ObjectiveTo investigate the performance of fibrosis-4 （FIB-4） versus aspartate aminotransferase-to-platelet ratio index （APRI） in predicting advanced liver fibrosis and disease progression in patients with chronic HBV infection. MethodsA total of 497 patients with chronic HBV infection who underwent liver biopsy in The First Affiliated Hospital of Guangxi Medical University from February 2013 to December 2022 were enrolled， among whom 404 were enrolled in a retrospective study and 75 were enrolled in a prospective study. Related indicators were collected， including demographic features （sex and age）， biochemical indices （alanine aminotransferase ［ALT］ and aspartate aminotransferase ［AST］）， and platelet count， and FIB-4 and APRI were calculated. The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups， and the Kruskal-Wallis H test was used for comparison between multiple groups； the chi-square test was used for comparison of categorical data between groups. The area under the ROC curve （AUC） was used to assess the ability of APRI and FIB-4 in evaluating liver fibrosis degree and disease progression in patients with chronic HBV infection. ResultsIn the retrospective analysis， compared with the FIB-4<2.67 group， the FIB-4≥2.67 group had a significantly higher proportion of the patients who were diagnosed with liver cirrhosis or hepatocellular carcinoma （66.19% vs 47.54%， χ²=12.75， P<0.001）. The medians of FIB-4 and APRI increased significantly with liver fibrosis degree from F0 to F4 （H=42.5 and 35.9， both P<0.001）. As for the fibrosis stage of F0-F4， the median of FIB-4 was significantly higher than that of APRI in the patients with the same fibrosis stage （H=59.71， P<0.001）. FIB-4 and APRI had a similar AUC for predicting stage F3 fibrosis （0.67 vs 0.65， Z=0.71， P=0.480）， while FIB-4 had a higher AUC for predicting stage F4 fibrosis than APRI （0.72 vs 0.64， Z=10.50， P<0.001）. In the prospective study cohort， FIB-4 and APRI showed an increasing trend over time in predicting disease progression （chronic hepatitis B to liver cirrhosis）， with an AUC of 0.718 （95% confidence interval ［CI］： 0.476‍ ‍—‍ ‍0.760） and 0.555 （95%CI： 0.408‍ ‍—‍ ‍0.703）， respectively， and FIB-4 had a significantly higher accuracy than APRI in predicting disease progression （χ²=12.44， P<0.001）. ConclusionFIB-4 and APRI can be used to evaluate advanced liver fibrosis （F3 and F4） and predict disease progression， and FIB-4 is superior to APRI in certain aspects.

Objective To investigate the microbiome composition of deep invasive endometriosis lesions,offering novel insights into its pathogenesis,diagnosis,and treatment strategies.Methods From May 2021 to May 2022,we collected samples of normal endometrium(normal group,n=10),endometrium from patients with deep infiltrating endometriosis(DIE endometrium group,n=14),and lesions from these patients(DIE lesion group,n=10)for 16s rRNA sequencing analysis.We employed the bacterial community diversity algorithm(alpha diversity and beta diversity),principal coordinate analysis(PCoA)distance matrix algorithms(Bray-Curtis and Unifrac matrices),as well as the biological identification algorithm(LeFSe)to investigate microbiome differences between groups and identify differentially abundant bacteria and enriched KEGG functions.Results The diversity of the three groups did not show any significant difference,while the β diversity exhibited a statistically significant distinc-tion(P=0.005 5).The focus group had a relatively low abundance of Firmicutes at the phylum level and a relatively increased abundance of Fusobacteria.At the genus level,there was an increased relative abundance of Enterococcus and Prevotella.LEFse analysis suggested that Proteobacteria and Gammaproteobacteria were the main dominant in the lesion group.Notably,Gamma proteobacteria emerged as a key differential species among the three groups'microbial flora with statistical significance(P=0.021 2).Conclusion Compared to the normal group and DIE group,there was a significant increase in the abundance of Fusobacteria,Proteobacteria,Gammaproteobacteria,Enterococcus,and Prevotella.These findings offer novel therapeutic targets for the prevention and intervention of deep infiltrating endometriosis.

Objective:To compare the efficacy and safety of different dosages of new drugs in the treatment of PsA by using network meta-analysis.Methods:Three medical databases (PubMed, Web of Science, Cochrane Library) were searched for the studies that compared the efficacy and safety of 4 new drugs (secukinumab, ixekizumab, apremilast, tofacitinib) with different dosages in the treatment of PsA. Data from included studies were analyzed by Stata 15.0.Results:A total of 16 RCTs were included. The results of the network meta-analysis showed that: (1) Among the overall patients, in terms of ACR20 response rate, the larger the surface under the cumulative ranking (SUCRA), the more effective it is. Secukinumab 300 mg Q4W(96.1%) had the best efficacy, followed by ixekizumab 80 mg Q4W(79.0%), ixekizumab 80 mg Q2W(75.1%), secukinumab 150 mg Q4W(73.2%), apremilast 30 mg BID(50.6%), apremilast 20 mg BID(38.6%), tofacitinib 5 mg BID(18.1%), tofacitinib 10 mg BID(17.7%) and placebo(2.0%). (2) In terms of PASI75 response rate, the larger the area under the SUCRA curve, the more effective it is. Ixekizumab 80 mg Q4W(96.1%) had the best efficacy, followed by ixekizumab 80 mg Q2W(88.7%), secukinumab 300 mg Q4W(75.6%), secukinumab 150 mg Q4W(63.3%), apremilast 30 mg BID(44.5%), apremilast 20 mg BID(38.4%), tofacitinib 10 mg BID(30.0%), tofacitinib 5 mg BID(12.5%) and placebo(1.0%). (3) Among the overall patients, in terms of safety, the smaller the area under the SUCRA curve, the higher the safety it is. Secukinumab 300 mg Q4W (17.3%) has the best safety. (4) The results of subgroup analysis showed that in terms of ACR20 response rate, ixekizumab 80 mg Q2W(85.3%) had the best efficacy in bDMARDs-na?ve patients, while in bDMARDs-IR patients, secukinumab 300 mg Q4W(83.9%) had the best efficacy.Conclusion:Among all patients, secukinumab 300 mg Q4W is the best in terms of ACR20 response rate and safety, but ixekizumab 80 mg Q4W is more effective in improving PsA lesions comparing yo other drugs.

【Objective】 To discuss the regulating effect of stored red blood cells (RBCs) transfusion on BMDMs in inflammatory conditions, and the relationship between stored RBCs transfusion and inflammatory response induced by bacterial infection. 【Methods】 Forty C57BL/6 male mice of 6-8 weeks (18-22 g/mouse) were randomly divided into experimental group and control group. Each mouse was infected with 200 µL Pseudomonas aeruginosa injecting into the tail vein, and 400 µL fresh (storage >14 d) and stored RBCs (storage <24 h) suspension was infused through the posterior venous plexus into the isoflurane anesthetized mice (1%-3%). The BMDMs of Pseudomonas aeruginosa-infected mice were cultured, and CD86, CD197, CD209 in BMDMs were detected using FCM (flow cytometry) technique. The livers were removed 2, 4 and 8 hours after RBCs infused, then F4/80, M1 and M2 in liver tissues were tested using qRT-PCR. The data were analyzed using statistical software 17.0. 【Results】 CD86 and CD197 (%) of experimental group and control group were 86 88±1.01 vs 79.24±2.65 and 38.59± 3.73 vs 25.95+0.86 (P<0.05), and CD209 (%) were 23.88±2.23 vs 21.91+3.58 (P>0.05). F4/80 of experimental group and control group 2, 4 and 8 hours after RBCs infused were 1.83±0.11 vs 0.75±0.06, 0.46±0.06 vs 0.33±0.06 (P<0.05) and 0.33± 0.03 vs 0.35±0.05 (P>0.05), respectively. iNOS, TNF-α, MCP1 of M1 in liver of experimental group and control group 2, 4 and 8 hours after RBCs infused were respectively: iNOS 3.44±0.20 vs 2.46±0.08, 9.25±0.55 vs 2.67±0.12, 2.80±0.08 vs 2.39 ±0.01; TNF-α 1.69±0.22 vs 1.13±0.03, 1.44±0.24 vs 0.96±0.09, 1.31±0.05 vs 0.96±0.06; MCP1 4.96±0.08 vs 4.28±0.27, 4.63±0.04 vs 2.07±0.09, 2.28±0.19 vs 1.33±0.03 (P<0.05). Arg1, Mrc2 and CD163 of M2 were respectively: Arg1 0.81±0.21 vs 0.82±0.18, 0.66±0.11 vs 0.58±0.09, 0.39±0.17 vs 0.37±0.15; Mrc2 0.99±0.91 vs 0.97±0.08, 0.98±0.12 vs 1.02±0.11, 0.59±0.19 vs 0.57±0.08; CD163 1.75±0.20 vs 1.69±0.18, 0.22±0.02 vs 0.21±0.01, 0.04±0.01 vs 0.03±0.01 (P>0.05). 【Conclusion】 Stored RBCs infusion can greatly promote the M1 polarization of BMDMs in liver.

【Objective】 To analyze the safety of homotypic transfusion in military donors with negative unexpected antibody. 【Methods】 Blood samples (4 mL/person)of eligible military blood donors from November 2018 to October 2019 in our hospital (also working as forces blood station) were conducted for RBC antigen typing, unexpected antibody screening, direct antiglobulin test and cross-match test using microcolumn gel technology, and the compatibility of homotype blood samples was statistical analyzed. 【Results】 A total of 1 577 samples from eligible military blood donors were collected, including A RhD (+ ), B RhD (+ ), O RhD (+ ) and AB RhD (+ ), accounting for 31.39% (495/1 577), 34.37% (542/1 577), 24.10% (380/1 577) and 10.15% (160/1 577), respectively. Six samples presenting positive unexpected antibodies (0.38%, 6/1 577) were screened out, and a total of 7 141 cross-matching tests were performed on 1 571 unexpected antibody negative samples, including A RhD (+ ) [37.36% (2 668/7 141)], B RhD (+ ) [34.81% (2 486/7 141)], O RhD (+ ) [17.71% (1265/7 141)] and AB RhD (+ ) [10.11% (722/7 141)]. There was only 1 case of incompatible cross-matching presented between other donors and clinical patients, and the direct antiglobulin test was 1+ , therefore suspended red blood cells of the donor were scrapped. 【Conclusion】 There was high compatibility and good security of homotype transfusion of military blood donors with negative unexpected antibody.

Objective:To summarize the clinical characteristics and prognosis of 51 patients with Waldenstr?m’s macroglobulinemia (WM) and evaluate the efficacy and adverse reactions of ibrutinib in the treatment of WM.Methods:We carried out a single-center retrospective study, including 51 patients with WM of our single center from November 2008 to October 2019.Results:The median age at diagnosis was 65 years with a male-to-female ratio of 2.64∶1. There were 9 (18%) , 21 (41%) , and 21 (41%) ISSWM stage low-, intermediate- and high-risk patients identified, respectively. A total of 27 (73%) patients harbored MYD88 L265P mutation. The median follow-up time was 38.6 (0.3-120.0) months, the median progression free survival was 46.4 months, and the median overall survival was not reached. The overall remission and major remission rates of patients who received ibrutinib were 87% and 80%, respectively. The median time to achieve at least partial remission of patients treated with ibrutinib was 8 weeks, which was earlier than those treated with other drugs ( P<0.05) . Conclusion:WM is often seen in elderly men. MYD88 L265P had a high frequency in WM. The findings of our study validate the efficacy of ibrutinib monotherapy. Even in patients with advanced age and at high risk of ISSWM, the overall remission rate and major remission rate are high. Ibrutinib is a safe and effective therapy because of its rapid onset and rare serious adverse reactions.

Objective To assess the risk factors of carbapenem -resistant Acinetobacter baumannii (CRAB) infection.Methods Clinical data of patients with positive bacterial culture in Tianjin Medical University General Hospital during January 2011 and December 2015 were retrospectively analyzed, including 68 patients with carbapenem resistant Acinetobacter baumannii (CRAB) bacteremia, 68 patients with carbapenem sensitive Acinetobacter baumannii ( CSAB) bacteremia, and 68 patients with positive culture of other bacteria (control group).The risk factors of Acinetobacter baumannii infection were analyzed by univatiate and multivariate Logistic regression analyses .Results Univariate analysis showed that bacteremia /sepsis,use of carbapenems,β-lactamase inhibitor compound,tigecycline,combined antibiotics, glucocorticoids,surgery within one month, mechanical ventilation, central venous catheters ( CVCs ), arteriopuncture,indwelling catheter≥3 days and indwelling gastric tube were risk factors of CRAB infection (CRAB vs.control: χ2 =4.96,15.56,7.64,9.22,5.89,6.80,17.00,11.83,18.22,8.24,25.24 and 7.70, P <0.05 or P <0.01, respectively); while use of third-generation cephalosporin,CVCs,length of hospital stay were risk factors of CSAB infection (CSAB vs.control: χ2 =11.93 and 6.94,U =1555, P <0.05).Multivariate logistic analysis showed that bacteremia /sepsis (OR =4.01, 95%CI:1.13 ~14.20), use of carbapenems (OR =4.17, 95%CI :1.79 ~9.73), CVCs (OR =2.93, 95% CI: 1.22 ~7.08), indwelling catheter≥3 days (OR =6.08,95%CI:2.39 ~15.46) were independent risk factors of CRAB infection; use of third-generation cephalosporin (OR =3.98, 95% CI :1.88 ~8.43 ),CVCs(OR =3.40, 95% CI:1.48 ~7.81) were independent risk factors of CSAB infection .Conclusions Long-term use of carbapenems and invasive procedures are associated with CRAB infection , strict control of invasive procedures and rational use of antibiotics may reduce CRAB infection .

Objective:To observe the effects of bama nectar in kidney-yang deficienct mice and on the mating ability and sperm counts of normal mice. Methods:The weight, body temperature, locomotor activity, cold-resistant,genital organ coefficient and lipid peroxidation of the hydrocortisone-induced kidney-yang deficient mice were detected. The genital organ ccoefficient, immune organ co-efficient and erectile function of the ovariectomized mice were detected. The mating ability and the sperm counts of normal mice were measured. Results:Compared with the model group, bama nectar obviously increased the weight, body temperature and locomotor ac-tivity of the hydrocortisone-induced kidney-yang deficient mice, and improved the locomotor activity, the organ coefficient of seminal vesicle, prostate gland, preputial gland and epididymis. Furthermore, bama nectar significantly increased the SOD activity in serum and reduced the level of MDA in serum when compared with the model group (P<0.05 or P<0.01). Compared with the model group, bama nectar could increase the organ coefficient of foreskin and thymus gland in the ovariectomized mice, and shorten the erec-tile latency (P<0. 05). Compared with the normal group, bama nectar improved the mating ability and the sperm counts of the male mice (P<0. 05 or P<0. 01). Conclusion:Bama nectar has beneficial effects on invigorating kidney and strengthening yang.

The molecular descriptors of impurities with known structure in cefdinir were calculated, selected and associated with the chromatographic retention behavior to establish a model. This quantitative structure retention relationships (QSRR) model for the related substances of cefdinir was established under specific chromatographic condition and verified by other impurities. 12 molecular descriptors were used to establish the QSRR model, F_AFRBWF, Blbn_J, SsCH3, SssCH2, SsNH2, SssNH, SssS, SHdCH2, EEM_AFc, EEM_AFpl, EEM_XFpl and Pi_MaxQ. The relativity between true values and predictions in QSRR of cefdinir is R2 = 0.9836 (n = 18), ΔRRT is no more than 0.154, as 10.17% in RRT. The results indicate that the QSRR model for the related substances of cefdinir can be used to evaluate the analysis methods for related substances and predict the chromatographic behavior of new impurities, which will provide a new way for the evaluation of the effectiveness for drug quality control.

Objective To investigate the antibiotic resistance of Acinetobacter baumannii,and to identify the risk factors for fatality of Acinetobacter baumannii bloodstream infection.Methods A retrospective review was conducted on 80 patients with Acinetobacter baumannii bloodstream infections admitted in Tianjin General Hospital during January 2011 to May 2014.Clinical data including demographic information,the ward of stay,underlying diseases,treatment,invasive procedures,antibiotic resistance,acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score at admission were collected.Multivariate Logistic regression analysis was performed to identify the risk factors for fatality.Results There were ≥90％ strains resistant to ceftazidime,ceftriaxone and cefoxitin,and 66.3％ strains were resistant to imipenem.While most strains were sensitive to cefoperazone/shubatan and tigecycline,and the resistance rates were 7.5％ and 2.5％,respectively.ICU admission (OR =6.67,95％ CI:2.01-22.07,P ＜0.01),multi-drug resistance (OR =3.55,95％ CI:1.30-9.69,P ＜ 0.05),APACHE Ⅱ score ≥ 19 (OR =39.00,95％ CI:9.87-154.09,P ＜ 0.01),artery catheterization (OR =3.24,95％ CI:1.16-9.04,P ＜ 0.05),central venous catheterization (OR =3.33,95％ CI:1.22-9.12,P ＜ 0.05),tracheal catheterization (OR=3.60,95％CI:1.31-9.88,P＜0.05),tracheostomy (OR=3.21,95％CI:1.19-8.66,P＜0.05),and other invasive procedures (OR =3.00,95％ CI:1.11-8.08,P ＜ 0.05) were the risk factors for fatality.Conclusion Invasive procedures and multi-drug resistance are associated with increased fatality of patients with Acinetobacter baumannii bloodstream infection.