[Objective]To investigate the depression status and its influencing factors in HIV/AIDS patients receiving antiviral therapy.[Methods]From July 2022 to September 2022,successive sampling method was used to recruit HIV/AIDS patients receiving antiviral therapy from antiviral treatment institutions in Nanjing,and they were instructed to fill out anonymous questionnaires.The questionnaire collected the basic information of patients,and depression,HIV stigma score and social support level were investigated by Patient Health Questionnaire-9(PHQ-9),Berger HIV stigma scale(BHSS)and Multidimensional Scale of Perceived Social Support(MSPSS).Multivariate Logistic regression was used to an-alyze the influencing factors of depression.[Results]A total of 1879 valid questionnaires were collected in this study,and the detection rate of depression was 50.1%.The results of multivariate logistic analysis showed that compared with patients with middle school or below,the risk of depression was lower for those with postgraduate or above[OR=0.534,95%CI(0.341,0.835),P=0.006].Compared with antiviral therapy duration<1 year,antiviral therapy duration for 1 to 5 years[OR=0.729,95%CI(0.536,0.991)],>5 to 10 years[OR=0.516,95%CI(0.379,0.702)],>10 years[OR=0.603,95%CI(0.375,0.969)]was associated with a lower risk of depression.High level of social support was a protective factor for depression in HIV/AIDS patients compared with middle and low level of social support[OR=0.430,95%CI(0.349,0.530),P<0.001].There was a higher risk of depression with side effects than without side effects[OR=2.260,95%CI(1.833,2.786),P<0.001].The higher the score on the HIV stigma scale,the higher the possibility of depression was.[Conclusion]The detection rate of depression of patients receiving antiviral therapy in Nanjing is high.After starting antivi-ral therapy,we should strengthen the monitoring of side effects and psychological status of patients,carry out psychologi-cal intervention,alleviate psychological problems,and improve the quality of life of patients receiving antiviral therapy.

Objective:To explore the value of a nomogram model based on the CT enterography (CTE) signs for prediction of intestinal penetrating lesions in patients with Crohn disease (CD).Methods:The clinical and CTE data of CD patients who underwent at least two CTE examinations from January 2010 to June 2020 in the First Affiliated Hospital of Sun Yat-sen University were retrospectively collected. A total of 112 patients were enrolled, and according to whether there was intestinal wall penetration in the last CTE observation were divided into non-penetration group (84 cases) and penetration group (28 cases). First, the clinical and CTE data for the first examination was analyzed by using univariate and multivariate Cox proportional hazards regression to screen out high-risk factors that could effectively predict intestinal wall penetrating lesions in CD patients and established a nomogram model. Then the change trend of CTE data (ΔCTE) between the first and last clinical and CTE signs was analyzed by using univariate and multivariate Cox proportional hazards regression, and built a nomogram model to sort out ΔCTE that may accompany the development of penetrating lesions in CD patients. The Harrell concordance index was used to evaluate the discriminative ability of the nomogram model.Results:In the first time clinical and CTE signs, multivariate Cox proportional hazards regression results showed that numbers of diseased bowel segments (HR=0.686, 95%CI 0.475-0.991, P=0.045) and the shortest diameter of the largest lymph node (HR=0.751, 95%CI 0.593-0.949, P=0.017) were independent protection factors for penetrating lesions, and rough bowel wall surface (HR=5.626, 95%CI 2.466-12.839, P<0.001) was an independent risk factor for penetrating lesions. The specificity and sensitivity of the nomogram model to predict non-penetration lesions were 82.1% and 59.5% respectively, and the Harrell concordance index was 0.810 (95%CI 0.732-0.888). In the ΔCTE signs, multivariate Cox proportional hazards regression showed that Δrough bowel wall surface (always rough bowel wall surface HR=12.344, 95%CI 2.042-74.625, P=0.006; slide bowel wall surface becomes rough bowel wall surface HR=28.720, 95%CI 4.580-180.112, P<0.001) and Δthe shortest diameter of the largest lymph node (HR=1.534, 95%CI 1.091-2.157, P=0.014) were independent risk factors for penetrating lesions. The specificity and sensitivity of the nomogram model were 89.3% and 79.2% respectively, and the Harrell concordance index was 0.876 (95%CI 0.818-0.934). Conclusion:The nomogram based on CTE signs of numbers of diseased bowel segments, the shortest diameter of the largest lymph node and rough bowel wall surface and ΔCTE can effectively predict the intestinal wall penetrating lesions of CD patients.

Objective:To compare the efficacy of forceful reduction percutaneous pedicle screw and ordinary percutaneous pedicle screw in the treatment of osteoporotic thoracolumbar burst fracture with kyphosis.Methods:A retrospective cohort study was conducted to analyze the clinical data of 566 patients with osteoporotic thoracolumbar burst fracture with kyphosis admitted to Honghui Hospital, Xi ′an Jiaotong University from January 2015 to December 2018, including 191 males and 375 females, with age range of 48-79 years [(61.7±10.7)years]. Fracture segments were located at T 11 in 134 patients, T 12 in 154, L 1 in 160, and L 2 in 118. All fractures were type IIIA according to the acute symptomatic osteoporotic thoracolumbar fracture classification (ASOTLF). The thoracolumbar osteoporotic fracture severity score assessment system (TLOFSAS) score was ≥5 points. A total of 275 patients underwent forceful reduction and percutaneous pedicle screw internal fixation (forceful reduction screw group), and 291 patients underwent common percutaneous pedicle screw internal fixation (common screw group). The operation time, intraoperative blood loss, times of X-ray exposure on patients and measures documented before operation, at 3 days after operation and at 2 years after operation including anterior height ratio of the injured vertebrae, sagittal Cobb angle of the injured vertebrae, Japanese Orthopaedic Association (JOA) score and visual analog scale (VAS) were compared between the two groups. Moreover, degree of correction of Cobb angle at 3 days after operation, loss of correction of Cobb angle at 2 years after operation and postoperative complications were observed. Results:All patients were followed up for 25-34 months [(29.9±3.4)months]. The operation time, intraoperative blood loss and times of X-ray exposure on patients in forceful reduction screw group were (69.4±10.2)minutes, (60.3±13.1)ml and (26.8±3.7)times, less than (80.6±11.9)minutes, (80.7±15.4)ml and (30.4±3.4)times in common screw group (all P<0.01). There was no significant difference in anterior height ratio of the injured vertebrae between the two groups before operation and at 3 days after operation (all P>0.05). The anterior height ratio of the injured vertebrae in forceful reduction screw group was (95.5±2.3)% at 2 years after operation, significantly higher than (85.4±1.7)% in common screw group ( P<0.01). There was no significant difference in sagittal Cobb angle of the injured vertebrae between the two groups before operation ( P>0.05). The sagittal Cobb of the injured vertebrae in forceful reduction screw group at 3 days and 2 years after operation were (7.9±1.6)° and (8.8±1.5)°, lower than (10.6±1.1)° and (12.3±1.2)° in common screw group ( P<0.05 or 0.01). There were no significant difference in JOA score and VAS between the two groups before operation, at 3 days and at 2 years after operation (all P>0.05). The degree of correction of Cobb angle in forceful reduction screw group was (19.4±2.5)°, higher than (17.3±2.6)° in common screw group ( P<0.05). The loss of correction of Cobb angle in forceful reduction group was less than that in common screw group at 2 years after operation, but the difference was not statistically significant ( P>0.05). The incidence of postoperative complications in forceful reduction screw group was 12.4% (34/275), compared to 14.1% (41/291) in common screw group ( P>0.05). There were no complications such as iatrogenic nerve injury, fracture or loosening of internal fixator or leakage of bone cement in the spinal canal in both groups. Conclusions:For osteoporotic thoracolumbar burst fracture with kyphosis, forceful reduction and percutaneous pedicle screw internal fixation can significantly shorten operation time, reduce intraoperative blood loss and times of X-ray exposure on patients, restore height of the injured vertebrae, correct kyphosis and maintain reduction height of the injured vertebrae in contrast with conventional percutaneous pedicle screw internal fixation.

Objective:To investigate the efficacy of flexion-lateral curvature-supination reduction combined with primary anterior surgery for the treatment of lower cervical dislocation with unilateral facet inter-locking.Methods:A retrospective analysis was performed in the 32 patients who had been admitted to Department of Spine Surgery, Honghui Hospital for lower cervical dislocation with unilateral facet interlocking from November 2015 to October 2018. According to their treatments, they were divided into 2 groups. In the emergency group treated by flexion-lateral curvature-supination reduction combined with primary anterior surgery, there were 13 males and 3 females, aged from 24 to 63 years. In the traction group treated by cranial traction reduction combined with secondary anterior surgery, there were 12 males and 4 females, aged from 20 to 64 years. The operation time, intraoperative blood loss, hospital stay, bone graft fusion, American Spinal Injury Association (ASIA) grade and Japanese Orthopaedic Association (JOA) score were compared between the 2 groups.Results:There was no significant difference in the preoperative general data between the 2 groups, showing they were comparable ( P<0.05). All patients were followed up from 26 to 40 months. The hospital stay for the emergency group [(7.2±1.2) d] was significantly shorter than that for the traction group[(10.9±1.2) d] ( P<0.05). There was no significant difference in the operation time, blood loss, ASIA grade or JOA score between the 2 groups ( P>0.05). All patients achieved osseous fusion of intervertebral space. Conclusion:Compared with traditional methods, flexion-lateral curvature-supination reduction combined with primay anterior surgery shows no significant difference in the recovery of neurological function but leads to a shorter hospital stay.

To predict the epidemiological trend of coronavirus disease 2019 (COVID-19) by mathematical modeling based on the population mobility and the epidemic prevention and control measures. : As of February 8，2020，the information of 151 confirmed cases in Yueqing，Zhejiang province were obtained，including patients' infection process，population mobility between Yueqing and Wuhan，etc. To simulate and predict the development trend of COVID-19 in Yueqing, the study established two-stage mathematical models，integrating the population mobility data with the date of symptom appearance of confirmed cases and the transmission dynamics of imported and local cases. : It was found that in the early stage of the pandemic，the number of daily imported cases from Wuhan (using the date of symptom appearance) was positively associated with the number of population travelling from Wuhan to Yueqing on the same day and 6 and 9 days before that. The study predicted that the final outbreak size in Yueqing would be 170 according to the number of imported cases estimated by consulting the population number travelling from Wuhan to Yueqing and the susceptible-exposed-infectious-recovered (SEIR) model; while the number would be 165 if using the reported daily number of imported cases. These estimates were close to the 170，the actual monitoring number of cases in Yueqing as of April 27，2020. : The two-stage modeling approach used in this study can accurately predict COVID-19 epidemiological trend.
COVID-19 ; China/epidemiology* ; Disease Outbreaks ; Humans ; Models, Theoretical ; Pandemics ; SARS-CoV-2

Objective:To explore the proportion of obstructive sleep apnea (OSA) in primary aldosteronism (PA) in Chinese population and compare the clinical characteristics between PA patients with OSA and those without.Methods:A total of 96 patients diagnosed with PA from September 2015 to November 2018 were recruited in this study. OSA was screened by cardio-respiratory polygraphy. According to the apnea hypopnea index (AHI), the patients were divided into PA with OSA group (AHI ≥5 times) and PA without OSA group (AHI<5 times).Results:Among all patients (96), 69 (71.9%) were with OSA, among them 22 patients (22.9%) were with mild OSA, 17 patients (17.7%) were with moderate OSA and 30 patients (31.3%) were with severe OSA. Compared with the patients without OSA, the patients with OSA were elder, and had higher levels of body mass index (BMI), waist circumference (WC), hip circumference (HC), creatinine (CR) and glycosylated haemoglobin (HbA1c) ( P<0.05), but lower concentrations of plasma aldosterone (PAC), supine aldosterone renin concentration ratio(ARR) and the PAC after the diagnosis test ( P<0.05). Spearman correlation analyses showed that BMI, WC, HC, CR and HbA1c were positively correlated with AHI ( P<0.05), while high-density lipoproteincholesterol (HDL-C), supine-PAC and saline infusion test(SIT)-post PAC were negatively correlated with AHI ( P<0.05). Conclusions:The proportion of OSA in PA patients is relatively high (71.9%). Metabolic abnormalities are more common in PA patients with OSA, indicating that screening for OSA should be carried out routinely in PA patients.

Objective To investigate the hydrophilic chemical constituents from Thesium Chinensis Turcz.Methods The water extract of Thesium Chinensis Turcz.was adsorbed onto AB-8 resin column and eluted with 50% ethanol to give the hydrophilic portion TT50.TT50 was further separated and purified by repeated column chromatography on silica gel,Sephadex LH-20.The structures of these purified compounds were identified by NMR spectral analysis and comparison with the reported data.Results Six compounds were isolated and identified as kaempferol(1),kaempferol-3-O-glucoside(2),kaepmferol-3,7-di-O-β-D-glucopyranoside(3),kaempferol-3-O-L-rhamnopyranosyl(1 → 2)-β-D-glucopyranoside(4),kaemperol-3-O-α-L-rham-nopyranosyl(1→2)-[6-O-acetyl]-β-D-glucopyranoside(5),rutinoside(6).Conclusion The main constituents of TT50 were kaempferol glycosides.Compounds 4 and 5 were isolated from this plant for the first time.

Objective To study the clinical situation of neonates with mechanical ventilation complicated with respiratory tract infection.Methods Fifty neonates treated in our hospital were selected,and the difference of respiratory tract infection patients were compared,and pathogen of the respiratory tract infection of neonates was culture,and cultured pathogen was analyzed.Results Out of 50 neonates with respiratory tract infection,32 cases (64.00％) occurred respiratory tract infection.The pathogen and drug sensitivity test showed there were six pathogens,among which Escherichia coli,Klebsiella pneumoniae,Pseudomonas aeruginosa were commonly seen,but there was no significant difference among these pathogens (P ＞ 0.05).Gram-negative bacteria was more common,drug susceptibility results showed that it had higher sensitivity to ciprofloxacin,imipenem.Newborns with 3 ～7 d,＞ 7 d mechanical ventilation had higher respiratory tract infection than those with ＜ 1 d,1 ～ 3 d (P ＜ 0.05).The incidence of respiratory tract infection in premature infants was higher than that in full term infants,but there was no significant difference between the two groups (P ＞ 0.05).After antibiotics and symptomatic treatment,34 cases were cured,14 cases quitted the treatment due to severe illness or economic pressure,and 2 patients were died (P ＞ 0.05).Conclusion The pathogenesis of respiratory tract infection is mainly Gram-negative bacteria,and the incidence of respiratory infection is closely correlated to time of mechanical ventilation.Therefore,drug sensitivity test,antibiotics application should be done in clinic,and the ventilator can be evacuated as soon as possible.

Objective To study the clinical situation of neonates with mechanical ventilation complicated with respiratory tract infection.Methods Fifty neonates treated in our hospital were selected,and the difference of respiratory tract infection patients were compared,and pathogen of the respiratory tract infection of neonates was culture,and cultured pathogen was analyzed.Results Out of 50 neonates with respiratory tract infection,32 cases (64.00％) occurred respiratory tract infection.The pathogen and drug sensitivity test showed there were six pathogens,among which Escherichia coli,Klebsiella pneumoniae,Pseudomonas aeruginosa were commonly seen,but there was no significant difference among these pathogens (P ＞ 0.05).Gram-negative bacteria was more common,drug susceptibility results showed that it had higher sensitivity to ciprofloxacin,imipenem.Newborns with 3 ～7 d,＞ 7 d mechanical ventilation had higher respiratory tract infection than those with ＜ 1 d,1 ～ 3 d (P ＜ 0.05).The incidence of respiratory tract infection in premature infants was higher than that in full term infants,but there was no significant difference between the two groups (P ＞ 0.05).After antibiotics and symptomatic treatment,34 cases were cured,14 cases quitted the treatment due to severe illness or economic pressure,and 2 patients were died (P ＞ 0.05).Conclusion The pathogenesis of respiratory tract infection is mainly Gram-negative bacteria,and the incidence of respiratory infection is closely correlated to time of mechanical ventilation.Therefore,drug sensitivity test,antibiotics application should be done in clinic,and the ventilator can be evacuated as soon as possible.

Objective To understand the prevalence of unsafe riding practice among electric bicycle riders,and to provide scientific basis for intervention strategies in Ma'anshan city of Anhui Province.Methods Observational method was used to observe electric bicycle riders' behavior of running red light,wearing a helmet,and manned act.The radar speed measuring instrument was used to measure the speed of electric bicycle.Results The rate of electric bicycle riders' running red light was 13.09％ (1 285/9 815),helmet wearing rate was 5.90％ (1 510/25 576),and manned rate was 20.28％ (5 187/25 576).The average speed was 24 ki/h,and the electric bicycles whose speed were ＞ 20 km/h accounted for 74.60％.There were significant differences in the running red light rate,helmet wearing rate and the average speed of travel among different time periods and dates (all P ＜ 0.05).More running the red light occurred during 13:30-14:30 and 15:00-16:00.Less helmet wearing occurred during 10:00-11:00 and 08:30-09:30.The periods with highest average speed were at07:00-08:00,08:30-09:30,11:30-12:30,and 13:30-14:30,which was 24 km/h.The helmet wearing rate of females (6.54％) was higher than that of males(5.46％),the men's average speed (24 km/h) was higher than women's (23 ki/h),and the differences were both statistically significant(all P ＜ 0.001).Conclusion The electric bicycle riders in Ma'anshan city of Anhui Province have the dangerous behavior of running red lights,not wearing a helmet,manned act and speeding.Targeted interventions should be taken to reduce the occurrence of related risk behaviors.