2022年 · 第135卷第22期

Metabolic disorders, including endocrine disorders, obesity, diabetes, cerebrocardiovascular disease, and even cancer, are the most common and lethal diseases with the leading all-cause mortality around the globe.^[1]For example, according to the World Health Organization, type 2 diabetes mellitus (T2DM) as a chronic disease owing to insulin resistance became the ninth leading cause of death with 1.5 million deaths in 2019.^[2]Currently, there are approximately 422 million people worldwide suffering from diabetes, with the majority living in low- and middle-income countries.^[3]High T2DM prevalence has been associated with obesity and lifestyle factors such as lack of physical exercise, although genetic factors are linked to a subpopulation of T2DM patients.^[4]

In recent years, with the increased prevalence of multi-drug resistant (MDR) bacterial infection and chronic pulmonary infection, the topical application of antimicrobial agents, mainly inhaled antibiotics, has come back to clinical practice. Several formulations for nebulization and dry powder inhaler (DPI) have been approved for inhaled anti-infective therapy. Meanwhile, evidence and experience have been accumulated in the use of anti-microbial agents delivered via airway. However, the available studies in this field are heterogenous in the study population, drug delivery route and dosages. The efficacy and safety of inhaled anti-infective therapy in various types of lower respiratory tract infections (LRTIs) need to be evaluated. Moreover, due to the lack of formulations developed for inhalation in China, there are problems including topical use of intravenous preparations. To standardize the clinical practice of topical anti-infective treatment of adult LRTIs, the Pulmonary Infection Assembly of Chinese Thoracic Society initiated and organized experts to formulate a consensus document, in which anti-microbials for respiratory topical use and their indications are summarized based on available evidence. As the high-quality evidence is scarce, the levels of recommendation are not stated. This article is the executive summary of the consensus, and the full text was published in theChinese Journal of Tuberculosis and Respiratory Diseases.^[1]

It is controversial whether the apolipoprotein E epsilon 4 allele (APOE ε4) is a risk gene for human immunodeficiency virus (HIV)-related neurocognitive impairment. This meta-analysis aimed to summarize evidence of the associations between APOE ε4 and cognitive impairment in people living with HIV (PLWH).

Our study conducted a systematic literature search of PubMed, Web of Science, Embase, Google Scholar, and ProQuest for studies published before April 11, 2022 that evaluated associations between APOE ε4 and cognitive impairment in adult PLWH (aged ≥18 years). We calculated pooled odds ratios (ORs) of global cognitive impairment and 95% confidence intervals (CIs) and standardized mean differences (SMDs) for specific cognitive domains between APOE ε4 carriers and non-carriers. Subgroup meta-analyses were used to evaluate the result profiles across different categorical variables.

Twenty studies met the inclusion criteria, including 19 that evaluated global cognitive impairment. APOE ε4 was significantly associated with global cognitive impairment in PLWH (OR = 1.36, 95% CI = [1.05, 1.78], number of estimates [k] = 19, P = 0.02, random effects). Subgroup meta-analysis based percentage of females showed evident intergroup differences in global cognitive performance between ε4 carriers and non-carriers (P = 0.015). APOE ε4 carriers had lower cognitive test scores than non-carriers in all seven cognitive domains, including fluency (SMD = -0.51, 95% CI = [-0.76, -0.25], P < 0.001, k = 4, I²= 0%), learning (SMD = -0.52, 95% CI = [-0.75, -0.28], P < 0.001, k = 5, I² = 0%), executive function (SMD = -0.41, 95% CI= [-0.59, -0.23], P < 0.001, k= 8, I²= 0%), memory (SMD=-0.41, 95% CI= [-0.61, -0.20], P < 0.001, k= 10, I²= 36%), attention/working memory (SMD=-0.34, 95% CI= [-0.54, -0.14], P= 0.001, k= 6, I²= 0%), speed of information processing (SMD = -0.34, 95% CI = [-0.53, -0.16], P < 0.001, k = 8, I² = 0%), and motor function (SMD = -0.19, 95% CI = [-0.38, -0.01], P = 0.04, k = 7, I² = 0%).

Our meta-analysis provides significant evidence that APOE ε4 is a risk genotype for HIV-associated cognitive impairment, especially in cognitive domains of fluency, learning, executive function, and memory. Moreover, the impairment is sex specific.

PROSPERO, CRD 42021257775.

Talaromycosis (formerly named penicilliosis) is an important invasive mycosis caused byTalaromyces marneffei(formerlyPenicillium marneffei,T. marneffei).^[1]The World Health Organization and Food and Drug Administration have recently paid increasing attention to the disease as a neglected tropical disease due to the growing burden ofT. marneffeiinfection globally.^[1,2]Talaromycosis is a common opportunistic disease and a leading cause of death in patients with acquired immune deficiency syndrome (AIDS) in endemic regions; moreover, it is increasingly being reported in human immunodeficiency virus (HIV)-negative individuals and outside of epidemic areas.^[3,4]The mortality of talaromycosis is up to 30% in both HIV-positive and HIV-negative individuals, which is associated with late diagnosis and untimely or ineffective antifungal therapy.^[5]Therefore, early diagnosis and effective antifungal treatment are critical to reduce the mortality.

A more comprehensive understanding of the trends of incidence, prevalence, and mortality in human immunodeficiency virus (HIV), and their complex interrelationships, may provide important evidence for decision-making related to HIV prevention and control. The variances in these indices between different population groups, genders, and ages are critical to decipher evolving patterns of the HIV epidemic in specific populations.

A secondary analysis of relevant data was conducted using data extracted from the Global Burden of Disease study of 2019. HIV/acquired immune deficiency syndrome (AIDS) incidence, prevalence, AIDS-related mortality, and mortality-to-prevalence ratio (MPR) for annual percentage change, average annual percentage change (AAPC), and corresponding 95% confidence intervals (CIs) were calculated using joinpoint regression statistical analysis.

The AAPC of HIV/AIDS incidence, prevalence, AIDS-related mortality rate, and MPR were -1.4 (95% CI: -1.6, -1.2), 4.1 (95% CI: 4.0, 4.3), 2.0 (95% CI: 1.7, 2.3), and -2.1 (95% CI: -2.3, -1.8) between 1990 and 2019 globally, and were 3.5 (95% CI: 2.2, 4.8), 6.9 (95% CI: 6.8, 7.0), 8.1 (95% CI: 7.1, 9.1), and 1.2 (95% CI: 0.1, 2.3) in China during the same period. In terms of differences in the preceding indicators by gender, we observed a similar pattern of trends for male and female genders both globally and in China during the entire study period. Each specific age group exhibits a distinct pattern in terms of incidence, prevalence, mortality rate, and MPR both globally and in China.

Prevalence and mortality rates of HIV/AIDS have increased between 1990 and 2019 globally and in China. While the incidence rate and MPR have declined globally over the past three decades, these two indicators are observed to present an increasing trend in China. There is a high HIV burden among young and middle-aged adults globally; however, the elderly have a high HIV burden in China. HIV screening at older age should be scaled up, and patients with advanced HIV disease should be provided early with additional care and health resources.

Chronic liver disease has emerged as a leading cause of non-acquired immune deficiency syndrome (AIDS)-related mortality in hepatitis C virus (HCV)/human immunodeficiency virus (HIV)-coinfected patients. The relationship between CD4 cell count and HIV-related opportunistic infections and tumors has been well characterized; however, it is unclear whether CD4 cell count is associated with HCV-related hepatic events.

This observational cohort study enrolled HCV/HIV-coinfected patients from the National Free Antiretroviral Treatment Program of China from 2004 to 2019 in Guangzhou. The primary outcome was a composite of hepatic events, including cirrhosis complications, hepatocellular carcinoma (HCC), and liver-related mortality. Kaplan-Meier survival and multivariate logistic regression analyses were performed.

Among the 793 patients, 43 developed hepatic events during a median follow-up of 6.7 years, including 35 cirrhosis complications, 13 HCC cases, and 14 cases of liver-related mortality. The 5-year and 10-year cumulative incidences of hepatic events were 4.2% and 9.3%, respectively. Patients who developed hepatic events had a less satisfactory increase in CD4 cell count, lower peak CD4 (354.5 cells/μL vs. 560.0 cells/μL, P < 0.001), and lower percentage of peak CD4 > 500 cells/μL (30.2% vs. 60.7%, P < 0.001) after the initiation of antiretroviral therapy (ART) than those who did not. The cumulative incidences of hepatic events were higher in patients with lower peak CD4 levels with adjusted odds ratios of 3.96 (95% confidence interval [CI]: 1.51-10.40), 2.25 (95% CI: 0.87-5.86), and 0.98 (95% CI: 0.35-2.74) for patients with peak CD4 at <200 cells/μL, 200-350 cells/μL, and 351 to 500 cells/μL, respectively, relative to those with peak CD4 > 500 cells/μL. Peak CD4 was negatively associated with the risk of hepatic events in a dose-response manner (P-value for trend = 0.004).

Persistently low CD4 cell counts after ART are independently associated with a high risk of hepatic events in HCV/HIV-coinfected patients, highlighting the important role of immune reconstitution in improving liver outcomes.

Ubiquitination plays an essential role in many biological processes, including viral infection, and can be reversed by deubiquitinating enzymes (DUBs). Although some studies discovered that DUBs inhibit or enhance viral infection by various mechanisms, there is lack of information on the role of DUBs in virus regulation, which needs to be further investigated.

Immunoblotting, real-time polymerase chain reaction, in vivo/in vitro deubiquitination, protein immunoprecipitation, immunofluorescence, and co-localization biological techniques were employed to examine the effect of ubiquitin-specific protease 3 (USP3) on APOBEC3G (A3G) stability and human immunodeficiency virus (HIV) replication. To analyse the relationship between USP3 and HIV disease progression, we recruited 20 HIV-infected patients to detect the levels of USP3 and A3G in peripheral blood and analysed their correlation with CD4⁺ T-cell counts. Correlation was estimated by Pearson correlation coefficients (for parametric data).

The results demonstrated that USP3 specifically inhibits HIV-1 replication in an A3G-dependent manner. Further investigation found that USP3 stabilized 90% to 95% of A3G expression by deubiquitinating Vif-mediated polyubiquitination and blocking its degradation in an enzyme-dependent manner. It also enhances the A3G messenger RNA (mRNA) level by binding to A3G mRNA and stabilizing it in an enzyme-independent manner. Moreover, USP3 expression was positively correlated with A3G expression (r= 0.5110) and CD4⁺ T-cell counts (r= 0.5083) in HIV-1-infected patients.

USP3 restricts HIV-1 viral infections by increasing the expression of the antiviral factor A3G. Therefore, USP3 may be an important target for drug development and serve as a novel therapeutic strategy against viral infections.

The preferred therapeutic regimen for Toxoplasma encephalitis (TE) is a combination of pyrimethamine and sulfadiazine, and trimethoprim-sulfamethoxazole (TMP-SMX) plus azithromycin is the widespread alternative therapeutic regimen. The synergistic sulfonamides tablet contains TMP, sulfadiazine, and SMX and hypothetically could be used for TE treatment. This study aimed to compare the efficacy and safety of synergistic sulfonamides plus clindamycin (regimen B) with TMP-SMX plus azithromycin (regimen A) for the treatment of human immunodeficiency virus (HIV) associated TE.

This was an open-labeled, multi-center randomized controlled trial recruited from 11 centers. Each recruited patient was randomly assigned to receive regimen A or regimen B for at least 6 weeks. The overall response was evaluated by assessment of the clinical response of TE-associated clinical features and the radiological response of TE-associated radiological findings. The overall response rate, clinical response rate, radiological response rate, and adverse events were assessed at 2, 6, and 12 weeks. Death events were compared between the two regimens at 6, 12, and 24 weeks.

A total of 91 acquired immunodeficiency syndrome (AIDS)/TE patients were included in the final analysis (44 in regimen A vs. 47 in regimen B). The overall response rate, which refers to the combined clinical and radiological response, was 18.2% (8/44) for regimen A and 21.3 % (10/47) for regimen B at week 6. The results of clinical response showed that, in comparison with regimen A, regimen B may perform better with regards to its effect on the relief of clinical manifestations (50.0% [22/44] vs. 70.2% [33/47], P = 0.049). However, no significant differences in radiological response, mortality events, and adverse events were found between the two regimens at week 6.

Synergistic sulfonamides plus clindamycin, as a novel treatment regimen, showed no significantly different efficacy and comparable safety in comparison with the TMP-SMX plus azithromycin regimen. In addition, the regimen containing synergistic sulfonamides may exhibit advantages in terms of clinical symptom alleviation.

ChiCTR.org.cn, ChiCTR1900021195.

Single-tablet regimen (STR) provides a convenient once-daily regimen for the prevention of human immunodeficiency virus (HIV) infection. Here, we investigated the safety and tolerability of coformulated bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) as a three-drug, STR for post-exposure prophylaxis (PEP) in Chinese individuals.

This was a prospective, open-label, single-arm trial conducted in a sexually transmitted diseases and acquired immunodeficiency syndrome clinic of a tertiary hospital in Beijing, China. Adults requiring PEP were prescribed BIC/FTC/TAF one pill once a day for 28 days. Clinical and laboratory data were collected and analyzed at baseline, weeks 2, 4, 8, 12, and 24.

Of 112 participants enrolled in the study, 109 (97.3%) were male and the mean age was 30 ± 8 years. PEP completion was 96.4% (95% confidence interval: 91.1-99.0%). Two participants stopped PEP after 2 days because the source partner was identified as HIV uninfected. One participant was excluded due to hepatitis B virus infection according to the exclusion criteria. One discontinued due to the participant’s decision. No participant acquired HIV through week 24. Adherence was 98.9% (standard deviation [SD]: 3.3%) by self-reporting and 98.5% (SD: 3.5%) by pill count. Only five participants experienced mild clinical adverse events attributed to the study drug (including headache, diarrhea, and nausea) and four participants had elevated serum creatinine (grade 1).

A once daily, STR of BIC/FTC/TAF used as PEP was safe and well-tolerated with a high rate of completion and adherence in Chinese. BIC/FTC/TAF may be a good option for PEP.

ChiCTR.org.cn, ChiCTR2100048080

Understanding the characteristics of newly diagnosed primary human deficiency virus-1 (HIV-1) infection in the context of the post-antiretroviral therapy era and HIV drug prophylaxis is essential for achieving the new target of 95-95-95-95 by 2025. This study reported the characteristics of newly diagnosed primary HIV-1 infection in Shenzhen.

This is a real-world retrospective study. Eighty-seven newly diagnosed primary HIV-1-infected patients were recruited from January 2021 to March 2022 at the Third People’s Hospital of Shenzhen. Demographic, epidemiological, diagnostic, drug resistance, and medical data were described and analyzed.

Overall, 96.6% (84/87) of the newly identified primary HIV-1-infected patients were male, including 88.5% (77/87) men have sex with men (MSM), with a median age of 29.0 years (Q₁-Q₃: 24.0-34.0 years); of these, 85.1% (74/87) reported high-risk sexual behaviors with casual partners. The rate of condom usage was only 28.7% (25/87). The overall rate of pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) was 8.0% (7/87, including 4 PrEP and 3 PEP cases) around the potential exposure, although 41.4% of the patients had prior awareness of such interventions. Moreover, only 19.5% (17/87) had previously used PrEP or PEP. Of those, 58.8% (10/17) of the patients obtained drugs from the internet, and only 35.3% (6/17) reported good compliance. A total of 54.0% (47/87) of subjects were diagnosed by the HIV nucleic acid test. Acute retroviral syndrome appeared in 54.0% (47/87) of patients. The prevalence of transmitted drug resistance (TDR) mutation was 33.9% (19/56), including 6 (10.7%) against nucleoside reverse transcriptase inhibitor (NRTI) plus non-nucleoside reverse transcriptase inhibitor (NNRTI), 8 (14.3%) against NNRTI, and 5 (8.9%) against protease inhibitor (PI) only.

Owing to the low utilization rate and incorrect usage of PrEP and PEP, massive efforts are needed to promote HIV-preventive strategies in the MSM population. The extremely high prevalence of TDR mutation in this population implies the need for future pretreatment drug resistance surveillance.

Globally, the prevalence of food allergy in children is estimated to be approximately 4% to 10%.^[1]Food allergy usually begins early in the allergic march, and cow’s milk allergy (CMA) is one of the most common food allergens in infants and children. In Europe, the overall incidence of challenge-proven CMA is 0.54%, and in the United States, the overall prevalence is 0.4% and pediatric prevalence is 1.9%.^[2,3,4]In China, the prevalence of oral food challenge (OFC)-confirmed CMA is 0.83% to 3.5% in various cities.^[5]Double-blind placebo-controlled food challenge is not applied widely in clinical practice because of its complex process and the risk of anaphylaxis for patients that receive the test. Allergen-specific IgE (sIgE) is usually used as a critical assessment method for food allergy.

Chronic hepatitis B virus (HBV) infection is a major global public health problem. Approximately 887,000 people die of HBV infection-related diseases annually, with cirrhosis and hepatocellular carcinoma (HCC) being the principal causes of mortality.^[1]Timely antiviral therapy greatly reduces the risks of cirrhosis and HCC. However, unfortunately, of those patients who are eligible for antiviral treatment, only 25% of patients in clinic settings and 12% of those in community settings obtain timely antiviral therapy.^[2]Therefore, reliable means of identifying patients with chronic HBV infection that require antiviral therapy are necessary, particularly for use in the community.

Reports suggest that approximately 37.7 million people are infected with human immunodeficiency virus (HIV) worldwide,^[1]and 10% to 28% of people living with HIV (PLWH) are coinfected with hepatitis B virus (HBV).^[2]The routes of transmission shared by both HIV and HBV may explain the relatively high proportions of HIV/HBV coinfection,^[3]which represent a significant challenge to global public health. In China, hepatitis B surface antigen (HBsAg) prevalence is estimated at 13.7% in PLWH.^[4]

To the Editor: With recent advances in antiretroviral therapy (ART) regimens, many patients may benefit from switching drugs. The new combination drug, elvitegravir/cobicistat/emtricitabine/tenofovir (E/C/F/TAF), has been approved for use in people living with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AID [PLWHA]) in China and has also been included within the scope of medical insurance. This single-tablet regimen provides a convenient, once-daily, treatment option for many PLWHA. E/C/F/TAF was shown to increase adherence to ART and decrease the risk of drug resistance and virological failure.^[1,2,3,4]However, another study showed a higher level of several lipid parameters in patients with tenofovir alafenamide (TAF)-based therapy compared with tenofovir (TDF)-based therapy in treatment-naïve and -experienced adults.^[5]In 2019, a phase IV clinical study of E/C/F/TAF was conducted at our Antiviral Treatment Center, allowing us to explore the virological and immunological responses during 12 months of follow-up after switching. We also explored the changes in renal function, liver function, and lipid parameters in PLWHA.

To the Editor:Even with the emergence of highly active antiretroviral therapy, human immunodeficiency virus type 1 (HIV-1) remains a serious public health problem worldwide. The widespread use of antiretroviral therapy (ART) has, on the one hand, significantly improved life expectancy in patients infected with HIV-1; on the other hand, it has inevitably brought along with it a difficult problem—viral resistance. Viral resistance is a common phenomenon evolutionarily, particularly in patients with poor adherence and suboptimal drug levels. Failed viral suppression due to viral resistance emerging in treatment-experienced patients can be avoided by adopting viral-susceptible ART regimens. However, viral resistance obtained during transmission, known as "transmitted drug resistance," can be a major hurdle against the elimination of HIV-1 infection. As genotypic drug resistance testing in treatment-naive or newly diagnosed HIV-1 patients is not as widely implemented as in treatment-experienced patients. Transmitted drug resistance mutations (TDRMs) in HIV-1 pose a serious threat to the efficacy of current ART regimens and pre-exposure prophylaxis (PrEP). A better understanding of the prevalence of local TDRMs can provide valuable data for clinical- and government-level decision-making.

To the Editor: Computed tomography (CT) has been used for the screening of lung cancer in high-risk populations, with a subsequent reduction in lung cancer-related mortality.^[1]However, it has also resulted in a considerable increase in the discovery of peripheral pulmonary nodules (PPNs), which require further diagnosis. Conventional bronchoscopy is used to biopsy lung tissues from the endoluminal route to ensure minimum invasion. However, reaching the periphery of the lung is challenging because of the relatively large diameter of the bronchoscope, which limits the diagnostic value of bronchoscopy for PPNs. Although various advanced bronchoscopic techniques have been developed to improve PPN diagnosis, the pooled diagnostic yield is only 70%,^[2]which indicates that diagnostic accuracy can still be improved. Robotic-assisted bronchoscopy systems may be an alternative solution for addressing these limitations. The ION^TMsystem (Intuitive Surgical, Inc., Sunnyvale, CA, USA) is a robotic-assisted bronchoscopy platform that uses shape-sensing technology, which significantly increases the ability to localize and puncture small PPNs.^[3]However, few studies have evaluated the use of this system in the Chinese population.

To the Editor: Pneumocystis jirovecii (P. jirovecii)pneumonia (PJP) is an opportunistic infection that usually occurs in immunosuppressed patients. Solid organ transplant (SOT) recipients have a high incidence of PJP due to the use of immunosuppressive therapy. In recent years, metagenomic next-generation sequencing (mNGS) has been increasingly used in the diagnosis of infectious diseases. Herein, we report ten cases of PJP diagnosed by mNGS and compare the diagnostic value of mNGS with that of conventional laboratory methods.

To the Editor:In China, colorectal cancer (CRC) ranks third in cancer incidence and fifth in cancer-related deaths.^[1]Most CRCs arise from adenomatous polyps. Colonoscopy can detect and remove polyps early to prevent CRC. However, the polyp miss rate in conventional colonoscopy may be more than 40%.^[2]New endoscopic devices for detecting polyps have made some progress over the past few decades,^[3]but are still operator-dependent and require additional costs. Therefore, artificial intelligence (AI)-assisted polyp detection systems have emerged in recent years. This study aimed to evaluate the effectiveness of our newly developed AI-assisted polyp detection system for colonoscopy in a preclinical manner.

To the Editor:Femoral rotational alignment not only affects patellar tracking and alters peak contact forces, but also determines the flexion gap of the components.^[1]If the angle of the external rotation is too large, it would lead to medial compartment loosing during knee flexion; if the angle is too small, it would lead to a narrowing medial compartment. A series of studies have found that the malalignment of femoral prosthesis resulted in poor outcomes after total knee arthroplasty (TKA), such as the lower Knee Society Scores, flexion instability, premature wear of the polyethylene, premature loosening of component and ongoing knee pain. It is helpful to introduce a new bony landmark to assist the femoral rotational alignment, and decrease the adverse effects caused by poor alignment of femoral rotation in TKA. The surface upon the medial trochlea, which was named as medial trochlea superior surface (MTSS) in this research, was found possibly parallel to the surgical transepicondylar axis (sTEA), which was usually used as a referential axis for femoral rotational alignment in TKA. Hence, MTSS might be used as a referential surface in TKA for its special anatomical position. The medial boundary of MTSS is close to the axis of the femoral shaft, and the distal end is immediately adjacent to the upper edge of the medial trochlea. The specific location of MTSS in TKA is shown inFigure 1A.

To the Editor: There is controversy in the literature on the benefits of open reduction and internal fixation (ORIF) and minimally invasive plating osteosynthesis (MIPO) for mid-distal humeral shaft fractures.^[1]ORIF has the advantages of anatomical reduction, strong fixation, and little impact on the function of the elbow and shoulder joints. Nevertheless, it has some disadvantages, including the need for a large incision and more dissection of soft tissues, interrupting blood supply to the fracture site, resulting in difficulties in healing and an increased risk of bone non-union, and a high risk of iatrogenic radial nerve injury. In contrast, treatment of mid-distal humeral shaft fractures by MIPO has the advantages of less dissection of soft tissues, avoidance of exposure of the radial nerve, and a low risk of iatrogenic radial nerve palsy. This study aimed to compare the medium-term safety and effectiveness of MIPO and conventional ORIF in the treatment of mid-distal humeral shaft fractures.

To the Editor: As one of the most powerful tools for urologists, ureteral stents are often used in diseases such as calculi, obstruction, ureteral injury, and kidney transplantation and are removed after 3 days to 4 weeks with a visualization instrument. Initially, rigid cystoscopy (RC) was most often used for stent removal, but due to its inflexibility and large diameter, RC often results in pain and potential damage to patients like hematuria, pain, and lower urinary tract symptoms, especially to men.

To the Editor: Montegazza in 1866 was the first to suggest banks for frozen human semen.^[1]In 1981, China’s first human sperm bank was successfully established at the CITIC Xiangya Hospital. During the previous four decades, from 1981 to 2020, there were 27 human sperm banks in Chinese mainland. Human sperm banks provide cryopreservation of spermatozoa services for males needing to preserve fertility for an extended period in the Chinese mainland.