Molecular transmission network analysis of newly diagnosed HIV-1 infections in Nanjing from 2019 to 2021.

OBJECTIVE: The objective of this study was to conduct a comprehensive analysis of the molecular transmission networks and transmitted drug resistance (TDR) patterns among individuals newly diagnosed with HIV-1 in Nanjing. METHODS: Plasma samples were collected from newly diagnosed HIV patients in Nanjing between 2019 and 2021. The HIV pol gene was amplified, and the resulting sequences were utilized for determining TDR, identifying viral subtypes, and constructing molecular transmission network. Logistic regression analyses were employed to investigate the epidemiological characteristics associated with molecular transmission clusters. RESULTS: A total of 1161 HIV pol sequences were successfully extracted from newly diagnosed individuals, each accompanied by reliable epidemiologic information. The analysis revealed the presence of multiple HIV-1 subtypes, with CRF 07_BC (40.57%) and CRF01_AE (38.42%) being the most prevalent. Additionally, six other subtypes and unique recombinant forms (URFs) were identified. The prevalence of TDR among the newly diagnosed cases was 7.84% during the study period. Employing a genetic distance threshold of 1.50%, the construction of the molecular transmission network resulted in the identification of 137 clusters, encompassing 613 nodes, which accounted for approximately 52.80% of the cases. Multivariate analysis indicated that individuals within these clusters were more likely to be aged ≥ 60, unemployed, baseline CD4 cell count ≥ 200 cells/mm3, and infected with the CRF119_0107 (P < 0.05). Furthermore, the analysis of larger clusters revealed that individuals aged ≥ 60, peasants, those without TDR, and individuals infected with the CRF119_0107 were more likely to be part of these clusters. CONCLUSIONS: This study revealed the high risk of local HIV transmission and high TDR prevalence in Nanjing, especially the rapid spread of CRF119_0107. It is crucial to implement targeted interventions for the molecular transmission clusters identified in this study to effectively control the HIV epidemic.

Characteristics and Controlling Factors of Natural Fractures in Deep Carbonates of the Puguang Area, Sichuan Basin, China.

Understanding the types, characteristics, and controlling factors of natural fractures in deep and ultradeep carbonates is crucial for evaluating reservoir quality, optimizing well deployment, and comprehending their impact on hydrocarbon exploitation. Multiple types of natural fractures are widespread in the deep carbonates of the Feixianguan Formation in the Puguang area, northeastern Sichuan Basin, China, and the main controlling factors are complex. Based on geological, geophysical, and experimental data, this study defined fracture types and analyzed the fracture development characteristics in the deep Feixianguan carbonates. On this basis, the main geological factors that control the development and distribution of tectonic fractures were discussed by combining statistical and experimental analyses. Results indicate that natural fractures in the Feixianguan Formation can be genetically classified into tectonic and diagenetic fractures. Specifically, tectonic fractures include shear fractures and tensile fractures, in which the former are predominant. In the Feixianguan carbonates, tectonic shear fractures are mainly developed in the NE-SW and near E-W strikes, with dip angles mostly ranging from 30 to 70°. The majority of shear fractures appear on a small scale and have good effectiveness. The fracture heights and apertures are commonly less than 50 cm and 25 µm, respectively, and unfilled fractures account for more than half. The distribution and development of tectonic fractures are mainly controlled by lithology, mechanical stratigraphy, reservoir physical properties, diagenetic cementation, and faults. In the Feixianguan carbonates, tectonic fractures are more developed in crystalline dolomite. With the increasing thickness of mechanical stratigraphy, the fracture density decreases and the scale increases. The presence of early dissolution pores can prevent the formation of later tectonic fractures. Tectonic fractures in the NNW-SSE and near N-S strikes generally possess poor effectiveness due to multiple cementations after their formation. In the vicinity of faults, tectonic fractures generally stretch subparallel to the extension direction of the fault, and the development degree of fractures close to major faults is higher.

Transmitted drug resistance and transmission clusters among ART-naïve HIV-1-infected individuals from 2019 to 2021 in Nanjing, China.

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_BC (40.6%), CRF01_AE (38.4%) and CRF105_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_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.

Survival and risk factors associated with mortality in people living with HIV from 2005 to 2018 in Nanjing, China.

Background: Although the introduction of antiretroviral therapy (ART) decreased the mortality of people living with Human Immunodeficiency Virus (PLHIV), substantially, hundreds of thousands of people are dying of AIDS each year. The accurate survival patterns and factors related to death among PLHIV were rarely reported. In this study, we evaluated survival status and identified factors associated with death among PLHIV in Nanjing. Methods: We conducted a retrospective analysis of PLHIV followed-up in Nanjing and registered to the national HIV/AIDS comprehensive management information system from 2005 to 2018. We used the life table to calculate the cumulative survival rates. We applied the Kaplan-Meier to calculate median survival times and employed cox hazard proportional regression to analyze the associated factors related to death. Results: The median survival time of PLHIV was 11.8 (95%CI:11.6-11.9) years from 2005 to 2018. Among 4,235 PLHIV included in this study, 7.5% had died of AIDS-related disease and the AIDS-related mortality rate was 2.0/100 PYs. The cumulative proportion surviving at the end of the interval was 95.2% over the 1st year, 94.0% over the 2nd year, 91.8% over the 5th year, and 85.4% over the 10th year, respectively. PLHIV who unaccepted ART showed a greater risk of death compared to those who accepted ART (AHR = 16.2, 95%CI:11.9~22.2). For baseline CD4 count, compared to CD4 < 200 cell/µL, higher CD4 count was demonstrated as a protective factor, with AHR = 0.2 (95%CI: 0.1~0.3) for ≥500 cell/µL, AHR = 0.3 (95%CI:0.2~0.4) for 350~499 cell/µL, AHR = 0.4 (95%CI:0.3~0.6 for 200~349 cell/µL). In addition, we observed a higher death risk in PLHIV who were screened through outpatient (AHR = 1.6, 95%CI: 1.1~2.2) and inpatient (AHR = 1.6, 95%CI: 1.1~2.5) compared to through VCT; the age of diagnosis was ≥50 years old (AHR = 9.5, 95%CI: 3.7~24.1) and 25~49 years old (AHR = 5.0, 95%CI: 2.0~12.3) compared to ≤ 24 years old; educated from junior and below (AHR = 3.4, 95%CI: 2.3~5.1) and Senior high school (AHR = 1.7, 95%CI: 1.1~2.7) compared to college and above. Conclusion: The AIDS-related mortality among PLHIV in Nanjing was relatively low. A higher risk for AIDS-related deaths were observed among PLHIV who unaccepted ART, whose baseline CD4 cell count was<200 cell/µL, older age, and lower educated.

Trends in HIV Prevalence and HIV-Related Risk Behaviors Among Male Students Who Have Sex With Men From 2016 to 2020 in Nanjing, China: Consecutive Cross-Sectional Surveys.

Background: The growing HIV epidemic among student men who have sex with men (MSM) necessitates immediate attention from public health. In China, male students who have sex with men (SMSM) were also at an increasing risk of HIV transmission. The aim of this study was to investigate the trends in HIV prevalence, HIV-related risk behaviors, and HIV testing, as well as analyze the factors associated with HIV infection among SMSM in Nanjing. Methods: Data were collected through face-to-face questionnaire interviews and laboratory testing in Nanjing. The participants were recruited among SMSM by snowball sampling and internet-recruited convenience sampling annually from 2016 to 2020. The self-report data primarily included demographics, HIV knowledge, HIV-related behaviors, and HIV testing, while the laboratory test results of HIV and syphilis were collected. Linear-by-linear chi-square test was used to analyze the trends of HIV/syphilis prevalence and its risk behaviors. The binary logistic regression model was used to explore the factors associated with HIV infection. Results: During the 5 years from 2016 to 2020, a total of 775 SMSM were recruited in our survey (220, 112, 171, 142, and 120, respectively). The HIV prevalence was 5.2, 6.3, 5.3, 7.0, and 8.3%, without a significant increasing trend (P = 0.277). Syphilis prevalence fluctuated from 5.7% in 2016 to 4.2% in 2020, without a significant decreasing trend (P = 0.318). The proportion of consistent condom use in anal intercourse (48.5 to 56.2%, P < 0.05), and HIV testing in the past 12 months (51.0 to 59.2%, P < 0.05) were increasing. A remarkable growing trend has been reported in the percentage of MSM with more than one male sex partner (46.2 to 59.2%, P < 0.05). Multivariate analysis showed that HIV testing in the past 12 months was a protective factor against HIV infection. MSM who had unprotected anal intercourse (UAI) in the past 6 months, recreational drug use, and currently syphilis infection were risk factors for HIV infection. Conclusions: We observed stable HIV/ syphilis prevalence, increasing consistent condom use, increasing HIV testing rate, and increasing multiple male sex partners dramatically among SMSM in China. The original comprehensive intervention measures should be continuously strengthened for the subgroup. To satisfy the current HIV prevention requirements, new biological interventions should be introduced and carried out as major components of combination prevention programs.

Construction and validation of a prognostic nomogram for predicting the survival of HIV/AIDS adults who received antiretroviral therapy: a cohort between 2003 and 2019 in Nanjing.

BACKGROUND: Great achievements have been achieved by free antiretroviral therapy (ART). A rapid and accurate prediction of survival in people living with HIV/AIDS (PLHIV) is needed for effective management. We aimed to establish an effective prognostic model to forecast the survival of PLHIV after ART. METHODS: The participants were enrolled from a follow-up cohort over 2003-2019 in Nanjing AIDS Prevention and Control Information System. A nested case-control study was employed with HIV-related death, and a propensity-score matching (PSM) approach was applied in a ratio of 1:4 to allocate the patients. Univariable and multivariable Cox proportional hazards analyses were performed based on the training set to determine the risk factors. The discrimination was qualified using the area under the curve (AUC) and concordance index (C-Index). The nomogram was calibrated using the calibration curve. The clinical benefit of prognostic nomogram was assessed by decision curve analysis (DCA). RESULTS: Predictive factors including CD4 cell count (CD4), body mass index (BMI) and hemoglobin (HB) were determined and incorporated into the nomogram. In the training set, AUC and C-index (95% CI) were 0.831 and 0.798 (0.758, 0.839), respectively. The validation set revealed a good discrimination with an AUC of 0.802 and a C-index (95% CI) of 0.786 (0.681, 0.892). The calibration curve also exhibited a high consistency in the predictive power (especially in the first 3 years after ART initiation) of the nomogram. Moreover, DCA demonstrated that the nomogram was clinically beneficial. CONCLUSION: The nomogram is effective and accurate in forecasting the survival of PLHIV, and beneficial for medical workers in health administration.

Meta-analysis of infection and disease among household contacts of patients with drug-resistant tuberculosis / 中国热带医学

@#Abstract: Objective　To analyze the association between drug resistance and the risk of latent tuberculosis infection and disease among household contacts of patients with pulmonary tuberculosis, and to explore whether the compensatory mutation of drug-resistant Mycobacterium tuberculosis will enhance its pathogenicity or transmission ability. Methods　The English and Chinese databases, including PubMed, web of science, EMBASE, Cochrane library database, CNKI and Wanfang database, were searched by computer from the time of establishment of the database to January 2022. Cohort studies on the risk of infection and disease among household contacts of patients with drug-resistant and sensitive pulmonary tuberculosis were searched and screened according to the inclusion and exclusion criteria. The data were extracted and evaluated by NOS scale, using stata16.0 software meta-analysis to calculate the combined effect of tuberculosis infection and disease risk of family contacts, and carry out heterogeneity test, subgroup analysis and sensitivity analysis. Results　A total of 7 cohort studies involving 9653 TB index cases and 29, 734 house contacts were included. The results of meta-analysis showed that compared with drug-sensitive pulmonary tuberculosis patients, the risk of tuberculosis infection in house contacts of drug-resistant pulmonary tuberculosis patients was increased (OR=1.56, 95%CI=1.25-1.96, P<0.001), but there was no difference in the risk of incidence (RR=1.06, 95%CI=0.80-1.41, P=0.67>0.05). Subgroup analysis showed that the risk of latent tuberculosis infection in house contacts was affected by the study area, and the size of family contacts had an impact on the risk of TB . Sensitivity analysis showed that the results of meta-analysis were robust. Conclusion　Compared with drug sensitive TB patients, household contacts with drug-resistant TB patients had a higher risk of tuberculosis, but there was no difference in the risk of TB among the two groups.

Lipoprotein Lipase Gene Polymorphisms Are Associated with Myocardial Infarction Risk: A Meta-Analysis.

Aims: Many studies and researchers have reported on the genetic association between lipoprotein lipase (LPL) gene polymorphisms and myocardial infarction (MI). The results, however, have been inconclusive. Therefore, we assessed the relationship of LPL gene polymorphisms and MI risk by performing a meta-analysis. Methods: Literature was retrieved through PubMed, Web of Science, the Cochrane Library, Chinese National Knowledge Infrastructure (CNKI), and Embase databases. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were used to evaluate the genetic associations between LPL gene polymorphisms and MI risk. A total of nine studies, with 10 individual groups, comprising 2785 cases and 4317 controls were used for this meta-analysis. Results: The allelic (p = 0.0003, OR [95% CI] = 0.86 [0.79-0.93]) and dominant models (p = 0.001, OR [95% CI] = 0.83 [0.73-0.93]), but not the recessive model (p > 0.05) of LPL gene showed that the HindIII variant significantly decreased the risk of MI. In addition, the allelic model (p = 0.04, OR [95% CI] = 0.71 [0.50-0.99]) for the S447X variant showed a significant decrease in the risk of MI. No association was observed between the PvuII variant and MI (p > 0.05). A subgroup analysis based on ethnicity revealed that all of the genetic models (allelic model: p < 0.00001, OR [95% CI] = 0.62 [0.51-0.77]; dominant model: p = 0.003, OR [95% CI] = 0.66 [0.50-0.87]; recessive model (p = 0.02, OR [95% CI] = 0.47 [0.25-0.88]) found an association of the HindIII polymorphism with MI in the Asian, but not in the Caucasian population (p > 0.05). Under the dominant model the HindIII SNP was also shown to be associated with MI risk in the Caucasian population (p = 0.03, OR [95% CI] = 0.87 [0.76-0.99]). In addition, the allelic (p = 0.02, OR [95% CI] = 0.75 [0.59-0.95]) and dominant models (p = 0.02, OR [95% CI] = 0.51 [0.29-0.90]) for S447X demonstrated a significantly decreased MI risk in the Caucasian, but not in the Asian population (p > 0.05). Conclusions: LPL HindIII and S447X polymorphisms, but not PvuII might be the protective factors for MI. To confirm these results, case-control studies with larger numbers of subjects need to be conducted.

Polymorphism in GRHL2 gene may contribute to noise-induced hearing loss susceptibility: a meta-analysis / Polimorfismo no gene GRHL2 pode contribuir para a suscetibilidade à perda auditivainduzida por ruído: uma metanálise

Abstract Instruction: Noise-induced hearing loss is a leading occupational disease caused by gene-environment interaction. The Grainy Like 2, GRHL2, is a candidate gene. In this regard, many studies have evaluated the association between GRHL2 and noise-induced hearing loss, although the results are ambiguous and conflicting. Objective: The purpose of this study was to identify a precise estimation of the association between rs3735715 polymorphism in GRHL2 gene and susceptibility of noise-induced hearing loss. Methods: A comprehensive search was performed to collect data up to July 8, 2018. Finally, 4 eligible articles were included in this meta-analysis comprising 2410 subjects. The pooled odds ratios with 95% confidence intervals were used to evaluate the strength of the association. Results: Significant association was found in the overall population in the dominant model (GA/AA vs. GG, odds ratio = 0.707, 95% confidence interval = 0.594-0.841) and allele model (G allele vs. A allele, odds ratio = 1.189, 95% confidence interval = 1.062-1.333). When stratified by source of the subjects, we also found association between rs3735715 and noise-induced hearing loss risk in the dominant model (GA/AA vs. GG, odds ratio = 0.634, 95% confidence interval = 0.514-0.783) and allele model (G allele vs. A allele, odds ratio = 1.206, 95% confidence interval = 1.054-1.379). Conclusion: Rs3735715 polymorphism in GRHL2 gene may influence the susceptibility of noise-induced hearing loss. Additional large, well-designed and functional studies are needed to confirm this association in different populations.

Resumo Introdução: Perda auditiva induzida por ruído é uma das principais doenças ocupacionais causadas pela interação gene-ambiente. O Grainy Like 2, ou GRHL2 é um gene que tem sido considerado como candidato. Nesse sentido, muitos estudos avaliaram a associação entre o GRHL2 e perda auditiva induzida por ruído, embora os resultados sejam ambíguos e conflitantes. Objetivo: Identificar uma estimativa precisa da associação entre o polimorfismo rs3735715 no gene GRHL2 e a suscetibilidade à perda auditiva induzida por ruído. Método: Uma pesquisa abrangente foi feita para coletar dados até 8 de julho de 2018. No fim, quatro artigos elegíveis foram incluídos nesta metanálise, abrangeram 2.410 indivíduos. As odds ratios agrupadas com intervalos de confiança de 95% foram usadas para avaliar a força da associação. Resultados: Uma associação significante foi encontrada na população geral no modelo de dominância (GA/AA vs. GG, odds ratio = 0,707, intervalo de confiança 95% = 0,594-0,841) e modelo de alelo (alelo G vs. alelo A; odds ratio = 1,189, intervalo de confiança 95% = 1,062 a 1,333). Quando estratificados pelo local de trabalho dos indivíduos, também encontramos associação entre rs3735715 e risco de perda auditiva induzida por ruído no modelo de dominância (GA/AA vs. GG, odds ratio = 0,634, intervalo de confiança 95% = 0,514 ± 0,783) e modelo de alelo (alelo G vs. alelo A; odds ratio = 1,206, intervalo de confiança 95% = 1,054- 1,379). Conclusão: O polimorfismo Rs3735715 no gene GRHL2 pode influenciar a suscetibilidade à perda auditiva induzida por ruído. Estudos adicionais, amplos, bem desenhados e funcionais são necessários para confirmar essa associação em diferentes populações.

Epidemiological characteristics of HIV infection among college students in Nanjing, China: a cross-sectional survey.

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.

Multiple HIV-1 Genotypes Circulating Among College Students in Nanjing, China.

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_AE (37.66%), CRF07_BC (32.90%), CRF55_01B (5.63%), CRF68_01B (3.46%), CRF67_01B (3.03%), subtype B (1.73%), and CRF58_01B (1.30%) and unique recombinant forms (URFs) of 01C_like (7.08%), 0107_like (3.98%), 01BC_like (2.21%), and 01B_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_like, 01C_like 1, and 01C_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.

Polymorphism in GRHL2 gene may contribute to noise-induced hearing loss susceptibility: a meta-analysis.

INSTRUCTION: Noise-induced hearing loss is a leading occupational disease caused by gene-environment interaction. The Grainy Like 2, GRHL2, is a candidate gene. In this regard, many studies have evaluated the association between GRHL2 and noise-induced hearing loss, although the results are ambiguous and conflicting. OBJECTIVE: The purpose of this study was to identify a precise estimation of the association between rs3735715 polymorphism in GRHL2 gene and susceptibility of noise-induced hearing loss. METHODS: A comprehensive search was performed to collect data up to July 8, 2018. Finally, 4 eligible articles were included in this meta-analysis comprising 2410 subjects. The pooled odds ratios with 95% confidence intervals were used to evaluate the strength of the association. RESULTS: Significant association was found in the overall population in the dominant model (GA/AA vs. GG, odds ratio=0.707, 95% confidence interval=0.594-0.841) and allele model (G allele vs. A allele, odds ratio=1.189, 95% confidence interval=1.062-1.333). When stratified by source of the subjects, we also found association between rs3735715 and noise-induced hearing loss risk in the dominant model (GA/AA vs. GG, odds ratio=0.634, 95% confidence interval=0.514-0.783) and allele model (G allele vs. A allele, odds ratio=1.206, 95% confidence interval=1.054-1.379). CONCLUSION: Rs3735715 polymorphism in GRHL2 gene may influence the susceptibility of noise-induced hearing loss. Additional large, well-designed and functional studies are needed to confirm this association in different populations.

AIDS knowledge status and influencing factors of high-risk sexual behavior among male college students in Nanjing / 中国学校卫生

Objective@#To understand the AIDS knowledge of male college students who have sex experience and the influencing factors of high-risk sexual behaviors, so as to provide a basis for AIDS prevention and control on campus.@*Methods@#A total of 5 718 male college students who have sex from 18 colleges and universities in Nanjing were investigated by stratified random cluster sampling method from April to June in 2019. Their AIDS knowledge and high-risk sexual behaviors were investigated and risk factors were analyzed.@*Results@#Male college students had poor AIDS related knowledge and the incidence of high-risk sexual behaviors was 61.5%. Logistic regression analysis showed that the proportion of male college students with sexual orientation of bisexuality(OR=1.61), uncertainty (OR=2.41) and heterosexuality (OR=1.47) who had high-risk sexual behaviors were higher than those of homosexuals. The age of first sexual intercourse ≤14 years old(OR=2.71), 15 to 17 years old(OR=1.87), and 18 to 20 years old (OR=1.35) had a higher proportion of high-risk sexual intercourse than the age of first sexual intercourse of older than 20 years old. In the past year, the proportion of commercial sex(OR=1.80), drug use(OR=4.28), sexually transmitted disease (OR=3.34) diagnosed in the most recent year who had high-risk sexual behaviors were higher. In the pust year, the proportion of stable relationship and cohabitation(OR=0.25), those who had received AIDS prevention propaganda in the most recent year(OR=0.81), and those who knew about AIDS (OR=0.65) were less likely to engage in high-risk sexual behaviors.@*Conclusion@#The knowledge rate of HIV/AIDS was low and the incidence of high-risk sexual behavior was high among male college students. Therefore, colleges are encouraged to, actively carry out AIDS prevention and control work, improve the awareness of both HIV/AIDS knowledge and safe sex basics.

Trends in HIV prevalence and risk behaviours among men who have sex with men from 2013 to 2017 in Nanjing, China: a consecutive cross-sectional survey.

OBJECTIVE: To examine the trends of HIV prevalence, risk behaviours and HIV testing among men who have sex with men (MSM) in Nanjing. DESIGN: Five consecutive cross-sectional surveys. SETTING: Nanjing, China. PRIMARY AND SECONDARY OUTCOME MEASURES: HIV and syphilis prevalence, HIV testing rate and factors associated with HIV infection; demographic characteristics and behaviours. RESULTS: 649, 669, 577, 633, 503 MSM were recruited from 2013 to 2017. HIV prevalence was 9.9%, 12.3%, 12.5%, 9.8% and 10.1%, respectively. Syphilis prevalence decreased with a range from 10.6% to 5.6%. Risk behaviours like unprotected anal intercourse (UAI) and unprotected virginal sex in the past 6 months decreased, but multiple sex partners and ever used rush popper rose significantly. MSM tested for HIV in the previous year remained stable from 57.0% to 64.1% (P=0.633). Multivariate analysis showed that tested for HIV in the past year was protective factor against HIV infection. MSM who had UAI in the past 6 months, sex role as receptive and dual, diagnosed with sexually transmitted diseases (STDs) in the past year and currently syphilis infected were risk factors for HIV infection. CONCLUSIONS: We observed stable high HIV prevalence, a steady HIV testing rate, decreasing syphilis prevalence and UAI among MSM in Nanjing. However, rush popper use rose dramatically. The HIV preventive strategies for MSM including condom promotion, HIV testing expansion and reduction of rush popper use, STDs screening and standardised treatment should be strengthened.

Expression of Bcl-2, Bax and Caspase-3 in nerve tissues of rats chronically exposed to 2,5-hexanedione.

Occupational exposure and experimental intoxication with n-hexane or its metabolite 2,5-hexanedione (HD) produce a central-peripheral neuropathy. However, the mechanism remains unknown. We hypothesized that HD affected the expression of Bcl-2, Bax and Caspase-3 in the central nervous system (CNS) and the peripheral nervous system (PNS). Male adult Wistar rats were administered by intraperitoneal injection at a dosage of 200 or 400 mg/kg HD, five days per week for 8 weeks. Samples of the cerebral cortex, cerebellum, spinal cord and sciatic nerves were collected and examined for Bcl-2, Bax and Caspase-3 expression using Western blotting. Subchronic exposure to HD resulted in significantly increased expression of both anti-apoptotic protein Bcl-2 and pro-apoptotic protein Bax and Caspase-3 in cerebral cortex and cerebellum, which exhibited a dose-dependent pattern. Though little change was detected in spinal cord, our results showed that the expression of Bcl-2, Bax and Caspase-3 was markedly enhanced in the sciatic nerves. These findings suggested that the changes of apoptosis-related protein level in rat nerve tissues were associated with the intoxication of HD, which might be involved in early molecular regulatory mechanism of apoptosis in the HD-induced neuropathy.

[Effects of mono(2-ethylhexyl) phthalate on testosterone biosynthesis in leydig cells cultured from the rat testis].

OBJECTIVE: To investigate the effects of mono(2-ethylhexyl) phthalate(MEHP), the primary metabolite of di(2-ethylhexyl) phthalate (DEHP), on testosterone biosynthesis in Leydig cells cultured from the Sprague Dawley rat testis. METHODS: Based on the primary Leydig cell culture model, MEHP exposure groups involved control (0 micromol/L), 62.5, 125, 250, 500 and 1000 micromol/L. We observed mitochondria activity with the MTT method, measured the testosterone level with RIA and determined steroidogenesis acute regulatory protein (StAR) mRNA expression with RT-PCR. RESULTS: After Leydig cells were exposed to MEHP for 24 hours, the activity of mitochondria enhanced evidently at 250 micromol/L and then declined markedly at 1000 micromol/L compared with the control group (P < 0.01). The testosterone level showed an increasing tendency in both basal and hCG-stimulated states with statistical significance at 250 and 500 micromol/L compared with the control group (P < 0.01). However, the expression of StAR mRNA appeared unchanged at 62.5, 125 or 250 micromol/L, but exhibited a decreasing tendency at 500 and 1000 micromol/L (P < 0.01). CONCLUSION: ME- HP directly affected the activity of mitochondria and testosterone biosynthesis of the Leydig cells in vitro. StAR, the regulator of cholesterol transport into mitochondria, might not be responsible for the increase of testosterone biosynthesis induced by MEHP.

[Effects of dibutyl phthalate on sertoli cells of rat testis].

OBJECTIVE: The present study was performed to examine functional and structural impairment of rat sertoli cells following dibutyl phthalate (DBP) exposure. METHODS: The 6-week-old healthy male Sprague Dawley rats were randomly divided into 4 groups with 16 animals in each group. DBP dissolved in peanut oil was administered by gavage at doses of 0, 250, 500 and 1 000 mg/kg. After 2-week DBP treatment, half of the rats were sacrificed. The rest were killed following 4-week DBP exposure. Follicle stimulating hormone (FSH) was analysed by radioimmunoassay. The relative expression levels of androgen binding protein (ABP) mRNA and inhibin (INH)alpha mRNA were determined by semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR). The sertoli cell ultrastructures were observed by using transmission electron microscope (TEM). RESULTS: FSH levels were increased after 4-week DBP exposure with significance at doses of 250 and 1 000 mg/kg. Sperm head count and daily sperm product were decreased significantly in 500 and 1 000 mg/kg groups. The expression levels of ABP mRNA were 0.89 +/- 0.15, 0.85 +/- 0.23, 0.54 +/- 0.17, 0.52 +/- 0.16 and 0.88 +/- 0.16, 0.61 +/- 0.12, 0.48 +/- 0.15, 0.47 +/- 0.11 for 0, 250, 500 and 1 000 mg/kg after 2- and 4-week DBP treatments respectively with significance at doses of 500 and 1 000 mg/kg (P < 0.01), while the levels of INHalpha mRNA were 0.88 +/- 0.16, 0.61 +/- 0.12, 0.48 +/- 0.15, 0.47 +/- 0.11 and 0.75 +/- 0.19, 0.56 +/- 0.16, 0.53 +/- 0.08, 0.45 +/- 0.10 with significance at all exposure groups (P < 0.01 or P < 0.05). In sertoli cells of rats exposed to 1 000 mg/kg DBP, TEM photos showed more lysosomes in cytoplasm, proliferated and expanded endoplasmic reticulum and nuclei malformation. CONCLUSIONS: Sertoli cell should be one of the major toxic targets. Impairment of spermatogenesis caused by DBP should be partly due to the suppression of ABP and INHalpha biosynthesis.

[Effect of dibutyl phthalate on the biochemical enzymes and lipid peroxidation in rat testes].

OBJECTIVE: To explore the effect of dibutyl phthalate (DBP) on the biochemical enzymes and lipid peroxidation in rats. METHODS: Healthy 6-week old male Sprague-Dawley rats were randomly divided into 4 groups with 16 in each. DBP dissolved in peanut oil was administered by gavage at dosages of 0, 250, 500 and 1000 mg/(kg x d). After 2- and 4-week DBP exposure, 8 rats in each group were killed, with certain organs selected and weighed. The activities of biochemical enzymes and glutathione peroxidase (GSH-Px) and the levels of glutathione (GSH) in the serum and testis homogenate were determined respectively. RESULTS: DBP induced a rise in the liver organ body weight ratio, but a fall in the testis organ body weight ratio, and it was significant in the highest exposure group compared with the control after either 2-week or 4-week treatment (P < 0.01). After 2-week DBP exposure, GSHPx activities in the serum and GSH levels in the testis homogenate showed a decreasing tendency, but GSHPx activities increased markedly in the testis homogenate (P < 0.05). After 4-week DBP exposure, while alkaline phosphatase (ALP) activities in the serum revealed an increasing tendency, sorbitol dehydrogenase (SDH) activities were inhibited significantly in both the serum and the testis homogenate at the dosage of 1000 mg/(kg x d) compared with the control group (P < 0.01). Furthermore, GSH contents in the serum were also affected at this dose (P < 0.05). CONCLUSION: The results indicate that DBP administration strongly affects the liver and the testis organ body weight ratios. Lipid peroxidation is one possible toxic mechanism caused by DBP. SDH may be one of the most sensitive toxic indices when exposed to DBP.

[Effects of di-butyl phthalate on sperm motility and oxidative stress in rats].

OBJECTIVE: To evaluate the effects of di-butyl phthalate(DBP) on the sperm motility and oxidative stress in rats. METHODS: Healthy 6-week-old male Sprague Dawlay rats were randomly divided into 4 groups with 8 in each group. DBP dissolved in peanut oil was administered by gavage at dosage of 0, 250, 500, 1,000 mg/(kg.d). After 4-week DBP exposure, the animals were killed and the organs were selected and weighed. The sperm VCL, VSL, VAP, BCF, ALH, LIN, MAD and STR in the cauda epididymis were assessed by computer assisted sperm analysis (CASA), and the activities of superoxide dismutase (SOD) and the contents of malondialdehyde (MDA) in serum and testis homogenate were measured simultaneously. The increase of body weight per day and the organ body weight ratio changes of the liver, testes and epididymides were also observed. RESULTS: The liver organ body weight ratios of the treated groups were higher than those of the control (P < 0.01), while the testis organ body weight ratios were lower at dosage of 1,000 mg/(kg.d) DBP. Compared with the control group, the parameters of rat sperm VCL and ALH declined significantly at dosage of 1,000 mg/(kg.d) DBP. In addition, DBP showed inhibiting effect on SOD activities in the testis, and it was significant in the highest exposure group compared with the control (P < 0.05). However, there were no differences in serum SOD activities between the treated groups and the control. CONCLUSION: DBP exposure may affect the sperm motility and the anti-oxidative systems. The testis is a vital target organ influenced by DBP.