty WhuZhiShan piglets.CPR was performed until ROSC occurred.The animals were randomized (random number)into two groups:IMgroup (n =10)and control group (n =10).IM [2 μg/(kg· min)]or the equivalent volume in saline was administered respectively for 6 h after ROSC.Hemodynamics and post-resuscitation cardiac function were monitored until 24 h after ROSC. Echocardiography and transmission electron microscopy were useed at 72 h after ROSC.Results There was no significant difference in survival rate between the two groups.No significant differences in mean arterial pressures (mmHg)at ROSC 6 h (88.5 ±5.6 vs.87.8 ±6.0,P =0.790)and ROSC 24 h (89.3 ±3.8 vs.86.9 ± 5.0,P =0.245)between the two groups were found.Cardiac outputs (L/min)were significantly increased at ROSC 6 h (2.40 ±0.17 vs.1.60 ±0.14,P <0.01)and ROSC 24 h (2.49 ±0.17 vs.2.09 ±0.21,P<0.01);and ejection fraction at ROSC 72 h (0.67 ±0.08 vs.0.56 ±0.09,P =0.044)was improved too,and significant differences were found between the two groups.The ultra-structural myocardial injury was ameliorated in the MI group at 72 h after CPR observed by using electron microscopy.Conclusions IM can ameliorate post-resuscitation cardiac dysfunction in porcine models of cardiac arrest induced by ventricular fibrillation.

Objective To evaluate the clinical efficacy of the intratympanic inflation by tympanum inflatable balloon for patients with Meniere’s disease(MD) .Methods A total of 36 confirmed cases (according to the listening stage) of Ⅱ - Ⅲ period of MD patients were randomly divided into two groups :experimental group and control group ,18 cases of matched group ,who were staged before preoperation by hearing ,Ⅱ period (average threshold 25~40 dB HL) 6 cases ,Ⅲ period (41~70 dB HL) 12 cases ,were treated by intratympanic methylprednisolone per‐fusion after putting tympanostomy tube under endotoscope ,then once every 3 days perfusion with a total of three times .There were 18 cases of experimental group staged before preoperation by hearing ,Ⅱ period (average thresh‐old 25~40 dB HL) in 5 cases ,Ⅲ period (41~70 dB HL) 13 cases treated by using tympanum inflatable balloon in the tympanum under endotoscope .Two groups were given conventional improved microcirculation and nutritional therapy .Results In 18 cases of patients in experimental group ,for the 18 to 24 months follow -up after treatment ,6 cases of vertigo were fully controlled (grade A) ,10 cases of vertigo basically controlled (grade B) ,2 cases of vertigo partly controlled (grade C) .Vertigo effective control rate was 88 .89% (16/18) .After 18 to 24 months treatment ,two groups of 36 patients with tinnitus and pure tone average threshold had no obvious change .In 18 ca‐ses of patients in the matched group ,during the 18 to 24 months follow -up after treatment ,3 cases of vertigo were fully controlled (grade A) ,7 cases of vertigo basically controlled (grade B) ,8 cases of vertigo partly controlled (grade C) .Vertigo effective control rate was 55 .56% (10/18) .The experimental vertigo basic control rates were higher than the control group (χ2 = 4 .985 ,P<0 .05) .The activitives in the two groups had improved significantly . No obvious differences were found between two groups .Conclusion With the intratympanic gasing by tympanum in‐flatable balloon for patients of Ⅱ - Ⅲ Menier’s disease ,control rates was high and motile ability were improved , but tinnitus and hearing improvement was not obvious .