[High-risk sexual behaviors of HIV/AIDS and related factors in young students in Guangzhou].

Objective: To explore high-risk sexual behaviors of HIV/AIDS and related factors in young students in Guangzhou. Methods: A cross-sectional survey was conducted in 5 different types of Guangzhou colleges by convenience sampling with minimum number of classes per grade and 600 samples per school from September to November 2021. The R 4.2.2 software was used to consolidate databases. Simultaneously, a logistic regression model and a decision tree algorithm model, stratifying by whether sexual behaviors had occurred before, were constructed. In each layer, the prediction performance of the two models was evaluated through area under receiver operating characteristic and the confusion matrix, and then the model with high prediction performance was retained. Results: A total of 7 346 students were surveyed. The proportion of the respondents reporting sexual experience were 9.08% (667/7 346), in whom 26.24% (175/667) had risky sexual activity in the past year. The decision tree algorithm model performs well in predicting whether high-risk sexual behaviors have occurred in the past year. When the complexity parameter value is 0.018, and nsplit reaches 4, which means there are 5 leaf nodes in the model, the cross error of the tree will be the smallest. The first best grouping variable in the decision tree was whether to use condoms throughout the first sexual behavior. If condoms were used at their sexual debut, but homosexual practices have occurred in the past year, the probability of risky sexual behavior will increase. If homosexual practices have not occurred in the past year, but the age of sexual debut was below 18 years old while the period of HIV education was after high school, the probability of risk sexual behavior will also increase. Conclusions: AIDS-related risky behaviors of young students still deserved attention. The experience of sexual debut and whether AIDS-related health education has been received before the sexual debut were significant predictors for the occurrence of high-risk sexual behavior. The decision tree algorithm model has particular applicability for predicting and screening potential risk populations.

[The effect of Ba Duan Jin on the balance of community-dwelling older adults: a cluster randomized control trial].

Objective: To assess the effectiveness of a 6-month Ba Duan Jin exercise program in improving the balance of community-dwelling older adults. Methods: A two arms, parallel-group, cluster randomized controlled trial was conducted in 1 028 community residents aged 60-80 years in 40 communities in 5 provinces of China. Participants in the intervention group (20 communities, 523 people) received Ba Duan Jin exercise 5 days/week, 1 hour/day for 6 months, and three times of falls prevention health education, and the control group (20 communities, 505 people) received falls prevention health education same as the intervention group. The Berg balance scale (BBS) score was the leading outcome indicator, and the secondary outcome indicators included the length of time of standing on one foot (with eyes open and closed), standing in a tandem stance (with eyes open and closed), the closed circle test, and the timed up to test. Results: A total of 1 028 participants were included in the final analysis, including 731 women (71.11%) and 297 men (28.89%), and the age was (69.87±5.67) years. After the 3-month intervention, compared with the baseline data, the BBS score of the intervention group was significantly higher than the control group by 3.05 (95%CI: 2.23-3.88) points (P<0.001). After the 6-month intervention, compared with the baseline data, the BBS score of the intervention group was significantly higher than the control group by 4.70 (95%CI: 4.03-5.37) points (P<0.001). Ba Duan Jin showed significant improvement (P<0.05) in all secondary outcomes after 6 months of exercise in the intervention group compared with the control group. Conclusions: This study showed that Ba Duan Jin exercise can improve balance in community-dwelling older adults aged 60-80. The longer the exercise time, the better the improvement.

[Perception of HIV-related behavior and influencing factors among young students in Guangzhou].

Objective: To investigate the risk perception for risky behavior of HIV/AIDS infection among young students and to analyze the related influencing factors. Methods: A cross-sectional survey was conducted in 5 different types of Guangzhou colleges from September to November 2021, in which convenience sampling and a minimum number of classes per grade and 600 samples per school were used according to the national unity program. Disordered multi-classification logistic regression was used to construct a risk perception model and analyze influencing factors in different risk perception levels. Results: A total of 7 346 young students were surveyed, and most rated themselves at low risk of HIV/AIDS infections (90.58%, 6 654/7 346). A total of 89.10% (6 545/7 346) of subjects' perception of their HIV/AIDS infection risk was consistent with their risk behavior, while 10.90% (801/7 346) was inconsistent. Among those inconsistent subjects, 19.10% (153/801) showed underestimating their risk , while 80.90% (648/801) seen overestimating their risk. Disordered multi-classification logistic regression analysis showed that, after controlling for other factors, compared with the non-sexual group, respondents whose first sex age under 18 had a higher rate of underestimating their risk of infection (OR=129.39, 95%CI: 73.28-228.48), as well as a higher rate of overestimated their risk of infection (OR=1.76, 95%CI: 1.04-2.99). First sexual intercourse at age 18 or older was a risk factor for underestimating risk (OR=70.56, 95%CI: 42.72-116.53), but was not statistically associated with overestimating risk. Being female, other school type, non-heterosexual orientation, and self-rated HIV-related knowledge as fair or no knowledge were risk factors for overestimating risk but were not statistically associated with underestimating risk. Conclusions: Overall, young students in universities of Guangzhou have a good risk perception of HIV/AIDS infection. Individual factors, education factors and sexual experience will influence students' risk perception of HIV/AIDS infection. Raising the awareness rate of HIV/AIDS knowledge and delaying the age of first sexual intercourse will improve the risk perception ability of young students.

[Association between different treatment timings and adverse neonatal outcomes in pregnant women with syphilis during pregnancy].

Objective: To analyze the association between different treatment timings and adverse neonatal outcomes (premature birth, death, congenital syphilis) in syphilis-infected pregnant women. Methods: The National Management Information System for Prevention of HIV, Syphilis and HBV Mother-to-Child Transmission was used to collect information on the detection and treatment of syphilis-infected pregnant women and their newborns in Guangdong Province from October 2011 to December 2021. According to the gestational weeks of syphilis-infected pregnant women receiving penicillin treatment for the first time, they were divided into four groups: treatment in the first trimester, treatment in the second trimester, treatment in the third trimester, and no treatment during pregnancy. Multivariate logistic regression was used to analyze the association between different treatment timings and adverse neonatal outcomes in syphilis-infected pregnant women. Results: A total of 22 483 syphilis-infected pregnant women were included. The number of pregnant women who started treatment in the first trimester, second trimester, and third trimester and did not receive treatment during pregnancy were 4 549 (20.23%), 8 719 (38.78%), 2 235 (9.94%) and 6 980 (31.05%), respectively. Compared with pregnant women who started treatment in the first trimester, pregnant women who did not receive anti-syphilis treatment during pregnancy had increased risks of neonatal preterm birth (OR=1.42, 95%CI: 1.24-1.62), death (OR=4.27, 95%CI: 1.64-14.69) and congenital syphilis (OR=12.26, 95%CI: 6.35-27.45). At the same time, the risk of congenital syphilis in the newborns of pregnant women who started anti-syphilis treatment in the second trimester (OR=2.68, 95%CI: 1.34-6.16) and third trimester (OR=6.27, 95%CI: 2.99-14.80) also increased. Conclusion: Early initiation of anti-syphilis treatment during pregnancy in patients with syphilis can improve neonatal outcomes.

Impact of sarcopenia and low muscle attenuation on outcomes of ovarian cancer: a systematic review and meta-analysis.

OBJECTIVE: The aim of this study was to examine the association of sarcopenia and low muscle attenuation with survival and other clinical outcomes in patients with ovarian cancer. MATERIALS AND METHODS: Systematic search was done in PubMed, EMBASE and Scopus databases for observational studies that documented the link between sarcopenia and outcomes of interest in patients with ovarian cancer, with long-term survival as a primary outcome. Other outcomes included risk of recurrence, progression-free survival and complications. Pooled effect sizes were reported as hazards ratio (HR), relative risk ratio (RR) or weighted mean difference (WMD). Random effects model was used for the analysis. RESULTS: Twenty-two studies were selected, of which all, except one, were retrospective in design. Low skeletal muscle index (SMI, indicating muscle mass) (HR 1.30, 95% CI: 1.07, 1.58) and low muscle quality (HR 1.24, 95% CI: 1.03, 1.49) were associated with poor long-term survival, but not with the risk of recurrence and progression-free survival. Both low skeletal muscle index (SMI) (RR 1.49, 95% CI: 1.13, 1.98) and low muscle quality (RR 1.99, 95% CI: 1.04, 3.79) were associated with increased risk of complications. CONCLUSIONS: Both low skeletal muscle mass and low muscle quality showed significant association with poor long-term survival and an increased risk of complications. However, they do not have a significant association with the risk of recurrence and progression-free survival. There is a need for more prospective studies to confirm these associations.

[Changing trend of incidence and mortality of esophageal cancer during 2010-2016 in Henan Province, China].

Objective: To estimate the incidence and mortality of esophageal cancer in 2016 and their changing trend during 2010-2016 according to the cancer registration data in Henan province. Methods: The data quality including completeness, validity, and reliability of local registries which submitted the cancer registration data of 2016 were assessed according to the criteria of Guideline on Cancer Registration in China and IARC/IACR. Esophageal cancer cases (ICD10: C15) were extracted from the database, and the incidence and mortality stratified by gender, age, and areas (urban/rural) were calculated, the incidence and mortality of provincial cancer were estimated combined with provincial population data. China's 2000 census population and Segi's population were used to calculate the age-standardized rate. Joinpoint model was used to estimate the changing trend of age standardized incidence and mortality along with the calendar year. Results: Approximately 40.10 thousand new esophageal cancer cases were diagnosed in Henan in 2016, accounting for 13.46% of all new cancer cases, and it ranked the third among cancer of all sites. The crude incidence of esophageal cancer was 37.21/100 000 with an age-standardized incidence rate by China standard population (ASIRC) of 26.74/100 000 and an age-standardized incidence rate by world standard population (ASIRW) of 27.12/100 000. The incidence of esophageal cancer in males was higher than that in females, with the ASIRC of 34.53/100 000 and 19.19/100 000, respectively. It was higher in rural areas than that in urban areas, with the ASIRC of 28.13/100 000 and 20.90/100 000, respectively. About 29.30 thousand deaths of esophageal cancer in Henan in 2016, accounting for 15.61% of all cancer deaths in Henan, which ranked the third among cancer of all sites. The crude mortality rate was 27.14/100 000 with an age-standardized mortality rate by China standard population (ASMRC) of 18.74/100 000 and an age-standardized mortality rate by world standard population (ASMRW) of 18.78/100 000. The mortality in males was higher than that in females, with the ASMRC of 24.78/100 000 and 13.12/100 000, respectively. It was also higher in rural areas than that in urban areas, with the ASMRC of 19.48/100 000 and 15.73/100 000, respectively. The ASIRC and ASMRC were declining with annual percent change (APC) of 3.12% (APC=-3.12%; 95%CI: -5.30%, -0.90%; P=0.015) and 2.47% (APC=-2.47%; 95%CI: -4.70%, -0.20%; P=0.039) during 2010-2016. However, the significant declining trend was only observed in rural areas in Henan, and the changing trend was same between males and females. Conclusions: The incidence and mortality of esophageal cancer are declining since 2010, however, the disease burden remains large in Henan. Therefore, comprehensive prevention and control efforts should be strengthened according to its epidemic characteristics and risk factors.

[Changing trend of incidence and mortality of stomach cancer during 2010-2016 in Henan Province, China].

Objective: To estimate stomach cancer incidence and mortality in Henan, 2016 and analyze the trend of stomach cancer incidence and mortality from 2010 to 2016. Methods: Stomach cancer related data in 2016 was extracted from Henan cancer registration and follow-up system. All data were qualified in validity, reliability and completeness according to the Guideline on Cancer Registration in China and International Agency for Research on Cancer (IARC/IACR). The incidence and mortality of stomach cancer were estimated by areas, gender and age based on the quality data and the registered population data of Henan province in 2016. The epidemic trend of stomach cancer was also been evaluated based on the age-standardized incidence and mortality by Chinese population (ASR China) from 2010 to 2016. Results: In 2016, the estimated incident cases of stomach cancer were 44 311. The incidence was 41.07/100 000, ASR China was 30.17/100 000, ASR by world population (ASR world) was 30.36/100 000, and the cumulative incidence rate was 3.84%. The incidences of male and female were 55.65/100 000 and 25.35/100 000, respectively. Meanwhile, 32 927 people died of stomach cancer in Henan. The mortality was 30.52/100 000, ASR China was 21.45/100 000, ASR world was 21.54/100 000, and the cumulative mortality was 2.53%. From 2010 to 2016, both the ASR China for incidence and mortality of stomach cancer in Henan showed a steady downward trend. In rural, the ASR China for incidence and mortality decreased rapidly, while the stable trend was observed in urban. Nevertheless, the incidence and mortality of stomach cancer in rural were still higher than those in urban. Conclusions: The incidence and mortality of stomach cancer in Henan province showed steadily declining trend from 2010 to 2016, and the geographical distribution difference between rural and urban areas was gradually narrowing. However, the disease burden was still high in 2016.

[Noninvasive assessment of the risk of esophageal variceal bleeding from noncirrhotic portal hypertension].

Objective: To verify Baveno VI criteria, Expanded-Baveno VI criteria, liver stiffness×spleen diameter-to-platelet ratio risk score (LSPS), and platelet count/spleen diameter ratio (PSR) in evaluating the severity value of esophageal varices (EV) in patients with non-cirrhotic portal hypertension (NCPH). Methods: 111 cases of NCPH and 204 cases of hepatitis B cirrhosis who met the diagnostic criteria were included in the study. NCPH included 70 cases of idiopathic non-cirrhotic portal hypertension (INCPH) and 41 cases of nontumoral portal vein thrombosis (PVT). According to the severity of EV on endoscopy, they were divided into the low-bleeding-risk group (no/mild EV) and the high-bleeding-risk group (moderate/severe EV). The diagnostic value of Baveno VI and Expanded-Baveno VI criteria was verified to evaluate the value of LSPS and PSR for EV bleeding risk severity in NCPH patients. The t-test or Mann-Whitney U test was used to compare the measurement data between groups. Comparisons between counting data groups were performed using either the χ2 test or the Fisher exact probability method. Results: Considering endoscopy was the gold standard for diagnosis, the missed diagnosis rates of low/high bleeding risk EVs in INCPH/PVT patients with Baveno VI and Expanded-Baveno VI criteria were 50.0%/30.0% and 53.8%/50.0%, respectively. There were no statistically significant differences in platelet count (PLT), spleen diameter, liver stiffness (LSM), LSPS, and PSR between low-bleeding-risk and high-bleeding-risk groups in INCPH patients, and the area under the receiver operating characteristic curve (AUC) of LSPS and PSR was 0.564 and 0.592, respectively (P=0.372 and 0.202, respectively). There were statistically significant differences in PLT, spleen diameter, LSPS, and PSR between the low and high-bleeding risk groups in PVT patients, and the AUCs of LSPS and PSR were 0.796 and 0.833 (P=0.003 and 0.001, respectively). In patients with hepatitis B cirrhosis, the Baveno VI and Expanded-Baveno VI criteria were used to verify the low bleeding risk EV, and the missed diagnosis rates were 0 and 5.4%, respectively. There were statistically significant differences in PLT, spleen diameter, LSM, LSPS and PSR between the low-bleeding-risk and high-bleeding-risk groups (P<0.001). LSPS and PSR AUC were 0.867 and 0.789, respectively (P<0.05). Conclusion: Baveno VI and Expanded-Baveno VI criteria have a high missed diagnosis rate for EVs with low bleeding risk in patients with INPCH and PVT, while LSPS and PSR have certain value in evaluating EV bleeding risk in PVT patients, which requires further clinical research.

[Acceptance evaluation of urine self-sampling, vaginal self-sampling and physician sampling in cervical cancer screening].

Objective: To compare the acceptance of urine self-sampling, vaginal self-sampling and physician sampling in cervical cancer screening. Methods: Questionnaire surveys were conducted in women attending cervical cancer screening in Xiangyuan County and Yangcheng County in Shanxi Province from July to November 2015 and from October to December 2018. Both surveys included the following three parts: feelings and acceptance of women in urine self-sampling, vaginal self-sampling and physician sampling, and the ease evaluation of two self-samplings. Results: There were 3 485 questionnaires were collected finally. The proportions of women felt embarrassed in urine self-sampling, vaginal self-sampling and physician sampling were 2.3% (81/3 472), 7.1% (247/3 472) and 8.6% (299/3 472), and 1.3% (46/3 472), 9.7%(3 37/3 472) and 14.9% (518/3 472) of women felt uncomfortable, and 1.0% (35/3 469), 8.5% (295/3 469) and 15.3% (531/3 469) felt pain, and 98.3% (3 334/3 393), 96.3% (3 267/3 393) and 99.0% (3 360/3 393) thought that the sampling were conducted properly (P<0.05). Based on the feeling during sample collection, 61.2% (1 876/3 064), 39.1% (1 199/3 064) and 66.5% (2 037/3 064) women were willing to use the corresponded sampling methods in cervical cancer screening, respectively (P<0.05). If the accuracy was the same, there were 31.8% (1 109/3 485) women preferred self-sampling and 68.2% (2 376/3 485) preferred physician sampling for cervical cancer screening. Meanwhile, 23.5% (820/3 482) preferred vaginal self-sampling in comparison with 76.5% (2 662/3 482) for urine self-sampling in cervical cancer screening. 86.5% (3 007/3 478) of the women thought urine self-sampling was very easy, comparing 40.9% (1 423/3 478) for vaginal self-sampling. Conclusions: The bad feeling of women during urine self-sampling is less common and less serious than those during physician sampling and vaginal self-sampling, and the acceptance for physician sampling is highest, following by urine self-sampling and vaginal self-sampling. Urine self-sampling is much easier than vaginal self-sampling.

[To promote AIDS preventive health education in schools].

In recent years, the annual number of newly reported HIV/AIDS cases in young students remained to be 3 000 approximately, which has arisen a serious social concern. This paper focuses on the analysis on the epidemic characteristics of AIDS in young students in China and the weak points in preventive health education, and puts forward some thoughts on promoting the preventive health education in schools and introduces a WeChat applet for sexual health and HIV infection risk assessment in young students, which is called "Detective Bear" and developed based on self-categorization theory in Guangzhou to help young students to be aware of their own risks and specific problems and provide individualized intervention for the better implementation of AIDS prevention health education in schools in China in the new era.

[Development of Risk Assessment Index System on HIV infection among young students based on Delphi method].

Objective: To develop a Risk Assessment Index System (RAIS) on HIV infection among young students based on Delphi method and to provide individual HIV infection risk assessment, targeted prevention and control measures. Methods: Delphi method was applied to determine the index system and weight of the assessment tool through three rounds of expert consultation and overall consideration of opinions and suggestions from 19 experts. Results: The positivity coefficients of three rounds of expert consultation were 100%. The authority coefficient of experts was between 0.887 and 0.945. The Kendall's W coefficients through first, second and third round specialist consultation was 0.379, 0.329 and 0.248, respectively (all P<0.001). The coefficients of variation in the third round were all less than 0.25, indicating that experts' opinion tend to be consistent and the results are highly reliable. The HIV infection risk assessment index system among young students consisted of 7 first grade indices and 54 second grade indices, of which weight was calculated. Conclusions: The RAIS on HIV infection for young students was initially established based on Delphi method, and could be used in the development of HIV infection risk assessment tools for personalized prevention and intervention among young students. However, the reliability, validity and effect of this assessment index system need to be further evaluated.

[Cluster analysis on survey of sexual health characteristics and health education demands in young students].

Objective: To explore the difference of sexual health characteristics and demands in students in different groups, and provide the basis for targeted sexual health eduction for AIDS prevention in young students. Methods: A survey was conducted based on the requirement of health education about sexual health and AIDS prevention in young students by the education department of Guangdong province. A two-step cluster analysis was performed on the survey data obtained by convenient sampling, the variables and number of clusters included were determined by combination of analysis results and professional knowledge. The demographic characteristics, the content and form of sexual health education needed were compared among different groups. Results: Survey data of 3 884 students were collected, and six variables were used for classification: cognition or occurrence masturbation, sexual behavior, frequency of sexual information acquisition, number of acceptable sex partners and AIDS knowledge awareness rate. By these variables, the students were classified into three levels of risk groups: high risk group (46.6%), medium risk group (39.9%) and low risk group (13.5%). As for demographic characteristics, high risk group, with a median age of 19 years, had the highest proportions of boys (65.9%), students with non-heterosexuality orientation (15.2%), urban residents (58.2%), only children (30.8%) and undergraduates (54.7%). Medium risk group, with a median age of 19 years, had the highest proportions of girls (82.7%) and vocational college students (34.0%). Low risk group, with a median age of 18 years, had the highest proportions of rural residents (52.4%), non-only child (80.6%), senior high school students (41.3%), non-boarding students (17.5%) and students without internship and part-time job experience (43.2%). In terms of health education demands, high risk group had a higher demand of information about self-identity, sexual safety, sexual decision making, contraception, abortion, and sexually transmitted disease or AIDS prevention. Medium risk group paid more attention to value on love and marriage, sexual assault. Low risk group showed a higher demand of adolescent physiology knowledge. Compared with low risk group, high risk group had a higher demand of peer education, Internet/multimedia, anonymous counseling and other forms of sexual health education. The differences were significant. Conclusion: The characteristics, sexual knowledge awareness, attitude and behavior, and health education demands of young students in different groups are different, so health education materials and methods should be developed according to the characteristics of different groups to enhance the acceptance and enthusiasm of students and improve the quality of sexual health education.

[Analysis on influencing factors of HIV testing services utilization in students with self-assessed high risk of HIV infection based on Andersen's model].

Objective: To analyze the influencing factors for HIV testing services utilization in students with self-assessed high risk of HIV infection. Methods: The research framework of the influencing factors for HIV testing services utilization in students was developed based on Andersen's health services utilization behavioral model and related literature. A cross-sectional survey was performed in students with self-assessed high risk of HIV infection by an online HIV infection risk assessment tool from March to April 2019. Multiple logistic regressions were applied with hierarchical model. Results: A total of 526 students were included in the study (age: 19.30±1.19 years old), in whom 96.2% agreed that HIV testing should be received after high-risk behavior. 56.7% (298/526) had sexual behavior and the HIV testing rate was 11.0% (58/526). The HIV testing rates in students who had and had no sex behavior were 13.42%(40/298) and 7.89% (18/228), respectively. According to the results from multivariate logistic regression analysis, non-heterosexual (compared with heterosexual, OR=7.88, 95%CI: 3.98-15.61) and higher score of AIDS knowledge awareness (compared with lower score, OR=2.05, 95%CI: 1.07-3.93) in propensity factor module, and having risk sexual behavior (compared with having no risk sexual behavior, OR=2.66, 95%CI: 1.41-5.03) and having diagnosis of STD infection in hospital (compared with having no such diagnosis, OR=6.35, 95%CI: 2.21-18.27) in demand factor module, and receiving health education about AIDS prevention in the past year (compared with receiving no such health education, OR=0.29, 95%CI: 0.11-0.76) and receiving health education about AIDS testing service in the past year (compared with receiving no such health education, OR=3.67, 95%CI: 1.71-7.90) in ability factor module were the influencing factors for utilization of HIV testing services. Conclusions: The acceptance of HIV testing in students needs to be improved urgently. Propensity factors, such as their AIDS knowledge awareness and sexual orientation, and demand factors, such as having risk sexual behavior and STD infection, have obvious impacts on the utilization of HIV testing services. However, health education about AIDS prevention and HIV testing service can play a more important role in facilitating the utilization of HIV testing in students. In the future, we should further strengthen the publicity of voluntary HIV counseling and testing service in students with particular attention to girls and those with risk sexual behaviors.

[Influence of self-categorized deviation in knowledge, attitude and practice for sexual health on the willingness to seek help for corresponding problems among young students].

Objective: To evaluate the effect of "self-categorization" on decision of health preference and the influence of self-categorized deviation in knowledge, attitude and practice (KAP) on the willingness of seeking help for sexual health among young students. Methods: From March to April 2019, young students who used a WeChat applet for sexual health and HIV infection risk assessment, which is called "Detective Bear" were recruited and investigated. According to the consistency between the self-categorization of KAP for sexual health and the systematic categorization from their honest answers, the participants were allocated into three groups: consistent, low or high status, according to their judgment on sexual information acquisition, sexual attitude, and the actual number of sexual experiences. Logistic regression was used to analyze the differences in the willingness to seek help for sexual health problems between the three groups. Results: 2 009 students with an average age of (19.2±1.1) were included. 54.7% (1 099/2 009) were female, and 98.4% (1 976/2 009) were college, undergraduate or postgraduate students. 49.0% (984/2 009) were in the consistent group, 10.9% (219/2 009) had a lower self-categorization, 40.1% (806/2 009) had a higher self-categorization. Compared with the consistent group, students with lower self-categorization of KAP for sexual health were less likely to assess HIV voluntary counseling and testing (aOR=0.65, 95%CI: 0.43-0.99). However, students with higher self-categorization seemed to dislike seeking help for sexually transmitted diseases (aOR=0.76, 95%CI: 0.59-0.98). Conclusions: Deviation in self-categorization of KAP for sexual health will reduce the young students' willingness to seek help for related problems. Especially those with lower self-categorization, lack of risk consciousness, and refuse to assess counseling and testing may increase the HIV/AIDS epidemic among this population. It is necessary to strengthen the capacity of self-assessment for young students while promoting sex education.

[Design and analysis of testing results of a WeChat applet for sexual health and HIV infection risk assessment in young students].

Objective: To summarize the design and analysis of testing results of a WeChat applet, which is called "Detective Bear", for sexual health and HIV infection risk assessment in young students, and evaluate its feasibility and effectiveness. Methods: Based on self-categorization theory, by using cluster analysis and Delphi expert consulting method, the framework of WeChat applet, risk assessment index system and preventive intervention content were determined. Young students were recruited by student associations for the application test, the results of the repeated tests and the satisfaction survey were collected and analyzed. Results: The study included 393 participants who repeated the test twice and 750 participants who volunteered to participate in the satisfaction questionnaire survey. The applet contains five modules: self-role judgment, self-test, risk assessment, assessment report generation and background management. The risk assessment module contains 6 first-level indicators and 55 second-level indicators. Assessment report generation module includes role diagnosis type, radar chart of HIV sexual health KAP and intervention prescription. In 393 students who repeated the test, the awareness of AIDS to be a serious sexually transmitted disease, the epidemic trend in young students in China, with active seeking HIV testing services and caring the infected improved. The satisfaction survey showed that 75.7% of students (568/750) accepted the applet, 86.5% (649/750) agreed the evaluation report, 83.1%(623/750) thought that there were some problems, but it was easy to use, 93.3% (700/750) said they can learn something from the applet and 84.1% (631/750) satisfied with the page design. Some students thought the questionnaire was too long and somewhat difficult to complete (P<0.05), and some reported that more can be learned (P<0.05). Conclusions: The applet integrates AIDS prevention related knowledge and practice into a challenging, interesting, interactive game and provide individualized, concrete risk assessment and self-intervention for young students, which can effectively help students to improve the awareness of AIDS related knowledge and get links for access to condoms, testing and other intervention services. However, its large-scale application and long-term effect need to be further tested.

[Analysis of factors related to the online social interaction and causal sexual behaviors among foreigners in Guangzhou].

Objective: To understand the social support, social network, and sexual behavior characteristics of foreigners living in Guangzhou, analyze factors relating to aspects of online social interactions and sexual behaviors of foreigners in Guangzhou, and provide references for targeted HIV intervention services for foreigners. Methods: A cross-sectional survey (both online and offline), among those who met the inclusion criteria was conducted between November 2019 and January 2020. Data were collected on demographics, social support, online social interactions, sexual behaviors, and so on. Statistics were compiled to analyze the factors that may influence casual sexual behaviors. Results: A total of 434 participants were included in the study (241 offline and 193 online). The majority of the participants were male 68.4% (297/434), age (31.0±8.8) years old, African 79.0% (343/434), business people 46.5% (202/434), students 48.2% (209/434), who have business partners and family members in China were 59.4% (258/434) and 28.1% (122/434) separately. They also had the following features: less than 10 close friends 57.1% (248/434); spend 1-3 hours on social applications per day 43.3% (188/434), had casual sexual behaviors in the last 3 months 15.2% (55/363). Multiple logistic regression model analysis showed that compared with those who used social applications for less than 1 hour per day, participants who used social applications for more than 6 hours per day were more likely to have casual sexual behaviors in the last 3 months (OR=3.63, 95%CI: 1.31-10.08). Conclusions: Participants who used social applications for a longer period every day were more likely to have casual sexual behaviors among foreigners in Guangzhou. Good use of social applications for health promotion and education of HIV can increase the health awareness of foreigners in China.

[The characteristics of digital subtraction angiography and the analysis of the therapeutic effect of interventional therapy on hemorrhage after partial nephrectomy].

Objective: To investigate the digital subtraction angiography (DSA) manifestations of hemorrhage after partial nephrectomy (PN) for renal tumors, and the safety and efficacy of interventional therapy. Methods: The clinical data, DSA images and interventional treatment of 15 patients undergoing emergency interventional therapy due to hemorrhage after PN in the Department of Interventional Therapy of Beijing University Cancer Hospital from January 2015 to January 2019 were retrospectively analyzed. The DSA manifestations, safety and prognosis of interventional therapy were summarized. Results: Among the 15 patients, 10 had abdominal hemorrhage, 2 had abdominal hemorrhage with hematuria, and 3 had hematuria, all of which occurred 6 hours to 7 days after the operation. The DSA manifestations included contrast medium overflow, local artery wall unevenness, local artery branch expansion, pseudoaneurysm formation and renal arteriovenous fistula. There were 14 survivors, followed up for 6-12 months, and further no bleeding occurred. The success rate of interventional therapy was 100% (14/14), and the success rate of hemostasis was 100% (14/14). One patient died of asphyxia due to intraoperative nausea and vomiting. The creatinine levels were (76.0±11.0), (80.0±9.0), (76.0±9.0) µmol/L before operation, 1 week after operation and 1 month after operation respectively. There was no significant difference in creatinine levels among the three groups (F=3.171, P=0.058). The levels of urea nitrogen before operation, 1 week after operation and 1 month after operation were (6.80±1.04), (7.13±0.89), (6.81±0.79) µmol/L respectively. There was significant difference among the three groups (F=4.322, P=0.024). The level of urea nitrogen at 1 month after operation was significantly lower than that at 1 week after operation (P=0.016), but there was no difference compared with that before operation (P=1.000). Conclusion: Contrast medium overflow, pseudoaneurysm formation and renal arteriovenous fistula were the main manifestations of DSA hemorrhage after PN. Interventional therapy was safe and effective and might be a priority in cases of hemorrhage after PN.

[Distribution of the anterior corneal astigmatism in over 140 000 patients with age-related cataract].

Objective: To analyze the distribution characteristics of the anterior corneal astigmatism in 140 000 cataract patients from 18 hospitals in China. Methods: Retrospective study. A total of 143 889 patients (143 889 right eyes) over the age of 40 years with age-related catarac were admitted to 18 Aier eye hospitals in China from July 2015 to October 2018. The average values of the three measurements of the magnitude of anterior corneal astigmatism, the meridian of corneal astigmatism, anterior chamber depth, corneal refractive power, and axial length measured by IOLMaster 500 were obtained. The data acquisition method of each sub-center was to collect and analyze the electronic case data in accordance with the inclusion and exclusion criteria, and to provide them for the sponsor Wuhan Aier Eye Hospital. Non-normal distribution data are presented as M (P25, P75). Mann-Whitney test, Kruskal-Wallis test, Chi-square test were used to analyze the distribution differences of the magnitude of corneal astigmatism and the meridian of corneal astigmatism in gender, age, anterior chamber depth, corneal refractive power and axial length. Results: Among the 143 889 patients, 84 319 were females and 59 570 were males, the median age was 72 (65, 78) years old, the median corneal astigmatism was 0.84 (0.51, 1.33) D; the corneal astigmatism was ≥0.75 D in 80 895 patients (56.22%) and was ≥1.00 D in 57 304 patients (39.83%). The median corneal astigmatism was 0.87 (0.53, 1.37) D in women and 0.82 (0.50, 1.29) D in men; with statistical difference (U=-14.891; P<0.05). The proportion of with-the-rule (WTR) astigmatism was 33.26% (28 046/84 319) for women and 34.26% (20 408/59 570) for men; The proportion of against-the-rule (ATR) astigmatism was 49.08% (41 385/84 319) for women and 46.91% (27 945/59 570) for men, with statistical difference (χ²=70.913; P<0.05). With the increase of age, the magnitude of corneal astigmatism first decreased from 0.94 (0.57, 1.48) D to 0.75 (0.46, 1.18) D, and then increased to 1.19 (0.74, 1.79) D, with statistical difference (H=1 263.438; P<0.05), and the change was at 61 to 70 years old. With the increase of age, the proportion of WTR astigmatism decreased from 77.50% (396/511) to 12.50% (3/24), the proportion of ATR astigmatism increased from 11.15% (57/511) to 79.07% (34/43), and the proportion of oblique astigmatism changed little from 17.02% (16/94) to 19.92% (245/1 230), the distribution difference was significant (χ²=10 174.496; P<0.05). As the anterior chamber became shallow, the magnitude of corneal astigmatism significantly increased from 0.82 (0.51, 1.31) D to 1.05 (0.61, 1.56) D, and the proportion of ATR astigmatism increased from 47.32% (60 207/127 227) to 51.69% (184/356) (H=409.961, χ²=120.995, both P<0.05). With the corneal refractive power rising, the magnitude of corneal astigmatism increased from 0.80 (0.49, 1.33) D to 0.95 (0.58, 1.53) D, the proportion of ATR astigmatism decreased from 52.84% (4 963/9 392) to 39.97% (9 023/22 577); the difference was significant (H=808.562, χ²=752.147, both P<0.05). When the axial length was>25.00 mm, the magnitude of corneal astigmatism was highest [1.04 (0.62, 1.65) D], and the proportion of ATR astigmatism was also highest [49.00% (10 964/22 376)]; the difference was significant (H=2 071.198, χ²=131.130, all P<0.05). Conclusions: The meridian of corneal astigmatism in middle-aged and elderly cataract patients is mainly ATR astigmatism. With the increasing of age, the magnitude of corneal astigmatism decreases first and then increases. The turning point from the proportion of WTR astigmatism to the proportion of ATR astigmatism is 65 years old. The shallower the anterior chamber is, the more the magnitude of corneal astigmatism and the proportion of ATR astigmatism increase. When the axial length is>25.00 mm, both the magnitude of corneal astigmatism and the proportion of ATR astigmatism reach the peak. (Chin J Ophthalmol, 2021, 57: 56-62).

[Analysis on influencing factors on HIV testing behaviors in some foreigners in Guangzhou].

Objective: To analyze the influencing factors of HIV testing behavior among foreigners in Guangzhou, and provide a reference for promoting HIV testing and intervention services in foreigners. Methods: A cross-sectional survey was conducted from November 2019 to January 2020 among 230 eligible foreigners selected in Guangzhou through convenient sampling method in the form of one-to-one questionnaire interview, HIV testing behaviors and related influencing factors were described and analyzed with χ(2) test and multivariate logistic regression model. Results: A total of 230 foreigners were included in the study, in whom 156 were males (67.8%), 217 were from Africa (94.3%), 138 (60.0%) were with education level of university and above, 169 (73.5%) were in business, 47 (20.4%) were students, 132 (57.4%) had cumulative residence >12 months in Guangzhou and 113 (49.1%) had health examination in China in the past 6 months. In these foreigners, the rate of AIDS-related knowledge awareness was 76.0%, the proportion of condom use in the last sex was 39.6%(89/225) and 47.8%(110/230) received HIV tests in the past 3 months. Multivariate logistic regression analysis showed, the influencing factors of HIV testing behavior in the past 3 months included cumulative residence ≤12 months (compared with cumulative residence >12 months, OR=3.12, 95%CI: 1.49-6.56), health examination in China in the past 6 months (compared to those who had not, OR=2.53, 95%CI: 1.17-5.48), awareness of HIV testing and consulting service in Guangzhou (compared with those who had no awareness, OR=3.65, 95%CI: 1.71-7.78). Conclusions: Some foreigners in Guangzhou had relatively low rates of HIV testing and condom use. Those who pay attention to their own health status and know well about HIV testing and consulting services are more likely to receive HIV testing, foreigners in Guangzhou should be encouraged to receive HIV testing. Their self-testing awareness should be improved.

[Performance of high-risk HPV typing test in early diagnosis of cervical cancer].

Objective: To evaluate the performance of High-risk HPV typing detection in cervical cancer screening. Methods: A total of 3 231 women were recruited as the subjects of cervical cancer screening from Jiyuan city of Henan provinces from June to July 2017. All women underwent HPV DNA test. The women with cytological examination ≥ASCUS or cytological examination negative and HPV 16/18 positive underwent colposcopy biopsy and pathological examination. Pathological diagnosis was used as the gold standard. Sensitivity, specificity, positive predictive value (PPV), negative predictive value(NPV) as well as corresponding 95% confidence interval (CI) of HR-HPV and HPV 16/18 were calculated. Results: The mean age of 3 231 subjects selected in this study was 46.84±10.00 (21-64) years old. 524 subjects had the positive results of HR-HPV, including 91 of HPV16 and 15 of HPV18. Pathological test result CIN2+ was the gold standard. The sensitivity and specificity of HR-HPV for cervical precancer lesions screening were 93.75 (95%CI: 79.85-98.27) and 84.56% (95%CI: 83.26-85.77), respectively. To compared with HR-HPV, HPV16/18 had low sensitivity (65.63%, 95%CI: 48.31-79.59)and higher specificity (97.44%, 95%CI: 96.83-97.93). After age stratification by age 30 and 45, the sensitivity of HPV 16/18 was same with HR-HPV (100%, 95%CI: 34.24-100.00), the specificity of HPV 16/18 was higher than HR-HPV (98.71%, 95%CI: 96.27-99.56 vs 84.48%, 95%CI: 79.27-88.58) in<30 age group.The sensitivity of HR-HPVin 30-45 and ≥45 age group were higher than HPV16/18 (85.71%, 95%CI: 48.69-97.43 vs 71.43%, 95%CI: 35.89-91.78, 95.65%, 95%CI: 79.01-99.23 vs 60.87%, 95%CI: 40.79-77.84), but the specificity werelower than HPV16/18 (86.89%, 95%CI: 84.58-88.90 vs 98.51%, 95%CI: 97.51-99.11、83.49%, 95%CI: 81.81-85.04 vs 96.80%, 95%CI: 95.94-97.48). Conclusions: HR-HPV detection has relatively high sensitivity and specificity in cervical cancer screening. For >30 years old women, HR-HPV is more recommended in cervical cancer screening. Therefore, HR-HPV detection is an effective method for cervical cancer screening.