简介：Aplateaurailway,theQinghai-TibetRailway,willrunacrossthe"roofoftheworld"withanaverageelevationofmorethan4,000meters.Therailway,thehighestinaltitudeintheworld,willterminateinLhasa,capitalofTibetAutonomousRegion.Thissteelarteryislikenedtoa"goldenbridge"onthegreatplateau.FortheTibetanpeople,the"goldenbridge"leadstoBeijingandtoabetterlife.

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简介：AbstractBackground:The burden of human immunodeficiency virus (HIV) infection in people who use drugs (PWUD) is significant. We aimed to screen HIV infection among PWUD and describe their retention in HIV care. Besides, we also screen for hepatitis C virus (HCV) infection among HIV-seropositive PWUD and describe their linkage to care.Methods:We conducted a prospective study in 529 PWUD who visited the "Cañada Real Galiana" (Madrid, Spain). The study period was from June 1, 2017, to May 31, 2018. HIV diagnosis was performed with a rapid antibody screening test at the point-of-care (POC) and HCV diagnosis with immunoassay and PCR tests on dried blood spot (DBS) in a central laboratory. Positive PWUD were referred to the hospital. We used the Chi-square or Fisher’s exact tests, as appropriate, to compare rates between groups.Results:Thirty-five (6.6%) participants were positive HIV antibodies, but 34 reported previous HIV diagnoses, and 27 (76%) had prior antiretroviral therapy. Among patients with a positive HIV antibody test, we also found a higher prevalence of homeless (P < 0.001) and injection drug use (PWID) (P < 0.001), and more decades of drug use (P= 0.002). All participants received HIV test results at the POC. Of the 35 HIV positives, 28 (80%) were retained in HIV medical care at the end of the HIV screening study (2018), and only 22 (62.9%) at the end of 2020. Moreover, 12/35 (34.3%) were positive for the HCV RNA test. Of the latter, 10/12 (83.3%) were contacted to deliver the HCV results test (delivery time of 19 days), 5/12 (41.7%) had an appointment and were attended at the hospital and started HCV therapy, and only 4/12 (33.3%) cleared HCV.Conclusions:We found almost no new HIV-infected PWUD, but their cascade of HIV care was low and remains a challenge in this population at risk. The high frequency of active hepatitis C in HIV-infected PWUD reflects the need for HCV screening and reinforcing the link to care.

简介：IntroductionAsoneJewishhistorianwhofollowsclassicaltraditioninhishistoricalcomposition,Josephus’lifewascolorfulandlegendary.1BornasaJewishpriest2andlaterappointedasaseniorgeneralduringthejewishrevoltin68AD,josephussurrenderedtoRomeinGalileeafteranunsuccessfulresistanceanddestineddefeat,afterwhichhewassetfreebyVespasian,wenttosettledowninRome

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简介：习惯决定了我们的性格。改变习惯固然困难,但只要不断努力,就可以做到。(良好的)习惯由知识、技能和意愿组成。它是在行动和思维的不断转换中产生的。实现目标就是在一种成熟模式上不断进步的过程,即:从依赖到独立,再到互相依赖。尽管独立是现代社会所推崇的模式,我们却可通过合作和专业化取得更多的成功。但是,在选择互相依赖之前,我们必须先学会独立。

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简介：EDITOR'SNOTE:Inaninterviewgivenoflatetoourstaffreporter,GaoQiang,ChineseMinisterofHealth,spokeontheachievementsmadebyChinainmedicalandhealthworkduringtheTenthFive-YearPlanperiod(2001-2005),thesoaringmedicalcoststhathaveinvokedmuchpubliccomplaint,waysofcarryingtodepththereformofthemedicalservicesystem,developmentoftheruralcooperativemedicalsystemandcommunity-basedmedicalservicesincities,aswellaspreventionandcontrolofAIDS.Followingisatranscriptoftheinterview.

简介：Objectives:Theaimofourstudyistoexaminevestibular-evokedmyogenicpotentials(VEMPs)elicitedbythegalvanicvestibularstimulationinthesternocleidomastoidmuscle(SCM)inhealthysubjectsforclinicalapplicationsofauditoryneuropathyorvestibularneuropathyinthefuture.Methods:WeenrolledsixteenhealthysubjectstorecordtheaverageresponsesofSCMtogalvanicvestibularstimulation(GVS)[current3mA;duration1ms]byelectromyography(EMG).SPSS18.0softwarewasusedtoanalyzetheobtaineddataformeanandstandarddeviation.Results:Inallhealthysubjectsmastoid-foreheadgalvanicvestibularstimulationproducedapositive-negativebiphasicEMGresponsesonSCMipsilateraltothecathodalelectrode.Thelatencyofp13was11.7±3.0ms.Thelatencyofn23was17.8±3.4ms.Theamplitudeofp13-n23was147.0±69.0mV.Theinterauralasymmetryratio(AR)ofp13,n23latencyandtheamplitudewasrespectively0.12±0.09,0.08±0.08and0.16±0.10.Discussions:GalvanicvestibularstimulationcouldelicitbiphasicEMGresponsesfromSCMviathevestibularnervebutnotfromtheotolithorgans.Galvanicstimulationtogetherwithairconductedsound(ACS)orboneconductedvibration(BCV)canelicitVEMPsandmayenablethedifferentiationofretrolabyrinthinelesionsfromlabyrinthinelesionsinvestibularsystem.

简介：Ⅰ.Public-and-PrivateSectorSeparationinChina1.1.Quasi-SeparationofPublicandPrivateSectors:before1949PriortotheQinDynasty,thefeudalsystemwaspursuedastherulingmodeinChina.Publicpowerwasdecentralized.Feudalprinceswereinchargeoflocalaffairs,andtheimpactofkingshiponsocietywasindirect.Atthattime,dictatorialoppressivepowerdidnotappear.Therefore,therewasnoneedtoseparatepublicsectorsfromprivatesectors.

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简介：AbstractBackground:Few data are available regarding the long-term case-fatality rate (CFR) among people living with HIV (PLWH) with nontuberculous mycobacteria (NTM) disease. The aim of this study is to analyze the long-term CFR in patients with NTM disease and to identify risk factors for their death.Methods:A retrospective cohort study of 379 cases of microbiologically confirmed NTM disease in PLWH was conducted from January 1, 2012, to December 31, 2020, in Shanghai, China. We used Kaplan-Meier survival analysis and the log-rank test to compare the long-term CFR in patients with disseminated NTM (DNTM) and localized NTM disease. Univariate Cox proportional hazards regression analysis and a stepwise Cox proportional hazards regression model were used to estimate the predictors of long-term CFR.Results:The cohort was followed up for a median of 26 months. The total CFR was 15.7% by one year and increased to 22.6% at 5 years after the diagnosis of NTM disease. The 5-year CFR of PLWH with DNTM was significantly higher than that of PLWH with localized NTM (26.7% vs 19.6% for DNTM and localized NTM disease, respectively). Older age [hazard ratio (HR)= 1.04, 95% confidence interval (CI): 1.02-1.06, P < 0.001], comorbidity (HR= 2.05, 95% CI: 1.21-3.49, P < 0.01), DNTM (HR= 2.08, 95% CI: 1.17-3.68, P < 0.05), and HIV viral load (HR= 1.32, 95% CI: 1.12-1.55, P < 0.001) were all independent risk factors for long-term CFR. In the subgroup analysis, time to culture positivity was negatively correlated with CFR in patients with DNTM (HR= 0.90, 95% CI: 0.82-0.98, P < 0.05).Conclusions:NTM was associated with a high long-term CFR in PLWH. Further approaches to prevent NTM disease in PLWH are urgently needed.

简介：ＡｔｔｅｎｄｉｎｇｔｏｔｈｅＮｅｅｄｓｏｆＬｏｃａｌＰｅｏｐｌｅｉｎＮａｔｕｒｅＲｅｓｅｒｖｅｓ－ＡｎＩｍｐｏｒｔａｎｔＭｅａｓｕｒｅｉｎｔｈｅＥｓｔａｂｌｉｓｈｍｅｎｔａｎｄＰｒｏｔｅｃｔｉｏｎｏｆＮａｔｕｒｅＲｅｓｅｒｖｅｓTXＡｔｔｅｎｄｉｎｇｔ...

简介：IntroductionHIVserostatusdisclosurehasbecomeanentrycriterionforpreventionofsexualpartnersspread,soweaimedtoexaminetheprevalenceofdisclosureandassociatedfactorsamongpeoplelivingwithHIV/AIDS(PLWHA)inLiuzhouCity,GuangxiZhuangAutonomousRegion,southernChina.MethodsThePLWHAwithmaritalorregularsexualrelationshipwereeligibleforourstudy,andaself-designedquestionnairewasassignedtoalltheconvenientlysampledparticipants.Determinantsofdisclosurewereanalyzedusingchi-squaretestandbinaryLogisticregression.ResultsAtotalof425PLWHAwereincludedinthepresentstudy.Twohundredandforty-five(57.6%)disclosedtheirHIV-positivestatustotheirspouses/regularsexualpartners,while180(42.4%)didnot.Amongthe245informedspouses/regularsexualpartners,236(96.3%)hadreceivedtheHIVtestingandthepositiveratewas50.4%.Whileamongthenon-in-formedspouses/regularsexualpartners,63(35.0%)hadreceivedtheHIVtestingandthepositiveratewas3.2%.BinaryLogisticregressionanalysisindicatedthatage,area,monthlyincome,HIV/AIDSrelatedknowledgeandantiretroviraltherapy(ART)wereindependentlyassociatedwithHIVserostatusdisclosure.ConclusionsThedisclosureratewaslowinthisstudy.Astoitsinfluencingfactors,itisnecessarytoprovidecomprehensivedisclosureconsultingamongPLWHAlivinginurban,theelderlyorhighmonthlyincomeandemphasizethepropagandaonHIV/AIDSrelatedknowledge,expandcoverageforantiretroviraltherapy,soastoprovidescientificreferenceforpromotingHIVdisclosureandreducingtheHIVincidenceofspouses/regularsexualpartnersamongPLWHA.

简介：AccordingtotheChineseGovernmentWebsite,allthedistrictsandcountiesunderthejurisdictionofGuyuanCitylocatedinLiupanshanMountainofSouthernNingxia

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简介：The61stUNGeneralAssemblyadoptedtheConventionontheRightsofPersonswithDisabilitiesinNewYorkCityonDecember13,2006.Thisisthefirstlegallybindinginternationalconventionontheprotectionoftherightsofdisabledpersons,thefirstofitskindinthehistoryoftheUnitedNations.Itisalsothelatesteffortsoftheinternationalcommunitytoprotectandpromotehumanrightsanddevelopmentofpersonswithdisabilities.OnMarch30,2007,ChinasignedtheConvention.ThefollowingisaninterviewwithMr.ZhangGuozhongoftheInternationalDepartmentoftheChinaFederationforDisabledPersons,whowitnessedthewholeprocessofthenegotiationsontheConvention:

简介：AbstractPurpose:As COVID-19 spreads globally and affects people's health, there are concerns that the pandemic and control policies may have psychological effects on young people (age from 17 to 35 years). This psychological impact might vary in different countries, and thus we compared the prevalence of self-reported psychological distress, loneliness and posttraumatic stress symptoms (PTSS) among young people in the United Kingdom (UK) and China at the beginning of the COVID-19 pandemic.Methods:Data of this study came from two sources. One source was the first wave of COVID-19 study in Understanding Society, a special wave of the UK household longitudinal study, which provided the high-quality, national-wide representative panel data. The sample comprised 1054 young people. The other source was an online survey on the mental health of 1003 young people from Shanghai, a highly developed area in China. The questionnaire included questions on the prevalence of common mental disorders (cut-off score ≥ 4), loneliness and potential PTSS (cut-off ≥ 33). Univariable analyses were conducted to test the differences in the self-reported prevalence of psychological distress and loneliness between the two groups. Multivariable logistic regression analyses were run to explore the predictors of psychological distress and loneliness among all the young people from England and Shanghai.Results:Among the samples with self-reported psychological distress, the UK sample accounted for 34.4% (n=1054) and the Chinese sample accounted for 14.1% (n=1003). The difference between the two groups was statistically significant (p < 0.001). Additionally, 57.1% of people in the UK and 46.7% in China reported that they sometimes or often felt lonely, of which the difference is statistically significant (p < 0.001). Regression analysis of the entire samples showed that nationality, gender, psychotherapy and loneliness were significant predictors of 12-item General Health Questionnaire scores, while the variables of age and living alone were not. Significant predictors of self-reported loneliness were the nationality, gender, age, living alone and psychotherapy. In China, 123 (12.3%) young people, 49 men (11.3%) and 74 women (13.0%), met the criteria of PTSS symptoms (cut-off scores ≥ 33). These scores were only collected in China.Conclusion:This evidence suggests that mental health and loneliness reported by young people were lower in China than that in the UK during the studied period. More research is needed to understand these differences. If the differential negative psychological impacts are confirmed, country-specific measures of prevention and intervention should be adopted to improve the mental health of young people under the ongoing impact of the pandemic.

简介：March28ofthisyearisthesecondTibetanSerfsEmancipationDay.PeopleofallnationalitiesinTibetmarkedthedaybyhoistingthenationalflagandbysinginganddancing.Smileswereoneveryfaceandafestiveatmospherepervadedthesnow-coveredplateauregion.