BACKGROUND With the continuous development and progress of medical technology,the position of surgical nursing in the field of clinical medicine is becoming in-creasingly prominent.As an important branch of the surgic...BACKGROUND With the continuous development and progress of medical technology,the position of surgical nursing in the field of clinical medicine is becoming in-creasingly prominent.As an important branch of the surgical field,the nursing requirements and difficulty of gastrointestinal surgery are also increasing.In order to improve the teaching quality of nursing care in gastrointestinal surgery,many educators and researchers are actively exploring new teaching methods.Among them,the teaching method case-based learning(CBL),scene-simulated learning(SSL),task-based learning(TBL),combining self-evaluation and training mode is considered as an effective method.This method aims to help students to better master knowledge and skills and improve their comprehensive quality by cultivating their self-evaluation ability.AIM To explore the practical effect of CBL-SSL-TBL combined with training mode and student self-assessment in nursing teaching of gastrointestinal surgery.METHODS Seventy-one nursing interns in our hospital from December 2020 to December 2021 were selected.According to different teaching modes,they were divided into observation group CBL-SSL-TBL combined with training mode combined with student self-assessment and control group(conventional teaching mode),of which 36 were in observation group and 35 were in control group.The results of operational skills,theoretical knowledge,nursing students'satisfaction,learning effectiveness questionnaire and teaching effect were compared between the two groups.RESULTS Compared between the two groups,the operational skills and theoretical knowledge scores of the observation group were higher than those of the control group,and the difference was statistically significant(P<0.05).Compared between the two groups,the total satisfaction ratio of the observation group was higher than that of the control group,the difference was statistically significant(P<0.05).Compared between the two groups,the observation group was lower than the control group in the questionnaire results of learning efficacy,and the difference was statistically significant(P<0.05).Compared between the two groups,the proportion of thinking ability,subjective initiative and understanding of theoretical knowledge in the observation group was higher than that in the control group,the difference was statistically significant(P<0.05).CONCLUSION The use of CBL-SSL-TBL combined with training mode and student self-assessment in gastrointestinal surgery nursing teaching can improve the operational skills of nursing interns,theoretical knowledge and satisfaction scores of nursing students,improve the results of learning efficiency questionnaire and teaching effect,which can be popularized in clinical teaching.展开更多
Summary What is already known about this topic?The World Health Organization(WHO)has recommended the inclusion of the C-reactive protein(CRP)test in active tuberculosis(ATB)screening algorithms among human immunodefic...Summary What is already known about this topic?The World Health Organization(WHO)has recommended the inclusion of the C-reactive protein(CRP)test in active tuberculosis(ATB)screening algorithms among human immunodeficiency virus(HIV)-infected individuals.The performance of the CRP test in African regions has been well-documented.What is added by this report?This study analyzed data from a big data platform of Shanghai medical records together with infectious disease surveillance systems.展开更多
We study the behaviors of three-dimensional double and triple Weyl fermions in the presence of weak random potential.By performing the Wilsonian renormalization group(RG)analysis,we reveal that the quasiparticle exper...We study the behaviors of three-dimensional double and triple Weyl fermions in the presence of weak random potential.By performing the Wilsonian renormalization group(RG)analysis,we reveal that the quasiparticle experiences strong renormalization which leads to the modification of the density of states and quasiparticle residue.We further utilize the RG analysis to calculate the classical conductivity and show that the diffusive transport is substantially corrected due to the novel behavior of the quasiparticle and can be directly measured by experiments.展开更多
We report an exact numerical study on disorder effect in double-Weyl semimetals,and compare exact numerical solutions for the quasiparticle behavior with the Born approximation and renormalization group results.It is ...We report an exact numerical study on disorder effect in double-Weyl semimetals,and compare exact numerical solutions for the quasiparticle behavior with the Born approximation and renormalization group results.It is revealed that the low-energy quasiparticle properties are renormalized by multiple-impurity scattering processes,leading to apparent power-law behavior of the self-energy.Therefore,the quasiparticle residue surrounding nodal points is considerably reduced and vanishes as ZE∝Er with nonuniversal exponent.We show that such unusual behavior of the quasiparticle leads to strong temperature dependence of diffusive conductivity.Remarkably,we also find a universal minimum conductivity along the direction of linear dispersion at the nodal point,which can be directly observed by experimentalist.展开更多
Background:Y-box binding protein 1(YB1 or YBX1)plays a critical role in tumorigenesis and cancer progression.However,whether YB1 affects malignant transformation by modulating non-codingRNAs remains largely unknown.Th...Background:Y-box binding protein 1(YB1 or YBX1)plays a critical role in tumorigenesis and cancer progression.However,whether YB1 affects malignant transformation by modulating non-codingRNAs remains largely unknown.This study aimed to investigate the relationship between YB1 and microRNAs and reveal the underlying mechanism by which YB1 impacts on tumor malignancy via miRNAs-mediated regulatory network.Methods:The biological functions of YB1 in hepatocellular carcinoma(HCC)cells were investigated by cell proliferation,wound healing,and transwell invasion assays.The miRNAs dysregulated by YB1 were screened by microarray analysis in HCC cell lines.The regulation of YB1 on miR-205 and miR-200b was determined by quantitative real-time PCR,dual-luciferase reporter assay,RNA immunoprecipitation,and pull-down assay.The relationships of YB1,DGCR8,Dicer,TUT4,and TUT1 were identified by pull-down and coimmunoprecipitation experiments.The cellular co-localization of YB1,DGCR8,and Dicer were detected by immunofluorescent staining.The in vivo effect of YB1 on tumor metastasis was determined by injecting MHCC97H cells transduced with YB1 shRNA or shControl via the tail vein in nude BALB/c mice.The expression levels of epithelial tomesenchymal transition markerswere detected by immunoblotting and immunohistochemistry assays.Results:YB1 promoted HCC cell migration and tumor metastasis by regulating miR-205/200b‒ZEB1 axis partially in a Snail-independent manner.YB1 suppressedmiR-205 and miR-200b maturation by interacting with the microprocessors DGCR8 and Dicer as well as TUT4 and TUT1 via the conserved cold shock domain.Subsequently,the downregulation of miR-205 and miR-200b enhanced ZEB1 expression,thus leading to increased cell migration and invasion.Furthermore,statistical analyses on gene expression data from HCC and normal liver tissues showed that YB1 expression was positively associated with ZEB1 expression and remarkably correlated with clinical prognosis.Conclusion:This study reveals a previously undescribed mechanism by which YB1 promotes cancer progression by regulating the miR-205/200b‒ZEB1 axis in HCC cells.Furthermore,these results highlight that YB1 may play biological functions via miRNAs-mediated gene regulation,and it can serve as a potential therapeutic target in human cancers.展开更多
Reduction pretreatment(RP)process,which is implemented after the billet is completely solidified,is an alternative process to further improve billet quality.Finite element method and experiment were used to investigat...Reduction pretreatment(RP)process,which is implemented after the billet is completely solidified,is an alternative process to further improve billet quality.Finite element method and experiment were used to investigate the effect of the RP process on the internal quality of 42CrMo billet.An ultrasonic testing technology was used to study the influence of the RP process on the micro-porosities.Through a three-dimensional finite element model,the mechanism of the RP process on the porosity closure was studied.The experimental results show that the RP process eliminates the macro-porosities of the billet center.The number of micro-porosities in the billets is effectively reduced,and the increase in deformation contributes to the reduction in micro-porosities.Compared with isothermal rolling,the RP process leads to a larger equivalent strain and hydrostatic integration in the billet center because of the temperature gradient,and the effect of the temperature gradient is greater with the increase in deformation.The closure effect of micro-porosity is related not only to the stress state,but also to the distribution of micro-porosity.The increase in three-dimensional compressive stress is beneficial to the porosity closure.If the micro-porosities distributed densely,excessive stress could induce micro-porosity coalescence,which has the risk of inducing cracks.展开更多
Background:In an era when HIV transmission has been on the rise among men who have sex with men(MSM),transgender women may play a considerable role in China’s current HIV epidemic as a potential“bridge”of HIV trans...Background:In an era when HIV transmission has been on the rise among men who have sex with men(MSM),transgender women may play a considerable role in China’s current HIV epidemic as a potential“bridge”of HIV transmission between homosexual and heterosexual populations.We sought to understand the risk behaviours and factors associated with HIV infection among transgender women in two cities in China.Methods:From January to December 2016,we recruited transgender women with the help of community-based organizations(CBOs)through a wide range of methods,including snowball sampling.After recruitment,we asked participants to fill out a structured questionnaire including questions about socio-demographics,sexual behaviours,condom use,substance use and uptake of health care services.HIV infection status was determined by using two different rapid testing reagents.Results:Among 498 subjects enrolled in this study,233 were from Shanghai and 265 were from Tianjin.The median age was 30 years(range:18-68;IQR:24-33).Of them,337(67.7%)preferred feminine dress,13(2.6%)had undergone transsexual operation and 68(13.7%)had used hormones for transition purposes.Nearly half(45.6%)reported having regular partners,and 351(70.5%)had casual partners.Regarding condom use,81.5%reported not always using condoms with stable partners,and 70.9%reported not using condoms with casual partners.Twentyfive(5.0%)had a history of buying sex and fifty-one(10.2%)had a history of selling sex in the past three months.A total of 200(40.2%)participants had used at least one kind of controlled substance in the past six months.The most commonly used substances were amyl nitrates(rush popper)(99.5%)and 5-MeO-DiPT(20.0%).Among rush popper users,170(85.4%)reported always having sex while on the drug,and 177(88.9%)reported increased sexual pleasure after using the drug.The HIV infection risk factors identified in our study were being located in Shanghai(aOR=9.35,95%CI=3.89-22.49),selling sex in the past three months(aOR=3.44,95%CI=1.31-9.01),and substance use in the past six months(aOR=5.71,95%CI=2.63-12.41).Conclusions:Transgender women bear a high HIV burden in the two Chinese cities.Those involved in commercial sex tended to have inconsistent condom use,leading to high risk of HIV infection.Substance use was an independent risk factor of HIV infection by increasing sexual activities and unprotected sex,which indicated an aggravated and complex situation with possible interacting syndemic factors that could cumulatively facilitate sexual risk behaviours and HIV infection in transgender women.There is an urgent need for innovative and appropriate HIV prevention programmes targeting this unique population.Efforts should be made to provide them with tailored services including persuasive communication on consistent condom use,substance use counselling and related referral services,all with the goal of reducing HIV epidemic among transgender women.展开更多
The compressive deformation behavior of 95CrMo hypereutectic steel was studied at temperatures ranging from 800 to 1050 ℃ and strain rates from 0.1 to 3 s-1 on a Gleeble-3500 thermo-simulation machine. The results sh...The compressive deformation behavior of 95CrMo hypereutectic steel was studied at temperatures ranging from 800 to 1050 ℃ and strain rates from 0.1 to 3 s-1 on a Gleeble-3500 thermo-simulation machine. The results showed that, with the decrease in deformation temperature and increase in strain rate, the fragmented retained austenite in finer and distributed more uniformly in the ferrite matrix as a result of the inhibited recovery. The recorded flow stress suggested that the stress level decreases with increasing temperature and decreasing strain rate. Based on the classical stress-dislocation relation, the constitutive equations of flow stress determined by work-hardening and softening mechanisms were estab- lished. A comparison between the experimental and calculated values confirmed the reliability of the model, and the predictability of the model was also quantified in terms of correlation coefficients and average absolute relative errors, which were found generally above 0.99 and below 2.50%, respectively. In the whole range of strain rate, the activation energy is 419.84 kJ/mol. By further identification based on Sch6ck＇s model and Kocks-Argon-Ashby model, the rate- controlling mechanism is found to be dislocation cross-slip.展开更多
Background:HIV epidemic among men who have sex with men(MSM)remains a major public health concern in China.Despite a growing body of research on transgender women worldwide,little is known about Chinese transgender wo...Background:HIV epidemic among men who have sex with men(MSM)remains a major public health concern in China.Despite a growing body of research on transgender women worldwide,little is known about Chinese transgender women within MSM.We sought to estimate HIV incidence and distinguish risk factors of HIV acquisition among them from that among cisgener(non-transgender)MSM(cis-MSM).Methods:We conducted an open cohort study among Chinese MSM,including those who were identifed as transgender in Shanghai and Tianjin.Participants were initially recruited by local community-based organizations from January to June,2016,and were followed up approximately every 6 months until June 2018.At each visit,a structured questionnaire was used to gather information on demographics,sexual risk behaviors,and HIV status.HIV incidence was calculated as the number of seroconversions divided by total number of person-years of follow-up among HIV-negatives at baseline.Risk factors of HIV acquisition were assessed by univariate and multivariate Cox regression models with time-dependent variables.Results:A total of 1056 participants contributed 1260.53 person-years(PYs)of follow-up,33 HIV seroconversions occurred during the follow-up period,yielding an estimated HIV incidence of 2.62(95%CI 1.80–3.68)per 100 PYs.HIV incidence among transgender women was 4.42 per 100 PYs,which was signifcantly higher than that of 1.35 per 100 PYs among cis-MSM,demonstrating a threefold higher odds of HIV infection than cis-MSM.For transgender women,those lived locally≤2 years(adjusted hazard ratio[aHR]=1.76,95%CI 1.13–2.76)and unprotected anal sex last time(aHR=4.22,95%CI 1.82–9.79)were more likely to acquire HIV.For cis-MSM,factors associated with HIV acquisition were frequency of anal sex≥3 times in past one month(aHR=4.19,95%CI 1.06–16.47)and unprotected anal sex last time(aHR=5.33,95%CI 1.52–18.73).Conclusions:Compared to cis-MSM,transgender women were at higher risk of HIV acquisition,highlighting an urgent need of tailored prevention.Future HIV program should consider to include them to ensure that this population in China are not left behind.展开更多
文摘BACKGROUND With the continuous development and progress of medical technology,the position of surgical nursing in the field of clinical medicine is becoming in-creasingly prominent.As an important branch of the surgical field,the nursing requirements and difficulty of gastrointestinal surgery are also increasing.In order to improve the teaching quality of nursing care in gastrointestinal surgery,many educators and researchers are actively exploring new teaching methods.Among them,the teaching method case-based learning(CBL),scene-simulated learning(SSL),task-based learning(TBL),combining self-evaluation and training mode is considered as an effective method.This method aims to help students to better master knowledge and skills and improve their comprehensive quality by cultivating their self-evaluation ability.AIM To explore the practical effect of CBL-SSL-TBL combined with training mode and student self-assessment in nursing teaching of gastrointestinal surgery.METHODS Seventy-one nursing interns in our hospital from December 2020 to December 2021 were selected.According to different teaching modes,they were divided into observation group CBL-SSL-TBL combined with training mode combined with student self-assessment and control group(conventional teaching mode),of which 36 were in observation group and 35 were in control group.The results of operational skills,theoretical knowledge,nursing students'satisfaction,learning effectiveness questionnaire and teaching effect were compared between the two groups.RESULTS Compared between the two groups,the operational skills and theoretical knowledge scores of the observation group were higher than those of the control group,and the difference was statistically significant(P<0.05).Compared between the two groups,the total satisfaction ratio of the observation group was higher than that of the control group,the difference was statistically significant(P<0.05).Compared between the two groups,the observation group was lower than the control group in the questionnaire results of learning efficacy,and the difference was statistically significant(P<0.05).Compared between the two groups,the proportion of thinking ability,subjective initiative and understanding of theoretical knowledge in the observation group was higher than that in the control group,the difference was statistically significant(P<0.05).CONCLUSION The use of CBL-SSL-TBL combined with training mode and student self-assessment in gastrointestinal surgery nursing teaching can improve the operational skills of nursing interns,theoretical knowledge and satisfaction scores of nursing students,improve the results of learning efficiency questionnaire and teaching effect,which can be popularized in clinical teaching.
基金Supported by the Shanghai three-year(2023-2025)action plan to strengthen the public health system(GWVI-11.1-05),the Top Young Talents in Shanghai.
文摘Summary What is already known about this topic?The World Health Organization(WHO)has recommended the inclusion of the C-reactive protein(CRP)test in active tuberculosis(ATB)screening algorithms among human immunodeficiency virus(HIV)-infected individuals.The performance of the CRP test in African regions has been well-documented.What is added by this report?This study analyzed data from a big data platform of Shanghai medical records together with infectious disease surveillance systems.
基金National Institute of Clinical Specialties-Shanghai Mental Health Center(Office of Medical Administration,Ministry of Health)(OMA-MH 2011-873)Shanghai Education Commission High Peak and High Altitude Discipline Construction Plan(20152235)
基金Project supported by the National Natural Science Foundation of China(Grant No.11874337).
文摘We study the behaviors of three-dimensional double and triple Weyl fermions in the presence of weak random potential.By performing the Wilsonian renormalization group(RG)analysis,we reveal that the quasiparticle experiences strong renormalization which leads to the modification of the density of states and quasiparticle residue.We further utilize the RG analysis to calculate the classical conductivity and show that the diffusive transport is substantially corrected due to the novel behavior of the quasiparticle and can be directly measured by experiments.
基金Supported by the the National Natural Science Foundation of China(Grant No.11874337)。
文摘We report an exact numerical study on disorder effect in double-Weyl semimetals,and compare exact numerical solutions for the quasiparticle behavior with the Born approximation and renormalization group results.It is revealed that the low-energy quasiparticle properties are renormalized by multiple-impurity scattering processes,leading to apparent power-law behavior of the self-energy.Therefore,the quasiparticle residue surrounding nodal points is considerably reduced and vanishes as ZE∝Er with nonuniversal exponent.We show that such unusual behavior of the quasiparticle leads to strong temperature dependence of diffusive conductivity.Remarkably,we also find a universal minimum conductivity along the direction of linear dispersion at the nodal point,which can be directly observed by experimentalist.
基金NationalNatural Science Foundation of China,Grant/Award Numbers:81672440,31701156,81972625DICP,Grant/Award Number:ZZBS201803The Construction of Liaoning CancerResearch Center,Grant/Award Number:1564992449013。
文摘Background:Y-box binding protein 1(YB1 or YBX1)plays a critical role in tumorigenesis and cancer progression.However,whether YB1 affects malignant transformation by modulating non-codingRNAs remains largely unknown.This study aimed to investigate the relationship between YB1 and microRNAs and reveal the underlying mechanism by which YB1 impacts on tumor malignancy via miRNAs-mediated regulatory network.Methods:The biological functions of YB1 in hepatocellular carcinoma(HCC)cells were investigated by cell proliferation,wound healing,and transwell invasion assays.The miRNAs dysregulated by YB1 were screened by microarray analysis in HCC cell lines.The regulation of YB1 on miR-205 and miR-200b was determined by quantitative real-time PCR,dual-luciferase reporter assay,RNA immunoprecipitation,and pull-down assay.The relationships of YB1,DGCR8,Dicer,TUT4,and TUT1 were identified by pull-down and coimmunoprecipitation experiments.The cellular co-localization of YB1,DGCR8,and Dicer were detected by immunofluorescent staining.The in vivo effect of YB1 on tumor metastasis was determined by injecting MHCC97H cells transduced with YB1 shRNA or shControl via the tail vein in nude BALB/c mice.The expression levels of epithelial tomesenchymal transition markerswere detected by immunoblotting and immunohistochemistry assays.Results:YB1 promoted HCC cell migration and tumor metastasis by regulating miR-205/200b‒ZEB1 axis partially in a Snail-independent manner.YB1 suppressedmiR-205 and miR-200b maturation by interacting with the microprocessors DGCR8 and Dicer as well as TUT4 and TUT1 via the conserved cold shock domain.Subsequently,the downregulation of miR-205 and miR-200b enhanced ZEB1 expression,thus leading to increased cell migration and invasion.Furthermore,statistical analyses on gene expression data from HCC and normal liver tissues showed that YB1 expression was positively associated with ZEB1 expression and remarkably correlated with clinical prognosis.Conclusion:This study reveals a previously undescribed mechanism by which YB1 promotes cancer progression by regulating the miR-205/200b‒ZEB1 axis in HCC cells.Furthermore,these results highlight that YB1 may play biological functions via miRNAs-mediated gene regulation,and it can serve as a potential therapeutic target in human cancers.
文摘Reduction pretreatment(RP)process,which is implemented after the billet is completely solidified,is an alternative process to further improve billet quality.Finite element method and experiment were used to investigate the effect of the RP process on the internal quality of 42CrMo billet.An ultrasonic testing technology was used to study the influence of the RP process on the micro-porosities.Through a three-dimensional finite element model,the mechanism of the RP process on the porosity closure was studied.The experimental results show that the RP process eliminates the macro-porosities of the billet center.The number of micro-porosities in the billets is effectively reduced,and the increase in deformation contributes to the reduction in micro-porosities.Compared with isothermal rolling,the RP process leads to a larger equivalent strain and hydrostatic integration in the billet center because of the temperature gradient,and the effect of the temperature gradient is greater with the increase in deformation.The closure effect of micro-porosity is related not only to the stress state,but also to the distribution of micro-porosity.The increase in three-dimensional compressive stress is beneficial to the porosity closure.If the micro-porosities distributed densely,excessive stress could induce micro-porosity coalescence,which has the risk of inducing cracks.
基金This study was funded by M.A.C.AIDS Fund(A-P-15-20660).The funder had no role in study design,data collection and analysis,decision to publish,or preparation of the manuscript.
文摘Background:In an era when HIV transmission has been on the rise among men who have sex with men(MSM),transgender women may play a considerable role in China’s current HIV epidemic as a potential“bridge”of HIV transmission between homosexual and heterosexual populations.We sought to understand the risk behaviours and factors associated with HIV infection among transgender women in two cities in China.Methods:From January to December 2016,we recruited transgender women with the help of community-based organizations(CBOs)through a wide range of methods,including snowball sampling.After recruitment,we asked participants to fill out a structured questionnaire including questions about socio-demographics,sexual behaviours,condom use,substance use and uptake of health care services.HIV infection status was determined by using two different rapid testing reagents.Results:Among 498 subjects enrolled in this study,233 were from Shanghai and 265 were from Tianjin.The median age was 30 years(range:18-68;IQR:24-33).Of them,337(67.7%)preferred feminine dress,13(2.6%)had undergone transsexual operation and 68(13.7%)had used hormones for transition purposes.Nearly half(45.6%)reported having regular partners,and 351(70.5%)had casual partners.Regarding condom use,81.5%reported not always using condoms with stable partners,and 70.9%reported not using condoms with casual partners.Twentyfive(5.0%)had a history of buying sex and fifty-one(10.2%)had a history of selling sex in the past three months.A total of 200(40.2%)participants had used at least one kind of controlled substance in the past six months.The most commonly used substances were amyl nitrates(rush popper)(99.5%)and 5-MeO-DiPT(20.0%).Among rush popper users,170(85.4%)reported always having sex while on the drug,and 177(88.9%)reported increased sexual pleasure after using the drug.The HIV infection risk factors identified in our study were being located in Shanghai(aOR=9.35,95%CI=3.89-22.49),selling sex in the past three months(aOR=3.44,95%CI=1.31-9.01),and substance use in the past six months(aOR=5.71,95%CI=2.63-12.41).Conclusions:Transgender women bear a high HIV burden in the two Chinese cities.Those involved in commercial sex tended to have inconsistent condom use,leading to high risk of HIV infection.Substance use was an independent risk factor of HIV infection by increasing sexual activities and unprotected sex,which indicated an aggravated and complex situation with possible interacting syndemic factors that could cumulatively facilitate sexual risk behaviours and HIV infection in transgender women.There is an urgent need for innovative and appropriate HIV prevention programmes targeting this unique population.Efforts should be made to provide them with tailored services including persuasive communication on consistent condom use,substance use counselling and related referral services,all with the goal of reducing HIV epidemic among transgender women.
基金supported by the National Science & Technology Pillar Program during the Twelfth Five-year Plan Period(Grant Nos.2012BAE03B01)
文摘The compressive deformation behavior of 95CrMo hypereutectic steel was studied at temperatures ranging from 800 to 1050 ℃ and strain rates from 0.1 to 3 s-1 on a Gleeble-3500 thermo-simulation machine. The results showed that, with the decrease in deformation temperature and increase in strain rate, the fragmented retained austenite in finer and distributed more uniformly in the ferrite matrix as a result of the inhibited recovery. The recorded flow stress suggested that the stress level decreases with increasing temperature and decreasing strain rate. Based on the classical stress-dislocation relation, the constitutive equations of flow stress determined by work-hardening and softening mechanisms were estab- lished. A comparison between the experimental and calculated values confirmed the reliability of the model, and the predictability of the model was also quantified in terms of correlation coefficients and average absolute relative errors, which were found generally above 0.99 and below 2.50%, respectively. In the whole range of strain rate, the activation energy is 419.84 kJ/mol. By further identification based on Sch6ck＇s model and Kocks-Argon-Ashby model, the rate- controlling mechanism is found to be dislocation cross-slip.
文摘Background:HIV epidemic among men who have sex with men(MSM)remains a major public health concern in China.Despite a growing body of research on transgender women worldwide,little is known about Chinese transgender women within MSM.We sought to estimate HIV incidence and distinguish risk factors of HIV acquisition among them from that among cisgener(non-transgender)MSM(cis-MSM).Methods:We conducted an open cohort study among Chinese MSM,including those who were identifed as transgender in Shanghai and Tianjin.Participants were initially recruited by local community-based organizations from January to June,2016,and were followed up approximately every 6 months until June 2018.At each visit,a structured questionnaire was used to gather information on demographics,sexual risk behaviors,and HIV status.HIV incidence was calculated as the number of seroconversions divided by total number of person-years of follow-up among HIV-negatives at baseline.Risk factors of HIV acquisition were assessed by univariate and multivariate Cox regression models with time-dependent variables.Results:A total of 1056 participants contributed 1260.53 person-years(PYs)of follow-up,33 HIV seroconversions occurred during the follow-up period,yielding an estimated HIV incidence of 2.62(95%CI 1.80–3.68)per 100 PYs.HIV incidence among transgender women was 4.42 per 100 PYs,which was signifcantly higher than that of 1.35 per 100 PYs among cis-MSM,demonstrating a threefold higher odds of HIV infection than cis-MSM.For transgender women,those lived locally≤2 years(adjusted hazard ratio[aHR]=1.76,95%CI 1.13–2.76)and unprotected anal sex last time(aHR=4.22,95%CI 1.82–9.79)were more likely to acquire HIV.For cis-MSM,factors associated with HIV acquisition were frequency of anal sex≥3 times in past one month(aHR=4.19,95%CI 1.06–16.47)and unprotected anal sex last time(aHR=5.33,95%CI 1.52–18.73).Conclusions:Compared to cis-MSM,transgender women were at higher risk of HIV acquisition,highlighting an urgent need of tailored prevention.Future HIV program should consider to include them to ensure that this population in China are not left behind.
