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Although dialectical thinking plays an important role in daily life, this ability among adults, including university students, is not always well developed. The present study used three experimental designs to explore efficient ways to promote university students' dialectical thinking ability. The results showed that university students' dialectical thinking ability can be improved after receiving instruction according to specific teaching practices. The debate approach was a more interesting and efficient teaching method for cultivating dialectical thinking ability than the lecture approach. These findings broaden and deepen our understanding about the development of dialectical thinking ability and suggests that debate can be used as an alternative way, in many university courses or training projects, to improve students' dialectical thinking ability.

This study aimed to investigate the influence of a team leader's personality on students' academic performance and explore the underlying mechanism. Three hundred thirty-eight university students who were enrolled in a Happy Psychology curriculum participated in the survey. Hierarchical linear regression was used to test the hypotheses, with academic performance as the outcome, the team leader's personality as the independent variable, group participation as the mediator, and gender diversity as the moderator. The results showed that the neuroticism and conscientiousness of the team leader had a direct or indirect effect (through group participation) on university students' academic performance and that gender diversity moderated the direct or indirect effect of group participation on students' academic performance. These findings could broaden and deepen the understanding of the influence of team leaders' personality on students' academic performance in problem-based classes. A team leader's personality and gender diversity should be considered in team construction.

Background: Accurately stratifying patients with pulmonary arterial hypertension (PAH) is very important, and traditional risk scores still have internal heterogeneity. This study aimed to construct a risk stratification model that can accurately identify clinical worsening (CW) events in conventional low‐intermediate risk patients with pulmonary hypertension under targeted drug treatment by using echocardiographic parameters. Methods: This study is a single‐center, prospective study, including 105 PAH patients who underwent regular follow‐up at Guangdong Provincial People's Hospital from October 2021 to April 2023. The primary endpoint was the occurrence of CW, including death, hospitalization due to pulmonary hypertension, escalation of targeted drug therapy, and worsening of PAH. The predictive value of the echocardiography‐based three‐strata risk model was assessed using Kaplan‐Meier curves and COX regression analysis. Results: A total of 98 PAH patients were ultimately included in this study. The median follow‐up duration was 26 months (range 7–28 months). The echocardiography‐based three‐strata model included the ratio of tricuspid annular plane systolic excursion and pulmonary artery systolic pressure (TAPSE/PASP) and inferior vena cava (IVC). The echocardiography‐based three‐strata model had higher diagnostic value (C‐index =.76) compared to the 2022 ESC/ERS three‐strata model and four‐strata model (C‐index =.66 and C‐index =.61, respectively). PAH patients with lower TAPSE/PASP and wider IVC showed a higher CW rate compared to patients with higher TAPSE/PASP and normal IVC (HR = 15.1, 95%CI:4.4‐51.9, p <.001). Conclusion: The echocardiography‐based three‐strata model based on TAPSE/PASP and IVC can effectively improve the stratification of low‐intermediate risk PAH patients under targeted treatment. [ABSTRACT FROM AUTHOR]

The present study was designed to investigate the association and the underlying mechanism between parental conflict and adolescent depression during the COVID-19 pandemic. In a longitudinal study, a total of 655 Chinese adolescents ranging from 13 to 16 years old completed a three-wave survey (W1, W2, W3) via a survey website. The data was collected three times: March 15–20, 2020 (W1, the outbreak period of the COVID-19 pandemic in Mainland China), June 20–25, 2020 (W2, the trough stage), and December 15–20, 2020 (W3, six months after the trough stage). The SPSS 16.0 software was used to investigate the relationships among study variables. The findings showed that a double-hump effect was found for depression detection among adolescents during the pandemic, with depression rates in W1 (26.9%) and W3 (29%) were higher than that in W2 (21.9%). The parental conflict subscales of content and resolution had a greater impact on adolescent adjustment than other subscales. The parental conflict had direct and indirect impacts (through reducing family support and increasing burdensomeness) on adolescent depression symptoms in W3. It was concluded that when the COVID-19 pandemic was in a trough curve for more than six months, adolescent adjustment was significantly impacted by the pandemic, and parental conflict was an important risk factor in predicting individual adjustment. Therefore, family intervention is recommended when improving adolescent adjustment during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Traditional stress sensitivity experiments are typically conducted under dry conditions, without considering the reservoir's water content. In reality, the presence of water within pores significantly influences the extent of stress sensitivity damage in tight sandstone oil formations, subsequently affecting the determination of stress sensitivity coefficients during experimentation. By investigating sandstone samples from wells in the Mahu Block of China's Xinjiang province, we observed that increasing water saturation reduces the stress sensitivity of tight sandstone. By conducting stress sensitivity experiments under varying water content conditions, we found that the stress sensitivity coefficient is not a constant value but decreases as water saturation increases. Based on experimental comparisons, an optimized power-law model for stress-sensitive damage assessment was refined. By conducting stress-sensitive damage assessment experiments under different water content conditions and integrating the concept of comprehensive compression coefficient, an improved stress-sensitive power-law model was established allowing for the influence of water content. The accuracy of this improved model was increased by 46.98% compared to the original power-law model through experimental validation. The research outcomes can enhance the accuracy of permeability and productivity evaluation, providing valuable guidance for unconventional oil and gas development. [ABSTRACT FROM AUTHOR]

As China launches its second COVID-19 booster campaign and races to bring new vaccine technologies to protect against severe COVID-19 infections, there is limited research on how Chinese residents search for vaccine-related information. This study examined the factors influencing Chinese residents' information-seeking behaviors regarding COVID-19 boosters with a sample of 616 respondents with a mean age of 31.53 from a research panel. Structural equation modeling was used to report factors that influenced respondents' seeking intent. The results indicated that seeking-related subjective norms (β = −0.55, p < 0.001), negative affect (β = 0.08, p < 0.05), positive affect (β = 0.18, p < 0.001), and perceived knowledge insufficiency (β = 0.10, p < 0.001) are strong predictors of one's seeking intent. We also discovered that there was an inverse relationship between risk perception and positive affect (β = −0.55, p < 0.001) and between negative and positive affect (β = −0.19, p < 0.01), while all measurements were either directly or indirectly related to information-seeking intent. A few more indirect but important relationships were also included in our discussion. In conclusion, the present study helps understand what motivates Chinese residents to seek COVID-19 booster information when limited information is available. [ABSTRACT FROM AUTHOR]

In order to study the main control factors of volcanic reservoirs with complex oil–water relationships, the Carboniferous in the Chepaizi Uplift of the Junggar Basin was taken as an example and the lithofacies characteristics, main control factors, and hydrocarbon accumulation model of volcanic reservoirs were investigated by combining the petroleum geology with field testing (data of core analysis, well logging, formation testing, and production testing). The results show that the Carboniferous in the Chepaizi Uplift experienced three stages of volcanic activities and developed seven volcanic lithofacies bodies, distributed in a bead-string connected planar form along the Hongche fault. There is no unified oil–water interface across the whole study area and there are multiple oil–water systems within one fault block. The Carboniferous volcanic reservoir experienced two stages of hydrocarbon accumulation from two different source rocks. The distribution of faults penetrating hydrocarbon kitchens and source rocks controls the macro-scale distribution of reservoirs. The physical properties of reservoirs affect the pattern of oil and water differentiation in volcanic rock bodies, while the lithofacies body-controlled hydrocarbon accumulation mode highlighting "one rock body for one reservoir" determines the distribution of reservoirs. The matching between the paleo-structure and hydrocarbon accumulation stage controls the accumulation and adjustment of hydrocarbon distribution. The Permian source rocks in the Shawan Sag serve as the lateral hydrocarbon supply and hydrocarbons accumulate in the Carboniferous structural-lithologic traps, which are summarized as the two stages of hydrocarbon accumulation of newly generated hydrocarbons into older reservoir rocks. This study of the hydrocarbon accumulation pattern in volcanic rocks aims at guiding the development of Carboniferous reservoirs with complex oil and water relationships in this area. [ABSTRACT FROM AUTHOR]

Present study aimed to explore adolescent depression trajectory during the COVID-19 pandemic, and the impact of parental style on it. Five-wave data of adolescent sample in China mainland were collected, and the group-based trajectory modeling was used to examine the theory constructs. Findings showed that, during the COVID-19 pandemic, there are four distinct patterns of change in depression symptoms over time, namely, resistance (72.3 %), recovery (15.3 %), increasing (6.7 %), chronic (5.7 %). Differences about the impact of parental style and grade on depression trajectory were found. Findings contribute to the knowledge of the impact of the COVID-19 pandemic on depression trajectory among general population, and parental style and grade should be considered in adolescent psychological intervention in the pandemic. • Adolescent's depression symptom during the pandemic was identified as four trajectories. • Father's emotion warmth was less likely to be associated with chronic group, and had larger impact on mother's. • High grade students were more likely to relate with resistance and recovery depression groups. [ABSTRACT FROM AUTHOR]

To test the impact of work stress on Chinese rural school principal turnover intention, 490 rural school principals in the mainland of China were asked to participate in a survey. Multiple linear regression analyses showed that work stress had a positive relation with turnover intention, while achievement motivation and place attachment had negative relations. Additionally, place attachment was a protective factor that could reduce the negative effect of work stress on job satisfaction or the positive effect of work stress on turnover intention. Additionally, the moderating effects of place attachment were mediated by job satisfaction. These findings can enrich our understanding of the relation between work stress and school principal turnover behavior and can provide some suggestions for reducing school principal turnover intention in developing countries such as the mainland of China. [ABSTRACT FROM AUTHOR]

Although the impacts of infertility‐related stress on mental health have been testified in the literature, the underlying mechanism between them is still not clear. In response to this issue, 286 Chinese women who were pursuing medical treatment for fertility problems in two state‐owned hospitals were invited to complete the survey, including the 7‐item Dyadic Adjustment Scale (DAS), the Fertility Problem Inventory (FPI), the 5‐item Mental Health Inventory (MHI‐5), and demographic variables (e.g., age). The multiple linear regression method (SPSS 16) was used to investigate the impact of infertility‐related stress and marital satisfaction on infertile women's mental health. Results showed that the total FPI score—and the specific domains of Social Concern, Relationship Concern, and Rejection of Child‐Free Lifestyle in particular—had a significant negative relation with infertile women's mental health and marital satisfaction as a moderator between them. Therefore, the core of marital relationship and specific infertility‐related stress should be addressed in psychological intervention programs for people facing infertility in mainland China. [ABSTRACT FROM AUTHOR]

Men who have sex with men (MSM) have recently accounted for an alarmingly increasing proportion of HIV-1 transmission in China. In order to investigate the immune status as a result of CRF01_AE infection and CXCR4 co-receptor usage in a young Shanghai-based HIV-1-infected MSM population in Shanghai, 364 HIV-1-infected MSM with average age of 22.7 years old, newly diagnosed between Jan 2009 and Jul 2013 were analyzed for CD4+T cell count, subtyping using phylogenetic analysis, and viral co-receptor tropism using Geno2pheno and webPSSM in combination. A total of 276 individuals were identified as recently infected. Subtype assignment were as follows: 176 (63.8%) CRF01_AE, 77 (27.9%) CRF07_BC, and 23 (8.3%) subtype B. Besides, 24 second-generation recombinant strains were identified. A lower CD4+T cell count at baseline survey was observed among CRF01_AE strain-infected individuals, compared to those who were infected with CRF07_BC (P<0.01). The frequency of baseline CD4+T cell count <200 was higher and the frequency of CD4 T counts >500 lower in CRF01_AE infection than CRF07_BC infection. It is worth noting that 32.4%–40.9% of CRF01_AE strain-infected individuals were predicted to carry CXCR4-tropic viruses whereas none of CRF07_BC and subtype B were found to be as CXCR4-tropic viruses (P<0.001). As could be expected CXCR4 tropism was associated with lower CD4 T counts. This study revealed that CRF01_AE strains with high frequency of CXCR4 tropism are prevailing in the young MSM population in China and could potentially cause a severe loss of CD4+T cell count and rapid disease progression. A regular surveillance of HIV-1 subtypes, CD4+T cell count and viral co-receptor usage would be greatly beneficial for effectively monitoring disease progression, improvement of antiretroviral therapy strategy and prompt intervention of transmission. [ABSTRACT FROM AUTHOR]

Summary: Background: Asian HIV epidemics are concentrated among particular behavioural groups, but large variations exist in epidemic types, timing, and geographical spread between countries and within countries, especially in China. We aimed to understand the complexity of HIV epidemics in China by systematically analysing prevalence trends by data source, region, population group, and time period. Methods: We collected HIV prevalence data from official national sentinel surveillance sites at the provincial level from Jan 1, 1995, to Dec 31, 2010. We also searched PubMed, VIP Chinese Journal Database (VIP), China National Knowledge Infrastructure, and Wanfang Data from Jan 1, 1990, to Dec 31, 2012, for independent studies of HIV prevalence. We integrated both sets of data, and used an intraclass correlation coefficient test to assess the similarity of geographical pattern of HIV disease burden across 31 Chinese provinces in 2010. We investigated prevalence trends (and 95% CIs) to infer corresponding incidence by region, population group, and year. Findings: Of 6850 articles identified by the search strategy, 821 studies (384 583 drug users, 52 356 injecting drug users, 186 288 female sex workers, and 87 834 men who have sex with men) met the inclusion criteria. Official surveillance data and findings from independent studies showed a very similar geographical distribution and magnitude of HIV epidemics across China. We noted that HIV epidemics among injecting drug users are decreasing in all regions outside southwest China and have stabilised at a high level in northwest China. Compared with injecting drug users, HIV prevalence in female sex workers is much lower and has stabilised at low levels in all regions except in the southwest. In 2010, national HIV prevalence was 9·08% (95% CI 8·04–10·52) in injecting drug users and 0·36% (0·12–0·71) in female sex workers, whereas incidence in both populations stabilised at rates of 0·57 (0·43–0·72) and 0·02 (0·01–0·04) per 100 person-years, respectively. By comparison, HIV prevalence in men who have sex with men increased from 1·77% (1·26–2·57) in 2000, to 5·98% (4·43–8·18) in 2010, with a national incidence of 0·98 (0·70–1·25) per 100 person-years in 2010. We recorded strong associations between HIV prevalence among at-risk populations in each province, supporting the existence of overlap in risk behaviours and mixing among these populations. Interpretation: HIV epidemics in China remain concentrated in injecting drug users, female sex workers, and men who have sex with men. HIV prevalence is especially high in southwest China. Sex between men has clearly become the main route of HIV transmission. Funding: The World Bank Group, the Australian Research Council, the University of New South Wales, and Chinese Center for Disease Control and Prevention. [ABSTRACT FROM AUTHOR]

To investigate the evolutionary dynamics and characteristic of the molecular transmission networks of HIV-1 CRF01_AE in Nanjing. Viral samples were collected from 580 newly diagnosed HIV-1-infected patients. HIV-1 pol sequences were obtained and used for for molecular evolutionary analyses. The ML trees were constructed by MEGA 6.0 using under GTR+ G + I model with 1000 bootstrap replicates. The emergence and estimation of tMRCA and the evolutionary rate of the different CRF01_AE clusters were inferred using Bayesian phylogenetic analysis approaches implemented in the BEAST package. Pairwise genetic distances were calculated under the Tamura-Nei 93 model, a genetic distance threshold of ≤1.2% was used to identify potential transmission clusters. Network diagrams were plotted using Cytoscape 3.3.0. Of these HIV-1-infected patients, 551 (91.5%) were males. The largest number of infections were attributed to homosexual (462, 79.7%). A total of 518 full-length pol genes were successfully amplified, based on the phylogenetic analysis CRF01_AE was the most predominantly circulating strain (45.0%, 233/518). As shown in the ML tree, three distinct clusters were observed. The 'Nanjing lineage' 1, 2, 3 has an estimated tMRCA around1996.61, 1993.61, 1984.61 respectively. Of 233 Nanjing sequences, 123 (55.2%) distributed in 30 molecular clusters, average Links/node was 7.8 with range (1−33), most of Nanjing strains shared links with local strains. HIV-1 CRF01_AE was the most predominantly circulating strain, the epidemic of CRF01_AE in Nanjing was driven by multiple clusters of HIV-1 strains, and most CRF01_AE stains in our study were estimated to have originated in China in the 1990s. • We sought to characterize the HIV-1 CRF01_AE epidemic in Nanjing, and intended to better understand the dynamics of local HIV-1 transmission. • Our study is one of the most extensive report to clarify and promote a deeper understanding of the epidemic status of multiple lineages of HIV-1 CRF01_AE strains in Nanjing. • HIV-1 CRF01_AE was the most predominantly circulating strain, the epidemic of CRF01_AE in Nanjing was driven by multiple clusters of HIV-1 strains, most HIV-1 CRF01_AE stains in our study were estimated to have originated in China in 1990s. • The continuous study and surveillance of China's HIV-1 CRF01_AE variants is important for understanding their increasing transmission and continued evolution of HIV and helps to inform effective intervention programs. [ABSTRACT FROM AUTHOR]

Oral microbiota is vital for human health and can be affected by various factors (i.e. diets, ethnicity). However, few studies have compared oral microbiota of individuals from different nationalities in the same environment. Here, we explored the assembly and interaction of oral microbial communities of Chinese and Pakistanis in one university. Firmicutes and Proteobacteria were the predominant microorganisms in the oral cavity of Chinese and Pakistanis. Streptococcus and Neisseria were the dominant genera of China, while Streptococcus and Haemophilus were the dominant genera of Pakistanis. In addition, the oral community membership and structure were not influenced by season, Chinese/Pakistani student and gender, reflecting the stability of the human oral microbiome. The beta diversity of oral microbiomes between Chinese and Pakistanis significantly differed in winter, but not in spring. The alpha diversity of Chinese students and Pakistani students was similar. Moreover, oral microbial community of both Chinese and Pakistani students was mainly driven by stochastic processes. The microbial network of Chinese was more complexity and stability than that of Pakistanis. Our study uncovers the characteristics of human oral microbiota, which is of great significance for oral and human health., (© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Background: Transmitted drug resistance (TDR) is an increasingly prevalent problem worldwide, which will significantly compromise the effectiveness of HIV treatments. However, in Nanjing, China, there is still a dearth of research on the prevalence and transmission of TDR among ART-naïve HIV-1-infected individuals. This study aimed to understand the prevalence and transmission of TDR in Nanjing., Methods: A total of 1,393 participants who were newly diagnosed with HIV-1 and had not received ART between January 2019 and December 2021 were enrolled in this study. HIV-1 pol gene sequence was obtained by viral RNA extraction and nested PCR amplification. Genotypes, TDR and transmission cluster analyses were conducted using phylogenetic tree, Stanford HIV database algorithm and HIV-TRACE, respectively. Univariate and multivariate logistic regression analyses were performed to identify the factors associated with TDR., Results: A total of 1,161 sequences were successfully sequenced, of which CRF07&#95;BC (40.6%), CRF01&#95;AE (38.4%) and CRF105&#95;0107 (6.3%) were the main HIV-1 genotypes. The overall prevalence of TDR was 7.8%, with 2.0% to PIs, 1.0% to NRTIs, and 4.8% to NNRTIs. No sequence showed double-class resistance. Multivariate logistic regression analysis revealed that compared with CRF01&#95;AE, subtype B (OR = 2.869, 95%CI: 1.093-7.420) and female (OR = 2.359, 95%CI: 1.182-4.707) were risk factors for TDR. Q58E was the most prevalent detected protease inhibitor (PI) -associated mutation, and V179E was the most frequently detected non-nucleoside reverse transcriptase inhibitor (NNRTI) -associated mutation. A total of 613 (52.8%) sequences were segregated into 137 clusters, ranging from 2 to 74 sequences. Among 44 individuals with TDR (48.4%) within 21 clusters, K103N/KN was the most frequent TDR-associated mutation (31.8%), followed by Q58E/QE (20.5%) and G190A (15.9%). Individuals with the same TDR-associated mutations were usually cross-linked in transmission clusters. Moreover, we identified 9 clusters in which there was a transmission relationship between drug-resistant individuals, and 4 clusters in which drug-resistant cases increased during the study period., Conclusion: The overall prevalence of TDR in Nanjing was at a moderate level during the past 3 years. However, nearly half of TDR individuals were included in the transmission clusters, and some drug-resistant individuals have transmitted in the clusters. Therefore, HIV drug-resistance prevention, monitoring and response efforts should be sustained and expanded to reduce the prevalence and transmission of TDR in Nanjing., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Xu, Shi, Dong, Ding, Wu, Li, Zhang, Qiao, Li and Zhu.)

The deep mechanisms shaping bacterial assembly are a crucial challenge in drinking water ecosystem. However, much less is known about seasonal diversity distributions and assembly mechanisms of abundant and rare bacteria in drinking water. The combination of environmental variables and high-throughput 16S rRNA gene sequencing was conducted to examine the composition, assembly, co-occurrence patterns of abundant and rare bacteria from five drinking water sites across four seasons in one year in China. The results indicated that abundant taxa were mainly composed of Rhizobiales&#95;UG1, Sphingomonadales&#95;UG1, and Comamonadaceae, while rare taxa were Sphingomonadales&#95;UG1, Rhizobiales&#95;UG2, and Rhizobiales&#95;UG1. The richness of rare bacteria was greater than that of abundant ones, and the richness had no differences among seasons. The beta diversity was significantly discrepant in abundant and rare communities and among seasons. Deterministic mechanism accounted for a larger contribution to abundant taxa than rare taxa. Furthermore, water temperature had higher effects on abundant microbiome than rare ones. Co-occurrence network analysis indicated that abundant taxa that occupied frequently in central positions had stronger effect on co-occurrence network. In our study, these results collectively suggested that rare bacteria respond to environmental variables with an analogical pattern to abundant counterparts (similar community assembly), but their ecological diversities, driving forces, and co-occurrence patterns were not equivalent in drinking water., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

This study aims to examine the relation between COVID-19-related stressors and mental health among Chinese college students during the pandemic outbreaks, and the possible mediator or moderator between them. Five hundred and fifty Chinese college students were invited to complete an anonymous survey, and the data were analyzed with SPSS 16.0 software. The results shows that the number of stressors has a negative direct and indirect (through risk perception of being infected with COVID-19 disease) impacts on college students' mental health. Adaptive coping is a protective factor of students' mental health, and could be regarded as a buffer that attenuates the negative effect of the COVID-19-related stressors on risk perception of being infected with COVID-19 disease (or mental health). With regard to demographic variables, females, junior and senior students, or students whose family residence was worst hit by the pandemic tend to report poorer mental health during the pandemic outbreak. These findings enrich our understanding about the impact of the COVID-19 pandemic on college population and have implications for university counseling services during times of acute, large-scale infective disease outbreaks., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Han, Tang, Li, Shen, Li, Wang, Chen and Hu.)

Background: The organ donation in China has developed rapidly since fully launched donations after citizens death in 2015. This study was conducted to evaluate how the Chinese general public views changed on deceased organ donation, and to improve the donation process., Methods: A total of 110 eligible studies, including 103, 410 individuals, were selected to analyze through searching PubMed, CBMdisc, CQVIP, CNKI, and Wanfang Data from Jan 1, 1990 to May 31, 2019. The pooled proportions (and 95% CIs) of cognition, attitudes and willingness related to organ donation were calculated using the Freeman-Tukey double arcsine transformation., Results: The pooled proportions of knowing about organ donation and willing to donate increased from 84.6% (73.0-93.4) and 32.4% (23.9-41.6) before 2015, to 86.4% (74.5-95.1) and 39.9% (32.8-47.2) after 2015, respectively. The willingness to posthumous organ donation for cornea, heart, kidney, and liver had a significant improvement. Especially, the proportion of willingness to donate cornea increased to 56.0% (43.3-68.3) after 2015, from 39.2% (31.2-47.4) before 2015. However, although 69.7% (62.7-76.4) of participants approved the deceased organ donation, only 35.6% (29.7-41.8) and 43.9% (37.2-50.8) were willing to donate their own and relatives organs postmortem, respectively. The leading reasons for refraining from donating organs postmortem were distrusting the medical professionals (49.8%, 35.2-64.4) and traditional Chinese values (40.6%, 32.4-49.0). Popularizing knowledge about organ donation (61.5%, 45.7-76.1), humanitarian aid (57.1%, 48.8-65.3), and priority of using donated organs for relatives (53.1%, 30.8-74.7) were the applauded strategies to improve the willingness to posthumous organ donation., Conclusions: The willingness toward posthumous organ donation has a significant improvement among Chinese general public since 2015, however, several important measures still need to be taken to promote the favorable attitudes and willingness toward organ donation.

To understand the epidemiology, evolutionary and transmission characteristics of HIV-1 CRF07&#95;BC in Nanjing, China. One hundred and fifty-nine patients with HIV-1 CRF07&#95;BC were recruited. DNA sequencing, phylogenetic analysis, and molecular transmission cluster analysis were conducted to determine the molecular epidemiology and evolutionary characteristics. Of these HIV-1-infected patients, 95.6% were male, and men who sex with men (76.7%) were the main transmission route. Only 34.0% of these cases were born in Nanjing, and most of them (64.8%) reported having multiple sex partners in the last 6 months. The maximum likelihood phylogenetic analyses of HIV-1 CRF07&#95;BC revealed two lineages. Overall, 67.3% of Nanjing sequences were connected to at least one other individual distributed in 11 clusters, and the average degree was 21.2 with range (1-178). The clustered patients were more likely to be male. The time to a most recent common ancestor for the early HIV-1 CRF07&#95;BC circulating in Nanjing was estimated to be 1998.71[1997.36-2001.07]. The mean estimated evolutionary rate for the epidemic cluster was slightly lower at 2.38[2.12-2.65]  ×  10 -3 per site per year with the relaxed exponential clock model. HIV-1 CRF07&#95;BC was transmitted into Nanjing more than 20 years ago from Yunnan and has become one of the most predominant subtypes with a higher evolutionary rate than before., (© 2020 Wiley Periodicals, Inc.)

Competing Interests: Competing interests: None declared.

College students are disproportionately affected by HIV-1 in China. However, little is known about the genetic characteristics of HIV-1 among this population. A molecular epidemiological investigation was conducted among the newly diagnosed antiretroviral therapy-naïve HIV-1-infected individuals during 2015-2019 in Nanjing city, China. The pol fragment (HXB2: 2,253-3,311) was obtained by HIV-1 RNA extraction and gene amplification, and subjected to genotyping, recombination analysis, and phylogenetic inference. A total of 945 pol sequences from 226 students and 719 nonstudents were successfully amplified. Multiple genotypes were identified in students, including CRF01&#95;AE (37.66%), CRF07&#95;BC (32.90%), CRF55&#95;01B (5.63%), CRF68&#95;01B (3.46%), CRF67&#95;01B (3.03%), subtype B (1.73%), and CRF58&#95;01B (1.30%) and unique recombinant forms (URFs) of 01C&#95;like (7.08%), 0107&#95;like (3.98%), 01BC&#95;like (2.21%), and 01B&#95;like (1.33%). The distribution of genotypes among students was similar to that among nonstudents. The estimated mean evolutionary rate of URFs was 2.89 × 10 -3 [95% Bayesian credible interval: 1.89-3.90] nucleotide substitutions/site/year. Approximately 64% (21/33) of URFs among students were located in three major clusters (0107&#95;like, 01C&#95;like 1, and 01C&#95;like 2 clusters), which had recent time to the most recent common ancestors and low mean genetic distance, and presumably originated from Nanjing (posterior probability ≥0.99, state probability ≥0.9). Among 226 students with pol segments, the prevalence of primary and transmitted drug resistance mutations was 15.93% and 3.98%, respectively. The rapid evolution of multiple HIV-1 genotypes and high prevalence of URFs circulating among students in Nanjing emphasized the necessity of comprehensive surveillance for HIV-1 transmission among this population.

Objective: This study aimed to investigate the epidemiological characteristics and HIV/AIDS-related knowledge, attitudes and practice (KAP) among HIV-positive college students., Design: A cross-sectional study., Setting: Five districts of Nanjing, China., Participants: A total of 156 college students with newly diagnosed HIV infection between September 2015 and July 2017., Main Outcome Measures: Social-demographic characteristics, mode of HIV acquisition, infection of sexually transmitted diseases, risky sexual behaviours and HIV/AIDS-related KAP were collected by a face-to-face questionnaire administered by trained interviewers., Results: About 98.7% (154/156) of HIV-positive college students in our study were men, and 96.1% (148/154) of them were infected by sexual intercourse with men. More than half (52.5%, 82/156) of participants were freshmen or sophomores. Nearly 30% (44/154) of male students did not realise the severe status of the HIV/AIDS epidemic among students who are men who have sex with men (MSM). More than four-fifths of male students did not know if their male regular (83.0%, 93/112) or casual (95.9%, 94/98) sexual partners were HIV-positive, while less than half of them had high-risk perceptions towards HIV infection from male regular and occasional sexual partners. Approximately one-half and four-fifths of male students had more than two regular (54.5%, 61/112) and occasional (79.6%, 78/98) partners during lifetime, respectively. However, only 62.5% (70/112) and 66.3% (65/98) of male students used condoms consistently during sexual intercourse with regular and casual partners, respectively. Geosocial networking apps have become the most dominant way for male students to seek sexual partners., Conclusions: This study reported a low level of HIV/AIDS-related knowledge, a high level of exposure to risky sexual behaviours and some valuable epidemiological characteristics among HIV-positive college students, which highlighted the importance of carrying out HIV/AIDS prevention education and risk warning education early and timely towards college students on campus., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Cardiovascular autonomic dysfunction is closely related to increased mortality in patients with diabetes. Previous studies have proved that cystatin C (CysC) is an important predictor of both peripheral neuropathy and cardiovascular events. However, whether CysC is also associated with cardiovascular autonomic dysfunction remains unclear. Therefore, the aim of this study was to investigate the relationship between CysC and cardiovascular autonomic dysfunction in type 2 diabetic patients without renal dysfunction., Methods: A total of 161 type 2 diabetic patients with normal serum creatinine (less than 133  μ mol/l) and estimated glomerular filtration rate (eGFR) higher than 60 ml/min per 1.73 m 2 were recruited in our study. Cardiovascular autonomic dysfunction was determined by heart rate variability (HRV) measured by a 24-hour Holter monitor. Serum CysC was tested by particle-enhanced turbidimetric immunoassay, and subjects were divided into three groups based on the tertiles of CysC. Pearson correlation analysis was used to evaluate the association between different indexes, and the association of CysC with HRV indexes was assessed by multivariate linear regression analysis., Results: The HRV parameters were lower in the group with the highest CysC concentration than in the groups with lower levels of CysC ( P < 0.05). Pearson correlation analysis showed a negative relationship between CysC and the HRV parameters, including SDNN ( r = -0.31, P < 0.001), SDANN ( r = -0.25, P = 0.002), and logLF ( r = -0.18, P = 0.023). Furthermore, multivariate linear regression analysis revealed that CysC was independently correlated with SDNN ( β = -24.11, P = 0.015) and SDANN ( β = -19.88, P = 0.047) after adjusting for the confounding factors of gender, age, blood pressure, body mass index, eGFR, and hemoglobin A1c., Conclusions: Serum CysC levels are associated with cardiovascular autonomic dysfunction; furthermore, CysC may be a reliable and convenient biomarker for detecting cardiovascular autonomic dysfunction.

Comprehensive data on hepatitis C virus (HCV) genotypes distribution is critical for treatment regimen selection, vaccine design, and drug development. This study aimed to understand the dynamic distribution of HCV genotypes in Mainland China. Three hundred sixty-two studies published from January 1993 to December 2017 involving 64 891 samples (5133 injecting drug users, 2748 volunteer blood donors, 1509 former paid plasma donors, 160 sexually encounters, and 1992 human immunodeficiency virus (HIV)/HCV coinfection patients) were eligible for the quantitative synthesis estimation. Pooled proportion of HCV genotypes (and 95% confidence intervals [CIs]) was estimated through the Freeman-Tukey double arcsine transformation by period, region, and risk group. A sharp decline of the subtype 1b was observed in all regions except in northwestern and central regions. The genotypes 3 and 6 showed an obvious increase in southern and southwestern regions and have already spread nationwide. After 2010, subtype 1b was the most dominant variant in all regions and risk groups, accounting for 54.0% (95% CI, 51.9-56.1) of all national infections. Subtype 2a was the second most prevalent strain in all regions except in the south and southwest, with 15.4% (95% CI, 13.1-17.8) national infections. The subtype 6a in southern region and 3b and 3a in southwestern region had a higher proportion of infections than that in other regions. In addition, the genotypes 3 and 6 are already prevalent in almost all risk groups. The distribution of HCV genotypes were sharply shifting in China in the past three decades. The HCV subtype 1b posed a sharp decline, whereas genotypes 3 and 6 played an increasing role in the regional and populational HCV pandemic., (© 2018 Wiley Periodicals, Inc.)

Background: People with allergic rhinitis (AR) often seek help from Chinese medicine due to dissatisfaction with conventional treatments. Lung-spleen qi deficiency syndrome (LSQDS) is the most common type of AR, and the Chinese herbal medicine formula bi min fang (BMF) is commonly prescribed for AR patients with LSQDS. However, direct evidence supporting its efficacy and safety is not available, and its potential mechanism of action remains unclear., Methods/design: This paper presents a double-blind, double-dummy, randomized controlled trial. After a 2-week run-in period, 80 AR patients with LSQDS will be recruited and randomly allocated to the BMF group or the control group in a 1:1 ratio. The patients in the BMF group will receive BMF and the placebo for levocetirizine hydrochloride orally, while the control group participants will receive levocetirizine hydrochloride and the placebo for BMF orally. All participants will receive 4 weeks of treatment and 12 weeks of follow-up. The primary outcome is a change in the Total Nasal Symptom Score (TNSS). Secondary outcomes include changes in scores for the standard version of the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ(S)), and visual analog scale (VAS); changes in serum levels of the cytokines interleukin-4, interferon-γ, transforming growth factor β-1, and interleukin-17; and changes in the gut microbiota composition in the stool. The TNSS, RQLQ(S), and VAS will be recorded at the beginning of, middle of and after the treatment period and at the end of each month in the 3-month follow-up period. Blood and stool samples will be collected at baseline and the end of the treatment. The aforementioned four cytokines will be detected in the serum using enzyme-linked immunosorbent assays, and the stool gut microbiota will be detected using 16S ribosomal ribonucleic acid sequencing. Any side effects of the treatment will be recorded., Discussion: The results of this trial will provide consolidated evidence of the effect of BMF on AR and the potential mechanism by which BMF acts. This study will be the first to explore the mechanism of action of Chinese herbal medicine on the gut microbiota in AR., Trial Registration: Chinese Clinical Trial Registry, ChiCTR-IPR-17010970 . Registered on 23 March 2017.

We aimed to investigate the molecular epidemic characteristics and viral transmission patterns of HIV-1 in a typical labor export area, Guangyuan city, China. Based on conducting phylogenetic trees and molecular transmission networks, a phylogenetic analysis was performed on HIV-1 pol sequences obtained from 211 migrant-history workers, 83 non-migrant-history individuals, and 21 migrant-history unknown individuals between January, 2012 and February, 2017 in Guangyuan city. Phylogenetic analysis revealed that CRF07&#95;BC (48.3%, n = 152) and CRF01&#95;AE (33.3%, n = 105) were the dominant strains in Guangyuan city, and circulated by multiple lineages with various epidemic characteristics. Geographic network analysis showed that Guangyuan city-related sequences with 20.3% CRF07&#95;BC and 28.3% CRF01&#95;AE were linked to that of other provinces, compared to that with 1.7% CRF07&#95;BC and 5.0% CRF01&#95;AE in cities of Sichuan. Molecular transmission network analysis further illustrated that migrant-history workers linked more sequences from other provinces than non-migrant-history individuals in both CRF07&#95;BC (29.3% versus 0.0%, P = 0.013) and CRF01&#95;AE (40.5% versus 10.0%, P = 0.001) networks. Our results highlighted that migrant-history workers in recent year played a vital role in fueling HIV-1 epidemic in Guangyuan city. Molecular transmission network analysis could be a useful approach for disclosing the transmission mechanism of HIV, which should be used in prevention and intervention efforts.

The HIV-1 epidemic among men who have sex with men (MSM) has been spreading throughout China. Shanghai, a central gathering place for MSM, is facing a continuously increasing incidence of HIV-1 infection. In order to better understand the dynamics of HIV-1 diversity and its influence on patient's immune status at baseline on diagnosis, 1265 newly HIV-1-infected MSM collected from January 2009 to December 2013 in Shanghai were retrospectively analyzed for genetic subtyping, CD4+T cell counts, and viral loads. HIV-1 phylogenetic analysis revealed a broad viral diversity including CRF01&#95;AE (62.13%), CRF07&#95;BC (24.51%), subtype B (8.06%), CRF55&#95;01B (3.24%), CER67&#95;01B (0.95%), CRF68&#95;01B (0.4%), CRF08&#95;BC (0.08%) and CRF59&#95;01B (0.08%). Twenty-four unique recombination forms (URFs) (1.98%) were identified as well. Bayesian inference analysis indicated that the introduction of CRF01&#95;AE strain (1997) was earlier than CRF07&#95;BC strain (2001) into MSM population in Shanghai based on the time of the most recent common ancestor (tMRCA). Three epidemic clusters and five sub-clusters were found in CRF01&#95;AE. Significantly lower CD4+T cell count was found in individuals infected with CRF01&#95;AE than in those infected with CRF07&#95;BC infection (P<0.01), whereas viral load was significantly higher those infected with CRF01&#95;AE than with CRF07&#95;BC (P<0.01). In addition, the patients with >45 years of age were found to have lower CD4+T cell counts and higher viral loads than the patients with <25 years of age (P<0.05). This study reveals the presence of HIV-1 subtype diversity in Shanghai and its remarkable influence on clinical outcome. A real-time surveillance of HIV-1 viral diversity and phylodynamics of epidemic cluster, patient's baseline CD4+T cell count and viral load would be of great value to monitoring of disease progression, intervention for transmission, improvement of antiretroviral therapy strategy and design of vaccines.