Over the past three decades， China has made significant progress in the prevention and control of viral hepatitis， and the incidence rates of new-onset pediatric hepatitis B virus infections and acute viral hepatitis in the population have reduced to a relatively low level； however， there is still a heavy disease burden of chronic viral hepatitis in China， which severely affects the health status of the population. This study systematically summarizes the achievements of viral hepatitis prevention and control in China， analyzes existing problems and challenges， and proposes comprehensive prevention and control strategies and measures to eliminate viral hepatitis as a public health threat based on the national conditions of China， in order to provide a reference for related departments in China on how to achieve the action targets for eliminating viral hepatitis as a public health threat by 2030.

Recent progress in targeted metabolic therapy of cancer has been limited by the considerable toxicity associated with such drugs. To address this challenge, we developed a smart theranostic prodrug system that combines a fluorophore and an anticancer drug, specifically 6-diazo-5-oxo-l-norleucine (DON), using a thioketal linkage (TK). This system enables imaging, chemotherapy, photodynamic therapy, and on-demand drug release upon radiation exposure. The optimized prodrug, DON-TK-BM3, incorporating cyanine dyes as the fluorophore, displayed potent reactive oxygen species release and efficient tumor cell killing. Unlike the parent drug DON, DON-TK-BM3 exhibited no toxicity toward normal cells. Moreover, DON-TK-BM3 demonstrated high tumor accumulation and reduced side effects, including gastrointestinal toxicity, in mice. This study provides a practical strategy for designing prodrugs of metabolic inhibitors with significant toxicity stemming from their lack of tissue selectivity.

Objective: To investigate the characteristics of AHFtest-based HIV antibody self-testing among male adolescents at ages of 15 to 24 years, so as to provide insights into the promotion of HIV antibody self-testing. Methods: Data were collected from male adolescents at ages of 15 to 24 years that applied for HIV antibody self-testing in the AHFtest platform from 2019 to 2021, with mailing address showing as Zhejiang Province, and demographics, applying cause and testing results were analyzed. Results: A total of 268 male adolescents were enrolled, with a median age of 22.00 (interquartile range, 3.00) years. There were 160 cases with an educational level of junior college/bachelor (59.70%), 147 students (54.85%), 175 men who had sex with men (65.30%), and 126 cases with a history of previous HIV antibody self-testing (47.01%). The main causes for applying for HIV antibody self-testing through AHFtest were "easy to operate" (259 cases, 96.64%) and "privacy protect" (102 cases, 38.06%). There were 203 subjects that applied once HIV antibody self-testing (75.75%), and 65 subjects that applied multiple self-testing (24.25%). There were 123 subjects that uploaded their test results (45.90%), including 3 cases with HIV antibody positive, and 125 subjects that did not tell others the self-testing results (46.64%). Conclusions Among male applicants at ages of 15 to 24 years in Zhejiang Province from 2019 to 2021, students are predominant occupation. Easy to operate and privacy protect are the main cause for the application, but the proportion of detection results uploading is relatively low.

Objective:To examine the burden and trends of acute viral hepatitis in Guangdong Province from 1990 to 2019, and provide reference evidences for hepatitis prevention and control in the province.Methods:Data on acute viral hepatitis (hepatitis A, B, C, and E) in Guangdong from 1990 to 2019 were extracted from the Global Burden of Disease Study 2019 database. The incidence, prevalence, mortality, and disability-adjusted life years (DALY) data were analyzed by age and gender, and the estimated annual percentage change (EAPC) was calculated to describe the changing trends in disease burden.Results:From 1999 to 2019, the standardized incidence, prevalence, mortality, and DALY of acute viral hepatitis in Guangdong were higher than the national averages. In 2019, 51.43% (2 245 087/4 365 221) of acute viral hepatitis cases in Guangdong Province were mainly attributed to hepatitis B, and 77.18% (106/138) of deaths were due to acute hepatitis B. In different age groups, except for acute hepatitis B, which was more common in adults, the incidence rates of other types of viral hepatitis such as hepatitis A, B, and E showed an overall decreasing trend with age. The mortality rates of different types of acute viral hepatitis, except for the <5 age group, increased with age. The overall incidence and mortality rates of acute viral hepatitis were higher in men than in women.Conclusions:The overall burden of acute viral hepatitis in Guangdong declined in 2019, but remained higher than the national level. Further efforts are needed to strengthen hepatitis prevention and screening in different population in Guangdong Province, especially in children and the elderly.

Objective To explore the optimal phases of reconstructed CT images under different heart rates based on dynamic phantom system simulating the motion of left ventricle and coronary arteries.Methods A dynamic phantom system which could simulate the periodic movements of the heart at 50-120 beats per minute(bpm)and the output of electrocardiogram signals was constructed.CT scanning were performed in the simulated R-R interval,and images were reconstructed with every 10％interval between 0 to 90％phases.Then subjective image quality scoring was performed,and inter-observer consistency of image quality scores was assessed.Finally the qualities of reconstructed images were compared among different phases under different heart rates.Results The inter-observer consistency of subjective imaging quality scores was high(Kendall W=0.83,P＜0.05).Under 50-60 bpm simulated heart rates,good reconstructed image qualities were obtained at most phases,especially at 30％,70％and 80％(all P＜0.05).When simulated heart rates were set as 65-75 bpm,the best reconstructing phases included 40％,70％and 80％(all P＜0.05),and images obtained in diastolic phase were better.Under 80-95 bpm,the best reconstructing phase was 30％(all P＜0.05).When the simulated heart rate reached 100 bpm and above,the reconstructed image qualities were poor at all phases.Conclusion The optimal reconstructed phases were different under different heart rates based on dynamic phantom system simulating the motion of left ventricle and coronary arteries.When the simulated heart rate reached 100 bpm and above,the qualities of reconstructed images were poor under all phases.

Objective:To investigate the application value of 3D printed model in hemostasis training for laparoscopic sleeve gastrectomy.Methods:The retrospective and descriptive study was conducted. Data were collected from six surgeons who participated in hemostasis training for laparoscopic sleeve gastrectomy using 3D printed model at Zhejiang Provincial People′s Hospital in July 2023. All participants were male, aged (33.5±9.9)years. A 3D printed model simulating bleeding during laparoscopic sleeve gastrectomy was created using hydrogel. Videos were recorded to document the surgeons′ hemostasis techniques and outcomes during laparoscopic sleeve gastrectomy. Two external expert reviewers blindly assessed the training videos using the objective structured assess-ment of technical skills (OSATS) scoring system to evaluate mesentery mobilization, vessel exposure, vessel clipping and bleeding after vessel clipping. Observation indicators: (1) face validity and content validity of the 3D printed model; (2) validity verification of the 3D printed model. Measurement data with normal distribution were represented as Mean± SD. Comparison between groups was conducted using the t test. Results:(1) Face validity and content validity of the 3D printed model. The surgeons′ scores for overall impression, fidelity, texture, appearance, workspace and tactile similarity of the 3D printed model were 4.5±0.6, 4.0±0.6, 3.7±0.5, 4.2±0.8, 3.8±0.8 and 4.2±0.4, respectively. The surgeons′ scores for similarity to real scenarios, operation convenience, learning curve shortening and operation skills improving, patient risk reduction, trainee′s interest enhancing, confidence increasing and recommendation for promotion were 4.0±0.6, 4.2±0.8, 4.3±0.8, 4.3±0.5, 4.3±0.5, 4.0±0.6 and 4.8±0.4, respectively. (2) Validity verification of the 3D printed model. The OSATS scores and operation time to treat bleeding during laparoscopic sleeve gastrectomy for expert surgeons were 18.7±0.6 and (125±12)seconds, respectively, versus 13.7±1.5 and (212±51)seconds for junior doctors, showing significant differences between the two groups ( t=5.30, -2.89, P<0.05). Conclusion:The 3D printed model effectively simulates bleeding scenarios during laparoscopic sleeve gastrectomy and distinguishes between different technical levels of expertise.

Objective : To analyze the problems in the AIDS control strategy in key areas of Zhejiang Province, so as to provide insights into the improvement of the control strategy. Methods : The AIDS control data were collected from 10 key counties (districts) in Zhejiang Province, and the AIDS control strategy was comprehensively evaluated using a SWOT analysis. Results : The strengths of the AIDS control strategy in key counties (districts) of Zhejiang Province included distinct working objectives, well-organized leadership, and effective control measures, the weaknesses included large number of HIV-infected cases, high burden of disease, difficulty in management of AIDS transmission and insufficient AIDS control capability, and the opportunities included the AIDS control in key counties (districts) conforming to the current status of AIDS control, strong support of innovative strategies and technical support from professional teams, while the threats included insufficient working mechanisms for AIDS control, the gap between the effectiveness of AIDS control and the target goal and unverified scientific evidence of the control strategy. Supported policies should be fully used, working mechanisms need to be improved, control strategies need to be innovated, and assessments need to be implemented for AIDS control in key counties (districts). Conclusions There are both opportunities and challenges for AIDS control in key counties (districts) of Zhejiang Province. Optimization of the working mechanisms, promotion of precision interventions, and search for repeatable control strategy in other disease-affected regions are required for AIDS control.

Objective:To evaluate the laparoscopic sleeve gastrectomy combined with hiatal hernia repair surgery for weight loss and antireflux.Methods:This study included 21 obese patients with gastroesophageal reflux who underwent laparoscopic sleeve gastrectomy at the Weight Loss Metabolism Center of the Department of Hepatobiliary and Pancreatic Surgery of Zhejiang Provincial People's Hospital from Dec 2019 to Dec 2020. Patients were divided into simple bariatric surgery group (9 cases) and simultaneous combined surgery group (12 cases).Results:In the combined surgery group, 1 case had postoperative gastric leakage. The postoperative body weight, waist circumference, and BMI indexes of the two groups showed a downward trend ( F=5.154, P=0.013; F=14.319, P<0.001; F=6.725, P=0.004). There was a statistically significant difference in the excess weight loss in both the two groups at 6 months after the operation compared to 1 month after the operation ( t=8.927, P<0.001; t=8.926, P<0.001). There was no statistically significant difference in postoperative lower esophageal sphincter resting pressure and Gerd symptom score in the bariatric surgery group compared with preoperative ( t=-0.891, P=0.507; t=0.629, P=0.298). The postoperative Gerd symptom score of the patients in the combined surgery group was significantly lower than that before the operation, and the resting pressure of the lower esophageal sphincter was significantly higher than that before the operation, ( t=-10.539, P<0.001; t=5.066, P=0.038). Conclusion:Combined surgery have the same weight loss effect as in simple bariatric surgery in obese patients with gastroesophageal reflux, in addition to stronger anti-reflux effect.

Objective: To investigate the factors affecting HIV testing among male college students with sexual behaviors, so as to provide the evidence for improving the detection of HIV testing among young college students. Methods: Four undergraduate universities and one junior college were randomly sampled from Hangzhou City using a purposive sampling method during the period between September and November, 2021, and male students with self-reported sexual behaviors were recruited as study students. Participants' demographics, AIDS-related knowledge, sexual behaviors and HIV testing were collected using questionnaires, and factors affecting HIV testing using a multivariable logistic regression model. Results: A total of 720 male college students with sexual behaviors were enrolled, including 180 freshmen (25.00%), 178 sophomores (24.72%), 163 juniors (22.64%), 50 seniors (6.94%) and 149 postgraduates (20.69%), and 94 students received HIV testing (13.06%), including 57.45% receiving self-testing. Multivariable logistic regression analysis identified postgraduates (OR=0.302, 95%CI: 0.127-0.719), sexual orientation (homosexual, OR=0.090, 95%CI: 0.028-0.294; bisexual/uncertain, OR=0.181, 95%CI: 0.066-0.495), awareness of HIV testing (low awareness, OR=0.411, 95%CI: 0.176-0.957; moderate awareness, OR=0.305, 95%CI: 0.123-0.757; high awareness, OR=0.087, 95%CI: 0.032-0.235) as factors affecting HIV testing among male college students with sexual behaviors. Conclusions The prevalence of HIV testing correlates with awareness of HIV testing among male college students with sexual behaviors. Improvements in health education of HIV testing and accessibility of HIV testing services are recommended.

Objective: To investigate the characteristics of temporary heterosexual behaviors among male college students through Internet dating, so as to provide insights into HIV/AIDS control among young college students. Methods: A total of 15 universities/colleges were sampled from Zhejiang Province using a stratified cluster sampling method, and 3 schools/departments were sampled from each university/college. Male college students with temporary heterosexual behaviors during the past year were recruited. Participants' demographics, AIDS-related knowledge, compliance to HIV/AIDS interventions, Internet dating and sexual behaviors were collected, and the characteristics of male college students with Internet dating were analyzed. Results : A total of 326 students were enrolled, including 202 participants from regular institutions of higher education (61.96%) and 124 students from higher vocational colleges (38.04%). There were 79 freshmen (24.23%), 99 sophomores (30.37%), 104 juniors (31.90%) and 44 seniors (13.50%), and there were 100 participants (30.67%) with temporary heterosexual behaviors through Internet dating during the past year. Among the 100 participants, there were 75.00% of participants knowing “man who have sex with man is the main transmission pattern of AIDS among young students in China”, 93.00% knowing “insisting on accurate use of condoms may reduce the risk of HIV infections and transmission” and 93.00% knowing “seeking HIV testing and counseling actively following high-risk behaviors”. There were 77 participants (77.00%) with students as their temporary heterosexual partners, 17 participants (17.00%) that had received HIV self-testing and 17 participants (17.00%) that had received HIV testing in medical institutions, 22 participants (22.00%) that had never used condoms during temporary heterosexual behaviors during the past year, and 29 participants (29.00%) with commercial sexual behaviors during the past year. In addition, male college students with temporary heterosexual behaviors through Internet dating were more unlikely to use condoms and more likely to have commercial sexual behaviors than those with dating through other ways (P<0.05). Conclusions Male college students with temporary heterosexual behaviors through Internet dating are more likely to have high-risk sexual behaviors than those with dating through other ways. Internet-based mobile sexual education and HIV/AIDS health education are recommended.