Effectiveness of onsite and online education in enhancing knowledge and use of human immunodeficiency virus pre-and postexposure prophylaxis

BACKGROUND Enhancing awareness and use of pre-exposure prophylaxis(PrEP)and postexposure prophylaxis(PEP)is vital to curb human immunodeficiency virus(HIV)spread.High-risk behaviors prevalent among sexually transmitted infection clinic outpatients underscore the need for increased PrEP/PEP education in this group.AIM To investigate the effects of both onsite and online health education on the knowledge of,and willingness to use,PrEP and PEP among individuals receiving PEP services.METHODS Participants were drawn from a cohort study on PEP service intervention at an STD/AIDS outpatient clinic in designated HIV/AIDS hospitals in Beijing,conducted from January 1 to June 30,2022.Health education was provided both onsite and online during follow-up.Surveys assessing knowledge of,and willingness to use,PrEP/PEP were administered at baseline and again at 24 wk post-intervention.RESULTS A total of 112 participants were enrolled in the study;105 completed the follow-up at week 24.The percentage of participants with adequate knowledge of,and willingness to use,PrEP significantly increased from 65.2%and 69.6%at baseline to 83.8%and 82.9%at the end of the intervention(both P<0.05).Similarly,those with adequate knowledge of,and willingness to use,PEP increased from 74.1%and 77.7%at baseline to 92.4%and 89.5%at week 24(P<0.05).Being between 31 years and 40 years of age,having a postgraduate degree or higher,and reporting a monthly expenditure of RMB 5000 or more were found to be significantly associated with knowledge of PrEP and PEP(both P<0.05).CONCLUSION The findings show that both onsite and online health education significantly improved the knowledge of,and increased willingness to use,PrEP and PEP in individuals utilizing PEP services.

Modeling the hydration,viscosity and ultrasonic property evolution of class G cement up to 90℃ and 200 MPa by a scale factor method

A comprehensive experimental program has been performed to characterize the hydration and engineering property evolution of a class G oil well cement under various curing temperatures from 30 to 90℃.The progress of hydration was monitored by isothermal calorimetry(atmospheric pressure);the viscosity evolution was measured using a high temperature and high pressure consistometer(up to 200 MPa);the ultrasonic property development was evaluated by an ultrasonic cement analyzer(up to 100 MPa).Test results indicate that the influences of curing temperature and pressure on the hydration,viscosity and ultrasonic property development can be modeled by a scale factor method that is similar to the maturity method used in the concrete industry.However,the key parameters of the scale factor model,namely the apparent activation energy and the apparent activation volume of cement showed obvious variations with test method and curing condition.The test results indicate that the curing temperature has a stronger effect on cement hydration rate than viscosity and ultrasonic property development rate,while the curing pressure has a much stronger influence on cement slurry properties before setting(viscosity)than after setting(ultrasonic property).

不同病程的2型糖尿病患者血清胆红素、25(OH)D3水平与胰岛素抵抗的相关性分析

目的探讨不同病程的2型糖尿病(T2DM)患者血清胆红素、25(OH)D3水平与胰岛素抵抗(IR)的相关性。方法选取2016年5月—2018年8月于秦皇岛市第一医院内分泌科就诊的171例T2DM患者作为研究对象。根据糖尿病病程分为T2DM-1组、T2DM-2组及T2DM-3组,分别测定TBIL、IBIL、DBIL、25(OH)D3等指标水平。采用Pearson相关性分析上述各指标与稳态胰岛素评价指数(HOMA-IR)的相关性,并采用多元线性回归分析IR的危险因素。结果T2DM-3组病程、SBP、DBP、LDL、FPG、2hPG、HbA1c、HOMA-IR及CRP较T2DM-1组和T2DM-2组高(P<0.05),FINS、TBIL、DBIL、IBIL及25(OH)D3较T2DM-1组和T2DM-2组低(P<0.05)。Pearson相关性分析显示,HOMAIR与BMI、CRP呈正相关(r=0.199和0.178,P<0.05),与25(OH)D3、DBIL呈负相关(r=-0.373和-0.346,P<0.05)。多元线性回归分析显示,25(OH)D3、DBIL是影响HOMA-IR的独立因素(P<0.05)。结论病程5~10年的T2DM患者存在IR、血脂及血压紊乱,患心血管疾病风险增加,DBIL、维生素D水平下降,CRP升高,机体慢性低度炎症水平升高,且25(OH)D3、DBIL是影响该类患者IR的独立因素。

On-treatment monitoring of liver fibrosis with serum hepatitis B core-related antigen in chronic hepatitis B

BACKGROUND Non-invasive evaluation for liver fibrosis is clinically important,especially in patients with undetectable hepatitis B virus(HBV)DNA treated with nucleoside analogs.AIM To clarify the monitoring power of hepatitis B core-related antigen(HBcrAg)for hepatic histologic changes in patients with chronic hepatitis B(CHB)treated with entecavir.METHODS This prospective multicenter study used multiple ordinal and multivariate logistics regression analysis to assess variables associated with Ishak fibrosis score and regression for fibrosis regression,respectively,in 403 CHB patients,including 374 with entecavir for 72 weeks(291 underwent paired liver biopsy)and 29 as controls.RESULTS Level of HBcrAg correlated negatively with liver fibrosis staging(γ=-0.357,P<0.001)in hepatitis B e antigen(HBeAg)-positive patients,and positively with liver fibrosis staging in HBeAg-negative patients.Higher HBcrAg concentration was associated with younger age,HBeAg positive status,high HBV DNA loads,high level of hepatitis B surface antigen(HBsAg)and higher necroinflammation,but not with HBV genotype.Serum concentration of HBcrAg,basal core promoter/precore(BCP/PC)mutant,quantitation of HBsAg(qHBsAg)and platelet counts were independently associated with Ishak fibrosis score on multiple ordinal regression.HBV DNA was undetectable in 88.37%of patients treated with entecavir at week 72,while their level of HBcrAg was still detectable.A greater reduction in post-treatment HBcrAg concentration was associated with the regression of hepatic fibrosis and histological improvement.HBcrAg concentration>6.33 log IU/mL at baseline and logarithmic reduction>1.03 log IU/mL at week 72 were associated with a higher chance of regression of liver fibrosis and histological improvement,respectively.CONCLUSION HBcrAg level is associated with liver fibrosis progression.HBcrAg is an excellent monitor of hepatic histological changes,especially in CHB patients treated with nucleoside analogs.

Efficacy and safety of the long-acting fusion inhibitor albuvirtide in antiretroviral-experienced adults with human immunodeficiency virus-1:interim analysis of the randomized,controlled,phase 3,non-inferiority TALENT study

Background:Albuvirtide is a once-weekly injectable human immunodeficiency virus(HIV)-1 fusion inhibitor.We present interim data for a phase 3 trial assessing the safety and efficacy of albuvirtide plus lopinavir-ritonavir in HIV-1-infected adults already treated with antiretroviral drugs.Methods:We carried out a 48-week,randomized,controlled,open-label non-inferiority trial at 12 sites in China.Adults on the World Health Organization(WHO)-recommended first-line treatment for>6 months with a plasma viral load>1000 copies/mL were enrolled and randomly assigned(1:1)to receive albuvirtide(once weekly)plus ritonavir-boosted lopinavir(ABT group)or the WHO-recommended second-line treatment(NRTI group).The primary endpoint was the proportion of patients with a plasma viral load below 50 copies/mL at 48 weeks.Non-inferiority was prespecified with a margin of 12%.Results:At the time of analysis,week 24 data were available for 83 and 92 patients,and week 48 data were available for 46 and 50 patients in the albuvirtide and NRTI groups,respectively.At 48 weeks,80.4%of patients in the ABT group and 66.0%of those in the NRTI group had HIV-1 RNA levels below 50 copies/mL,meeting the criteria for non-inferiority.For the per-protocol population,the superiority of albuvirtide over NRTI was demonstrated.The frequency of grade 3 to 4 adverse events was similar in the two groups;the most common adverse events were diarrhea,upper respiratory tract infections,and grade 3 to 4 increases in triglyceride concentration.Renal function was significantly more impaired at 12 weeks in the patients of the NRTI group who received tenofovir disoproxil fumarate than in those of the ABT group.Conclusions:The TALENT study is the first phase 3 trial of an injectable long-acting HIV drug.This interim analysis indicates that once-weekly albuvirtide in combination with ritonavir-boosted lopinavir is well tolerated and non-inferior to the WHO-recommended second-line regimen in patients with first-line treatment failure.Trial registration:ClinicalTrials.gov Identifier:NCT02369965;https://www.clinicaltrials.gov.Chinese Clinical Trial Registry No.ChiCTR-TRC-14004276;http://www.chictr.org.cn/enindex.aspx.

Purinergic 2X7Receptor is Involved in the Podocyte Damage of Obesity-Related Glomerulopathy via Activating Nucleotide-Binding and Oligomerization Domain-Like Receptor Protein 3 Inflammasome

Background:The nucleotide-binding and oligomerization domain-like receptor protein 3 (NLRP3) inflammasome composed of NLRP3,apoptosis-associated speck-like protein containing CARD (ASC),and caspase-1 is engaged in the inflammatory response of many kidney diseases and can be activated by purinergic 2X7 receptor (P2X7R).This study was conducted to explore whether P2X7R plays a pathogenic role in the podocyte damage of obesity-related glomerulopathy (ORG) and whether this role is mediated by the activation ofNLRP3 inflammasome.Methods:A mouse model of ORG was established by high-fat diet feeding.The conditionally immortalized mouse podocytes were cultured with leptin or with leptin and P2X7R antagonist (KN-62 or A438079).The mRNA and protein expression of the P2X7R and NLRP3 inflammasome components including NLRP3,ASC,and caspase-1,as well as the podocyte-associated molecules including nephrin,podocin,and desmin in mouse renal cortex or cultured mouse podocytes were tested by real-time-polymerase chain reaction and Westem blot analysis,respectively.Results:The significantly upregulated expression of P2X7R and NLRP3 inflammasome components and the NLRP3 inflammasome activation were observed in the renal cortex (in fact their location in podocytes was proved by confocal microscopy) of ORG mice in vivo,which were accompanied with the morphological changes of podocyte damage and the expression changes of podocyte-associated molecules.Similar changes in the expression of P2X7R and NLRP3 inflammasome components as well as in the expression ofpodocyte-associated molecules were also observed in the cultured podocyte studies treated by leptin in vitro,and all of the above changes were significantly attenuated by the P2X7R antagonist KN-62 or A438079.Conclusions:P2X7R could trigger the activation ofNLRP3 inflammasome,and the activated P2X7R/NLRP3 inflammasome in podocytes might be involved in the podocyte damage of ORG.

中国杭州市重症监护室34例COVID-19患者临床特点的分析

目的:本研究拟总结2020年1月22日至3月5日在中国杭州浙江大学医学院附属第一医院重症监护病房(ICU)收治的34例2019冠状病毒病(COVID-19)患者的临床和实验室特征。创新点:本研究比较了COVID-19患者有创机械通气组(IMV)与无创氧疗组(NIV)的临床和化验室特征,并探讨了两组患者间化验室指标的动态变化的差异。方法:纳入研究期间入住我院ICU的新冠肺炎重症患者,收集所有患者临床资料和化验室资料。根据是否接受有创机械通气将患者分为IMV组和NIV组。比较两组的临床特征参数,并动态观察两组化验室指标的变化。结论:NIV组患者急性肝、心、肾并发症发生率较高。两组患者在入院时均出现淋巴细胞减少,但随着病情进展IMV组出现更严重的淋巴细胞减少症。与B淋巴细胞相比,两组T淋巴细胞计数均更明显低于正常值下限。入院时,两组患者的血浆白介素-6(IL-6)水平均高于正常值上限。随着时间的推移,NIV组患者的IL-6水平下降更多。住院期间IMV组患者的血小板、血红蛋白、血尿素氮、凝血酶原时间、D-二聚体、乳酸脱氢酶和IL-6水平均高于NIV患者。

Localization Analysis of Heterophilic Antigen Epitopes of H1N1 Influenza Virus Hemagglutinin

Previous studies have indicated that two monoclonal antibodies(mAbs;A1-10 and H1-84)of the hemagglutinin(HA)antigen on the H1N1 influenza virus cross-react with human brain tissue.It has been proposed that there are heterophilic epitopes between the HA protein and human brain tissue(Guo et al.in Immunobiology 220:941-946,2015).However,characterisation of the two mAbs recognising the heterophilic epitope on HA has not yet been performed.In the present study,the common antigens of influenza virus HA were confirmed using indirect enzyme-linked immunosorbent assays and analysed with DNAMAN software.The epitopes were localized to nine peptides in the influenza virus HA sequence and the distribution of the peptides in the three-dimensional structure of HA was determined using PyMOL software.Key amino acids and variable sequences of the antibodies were identified using abYsis software.The results demonstrated that there were a number of common antigens among the five influenza viruses studied that were recognised by the mAbs.One of the peptides,P2(LVLWGIHHP191-199),bound both of the mAbs and was located in the head region of HA.The key amino acids of this epitope and the variable regions in the heavy and light chain sequences of the mAbs that recognised the epitope are described.A heterophilic epitope on H1N1 influenza virus HA was also introduced.The existence of this epitope provides a novel perspective for the occurrence of nervous system diseases that could be caused by influenza virus infection,which might aid in influenza prevention and control.

Preliminary Research on the Effect of Linolenic Acid on Human Oocyte Maturation

Objective:To investigate the effects of exogenousα-linolenic acid(ALA)on in vitro maturation(IVM)and developmental competence of human oocytes.Methods:Experiment 1 examined the effects of ALA at different concentrations(0[control],10,50,100,and 200μmol/L)in the IVM medium on oocyte maturation.Treatment with 50μmol/L ALA significantly accelerated oocyte maturation(P<0.05)and resulted in significantly higher mitochondrial DNA(mtDNA)copy number compared to the control.Hence,50μmol/L ALA was selected for combination with follicular fluid(FF)to investigate oocyte developmental potential.mtDNA of the matured oocyte was analyzed by real-time polymerase chain reaction.Experiment 2 investigated the effects of FF with optimal ALA concentration(Group A:ALA+FF+IVM medium)or without ALA(Group B:FF+IVM medium)on oocyte maturation,fertilization,2 pronuclear cleavage,and embryo and blastocyst development.Malondialdehyde(MDA)content and superoxide dismutase(SOD)activity were measured for maturation medium from Group A,Group B,and Group C(control group,IVM medium only).Results:Treatment with 50μmol/L ALA obviously accelerated oocyte maturation(P<0.05)and resulted in significantly higher mtDNA copy number(P<0.05)in the matured oocytes compared to the control(0μmol/L ALA).Supplementation of 50μmol/L ALA and FF(Group A)obviously increased the total maturation rate than FF-treated group(Group B)which has higher(P<0.05)total maturation rate than that of Group C.However,no significant differences were observed in fertilization,embryo availability,and blastocyst production among Group A,B,and C.Treatment with 50μmol/L ALA decreased the level of MDA(P<0.05),but had no effect on the activity of SOD in the IVM medium.Conclusions:Our results suggested that the treatment with 50μmol/L ALA during IVM improves maturation in human oocytes.It is also likely to improve embryo availability and blastocyst formation.This might be associated with the alteration of mtDNA replication(increased mtDNA copy number)and the reduction of oxidative stress(reduced MDA level).

Precise measurement of attenuation length of the JUNO liquid scintillator

Introduction The Jiangmen Underground Neutrino Observatory has critical requirements on quality of the liquid scintillator,one of which is long attenuation length.Purpose A system with a height of 3 m is used to precisely measure the attenuation length of the liquid scintillators.Methods The light generated by a LED is transmitted through an optical fiber.After being focused,filtered and collimated,the light enters the test tube with the liquid scintillator and is detected by the PMT.The stepping motor is controlled by the Labview program to adjust the level of the liquid scintillator,and the emitted light intensity of different liquid levels can be obtained to fit the attenuation length.In addition,the systematic errors have been studied,which includes the measurement error of the emitted light intensity and the error caused by the movement of light spot,and the latter is responded to the non-uniformity of the PMT photocathode.Meanwhile,analytical methods were improved.Results The system can measure the attenuation length stably and a small error was obtained,including statistical error and systematic error(0.69-23.70 m).

Disaster effects of climate change in High Mountain Asia:State of art and scientific challenges Disaster effects of climate change in High Mountain Asia:State of art and scientific challenges

High Mountain Asia(HMA)shows a remarkable warming tendency and divergent trend of regional precipitation with enhanced meteorological extremes.The rapid thawing of the HMA cryosphere may alter the magnitude and frequency of nature hazards.We reviewed the influence of climate change on various types of nature hazards in HMA region,including their phenomena,mechanisms and impacts.It reveals that:1)the occurrences of extreme rainfall,heavy snowfall,and drifting snow hazards are escalating;accelerated ice and snow melting have advanced the onset and increased the magnitude of snowmelt floods;2)due to elevating trigger factors,such as glacier debuttressing and the rapid shift of thermal and hydrological regime of bedrock/snow/ice interface or subsurface,the mass flow hazards including bedrock landslide,snow avalanche,ice-rock avalanches or glacier detachment,and debris flow will become more severe;3)increased active-layer detachment and retrogressive thaw slumps slope failures,thaw settlement and thermokarst lake will damage many important engineering structures and infrastructure in permafrost region;4)multi-hazards cascading hazard in HMA,such as the glacial lake outburst flood(GLOF)and avalanche-induced mass flow may greatly enlarge the destructive power of the primary hazard by amplifying its volume,mobility,and impact force;and 5)enhanced slope instability and sediment supply in the highland areas could impose remote catastrophic impacts upon lowland regions,and threat hydropower security and future water shortage.In future,ongoing thawing of HMA will profoundly weaken the multiple-phase material of bedrock,ice,water,and soil,and enhance activities of nature hazards.Compounding and cascading hazards of high magnitude will prevail in HMA.As the glacier runoff overpasses the peak water,low flow or droughts in lowland areas downstream of glacierized mountain regions will became more frequent and severe.Addressing escalating hazards in the HMA region requires tackling scientific challenges,including understanding multiscale evolution and formation mechanism of HMA hazard-prone systems,coupling thermo‒hydro‒mechanical processes in multi-phase flows,predicting catastrophes arising from extreme weather and climate events,and comprehending how highland hazards propagate to lowlands due to climate change.