Han Chinese Research Articles

"If I Stay Quiet, the Only Person That Gets Hurt Is Me": Anti-Asian Racism and the Mental Health of Chinese-Canadian Youth During the COVID-19 Pandemic.

Despite documented accounts of racial discrimination against Chinese communities during the COVID-19 pandemic, few studies have examined experiences of racism among Canadian youth. This qualitative study explored the experiences of Chinese-Canadian youth during the COVID-19 pandemic and their mental health. A qualitative descriptive research design, informed by Critical Race Theory (CRT), was used for this study. Data was collected using focus groups and image-based elicitation methods. Youth who self-identified as Chinese-Canadian, aged 18-24, and who experienced some account of self-defined racism were included. We analyzed the data using a coding system developed for this study and formulated key themes. Our analysis identified three themes: (I) Becoming racialized; (II) Learning the rules of racism; and (III) Effects of racism on mental health. We discuss findings in relation to the model minority stereotype, intersectionality of race and gender, and factors leading to a lack of support. This study provides evidence that racism had immediate and prolonged effects on the mental health of Chinese-Canadian youth and their relationships with peers, family, and even strangers. Our research suggests the need for enhanced services for Chinese-Canadian youth and other groups experiencing racism.

Understanding stigma and attitudes towards hepatitis B among university students in Australia of Chinese and Vietnamese background

IntroductionHepatitis B is a significant public health concern and a leading cause of liver cancer across the world. In Australia, hepatitis B is largely endemic in migrant communities, particularly amongst the Chinese and Vietnamese communities. Negative attitudes towards hepatitis B can be a major barrier to hepatitis B testing and linkage to care. This mixed-methods research explores the attitudes and beliefs, including stigma, about hepatitis B among students of Vietnamese and Chinese background in Australia. Students were chosen as participants as there is little research examining hepatitis B among university students in Australia and they provide a point of entry to communities with high prevalence of hepatitis B, that otherwise may be hard to access.MethodsOnline surveys were distributed in Chinese, Vietnamese, and English via social media and completed by 112 students of Chinese and 95 students of Vietnamese backgrounds. In-depth interviews were also conducted with 13 Vietnamese and 10 Chinese participants to further explore the survey results.ResultsSurvey findings suggest that students have varied attitudes towards people living with hepatitis B. Around half of the participants reported they would behave negatively towards other people with hepatitis B and that they would expect to experience stigma or discrimination if they had hepatitis B. While over 70% in both samples reported that people who have hepatitis B should not be isolated by family and friends, 47.6% of the Chinese sample and 28.3% of the Vietnamese sample reported they would avoid close contact with someone with hepatitis B. The qualitative data expands on the quantitative data. Four key themes were identified: (1) Caution not discrimination (2) Hepatitis B as a sign of immoral behaviour (3) Discriminatory behaviour based on perceived effects of hepatitis B and (4) Shifting attitudes.ConclusionThis research provides insights that could inform culturally sensitive health promotion programs to address negative attitudes towards hepatitis B among the broader Chinese and Vietnamese communities living in Australia.

Sea turtles stranded ashore: Sociocultural dissonance and identity conflicts in migration intentions of Chinese international student returnees

In the post-COVID-19 era, Chinese international student returnees are facing greater identity conflicts during their reintegration. Understanding their sociocultural and ideological identity negotiation will better accommodate their needs and facilitate their integration into society. This study explored identity conflicts experienced by Chinese student returnees across ecological systems after reentry to China during COVID-19. A qualitative approach was used with 20 returnees. The key findings of this study reveal multi-layered conflicts stemming from the discordance between traditional Eastern values and newly acquired Western perspectives across meso-to-macro systems. In addition, important factors corresponding to returnees’ social capital were identified during the acculturation. Coping mechanisms and migration intentions were observed to vary distinctly among the identified identity clusters. Individuals with a "homestayer" identity, characterized by a deep commitment to integrating with the Chinese community and a higher level of perceived social capital in China, predominantly employed positive coping strategies, such as behavioral adaptation. This group exhibited a strong inclination to remain in China. Conversely, those with a "wayfarer" identity, who experienced deeper immersion in foreign cultures and displayed critical views towards Chinese society with a perceived low social capital in China, tended to adopt negative coping strategies like social withdrawal, correlating with a pronounced intention to migrate. Finally, "navigators", who skillfully balance their native Chinese and foreign cultural identities and effectively manage transnational engagements and diverse cultural norms through their perceived strong social capital in both societies, demonstrated a tendency towards hybrid coping strategies tailored to individual scenarios, reflecting a nuanced, case-by-case approach. This group exhibited a mixed migration intention, indicative of their flexible identity orientation. These findings suggest the need for multi-level support systems and policies that not only facilitate returnee identity continuity but also foster an inclusive and diverse societal framework to effectively retain this valuable population.

A reflective study on the intricate history of Chinese immigration in Peninsular Malaysia

This article presents a reflective microcosm to faithfully echo the intricate history of Chinese immigration in Peninsular Malaysia, focusing on two migration waves that occurred during the Malacca Sultanate and colonial eras. It meticulously examines the underlying causes, defining the characteristics, patterns and quantities of each immigration wave by drawing upon historical documents, tombstone inscriptions and demographic data. In a significant departure from conventional wisdom, this study challenges the prevailing notion that Chinese immigrants were overwhelmingly male, shedding light on the fact that the initial wave featured a higher proportion of females. Moreover, the analysis illuminates the intricate interplay between local colonial policies and the external factors emanating from China, demonstrating their profound influence on migration patterns and quantities. The present quantitative study offers fresh insights into the multifaceted experiences of Chinese immigrants in Peninsular Malaysia. It underscores the key findings while bringing attention to the associated complexities and nuances.

Echoes of Speculation Underway in Relations Between the Occident and China

In a previous article I talked about speculative waves in sequence that have hit the global economy since the 2000s in a world struggling with deflation. Well, this wave of speculation has not stopped but today it seems to concern the transfer of industrial plants from the West to China. A process that was born with the good intentions of transferring industrial activities to developing countries with the dual objective. Give a boost to the economy in developing areas and at the same time reduce the management costs of large multinationals' plants. A process therefore that was born with a positive sign in the intent to help a coordinated development of the territories and a reduction in the costs of industrial products. Meanwhile, the objective of coordinating the development of the territories and continents has not been achieved and on the contrary the process has led to an almost exclusive delocalization of industrial production from the West to China. The excess of industrial localization has exacerbated the concentration of unassimilable waste with a worsening of the disease of the planet struggling with atmospheric overheating. The process, therefore, has been slowed down but not stopped for natural reasons. On the other hand, the acceleration of the development of the Chinese economy has also marked a halt coinciding with the spread of the global epidemic. After about fifty years of accelerated economic growth, the Chinese community has sensed the change in the country's economic prospects and has pulled the brakes on both consumption and investments, marking the end of the accelerated race on the road to development. The picture of the speculative evolution of industrial delocalization processes sees together the interest of mega companies in reducing management costs which is congenial to the increase in the financial values of companies that increase on the Western stock exchanges. In other words, delocalization helps reduce management costs and at the same time seems to support ultra increasing financial values. In short, it plays into the hands of speculation which is certainly not the interest of global social and economic development which instead requires coordination of the territories on the road to development. With the further dilemma that the fate of the global economy may be in the hands of the Boards of Directors of mega companies and not of states and communities.​

The Study of National Identity in the Framework of Chinese Ethnopsychology

The population of the Chinese nation makes up a quarter of the total population of the globe. If studies of the self-consciousness of the Chinese nation are not conducted in world psychology, then a significant gap will appear in this field of knowledge. It is no exaggeration to say that the study of Chinese national identity plays an important role in the field of world psychology. The self-awareness of the Chinese nation at the cognitive level is manifested in a full understanding of the traditional cultures of various Chinese ethnic groups, a rational attitude to ethnic cultural differences and the constant improvement of cultural adaptability. The self-awareness of the Chinese nation on an emotional level manifests itself in the form of close exchanges and contacts between various ethnic groups, constantly reducing the psychological distance between these groups, forming complex and harmonious ethnic relations; The will and beliefs are manifested as the will and determination of all ethnic groups in the process of realizing the great renaissance of the Chinese nation. A complete understanding of the conceptual system of self-awareness of the Chinese nation from the point of view of ethnic psychology is of great importance for building a Chinese national community.

"Accepting the Poem of Destiny": Identity Reconstruction in a Chinese Online Depression Community.

As online health communities become important platforms for people with depression to express themselves, digital narratives provide a lens for understanding their identity work. Drawing on the communication theory of identity (CTI), this article explored the members' identity reconstruction by analyzing their narratives posted in a Chinese online depression community. The four levels of identities constructed by the members include "laggard" and "pioneer" at the personal layer, "idler" and "fighter" at the enacted level, "stress-maker" and "escaper" at the relational layer, and support providers and receivers at the communal layer. These identities at different levels usually interact in the narratives, showing that identity gaps exist among the members. The study shows that the members' autobiographical accounts of depression entail multiplicities and ambivalences, denying the dominant and stigmatizing representation of it by common sense and the media as a reductionist downward and one-way experience that is valueless and offers no possibility for personal growth. The findings regarding the communal level of identity show that narratives can help the narrators to create bonds of solidarity of an experience that is often marginalized.

Conceptualizing National Security in an Era of Great Power Rivalry: Implications for International Economic Law

AbstractUntil recently, the national security exception in investment and trade was understood in terms of defense against military invasion or attack and possibly extendable to economic collapse. However, national security is increasingly understood far beyond the classical contours of territorial integrity. Driven primarily by the China-U.S. hegemonic competition, the new conceptualization is exemplified in a dramatic expansion in U.S. investment and trade measures based upon conceptualizing national security as encompassing threats to a fusion of interrelated spheres of national strength including economic, technological, and ideological power. Moreover, the U.S. now understands security as the retention of superiority in an array of power spheres and encompasses denying China access to emerging technologies. China has similarly expanded her definition of security which is often referenced as “national interests” and embraces political stability (Party dominance), social stability, ideological security, and the defense of Chinese overseas interests, all of which lie far outside the classical definition of security. The untethered expansion in both the U.S. and Chinese conceptualization of security raises significant ramifications for the international economic architecture. As the guardrails of security are abandoned in pursuit of policy goals, a potentially overly broad and excessive notion of security risks deepening several overlapping perils to the current international legal landscape. The focus of this article is on the expansion of the national security exception in investment and trade and potential implications arising from an unfettered expansion.

Inspiring Contributions: Fan Leaders’ Directives and Encouragement in the Chinese Online Celebrity Fan Community

Abstract In the neoliberal era, there is a new phenomenon where numerous fans follow fan leaders’ instructions to make tangible or intangible contributions to support celebrities, which has exacerbated economic polarization. Although past studies have explored fan empowerment in the Internet era, fan leaders’ promotion effect has remained unstudied. This study aimed to discover fan leaders’ role in guiding fans’ contributions in the Chinese fan community. By integrating a two-step flow model and participatory culture theory, it used qualitative content analysis to analyze 410 posts and 972 comments in the Chinese singer Song Yaxuan’s fan community from February 3 to 10, 2023. Through an inductive approach, four main themes were derived from results: (1) task delegation and empowerment; (2) user-friendly instructions and seamless communication; (3) highlighting a sense of crisis and putting pressure on fans; and (4) fostering a collective mindset. The findings revealed fan leaders use different techniques and the top-down structure in the community to encourage fans to give voluntary contributions of money or time to the celebrity’s development. Theoretically, this study showed internal operation logic in Chinese fan community. Practically, the study shed light on how to lessen the harmful consequences of neoliberalism’s features within the Chinese entertainment industry and realize healthy development.

Exploring Client Preferences for Psychological Counselors in a Chinese Online Health Community: Longitudinal Study.

Although online health communities are acknowledged for their role in bridging the supply-demand gap in mental health services, the client decision-making process in these environments remains underexplored. This study aimed to explore the impact of different signals presented on psychological counselors' home pages on clients' choices. Adopting signaling theory as the framework, this study classified information into online and offline signals and developed a theoretical model to examine client choice behaviors. We collected data from 487 psychological counselors in a leading Chinese online mental health community during March, June, September, and December 2023. Based on these data, we constructed a 4-period balanced panel dataset. A fixed effects model was used to analyze which signals influence clients' choices of psychological counselors. Regarding online signals, the service price (β=0.186, P<.001) and online reputation (β=0.489, P=.002) of psychological counselors positively influence clients' choices. Concerning offline signals, psychological counselors' practical experience (β=0.007, P<.001) is positively related to clients' choices. Moreover, the results indicate that the relationship between a counselor's prosocial behavior and clients' choices is not linear but rather exhibits an inverted U-shape. This study reveals that the varied information provided by psychological counselors has distinct impacts on clients' choices in online health communities. It broadens the application of signaling theory to online behaviors and emphasizes the importance of both online and offline signals. These insights offer strategic guidance for counselors and online platforms to better meet potential clients' needs by optimizing the information presented on psychological counselors' home pages.

Role of IL3RA in a Family with Lumbar Spinal Stenosis.

Lumbar spinal stenosis (LSS) is a degenerative spinal condition characterized by the narrowing of the spinal canal, resulting in low back pain (LBP) and limited leg mobility. Twin and family studies have suggested that genetics contributes to disease progression. However, the genetic causes of familial LSS remain unclear. We performed whole-exome and direct sequencing on seven female patients from a Han Chinese family with LBP, among whom four developed LSS. Based on our genetic findings, we performed gene knockdown studies in human chondrocytes to study possible pathological mechanisms underlying LSS. We found a novel nonsense mutation, c.417C > G (NM_002183, p.Y139X), in IL3RA, shared by all the LBP/LSS cases. Knockdown of IL3RA led to a reduction in the total collagen content of 81.6% in female chondrocytes and 21% in male chondrocytes. The expression of MMP-1, -3, and/or -10 significantly increased, with a more pronounced effect observed in females than in males. Furthermore, EsRb expression significantly decreased following IL3RA knockdown. Moreover, the knockdown of EsRb resulted in increased MMP-1 and -10 expression in chondrocytes from females. We speculate that IL3RA deficiency could lead to a reduction in collagen content and intervertebral disk (IVD) strength, particularly in females, thereby accelerating IVD degeneration and promoting LSS occurrence. Our results illustrate, for the first time, the association between IL3RA and estrogen receptor beta, highlighting their importance and impact on MMPs and collagen in degenerative spines in women.

Risk factors of foodborne parasitic diseases still remain in China: a WeChat-based knowledge, attitudes, and practices study

ObjectiveWith the progress of economic globalization and food diversification, foodborne parasitic diseases pose a significant public health challenge in China. This study aimed to explore the knowledge, attitudes, and practices regarding foodborne parasitic diseases among the Chinese population via WeChat, which is a promising tool for disease surveillance and health education.MethodsUsing a questionnaire, this cross-sectional study was conducted on September 25, 2023. Participants completed a structured questionnaire by scanning a QR code provided in a tweet from the WeChat official account of the Jiangsu Institute of Parasite Disease. Multivariable logistic regression analysis was employed to explore potential independent determinants of adequate knowledge of foodborne parasitic diseases, and the positive attitude and good practice rates of the participants were calculated.ResultsIn total, 5,675 valid questionnaires were collected via the WeChat official account. Most participants (79.91%) fell within the age range of 20–40 years, with a higher representation of males (53.18%), and 89.80% were of Han Chinese ethnicity. It was found that 76.65% of the participants had adequate level of knowledge. Multivariable logistic regression analysis revealed that individuals of Hui nationality (OR = 0.57, 95% CI: 0.40–0.81, p = 0.002), clinicians (OR = 0.13, 95% CI: 0.09–0.19, p < 0.001), teachers (OR = 0.48, 95% CI: 0.34–0.69, p < 0.001), and government staff (OR = 0.40, 95% CI: 0.30–0.53, p < 0.001) had significantly higher levels of knowledge. Among the participants, 33.9% reported consuming raw fish or drunken shrimp, 10.6% would still try to consume raw fish despite the risk of parasitic infection, and 84.1% did not use separate cutting boards for raw and cooked foods in their kitchens.ConclusionsAlthough majority of the Chinese public (76.65%) demonstrates adequate level of knowledge on foodborne parasitic diseases, there is a need to enhance personal hygiene practices and dietary habits, particularly the utilization of distinct cutting boards and the consumption of raw fish. A WeChat official account is an accessible tool for spreading foodborne parasitic diseases related health information to the public. WeChat-based health education should be implemented to enhance public awareness regarding the prevention and control of foodborne parasitic diseases.

Reconsidering gender norms in childcare within Chinese migrant families in Portugal.

Historically, Chinese societies have been characterized by patriarchal structures (Confucianism and filial piety) that assign distinct roles to men and women within the family unit. These norms typically dictate that women take on the primary responsibility for childcare and household duties, while men are expected to be the primary breadwinners. As the authors observe the second generation of Chinese immigrants settling in Portugal, the immigrants grapple with the significant challenge of striving to preserve cultural heritage with the adaptation to Western norms. Therefore, there is a growing recognition of the need to reassess these traditional gender norms. Women in these families are increasingly participating in the workforce, challenging the notion that childcare should be solely to their domain. This study focuses on the experiences of Chinese immigrants, including both married couples and single individuals residing in Portugal. Through qualitative research methods such as interviews (involving 25 participants) and observations, the research aims to gain a nuanced understanding of the attitude and engagement toward childcare, and the ways it differs between men and women in these immigrant families. Participants' responses indicate that men's anticipation of women dedicating more time to childcare is notably influenced by educational attainment and financial circumstances. Conversely, women generally believe that being exempt from labor is not a viable alternative irrespective of their educational qualifications. The traditional distribution of caregiving duties does not consistently apply to Chinese female immigrants. By exploring the influence of traditional Confucian culture on migrants' perspectives and challenges in assuming parental responsibilities, this study highlights gender disparities among Chinese immigrants and propose solutions to address this gender conflict on division.

Arthroscopic shoulder surgery for gouty long head of biceps tendinitis: a case report

ObjectiveThe objective of the case report is to analyze the clinical manifestations and imaging features of gouty long head of biceps tendinitis, and to summarize the methods and effects of shoulder arthroscopic surgery.Clinical presentation and interventionThe clinical data of a 39-year-old Han Chinese female with gouty long head of the biceps tendinitis was retrospectively analyzed, and the clinical manifestations, imaging features, and diagnosis and treatment were analyzed. The patient presented with pain and limited movement of right shoulder joint. Computed tomography showed irregular high-density shadows above the glenoid and adjacent to the coracoid process of the right shoulder. Magnetic resonance imaging revealed superior labrum anterior and posterior injury with edema in the upper recess and axillary sac. After arthroscopic surgery, the “tofu residue” tissue of the long head of the biceps was removed, and the postoperative pathological examination proved that it was gout stone.ConclusionGouty long head of the biceps tendinitis is a rare disease. Arthroscopic surgery can probe the structural lesions of shoulder cavity in all aspects, improve the surgical accuracy, and reduce the trauma.

The gender gap in early language development among children from peri-urban China

In rural China, there exists a gender gap in academic achievement where girls outperform boys, suggesting similar differences in early language development. Moreover, recent research has revealed that children in peri-urban communities have worse language outcomes than children in rural communities. This study examines the impact of gender on early language development in low-SES, peri-urban Chinese communities. Data from 81 children (56.79% boys) aged 18-24 months (Mage = 21.16) living in peri-urban China were collected using two caregiver-reported tests for child language development and ability, and language environment analysis technology for measuring the home language environment. Results show that in peri-urban communities, girls were generally exposed to more adult-child conversations and showed higher counts of vocalizations than did boys; girls scored higher on language development measures than did boys. The implications of these findings on the gender gap and child development are discussed.

Development and evaluation of a panel of newly screened Y chromosome InDels for inferring paternal ancestry information in Southwest China.

Y-InDels (insertions/deletions) are genetic markers which are extremely understudied. It is unknown whether this type of markers can be utilized for genetic ancestry inference. We have developed an innovative Y chromosome ancestry inference system tailored for forensic applications. This panel amplifies 21 Y chromosome loci, encompassing Y-InDels and Y-SNPs (Single Nucleotide Polymorphism), utilizing the capillary electrophoresis (CE) platform. The system performed well at DNA concentrations greater than 0.125 ng/ul and produced accurate results at a 1:100 mixing ratio of male and female DNA. The Cumulative probability of matching (CPM) was between 0.95 and 0.97 in the experimental population. The system's efficacy in inferring ancestral origins was demonstrated through intercontinental population discrimination, revealing high discrimination power between African and East Asian populations. Population genetic analyses conducted on Han, Qiang and Hui populations in Southwest China, where the smallest FST value was 0.0002 between Han Chinese in Beijing (from 1000 Genomes Project) and Qiang Chinese from Sichuan (CQSC). Phylogenetic tree construction further illuminated distinct haplotypes among populations, with ethnically unique haplotypes observed in 34.6% of Hui and 7.1% of Qiang populations. K-fold cross-validation show the system's inference abilities at the intercontinental level. In addition, our investigations identified potential associations between the Y-InDel locus Y: 15,385,547 (GRCh37) and haplogroup R1a1a1b2a2- Z2124, as well as locus Y: 13,990,180 (GRCh37) and haplogroup F-M89. In conclusion, we have established a Y-chromosome inference system tailored for grassroots-level application, underscoring the value of incorporating Y-InDel markers in forensic analyses.

Prognostic factors for premature cardiovascular disease mortality in Malaysia: a modelling approach using semi-parametric and parametric survival analysis with national health and morbidity survey linked mortality data.

Cardiovascular disease (CVD) is the leading cause of premature mortality worldwide. Despite existing research on CVD risk factors, the study of premature CVD mortality in Malaysia remains limited. This study employs survival analysis to model modifiable risk factors associated with premature CVD mortality among Malaysian adults. We utilised data from Malaysia's National Health and Morbidity Survey (NHMS) conducted in 2006, 2011, and 2015, linked with mortality records. The cohort comprised individuals aged 18 to 70 during the NHMS interview. Follow-up extended to 2021, focusing on CVD-related premature mortality between ages 30 and 70. We employed six survival models: a semi-parametric Cox proportional hazard (PH) and five parametric survival models, which were Exponential, Weibull, Gompertz, log-normal and log-logistic distributions using R software. The age standardized incidence rate (ASIR) of premature CVD mortality was calculated per 1000 person-years. Among 63,722 participants, 886 (1.4%) experienced premature CVD mortality, with an ASIR of 1.80 per 1000 person-years. The best-fit models (based on AIC value) were the stratified Cox model by age (semi-parametric) and the log-normal accelerated failure time (AFT) model (parametric). Males had higher risk (Hazard Ratio, HR = 2.68) and experienced 49% shorter survival time (Event Time Ratio, ETR = 0.51) compared to females. Compared to Chinese ethnicity, Indians, Malays, and other Bumiputera had higher HR and lower survival times. Rural residents and those with lower education also faced increased HRs and reduced survival times. Diabetes (diagnosed: HR = 3.26, ETR = 0.37; undiagnosed: HR = 1.63, ETR = 0.63), hypertension (diagnosed: HR = 1.84, ETR = 0.53; undiagnosed: HR = 1.46, ETR = 0.68), and undiagnosed hypercholesterolemia (HR = 1.31, ETR = 0.80) increased risk and decreased survival times. Additionally, current smoking and abdominal obesity elevated risk (HR = 1.38, 1.60) and shortened survival (ETR = 0.81, 0.71). The semi-parametric and parametric survival models both highlight the considerable impact of socioeconomic status and modifiable risk factors on premature CVD mortality, underscoring the imperative for targeted interventions to effectively mitigate these effects.

Using biothesiometer, Neuropathy Symptom Score, and Neuropathy Disability Score for the early detection of peripheral neuropathy: A cross-sectional study.

Patients with peripheral neuropathy could have damaged peripheral nerves, which leads to sensory and motor dysfunction. Diabetes, infections, and trauma are the major causes of peripheral neuropathy. Vibratory perception threshold (VPT) tools are commonly used to detect peripheral neuropathy. This study aims to determine the assessment of peripheral neuropathy through the different diagnostic tools in the community in Malaysia. A total number of 1283 participants were recruited from the seven retail pharmacies located in Selangor, Malaysia. The peripheral neuropathy test was conducted based on VPT tools on both feet using the digital biothesiometer. Following that, Neurological Symptom Score (NSS) and Neurological Disability Score (NDS) were taken from the participants to assess the neurological symptoms. Participants had an average age of 40.6 ± 12.9 years and were mostly of Chinese ethnicity (54.1%). The findings show that increasing age was associated with more severe peripheral neuropathy across the various assessment tools, but gender differences were found with the biothesiometer test and ethnicity has severity in the biothesiometer and disability scores. The sensitivity and specificity of the biothesiometer test were 0.63 and 0.84, respectively. The combined tool NSS and NDS had high specificity and a high positive predictive value, suggesting that it could be a reliable indicator of peripheral neuropathy when both scores are elevated. The findings show that the biothesiometer test, NSS, and NDS are considered screening VPT tools for diagnosing peripheral neuropathy. However, further evaluation and diagnostic testing are necessary in cases of a positive test result.

Severe hydronephrosis complicated with primary aldosteronism: a case report and review of the literature

BackgroundPrimary aldosteronism is characterized by high plasma aldosterone and low renin. The plasma aldosterone-to-renin ratio is recommended for screening. Severe hydronephrosis leads to renal parenchymal ischemia, resulting in increased renin secretion. Since nonsuppression of renin may cause a negative result in the aldosterone-to-renin ratio test, severe hydronephrosis and primary aldosteronism occurring simultaneously in a patient are challenging to diagnose.Case presentationA 54-year-old Chinese man of Han ethnicity was diagnosed with hypertension and severe hypokalemia (minimum 1.57 mmol/L) 13 years prior, and was also diagnosed with severe hydronephrosis due to congenital ureteral stenosis on the left side. His clinical features suggested primary aldosteronism, but the aldosterone-to-renin ratio result of the patient was negative every time he underwent the primary aldosteronism screening test. No further treatment for primary aldosteronism was performed, which led the patient to suffer from severe hypokalemia, such that he was taking 12–15 g/day potassium chloride orally to keep his blood potassium between 3.0 and 3.5 mmol/L (reference value, 3.5–5.5 mmol/L) for 13 years, and the patient needed to be hospitalized in the intensive care unit for rescue several times. At admission, although the aldosterone-to-renin ratio result of the patient was negative, we still did the saline stress test and captopril inhibition test, and the results showed that the plasma aldosterone level was not lower after the test than before the test. Adrenal enhanced computed tomography suggested an adenoma in the left adrenal gland, and the results of adrenal vein sampling suggested that the left side was the dominant side. Therefore, laparoscopic total resection of the left adrenal gland was performed, and 2 weeks later, the patient developed short-term renal function impairment and hyperkalemia, but his renal function and blood potassium returned to normal after treatment that included fluid rehydration. The patient’s biochemical test results and clinical symptoms were completely normal after 1 year.ConclusionWe suggest that for patients with a high suspicion of primary aldosteronism in the clinic, comprehensive analysis must be performed in combination with clinical characteristic assessments, such as severe hydronephrosis, if renin is within the normal range or if the aldosterone-to-renin ratio result is negative at screening and diagnostic tests, and adrenal vein sampling should be performed if necessary. It can help avoid misdiagnoses and contribute to the treatment of patients with severe hydronephrosis and primary aldosteronism.

Unveiling trends in late diagnosis among 22,504 people living with HIV in Hunan, China.

This study examined the prevalence of HIV late diagnosis (LD) and identified associated factors with LD among people living with HIV (PLWH). We extracted sociodemographic, epidemiological, and immunological information between 2018 and 2021 in Hunan, China from the HIV/AIDS Comprehensive Response Information Management System of China. The chi-squared test and multivariable logistic regression model were used to identify the factors associated with LD. Among 22,504 PLWH, 14,988 (66.6%) were diagnosed late. PLWH aged 50 and older had a higher proportion of LD (71.2%) than the younger group (60.0%). Older age, being male, Han ethnicity, being registered in Western Hunan, being transferred from health facilities, and being infected through heterosexual intercourse were associated with LD. Among PLWH younger than 50 years, apart from the factors mentioned above, individuals who had primary school or lower education, were non-student, and were divorced or widowed were more likely to be diagnosed late. Unlike younger PLWH, these factors were not associated with LD in the older group. But regional disparities in LD were more significant among them. LD in PLWH remains a severe issue, especially among older people. The study findings provided valuable insights into designing programs targeting groups at higher risk of LD to reduce its prevalence.