1.Analysis of hepatitis B infection characteristics in HBsAg-/HBV DNA+ blood donors in Taiyuan
Zhiye LI ; Baifeng SHAN ; Liuming ZHANG ; Yixuan LI ; Aichun CHU ; Weiyu YUAN ; Lixia DOU ; Qiang ZHANG ; Yuan BAI ; Yuan ZHOU
Chinese Journal of Blood Transfusion 2026;39(3):373-378
Objective: To analyze characteristics of hepatitis B infection in HBsAg-/HBV DNA+ blood donors in Taiyuan, so as to provide evidence for adjusting blood screening strategies. Methods: Blood samples of HBsAg-/HBV DNA+ donors were tested using enzyme-linked immunosorbent assay (ELISA), chemiluminescence assay, nucleic acid qualitative test, and nucleic acid quantitative test. Data on HBsAg-/HBV DNA+ donors in Taiyuan region from January 1, 2016 to December 31, 2024 were statistically analyzed to evaluate the detection rate, demographic characteristics, influencing factors of detection rate, nucleic acid quantitative results, and serological patterns of HBsAg-/HBV DNA+ donors. Results: From January 1, 2016 to December 31, 2024, 991 565 donor samples underwent nucleic acid testing in Taiyuan. A total of 309 HBsAg-/HBV DNA+ samples were detected, resulting in an HBsAg-/HBV DNA+ detection rate of 3.12 per 10 000. The detection rate varied significantly across different years (P<0.05). Males had a significantly higher HBsAg-/HBV DNA+ detection rate than females, first-time donors had a higher rate than repeat donors, and whole blood donors had a higher rate than apheresis donors (P<0.05). The detection rate also differed significantly among age groups (P<0.05). Logistic regression analysis showed that gender, age, donation frequency, and donation type were all influencing factors for HBsAg-/HBV DNA+ detection (all P<0.05). The predominant serological patterns among HBsAg-/HBV DNA+ donors were HBsAb+/HBcAb+ (43.69%, 135/309) or HBcAb+ alone (24.27%, 75/309). Viral load was detectable in 53.40% (165/309) of the HBsAg-/HBV DNA+ donors. Among these, 61.21% (101/165) donors had a viral load<20 IU/mL, and 94.55% (156/165) had a viral load<200 IU/mL. Donors with viral load<200 IU/mL primarily exhibited HBsAb+/HBcAb+ (41.67%, 65/156) or HBcAb+alone (36.54%, 57/156) serological patterns. Conclusion: The prevalence of HBsAg-/HBV DNA+ is low among blood donors in Taiyuan. Higher detection rates were observed in the 46-55 years age group, males, first-time donors, and whole blood donors. HBsAg-/HBV DNA+ donors exhibit specific serological patterns and generally have low viral loads, indicating a potential residual transfusion risk. It is recommended to add HBcAb testing, together with high-sensitivity nucleic acid testing technologies and donor follow-up, to ensure blood safety and guide donor reentry.
2.Explainable Machine Learning Model for Predicting Prognosis in Patients with Malignant Tumors Complicated by Acute Respiratory Failure: Based on the eICU Collaborative Research Database in the United States
Zihan NAN ; Linan HAN ; Suwei LI ; Ziyi ZHU ; Qinqin ZHU ; Yan DUAN ; Xiaoting WANG ; Lixia LIU
Medical Journal of Peking Union Medical College Hospital 2026;17(1):98-108
To develop and validate a model for predicting intensive care unit (ICU) mortality risk in patients with malignant tumors complicated by acute respiratory failure (ARF) based on an explainable machine learning framework. Clinical data of patients with malignant tumors and ARF were extracted from the eICU Collaborative Research Database in the United States, including demographic characteristics, comorbidities, vital signs, laboratory test indicators, and major interventions within the first 24 hours after ICU admission.The study outcome was ICU death.Enrolled patients were randomly divided into a training set and a validation set at a ratio of 7:3.Predictor variables were selected using least absolute shrinkage and selection operator (LASSO) regression.Five machine learning algorithms-extreme gradient boosting (XGBoost), support vector machine (SVM), Logistic regression, multilayer perceptron (MLP), and C5.0 Decision Tree-were employed to construct predictive models.Model performance was evaluated based on the area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, and other metrics.The optimal model was further interpreted using the Shapley additive explanations (SHAP) algorithm. A total of 3196 patients with malignant tumors complicated by ARF were included.The training set comprised 2, 261 patients and the validation set 935 patients; 683 patients died during ICU stay, while 2513 survived.LASSO regression ultimately selected 12 variables closely associated with patient ICU outcomes, including sepsis comorbidity, use of vasoactive drugs, and within the first 24 hours after ICU admission: minimum mean arterial pressure, maximum heart rate, maximum respiratory rate, minimum oxygen saturation, minimum serum bicarbonate, minimum blood urea nitrogen, maximum white blood cell count, maximum mean corpuscular volume, maximum serum potassium, and maximum blood glucose.After model evaluation, the XGBoost model demonstrated the best performance.The AUCs for predicting ICU mortality risk in the training and validation sets were 0.940 and 0.763, respectively; accuracy was 88.3% and 81.2%;sensitivity was 98.5% and 95.9%.Its predictive performance also remained optimal in sensitivity analyses.SHAP analysis indicated that the top five variables contributing to the model's predictions were minimum oxygen saturation, minimum serum bicarbonate, minimum mean arterial pressure, use of vasoactive drugs, and maximum white blood cell count. This study successfully developed a mortality risk prediction model for ICU patients with malignant tumors complicated by ARF based on a large-scale dataset and performed explainability analysis.The model aids clinicians in early identification of high-risk patients and implementing individualized interventions.
3.Nonlinear association of nap duration with anxiety and depressive symptoms among junior high school students
ZHOU Xin,LI Yanqiu,OU Junqi,LIN Jing,FENG Lihui,LIN Ziqiang,GAO Yanhui,LI Lixia
Chinese Journal of School Health 2026;47(4):558-562
Objective:
To explore the association between nap duration with anxiety and depressive symptoms among junior high school students, in order to provide evidence for mental health interventions for adolescents.
Methods:
From May to June 2022, a combination of convenience sampling and cluster sampling was used to select 2 491 students from 2 junior high schools in Haizhu District, Guangzhou City for questionnaire survey and physical examination. The questionnaire collected nap duration, night time sleep duration, bedtime, physical activity, and sedentary behavior. Anxiety and depressive symptoms were assessed using Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), respectively. Log-binomial regression model was used to analyze the association of nap duration with anxiety and depressive symptoms, as well as comorbidity among junior high school students, and a restricted cubic spline (RCS) Log-binomial regression model was employed to analyze the non linear relationship after adjusting for covariates.
Results:
The detection rates of anxiety symptoms, depressive symptoms and comorbidity among junior high school students were 13.29%,14.65%,9.19%. After adjusting for covariates such as age, gender and nighttime sleep duration, compared with a school day nap duration of <30 min/d, a nap duration of 30-<60 min/d was associated with a reduced risk of anxiety symptoms ( APR =0.68, 95% CI =0.49-0.98) and comorbidity ( APR =0.56, 95% CI =0.39-0.87)(both P < 0.05 ). Compared with no napping on weekends, a nap duration of 30-<60 min/d was associated with a reduced risk of anxiety symptoms ( APR =0.62, 95% CI =0.41-0.88), depressive symptoms ( APR =0.52, 95% CI =0.34-0.75) and comorbidity ( APR = 0.52 , 95% CI =0.30-0.83)(all P <0.05). RCS curves showed a nonlinear relationship between weekend nap duration and the prevalence of anxiety, depressive symptoms and comorbidity among junior high school students(all P non linear <0.05); weekend nap duration of <120 min was associated with a lower risk of anxiety and depressive symptoms, and weekend nap duration of >180 min was associated with an increased risk.
Conclusions
Appropriate nap duration can help reduce the risk of anxiety, depressive symptoms, and the comorbidity among junior high school students. Adolescents should be guided to reasonably arrange nap duration for promoting physical and mental health.
4.Application value of fibrosis-4 index and liver transient elastography in liver fibrosis risk stratification for metabolic associated fatty liver disease in community health institutions
Haiqing GUO ; Yaning LI ; Xiaohui LIU ; Jing ZHANG ; Yumin WANG ; Li CAO ; Lixia QIU
Journal of Clinical Hepatology 2026;42(6):1294-1300
ObjectiveTo perform metabolic associated fatty liver disease (MAFLD) screening among individuals attending community health institutions, to identify the patients at a low, moderate or high risk of advanced liver fibrosis based on fibrosis-4 index (FIB-4) and liver stiffness measurement (LSM) measured by liver transient elastography, and to implement stratified management. MethodsA cross-sectional study was conducted among 630 individuals attending Beijing Baizhifang Community Health Service Center from January to July 2024, and they were divided into MAFLD group and non-MAFLD group. According to body mass index (BMI), the MAFLD group was further divided into lean MAFLD group (BMI<23 kg/m2) and non-lean MAFLD group (BMI≥23 kg/m2). The above groups were compared in terms of demographic features, laboratory markers, hepatic steatosis, and LSM. Fibrosis risk stratification was performed for MAFLD patients based on FIB-4 and LSM, and a closed-loop management system involving referral to tertiary hospitals and follow-up at community health institutions was implemented. The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups, and the chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups. ResultsThere were 445 individuals (70.6%) in the MAFLD group and 185 individuals (29.4%) in the non-MAFLD group. Compared with the non-MAFLD group, the MAFLD group had a significantly lower proportion of male individuals (χ2=4.299, P<0.05), a significant reduction in the level of high-density lipoprotein cholesterol (Z=3.484, P<0.05), and significant increases in body weight (Z=-7.366, P<0.05), BMI (Z=-9.740, P<0.05), waist circumference (Z=-6.397, P<0.05), hip circumference (Z=-6.935, P<0.05), alanine aminotransferase (ALT) (Z=-2.765, P<0.05), fasting blood glucose (Z=-3.646, P<0.05), triglyceride (TG) (Z=-6.569, P<0.05), total cholesterol (Z=-2.033, P<0.05), low-density lipoprotein cholesterol (Z=-2.935, P<0.05), controlled attenuation parameter (CAP) (Z=-19.784, P<0.05), and LSM (Z=-5.703, P<0.05). Within the MAFLD group, there were 124 individuals (27.9%) in the lean MAFLD group and 321 individuals (72.1%) in the non-lean MAFLD group. Compared with the non-lean MAFLD group, the lean MAFLD group had significantly lower body weight (Z=-12.414, P<0.05), BMI (Z=-16.363, P<0.05), waist circumference (Z=-7.733, P<0.05), hip circumference (Z=-8.595, P<0.05), ALT (Z=-2.835, P<0.05), aspartate aminotransferase (Z=-1.972, P<0.05), TG (Z=-2.407, P<0.05), CAP (Z=-4.429, P<0.05), degree of steatosis (χ2=16.588, P<0.05), and LSM (Z=-3.908, P<0.05). Based on the results of FIB-4 and LSM, 76 patients at a moderate or high risk of liver fibrosis should be referred to a higher-level hospital for further management. ConclusionThe detection rate of MAFLD reaches 70.6% among the individuals attending community health institutions, among whom 76 (17.1%) should be referred to a higher-level hospital. Establishing a liver fibrosis risk stratification and management system based on FIB-4 and LSM among MAFLD individuals in communities provides a practical pathway for chronic disease management and referral system construction in community health institutions.
5.Global Trends and Research Hotspots in Exercise Intervention for Overweight and Obesity: A Bibliometric Analysis
Yuanchun ZHU ; Yuhang ZHANG ; Mingnan SHI ; Houqiang ZHANG ; Shufen LIU ; Qing LI ; Lixia CHEN
Medical Journal of Peking Union Medical College Hospital 2026;17(4):1051-1062
To analyze global trends and research hotspots in exercise intervention for overweight and obesity from 2010 to 2024, to provide novel perspectives for comprehensive management research on overweight and obesity. Relevant literature published between January 1, 2010, and December 31, 2024, was retrieved from all sub-databases of the Web of Science Core Collection, including articles and reviews. CiteSpace 6.4.R1 was used to perform co-occurrence and burst analysis of journals, institutions, authors and keywords. VOSviewer 1.6.20 was applied to construct co-citation networks among countries/regions and references. SPSS 26.0 was utilized to analyze trends in publication volume and citation frequency. A total of 113 080 publications on exercise interventions for overweight and obesity were obtained, including 98 188 articles and 14 892 reviews. Both annual publications ( Over the past 15 years, the field of exercise intervention for overweight and obesity has received considerable academic attention. Key research hotspots focus on monitoring the incidence of overweight and obesity and the correlation between physical activity and the health outcomes of individuals with overweight and obesity. Future research directions emphasize the effect of high-intensity interval training on the cardiometabolic health of individuals with overweight and obesity, the interaction of dietary habits and physical activity, and the focus on enhance physical activity levels are the primary global trends in this research field.
6.Exploration of Traditional Chinese and Western Medicine in Prevention and Treatment of DKD Based on Mitochondrial Autophagy Mediated by PINK1/Parkin Signaling Pathway: A Review
Runsheng LIU ; Xiaodong ZHANG ; Zhaoqing LI ; Jing WANG ; Jinglu ZHANG ; Lixia JIN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(7):302-313
Diabetic kidney disease (DKD) is one of the more common chronic kidney diseases,and its causes are complex. DKD is very easy to progress to end-stage renal disease,and the current therapeutic effect still needs to be improved. As an important excretive organ of the human body, the kidney has physiological functions such as discharging metabolic waste, regulating fluid balance, and maintaining the stability of the body's internal environment. These highly complex biochemical processes all depend on the energy support provided by mitochondria. Mitochondrial dysfunction is a key factor causing kidney injury, and the imbalance of mitochondrial homeostasis is an important link leading to mitochondrial dysfunction. The occurrence and development of DKD are often accompanied by the imbalance of mitochondrial homeostasis in renal cells. Mitochondrial autophagy, as a means of regulating mitochondrial homeostasis, is very important for the prevention and treatment of DKD. The PTEN-induced putative kinase 1 (PINK1)/Parkin pathway is one of the most classical pathways to regulate mitochondrial autophagy. Recent studies have found that some drugs can regulate the PINK1/Parkin signaling pathway to target mitochondrial homeostasis and exert renoprotective effects. In particular, traditional Chinese medicine has a significant effect on early and middle stage DKD by regulating PINK1/Parkin pathway-mediated mitochondrial autophagy. This article discussed the mechanism of PINK1/Parkin pathway in mitochondrial autophagy and DKD and reviewed the effect of PINK1/Parkin pathway-mediated mitochondrial autophagy on DKD. At the same time, it explored the therapeutic effect of traditional Chinese and western medicine on DKD mediated by PINK1/Parkin-mediated mitochondrial autophagy, aiming to broaden the ideas of traditional Chinese and western medicine for the prevention and treatment of DKD from the perspective of PINK1/Parkin regulating mitochondrial autophagy.
7.Exploration of Traditional Chinese and Western Medicine in Prevention and Treatment of DKD Based on Mitochondrial Autophagy Mediated by PINK1/Parkin Signaling Pathway: A Review
Runsheng LIU ; Xiaodong ZHANG ; Zhaoqing LI ; Jing WANG ; Jinglu ZHANG ; Lixia JIN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(7):302-313
Diabetic kidney disease (DKD) is one of the more common chronic kidney diseases,and its causes are complex. DKD is very easy to progress to end-stage renal disease,and the current therapeutic effect still needs to be improved. As an important excretive organ of the human body, the kidney has physiological functions such as discharging metabolic waste, regulating fluid balance, and maintaining the stability of the body's internal environment. These highly complex biochemical processes all depend on the energy support provided by mitochondria. Mitochondrial dysfunction is a key factor causing kidney injury, and the imbalance of mitochondrial homeostasis is an important link leading to mitochondrial dysfunction. The occurrence and development of DKD are often accompanied by the imbalance of mitochondrial homeostasis in renal cells. Mitochondrial autophagy, as a means of regulating mitochondrial homeostasis, is very important for the prevention and treatment of DKD. The PTEN-induced putative kinase 1 (PINK1)/Parkin pathway is one of the most classical pathways to regulate mitochondrial autophagy. Recent studies have found that some drugs can regulate the PINK1/Parkin signaling pathway to target mitochondrial homeostasis and exert renoprotective effects. In particular, traditional Chinese medicine has a significant effect on early and middle stage DKD by regulating PINK1/Parkin pathway-mediated mitochondrial autophagy. This article discussed the mechanism of PINK1/Parkin pathway in mitochondrial autophagy and DKD and reviewed the effect of PINK1/Parkin pathway-mediated mitochondrial autophagy on DKD. At the same time, it explored the therapeutic effect of traditional Chinese and western medicine on DKD mediated by PINK1/Parkin-mediated mitochondrial autophagy, aiming to broaden the ideas of traditional Chinese and western medicine for the prevention and treatment of DKD from the perspective of PINK1/Parkin regulating mitochondrial autophagy.
8.Extracellular vesicles: Roles in oocytes and emerging therapeutic opportunities.
Zhongyu ZHAO ; Yinrui SUN ; Renhao GUO ; Junzhi LIANG ; Wanlin DAI ; Yutao JIANG ; Yafan YU ; Yuexin YU ; Lixia HE ; Da LI
Chinese Medical Journal 2025;138(9):1050-1060
The production of high-quality oocytes requires precisely orchestrated intercellular communication. Extracellular vesicles (EVs) are cell-derived nanoparticles that play a vital role in the transfer of bioactive molecules, which has gained much attention in the field of diagnosis and treatment. Over the past ten years, the participation of EVs in the reproductive processes of oocytes has been broadly studied and has shown great potential for elucidating the intricacies of female reproductive health. This review provides an extensive discussion of the influence of EVs on oocytes, emphasizing their involvement in normal physiology and altered cargo under pathological conditions. In addition, the positive impact of therapeutic EVs on oocyte quality and their role in alleviating ovarian pathological conditions are summarized.
Humans
;
Extracellular Vesicles/physiology*
;
Oocytes/cytology*
;
Female
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Animals
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Cell Communication/physiology*
9.Pain, agitation, and delirium practices in Chinese intensive care units: A national multicenter survey study.
Xiaofeng OU ; Lijie WANG ; Jie YANG ; Pan TAO ; Cunzhen WANG ; Minying CHEN ; Xuan SONG ; Zhiyong LIU ; Zhenguo ZENG ; Man HUANG ; Xiaogan JIANG ; Shusheng LI ; Erzhen CHEN ; Lixia LIU ; Xuelian LIAO ; Yan KANG
Chinese Medical Journal 2025;138(22):3031-3033
10.Association between moderate to vigorous intensity physical activity and sedentary behavior among primary and secondary school students and their parents
YAO Zifeng, YE Rongrong, CHEN Jiade, XU Peng, HUANG Yanhong, LI Lixia, LI Hongjuan, GAO Yanhui
Chinese Journal of School Health 2025;46(1):68-72
Objective:
To explore the associations of moderate to vigorous intensity physical activity (MVPA) and sedentary behavior (SB) among primary and secondary school students and their parents, so as to provide a scientific basis for formulating targeted physical activity promotion strategies for children and adolescents.
Methods:
From 2021 to 2022, basic information and 24 h movement behaviors of 2 484 pairs of students and their parents were collected from five primary and secondary schools in Haizhu District, Guangzhou City, with a convenient sampling combining with cluster sampling method. Component regression models were constructed to analyze the relationship between parental MVPA, SB and primary and secondary school students MVPA and SB, and a component isochronous substitution model was used to explore the effects of mutual substitution between parental MVPA, residual components (time use components other than SB during the 24 h period), and SB on the behavioral activities of MVPA and SB in primary and secondary school students.
Results:
Parental MVPA and SB of students in grade 1 to 3 were positively correlated with both students MVPA and SB ( β=0.06, 0.12, P <0.01). The component isochronous substitution model showed that substituting 10 and 20 minutes of MVPA for SB by parents in grade 1 to 3 was associated with an increase in MVPA of students, and substituting 10 and 20 minutes of residual ingredients for SB was associated with a decrease in SB of students, with mean changes of 0.8 (95% CI =0.4-1.2) and 1.4 (95% CI =0.7-2.2) and -1.4 (95% CI =-1.7 to -1.1) and -2.9 (95% CI =-3.4 to -2.3)( P <0.05). No statistically significant associations were observed between parents of students in grades 4 to 6 and 7 to 9 and students physical activity and sedentary behaviour ( P >0.05).
Conclusions
Parents of students in grades 1 to 3 increases MVPA and decrease SB are beneficial to increase MVPA and decrease SB of students. Parents could promote physical activity among primary and secondary school students, and the intervention gateway should be advanced, with the low grades as the optimal intervention period.


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