Objective To explore the contemporary prevalence,cumulative incidence,distribution characteristics,and correlates of social isolation among middle-aged and older adults aged 45 years and older in China. Methods This study utilized data from the China Health and Retirement Longitudinal Study.Cross-sectional studies with stratified analysis were conducted to investigate the prevalence of social isolation and its age,gender,and regional differences in 2018 and 2020.A cohort study and binary logistic regression models were employed to analyze the cumulative incidence of social isolation and its correlates from 2018 to 2020.Multiple imputation based on chained equations and sensitivity analyses based on complete-case data were employed to ensure the reliability of the analysis. Results In 2018,the weighted prevalence of social isolation among middle-aged and older adults was 16.48%(95%CI=15.67%-17.32%).In 2020,the weighted prevalence of social isolation among middle-aged and older adults was 18.84%(95%CI=17.93%-19.74%).Weighted stratified analyses indicated that the prevalence of social isolation was significantly higher among older adults,individuals residing in rural areas,and females.The weighted cumulative incidence of social isolation during 2018-2020 was 9.24%(95%CI=8.47%-10.02%).The analysis revealed that 34.02%(95%CI=32.85%-35.19%)of middle-aged and older adults exhibited depressive symptoms.Depressive symptoms(OR=1.38,95%CI=1.07-1.78,P=0.013)were significantly associated with an elevated risk of social isolation. Conclusion The study reveals the epidemiology of social isolation among middle-aged and older adults in China,identifying advanced age,female gender,rural residence,and depressive symptoms as key correlates.These findings emphasize the need for early health management strategies to address social isolation in these high-risk populations.

Objective This study aims to assess the coverage of human papillomavirus(HPV)testing and the prevalence of HPV infection among men who have sex with men(MSM)using geosocial networking apps in China.It also explores the related influencing factors to provide evidence for designing effective prevention and control strategies for this population. Methods The study was conducted from July to August 2024 and recruited participants via the Blued app.Univariate and multivariate logistic regression models were used to analyze factors associated with HPV testing and infection among MSM. Results Among the 1,080 participants,23.3% had undergone HPV testing,and 43.3% of those tested were positive for HPV. The main reason for HPV testing was the presence or suspicion of HPV-related symptoms(n=224,58.9%).Logistic regression analysis showed that MSM with higher levels of HPV knowledge,higher income,and those who self-identified as homosexuals were more likely to undergo HPV testing.Additionally,MSM with higher HPV knowledge,those who self-identified as homosexuals,those who had sex with women in the past six months,and HIV-positive MSM were identified as high-risk groups for HPV infection. Conclusions In China,the HPV testing rate among MSM using geosocial networking apps is low.However,the prevalence of HPV infection remains relatively high.Therefore,the government and community should enhance HPV knowledge dissemination,promote HPV testing,and improve the accessibility and quality of HPV testing services.By doing so,they can increase the testing coverage and effectively control the spread of HPV among MSM.

Objective To investigate the value of repeat renal biopsy in the treatment and prognosis of nephrotic syndrome(NS)and acute kidney injury(AKI)following immunosuppressive therapy in patients with lupus nephritis(LN).Methods A retrospective analysis was conducted for the clinicopathological data and follow-up records of LN patients undergoing repeat renal biopsy at Peking Union Medical College Hospital from January 1,2009 to December 31,2021.Results A total of 76 patients(55 females,72.4%)were included in this study,with the mean age at the first biopsy being(29.0±10.4)years,the median inter-biopsy interval of 4.0(2.0,7.0) years,and the median total follow-up duration of 7.5(5.0,13.8)years.Pathological transformation occurred in 46(60.5%)patients,and 2 patients had comorbid diabetic nephropathy.At repeat renal biopsy,50(65.8%) patients presented NS.These patients demonstrated lower estimated glomerular filtration rate(eGFR)(P<0.001),higher chronicity index(CI)(P=0.029),and higher complement C3(P<0.001)and C4(P<0.001)levels than those with NS at the first renal biopsy(n=50).Among the 28(36.8%) patients with AKI at repeat renal biopsy,8(28.6%)experienced acute exacerbation of chronic renal insufficiency.These patients exhibited higher serum creatinine level(P=0.002),C4 level(P=0.033),CI(P=0.042),and prevalence of thrombotic microangiopathy(P=0.046)than the patients showing AKI at the first renal biopsy(n=16),while the activity index(AI)showed no significant difference(P=0.051).Over 50% of NS and AKI patients underwent treatment modifications post-repeat renal biopsy,with clinical remission rates comparable to those after the first renal biopsy(both P>0.05).Elevated CI(≥5,P=0.001)and serum creatinine(≥140 μmol/L,P<0.001)at repeat renal biopsy were identified as independent risk factors for poor prognosis.The patients with AKI at repeat renal biopsy had higher incidence of endpoint events than the non-AKI patients(P=0.015).Neither AKI at the first renal biopsy nor NS at both biopsies had significant associations with prognosis.Conclusions Repeat renal biopsy reveals not only sustained high disease activity but also accelerates chronic progression in LN patients,which underscore its critical role in guiding the therapy for severe LN post-immunosuppression.AKI,CI≥5,and serum creatinine ≥140 μmol/L at repeat renal biopsy are strongly associated with poor prognosis.

The establishment and development of neonatal intensive care unit(NICU)have significantly increased the survival rate of premature infants.However,the diagnosis,treatment,and surgeries performed in NICU may expose neonates to more noxious stimuli.As the neonatal period is crucial for brain development,these noxious stimuli may cause irreversible damage to the neonatal nervous system.Existing clinical studies have shown that repetitive noxious stimuli during the neonatal period can lead to poor brain development,persistent hyperalgesia,and various sequelae.However,the underlying mechanisms remain unclear,and effective treatment methods are lacking.This article summarizes the effects of repetitive noxious stimuli during the neonatal period on neural development and the complications,aiming to provide a basis for the neonatal analgesia management and the prevention and treatment of related sequelae.