Hepatitis B virus （HBV） infection is a global public health issue， affecting the health of 250 million people worldwide. Despite the significant progress in antiviral therapy for HBV， some patients still experience low-level viremia （LLV） after receiving antiviral therapy and fail to achieve viral clearance， with an HBV DNA load remaining at a relatively low level of 20 — 2 000 IU/mL. LLV is often caused by multiple factors such as the high stability of the virus， the difficulty in clearing the virus with antiviral drugs， host immune factors， and drug resistance， which increase the difficulties in antiviral therapy. In addition， LLV can also cause liver damage， which may eventually progress to severe outcomes such as hepatocellular carcinoma. This article reviews LLV in hepatitis B in terms of diagnosis， influencing factors， clinical significance， and treatment strategies.

In this study， bibliometric methods were used to systematically investigate the name and origin， the evolution of prescription composition， dose evolution， origin and processing method， decoction method， ancient application， modified application， modern application and other information of Huoxiang Zhengqisan. After research， Huoxiang Zhengqisan， also known as Huoxiang Zhengqitang， was first recorded in Taiping Huimin Hejijufang. The original formula is composed of 41.3 g of Arecae Pericarpium， 41.3 g of Angelicae Dahuricae Radix， 41.3 g of Perilla frutescens（actually Perillae Folium）， 41.3 g of Poria， 82.6 g of Pinelliae Rhizoma， 82.6 g of Atractylodis Macrocephalae Rhizoma， 82.6 g of Citri Reticulatae Pericarpium（actually Citri Exocarpium Rubbum）， 82.6 g of Magnoliae Officinalis Cortex， 82.6 g of Platycodonis Radix， 123.9 g of Pogostemonis Herba， and 103.25 g of Glycyrrhizae Radix et Rhizoma. In this formula， Magnoliae Officinalis Cortex is processed according to the specifications for ginger-processed products， Glycyrrhizae Radix et Rhizoma is processed according to the specifications for stir-fried products， and other herbs are used in their raw products. The botanical sources of the herbs are consistent with the 2020 edition of Pharmacopoeia of the People's Republic of China. The above herbs are ground into a fine powder with a particle size passing through a No. 5 sieve. For each dose， take 8.26 g of the powdered formula， add 300 mL of water， along with 3 g of Zingiberis Rhizoma Recens and 3 g of Jujubae Fructus， and decoct until reduced to 140 mL. The decoction should be administered hot， with three times daily. To induce sweating， the patient should be kept warm under a quilt， and an additional dose should be prepared and taken if needed. This formula is traditionally used to relieve the exterior and resolve dampness， regulate Qi and harmonize the middle， which is mainly used to treat a series of diseases of digestive and respiratory systems. However， potential adverse reactions， including allergies， purpura and disulfiram-like reactions， should be considered during clinical use. Huoxiang Zhengqisan features a rational composition， extensive clinical application， and strong potential for further research and development.

In this study， bibliometric methods were used to systematically investigate the name and origin， the evolution of prescription composition， dose evolution， origin and processing method， decoction method， ancient application， modified application， modern application and other information of Huoxiang Zhengqisan. After research， Huoxiang Zhengqisan， also known as Huoxiang Zhengqitang， was first recorded in Taiping Huimin Hejijufang. The original formula is composed of 41.3 g of Arecae Pericarpium， 41.3 g of Angelicae Dahuricae Radix， 41.3 g of Perilla frutescens（actually Perillae Folium）， 41.3 g of Poria， 82.6 g of Pinelliae Rhizoma， 82.6 g of Atractylodis Macrocephalae Rhizoma， 82.6 g of Citri Reticulatae Pericarpium（actually Citri Exocarpium Rubbum）， 82.6 g of Magnoliae Officinalis Cortex， 82.6 g of Platycodonis Radix， 123.9 g of Pogostemonis Herba， and 103.25 g of Glycyrrhizae Radix et Rhizoma. In this formula， Magnoliae Officinalis Cortex is processed according to the specifications for ginger-processed products， Glycyrrhizae Radix et Rhizoma is processed according to the specifications for stir-fried products， and other herbs are used in their raw products. The botanical sources of the herbs are consistent with the 2020 edition of Pharmacopoeia of the People's Republic of China. The above herbs are ground into a fine powder with a particle size passing through a No. 5 sieve. For each dose， take 8.26 g of the powdered formula， add 300 mL of water， along with 3 g of Zingiberis Rhizoma Recens and 3 g of Jujubae Fructus， and decoct until reduced to 140 mL. The decoction should be administered hot， with three times daily. To induce sweating， the patient should be kept warm under a quilt， and an additional dose should be prepared and taken if needed. This formula is traditionally used to relieve the exterior and resolve dampness， regulate Qi and harmonize the middle， which is mainly used to treat a series of diseases of digestive and respiratory systems. However， potential adverse reactions， including allergies， purpura and disulfiram-like reactions， should be considered during clinical use. Huoxiang Zhengqisan features a rational composition， extensive clinical application， and strong potential for further research and development.

Objective:To investigate the correlation between cerebral blood flow (CBF) in different brain regions and gait disorder (GD) in patients with cerebral small vessel disease (CSVD).Methods:Patients with CSVD visited the Department of Neurology, the Second Affiliated Hospital of Xuzhou Medical University from November 2023 to October 2024 were included prospectively. They were divided into GD group (<0.8 m/s) and non-GD group (≥0.8 m/s) based on their step speed. CBF was measured using 3D pseudo-continuous arterial spin labeling (3D-pCASL) perfusion imaging. Gait parameters were quantitatively evaluated using a wearable gait analyzer. Multivariate logistic regression analysis was used to determine independent factors associated with GD in patients with CSVD. Partial correlation analysis was used to determine the correlation between gait parameters and CBF in different brain regions. Results:A total of 52 patients with CSVD were enrolled, including 26 males and 26 females, aged 67.00±6.84 years. Thirty-eight cases (73.1%) had mild overall burden of CSVD, and 14 cases (26.9%) had a moderate to severe overall burden of CSVD. There were 17 patients (32.7%) in the GD group and 35 (67.3%) in the non-GD group. Compared with the non-GD group, the body mass index was significantly higher, the CBF of the left occipital lobe and bilateral cerebellum decreased significantly, the step speed, step length, stride length, step frequency, swing phase, peak arm angular velocity, arm swing amplitude, maximum calf anterior/posterior swing angle, peak calf angular velocity, foot swing speed, and peak sagittal plane angular velocity in the torso decreased significantly, while the number of steps, stance phase, step length asymmetry, stride length, and step length variability increased significantly in the GD group (all P<0.05). Multivariate logistic regression analysis showed that left cerebellar CBF was an independent protective factor for GD in patients with CSVD (odds ratio 0.902, 95% confidence interval 0.827-0.982; P=0.019). For every 1 ml/(100 g.min) decreased in left cerebellar CBF, the patients with CSVD had an increased risk of developing GD by approximately 9.8%. Partial correlation analysis showed that left occipital lobe CBF was significantly positively correlated with step speed ( r=0.305, P=0.032), maximum calf back swing angle ( r=0.314, P=0.026), and peak calf angular velocity ( r=0.356, P=0.011). The left cerebellar CBF was significantly positively correlated with step speed ( r=0.295, P=0.037) and significantly negatively correlated with step length variability ( r=-0.335, P=0.017); the right cerebellar CBF was significantly positively correlated with step speed ( r=0.309, P=0.029) and significantly negatively correlated with step length variability ( r=-0.344, P=0.014). Conclusion:GD in patients with CSVD is associated with decreased CBF in the left occipital lobe and bilateral cerebellum, and decreased CBF in the left cerebellum significantly increased the risk of GD in patients with CSVD.

Objective To investigate the efficacy of modified use of Huanglian Jiedu Decoction plus Xijiao Dihuang Decoction in the treatment of patients with psoriasis vulgaris of blood-heat syndrome and to observe its effect on Th1/Th2 balance in the patients.Methods The investigation was carried out in a total of 130 patients with psoriasis vulgaris of blood-heat syndrome,who were admitted to the dermatology department of the First Affiliated Hospital of Henan University of Chinese Medicine between January 2022 and June 2023.The patients were randomly divided into an observation group and a control group by the random number table method,with 65 patients in each group.The control group was treated with conventional western medicine,while the observation group was treated with modification of Huanglian Jiedu Decoction plus Xijiao Dihuang Decoction on the basis of treatment for the control group.Both groups were treated for four consecutive weeks and were followed up for one year.The changes in the scores of Psoriasis Area and Severity Index(PASI)and Dermatology Life Quality Index(DLQI),levels of peripheral blood Th1/Th2 balance indicators,and levels of peripheral Th1/Th2-related factors such as γ-interferon(INF-γ),interleukin 2(IL-2),and interleukin 4(IL-4)in the two groups of patients before and after treatment were observed.Moreover,the clinical efficacy and adverse reactions during treatment were evaluated,and the recurrent cases within one year in the two groups were counted.Results(1)After four weeks of treatment,the total effective rate of the observation group was 90.77%(59/65),and that of the control group was 76.92%(50/65).The intergroup comparison showed that the clinical efficacy of the observation group was significantly superior to that of the control group(P<0.05).(2)After treatment,the scores of PASI and DLQI in the two groups of patients were decreased when compared with those before treatment(P<0.05),and the decrease of PASI and DLQI scores in the observation group was significantly superior to that in the control group(P<0.01).(3)After treatment,the serum levels of Th1/Th2-related factors such as INF-γ and IL-2 in the two groups of patients were decreased when compared with those before treatment(P<0.05),and IL-4 level was increased when compared with that before treatment(P<0.05),and the decrease of serum INF-γ and IL-2 levels and the increase of serum IL-4 level in the observation group were significantly superior to those in the control group(P<0.05 or P<0.01).(4)After treatment,the peripheral blood levels of Th1/Th2 balance indicators of Th1,Th2 and Th1/Th2 in the two groups of patients were decreased when compared with those before treatment(P<0.05),and the decrease of peripheral blood Th1,Th2 and Th1/Th2 levels in the observation group was significantly superior to that in the control group(P<0.01).(5)The recurrence rate of the observation group was 20.69%(12/58)and that of the control group was 38.33%(23/60),and the recurrence time in the observation group was(8.49±1.43)months and that of the control group was(5.36±0.95)months.The intergroup comparison showed that the one-year recurrence rate of the observation group was significantly decreased compared with that of the control group(P<0.05),and the recurrence time was significantly prolonged compared with that of the control group(P<0.05).(6)The medicine-induced adverse reaction rate in the observation group was 10.77%(7/65)and that in the control group was 12.31%(8/65),and the intergroup comparison showed that the difference was not statistically significant(P>0.05).Conclusion Modified use of Huanglian Jiedu Decoction plus Xijiao Dihuang Decoction is effective on enhancing the clinical efficacy of patients with psoriasis vulgaris of blood-heat syndrome,and on improving the balance of Th1/Th2 and the severity of the disease,delaying the recurrence of psoriasis vulgaris,and reducing the recurrence rate,with high safety.

Objective To explore the differences of lipid metabolites in tongue coating between ischemic stroke patients and healthy people,thus to screen out the potential biomarkers for tongue coating of ischemic stroke patients.Methods Twenty patients confirmed as ischemic stroke were selected as the observation group,and another 20 controls receiving healthy medical checkup at the same period were selected as the control group.All of them were aged between 40 and 80 years.Using ultra-high performance liquid chromatography-mass spectrometry(UHPLC-MS)technology,and by combined with the statistical methods of principal component analysis(PCA)and partial least squares discriminant analysis(PLS-DA),non-targeted lipid metabolomics study was performed on tongue coating samples of the observation group and the control group.According to the criteria that the VIP value in the orthogonal signal correction-based orthogonal partial least squares discriminant analysis(OPLS-DA)model was greater than 1 and the P value of the Wilcoxon rank test was less than 0.05,lipid metabolites with significant differences were screened and determined.Results Differential lipid metabolites exist in ischemic stroke patients(observation group)and healthy people(control group),and a total of 14 lipid metabolites were identified,and they were free fatty acids,ceramide,sphingomyelin,cardiolipin,lecithin,etc.Of the 14 lipid metabolites,4 were down-regulated and 10 were up-regulated,and the differences were statistically significant(P＜0.05).Conclusion There exist differential lipid metabolites in tongue coating of patients with ischemic stroke and the healthy controls,and these different lipid metabolites are expected to become potential biomarkers for ischemic stroke.

Despite primary glomerulonephritis (PGN) being a leading cause of chronic kidney disease and end-stage renal disease, specific and sensitive biomarkers for the early detection and monitoring of this condition are lacking. We evaluated the value of the combined detection of serum cystatin C (CYSC), β2-microglobulin (β2-MG), and urine transferrin (TRF) for diagnosing early-stage PGN. From May 2021 to May 2023, we enrolled 105 patients in our hospital as the observation group and 50 healthy volunteers as the control group. Their serum expression levels of CYSC, β2-MG, and TRF were evaluated. We plotted separate ROC curves and calculated the area under the curve (AUC) values of CYSC, β2-MG, and TRF to assess their diagnostic performance in PGN. The levels of CYSC, β2-MG, and TRF were significantly higher (P < 0.05) in the observation group than in the healthy control group. CYSC, β2-MG, and TRF were expressed at significantly higher levels in G2, G3a, and G3b of PGN than in G1. The combined use of CYSC, β2-MG, and TRF as biomarkers could significantly improve the early diagnosis and monitoring of PGN and may lead to better patient outcomes by facilitating earlier intervention and treatment strategies.

Objective:To evaluate the role of nuclear factor E2-related factor 2 (Nrf2)/heme oxygenase (HO-1) signaling pathway in the attenuation of endotoxin-induced acute lung injury (ALI) by hydromorphone and the relationship with Golgi apparatus stress (GA stress) in mice.Methods:Eighteen SPF wild-type (WT) and 18 Nrf2 knockout (Nrf2 KO) male C57BL/6J mice, aged 6-8 weeks, weighing 18-20 g, were divided into 3 groups ( n=6 each) using a random number table method: control groups (WT+ Con group, Nrf2 KO+ Con group), ALI groups (WT+ ALI group, Nrf2 KO+ ALI group) and ALI+ hydromorphone groups (WT+ ALI+ HM group, Nrf2 KO+ ALI+ HM group). ALI was induced by injecting lipopolysaccharide (LPS) 15 mg/kg via the tail vein in anesthetized animals. Hydromorphone 120 μg was intraperitoneally injected at 15 min before LPS injection in WT+ ALI+ HM group and Nrf2 KO+ ALI+ HM group, and the equal volume of normal saline was given instead in control groups. The animals were sacrificed after anesthesia at 12 h after LPS injection, and lung tissues were obtained for examination of the pathological changes which were scored and Golgi ultrastructure (with a transmission electron microscope) and for determination of the content of malondialdehyde (MDA), activity of superoxide dismutase (SOD), and expression of Nrf2, HO-1 and Golgi stress-related markers (Golgi matrix protein 130 [GM130], Golgi autoantigen 97 kDa [Golgin-97], ATPase secretory pathway Ca 2+ Transporting 1 [ATP2C1], Golgi phosphoprotein 3 [GOLPH3]) (by Western blot). Results:Compared with WT+ Con group and Nrf2 KO+ Con group, the lung injury scores and content of MDA were significantly increased, the activity of SOD was decreased, the expression of GM130, Golgin-97 and ATP2C1 was down-regulated, the expression of GOLPH3 was up-regulated ( P<0.05), no significant changes were found in the expression of Nrf2 and HO-1 ( P>0.05), and the damage to the Golgi apparatus was aggravated in WT+ ALI group and Nrf2 KO+ ALI group. Compared with WT+ ALI group, the lung injury scores and content of MDA were significantly decreased, the activity of SOD was increased, the expression of Nrf2, HO-1, GM130, Golgin-97 and ATP2C1 was up-regulated, the expression of GOLPH3 was down-regulated ( P<0.05), and the damage to the Golgi apparatus was significantly attenuated in WT+ ALI+ HM group. Compared with Nrf2 KO+ ALI group, the lung injury scores were significantly decreased, and the activity of SOD was increased ( P<0.05), no significant changes were found in the content of MDA and expression of Nrf2, HO-1, GM130, Golgin-97, ATP2C1 and GOLPH3 ( P>0.05), and no significant reduction in the damage to the Golgi apparatus was found in Nrf2 KO+ ALI+ HM group. Compared with WT+ ALI+ HM group, the lung injury scores and content of MDA were significantly increased, the activity of SOD was decreased, the expression of Nrf2, HO-1, GM130, Golgin-97 and ATP2C1 was down-regulated, the expression of GOLPH3 was up-regulated ( P<0.05), and the damage to the Golgi apparatus was aggravated in Nrf2 KO+ ALI+ HM group. Conclusions:Nrf2/HO-1 signaling pathway is involved in the attenuation of endotoxin-induced ALI by hydromorphone, and it is associated with the inhibition of Golgi stress.

Objective:To investigate the differences in resistance to chemical disinfectants between bacteriophage Phi-X174 and disinfection effect indicator microorganisms, Staphylococcus aureus and Escherichia coli. Methods:Three commonly used disinfectants, including chlorine-containing disinfectants, alcohol-based disinfectants and quaternary ammonium salt disinfectants, were selected to analyze the differences in resistance of phage Phi-X174, Staphylococcus aureus and Escherichia coli by using the quantitative sterilization test of suspension. Results:The 250 mg/L sodium dichloroisocyanurate solution treated for 10 minutes yielded log reduction values of 3.39, 7.25 and 7.37 against phage Phi-X174, Staphylococcus aureus and Escherichia coli respectively. The 40% ethanol for 1 minute yielded log reduction values of 0.03, 2.46 and 7.30 against phage Phi-X174, Staphylococcus aureus and Escherichia coli, respectively. The 100 mg/L benzalkonium chloride for 10 minutes yielded log reduction values of 1.41, 6.84 and 0.93 for phage Phi-X174, Staphylococcus aureus and Escherichia coli, respectively. Conclusion:Phage Phi-X174 has stronger resistance to chlorine-containing disinfectants and alcohol-based disinfectants than Escherichia coli and Staphylococcus aureus. Its resistance to quaternary ammonium salt disinfectants is between that of Staphylococcus aureus and Escherichia coli.

Ulcerative colitis(UC)is a recurrent,chronic,nonspecific inflammatory bowel disease.Shaoyao Decoction has shown good efficacy in the treatment of UC,which mainly regulates the balance of cytokines to achieve the purpose of treating UC.This article reviewed the research progress in the mechanism of Shaoyao Decoction in the treatment of UC from two aspects of pro-inflammatory cytokines and anti-inflammatory cytokines.Research has shown that Shaoyao Decoction can regulate the body's immune response,alleviate intestinal inflammation,protect the intestinal mucosal barrier,restore normal structure and function of the colon mucosa through pro-inflammatory cytokines such as tumor necrosis factor-α,interferon-γ,interleukin(IL)-1β,IL-6,IL-8,IL-17,and anti-inflammatory cytokines such as transforming growth factor-β,IL-4,IL-10,IL-13,which can provide reference for UC related mechanism research and clinical treatment.