抑郁症患者临床特征的性别差异

目的探讨性别因素对抑郁症的影响。方法符合CCMD-3抑郁症诊断标准共195例,按男、女性别分组进行一般情况、汉密尔顿抑郁量表(HAMD)、明尼苏达多项人格测定(MMPI)评定。结果男性抑郁症未婚多、离婚少,首次发病和本次住院年龄小;HAMD评分睡眠障碍轻;MMPI测试D、Mf、Pt和Sc分高。结论男女抑郁症患者临床症状的差异较少,男性抑郁症病理性异常更严重,可能是社会文化变迁对男女心理尤其是人格的影响,并在抑郁症的病理塑形中反映出来。     

Estimating Changes in Population Size and Behavioral Characteristics in Men Who Have Sex With Men Between 2014 and 2019: Longitudinal Study

BackgroundMen who have sex with men (MSM) are at high risk for HIV infection. Accurate estimation of the population size and monitoring the risk sexual behavioral change of MSM is of great importance to develop targeted HIV prevention and interventions.ObjectiveThe goal of the research was accurate estimation of the population size and monitoring the risk sexual behavioral change of MSM.MethodsStreet interception investigation methods were conducted among males aged 16 years and older in selected sites in Shenzhen in 2014 and 2019. A population survey was used to estimate the population size of MSM. Logistic regression analysis was applied to evaluate the difference in behavioral characteristics in MSM from 2014 to 2019.ResultsIn this study, we surveyed 10,170 participants in 2014, of whom 448 (4.41%, 95% CI 4.01%-4.80%) participants were men who have ever had sex with another man (MSMe) and 229 (2.25%, 95% CI 1.96%-2.54%) were men who had sex with another man in the previous 6 months (MSMa). A total of 10,226 participants were surveyed in 2019, of which 500 (4.90%, 95% CI 4.47%-5.31%) and 208 (2.03%, 95% CI 1.76%-2.31%) participants were MSMe and MSMa, respectively. The results showed that the population size of MSM who are active (MSMa) in Shenzhen was 155,469 (2.29%, 95% CI 2.28%-2.30%) in 2014 and 167,337 (2.05%, 95% CI 2.04%-2.06%) in 2019. It was estimated that there were about 12,005,445 (2.04%, 95% CI 2.04%-2.04%) MSMa in China in 2019. Compared with 2014, the MSMa in 2019 were more likely to seek sex partners through mobile phone apps and less likely to have male and female sex partners in addition to having inconsistent condom use and more than 6 sex partners in the previous 6 months.ConclusionsIn Shenzhen, the proportion of MSMa among the general male population was lower in 2019 than in 2014, and the prevalence of HIV risk behavior was reduced in 2019. Although the preferred platform to find male sex partners among MSM has changed, intervention with high–HIV risk MSM could still help to reduce HIV risk behaviors among the whole MSM group. Because MSM prefer to seek sex partners through mobile phone apps, further study is needed to strengthen internet interventions with high–HIV risk MSM to curb the spread of HIV.     

Associations of muscle mass,strength, and quality with all-cause mortality in China: a population-based cohort study

BackgroundIt remains unclear about the association of muscle mass, strength, and quality with death in the general Chinese population of diverse economical and geographical backgrounds. The present study aimed to comprehensively examine such associations across different regions in China.MethodsBased on the China Kadoorie Biobank study, the present study included 23,290 participants who were aged 38 to 88 years and had no prevalent cardiovascular diseases or cancer. Muscle mass and grip strength were measured using calibrated instruments. Arm muscle quality was defined as the ratio of grip strength to arm muscle mass. Low muscle mass, grip strength, and arm muscle quality were defined as the sex-specific lowest quintiles of muscle mass index, grip strength, and arm muscle quality, respectively. Cox proportional hazards models yielded hazard ratios (HRs) and 95% confidence intervals (CIs) for risks of all-cause mortality in relation to muscle mass, strength, and quality.ResultsDuring a median follow-up of 3.98 years, 739 participants died. The HR (95% CI) of all-cause mortality risk was 1.28 (1.08–1.51) for low appendicular muscle mass index, 1.38 (1.16–1.62) for low total muscle mass index, 1.68 (1.41–2.00) for low grip strength, and 1.41 (1.20–1.66) for low arm muscle quality in models adjusted for sociodemographic characteristics, lifestyle factors, and medical histories.ConclusionLow muscle mass, grip strength, and arm muscle quality are all associated with short-term increased risks of mortality, indicating the importance of maintaining normal muscle mass, strength, and quality for general Chinese adults.     

国际抗癌联盟（UICC）第8版肺癌分期方案的验证

目的:验证国际抗癌联盟(UICC)第8版肺癌分期方案在中国肺癌患者中的应用价值。方法:分别应用UICC第8版分期方案和第7版分期方案对2010年6月至2018年4月在北京大学肿瘤医院暨北京市肿瘤防治研究所3 825例Ⅰ^Ⅳ期非小细胞肺癌术后患者的数据进行分期,使用Kaplan-Meier方法对每个亚组的患者进行生存分析,Cox回归方法评估各亚组之间的差异。结果:按照UICC第8版进行分期后,共有906例(23.7%)患者的分期发生变化,全部转向更晚分期。生存分析显示,根据第8版分期,除ⅠA1和ⅠA2亚组之间(P=0.057)差异无统计学意义以外,其余每两个相邻分期亚组之间的差异均具有统计学意义(均P<0.05)。T分期和N分期中,每两个相邻亚组之间的差异均具有统计学意义(均P<0.05)。M分期中,M0和M1a亚组之间的差异具有统计学意义(P<0.001),而M1a和M1b亚组之间未观察到显著性差异(P=0.397)。结论:与UICC第7版分期相比,第8版为中国肺癌患者提供了更准确的预后信息,尤其是对于分期为ⅠA1期、ⅠA2期和ⅠA3期的患者。     

Mutation in the D1 domain of CD4 receptor modulates the binding affinity to HIV-1 gp120

The gp120 surface subunit of HIV-1 envelope lycoprotein (Env) is the key component for the viral entry process through interaction with the CD4 binding site (CD4bs) of the primary receptor CD4. The point mutant was introduced into SD1, a CD4 D1 variant, to enhance the interaction with HIV-1 gp120.The three-dimensional structures of gp120 and SD1 were determined using homology modeling based on the results previously determined by X-ray crystallography. The binding models were carried out via protein–protein docking tools. The 5 best docking solutions were retained according to the docking scores and were used for structural assessment. Our results demonstrated the consistency between the 3D models of gp120 and SD1 predicted by molecular docking calculations and the co-crystallized data available. We first discovered that most residues in SD1 that interacted with gp120 were located within the region 6–94 of the first N-terminal D1 domain of CD4. SD1 bound to gp120 stably at which 15 residues formed 20 hydrogen bonds with 16 residues of gp120. Five pairs of electrostatic interactions between positively and negatively charged side chains of amino acids were identified in the SD1-gp120 interface, which showed an increased number of electrostatic interactions with gp120. The mutant in the D1 domain of human CD4 receptor could strengthen binding affinity with HIV-1 gp120 and might improve the interaction pattern of the neighboring residues. The sequence analysis of gp120 suggested that Asp186, Asn189, Arg191, Glu293, Phe318 and Tyr319 were located in the variable regions of gp120, which may be HIV-1 AE strain-specific amino acid residues. Together, the results presented in this study contributed to a better understanding of the changes in the interaction between the gp120 protein and the human host CD4 receptor associated with point mutation in the D1 domain. The stabilized derivative of human CD4 D1 should serve as a promising target for therapeutics development in HIV-1 vaccine and viral entry inhibitor and may warrant further investigation.

HIV-1 gp120 is the key component for viral entry through interaction with CD4 D1. The 5 best docking solutions were retained according to the docking scores. SD1 bound to gp120 at which 15 residues formed 20 hydrogen bonds with 16 residues of gp120.     

A novel biomarker for pleural effusion diagnosis: Interleukin‐36γ in pleural fluid

BackgroundNumerous studies have described the critical importance of interleukin (IL) ‐36γ in host defense against lung infections, but it is unknown whether it plays a role in infectious pleural effusion (IPE). This study aimed to examine the levels of IL‐36γ in pleural effusions of different etiologies and evaluate the diagnostic accuracy of IL‐36γ in the differential diagnosis of IPE.MethodsA total of 112 individuals was enrolled in this research. IL‐36γ levels in pleural fluids of all 112 patients were measured by enzyme‐linked immunosorbent assay (ELISA). We also characterized these markers'' diagnostic values across various groups.ResultsPatients with tuberculous pleural effusion (TPE) and parapneumonic effusion (PPE) had exhibited markedly higher IL‐36γ levels in their pleural fluid than the malignant pleural effusion (MPE) and transudative effusion patients. Furthermore, the IL‐36γ concentrations in TPE patients were evidently higher than in uncomplicated parapneumonic effusion (UPPE) patients but significantly lower than in complicated parapneumonic effusion (CPPE)/empyema patients. Pleural fluid IL‐36γ is a useful marker to differentiate TPE from UPPE, at a cut‐off value for 657.5 pg/ml (area under the curve = 0.904, p < 0.0001) with 70.0% sensitivity and 95.7% specificity.ConclusionsThe elevated IL‐36γ in pleural effusion may be used as a novel biomarker for infectious pleural effusion diagnosis, particularly in patients with CPPE/empyema, and is a potentially promising biomarker to differentiate between TPE and UPPE.