ObjectiveTo analyze the detected results of CD4⁺T lymphocytes and viral load in newly identified human immunodeficiency virus (HIV) infected patients in Huangpu District of Shanghai in 2023, to explore the correlation between them, so as to provide a scientific basis for the development of targeted prevention and control measures and antiviral treatment programs. MethodsThe data of CD4 cell count, viral load and demographic characteristics of the newly infected patients living with HIV in Huangpu District, Shanghai in 2023 were collected and analyzed by using descriptive epidemiological method. ResultsThe mean CD4 cell count of the 67 newly identified HIV infected patients in Huangpu District was (301.22±235.19) cells·µL^-1, with a mean viral load of (5.15±1.28) ×10⁵ copies·mL^-1.There were statistically significant differences in CD4 cell count and viral load among different age groups (P<0.05), but there were no statistically significant differences by gender and marital status (both P>0.05). The CD4 cell count and CD4/CD8 ratio both were negatively correlated with the lg value of viral load (r=-0.290, -0.378; P=0.027, 0.002). ConclusionThe CD4 cell counts of the newly identified HIV infected patients in Huangpu District in 2023 were generally low, the proportion of patients with high viral load was high, but the risk for elderly infected with HIV was high. The elderly have gradually become the key population for AIDS prevention and control in Huangpu District. It is recommended to expand HIV screening in the elderly to reduce the risk of HIV transmission and increase the rate of early detection and treatment.

Objective To establish ecological suitability zone of Forsythia suspensa(Thunb.)Vahl in Shanxi Province;To study the quality regionalization of Forsythia suspensa(Thunb.)Vahl from different producing areas in Shanxi Province;To provide reference for reasonable planting and wild tending of Forsythia suspensa(Thunb.)Vahl.Methods Maximum entropy(MaxEnt)model and ArcGIS software were used to study the ecological suitability of Forsythia suspensa(Thunb.)Vahl in Shanxi Province;By screening the main environmental factors and combining them with the content of forsythoside and forsythoside A in Forsythia suspensa(Thunb.)Vahl of different regions,a quality zoning of Forsythia suspensa Thunb.Vahl medicinal materials in Shanxi Province based on forsythoside,forsythoside A and environmental factors was constructed.Results The ecological suitable areas of Forsythia suspensa Thunb.Vahl in Shanxi Province were mainly distributed in the southern part of Shanxi Province,mainly in Linfen,Yuncheng,Changzhi,and Jincheng.The general contents of forsythoside and forsythoside A in the Forsythia suspensa(Thunb.)Vahl medicinal material were gradually reduced from southern part to northern part of Shanxi Province.The comprehensive quality was high in southern part of Shanxi Province,mainly in Linfen,Changzhi,Yuncheng and Jincheng.Conclusion The results of this study are consistent with the actual survey.The southern part of Shanxi province is a suitable planting area for high quality Forsythia suspensa(Thunb.)Vahl,which provides a reference for the standardized planting and wild tending of Forsythia suspensa(Thunb.)Vahl.

Post-traumatic stress disorder (PTSD),with the principal manifestations as invasive thinking,avoidance,negative emotions and cognition,and increased alertness,is a psychological disorder occurring after traumatic events. Sleep disorders are also considered as one of the core characteristics of PTSD. Previous studies have partly revealed the relationship between PTSD and sleep disorders,but the physiological mechanism of the relationship is still unclear. This article provides an overview of the clinical and physiological characteristics of PTSD and sleep disorders. Based on this,the bidirectional relationship between PTSD and sleep disorders is discussed,and the relevant physiological and brain mechanisms of the relationship between them are further explored. Future research needs to explore the neurophysiological mechanisms underlying the bidirectional relationship between PTSD and sleep by exploring the brain regions and neural circuits associated with both PTSD and sleep,providing more information and methods for the prevention and treatment of PTSD and sleep disorders.

Objective To analyze the characteristics of conventional ultrasound and contrast-enhanced ultrasound(CEUS)in hypovascular renal tumors,and to explore the application value of combining the 2 methods in diagnosing benign and malignant hypovascular renal tumors.Methods The conventional ultrasound and CEUS data of 104 hypovascular renal tumors(76 benign lesions[benign group]and 28 malignant lesions[malignant group])from 99 patients,who were confirmed by postoperative pathology,biopsy pathology or computed tomography(CT)/magnetic resonance imaging(MRI)enhancement combined with long-term follow-up in Ruijin Hospital,Shanghai Jiao Tong University School of Medicine and its Wuxi Branch from Oct.13,2009 to Oct.26,2022,were retrospectively analyzed.The location,size,internal echo,morphology,internal and peripheral blood supply of the lesions were observed by conventional ultrasound,and the perfusion mode,regression pattern,perfusion uniformity and ring enhancement signs were observed by CEUS.Taking the pathological results or confirmed results of CT/MRI enhancement combined with long-term follow-up as the gold standard,the value of conventional ultrasound combined with CEUS in the differential diagnosis of benign and malignant hypovascular renal tumors was analyzed.Results There were significant differences in gender,age of patients and internal echo,contrast agent regression and ring enhancement signs of lesions between the 2 groups(all P＜0.05).The malignant tumors were mostly found in males(78.6％,22/28)with an average age of(58.29±11.76)years old;the masses were mostly hypoechoic(64.3％,18/28),and rapid washout was predominant with CEUS(60.7％,17/28).In the benign group,most of the patients were female(55.3％,42/76),with an average age of(50.64±14.88)years old;the majority of the masses were hyperechoic(64.5％,49/76),and CEUS showed simultaneous washout as the main lesion(56.6％,43/76).Three patients(10.7％,3/28)with ring enhancement signs were all malignant.The diagnostic accuracy(82.7％)and specificity(88.2％)for benign and malignant hypovascular renal tumors were relatively high when combining the diagnostic indicators of ring enhancement signs and hypoechoic.The diagnostic sensitivity(85.7％)and negative predictive value(92.3％)were relatively high when combining the 3 diagnostic indicators of ring enhancement,hypoechoic,and rapid washout.Conclusion Conventional ultrasound combined with CEUS has significant clinical practical value in the differential diagnosis of benign and malignant hypovascular renal tumors.The ring enhancement sign is highly specific in the diagnosis of malignant hypovascular renal tumors.However,if this sign is not significant and conventional ultrasound shows hypoechoic or CEUS exhibits rapid washout,there is a strong suggestion that the mass may be a malignant lesion.

Objective:To analyze the epidemiological characteristics and economic burden of palmoplantar pustulosis (PPP) in China.Methods:A population-based retrospective study was conducted using the data from China′s Urban Basic Medical Insurance data from January 1, 2012, to December 31, 2016. International Classification of Diseases code and diagnoses in Chinese for PPP were used to identify cases and estimate the prevalence, incidence, and cost. Subgroup analyses were performed according to age and sex, and sensitivity analyses were conducted to evaluate the robustness of the results. Age-adjusted prevalence rates were calculated based on the 2010 national census data.Results:The crude prevalence and incidence rate of PPP in 2016 were 2.730/100 000 (95% CI: 2.218/100 000-3.242/100 000) and 1.556/100 000 (95% CI: 1.154/100 000-1.958/100 000), and the prevalence rate of females (2.910/100 000) was higher than that of males (2.490/100 000, χ2=97.48, P=0.001). The incidence rate of females (1.745/100 000) was also higher than that of males (1.418/100 000, χ2=85.02, P=0.001). The age peak of incidence and prevalence of patients with PPP was in the 30-39-year age group and a small peak existed in the 0-3-year age group among people under 20 years old. From 2012 to 2016, the average number of visits was (2.44±0.04) per patient, and the total per-capita cost per year was (982.40±39.19) yuan. Conclusion:In 2016, the prevalence and incidence rate of PPP in China were higher in females than in males, and the highest age peak was in the 30-39-year age group.

Objective:To investigate and analyze the correlation between the expression levels of CD38, HLA-DR and programmed cell death-1 (PD-1) on peripheral blood CD8 +T cells and HIV-1 RNA viral load, immune activation and exhaustion in patients with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). Methods:A total of 81 HIV/AIDS patients (64 without antiretroviral therapy and 17 with therapy) and 40 healthy donors in the same period were enrolled as the control group. Flow cytometry was used to analyze the CD4 +T lymphocyte count and the expression levels of activation markers CD38 and HLA-DR and apoptosis marker PD-1 on CD8 +T cells. HIV-1 RNA in the plasma of HIV-1 infected patients was quantitatively detected by real-time fluorescence quantitative polymerase chain reaction. Variance analysis was used to compare the expression levels of CD38, HLA-DR and PD-1 on CD8 +T cells between HIV/AIDS patients and healthy controls. Spearman correlation analysis was used to analyze the correlation between different T lymphocyte counts and HIV RNA viral load, and the correlation between HIV RNA viral load and peripheral blood CD8 +T cell CD38, HLA-DR and PD-1. Results:Among the 81 HIV/AIDS patients, 69 (85.19%) were males and 12 (14.81%) were females, with an age M ( Q1, Q3) of 58 (36.5, 65.0) years. There were 60 HIV/AIDS patients over 55 years old (74.07%) and 21 HIV/AIDS patients between 18 and 55 years old (25.93%). The results of variance analysis showed that compared with the healthy control group, the expression levels of CD38, HLA-DR and PD-1 on CD8 +T cells in HIV/AIDS patients increased, and the differences were statistically significant (all P<0.05). In addition, the expression of CD38, HLA-DR and PD-1 increased significantly in patients with CD4 +T cell count less than 350 cells/μl, and the differences were statistically significant (all P<0.05). Spearman correlation analysis showed that CD4 +and CD4 +/CD8 +were negatively correlated with viral load in HIV/AIDS patients ( r=-0.407 and -0.378, respectively, both P<0.05), and CD8 +was positively correlated with viral load ( r=0.356, P<0.05). When the HIV RNA level was≤10 5 CPs/ml, there was no correlation between the HIV RNA level and the expression levels of CD38, HLA-DR and PD-1 on CD8 +T cells (all P>0.05). However, when the level of HIV RNA was>10 5 CPs/ml, the level of HIV RNA was positively correlated with the expression levels of CD38, HLA-DR and PD-1 on CD8 +T cells ( r=0.412, 0.387, 0.395, respectively, all P<0.05). Conclusions:The activation levels of CD38 and HLA-DR and the expression of PD-1 on CD8 +T cells in the peripheral blood of HIV/AIDS patients are increased. When the viral load is high, the HIV RNA viral load is positively correlated with the activation and exhaustion levels of CD8 +T cells.

Objective:To analyze the epidemiological characteristics and economic burden of palmoplantar pustulosis (PPP) in China.Methods:A population-based retrospective study was conducted using the data from China′s Urban Basic Medical Insurance data from January 1, 2012, to December 31, 2016. International Classification of Diseases code and diagnoses in Chinese for PPP were used to identify cases and estimate the prevalence, incidence, and cost. Subgroup analyses were performed according to age and sex, and sensitivity analyses were conducted to evaluate the robustness of the results. Age-adjusted prevalence rates were calculated based on the 2010 national census data.Results:The crude prevalence and incidence rate of PPP in 2016 were 2.730/100 000 (95% CI: 2.218/100 000-3.242/100 000) and 1.556/100 000 (95% CI: 1.154/100 000-1.958/100 000), and the prevalence rate of females (2.910/100 000) was higher than that of males (2.490/100 000, χ2=97.48, P=0.001). The incidence rate of females (1.745/100 000) was also higher than that of males (1.418/100 000, χ2=85.02, P=0.001). The age peak of incidence and prevalence of patients with PPP was in the 30-39-year age group and a small peak existed in the 0-3-year age group among people under 20 years old. From 2012 to 2016, the average number of visits was (2.44±0.04) per patient, and the total per-capita cost per year was (982.40±39.19) yuan. Conclusion:In 2016, the prevalence and incidence rate of PPP in China were higher in females than in males, and the highest age peak was in the 30-39-year age group.

Objective:To investigate and analyze the correlation between the expression levels of CD38, HLA-DR and programmed cell death-1 (PD-1) on peripheral blood CD8 +T cells and HIV-1 RNA viral load, immune activation and exhaustion in patients with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). Methods:A total of 81 HIV/AIDS patients (64 without antiretroviral therapy and 17 with therapy) and 40 healthy donors in the same period were enrolled as the control group. Flow cytometry was used to analyze the CD4 +T lymphocyte count and the expression levels of activation markers CD38 and HLA-DR and apoptosis marker PD-1 on CD8 +T cells. HIV-1 RNA in the plasma of HIV-1 infected patients was quantitatively detected by real-time fluorescence quantitative polymerase chain reaction. Variance analysis was used to compare the expression levels of CD38, HLA-DR and PD-1 on CD8 +T cells between HIV/AIDS patients and healthy controls. Spearman correlation analysis was used to analyze the correlation between different T lymphocyte counts and HIV RNA viral load, and the correlation between HIV RNA viral load and peripheral blood CD8 +T cell CD38, HLA-DR and PD-1. Results:Among the 81 HIV/AIDS patients, 69 (85.19%) were males and 12 (14.81%) were females, with an age M ( Q1, Q3) of 58 (36.5, 65.0) years. There were 60 HIV/AIDS patients over 55 years old (74.07%) and 21 HIV/AIDS patients between 18 and 55 years old (25.93%). The results of variance analysis showed that compared with the healthy control group, the expression levels of CD38, HLA-DR and PD-1 on CD8 +T cells in HIV/AIDS patients increased, and the differences were statistically significant (all P<0.05). In addition, the expression of CD38, HLA-DR and PD-1 increased significantly in patients with CD4 +T cell count less than 350 cells/μl, and the differences were statistically significant (all P<0.05). Spearman correlation analysis showed that CD4 +and CD4 +/CD8 +were negatively correlated with viral load in HIV/AIDS patients ( r=-0.407 and -0.378, respectively, both P<0.05), and CD8 +was positively correlated with viral load ( r=0.356, P<0.05). When the HIV RNA level was≤10 5 CPs/ml, there was no correlation between the HIV RNA level and the expression levels of CD38, HLA-DR and PD-1 on CD8 +T cells (all P>0.05). However, when the level of HIV RNA was>10 5 CPs/ml, the level of HIV RNA was positively correlated with the expression levels of CD38, HLA-DR and PD-1 on CD8 +T cells ( r=0.412, 0.387, 0.395, respectively, all P<0.05). Conclusions:The activation levels of CD38 and HLA-DR and the expression of PD-1 on CD8 +T cells in the peripheral blood of HIV/AIDS patients are increased. When the viral load is high, the HIV RNA viral load is positively correlated with the activation and exhaustion levels of CD8 +T cells.

Objective To investigate the clinical value of contrast-enhanced ultrasound(CEUS)in differential diagnosis between benign and malignant gallbladder lesions which diameter more than 1 cm.Methods A retrospective analysis included CEUS data of 142 cases with gallbladder lesions diameter more than 1 cm.All lesions were confirmed by surgical pathology,enhanced CT/MRI or clinical diagnosis with following up more than 2 years.To summarize the CEUS characteristics of benign and malignant gallbladder lesions over 1 cm in diameter,the CEUS characteristics of benign and malignant gallbladder lesions diameter more than 1 cm were analyzed,referring to the gallbladder CEUS guidelines.The contrast medium washout before 35 s and 60 s were used as the combined diagnosis with CEUS standard to identify gallbladder cancer,and the diagnostic efficiency was calculated respectively.Results There were statistical differences between the malignant group and the benign group in terms of CEUS enhancement pattern,contrast arrival time,washout time,and gallbladder wall continuity,as well as enhancement levels(P<0.001).The sensitivity,specificity,accuracy in the diagnosis of gallbladder malignant lesions were 93.0%,83.8%,and 86.6%based on CEUS standard.The sensitivity,specificity and accuracy of diagnosis gallbladder malignant lesions were increased to 93.0%,92.9%and 93.0%when combined with washout before 35 s of contrast medium.Conclusions CEUS is highly valuable in differentiating benign and malignant gallbladder lesions diameter more than 1 cm.Combined with contrast medium washout before 35 s is helpful to improve the ability of differentiating benign and malignant gallbladder lesions.

Objective:To compare the predictive value of contrast-enhanced ultrasound(CEUS) Liver Imaging Reporting and Date System(LI-RADS) version 2017 with magnetic resonance imaging(MRI) LI-RADS version 2018 applied alone or in combination for focal liver lesions in high-risk patients.Methods:From January 2018 to October 2021, the clinical and imaging datas of 212 patients with 300 nodules underwent CEUS and contrast-enhanced MRI(CEMRI) within 4 weeks in Ruijin Hospital and its Wuxi branch were retrospectively analyzed. Each nodule was categorized according to the CEUS LI-RADS v2017 and CT/MRI LI-RADS v2018. Inter-modalities agreement was assessed with Cohen′s Kappa. The diagnostic performances of the two classification criteria applied alone and in combination for the predictive value of malignant risk of focal liver lesions were compared using histopathology or follow-up as gold standard.Results:The inter-modalities agreement of CEUS LI-RADS v2017 and MRI LI-RADS v2018 was moderate (Kappa=0.441). The specificity of CEUS LR-5, MRI LR-5 and CEUS LR-5+ MRI LR-5 in the diagnosis of HCC was 93.66%, 95.07% and 88.73% ( P>0.05), respectively, positive predictive values of them were 93.13%, 93.81% and 89.81%( P>0.05), respectively. The sensitivity of CEUS LR-M, MRI LR-M and CEUS LR-M+ MRI LR-M in the diagnosis of non-HCC malignancy was 85.71%, 82.86% and 100%, respectively. CEUS LR-M+ MRI LR-M had higher sensitivity than MRI LR-M( P=0.033), whereas no difference was found between CEUS LR-M+ MRI LR-M and CEUS LR-M( P=0.063). Conclusions:The inter-modalities agreement of the LI-RADS category between CEUS and MRI is moderate. The specificity and positive predictive values of HCC in LR-5 of the CEUS and MRI LI-RADS are comparable. In addition, the sensitivity of non-HCC malignancy in LR-M of the CEUS and MRI LI-RADS are comparable. The combined application of CEUS and MRI LR-M can improve the diagnostic sensitivity of non-HCC malignancy.