Objectives:To understand the awareness rate and its influencing factors of their HBV infection status among HBsAg-positive persons aged 15-69 years in China.Methods:A cross-sectional design was used to conduct a questionnaire survey on the awareness of their infection status among HBsAg-positive persons aged 15-69 years who were identified in the 2020 national hepatitis B seroepidemiology survey. The awareness rate of the whole respondent and respondents with different characteristics were described, and the differences were compared with the χ2 test. The logistic regression model was used to analyze the factors influencing the awareness rate. Results:The overall awareness rate among the respondents was 43.10% (1 828/4 241). The awareness rate was lower in males than in females (41.30% vs. 44.65%). The awareness rate was lower in the 60-69-years-old age group than in other age groups (30.38% vs. 36.77%-57.58%). The awareness rate was lower in rural areas than in urban areas (39.43% vs. 47.32%). The awareness rate was lower in regions with a per capita gross domestic product (GDP) below RMB 54 000 than in regions with a per capita GDP of RMB 54 000 and above (36.81% vs. 41.61%-50.30%). The awareness rate was lower in respondents without other liver diseases than with other liver diseases (41.52% vs. 60.68%). The awareness rate was lower in respondents without a family history of hepatitis B-related disease or unknown family history than with a family history (43.58% vs. 68.26%; 24.71% vs. 68.26%). Multivariate logistic regression analysis showed that male [odds ratio ( OR)=0.841, 95% confidence interval ( CI): 0.734-0.964], high school and below [primary school and below, junior middle school, high school/technical secondary school, OR (95% CI): 0.247 (0.190-0.321), 0.451 (0.352-0.577), 0.634 (0.486-0.827)], rural areas ( OR=0.822, 95% CI: 0.715-0.945) and regions with a per capita GDP below RMB 80 000 [54 000-80 000, OR (95% CI): 0.810 (0.688-0.954), below RMB 54 000, OR (95% CI): 0.793 (0.669-0.941)] were the negative factors influencing the awareness rate. While 30-39-years-old ( OR=2.089, 95% CI: 1.626-2.683) and 40-49-years-old ( OR=1.590, 95% CI: 1.250-2.023) age groups, with other liver diseases ( OR=2.244, 95% CI: 1.754-2.871) and family history related to hepatitis B ( OR=2.688, 95% CI: 2.242-3.223) were the positive factors influencing the awareness rate. Conclusion:The overall awareness rate of their infection status among HBsAg-positive persons aged 15-69 years is 43.10% in China. Health promotion and coverage expansion on HBV screening should be further strengthened to achieve the proposed World Health Organization's target of 90% HBV infection diagnosis rate by 2030.

Objective:To understand the characteristics of hepatitis B cases reported through the National Notifiable Disease Reported System (NNDRS) of China in 2019, analyze the quality of hepatitis B reporting.Methods:The survey forms and reporting cards of hepatitis B cases in 200 surveillance points in China in 2019 were collected from NNDRS, the completeness rate of the reporting card was calculated, and the reported hepatitis B cases were verified based on the diagnostic criteria (WS 299-2008). The clinical types of the cases after verification were compared with the reported ones, the consistency was evaluated with Kappa test. The reasons for the inconsistent clinical types of the cases were analyzed.Results:In 2019, a total of 64 686 hepatitis B cases were reported through NNDRS. Acute, chronic and unclassified hepatitis B cases accounted for 5.8%, 92.4% and 1.8%, respectively. The average age of reported cases was 47 (47±15) years, and males accounted for 64.4%. The average level of alanine aminotransferase was 214.2 (214.2±1 253.4) U/L. The reported cases mainly worked in agriculture, forestry, animal husbandry, fishery, and water conservancy (50.6%, 32 722). The proportions of cases reported from the eastern, western and central regions were 42.5% (27 501),22.1% (14 315) and 35.4% (22 870), respectively. The consistent rate of the clinical types between the reported cases and the verified cases was 58.8%, with a Kappa value of 0.15. For the 39 271 cases confirmed as acute and chronic hepatitis B cases in the reporting cards, the consistent rate of the clinical types between the reported cases and the verified cases was 96.9%, with a Kappa value of 0.73. In 94.5% (24 267/25 681) of the cases with inconsistent clinical types, the reporting card information were incomplete.Conclusion:The diagnosis of hepatitis B has been improved in the hepatitis B surveillance in China, but it is necessary to improve the completeness of the reporting cards of hepatitis B cases to NNDRS.

Lung cancer is the leading cause of cancer-related deaths. Traditional chemotherapy causes serious toxicity due to the wide bodily distribution of these drugs. Curcumin is a potential anticancer agent but its low water solubility, poor bioavailability and rapid metabolism significantly limits clinical applications. Here we developed a liposomal curcumin dry powder inhaler (LCD) for inhalation treatment of primary lung cancer. LCDs were obtained from curcumin liposomes after freeze-drying. The LCDs had a mass mean aerodynamic diameter of 5.81 μm and a fine particle fraction of 46.71%, suitable for pulmonary delivery. The uptake of curcumin liposomes by human lung cancer A549 cells was markedly greater and faster than that of free curcumin. The high cytotoxicity on A549 cells and the low cytotoxicity of curcumin liposomes on normal human bronchial BEAS-2B epithelial cells yielded a high selection index partly due to increased cell apoptosis. Curcumin powders, LCDs and gemcitabine were directly sprayed into the lungs of rats with lung cancer through the trachea. LCDs showed higher anticancer effects than the other two medications with regard to pathology and the expression of many cancer-related markers including VEGF, malondialdehyde, TNF-, caspase-3 and BCL-2. LCDs are a promising medication for inhalation treatment of lung cancer with high therapeutic efficiency.

Breast cancer brain metastases (BCBMs) are one of the most difficult malignancies to treat due to the intracranial location and multifocal growth. Chemotherapy and molecular targeted therapy are extremely ineffective for BCBMs due to the inept brain accumulation because of the formidable blood‒brain barrier (BBB). Accumulation studies prove that low density lipoprotein receptor-related protein 1 (LRP1) is promising target for BBB transcytosis. However, as the primary clearance receptor for amyloid beta and tissue plasminogen activator, LRP1 at abluminal side of BBB can clear LRP1-targeting therapeutics. Matrix metalloproteinase-1 (MMP1) is highly enriched in metastatic niche to promote growth of BCBMs. Herein, it is reported that nanoparticles (NPs-K-s-A) tethered with MMP1-sensitive fusion peptide containing HER2-targeting K and LRP1-targeting angiopep-2 (A), can surmount the BBB and escape LRP1-mediated clearance in metastatic niche. NPs-K-s-A revealed infinitely superior brain accumulation to angiopep-2-decorated NPs-A in BCBMs bearing mice, while comparable brain accumulation in normal mice. The delivered doxorubicin and lapatinib synergistically inhibit BCBMs growth and prolongs survival of mice bearing BCBMs. Due to the efficient BBB penetration, special and remarkable clearance escape, and facilitated therapeutic outcome, the fusion peptide-based drug delivery strategy may serve as a potential approach for clinical management of BCBMs.