Objective: To analyze the mediating effects of loneliness and depressive symptoms on family functioning and life satisfaction among rural elderly patients with chronic diseases, so as to provide the basis for improving the life satisfaction of this population. Methods: Rural elderly patients with chronic diseases aged ≥60 years in Qiannan Buyi and Miao Autonomous Prefecture, Guizhou Province were selected using a multi-stage stratified random cluster sampling method from June to September 2022. Basic information such as gender, age, and chronic diseases were collected. Family function, life satisfaction, loneliness and depressive symptoms were evaluated using Family Care Index Scale, the Satisfaction with Life Scale, the b-item Revised VCLA Loneliness Sale and the 15-item Geriatric Depression Scale, respectively. The structural equation model was constructed using Amos software to analyze the mediating effects of loneliness and depressive symptoms on the relationship between family function and life satisfaction. The Bootstrap method was employed to test the mediating effects. Results: A total of 1 145 rural elderly patients with chronic diseases were recruited, including 517 males (45.15%) and 628 females (54.85%). Among the participants, 657 individuals (57.38%) were aged 60-<71 years, and 540 individuals (47.16%) had three or more chronic diseases. The scores for family function, life satisfaction, loneliness, and depressive symptoms were (3.90±1.18), (18.88±5.25), (12.88±2.99), and (6.65±2.26), respectively. Mediating effect analysis showed that family function had a direct positive effect on life satisfaction (β=0.179, 95%CI: 0.126-0.231). It also indirectly positively influenced the life satisfaction of rural elderly patients with chronic diseases through the independent mediating effect of depressive symptoms (β=0.035, 95%CI: 0.021-0.054) and the chained mediating effect of loneliness and depressive symptoms (β=0.021, 95%CI: 0.013-0.030). The mediating effect of depressive symptoms accounted for 14.89% of the total effect, while the chained mediating effect of loneliness and depressive symptoms accounted for 8.94% of the total effect. Conclusion Good family function can directly enhance the life satisfaction of rural elderly patients with chronic diseases and can also indirectly improve their life satisfaction by reducing loneliness and depressive symptoms.

Objective: To investigate the characteristics of newly reported HIV/AIDS cases aged 15 years and older in Shangcheng District, Hangzhou City from 2006 to 2022, so as to provide the basis for improving AIDS prevention and control strategies. Methods: Data of newly reported HIV/AIDS cases aged 15 years and older in Shangcheng District from 2006 to 2022 were collected through HIV/AIDS Comprehensive Control System of Chinese Disease Prevention and Control Information System. Population distribution and transmission routes were analyzed, and changing trends in case number were analyzed using average annual percent change (AAPC) and annual percent change (APC). Results: A total of 4 409 HIV/AIDS cases aged 15 years and older were newly reported in Shangcheng District from 2006 to 2022, including 3 932 males (89.18%). There were 3 447 cases (78.18%) under 50 years old and 962 cases (21.82%) being 50 years and older. Sexual contact was a predominant transmission route, with 4 326 cases accounting for 98.12%, including 2 626 cases (59.56%) with homosexual contact and 1 700 cases (38.56%) with heterosexual contact. The number of HIV/AIDS cases showed an overall upward trend from 2006 to 2022 (AAPC=13.038%, P<0.05), with an upward trend from 2006 to 2015 (APC=42.578%, P<0.05) and a downward trend from 2015 to 2022 (APC=-19.713%, P<0.05). The increase in the number of cases aged 50 years and older group was faster than that of cases aged under 50 years (AAPC=22.641% vs. 11.162%, both P<0.05). The increase in the number of cases with homosexual contact transmission was faster than that of cases with heterosexual contact transmission (AAPC=20.417% vs. 7.455%, both P<0.05). Conclusions The number of newly reported HIV/AIDS cases aged 15 years and older in Shangcheng District performed an overall upward trend from 2006 to 2022. The cases aged 50 years and older and transmitted through homosexual contact increased rapidly, which should be taken seriously.

Objective:To investigate the prevalence of small intestinal bacterial overgrowth (SIBO) in patients with rosacea, and to analyze the relationship between breath test results and the occurrence of rosacea.Methods:Patients with rosacea were enrolled from the outpatient department of Xiangya Hospital from March 2022 to June 2023. The methane-hydrogen breath test was used to detect intestinal levels of methane and hydrogen in all patients to investigate the prevalence of SIBO. The basic information, clinical symptoms and severity, quality of life scores, gastrointestinal symptoms, and past medical history of the patients were collected. Statistical analysis was carried out by using the chi-square test, nonparametric test and multivariate logistic regression models to investigate the relationship between SIBO and the occurrence of rosacea.Results:A total of 116 patients with rosacea completed the methane-hydrogen breath test. They were aged 18 to 56 years (median [ Q1, Q3]: 25 [22, 33] years), and included 7 males (6.0%) and 109 females (94.0%) ; there were 43 cases (37.1%) of erythematotelangiectatic rosacea, and 73 (62.9%) of papulopustular rosacea. As the breath test showed, 94 patients were diagnosed with SIBO (81.0%, 95% CI: 72.7% - 87.7%) based on the breath tests, 84 showed positive hydrogen breath test results (72.4%, 95% CI: 63.3% - 80.3%), and 47 had positive methane breath test results (40.5%, 95% CI: 31.5% - 50%). Among the 67 patients with moderate to severe erythema, 33 (49.3%) showed positive methane breath test results, and 14 of 49 (28.6%) patients with mild erythema showed positive methane breath test results, with a rate difference of 20.7% ( P = 0.025, 95% CI: 13.9% - 27.5%) ; there were no significant differences in the positive rates of SIBO and hydrogen breath test results between the patients with moderate to severe erythema and those with mild erythema (both P > 0.05). No significant differences were observed in the age, gender, clinical subtypes, severity of papulopustules, flushing and burning sensation, or rosacea quality of life index scores between the SIBO-positive and -negative groups, between hydrogen-positive and -negative groups, and between methane-positive and -negative groups (all P > 0.05). Multivariate logistic regression analysis showed that methane positivity on breath test was associated with the severity of erythema in rosacea ( OR = 2.495, 95% CI: 1.102 - 5.649, P < 0.05) . Conclusions:The prevalence of SIBO was relatively high in the patients with rosacea. However, only the positive rate of methane breath test differed between the rosacea patients and non-rosacea controls, and there was some correlation between methane positivity on breath test and increased severity of rosacea erythema.

Objective To investigate the effect of Yinchenhao decoction on renal oxidative stress injury in rats with obstructive jaundice and its association with the regulation of the expression of nuclear factor erythroid 2-related factor 2 (Nrf2) and nuclear translocation. Methods A total of 32 male Sprague-Dawley rats were randomly divided into sham-operation group (S group), model group (O group), low-dose Yinchenhao decoction group (LY group), and high-dose Yinchenhao decoction group (HY group), with 8 rats in each group. For the rats in the S group, the upper common bile duct was isolated without ligation, and for those in the other groups, double ligation of the middle and upper 1/3 of the common bile duct was performed to establish a model of obstructive jaundice. After 7 days, the rats in the LY group and the HY group were given Yinchenhao decoction by gavage at a dose of 6.3 and 18.9 mL/kg, respectively, while those in the S and O groups were given an equal volume of distilled water by gavage every day for 7 consecutive days, and the rats were treated on day 14. ELISA was used to measure the serum levels of total bilirubin (TBil), direct bilirubin (DBil), alanine aminotransferase (ALT), gamma-glutamyl transpeptidase (GGT), blood urea nitrogen (BUN), and creatinine (Cr); spectrophotometry was used to measure the activity of the oxidative stress factors superoxide dismutase (SOD) and malondialdehyde (MDA) in renal tissue; quantitative real- time PCR and Western blotting were used to measure the mRNA and protein expression levels of Nrf2, Kelch-like ECH-associated protein 1 (Keap1), and NAD(P)H quinone dehydrogenase 1 (NQO1) in renal tissue; immunohistochemistry was used to measure observe the nuclear translocation of Nrf2 protein in renal tissue. A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the least significant difference t -test was used for further pairwise comparison within groups. Results Compared with the S group, the O group had significant increases in the levels of TBil, DBil, ALT、GGT, BUN, and Cr, a significant reduction in the activity of SOD, and a significant increase in the level of MDA (all P < 0.05). Compared with the O group, the LY group and the HY group had significant reductions in liver and renal function parameters, a significant increase in the activity of SOD, and a significant reduction in the level of MDA (all P < 0.05). Compared with the S group, the O group had significant reductions in the mRNA and protein expression levels of Nrf2 and NQO1 in renal tissue (all P < 0.05), and compared with the O group, the LY group and the HY group had significant increases in the mRNA and protein expression levels of Nrf2 and NQO1 (all P < 0.05), while there was no significant difference in the protein expression level of Keap1 between groups ( P > 0.05). Compared with the S group, the O group had a significant reduction in the positive rate of Nrf2 in cell nucleus in renal tissue ( P < 0.05), and compared with the O group, the LY group and the HY group had a significant increase in the positive rate of Nrf2 in cell nucleus ( P < 0.05). Conclusion Yinchenhao decoction can effectively alleviate renal injury caused by obstructive jaundice, possibly by upregulating the protein expression of Nrf2 in renal tissue and regulating the nuclear translocation of Nrf2 protein, so as to mediate the protein expression of downstream NQO1, regulate oxidative stress response caused by obstructive jaundice, and thereby alleviate renal injury in rats.

ObjectiveTo determine whether HBV DNA polymerase is associated with T-cell failure and thus mediates the immune escape of HBV-related hepatocellular carcinoma （HCC） tumor cells， and to investigate the specific molecular mechanisms. MethodsLiver cancer cell lines Huh7 and HepG2 stably transfected with HBV DNA polymerase expression plasmid with Flag （Flag-HBV-P） and intercellular adhesion molecule-1 （ICAM1） were co-cultured with Jurkat cells， and MTT assay， qRT-PCR， and ELISA were used to measure Jurkat cell proliferation， activation （CD69 expression）， and secretion of the cytokine IFN-γ. RNA-seq was used to screen for differentially expressed immune-associated molecules between stably transfected cell lines and control cells， and mRNA half-life and protein half-life assays were used to determine the specific levels of the immune-associated molecules that were affected by HBV DNA polymerase. Related websites were used to predict the transcription factors that may bind to the promoter region of this immune-associated molecule， Western blot was used to verify the effect of transcription factors on the immune-associated molecule， and rescue experiment was used to determine whether HBV DNA polymerase affects the expression level of the immune-associated molecule through this transcription factor. The independent-samples t test was used for comparison between two groups. ResultsThe experimental group had significant reductions in Jurkat cell proliferation， activation， and cytokine secretion compared with the control group （all P<0.01）. Compared with the control group， the experimental group （Huh7 and HepG2 cell lines） had significant reductions in the mRNA and protein expression levels of ICAM1 （all P<0.01）. Website prediction identified the ICAM1 promoter and preliminarily highlighted NFKB1， RELA， and STAT3. Compared with the control group， the experimental group （Huh7 and HepG2 cell lines） had a significant reduction in the protein expression level of p65 （all P<0.01）. After p65 overexpression， there was a significant increase in the protein expression level of ICAM1， and after the expression of p65 was reduced， there was a significant reduction in the protein expression level of ICAM1 （all P<0.01）. In the rescue experiment， there was no significant difference in the protein expression level of ICAM1 between the control group and the experimental group after p65 overexpression （all P>0.05）. After the overexpression of ICAM1， there were no significant differences in the proliferation， activation， and cytokine secretion of Jurkat cells between the control group and the experimental group （Huh7 and HepG2 cell lines） （all P>0.05）. ConclusionHBV DNA polymerase downregulates the level of ICAM1 to mediate HCC immune escape by inhibiting the expression of p65 in NF-κB.

Objective: To investigate the clinical efficacy of entecavir combined with Biejiajian pills and its influence on TCM syndrome scores during the treatment of chronic hepatitis B with hepatic fibrosis and blood stasis syndrome by prospective, randomized and controlled study. Methods: Patients with chronic hepatitis B with hepatic fibrosis and blood stasis syndrome were selected as the research subjects and randomly divided into a treatment group and a control group. Entecavir plus Biejiajian pills or entecavir plus a simulant of Biejiajian pills were given for 48 weeks. The changes in liver stiffness measurement (LSM) and TCM syndrome scores before and after treatment were compared between the two groups to analyze the correlation. The data between groups were analyzed by t-test/Wilcoxon rank sum test or χ(2) test. Pearson correlation coefficient was used to analyze the correlation between TCM syndrome scores and LSM values. Results: After 48 weeks of treatment, the LSM values of the two groups were significantly lower than those of the baseline (P < 0.001), liver fibrosis was significantly improved, and the LSM values of the treatment group were lower than those of the control group [(8.67 ± 4.60) kPa and (10.13 ± 4.43) kPa, t = -2.011, P = 0.049]. After 48 weeks of treatment, the TCM syndrome scores of the two groups were significantly reduced compared with the baseline (P < 0.001), and the clinical symptoms were significantly relieved, and the total effective rates of the improvement of the TCM syndrome scores in the two groups were 74.19% and 72.97%, respectively, but the differences between the groups were not statistically significant (χ(2) = 0.013, P = 0.910). Correlation analysis showed that there was no obvious trend between TCM syndrome scores and LSM values. There were no serious adverse reactions associated with the drug during the observation period of this study. Conclusion: Based on antiviral treatment with entecavir, regardless of whether it is combined with the Biejiajian pill, it can effectively reduce the LSM value, improve liver fibrosis, reduce TCM syndrome scores, and alleviate symptoms in patients with chronic hepatitis B with liver fibrosis and blood stasis syndrome. Compared with entecavir alone, the combined Biejia pill has greater efficacy in improving liver fibrosis and a favorable safety profile, meriting its implementation and widespread application.
Humans ; Antiviral Agents/therapeutic use* ; Hepatitis B, Chronic/drug therapy* ; Liver Cirrhosis/drug therapy* ; Prospective Studies ; Treatment Outcome

BACKGROUND: Intervertebral disk (IVD) degeneration, which can cause lower back pain, is a major predisposing factor for disability and can be managed through multiple approaches. However, there is no satisfactory strategy currently available to reconstruct and recover the natural properties of IVDs after degeneration. As tissue engineering develops, scaffolds with embedded cell cultures have proved critical for the successful regeneration of IVDs. METHODS: In this study, an integrated scaffold for IVD replacement was developed. Through scanning electron microscopy and other mechanical measurements, we characterized the physical properties of different hydrogels. In addition, we simulated the physiological structure of natural IVDs. Nucleus pulposus (NP) cells and annulus fibrosusderived stem cells (AFSCs) were seeded in gelatin methacrylate (GelMA) hydrogel at different concentrations to evaluate cell viability and matrix expression. RESULTS: It was found that different concentrations of GelMA hydrogel can provide a suitable environment for cell survival. However, hydrogels with different mechanical properties influence cell adhesion and extracellular matrix component type I collagen, type II collagen, and aggrecan expression. CONCLUSION This tissue-engineered IVD implant had a similar structure and function as the native IVD, with the inner area mimicking the NP tissue and the outer area mimicking the stratified annulus fibrosus tissue. The new integrated scaffold demonstrated a good simulation of disc structure. The preparation of efficient and regeneration-promoting tissueengineered scaffolds is an important issue that needs to be explored in the future. It is hoped that this work will provide new ideas and methods for the further construction of functional tissue replacement discs.

Objective: To investigate the characteristics and prevalence of HIV infection among AIDS volunteer counseling and testing ( VCT ) clients in Shangcheng District, Hangzhou City from 2016 to 2019, so as to provide insights into local AIDS control. Methods: The demographic features, reasons for counseling and detection of anti-HIV antibody were captured from the VCT clinic of Shangcheng Center for Disease Control and Prevention from 2016 to 2019, and the reasons for counseling and prevalence of HIV infections were analyzed. Results: A total of 2 205 clients were included, among whom 1 920 participants ( 87.07% ) were male, 1 094 ( 49.61% ) were at ages of < 30 years, 1 293 ( 58.64% ) were single, and 1 165 ( 52.83% ) had an education level of diploma and above. The common reasons for counseling included a history of homosexual behaviors with men (887 clients, 40.23%), non-commercial irregular heterosexual behaviors ( 661 clients, 29.98% ), commercial heterosexual behaviors ( 308 clients, 13.97% ), HIV-positive spouse/regular sex partners ( 123 clients, 5.58% ), and no high-risk behaviors ( 47 clients, 2.13% ). The positive rate of anti-HIV antibody was 2.95% among the 2 205 clients, and a high positive rate was observed among clients at ages of 50 years and below ( 6.15% ), single clients ( 3.71% ), clients with an education level of primary school and below ( 6.04% ) and clients with HIV-positive spouse/regular sex partners ( 11.38% ). Conclusions Single men at ages of less than 30 years and with a high education level are predominant among VCT clients in Shangcheng District, and a history of homosexual behaviors with men is the predominant reason for counseling. There is a relative low prevalence rate of HIV infection among VCT clients in Shangcheng District; however, a high prevalence rate is found among single visitors at ages of 50 years and older, with an education level of primary school and below and HIV-positive spouse/regular sex partners.

Objective: To analyze the characteristics of young students inquiry to voluntary counseling and testing (VCT) clinics, and to provide reference for AIDS prevention and control effectiveness of local schools. Methods: A total of 1 223 students aged 7-28 years were collected and characterized through HIV Testing Consulting Information Management System in Shangcheng VCT clinics during 2016-2020. The epidemic characteristics were analyzed by cross sectional studies. Results: Young students accounted for 25.21%(1 223/4 852) of the total counseling population in VCT clinics from 2016 to 2020. The main reason for counseling was non high risk (28.29%, 346 cases), followed by MSM (26.41%, 323 cases) and non commercial non fixed heterosexual behavior(25.92%, 317 cases). The counseling proportion of non commercial non fixed heterosexual behavior and commercial heterosexual sex behavior declined with time( χ 2 trend =-6.04, -3.59, P <0.01). The average of HIV positive detection rate among young students was 3.03%(37 cases), which increased with time( χ 2 trend=2.45, P <0.01). Conclusion Sex education and HIV/AIDS knowledge education are necessary in primary and secondary schools. Targeted strategies are in great need in terms of MSM behavior intervention.

Objective:To evaluate the correlation between the prognosis of patients with hilar cholangiocarcinoma and the degree of bile duct dilatation in MRCP .Methods:The clinical data of 89 patients with hilar cholangiocarcinoma undergoing radical operation at Tianjin Nankai Hospital from Jan 2009 to Dec 2013 were analyzed retrospectively.Results:Tumor size ( P=0.024), Bismuth-Corlette classification ( P=0.048) and tumor stage ( P=0.013) were related factors of biliary dilatation. Tumor differentiation ( P=0.002), R 0 resection ( P=0.002) and biliary dilatation ( P<0.001) were independent predictors of disease-free survival (DFS). Conclusion:The imaging evaluation of the degree of biliary dilatation has a certain predictive value for the prognosis of patients with hilar cholangio-carcinoma.