Yellow fever virus (YFV) is an arbovirus causing substantial human morbidity and mortality. The live-attenuated 17D strain serves as vaccine and is one of the most successful vaccines so far. Receptor usage between attenuated and pathogenic YFV strains remains unclear. Here we performed a barcoded, genome-wide human open-reading frame library screen and identified LRP8 (also named APOER2) as a receptor for YFV. We show that LRP8 expression increases YFV infection (17D and two clinical strains, BJ01 and Asibi) in cell lines by promoting entry. Adeno-associated virus-mediated expression of human LRP8 in mouse liver aggravates infection and pathology of the clinical strain BJ01. LRP8 knockdown decreases YFV infection in brain cells, primary human hepatocytes and mosquitoes. LRP8 directly interacts with YFV 17D particles via the viral envelope protein. A soluble LRP8 decoy protein can block YFV 17D and BJ01 infection. Our findings provide insights for understanding YFV entry, tropism and pathogenesis.

Abstract Background Pre-exposure prophylaxis (PrEP) has demonstrated a significant reduction in HIV infections among men who have sex with men (MSM), however, low medication adherence hinders its preventative effectiveness. Traditional approaches, such ashealth education and face-to-face inquiry (HEF), have demonstrated certain efficacy in improving PrEP adherence. However, these methods are resource-intensive and often plagued by delays, rendering timely and precise interventions challenging. This randomized controlled trial aims to assess the effectiveness of an intervention comprising AI-chatbot for PrEP (PrEP-bot) and Smart pillbox (SPB) (PrEP-bot-SPB) strategy to improve PrEP adherence among MSM compared to HEF. Methods and analysis A three-arm, multicenter, open-lable RCT will be conducted with Chinese MSM ≥18 years. A total of 300 participants will be recruited through three sources, including hospitals, community-based organizations (CBOs) and peer referral in five cities: Shenzhen, Beijing, Qingdao, Hangzhou and Zhengzhou. After completing baseline survey, participants will be randomized evenly into interventions or control groups: the PrEP-bot group, the PrEP-bot-SPB group, and the HEF control group. Participants in the PrEP-bot group will be granted access to an AI-chatbot agent through WeChat. This agent will: 1) generate personalized PrEP medication plans; 2) provide medication reminders and PrEP-related health check-ups notifications; 3) inquire about missed doses to deliver tailored interventions; 4) answer participant questions about PrEP using guideline-based knowledge. Participants in the PrEP-bot-SPB group will receive both the SPB and the PrEP-bot interventions. SPB could delivers medication reminders. Participants in HEF group will receive a health education pamphlet introducing PrEP and knowledge related to PrEP medication adherence at baseline and face-to-face inquiry every three months. Outcomes will be assessed for both short-term and medium-to-long-term effects. The primary objective is the effectiveness in improving PrEP adherence measured by self-report, Eight-Item Morisky medication adherence scale (MMAS-8) and concentration of Tenofovir in dried blood spots (DBS) (PrEP adherence ≥90%) at 3 months follow-up. Secondary outcomes include: 1) effectiveness in preventing HIV infection measured by HIV-self test (HIVST); 2) effectiveness of PrEP-related health check-ups; 3) the effectiveness, feasibility, acceptability, and user satisfaction with the PrEP-bot; 4) effectiveness in improving PrEP adherence at 6-month, 9-month and 12-month follow-up periods. All participants will receive quarterly follow-up visits during the 12-month study period. Intention-to-treat analysis and per protocol set (PPS) analysis will be used. Results Recruitment and enrollment of participants began in January 2026 and is currently ongoing. Discussion This study is expected to establish a novel AI-based intervention model for PrEP, providing innovative strategies for HIV control among MSM populations. If the PrEP-bot is proven non inferiority than HEF, it could offer users real-time, precise, and personalized interventions while simultaneously addressing PrEP-related inquiries and health check-ups reminders. Importantly, this approach would achieve significant reductions in resource requirements for implementation and maintenance and being more cost-effective. With the ongoing advancement of AI technologies, PrEP-bot hold substantial promise for widespread implementation in PrEP adherence, potentially revolutionizing HIV prevention for MSM in China through this innovative intervention modality. Trial registration ChiCTR2500111280 (Chinese Clinical Trial Registry). Date of registration: 29 October 2025.

Background Long-acting HIV pre-exposure prophylaxis (PrEP) may overcome adherence and discontinuation challenges facing oral PrEP, which remain unsystematically reviewed. This study aimed to synthesize the evidence on long-acting PrEP adherence and discontinuation. Methods We conducted a systematic review and meta-analysis of studies published from database inception to July 1, 2026 in PubMed, Web of Science, EMBASE, and Cochrane Library. Eligible studies reported adherence (on-time doses receipt at time points, e.g., at 2 months) or discontinuation (stopping doses or loss to follow-up within a time period, e.g., within 6 months) of long-acting PrEP, including long-acting injectable (LAI) and intravaginal ring (IVR) PrEP. Non-longitudinal designs and non-English publications were excluded. We used random-effects meta-analyses to pool estimates. Subgroup analyses were conducted by population, region, and study design. Findings We identified 46 eligible studies (28 LAI and 18 IVR) including 22,945 individuals (14,190 and 8755). Adherence to six-monthly and two-monthly LAI-PrEP at 12 months was 93.0% (95% CI: 91.6–94.3) and 88.1% (84.7–90.8%); discontinuation for the six-monthly and two-monthly regimens within 12 months was 8.2% (4.9–13.4) and 16.0% (10.8–23.1). Discontinuation for two-monthly LAI-PrEP was higher in implementation studies than in clinical trials (14.6% vs. 1.8% within 6 months; 32.0% vs. 10.3% within 12 months, P < 0.0001). IVR-PrEP adherence was 66.1% (42.2–83.9%) at 6 months and discontinuation was 21.4% (12.6–33.8%) within 12 months. Compared with clinical trials, implementation studies showed lower adherence (32.0% vs. 73.8%) and higher discontinuation (41.1% vs. 7.7%) at 6 months (P < 0.0001). Interpretation Adherence to LAI-PrEP remained high through 12 months, with the best adherence being observed in clinical trials, which serve as upper-bound benchmarks. Compared to LAI-PrEP, IVR-PrEP had lower adherence and higher discontinuation. Efforts facilitating longer-term adherence warrant research. Funding This study was supported by the National Key R&D Program of China.

Yellow fever virus (YFV), an arbovirus causing substantial human morbidity and mortality, was the first human virus discovered over a century ago. The live-attenuated 17D vaccine is among the most successful vaccines in medicine. Despite the importance of YFV, its receptor has remained unknown. Here, we performed a barcoded, genome-wide human ORF library screen and identified LRP8 (also named APOER2) as a receptor for YFV. We show that LRP8 expression specifically boosts YFV infection in cell lines by promoting entry. AAV-mediated expression of human LRP8 in mouse liver aggravates infection and pathology. LRP8 knockdown abolishes YFV infection in brain cells, primary human hepatocytes, and notably in mosquitoes. Biochemically, LRP8 directly interacts with YFV particles via the viral envelope protein. This function of LRP8 is conserved across species, particularly in mosquitoes and primates. A soluble LRP8 decoy protein can block YFV infection in vitro and in mice, providing a potential therapeutic or prophylactic strategy. Our findings provide groundwork for understanding YFV entry, tropism, and pathogenesis, and may enable development of novel therapeutics to treat YFV infection. ### Competing Interest Statement The authors have declared no competing interest.

BackgroundOral health is increasingly recognized as a crucial determinant of overall health in people living with HIV/AIDS (PLWHA). Specifically, the oral mycobiome may play a pivotal role in HIV-associated oral complications. However, the fungal species involved and their potential as biomarkers for HIV-related oral conditions remain poorly understood. This study investigates salivary fungal profiles in PLWHA who have sex with men (MSM), focusing on diversity, functional shifts, and correlations with disease progression.MethodsA cross-sectional study included 25 MSM participants divided into five groups: HIV-negative controls (n = 5) and four HIV-positive groups stratified by CD4 count: Stage 0 (HIV RNA-positive/antibody-negative; n = 5), Stage 1 (CD4 ≥500 cells/μL; n = 5), Stage 2 (CD4 200–499 cells/μL; n = 5), and Stage 3 (CD4 <200 cells/μL or opportunistic infections; n = 5). Saliva samples were collected and analyzed using metagenomic sequencing (Illumina NovaSeq platform). Bioinformatic analyses included genome assembly (MEGAHIT), gene clustering (CD-HIT), gene abundance calculation (SOAPaligner), species annotation (BLASTP), and KEGG pathway annotation (KOBAS 2.0). Statistical analyses (Kruskal-Wallis tests, Spearman’s correlation) assessed associations between fungal profiles, CD4 count, and viral loads.ResultsA total of 51 fungal genera were identified, with Pseudogymnoascus being the most abundant. Functional analysis revealed 113 shared KEGG pathways, of which 69 were unique to Stage 3, primarily related to metabolic and disease-related processes. Notably, Auricularia exhibited a positive correlation with CD4 count (P ≤ 0.01), while Mucor showed a negative correlation (P = 0.0299).ConclusionsSalivary mycobiome composition and function shift significantly across HIV stages, reflecting immune decline. Pseudogymnoascus dominance challenges conventional views of oral fungal ecology in immunocompromised hosts. These findings highlight the mycobiome’s diagnostic potential for monitoring HIV-related oral health. Longitudinal studies are needed to validate clinical relevance.

Oral emtricitabine-tenofovir disoproxil fumarate (F/TDF) for HIV pre-exposure prophylaxis (PrEP) demonstrates dual potential through antiviral activity against hepatitis B virus (HBV). While F/TDF lacks activity against hepatitis C virus (HCV), the use of F/TDF for HIV PrEP may elevate HCV risk through risk compensation. This study aims to investigate HBV/HCV incidence among men who have sex with men (MSM) using F/TDF-based HIV PrEP, addressing evidence gaps in low- and middle-income countries. We conducted a secondary analysis of the China Real-World Oral Intake of PrEP (CROPrEP) study, a multicenter prospective cohort of MSM (F/TDF users/non-users) from Beijing, Shenyang, Shenzhen, and Chongqing. Participants underwent HBV/HCV testing at baseline and at the 12-month follow-up. Only HBV-susceptible (hepatitis B surface antigen-negative, hepatitis B surface and core antibody-negative) MSM were included in the secondary analysis, to calculate HBV incidence. The primary outcomes were HBV/HCV incidence rates at the 12-month follow-up. Bayesian Poisson regression identified HBV/HCV infection risk factors. The CROPrEP cohort prospectively recruited 1023 F/TDF users and 507 F/TDF non-users at baseline. This secondary analysis included 259 F/TDF users and 120 non-users identified as HBV-susceptible at baseline. At the 12-month of follow-up, no incident HBV infections occurred in the F/TDF users group, and only one incident HBV infection occurred in the F/TDF non-users group. The incidence of new HBV infections was 0.00/100 person-years (PY) [95 https://www.chictr.org.cn/showproj.html?proj=22916 .

Oral pre-exposure prophylaxis (PrEP) effectively prevents HIV among men who have sex with men, but its adherence faces significant hindrances. We evaluated the effectiveness of real-time digital intervention in promoting oral PrEP adherence through a randomized controlled trial using electronic medication monitors. The trial was registered on the Chinese Clinical Trial Registry (ChiCTR1900025604) and randomized 442 MSM to intervention (247) or control group (195). At the 6-month follow-up, the intervention group exhibited significantly higher oral PrEP adherence than the control (83.1% vs. 59.8%; adjusted net difference: 21.0%, 95% confidence interval: 12.9-29.2%, p < 0.001), while no differences were detected in the number of male sexual partners, condomless anal intercourse prevalence, or substance use disorder, with consistent results across both daily and event-driven oral PrEP regimens. Therefore, digital intervention significantly increased oral PrEP adherence over 6 months in the daily and event-driven subgroups but demonstrated no effect on high-risk behaviors.

Background Major depressive disorder (MDD) is one of the most prevalent mental disorders worldwide, with high suicide risk. Although some studies have found suicide risk is associated with childhood trauma and distress tolerance, the psychological mechanism of how childhood trauma and distress tolerance influence suicide risk in patients with MDD is still unclear. Methods A cross-sectional survey was conducted among 136 patients with MDD. The Hamilton Depression Rating Scale 17-item (HAMD-17), Childhood Trauma Questionnaire-Short Form (CTQ-SF), Distress Tolerance Scale (DTS) and suicide module of the Mini International Neuropsychiatric Interview (MINI) were used to measure depressive severity, childhood trauma, distress tolerance, and suicide risk. Descriptive analysis, correlation analysis and mediation analysis were performed to explore the effect of distress tolerance on the relationship between childhood trauma and suicide risk. Results 67.65 % of the patients reported at least one type of childhood trauma. The indirect effect of childhood trauma on suicide risk through distress tolerance was significant (β = 0.032, SE = 0.017, 95 % CI [0.005, 0.070]). Childhood trauma had a significant direct effect on suicide risk in this mediation model (β = 0.193, SE = 0.058, p = 0.001, 95 % CI [0.078, 0.308]). Conclusions Distress tolerance partially mediated the relationship between childhood trauma and suicide risk. The findings highlighted the importance of distress tolerance in preventing and intervention in suicide risk among patients with MDD and childhood trauma.

Anxiety is one of the most common mental disorders. We aim to find novel biomarkers to explore its potential mechanism in anxiety disorders. Differentially expressed genes (DEGs) were screened out from GSE29014 and GSE100084 datasets. Protein-protein interaction network, enrichment analysis, and principal component analysis were employed to determine hub genes. The anxiety model was constructed by restraint stress. Behavioral tests, enzyme-linked immunosorbent assay, hematoxylin-eosin, and Nissl staining were applied to evaluate the anxiety model. The potential mechanisms were investigated by corticosterone (CORT)-induced PC12 cells as an in vitro model. Proteins and mRNA expression levels were measured by western blot and real-time quantitative polymerase chain reaction. Cell counting kit, 5-Ethynyl-2'-deoxyuridine, and flow cytometry assays were employed to measure proliferation and apoptosis. PTPRC, SMC3, STAG2, FLT3, SYNE1, TERF2IP, NIPBL, ZFP451, MLLT3, and JAK1 were identified as hub genes with high prediction value for anxiety. Hippocampal neurons were damaged with decreased 5-hydroxytryptamine, γ-amino butyric acid, and neuropeptide Y, as well as increased corticotrophin releasing factor and cholecystokinin in anxiety model. PTPRC, SMC3, STAG2, SYNE1, NIPBL, and ZFP451 were downregulated in anxiety mice. STAG2 was selected as the research target. In CORT-induced PC12 cells, STAG2 overexpression promoted cell proliferation, while inhibiting apoptosis and the expression of proteins in cGAS-STING pathway. STAG2 is a potential biomarker of anxiety that exerts a neuroprotective effect on CORT-induced PC12 cells via suppressing cGAS-STING pathway.

Early antiretroviral therapy (ART) is essential for controlling HIV-1 replication and boosting immune function. γδ T cells, as a vital component of the innate immune system, are implicated in the antiviral response. However, their immunological profile during acute HIV-1 infection and the early stages of ART remains unclear. This study aimed to delineate the immunological landscape of γδ T cells in individuals with acute HIV-1 infection undergoing early ART. We enrolled 65 participants who initiated ART immediately post-diagnosis and assessed the phenotypes and functions of γδ T cells using flow cytometry. We demonstrated that early ART significantly increased the frequency of Vδ2 T cells, while the Vδ1 T cell frequency remained stable and showed an inverse relationship with CD4+ T cell counts after ART. Early ART normalized the activation and PD-1 expression in Vδ1 and Vδ2 T cells, aligning with healthy controls (HCs) levels. Nevertheless, the proliferation of these cells, particularly within the PD-1+ subset, remains elevated post-ART. We also noted a reduction in perforin secretion in PD-1+ Vδ1 and Vδ2 T cells of people living with HIV (PLWH). Furthermore, Vδ1 T cells were identified as the predominant regulatory T cells, with TGF-β production and co-expression of CD127 and CXCR4, negatively correlated with CD8+ T cell activation. Our study elucidates the dynamic immunological characteristics of γδ T cells in acute HIV-1 infection and early ART, contributing to the understanding of their role in HIV-1 pathogenesis and the potential for γδ T cell-based immunotherapeutic strategies.

INTRODUCTION:This systematic review and network meta-analysis aimed to compare and evaluate the efficacy and safety of five medications, dupilumab, tralokinumab, upadacitinib, baricitinib, and abrocitinib, for the treatment of adolescent atopic dermatitis (AD), in order to provide decision support to support clinical decision-making by developing more scientifically grounded and effective treatment strategies. METHODS:A comprehensive search was conducted in PubMed, Embase, Web of Science (WoS), and the Cochrane database to collect randomized controlled trials (RCTs) and Phase 3 clinical trials up to April 13, 2024. Supplementary data were retrieved from trial registries, and researchers contacted study authors and pharmaceutical companies when necessary to obtain complete data. Inclusion criteria comprised treatment studies for moderate to severe AD in adolescents aged 12 and above, with outcome measures including efficacy and safety assessments. Data extraction and risk bias assessment were independently performed by two researchers, using Excel for data extraction and the netmeta package in R software for network meta-analysis. Sensitivity analysis and bias risk assessment were conducted to validate the robustness and credibility of the results. Our research protocol was registered in PROSPERO (CRD42023480597) and did not require approval from an Institutional Review Board or written informed consent. RESULTS:In the primary efficacy outcome measures, upadacitinib 30 mg/day, upadacitinib 15 mg/day, and dupilumab 300 mg/2 weeks demonstrated excellent efficacy in EASI75 compared to placebo, significantly outperforming other medications and placebo. Dupilumab 300 mg/2 weeks, upadacitinib 30 mg/day, and upadacitinib 15 mg/day showed excellent treatment effects in IGA0/1. Among the outcome measures for improvement in itch severity rating PP-NRS4, dupilumab 300 mg/2 weeks and tralokinumab 300 mg/2 weeks showed the highest efficacy values. Compared to these medications, baricitinib 1 mg/day exhibited weaker performance across all three indicators, particularly in EASI75 and IGA0/1, with effects approaching no significant difference. Due to limited sample sizes, estimates for treatment-emergent adverse events, serious adverse events (SAEs), and drug-induced adverse events safety indicators were unstable, preventing strong conclusions on safety outcomes. There are significant differences in the incidence rates of adverse reactions such as nasopharyngitis, acne, and AD among various medications. CONCLUSION:Upadacitinib and dupilumab demonstrate strong efficacy and symptom improvement in the treatment of moderate to severe AD in adolescents, particularly in reducing the severity of skin lesions and itchiness. Therefore, these medications should be considered as primary treatment options for adolescents with AD. However, further studies with long-term follow-up and larger sample sizes are necessary to thoroughly investigate the safety profiles of these medications in adolescents. This underscores the importance of closely monitoring the side effects of different drugs during clinical treatment to tailor optimal therapeutic strategies based on individual patient needs.

To analyze the psychometric properties of the adapted 6-item Hamilton Depression Rating Scale (HAMD-6) in Chinese patients with major depressive disorder (MDD) using the Rasch model. The HAMD-6 was administered to 279 patients with MDD. The Rasch analysis was conducted to evaluate the results in terms of unidimensionality, local dependency, item fit, reliability, orders of rating category, differential item functioning (DIF), and item-person targeting. Transformation from raw score to interval data was generated. Rasch analyses showed the unidimensional construct of HAMD-6. Item2 (Self-esteem and guilt) and item4 (Psychomotor retardation) presented slight dependency (residual correlation = -0.34) and item1 (Depressed mood) presented suspicious misfit (INFIT and OUTFIT ZSTD > 2.00). The reliability was ideal (Cronbach’s α = 0.91; person separation index = 2.24). The difficulties of response categories were monotonically increased, with no disorder was found. No DIF was found across gender, age and education. The HAMD-6 showed optimal discriminative ability for individuals with moderate levels of depression. A conversion table was established for raw score to interval data. The HAMD-6 was confirmed acceptable psychometric properties by Rasch model in MDD patients. It provided more optimal discriminative ability for individuals with moderate depression. The conversion table could be used for more precise measurement. However, item1, item2 and item4 needed further validation.

Compared to Classical Test Theory, Rasch analysis could provide more precise and specific estimates for the quality of measures. This study aimed to conduct Rasch analysis to examine the psychometric properties of the 10-item Connor-Davidson Resilience Scale (CD-RISC-10) in Chinese patients with major depressive disorder (MDD). The sample was comprised of 136 participants (66.9 % females). Severity of depression was assessed through the Hamilton Depression Rating Scale 17-item and resilience through the CD-RISC-10. Rasch analysis was employed to evaluate unidimensionality, local independence, item fit, reliability, differential item functioning (DIF), ordering of response category and targeting. Rasch analysis confirmed the unidimensionality of the CD-RISC-10. All items demonstrated adequate fit, and all items were locally independent. No evidence of disordered category or threshold of rating scale was observed, indicating reasonable response category setting. There was no significant DIF except for item 1 and item 6 concerning sex. Moreover, all items were well-targeted and patients with moderate levels of resilience were better targeted. The CD-RISC-10 demonstrated acceptable psychometric properties among Chinese patients with MDD, providing more precise estimations for patients with moderate levels of resilience than those with high and low levels.

What is already known about this topic?:The prevalence of monkeypox (mpox) infections is primarily observed among young men who engage in sexual activities with other men, and there is a possibility of sexual transmission. Co-occurring sexually transmitted infections have also been documented.What is added by this report?:In this report, we present a case of a patient in China who was simultaneously diagnosed with mpox, and acute human immunodeficiency virus (HIV) infection. The patient exhibited symptoms of fever and widespread papules on the trunk, face, and genital area.What are the implications for public health practice?:It is crucial for health agencies to prioritize HIV testing when mpox is suspected or diagnosed in individuals with recent engagement in high-risk sexual behavior.

Background National treatment guidelines of China evolving necessitates population-level surveillance of transmitted drug resistance (TDR) to inform or update HIV treatment strategies.Methods We analyzed the demographic, clinical, and virologic data obtained from people with HIV (PWH) residing in 31 provinces of China who were newly diagnosed between 2018 and 2023. Evidence of TDR was defined by the World Health Organization list for surveillance of drug resistance mutations.Results Among the 22 124 PWH with protease and reverse transcriptase sequences, 965 (4.36%; 95% CI, 4.1-4.63) had at least 1 TDR mutation. The most frequent TDR mutations were nonnucleoside reverse transcriptase inhibitor (NNRTI) mutations (2.39%; 95% CI, 2.19%-2.59%), followed by nucleoside reverse transcriptase inhibitor mutations(1.35%; 95% CI, 1.2%-1.5%) and protease inhibitor mutations (1.12%; 95% CI, .98%-1.26%). The overall protease and reverse transcriptase TDR increased significantly from 4.05% (95% CI, 3.61%-4.52%) in 2018 to 5.39% (95% CI, 4.33%-6.57%) in 2023. A low level of integrase strand transfer inhibitor TDR was detected in 9 (0.21%; 95% CI, .1%-.38%) of 4205 PWH.Conclusions Presently, the continued use of NNRTI-based first-line antiretroviral therapy regimen for HIV treatment has been justified. We found a significantly increasing prevalence of overall and nonnucleoside reverse transcriptase inhibitor transmitted drug resistance from 2018 to 2023, whereas integrase strand transfer inhibitor transmitted drug resistance was uncommon. Presently, the continued use of a first-line antiretroviral therapy regimen based on nonnucleoside reverse transcriptase inhibitors for HIV treatment has been justified.

Abstract Background To examine the factor structure and psychometric properties of the Patient Health Questionnaire for Adolescents (PHQ-A) in Chinese children and adolescents with major depressive disorder (MDD). Methods A total of 248 MDD patients aged between 12 and 18 years were recruited and evaluated by the Patient Health Questionnaire for Adolescents (PHQ-A), the Center for Epidemiological Survey Depression Scale (CES-D), the Mood and Feelings Questionnaire (MFQ), and the improved Clinical Global Impression Scale, Severity item (iCGI-S). Thirty-one patients were selected randomly to complete the PHQ-A again one week later. Confirmatory factor analysis (CFA) was used to test the construct validity of the scale. Reliability was evaluated by Macdonald Omega coefficient. Pearson correlation coefficient was used to assess the item-total correlation and the correlation of PHQ-A with CES-D and MFQ respectively. Spearman correlation coefficient was used to assess test-retest reliability. The optimal cut-off value, sensitivity, and specificity of the PHQ-A were achieved by estimating the Receiver Operating Characteristics (ROC) curve. Results CFA reported adequate loadings for all items, except for item 3. Macdonald Omega coefficient of the PHQ-A was 0.87. The Spearman correlation coefficient of the test-retest reliability was 0.70. The Pearson correlation coefficients of the PHQ-A with CES-D and MFQ were 0.87 and 0.85, respectively (p < 0.01). By taking the iCGI-S as the remission criteria for MDD, the optimal cut-off value, sensitivity and specificity of the PHQ-A were 7, 98.7%, 94.7% respectively. Conclusion The PHQ-A presented as a unidimensional construct and demonstrated satisfactory reliability and validity among the Chinese children and adolescents with MDD. A cut-off value of 7 was suggested for remission.

A large outbreak of monkeypox occurred in 2022, and most people lack immunity to orthopoxvirus. Smallpox vaccination is essential for preventing further smallpox outbreaks. This study evaluated the effectiveness, protection, safety, and cross-immunogenicity of smallpox vaccine in preventing monkeypox infection. PubMed, Embase, Scopus, and Web of Science were searched from database inception to 10 March 2024. We included studies involving "monkeypox virus" and "vaccinations", and excluded reviews, animal studies, and articles with missing or duplicate data. A total of 37 studies with 57,693 participants were included in the final analysis. The effectiveness data showed that monkeypox infection rates were lower in the smallpox-vaccinated group than in the unvaccinated group (risk ratio [RR]: 0.46; 95% confidence interval [CI]: 0.31-0.68). The protection data showed that smallpox vaccination effectively reduced the risk of severe monkeypox infection (RR: 0.61; 95% CI: 0.42-0.87). Third-generation vaccines showed greater efficacy (RR: 0.36, 95% CI: 0.22-0.56) than first-generation vaccines. The number of doses of smallpox vaccine has no significant effect on monkeypox. Safety data showed that adverse reactions after smallpox vaccination were mainly mild and included local erythema, swelling, induration, itching, and pain. Meanwhile, we found that smallpox vaccination could induce the production of neutralizing antibodies against monkeypox. Our findings offer compelling evidence supporting the clinical application of the smallpox vaccine for preventing monkeypox and advocate that high-risk groups should be prioritized for receiving one dose of the smallpox vaccine if the vaccine stockpile is low.

PurposeOngoing Monkeypox (MPX) outbreaks in countries outside Africa have unique characteristics. However, data on cohorts of confirmed cases in China is limited. The study provides important epidemiological, diagnostic, and clinical information about this disease in China.MethodsWe report a series of Chinese individuals with confirmed MPX infections identified at Beijing Youan Hospital (China) from June 10 to July 15, 2023. Samples were taken from the skin, anus, throat, and blood. An epidemiological questionnaire was used to collect demographic and clinical data. Further, we compared the MPX viral (MPXV) loads across different anatomical sites.Results66 samples were collected from 20 patients, all of whom were cisgender men. Median patient age was 29 years. Notably, 19 (95%) patients reported unprotected sexual encounters with men in the preceding month, and 13 (65%) were human immunodeficiency virus (HIV)-positive. Among those with HIV, 12 (92%) were receiving antiretroviral therapy, and 11 (85%) had well-controlled infections (HIV viral load <40/mL). The median CD4+ T cell count was 667 cells/mm3. In the HIV-negative group, three (43%) patients were taking preexposure prophylaxis. Fifteen patients (75%) had concurrent sexually transmitted infections (50% had syphilis and 65% had HIV) and eight (40%) had HIV and syphilis co-infection. MPXV loads were significantly higher in samples from the skin (cycle threshold value [Ct value]: 19·0) and anus (Ct value: 23.0) compared to samples from the throat (Ct value: 31.0) or blood (Ct value: 34.5). All patients had skin lesions (85% of whom presented with anogenital lesions). Common systemic symptoms included fever (85%) and lymphadenopathy (55%). The median incubation period was 8 d [interquartile range (IQR): 6–16 d]. The median time from the onset of skin lesions to scab removal was 14 d (IQR: 10–16 d). No deaths or severe cases were reported.ConclusionMPXV primarily affects young homosexual men. The high MPXV viral loads in skin and anal lesions indicate that transmission most likely occurs through direct and close body contact. This study also reports high rates of HIV and syphilis co-infection. Therefore, preventive efforts should focus on homosexual men.

BackgroundEngaging in anal sexual intercourse markedly increases the risk of developing HIV among men who have sex with men (MSM); oral sexual activities tend to uniquely introduce gut-derived microbes to salivary microbiota, which, combined with an individual’s positive HIV status, may greatly perturb oral microecology. However, till date, only a few published studies have addressed this aspect.MethodsBased on 16S rRNA sequencing data of bacterial taxa, MicroPITA picks representative samples for metagenomic analysis, effectively revealing how the development and progression of the HIV disease influences oral microbiota in MSM. Therefore, we collected samples from 11 HIV-negative and 44 HIV-positive MSM subjects (stage 0 was defined by HIV RNA positivity, but negative or indeterminate antibody status; stages 1, 2, and 3 were defined by CD4+ T lymphocyte counts ≥ 500, 200–499, and ≤ 200 or opportunistic infection) and selected 25 representative saliva samples (5 cases/stage) using MicroPITA. Metagenomic sequencing analysis were performed to explore whether positive HIV status changes salivary bacterial KEGG function and metabolic pathway in MSM.ResultsThe core functions of oral microbiota were maintained across each of the five groups, including metabolism, genetic and environmental information processing. All HIV-positive groups displayed KEGG functions of abnormal proliferation, most prominently at stage 0, and others related to metabolism. Clustering relationship analysis tentatively identified functional relationships between groups, with bacterial function being more similar between stage 0-control groups and stage 1-2 groups, whereas the stage 3 group exhibited large functional changes. Although we identified most metabolic pathways as being common to all five groups, several unique pathways formed clusters for certain groups; the stage 0 group had several, while the stage 2 and 3 groups had few, such clusters. The abundance of K03046 was positively correlated with CD4 counts.ConclusionAs HIV progresses, salivary bacterial function and metabolic pathways in MSM progressively changes, which may be related to HIV promoting abnormal energy metabolism and exacerbate pathogen virulence. Further, infection and drug resistance of acute stage and immune cell destruction of AIDS stage were abnormally increased, predicting an increased risk for MSM individuals to develop systemic and oral diseases.

The Baveno VII consensus recommends endoscopic screening for varicose veins in cases of liver stiffness measurement (LSM) ≥ 20 kPa or platelet count ≤ 150 × 109/L. Whether this approach was appropriate for patients with primary biliary cholangitis (PBC) remains uncertain. This study expanded the observed risk factors by adding analysis of ultrasound images as a non-invasive tool to predict the risk of esophageal or fundic varices. We enrolled 111 patients with PBC whose complete ultrasound images, measurement data, and LSM data were available. The value of the periportal hypoechoic band (PHB), splenic area, and LSM in determining the risk of varicose veins and variceal rupture was analyzed. A prospective cohort of 67 patients provided external validation. The area under the receiver operating characteristic curve (AUC) for predicting varicose veins using LSM > 12.1 kPa or splenic areas > 41.2 cm2 was 0.806 (95