Characteristics of the HIV/AIDS Epidemic among People Aged≥50 Years in China during 2018–2021

Objective This study aimed to determine the current epidemiological status of PLWHA aged≥50 years in China from 2018 to 2021.It also aimed to recommend targeted interventions for the prevention and treatment of HIV/AIDS in elderly patients.Methods Data on newly reported cases of PLWHA,aged≥50 years in China from 2018 to 2021,were collected using the CRIMS.Trend tests and spatial analyses were also conducted.Results Between 2018 and 2021,237,724 HIV/AIDS cases were reported among patients aged≥50 years in China.The main transmission route was heterosexual transmission(91.24%).Commercial heterosexual transmission(CHC)was the primary mode of transmission among males,while non-marital non-CHC([NMNCHC];60.59%)was the prevalent route in women.The proportion of patients with CHC decreased over time(Z=67.716,P<0.01),while that of patients with NMNCHC increased(Z=153.05,P<0.01).The sex ratio varied among the different modes of infection,and it peaked at 17.65 for CHC.The spatial analysis indicated spatial clustering,and the high-high clustering areas were mainly distributed in the southwestern and central-southern provinces.Conclusion In China,PLWHA,aged≥50 years,were predominantly infected through heterosexual transmission.The primary modes of infection were CHC and NMNCHC.There were variations in the sex ratio among different age groups,infected through various sexual behaviors.HIV/AIDS cases exhibited spatial clustering.Based on these results,the expansion of HIV testing,treatment,and integrated behavioral interventions in high-risk populations is recommended to enhance disease detection in key regions.

Bowel preparation protocol for hospitalized patients ages 50 years or older:A randomized controlled trial

BACKGROUND The incidence and mortality rate of colorectal cancer progressively increase with age and become particularly prominent after the age of 50 years.Therefore,the population that is≥50 years in age requires long-term and regular colonoscopies.Uncomfortable bowel preparation is the main reason preventing patients from undergoing regular colonoscopies.The standard bowel preparation regimen of 4-L polyethylene glycol(PEG)is effective but poorly tolerated.AIM To investigate an effective and comfortable bowel preparation regimen for hospitalized patients≥50 years in age.METHODS Patients were randomly assigned to group 1(2-L PEG+30-mL lactulose+a lowresidue diet)or group 2(4-L PEG).Adequate bowel preparation was defined as a Boston bowel preparation scale(BBPS)score of≥6,with a score of≥2 for each segment.Non-inferiority was prespecified with a margin of 10%.Additionally,the degree of comfort was assessed based on the comfort questionnaire.RESULTS The proportion of patients with a BBPS score of≥6 in group 1 was not significantly different from that in group 2,as demonstrated by intention-to-treat(91.2%vs 91.0%,P=0.953)and per-protocol(91.8%vs 91.0%,P=0.802)analyses.Furthermore,in patients≥75 years in age,the proportion of BBPS scores of≥6 in group 1 was not significantly different from that in group 2(90.9%vs 97.0%,P=0.716).Group 1 had higher comfort scores(8.85±1.162 vs 7.59±1.735,P<0.001),longer sleep duration(6.86±1.204 h vs 5.80±1.730 h,P<0.001),and fewer awakenings(1.42±1.183 vs 2.04±1.835,P=0.026)than group 2.CONCLUSION For hospitalized patients≥50 years in age,the bowel preparation regimen comprising 2-L PEG+30-mL lactulose+a low-residue diet produced a cleanse that was as effective as the 4-L PEG regimen and even provided better comfort.

Shift work aggravates metabolic syndrome development among early-middle-aged males with elevated ALT

AIM: To examine whether shift work accelerates metabolic syndrome (MetS) development among early middle-aged males with elevated alanine aminotransferase (e-ALT).METHODS: A retrospective, observational followup study on MetS development at a 5-year interval was conducted using health examination data. Nine hundred and ninety six male employees not fulfi lling MetS criteria at screening were enrolled. Age, MetScomponents, liver enzymes, serological markers for viral hepatitis, abdominal ultrasound, insulin resistance status, lifestyles, and workplace factors were analyzed.RESULTS: The prevalence of elevated serum ALT (> 40 U/L, e-ALT) at baseline was 19.1%. There were 381 (38.3%) workers with long-term exposures to day-night rotating shift work (RSW). 14.2% of subjects developed MetS during follow-up. After 5 years, the workers with e-ALT had significantly unfavorable changes in MetS-components, and higher rates of MetS development, vs subjects with normal baseline ALT levels. Workers with both baseline e-ALT and 5-year persistent RSW (pRSW) exposure had the highest rate of MetS development. Also, e-ALT-plus-pRSW workers had a significant increase in MetS-components atfollow-up, compared with the other subgroups. After controlling for potential confounders, e-ALT-plus-pRSW workers posed a signifi cant risk for MetS development (odds ratio, 2.7; 95% confi dence interval, 1.4-5.3, vs workers without baseline e-ALT nor pRSW). CONCLUSION: We suggest that all early middle-aged male employees with e-ALT should be evaluated and managed for MetS. Particularly in terms of job arrangements, impacts of long-term RSW on MetS development should be assessed for all male employees having baseline e-ALT.

Traditional Values on Males in Victorian Age——A Case study of Oscar Wilde’s The Importance of Being Earnest

In Victorian Age, many literary works recorded the social realities and traditional social value system, and Oscar Wilde's The Importance of Being Earnest is a good case in point. In this play, males are valued in terms of both birth condition and economic basis, which are two general standards from the traditional value system of the mainstream society. Oscar Wilde in this play satirizes the restrained and distorted traditional values and the hypocritical Victorian society. This paper will probe into how the social status and economic conditions determine males' fate in Victorian Age and on Oscar Wilde's creation.

Impact of chronological ageing on semen parameters in southern Indian men visiting infertility centre:A retrospective study

Objective:To investigate the association between age and semen parameters among male partners of subfertile couples.Methods:This retrospective study analyzed the semen of 1523 infertile men aged 26 to 50 years.Data were extracted from GarbhaGudi IVF Centre database from January 2019 to September 2020.The basic semen parameters were interpreted according to the WHO manual 2021,6th edition.Semen parameters in different age groups were compared.Results:Total and progressive motile sperms were significantly higher in the age group of 26-30 years compared to other age groups(P<0.05).Normal sperm count was significantly higher in the age group of 26-30 years compared to the age groups of 41-45 years and>46 years(P=0.001).However,sperm head defects,neck and midpiece defects,tail defects,and cytoplasmic droplets showed statistically insignificant difference in all the age groups(P>0.05).Semen viscosity showed no statistical difference in all the age groups compared to the reference age group of 26 to 30 years.Conclusions:Higher age can lead to a significant decrease in normal sperms and motility in subfertile men.Hence,male partner age should be considered as one of the major determining factors for reproductive outcomes.

No Evidence for Significant Effect of Body Size and Age on Male Mating Success in the Spot-legged Treefrog

In anurans, body size and age of individuals generally affect male mating success. To test whether body size and age have effects on male mating success in the foam-nesting treefrog Polypedates megacephalus, a species widely distributed in China, we analyzed differences in body size and age between mated and unmated males for three populations using a Generalized Linear Mixed Model（GLMM）. The results showed that mated males did not exhibit larger body size and older age than unmated males, suggesting that large and/or old male individuals did not have greater mating success than small and/or young males. Moreover, we also found a non-significant size-assortative mating pattern for all populations. Our findings suggest that body size and age of the foam-nesting treefrog do not affect male mating success.

Survey of Temporomandibular Disorder in Male Candidates of Conscription Age

[Objectives] To study the temporomandibular disorder(TMD) in male candidates of conscription age. [Methods] The TMD was surveyed in 2 152 young males who participated in 2015, 2016 and 2017 physical examinations for conscription in Qingzhou City, Weifang of Shandong Province. [Results] Cases with previous positive symptoms and with positive clinical signs respectively accounted for 5.02% and 18.91% of the whole respondents. Among the three major symptoms, the occurrence of clicking, accounting for 17.7% of the total case amount, ranked the first; among 407 cases with positive clinical signs, the top two symptoms were simple clicking(50.86%) and clicking with abnormal mandibular movement(36.85%). [Conclusions] TMD occurs in male candidates of conscription age with a relatively high occurrence, but most cases are mild with clicking as the major symptom.

Exploring the type of social support available to aged male hypertensive clients in Ghana

Objective: To explores the social support available to aged hypertensive male clients in a municipality in Ghana.Methods: The inclusion criteria were as follows: age ≥60 years and are known hypertensive patients. Data were collected from 186 selected aged male hypertensive patients for 3 months. The questionnaire was self-developed and open-ended. The data were processed and analyzed using SPSS version 23. Some of the variables were subjected to statistical tests and ranks in the order of impor tance to respondents. The enrolled respondents were allowed to par ticipate in the study after their informed consent was obtained. It was evident that respondents do not obtain much support or help in taking care of their condition.Results: The result revealed that the repondents has no support to help take care of their condition as evident by the responses in the study. The scores on average mean for some variables are(AM = 2.25, SD = 0.381) more than the test value of 2.50. Some of these supports were on feeding support(M = 3.97, SD = 0.278, n = 186), health support(M = 2.87, SD = 0.167, n = 186), and cleaning support(M = 2.59, SD = 0.868, n = 186). Supports such as clothing, socialization, medication, washing, transportation, and financial support were lacking.Conclusions: Based on the finding that certain forms of support were lacking, the study concludes that steps undertaken by the government, community, religious bodies, and family toward improving these supports can be of immense help for aged male hypertensive patients living in the Ejura-Sekyedumase municipality.

Ailogeneic hematopoietic cell transplantation for malignant hematological diseases in patients older than 50 years of age

Objective To investigate the efficiency and safety of allogeneic hematopoietic cell transplantation for malignant hematological diseases in patients older than 50 years of age. Methods From May 2002 to January 2010,35 patients P 】 50 years with malignant hematological diseases received allogeneic hematopoietic

MA XING ER SAN TANG FOR TREATMENT OF COR PULMONALE AT ACUTE ONSET STAGE -A Report Of 250 Cases

Ma Xing Er San Tang (麻杏二三汤) is a compound recipe derived from Ma Xing Shi Gan Tang (麻杏石甘汤 Decoction of Ephedra, Apricot Kernel, Gypsum and Licorice), Er Chen Tang (二陈汤 Decoction of Two Old Drugs) and San Zi Yang Qin Tang (三子养亲汤 Decoction of Three Kinds of Seeds for the Aged). Since 1990, the authors have used Ma Xing Er San Tang for treatment of 250 cases of Cor Pulmonale (CP) with satisfactory therapeutic results as reported below.

初三男生50M跑教学方案的优选实验研究

采用正交实验和教学实践相结合的研究方法，对提高初三男生５０Ｍ跑成绩的教学方案进行了研究。正交实验结果显示：影响５０Ｍ跑成绩的因素主次顺序为：绝对速度、速度力量、加速能力。速度耐力，最优教学方案为Ａ１Ｂ２Ｃ２Ｄ２；同步教学对比实验后，新教学方案不仅明显地提高了学生的运动能力，而且还很好地培养了学生的学习兴趣。

50 Hz磁场和双酚A暴露对大鼠脑组织和Neuro-2a细胞Tau蛋白磷酸化的影响

目的研究50 Hz磁场、双酚A(bisphenol A,BPA)单独和联合暴露对神经细胞Tau蛋白磷酸化的影响。方法24只SD雄性大鼠,体质量(150±10)g,分为对照组(生理盐水灌胃+50 Hz磁场假性暴露)、50 Hz磁场暴露组(0.5 mT、4 h/d 50 Hz磁场暴露+生理盐水灌胃)、BPA暴露组(BPA20μg·kg^(-1)·d^(-1)灌胃+50 Hz磁场假性暴露)、50 Hz磁场和BPA复合暴露组(BPA 20μg·kg^(-1)·d^(-1)灌胃+0.5 mT、4 h/d 50 Hz磁场暴露)4组,每组6只。处理1次/d,6 d/周,连续12周。小鼠神经母细胞瘤细胞株(Neuro-2a),分为对照组、50 Hz磁场暴露组(1 mT、48 h)、BPA暴露组(100μmol/L、24 h)、50 Hz磁场+BPA复合暴露组(1 mT、48 h+100μmol/L,24 h)4组。大鼠暴露结束按标准方法取材,组织免疫荧光化学方法检测大脑皮层和海马脑组织Tau-Thr^(231)、Tau-Ser^(404)的表达以及细胞凋亡。细胞实验暴露后采用CCK-8法检测细胞活力,采用细胞免疫荧光化学和Western blot方法检测Tau-Thr^(231)、TauSer;、Caspase-3的表达。结果50 Hz磁场暴露12周后,大鼠皮层和海马脑区Tau-Thr^(231)位点磷酸化水平明显升高(P<0.05);BPA暴露或与50 Hz磁场复合暴露12周后,大鼠皮层和海马脑区Tau-Thr^(231)位点磷酸化水平、皮层Tau-Ser^(404)位点磷酸化水平明显升高(P<0.05),复合暴露组皮层和海马脑区细胞凋亡水平变化明显(P<0.05)。50 Hz磁场暴露、BPA单独暴露或与50 Hz磁场复合暴露48 h后,Neuro-2a细胞活力均明显低于对照组(P<0.05)。50 Hz磁场暴露48 h后,Neuro-2a细胞Tau-Ser^(404)位点磷酸化水平明显高于对照组(P<0.05);BPA单独暴露或与50 Hz磁场复合暴露48 h后,Neuro-2a细胞Tau-Thr^(231)位点和Tau-Ser^(404)位点磷酸化水平、Caspase-3的表达水平明显升高(P<0.05)。结论50 Hz磁场、BPA暴露可引起神经细胞Tau蛋白不同位点过度磷酸化,并且二者之间存在协同效应,可引起神经细胞损伤。

The effects of advanced paternal age on fertility

Modern societal pressures and expectations over the past several decades have resulted in the tendency for couples to delay conception. While women experience a notable decrease in oocyte production in their late thirties, the effect of age on spermatogenesis is less well described. While there are no known limits to the age at which men can father children, the effects of advanced paternal age are incompletely understood. This review summarizes the current state of knowledge regarding advanced paternal age and its implications on semen quality, reproductive success and offspring health. This review will serve as a guide to physicians in counseling men about the decision to delay paternity and the risks involved with conception later in life.

Gastric polypoid lesions:Analysis of 150 endoscopic polypectomy specimens from 91 patients

AIM:To analyze gastric polypoid lesions in our patient- population with respect to histopathologic features and demographic,clinical,and endoscopic characteristics of patients. METHODS:Clinical records and histopathologic reports of patients with gastric polypoid lesions were analyzed retrospectively.All lesions had been totally removed by either endoscopic polypectomy or hot biopsy forceps.The histopathologic slides were re-evaluated by the same histopathologist. RESULTS:One-hundred and fifty gastric polypoid lesions were identified in 91 patients.There were 53(58 %)women and 38(42 %)men with a median age of 53(range,31 to 82)years.The most frequent presenting symptom was dyspepsia that was observed in 35(38.5 %)patients. Symptoms were mostly related to various associated gastric abnormalities such as chronic gastritis or H pylori infection rather than polypoid lesion itself.Polypoid lesions were commonly located in the antrum followed by cardia.Out of 150 lesions,80(53 %)had the largest dimensions less than or equal to 5 mm and only 7 were pedunculated.The frequencies of hyperplastic polyps,foveolar hyperplasia,and fundic gland polyps were 46 %,18 %,and 14 % respectively. We also detected gastritis varioliformis in 12 specimens, lymphoid follicles in 9,4 adenomatous polyps in 4,polypoid lesions with edematous mucosa in 4,inflammatory polyps in 3,and carcinoid tumor in 1.Adenomatous changes were observed within two hyperplastic polyps and low grade dysplasia in one adenoma.Histopathologic evaluation of the surrounding gastric mucosa demonstrated chronic gastritis in 72(79 %)patients and H pylori infection in 45(49 %). CONCLUSION:Hyperplastic polyps are the mbst frequently encountered subtype of gastric polypoid lesions.They are usually associated with chronic gastritis or H pylori gastritis.Contrary to the previous belief,they may harbour adenomatous changes or dysplastic foci. Therefore,endoscopic polypectomy seems as a safe and fast procedure for both diagnosis and treatment of gastric polypoid lesions at the same session.In addition, edematous mucosa may appear misleadingly as a polypoid lesion in some instances and it can be ruled out only by histopathologic examination.

Immunogenicity and reactogenicity of a recombinant hepatitis B vaccine in subjects over age of forty years and response of a booster dose among nonresponders

AIM:The study was initiated to evaluate the reactogenicity and immunogenicity of a recombinant hepatitis B vaccine in age group >40 years and to study the response of a single booster dose in primary non-responders to the hepatitis B vaccination. METHODS:A total of 102 volunteers without markers of hepatitis B infection (negative for HBsAg,anti-HBc antibody, HBeAg and anti-HBs antibody) received 20μg of recombinant HB vaccine intramuscularly at 0,1,and 6 months.Anti HBs titers were evaluated by a quantitative Elisa kit at 90 and 210 days.A booster dose of 20μg HB vaccine was given after 6 months of the 3^(rd) vaccine dose to the 15 non- responders and anti-HBs titers were measured after i month. RESULTS:Seroprotection (anti-HBs GMT^3 10 IU/L) was achieved in 85.3 % (87/102) volunteers.The mean GMT titers of the vaccine responders was 136.1 IU/L.Of the seroprotected individuals,there were 32.4% (33/102) hyporesponders (anti- HBs titers <10-99 mIU/ml) and 52.9% (54/102) were responders (anti-HBs titers >100 IU/L).All the non-responders (15/15) responded to a single dose of the booster dose of recombinant HB vaccine and their mean anti-HBs antibody titers were more than 100.5 mIU/ml after the booster dose. CONCLUSION:Recombinant hepatitis B vaccine offers good seroprotection in the age group >40 years and has a good safety profile.A single booster dose after 6 months in primary non-responders leads to good seroprotective anti-HBs antibody titers.However,larger population based studies are needed to evaluate the role of a booster dose in selected group of non-responders and whether such an approach will be cost effective.

Advanced paternal age and reproductive outcome

Women have been increasingly delaying the start of motherhood in recent decades. The same trend is seen also for men. The influence of maternal age on fertility, chromosomal anomalies, pregnancy complications, and impaired perinatal and post-natal outcome of offspring, has been thoroughly investigated, and these aspectsare clinically applied during fertility and pregestational counseling. Male aging and reproductive outcome has gained relatively less attention. The purpose of this review is to evaluate updated and relevant literature on the effect of paternal age on reproductive outcome.

Long-term results of graded pneumatic dilatation under endoscopic guidance in patients with primary esophageal achalasia

AIM:Achalasia is the best known primary motor disorder of the esophagus in which the lower esophageal sphincter (LES)has abnormally high resting pressure and incomplete relaxation with swallowing.Pneumatic dilatation remains the first choice of treatment.The aims of this study were to determine the long term clinical outcome of treating achatasia initially with pneumatic dilatation and usefulness of pneumatic dilatation technique under endoscopic observation without fluoroscopy. METHODS:A total of 65 dilatations were performed in 43 patients with achalasia[23 males and 20 females,the mean age was 43 years(range,19-73)].All patients underwent an initial dilatation by inflating a 30 mm balloon to 15 psi under endoscopic control.The need for subsequent dilatation was based on symptom assessment.A 3.5 cm balloon was used for repeat procedures. RESULTS:The 30 mm balloon achieved a satisfactory result in 24 patients(54%)and the 35 mm ballon in 78% of the remainder(14/18).Esophageal perforation as a short-term complication was observed in one patient(2.3%).The only late complication encountered was gastroesophageal reflux in 2(4%)patients with a good response to dilatation.The mean follow-up period was 2.4 years(6 mo-5 years).Of the patients studied,38(88%)were relieved of their symptoms after only one or two sessions.Five patients were referred for surgery(one for esophageal perforation and four for persistent or recurrent symptoms).Among the patients whose follow up information was available,the percentage of patients in remission was 79%(19/24)at 1 year and 54%(7/13)at 5 years. CONCLUSION:Performing balloon dilatation under endoscopic observation as an outpatient procedure is simple,safe and efficacious for treating patients with achalasia and referral of surgical myotomy should be considered for patients who do not respond to medical therapy or individuals that do not desire pneumatic dilatations.

Percutaneous transsplenic embolization of esophageal and gastrio-fundal varices in 18 patients

AIM: Clinical application and potential complication of percutaneous transsplenic varices embolization (PTSVE) of esophageal or gastrio-fundal varices in patients with hepatocellular carcinoma (HCC) complicated with portal vein cancerous thrombosis (PVCT).METHODS: 18 patients with HCC complicated with PVCT and esophageal or gastrio-fundal varices who underwent PTSVE were collected. The rate of success, complication, mortality of the procedure and postoperative complication were recorded and analyzed.RESULTS: PTSVE were successfully performed in 16 of 18cases, and the rate of success was 89%. After therapy erythrocyte counts decreased in all of the natunts. 5 of patients needed blood transfusion, 2 patients requiredsurgical intervention because of and 11 patients with ascites were alleviated by diuresis. Among these 18patients, the procedure-related mortality was 11% (2/18),one died of acute hepatic failure on the forth day after procedure, another died of acute renal failure on the fifth day. The patients were follow up for 112 mon exceptone. 13of them died of their tumors but none of them experienced variceal bleeding.CONCLUSION: PTSVE is a relatively safe and effective method to treat esophageal or gastrio-fundal varices in HCCpatients with PVCT when percutaneous transhepatic varices embolization (PTHVE) of varices is impossible.

Levels of v5 and v6 CD44 splice variants in serum of patients with colorectal cancer are not correlated with pT stage,histopathological grade of malignancy and clinical features

AIM:This study was designed to compare the levels of v5 and v6 splice variants of CD44 evaluated using EITSA test in the serum of patients with colorectal cancer in different stages of progression of the disease estimated in pT stage according to WHO score,histopathological grade of malignancy and some clinicopathological features. METHODS:The serum obtained from 114 persons with colorectal adenocarcinomas was examined using ELISA method,pT stage and grade of malignancy of the tumour were examined in formalin fixed and paraffin embedded materials obtained during operation. RESULTS:Only the level of CD44 v5 in the serum of patients before operation with G2 pT4 tumour was lower than that in other probes and the difference was statistically significant. We did not find any other correlations between the level of v5 and v6 CD44 variants and other evaluated parameters. CONCLUSION:The level of CD44 v5 and v6 estimated by ELISA test in the serum can not be used as a prognostic factor in colorectal cancer.

Acupuncture and the Elevation Manipulation of Massage for Treatment of Frozen Shoulder

The authors have treated 50 cases of frozen shoulder in recent years with electro-acupuncture and the elevation manipulation. The results were satisfactory and reported as follows.