Objective:This study aimed to investigate the association between genetic factors and the risk of developing treatment-resistant depression (TRD), as well as the efficacy of modified electroconvulsive therapy (MECT), with a specific focus on identifying gene polymorphisms that can differentiate TRD from non-TRD.Methods:This case-control study included inpatients with depression in Adult Psychiatry Department, Affective Disorders Department and Geriatrics Department of Guangzhou Medical University Affiliated Brain Hospital from January 2023 to June 2024, as well as healthy individuals undergoing physical examinations in the outpatient department. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) was utilized to genotype 16 loci across 10 candidate genes in 107 non-TRD patients, 101 TRD patients and 281 healthy controls. Hardy-Weinberg equilibrium testing, genotype frequency distribution analysis, and genetic association studies were conducted using PLINK software. Univariate binary logistic regression under a dominant model was performed using R software to analyze gene loci associated with non-TRD and TRD.Results:All 16 gene loci in the control group, the TRD group, and the non-TRD group were found to be in Hardy-Weinberg equilibrium ( P>0.05). No significant differences were observed in the genotype distribution of these gene loci across the groups ( P>0.05). Univariate binary logistic regression analysis revealed that individuals with depression carrying the HTR2A-rs7997012 G allele had a significantly lower risk of developing TRD ( OR=0.26, P=0.047). Among the patients receiving MECT, the proportion of G allele carriers who showed improvement at 2, 4, and 6 weeks of treatment was significantly higher compared to those who did not show improvement (96.61% vs. 80.95%, 96.55% vs. 50.00%, 96.59% vs. 46.15%, respectively), with χ2 values of 6.743, 29.295, and 32.300, respectively, and all P values <0.05. Conclusion:The HTR2A-rs7997012 polymorphism may represent a genetic distinction between TRD and non-TRD. Depressed patients with the rs7997012 G allele have a reduced likelihood of developing TRD, moreover, MECT demonstrates superior efficacy in this patient population.

Objective:To evaluate the prevalence of hepatitis C virus (HCV) infection among patients attending a comprehensive tertiary hospital in Beijing and to pinpoint the key demographics for anti-HCV screening.Methods:A comprehensive retrospective analysis was undertaken, examining data from 631 424 patients who underwent anti-HCV testing between 2017 and 2023. Testing for anti-HCV was conducted using the Abbott i2000 fully automated chemiluminescent immunoassay analyzer. HCV nucleic acid testing was performed with the Roche Cobas AmpliPrep/Cobas TaqMan 96 fluorescent quantitative PCR system, while HCV genotyping was achieved through sequencing.Results:The positive rate of HCV antibodies demonstrated a gradual decline over the years, decreasing from 1.62% in 2017 to 1.01% in 2023. The overall positive rate stood at 1.36% (8 574/631 424), with a nucleic acid testing rate of 59.24% (5 079/8 574) and a nucleic acid positive rate of 34.28% (1 741/5 079). The majority of anti-HCV positive patients came from the department of hepatology (12.17%), followed by hepatobiliary surgery (3.03%), emergency medicine (1.68%), cardiovascular medicine (1.24%) and ophthalmology clinic (1.23%). Notably, the anti-HCV positive rate was significantly elevated in the ≥40 years old group compared to the <40 years old group, with statistical significance ( χ2=1 892.577, P=0.000). The highest anti-HCV positive rates were observed within the 60-69- and 80-99-years old brackets (both at 1.85%), while the peak HCV RNA positive rate was recorded in the 50-59 years old group (27.08%). Females exhibited a significantly higher positive rate (18.53%) than males (15.75%) ( χ2=8.066, P<0.01). When anti-HCV levels surpassed 9 S/CO, the HCV RNA positive rate was notably high, exceeding 38.97%. Intriguingly, at antibody levels ranging from 15 to 16 S/CO, the HCV RNA positive rate climbed to a maximum of 56.17%. Conclusions:This study has successfully identified the key populations for anti-HCV screening: Patients aged over 40, particularly female patients within the 50-69 age bracket; Patients in hepatology, hepatobiliary surgery, emergency medicine, cardiovascular medicine and ophthalmology departments.

Objective:To explore the predictive value of baseline serum levels of hepatitis B virus (HBV) RNA for HBeAg seroconversion in chronic hepatitis B (CHB) subjects with advanced fibrosis/compensated cirrhosis undergoing tenofovir disoproxil fumarate (TDF) therapy.Methods:A case-control study was conducted on 141 patients with CHB combined with advanced fibrosis/compensated cirrhosis who were treated with TDF and tested at Peking University People′s Hospital from January 2015 to December 2020. Patients were divided into HBeAg seroconversion (16 cases) group and non-seroconversion (59 cases) group based on whether HBeAg seroconversion occurred at 240 weeks after treatment. The patients were divided into HBeAg positive and negative groups at baseline (75 and 66 cases, repectively) and at 12 weeks treatment (61 and 80 cases, repectively). The baseline serum levels of relevant indicators were analyzed. HBV RNA levels were measured at baseline and at 240 weeks after treatment. The correlation between HBV RNA and HBV DNA was analyzed using Pearson correlation analysis, and the predictive value was evaluated using the receiver operating characteristic (ROC) curve.Results:For the 75 HBeAg-positive patients at baseline, 21.3% (16/75) achieved HBeAg seroconversion. The HBV DNA and HBV RNA in the HBeAg-positive group were significantly higher than that in the HBeAg-negative group (all P<0.001). Compared with the non-seroconversion group, the HBeAg seroconversion group had significantly lower baseline serum levels of HBV RNA ( P<0.05). Pearson correlation analysis showed that serum HBV RNA levels were positively correlated with HBV DNA in both baseline and 12 weeks HBeAg-negative group and HBeAg-positive group, respectively (baseline: r=0.718, 0.794, P<0.001; 12 weeks: r=0.689, 0.750, P<0.001). ROC curve showed that baseline levels of HBV RNA could be used as a predictor of HBeAg seroconversion in CHB patients with advanced fibrosis/compensated cirrhosis treated with TDF. The area under curve was 0.781, the sensitivity was 75.0%, and the specificity was 78.0%. Conclusion:Baseline serum levels of HBV RNA has a predictive value for HBeAg seroconversion in CHB patients with advanced fibrosis/compensated cirrhosis treated with TDF.

Objective:To establish a genomic nucleic acid mass spectrometry detection platform for allelic risk associated with Alzheimer's disease.Methods:Whole blood samples of 61 patients diagnosed as Alzheimer's disease in the Affiliated Brain Hospital of Guangzhou Medical University from December 28th, 2023 to 31st, March 2024 were collected and deoxynucleic acid (DNA) was extracted, including 22 males and 39 females, aged (67.36 ± 8.18) years old. After screening out 17 risk gene loci in Chinese population, multiplex polymerase chain reaction primers, single-base extension primers and Sanger sequencing primers were designed. Ten samples were used for primer optimization and debugging through Sanger sequencing and time-of-flight mass spectrometry to establish a detection system. The remaining samples were genotyped using a time-of-flight mass spectrometer and verified by Sanger sequencing for accuracy evaluation. Five samples were selected for gradient dilution and then subjected to time-of-flight mass spectrometry detection to evaluate the detection limit. Three clinical samples, one case of Escherichia coli and one case of Staphylococcus aureus genomic DNA samples were selected for cross-reaction research. The anti-interference ability of the detection system was evaluated against hemolysis, chylous substances and conventional anticoagulants in the samples. Two samples, one wild and one homozygous mutation sample with representative peak shapes, were selected to evaluate the anti-interference ability. Four samples containing the common genotypes of all gene loci in the system were selected and repeated 10 times to evaluate the precision.Results:The minimum intensity of single-base extension primers on mass spectrometry is greater than half of the maximum intensity. All 17 risk gene loci screened were successfully typed. The time-of-flight mass spectrometry detection results of 1,037 loci from 61 samples showed that the genotyping detection rate was 100%. The genotypes of the 20 DNA samples were completely consistent with the results of Sanger sequencing, with an accuracy rate of 100%. The mass spectrometry detection results of five samples after gradient dilution indicated that the low detection limit was 5 ng of DNA. The reaction system has a strong anti-interference ability against hemolysis of samples, chylous substances, conventional anticoagulants and DNA cross-contamination. Homologous allele interference and no cross-reaction between the bacterial genome and 17 gene loci do not affect the risk genome detection results. The results of 10 repeated mass spectrometry tests on 4 samples showed that the precision was 100%.Conclusion:The genomic detection system of Alzheimer's disease risk has been successfully established to provide an auxiliary mean for disease diagnosis and risk assessment.

Objective:This study aimed to investigate the association between genetic factors and the risk of developing treatment-resistant depression (TRD), as well as the efficacy of modified electroconvulsive therapy (MECT), with a specific focus on identifying gene polymorphisms that can differentiate TRD from non-TRD.Methods:This case-control study included inpatients with depression in Adult Psychiatry Department, Affective Disorders Department and Geriatrics Department of Guangzhou Medical University Affiliated Brain Hospital from January 2023 to June 2024, as well as healthy individuals undergoing physical examinations in the outpatient department. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) was utilized to genotype 16 loci across 10 candidate genes in 107 non-TRD patients, 101 TRD patients and 281 healthy controls. Hardy-Weinberg equilibrium testing, genotype frequency distribution analysis, and genetic association studies were conducted using PLINK software. Univariate binary logistic regression under a dominant model was performed using R software to analyze gene loci associated with non-TRD and TRD.Results:All 16 gene loci in the control group, the TRD group, and the non-TRD group were found to be in Hardy-Weinberg equilibrium ( P>0.05). No significant differences were observed in the genotype distribution of these gene loci across the groups ( P>0.05). Univariate binary logistic regression analysis revealed that individuals with depression carrying the HTR2A-rs7997012 G allele had a significantly lower risk of developing TRD ( OR=0.26, P=0.047). Among the patients receiving MECT, the proportion of G allele carriers who showed improvement at 2, 4, and 6 weeks of treatment was significantly higher compared to those who did not show improvement (96.61% vs. 80.95%, 96.55% vs. 50.00%, 96.59% vs. 46.15%, respectively), with χ2 values of 6.743, 29.295, and 32.300, respectively, and all P values <0.05. Conclusion:The HTR2A-rs7997012 polymorphism may represent a genetic distinction between TRD and non-TRD. Depressed patients with the rs7997012 G allele have a reduced likelihood of developing TRD, moreover, MECT demonstrates superior efficacy in this patient population.

Objective:To evaluate the prevalence of hepatitis C virus (HCV) infection among patients attending a comprehensive tertiary hospital in Beijing and to pinpoint the key demographics for anti-HCV screening.Methods:A comprehensive retrospective analysis was undertaken, examining data from 631 424 patients who underwent anti-HCV testing between 2017 and 2023. Testing for anti-HCV was conducted using the Abbott i2000 fully automated chemiluminescent immunoassay analyzer. HCV nucleic acid testing was performed with the Roche Cobas AmpliPrep/Cobas TaqMan 96 fluorescent quantitative PCR system, while HCV genotyping was achieved through sequencing.Results:The positive rate of HCV antibodies demonstrated a gradual decline over the years, decreasing from 1.62% in 2017 to 1.01% in 2023. The overall positive rate stood at 1.36% (8 574/631 424), with a nucleic acid testing rate of 59.24% (5 079/8 574) and a nucleic acid positive rate of 34.28% (1 741/5 079). The majority of anti-HCV positive patients came from the department of hepatology (12.17%), followed by hepatobiliary surgery (3.03%), emergency medicine (1.68%), cardiovascular medicine (1.24%) and ophthalmology clinic (1.23%). Notably, the anti-HCV positive rate was significantly elevated in the ≥40 years old group compared to the <40 years old group, with statistical significance ( χ2=1 892.577, P=0.000). The highest anti-HCV positive rates were observed within the 60-69- and 80-99-years old brackets (both at 1.85%), while the peak HCV RNA positive rate was recorded in the 50-59 years old group (27.08%). Females exhibited a significantly higher positive rate (18.53%) than males (15.75%) ( χ2=8.066, P<0.01). When anti-HCV levels surpassed 9 S/CO, the HCV RNA positive rate was notably high, exceeding 38.97%. Intriguingly, at antibody levels ranging from 15 to 16 S/CO, the HCV RNA positive rate climbed to a maximum of 56.17%. Conclusions:This study has successfully identified the key populations for anti-HCV screening: Patients aged over 40, particularly female patients within the 50-69 age bracket; Patients in hepatology, hepatobiliary surgery, emergency medicine, cardiovascular medicine and ophthalmology departments.

Objective:To explore the predictive value of baseline serum levels of hepatitis B virus (HBV) RNA for HBeAg seroconversion in chronic hepatitis B (CHB) subjects with advanced fibrosis/compensated cirrhosis undergoing tenofovir disoproxil fumarate (TDF) therapy.Methods:A case-control study was conducted on 141 patients with CHB combined with advanced fibrosis/compensated cirrhosis who were treated with TDF and tested at Peking University People′s Hospital from January 2015 to December 2020. Patients were divided into HBeAg seroconversion (16 cases) group and non-seroconversion (59 cases) group based on whether HBeAg seroconversion occurred at 240 weeks after treatment. The patients were divided into HBeAg positive and negative groups at baseline (75 and 66 cases, repectively) and at 12 weeks treatment (61 and 80 cases, repectively). The baseline serum levels of relevant indicators were analyzed. HBV RNA levels were measured at baseline and at 240 weeks after treatment. The correlation between HBV RNA and HBV DNA was analyzed using Pearson correlation analysis, and the predictive value was evaluated using the receiver operating characteristic (ROC) curve.Results:For the 75 HBeAg-positive patients at baseline, 21.3% (16/75) achieved HBeAg seroconversion. The HBV DNA and HBV RNA in the HBeAg-positive group were significantly higher than that in the HBeAg-negative group (all P<0.001). Compared with the non-seroconversion group, the HBeAg seroconversion group had significantly lower baseline serum levels of HBV RNA ( P<0.05). Pearson correlation analysis showed that serum HBV RNA levels were positively correlated with HBV DNA in both baseline and 12 weeks HBeAg-negative group and HBeAg-positive group, respectively (baseline: r=0.718, 0.794, P<0.001; 12 weeks: r=0.689, 0.750, P<0.001). ROC curve showed that baseline levels of HBV RNA could be used as a predictor of HBeAg seroconversion in CHB patients with advanced fibrosis/compensated cirrhosis treated with TDF. The area under curve was 0.781, the sensitivity was 75.0%, and the specificity was 78.0%. Conclusion:Baseline serum levels of HBV RNA has a predictive value for HBeAg seroconversion in CHB patients with advanced fibrosis/compensated cirrhosis treated with TDF.

Objective:To establish a genomic nucleic acid mass spectrometry detection platform for allelic risk associated with Alzheimer's disease.Methods:Whole blood samples of 61 patients diagnosed as Alzheimer's disease in the Affiliated Brain Hospital of Guangzhou Medical University from December 28th, 2023 to 31st, March 2024 were collected and deoxynucleic acid (DNA) was extracted, including 22 males and 39 females, aged (67.36 ± 8.18) years old. After screening out 17 risk gene loci in Chinese population, multiplex polymerase chain reaction primers, single-base extension primers and Sanger sequencing primers were designed. Ten samples were used for primer optimization and debugging through Sanger sequencing and time-of-flight mass spectrometry to establish a detection system. The remaining samples were genotyped using a time-of-flight mass spectrometer and verified by Sanger sequencing for accuracy evaluation. Five samples were selected for gradient dilution and then subjected to time-of-flight mass spectrometry detection to evaluate the detection limit. Three clinical samples, one case of Escherichia coli and one case of Staphylococcus aureus genomic DNA samples were selected for cross-reaction research. The anti-interference ability of the detection system was evaluated against hemolysis, chylous substances and conventional anticoagulants in the samples. Two samples, one wild and one homozygous mutation sample with representative peak shapes, were selected to evaluate the anti-interference ability. Four samples containing the common genotypes of all gene loci in the system were selected and repeated 10 times to evaluate the precision.Results:The minimum intensity of single-base extension primers on mass spectrometry is greater than half of the maximum intensity. All 17 risk gene loci screened were successfully typed. The time-of-flight mass spectrometry detection results of 1,037 loci from 61 samples showed that the genotyping detection rate was 100%. The genotypes of the 20 DNA samples were completely consistent with the results of Sanger sequencing, with an accuracy rate of 100%. The mass spectrometry detection results of five samples after gradient dilution indicated that the low detection limit was 5 ng of DNA. The reaction system has a strong anti-interference ability against hemolysis of samples, chylous substances, conventional anticoagulants and DNA cross-contamination. Homologous allele interference and no cross-reaction between the bacterial genome and 17 gene loci do not affect the risk genome detection results. The results of 10 repeated mass spectrometry tests on 4 samples showed that the precision was 100%.Conclusion:The genomic detection system of Alzheimer's disease risk has been successfully established to provide an auxiliary mean for disease diagnosis and risk assessment.

Hepatitis C virus （HCV） can develop into liver cirrhosis or hepatocellular carcinoma， imposing a heavy burden on the patient’s family and the society. Hepatitis C is one of the major public threats for humans， and eliminating hepatitis C is a common goal of all humans. Direct-acting antiviral agents （DAAs） are currently a relatively safe treatment regimen for hepatitis C that can reach a relatively high cure rate and can target different HCV genotypes， making it possible to eliminate HCV infection. China actively promotes the clinical application of DAAs， accelerates drug approval， improves the accessibility of DAAs， and strengthens population intervention. National Medical Insurance Administration has gradually included DAAs in the national medical insurance directory， providing strong support for eliminating HCV infection. In response to the WHO’s goal of eliminating viral hepatitis as a public health hazard by 2030， China has successively released national strategic plans and action plans in recent years， making significant achievements in HCV infection elimination， forming a joint prevention and control system across multiple sectors of the society， and ultimately achieving the goal of eliminating HCV infection. With a focus on the current status of HCV infection in China and prominent prevention and control strategies， this article analyzes and summarizes the practical process of the prevention， control， and micro-elimination of HCV infection， in order to provide a policy reference for carrying out HCV elimination in China and help to achieve the goal of comprehensive elimination of HCV infection.

Objective: To explore the perioperative clinical treatment of thyroid cancer patients with heart disease. Methods: A retrospective analysis was conducted on 39 thyroid cancer patients with heart disease admitted to the Department of Otorhinolaryngology Head and Neck Surgery, Beijing Anzhen Hospital,Capital Medical University from April 2014 to February 2018,including 25 males and 14 females, the age ranged from 59 to 75 years,with an average age of 67.3±6.2 years. Perioperative clinical monitoring indicators included cardiac ultrasound left ventricular ejection fraction (LVEF), degree of vascular stenosis revealed by coronary CT, hypersensitive troponin I (TNI), b-type natriuretic peptide (BNP), fibrinogen degradation products,and coagulation indexes. This panel of patients comprised 26 cases with 50% ≤ LVEF<60%,10 cases with 40% ≤ LVEF<50%, 3 cases with 36% ≤ LVEF<40%, 27 cases with 0≤BNP<100 ng/L, 7 cases with 100≤BNP<400 ng/L, and 5 cases with 400≤BNP<700 ng/L. Coronary CT showed no coronary artery stenosis>75%. The vascular graft was patent and the coronary artery after stenting was unobstructed. For 3 patients with LVEF<40% and 5 patients with BNP>400 ng/L,cardiotonic,diuretic,and nutritional myocardial therapy were used for 1 week. SPSS 17.0 software was used to analyze the data. Results: All 39 patients successfully completed the operation under general anesthesia,including 32 cases of total thyroidectomy,7 cases of glandular lobe and isthmic resection,and 40 cases of lateral neck dissection. One patient developed heart failure three days after surgery and was discharged after two weeks of treatment. No other cardiac related events,cerebrovascular and pulmonary thrombosis occurred during the perioperative period. The anesthesia preparation time was significant different between the group with 0≤BNP<100 ng/L and 50%≤LVEF<60% and the group with 0≤BNP<100 ng/L and 36%≤LVEF<50%. Conclusions Multi-indicators were utilized to adequately assess cardiac function before surgery. According to the results of cardiac ultrasound and coronary CT examination, the corresponding treatment should be conducted to improve the cardiac function. After the perioperative risk assessment and management of thyroid cancer patients with heart disease,standardized thyroid cancer surgery can be performed safely.