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The present study aimed to equate the 9-item Patient Health Questionnaire (PHQ-9) and 7-item Generalized Anxiety Disorder Scale (GAD-7) to the Hospital Anxiety and Depression Scale (HADS) depression and anxiety subscales (HADS-D,HADS-A) respectively in patients with major depressive disorder (MDD) and generate crosswalks of raw scores.As it is a single group design that adopts common-person equating method, a total of 460 patients with MDD completed the PHQ-9, GAD-7 and HADS at the same time. Rasch analysis was used to filter out invalid participants, investigate the psychometric properties of test items and participants, link the PHQ-9 and HADS-D as well as GAD-7 and HADS-A, and produce conversion tables respectively. The differences between original scores and converted scores were analyzed to validate the crosswalks.401 samples of depression part and 396 samples of anxiety part were left for final samples. Both the PHQ-9 / HADS-D and GAD-7 / HADS-A combined analysis adequately fit the unidimensional Rasch model, demonstrated acceptable reliability and item-person targeting and showed no disordering category. Slight differential item functioning across gender was found in item PHQ9 and item GAD6. The crosswalks were generated and verified to be validity.The results might be restricted to patients with MDD recruited in a single mental health center.The PHQ-9, GAD-7 and HADS depression and anxiety subscales were successfully linked, producing conversion tables that could be used for directly converting raw score from one instrument to the other.

Objective To examine the psychometric properties of the Chinese version of the Clinically Useful Depression Outcome Scale (CUDOS) in the Chinese patients with major depressive disorder (MDD) using Rasch analysis. Method The sample consisted of 283 patients with MDD (69% females). The Rasch model was applied to examine the overall fit of the Chinese version of CUDOS and the fit of the 18 items to the Rasch model. Dimensionality, item-model fit, differential item functioning (DIF), reliability, ordering of response categories and targeting were tested to examine the psychometric properties of the Chinese version of CUDOS. Results Rasch analysis demonstrated the unidimensionality of the Chinese version of CUDOS. Of the 18 items, three items (item 4, item 5, item 6) showed misfit in the model. After merging item 4 into item 3 and item 6 into item 5, the overall model fit improved. The person separation index (PSI) was 3.0 and the person reliability coefficient was 0.90. No evidence of significant differential item functioning(DIF) was found when associated with gender and age. No disordered category and threshold of the rating response were observed, which meant the response categories setting was reasonable. The mean ability of person was − 0.53. Conclusion The results suggested that the Chinese version of CUDOS has acceptable psychometric properties. In order to improve the quality and applicability of the Chinese version of CUDOS, the merging of item 4 into item 3 and item 6 into item 5 are suggested.

To highlight characteristics in the misdiagnosis of cytomegalovirus retinitis (CMVR).Misdiagnosed cases related to CMVR were analyzed retrospectively at the Department of Ophthalmology, Beijing Youan Hospital, from July 2017 to October 2019. The medical records were reviewed by two independent senior ophthalmologists and the patients' clinical characteristics were analyzed.Eight patients (16 eyes) were identified with misdiagnoses related to CMVR. Six of the patients with CMVR were previously unaware of their human immunodeficiency virus (HIV) infection; one patient with CMVR concealed their history of HIV infection. The cases were initially misdiagnosed as diabetic retinopathy (1/7, 14.3%), branch retinal vein occlusion (1/7, 14.3%), ischemic optic neuropathy (1/7, 14.3%), Behçet's disease (1/7, 14.3%), iridocyclitis (2/7, 28.6%), and progressive outer retinal necrosis (1/7, 14.3%). One patient with binocular renal retinopathy and chronic renal insufficiency was misdiagnosed with CMVR. Four eyes (4/16, 25%) presented with pan-retinal involvement. Fourteen eyes (14/16, 87.5%) had optic disc or macular area involvement. At the final diagnosis, one patient was blind, and two patients had low vision. Seven AIDS patients showed an extremely low level of CD4CMVR may be misdiagnosed in the absence of known immune suppression. CMVR and HIV screening cannot be overlooked if a young male patient presents with yellowish-white retinal lesions. These misdiagnosed patients had severe retinitis associated with poor vision.

Hai-Yan Ma,1,2 Xue-Mei Wang,1,2 Xiao-Jie Huang,2 Cheng-Jia Yang,2 Dong-Fang Sheng,2 Jing-Jing Yang,2 Ming-Zhi Xu2 1The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, People’s Republic of China; 2Guangdong Mental Health Center, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, People’s Republic of ChinaCorrespondence: Ming-Zhi XuGuangdong Mental Health Center, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, No. 123 Huifu West Road, Guangzhou, 510120, Guangdong, People’s Republic of ChinaTel +86 81888553Fax +86 81862664Email mingzhixu@126.comObjective: This study aimed to evaluate the psychometric properties of the Chinese version of the Clinically Useful Depression Outcome Scale (CUDOS).Methods: One hundred ninety patients with major depressive disorder (MDD) according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria were recruited to the study. The English version of the CUDOS was translated into Chinese using a forward and backward translation method, which was according to the guidelines of adaptation and validation of instruments in cross-cultural health care research. The Chinese version of the CUDOS, the 17-item Hamilton Rating Scale for Depression (HRSD) and the improved Clinical Global Impression-Severity Scale (iCGI-S) were used to evaluate depressive symptoms in one hundred ninety patients with MDD. One week after the first evaluation, sixteen patients were selected randomly for a second assessment. Reliability and validity tests and receiver operating characteristic curves were performed.Results: The internal consistency of the CUDOS was 0.95, and the split-half reliability coefficient of the CUDOS was 0.92. The correlation coefficient of the retest in sixteen patients was 0.77 (P < 0.01). There was a significant difference in the total score of the Chinese version of the CUDOS between the different levels of depression severity groups (P < 0.01). The ability of the CUDOS to identify patients in remission was high (area under ROC curve= 0.97). A cut-off score of 14/15 yielded 90.20% sensitivity and 93.60% specificity when iCGI-S=1.Conclusion: The Chinese version of the CUDOS is valuable as a brief and reliable instrument to assess depressive symptoms and clinical outcome. The findings suggest that the optimal cut-off score to identify patients in remission was 14/15.Keywords: MDD, the Chinese version of CUDOS, validity, reliability, cut-off score

The effect of Rayleigh number and nanoparticle concentration on the flow dynamics and natural convection in three-dimensional large- and moderate-gap annuli is analyzed in detail in this work. A nanofluid is applied as the working fluid, with typical nanoparticle concentration ranging from zero to nine percent. The results indicate that the flow strength and deformation of isotherms becomes less intensive with an increase in the nanoparticle concentration for both large- and moderate-gap annuli. There exists a core region in the large-gap annulus, where the flow is two-dimensional and the value of the local Nusselt number is almost uniform in the axial direction. The core region exists between two secondary rolls, which are adjacent to the primary end rolls. The secondary flow decreases in size and finally disappears with an increase in the nanoparticle concentration. For the moderate-gap annulus, the space between the two end walls near the top portion is filled by multiple rolls, and an increase in the nanoparticle concentration gradually reduces the number of the rolls. The locations of the descending and ascending rolls relate to the maximum peaks of the Nusselt number on the inner and outer cylinders, respectively. The heat transfer enhancement only occurs at low nanoparticle concentrations ( φ 105) for a large-gap annulus. Otherwise, in general, a deterioration in heat transfer is observed when the nanoparticle concentration increases from 1 to 9% for both large- and moderate-gap annuli.

The objective of this research was to verify the psychometric characteristics of the Chinese Adaptation of self-report HAMD-6.Outpatients and inpatients who met the DSM-5 criterion for major depressive disorder (MDD) were evaluated by the Chinese self-report HAMD-6, seventeen items of Hamilton Depression Rating Scale (HAMD-17), Patient Health Questionnaire Depression Scale (PHQ-9) and Improved Clinical Global Impression Scale (iCGI-S). The internal consistency reliability, retest reliability, criterion validity and construct validity of the Chinese self-report HAMD-6 were tested. Pearson correlation coefficient was used to assess the correlativity between the total score and the item scores. By drawing the Receiver Operating Characteristics (ROC) curve, the best cut-off value, sensitivity and specificity of Chinese Adaptation self-report HAMD-6 were obtained.Cronbach's alpha coefficient of the Chinese self-report HAMD-6 was 0.91, and the intra-group correlation coefficient (ICC) of retest reliability was 0.81(P 0.01). The Spearman correlation coefficients of the Chinese self-report HAMD-6, Chinese clinician version of HAMD-6, PHQ-9 and HAMD-17 were 0.86, 0.81 and 0.86, respectively (all P 0.01). Results of the confirmatory factor analysis (CFA) supported a unidimensional construct. In addition, HAMD-17 ≤ 7 and iCGI-S= 1 were taken as the remission criteria for depression disorder, and the ROC curves of the Chinese self-report HAMD-6 were plotted with a cut-off value of 3/4, the specificity and sensitivity were 0.85/0.92 and 0.96/0.93 respectively.These results suggested that the abbreviated Chinese self-report HAMD-6 has good reliability and validity among the Chinese population. This study suggested that the remission cut-off value of the scale is 3/4.

To explore the efficacy of integrating Traditional Chinese Medicine (TCM) and anti-retroviral therapy (ART), a customized combination of different classes of medications which was also called cock-tail treatment, on the immunological nonresponse (INR) in people living with human immunodeficiency virus (HIV) (PLWH).Relevant literature in databases such as China National Knowledge Infrastructure Database (CNKI), Wanfang Digital Journal, Chinese Medical Journal Database (CMJD), Chinese Biomedical Literature Database (CBM), PubMed, Cochrane, and Embase was reviewed by two independent investigators. Data were extracted from the studies according to the eligible criteria and analyzed using Review Manager 5.3.Nine randomized controlled trials (RCTs) with 1078 patients were analyzed. Our analyses showed that CD4 T cell counts in the treatment group improved compared with that in the control group [mean difference (MD) = 13.51, 95% confidence interval (CI): 7.42-19.60, P0.0001]. There was no significant difference between the treated and control groups after 3 months (MD = 25.31, 95% CI: ?2.78 to 53.41, P = 0.08). However, after 6 and 12 months, the response of the treatment group was superior to the control group (MD = 27.45, 95% CI: 7.09-47.81, P = 0.008 and MD = 27.34, 95% CI: 6.31-48.37, P = 0.01, respectively). The clinical efficacy of the treatment group was also higher than that of the control group (RR = 1.75, 95% CI: 1.16-2.65, P = 0.007). However, CD45RO and CD45RA T cell counts did not differ significantly between the two groups (MD = 12.37, 95% CI: ?6.71 to 31.45, P = 0.20 and MD = 5.67, 95% CI: ?3.00 to14.35, P = 0.20, respectively).The combined treatment strategy of integrated TCM and Western Medicine promotes long-term reconstitution of the immune system and thus, is beneficial and has potential use for improving INR in PLWH. However, large-scale RCTs are required to provide evidence for optimal intervention strategies.

In order to understand the effects of Rayleigh number and the density inversion parameter on the flow structures, the turbulent characteristics and the heat transfer ability, a series of large eddy simulations on turbulent Rayleigh-Benard convection in a cubical container with cold water near its maximum density were carried out. Results indicate that the large scale circulation (LSC) moves along the diagonal plane at small and medium density inversion parameters. However, at a large density inversion parameter, the LSC disappears. With the increase of the density inversion parameter, there are an increase of temperature in the bulk region and a decrease of penetration depth. Furthermore, with the increase of Rayleigh number, the deformation of isothermal surfaces becomes intense until the plumes are observed. At the same time, the scale of vortices reduces and the fluctuation of Nusselt number amplifies with the increase of Rayleigh number. Based on the numerical results, the dependence of Nusselt number on Rayleigh number and the density inversion parameter is achieved within a satisfactory uncertainty.

Background: In the absence of AIDS vaccine，antiretroviral therapy (ART) was the most effective tool to prevent and control the HIV pandemic. But the widespread use of ART has raised concerns about the emergence of HIV transmitted drug resistance (TDR). Acute HIV infection (AHI) was the most appropriate time to detect the spread of TDR. In this meta-analysis, our purpose was to evaluate the level of TDR in ART-naive patients with acute/ primary/ early HIV infection, and describe the critical drug-resistant mutations. Methods: We systematically reviewed 1192 studies published between January 1, 2008 and December 30, 2019 in PubMed, Web of Science, Embase, and the Cochrane Library, and selected 12 studies that meet our inclusion criteria. To evaluate the overall prevalence of TDR, we extracted raw data and analyzed prevalence estimates using Stata SE. Estimates of mixed-effects were calculated by random-effects meta-analysis, and the I²statistics were used to estimate the heterogeneity of all included studies.Results: The Data of this meta-analysis come from 12 observational studies, covering 3558 ART-naive individuals with PHI, AHI or EHI. The overall prevalence of HIV-TDR is 9.8% (95% confidence interval (CI): 7.2%–12.3%, pConclusion: The overall prevalence of TDR is high among AHI patients who have never received ART. This emphasizes the importance of baseline drug resistance testing for public health surveillance and guiding the choice of ART. In addition, the prevalence of TDR to NNRTIs is the highest, while the TDR to INIs is the lowest. This may guide the selection of clinical antiretroviral drugs.

Introduction This study explores the preference for daily versus on‐demand pre‐exposure prophylaxis (PrEP) among men who have sex with men (MSM) in developing countries when both regimens are available. Methods From 11 December 2018 to 19 October 2019, we recruited MSM for an open‐label real‐world PrEP demonstration study in four major cities in China. Subjects selected their preferred PrEP (oral tenofovir/emtricitabine) regimen (daily vs. on‐demand) at recruitment and underwent on‐site screening before initiation of PrEP. We used logistic regression to assess preference for daily PrEP and correlates. Results Of 1933 recruited MSM, the median age was 29 years, 7.6% was currently married to or living with a female; the median number of male sexual partners was four and 6.1% had used post‐exposure prophylaxis (PEP) in the previous six months. HIV infection risk was subjectively determined as very high (>75%) in 7.0% of subjects, high (50% to 75%) in 13.3%, moderate (25% to 49%) in 31.5% and low or none (0% to 24%) in 48.1%. On average, participants preferred on‐demand PrEP over daily PrEP (1104 (57.1%) versus 829 (42.9%)) at recruitment. In multivariable analysis, currently being married to or living with a female was associated with 14.6 percentage points lower preference for daily PrEP (marginal effect = −0.146 [95% CI: −0.230, −0.062], p = 0.001); whereas the number of male sexual partners (marginal effect = 0.003 [95% CI: 0.000, 0.005], p = 0.034) and a subjective assessment of being very high risk of HIV infection (vs. low and no risk, marginal effect size = 0.105 [95% CI: 0.012, 0.198], p = 0.027) were associated with increased preference for daily versus on‐demand PrEP. Among the 1933 potential participants, 721 (37.3%) did not attend the subsequent on‐site screening. Lower‐income, lower education level, lower subjective expected risk of HIV infection risk and younger age positively correlated with the absence of on‐site screening. Conclusions MSM in China prefer both daily and on‐demand PrEP when both regimens are provided free. Social structural factors and subjective risk of HIV infection have significant impacts on PrEP preference and use. The upcoming national PrEP guideline should consider incorporating both regimens and the correlates to help implement PrEP in China.

Background: Many Pre-exposure prophylaxis (PrEP) users have difficulty attending the quarterly facility-based HIV testing, which leads to the potential risk of drug resistance in the context of breakthrough infection with low drug compliance. We explored the acceptance of HIV self-testing (HIVST) service among PrEP recipients. Methods: MSM were recruited for the PrEP demonstration in four major cities in China from December 2018 to September 2019, provided with regimens of both daily and on-demand PrEP. Facility-based HIV testing was provided quarterly at clinic visits. Previous HIV testing history and acceptance of free HIVST kits to use between each quarterly clinic visit was collected. Correlates of levels of acceptance were analysed using multivariable ordinal logistic regression. Results: We recruited 1,222 MSM. among which 48.5% preferred daily PrEP and 51.5% preferred on-demand PrEP. There was 26.8% (321/1222) had never been to any facility-based HIV testing previously, and the self-reported major reason was that they had already routinely used HIVST. A quarter of the participants (74.5%, 910/1222) had used HIVST previously. There were 1184 MSM (96.9%) accepted to use HIVST between each quarterly clinic visits during PrEP usage, composing 947 ( 77.5%) very willing to, 237（19.4%）willing to, 29 (2.4%) unwilling to, and 9 (0.7%) very unwilling to. Participants preferred daily PrEP (vs. on-demand PrEP, aOR=1.8, 95% CI:1.3-2.4) and had less than 2 times of facility-based HIV testing in the past year (vs. ³2, aOR=1.4,95% CI:1.1-1.9) were more likely to have higher level of acceptance of HIVST.Conclusions: MSM had high acceptance of HIVST, especially among those preferred daily PrEP and with less facility-based HIV testing in the previous year. Offering HIVST services PrEP recipients is feasible and necessary. Above result is of great significance for promoting HIVST among PrEP users during COVID-19, improving awareness of their HIV infection status and ensuring compliance with medication. Future study should exam the impact of HIVST on HIV testing frequency among PrEP users.Trial registration: ChiCTR1800020374 on 27th Dec 2018. http://www.chictr.org.cn/searchproj.aspx

In order to understand the effects of density inversion parameter and Rayleigh number on the fluid motion and heat transfer characteristics of penetrative Rayleigh-Benard convection in a cylindrical container, a series of large eddy simulations were performed. The working fluid is cold water and Prandtl number is 11.57. Rayleigh number up to 10 11 is considered and the density inversion parameter ranges from 0 to 0.7. The results indicate that the effect of cold plumes on the larger scale circulation gradually diminishes and finally disappears with the increase of density inversion parameter. Furthermore, an increase of the temperature within the bulk region and a decrease of the penetration depth are also certified with the increase of density inversion parameter. With the increase of Rayleigh number, soft and hard turbulent states are successively observed. In the soft turbulence state, the evolution of Nusselt number shows a weak fluctuation, the corresponding histogram has a Gaussian distribution, and the penetration depth increases sharply with the increase of Rayleigh number. In the hard turbulence state, the evolution of Nusselt number presents a much stronger fluctuation than that in the soft turbulence state, the corresponding histogram fits more exponential distribution, and the variation of the penetration depth with Rayleigh number is small. A single power law between the heat transfer efficiency (Nusselt number) and Rayleigh number that covers soft and hard turbulence states is developed for each density inversion parameter. It is found that the average Nusselt number decreases linearly with the increase of density inversion parameter.

The effects of geometric and thermal properties of multilayer nominal three-dimensional chip on the temperature hotspots are investigated in this work. Based on heat-transfer computational fluid dynamic analysis, various effective parameters which correlate with reducing the hotspot temperature are studied. A new analytical method for the equivalent thermal conductivity of the thermal interface material (TIM) layer and the chip layer structure in the multilayer chip is proposed, the deviation between the present results and the prior literature is less than 2%. For different chip structures and through silicon vias (TSV) arrangements, the higher the number of multi-layer chips subject to a low Reynolds number, the higher the hotspot temperature. The hotspot temperature gradually decreases linearly with an increase in the Reynolds number. For a convective cooling environment, comparing the two cases with and without the TSV, the variation of Nusselt number for the chip package surface facing the coolant is less than 1. The staggered core structure has a lower hotspot temperature for the no TSV case. When the Core-Centralized TSV is introduced, the overlapping core structure influences the internal heat dissipation the most. When the Reynolds number increases to 2000 and the number of chip layers is greater than 10, the hotspot temperature is almost insensitive to the chip layer and the hotspot temperature difference among different multilayer 3D chips does not exceed 0.2%. The layer where the hotspot temperature exists is different for different TSV arrangements.

To verify whether the new Asian modified CKD-EPI equation improved the performance of original one in determining GFR in Chinese patients with CKD. A well-designed paired cohort was set up. Measured GFR (mGFR) was the result of 99mTc-diethylene triamine pentaacetic acid (99mTc-DTPA) dual plasma sample clearance method. The estimated GFR (eGFR) was the result of the CKD-EPI equation (eGFR1) and the new Asian modified CKD-EPI equation (eGFR2). The comparisons were performed to evaluate the superiority of the eGFR2 in bias, accuracy, precision, concordance correlation coefficient and the slope of regression equation and measure agreement. A total of 195 patients were enrolled and analyzed. The new Asian modified CKD-EPI equation improved the performance of the original one in bias and accuracy. However, nearly identical performance was observed in the respect of precision, concordance correlation coefficient, slope of eGFR against mGFR and 95 % limit of agreement. In the subgroup of GFR 60 mL min−1/1.73 m2, eGFR2 performed better than eGFR1 in terms of bias and accuracy. The new Asian modified CKD-EPI equation can lead to more accurate GFR estimation in Chinese patients with CKD in general practice, especially in the higher GFR group.

To study the effect of straw ash dosage and the function of drying temperature on nutrient losses, imitate disk granulation technology was used to make ash compound fertilizer; the water immersion test was chosen to study the effect of ash on nutrient leaching characteristics of ash compound fertilizer. The results show that the total nutrient loss was the least at drying temperature of 80°C; with the rise of ash content from 15% to 20%, the release content of nitrogen and phosphorus increase, indicated that ash is able to retard the release of nitrogen and phosphorus, the dissolution rate slows down with reducing ash content, which indicates adding ash can extend the time of nutrient supply, and the effect increased with the rise of ash content.

The level of web accessibility construction affects the information interactive ability of special populations directly, how to evaluate the Web Accessibility Level efficiently is a research hotspot. A part of the current evaluation metrics needs human intervention, and it requires the worker to master enough professional knowledge, at the same time, it is likely to reduce efficiency because of duplication of work. We have designed an interactive mode to aid Web Accessibility Evaluation, which uses short tutorials and leading tasks to make the worker master the necessary knowledge quickly, in additions, with the help of the mask, embedded information tips, and real-time assistant functions for the actual evaluation task, the evaluation efficiency has been improved.

The aim of this research is to understand the effect of the aspect ratio on the heat transfer ability and hydrodynamics characteristics of Rayleigh-Benard convection of cold water near its maximum density in box-shaped containers. The Rayleigh number is fixed at 109, density inversion parameters are 0.3, 0.5 and 0.7, and the aspect ratio ranges from 1/60 to 1. Results indicate that the average Nusselt number presents a weak dependence on the aspect ratio at the large aspect ratio (A > 0.3). However, it reaches the maximum and then drops when the aspect ratio decreases from A = 0.3. Large scale circulations are observed for containers at the large aspect ratio, and the confinement of sidewalls weakens the large-scale circulation and eventually destructs it. At the large aspect ratio, the velocity fluctuation near the sidewalls is stronger than that in the center zone, because plumes primarily move along the sidewalls of the container. At a small aspect ratio, more plumes appear in the center of the container, where the fluctuation is stronger than that near sidewalls. The effect of cold plumes on the flow is reduced as the density inversion parameter increases. Therefore, the flow is mainly driven by hot plumes, and the velocity magnitude and fluctuation decrease significantly.The aim of this research is to understand the effect of the aspect ratio on the heat transfer ability and hydrodynamics characteristics of Rayleigh-Benard convection of cold water near its maximum density in box-shaped containers. The Rayleigh number is fixed at 109, density inversion parameters are 0.3, 0.5 and 0.7, and the aspect ratio ranges from 1/60 to 1. Results indicate that the average Nusselt number presents a weak dependence on the aspect ratio at the large aspect ratio (A > 0.3). However, it reaches the maximum and then drops when the aspect ratio decreases from A = 0.3. Large scale circulations are observed for containers at the large aspect ratio, and the confinement of sidewalls weakens the large-scale circulation and eventually destructs it. At the large aspect ratio, the velocity fluctuation near the sidewalls is stronger than that in the center zone, because plumes primarily move along the sidewalls of the container. At a small aspect ratio, more plumes appear in the center of the contain...

Poly (dimethylsiloxane) (PDMS) silicones have found many applications in biomedical devices, such as catheters and intraocular lenses. But their hydrophobicity makes the possibility of the unexpected bioadhesion. In this paper, we reported a facile and efficient anti-fouling surface modification method on PDMS via self-polymerization of dopamine and the followed hyaluronic acid immobilization. Dopamine, commonly used as a neurotransmitter, is also a small molecule mimic of the adhesive proteins of mussels. Self-polymerization of dopamine can produce a thin polydopamine (PDA) layer on PDMS surface. Subsequently, thiol group functionalized hyaluronic acid (denoted as HA-SH) was immobilized covalently onto the resultant surface by the coupling between thiol group and reactive polydopamine layer. Then, the in vitro adhesion behaviors of the lens epithelial cells (LECs) and macrophage were investigated for evalution the anti-fouling effect of the hyaluronic acid modified PDMS surface. The results indicated that the cellular adhesion on PDMS were greatly decreased after hyaluronic acid modification, which suggested the potential application of such hyaluronic acid modified PDMS in biomedical applications.

The steroid hormone progesterone is an essential regulator of the cellular processes that are required for the development and maintenance of reproductive function. The diverse effects of progesterone are mediated by the progesterone receptor (PR). The functions of the PR are regulated not only by ligands but also by modulators of various cell signaling pathways. However, it is not clear which energy state regulates PR activity. AMP-activated protein kinase (AMPK), a serine/threonine protein kinase, is a key modulator of energy homeostasis. Once activated by an increasing cellular AMP:ATP ratio, AMPK switches off ATP-consuming processes and switches on ATP-producing processes. We found that both 5-aminoimidazole-4-carboxamide 1-β-d-ribofuranoside (AICAR) and metformin, traditional pharmacological activators of AMPK, inhibited the PR pathway, as evidenced by progesterone response element (PRE)-driven luciferase activity and PR target gene expression. Compound C, an inhibitor of AMPK, partly but significantly reversed the anti-PR effects of AICAR and metformin. The downregulation of endogenous AMPK by small interfering RNAs (siRNAs) stimulated PR activity. AMPK activation by AICAR decreased the progesterone-induced phosphorylation of PR at serine 294 and inhibited the recruitment of PR to an endogenous PRE. Taken together, our data suggest that AMPK, an energy sensor, is involved in the regulation of PR signaling.

In order to understand the effect of the Rayleigh number, the density inversion phenomenon and the aspect ratio on the flow patterns and the heat transfer characteristics of Rayleigh–Benard convection of cold water in the neighborhood of the maximum density, a series of large eddy simulations are conducted by using the finite volume method. The Rayleigh number ranges between 106 and 109, the density inversion parameter and the aspect ratio are varied from 0 to 0.9 and from 0.4 to 2.5, respectively. The results indicate that the reversal of the large scale circulation (LSC) occurs with the increase of the Rayleigh number. When there exists a density inversion phenomenon, the key driver for the LSC is hot plumes. When the density inversion parameter is large enough, a stagnant region is found near the top of the container as the hot plumes cannot move to the top wall. The flow pattern structures depend mainly on the aspect ratio. When the aspect ratio is small, the rolls are vertically stacked and the flow keeps on switching among different flow states. For a moderate aspect ratio, different long-lived roll states coexist at a fixed aspect ratio. For a larger aspect ratio, the flow state is everlasting. The number of rolls increases with the increase of the aspect ratio. Furthermore, the aspect ratio has only slight influence on the time averaged Nusselt number for all density inversion parameters.

Rationale Camurati-Engelmann disease (i.e., progressive diaphyseal dysplasia) is an extremely rare autosomal dominant bone disorder. The most common clinical manifestations were chronic skeletal pain, waddling gait, muscular weakness. Patient concerns We described that a 27-year-old male with a 1-year history of intermittent tetany was referred for bone scintigraphy. The whole body bone scan images showed abnormal increased uptake of the tracer in the long bones of the upper and lower extremities as well as in the skull. Diagnoses Combined the family history, the findings of the images and the genetic study, the diagnosis of Camurati-Engelmann disease was confirmed. Interventions and outcomes The patient responded well to the treatment of calcium gluconate. Lessons Bone scintigraphy would be helpful in the diagnosis and assessing the severity of Camurati-Engelmann disease.

To explore the immunoregulatory effects of human amniotic mesenchymal cells (hAMCs) on allogeneic peripheral blood lymphocytes.The hAMCs were isolated from abandoned human amnion. Peripheral blood mononuclear lymphocytes (PBMLs) were separated from healthy donors by density gradient centrifugation. Then, PBMLs were treated with phytohemagglutinin (PHA) and different concentrations of hAMCs. Proliferation effect of PBMLs was tested using MTS assay, and production of IFN-gamma and TNF-alpha by PBMLs was detected by ELISA.hAMCs could remarkably inhibit the lymphocytes proliferation. When the ratios of hAMCs to PBMLs were 0.05: 1, 0.10 :1, 0.20: 1, the inhibitory rates of PBMLs proliferation were 16.91%, 20.83% and 28.19%, respectively. HAMCs also decreased the production of IFN-gamma and TNF-alpha by PBMLs in a dose-dependent manner (P0.01).HAMCs could inhibit the proliferation of allogeneic lymphocytes and reduce secretion of IFN-gamma and TNF-alpha, which might be one of the mechanism for prevention and remission of transplant rejection.

Background Among the Chinese population of 1.3 billion, there are an estimated 93 million carriers of hepatitis B virus (HBV). Men who have sex with men (MSM) are at increased risk for HBV infection; however, the prevalence of HBV immunization and infection among Chinese MSM remains undetermined. Methods A cross-sectional survey of 1,114 eligible participants was conducted in Beijing, China. Multiple methods were used to recruit study participants. Demographic information and potential correlated factors were collected by questionnaire. Additionally, blood specimens were collected and tested for sexually transmitted infections and serologic markers of hepatitis B immunization and infection. Results Laboratory data were available for 1,111 participants (99.7%), the prevalence of hepatitis B immunization was 38.9%, and 26.5% had serologic markers of HBV infection. Multivariate analyses indicated that higher education level, smaller number of male sex partners in the past 12 months, reported diagnosis of sexually transmitted disease (STD), and history of blood donation were independently associated with HBV immunization. Absence of steady male sex partner(s) in the past 12 months, and reported diagnosis of STD were shown to be independently associated with HBV infection. MSM positive for HBV infection were more likely to have past or current syphilis infection. Conclusions Low prevalence of HBV immunization and high prevalence of HBV infection among Chinese MSM and a correlation between sexual risk factors and hepatitis B infection indicate that comprehensive preventative measures for HBV among MSM, including blood donor and HIV-STD clinic vaccination programs as well as targeted health education campaigns should be developed in China.

Liver injury is one of the most important adverse effects of antiretroviral therapy, leading to therapy changing or discontinuation. Data on liver injury in human immunodeficiency virus-1-infected patients receiving antiretroviral therapy are limited in China. The purpose of this study was to investigate the features of liver injury in human immunodeficiency virus type 1-infected patients receiving non-nucleosides reverse transcriptase inhibitors-based antiretroviral therapy in China.Seventy-five patients on antiretroviral therapy containing non-nucleosides reverse transcriptase inhibitors were retrospectively studied. The patients were divided into 2 groups: group 1 (with liver injury, n = 45) and group 2 (without liver injury, n = 30). The features of liver injury were analyzed. The sex, age, baseline CD4 counts, hepatitis B virus (HBV) and/or hepatitis C virus (HCV) co-infection, hepatotoxic drug use and nevirapine or efavirenz use were compared between two groups.Forty-five patients (60.0%), 31 (68.9%) males and 14 (31.1%) females, aged 12 to 52 years (averaged (39 ± 9) years), experienced at least one episode of liver injury. Forty (53.3%) patients were co-infected with HBV and/or HCV, 42 (56%) patients had concomitant use of antituberculosis drugs or cotrimoxazole, 46 (61.3%) and 29 (38.7%) patients received regimen containing nevirapine and efavirenz, respectively. Grade 1 liver injuries were observed in 26 (57.8%) patients, grade 2 in 16 (35.6%), grade 3 in 2 (4.0%) and grade 4 in 1 (2.2%). Three (6.7%) patients discontinued highly active antiretroviral therapy (HAART) due to liver injury. In group 1, there were 29 (64.4%) patients co-infected with HBV and/or HCV, 32 (71.1%) patients received regimen containing nevirapine, and 30 (66.7%) patients had concomitant use of anti-tuberculosis drugs or cotrimoxazole, respectively, significantly higher than those in group 2 (11 (36.7%), 14 (46.7%) and 12 (40%), respectively; P = 0.018, 0.033, 0.023, respectively). The sex, age, baseline CD4 counts and disease stage were not factors associated with liver injury.Liver injury associated with HAART containing non-nucleosides reverse transcriptase inhibitors was mild to moderate and those who were co-infected with HBV and/or HCV, had concomitant use of antituberculosis drugs or cotrimoxazole and received a regimen containing nevirapine were prone to liver injury while receiving HAART.

To characterize the variation in V3 loop of HIV-1 B'strains circulating in Chinese blood donors.The c2-c3 regions of the HIV envelop gene were amplified by nest-PCR from 32 HIV-1-infected blood donors in He Nan province in China. The BIOEDIT and MEGA software are used to analyze the sequences of V3 loop.There are five types of central motifs of the 32 samples, in which GPGR and GPGQ are most common. More variations associated with T tropic/SI phenotype can be seen in AIDS group.The V3 tip motifs of HIV-1B' strains circulating in Chinese blood donors are various, the different characterization of V3 loop between AIDS and asymptomatic patients indicates different biological phenotype and pathogenesis which warrant additional investigation.

To investigate the spectra of opportunistic infections (OIs) in HIV/AIDS patients in China and evaluate the relation between OIs and CD(4)(+), CD(8)(+) T cell counts so as to suggest when the prophylaxis for OIs should begin.The clinical and immunological characteristics of 181 patients with HIV/AIDS admitted into the Department of Infectious Disease, Beijing Youan Hospital from 2002 to 2005 were retrospectively analyzed.One hundred and four of the 181 HIV-positive patients experienced at least one HIV-related opportunistic infection. The most common opportunistic infections were as follows: oral candidal pharyngitis (52.9%), Pneumocystis carinii pneumonia (PCP) (31.7%), tuberculosis (21.2%), systemic mycosis (15.4%), viral herpes (12.5%) and other respiratory infections (6.7%), etc. The medians of CD(4)(+), CD(8)(+) T cell counts and CD(4)/CD(8) ratios in the patients with OIs were lower as compared with those in the patients without OIs. The patients who experienced OIs had similar CD(4)(+) T cell count with no statistical difference, no matter there was one or more than one OIs. The CD(+)(4) T cell counts lowered in accordance with increase of the number of OIs. The similar results were found in the CD(4)/CD(8) ratios. There was significant difference between CD(4)/CD(8) in patients with tuberculosis and those with PCP.HIV-related OIs are easily encountered in digestive and respiratory systems of HIV/AIDS patients and it is shown that a close correlation exists between CD(4)(+) T cell count, CD(4)/CD(8) ratio and opportunistic infections. Patients with CD(4)(+) T cell count below 200 cells/microl, CD(4)/CD(8) less than 0.20 especially are at higher risk of developing opportunistic infections and they generally have diverse OIs. Our findings are helpful to predict the initiation both primary and secondary prophylaxis for OIs in HIV/AIDS patients in China.

To investigate the copy numbers of porcine endogenous retroviruses in genome of Banna miniature swines for screening of donors in xenotransplantation with porcine transplants.The genomic DNA of peripheral blood mononuclear cells(PBMCs) of 50 Banna miniature swines in 4 inbred sublines and 5 European Large White Pigs was extracted for the detection to pol, envA, envB, envC and envA/C recombinant in PERVs with real-time quantitative/semi-quantitative PCR and normal PCR.PCR products of pol, envA and envB of PERV could be obtained from all the Banna samples, and the mean amount of these products was 24.2+/-9.4,13.1+/-8.4,16.4+/-9.8 respectively and was significantly different among the inbred herds (P0.01). The envC and envA/C were not amplified.The copy numbers of pol, envA and envB genes of PERV in porcine genome were significantly different among the inbred herds of Banna miniature swines, and envC and envA/C were absent in genome of Banna Miniature Swines.